“Although scientists are still learning how the SARS-CoV-2 virus is able to invade the brain and central nervous system, the fact that it’s getting in there is clear. Our best understanding is that the virus can cause insult to brain cells, with potential for neurodegeneration to follow on from there,” said Professor Kevin Barnham from the Florey Institute of Neuroscience & Mental Health.

The silent wave

In a review paper published on 22^nd September 2020, researchers put spotlight on the potential long-term neurological consequences of COVID-19, dubbing it the ‘silent wave’. They are calling for urgent action to be taken to have available more accurate diagnostic tools to identify neuro-degeneration early on and a long-term monitoring approach for people who have been infected with the SARS-CoV-2 virus.

The researchers report that neurological symptoms in people infected with the virus have ranged from severe, such as brain hypoxia (lack of oxygen), to more common symptoms such as loss of smell.

“We found that loss of smell or reduced smell was on average reported in three out of four people infected with the SARS-CoV-2 virus. While on the surface this symptom can appear as little cause for concern, it actually tells us a lot about what’s happening on the inside and that is that there’s acute inflammation in the olfactory system responsible for smell,” explained Florey researcher Leah Beauchamp.

Early diagnosis is key

Inflammation is understood to play a major role in the pathogenesis of neurogenerative disease and has been particularly well studied in Parkinson’s. Further research into these illnesses may prove critical for future impacts of SARS-CoV-2.

“We believe that loss of smell presents a new way forward in detecting someone’s risk of developing Parkinson’s disease early. Armed with the knowledge that loss of smell presents in around 90% of people in the early stages of Parkinson’s disease and a decade ahead of motor symptoms, we feel we are on the right track,” added Ms Beauchamp.

Clinical diagnosis of Parkinson’s disease currently relies on presentation of motor dysfunction, but research shows that by this time 50-70% of dopamine cell loss in the brain has already occurred.

“By waiting until this stage of Parkinson’s disease to diagnose and treat, you’ve already missed the window for neuroprotective therapies to have their intended effect. We are talking about an insidious disease affecting 80,000 people in Australia, which is set to double by 2040 before even considering the potential consequences of COVID, and we currently have no available disease-modifying therapies,” said Professor Barnham.

Aiming for cost-effective screening protocol

The researchers hope to establish a simple, cost-effective screening protocol aiming to identify people in the community at risk of developing Parkinson’s, or who are in early stages of the disease, at a time when therapies have the greatest potential to prevent onset of motor dysfunction. They plan to put the proposal forward for funding from the Australian Government’s Medical Research Future Funding scheme.

Additionally, the team have developed two neuroprotective therapies currently under investigation and have identified a cohort of subjects who are ideally suited to study the treatments. Through their research they gained new evidence that people with REM sleep behaviour disorder have a higher predisposition to go on to develop Parkinson’s disease.

“We have to shift community thinking that Parkinson’s not a disease of old age. As we’ve been hearing time and time again, the coronavirus does not discriminate—and neither does Parkinson’s,” said Professor Barnham.

“We can take insight from the neurological consequences that followed the Spanish Flu pandemic in 1918 where the risk of developing Parkinson’s disease increased two to three-fold. Given that the world’s population has been hit again by a viral pandemic, it is very worrying indeed to consider the potential global increase of neurological diseases that could unfold down track.”

He added, “The world was caught off guard the first-time, but it doesn’t need to be again. We now know what needs to be done. Alongside a strategized public health approach, tools for early diagnosis and better treatments are going to be key.”

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Adding to the impact of social isolation is the anxiety about the dreaded coronavirus. As a psychiatrist, I am not going to engage you in a long-drawn therapeutic process or suggesting that your anxiety is baseless. The fears brought on by the virus are real but the key to dealing with those fears are also real, and they are also quite simple.

I list a few practical suggestions that will prove useful to most of you in caring for your mental health during lockdown. For those who are acