The New Normal

by Dr. Renae Norton

the new normal

Where are we now?

Winston Churchill said:

“Now, this is not the end. It is not even the beginning of the end. But it is, perhaps, the end of the beginning.”

I think that does a really good job of summing up our current situation with COVID-19. We are through the beginning and we have learned a lot so far, but we have a long way to go. We are nowhere near the end. How long it takes us to get there and where we end up depends upon how well we apply what we have learned so far.

One thing we have learned is that this is not the flu and it is not like the flu, except for the fact that it shares a few symptoms. Otherwise, it is a different animal. For one thing it is much more contagious and can do significantly more damage. For example:

A comparison of lung tissue from people who died of COVID-19 and those who died of the flu shows that COVID-19 is significantly worse than the flu in terms of the damage it does to lung tissue.[1]

We’ve also learned that COVID-19 is more lethal for individuals with “co-morbid” conditions, which include hypertension (affecting about 53% of all COVID-19 patients), obesity (affecting about 42% of patients with BMI data) and diabetes (affecting about 32% of all patients) according to a new study, published in the Journal of the American Medical Association (JAMA.)[2]
Here are the results of the study: Chart: Elijah Wolfson for TIME Source: JAMA Network Get the data Created with Datawrapper.

Based on a study of 5,700 patients in the New York City area of all hospitalized patients, here is the breakdown of those infected while having more than one comorbidity:

More than one
88%
One
6.3%
None
6.1%

What this means is that if you suffer from one or more of these conditions, you have a better chance of contracting and dying from the virus.

We have also discovered some other things that were not as obvious. In fact, there were misconceptions about the virus that we are only now putting to rest. In a nutshell, it causes symptoms that you would not expect to see with other respiratory diseases. Here are the highlights in terms of what we have learned to date about COVID-19:

  • The novel coronavirus can cause severe damage to the blood vessel level, including to the capillaries in the lungs, which makes it difficult to impossible for the lungs to do their job and allow us to breath.
  • A new study shows that blood clotting might be a significant coronavirus symptom that can go undetected. Blood thinners are the new standard treatment.
  • Children can have an entirely different version of the virus that is very dangerous called pediatric inflammatory multisystem syndrome (PIMS).
  • Obesity is a risk factor for the virus among children as well as adults.

Doctors on the front lines have started seeing unusual symptoms including cardiac issues as well as neurological symptoms.[3] Some hospitals are noticing an increase in strokes in young patients who would not normally be at risk. It turns out that COVID-19 causes unusual blood clotting affecting the brain, the heart and other organs. [4] Some researchers have gone so far as to recommend blood thinners as a precaution and this now appears to be a standard approach to treating the infection in many institutions.

Another misconception was that the virus does not affect young children. Although severe illness with COVID-19 remains rare among children, they are not immune from life-threatening complications. Currently, there seems to be an inflammatory syndrome affecting young children that may be connected to coronavirus. New York has seen 93 children with this syndrome, called pediatric inflammatory multisystem syndrome (PIMS) which appears to be related to having had COVID-19. Three children have died from the syndrome and two more deaths are currently being investigated.

Symptoms of this inflammatory version of the illness include a persistent high fever, low blood pressure and abdominal pain. So not like the symptoms we look for in COVID-19 in adults. The new illness, which can look like toxic shock syndrome and Kawasaki disease, both of which also cause inflammation in the blood vessels, could easily be missed.

A possible contributing issue for us here in the US is that besides being the most obese nation in the developed world, we also have the most obese children. Fully 1/3 of US children are obese. This puts our children more at risk since the virus uses adipose tissue to infect its host. Indeed, a high percentage of the children getting PIMS were obese. It is not clear yet whether this is true for the overall number of children infected with COVID-19.

So, we know a lot more now than we did when this started. But there are still many unknowns. Like what happens as we lighten up on the restrictions and the sheltering in place? Will there be a second, third or even forth wave? If so, how will that affect us individually, as a nation and globally?

Solutions:

One thing we do know is that social distancing and wearing masks works. This makes sense since the virus cannot survive on its own. It has to have a host. It does not travel on its own; it has no legs or wings. It uses us for getting around by landing on our bodies, hoping for a shot at our noses (that is how it gets to the lungs.)

The virus, which is usually propelled by droplets from our mouths, gets on our hands because we touch our noses, mouths, and eyes a lot. We then pass it on to others by touching them or touching something that they touch. The virus is very opportunistic just waiting for the right time and place to infect another host. Because it is, we can really slow it down if we keep people apart from each other and wash our hands. It lives a long time, but it does not live forever, so social distancing and hand-washing work.

The problem is that if we abandon the social distancing too soon, the virus will, in all likelihood, take off again. Since some are pushing for the end of social distancing, which is currently our only safety net, it is difficult to predict what will happen next.

There is no question the virus is still spreading in communities throughout the U.S. With the loosening of restrictions, this could mean that mass gatherings this summer will result in a new upsurge of infections and death. There is also evidence of repeat infections, meaning that until a vaccine is available and widely administered, we will continue with outbreaks and shutdowns. A repeat of the need for restrictions is practically certain for this fall.

So far, many local communities have done an excellent job of rising to the challenge of this pandemic, along with their state governments. We have a ways to go, but if we continue listening to our public health officials and the responsible elected officials, and if we comply with all reasonable recommendations, we can limit the spread of the virus and the death toll.

The key seems to be our ability to rapidly identify those infected, isolate them and do the contact tracing that allows us to control future outbreaks. But to do that we need millions more tests, preferably ones that are accurate, and we need people to do the contact tracing. We also need action at the federal level instead of putting all of the responsibility on the states, who then must compete with each other for resources.

How Will This Change Us?

One of the things that will change, possibly forever, is the number of people who end up working from home. Employers are just now realizing that it’s possible for their employees to be productive away from the office. This means that they do not need the expensive leases or mortgages, which drive profits down. So, post COVID business profits could actually go up. (Unfortunately this may have a negative impact on commercial real estate.)

For the individual, working from home this means less time commuting and more time with family and friends. But it also means more isolation for some people. There are many people who get their energy from others. They will need to work harder to feel connected and energized. If you are one of those individuals, it will be important to learn how to connect in meaningful ways in this virtual work world. Seek help if you feel overwhelmed or hopeless.

There is an ancient Chinese symbol called Wei Chi. It means “Opportunity in Crisis.” The people who will thrive after the pandemic will be those who find ways of taking advantage of the new reality while following the rules designed to protect themselves and others.

If you could use a little help finding your own Wei Chi or if you have anxiety about the “new normal” contact us for a free consultation. Speak with Dr. Renae Norton directly by calling 513-205-6543 today!

[1] https://bgr.com/2020/04/07/coronavirus-symptoms-heart-damage-after-covid-19-infection/
[2] https://jamanetwork.com/journals/jama/fullarticle/2765184?guestAccessKey=906e474e-0b94-4e0e-8eaa 606ddf0224f5&utm_source=For_The_Media&utm_ medium=referral&utm_ campaign=ftm_l inks&utm _content=tfl&utm_term=042220
[3] https://bgr.com/2020/04/07/coronavirus-symptoms-heart-damage-after-covid-19-infection/
[4] https://bgr.com/2020/05/07/coronavirus-treatment-blood-thinners-might-reduce-the-risk-of-death/

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Materials contained on this site are made available solely for educational purposes and as part of an effort to raise general awareness of the psychological treatments available to individuals with health issues. These materials are not intended to be, and are not a substitute for, direct professional medical or psychological care based on your individual condition and circumstances.  Dr. J. Renae Norton does not diagnose or treat medical conditions. While this site may contain descriptions of pharmacological, psychiatric and psychological treatments, such descriptions and any related materials should not be used to diagnose or treat a mental health problem without consulting a qualified mental health care provider.  You are advised to consult your medical health provider about your personal questions or concerns.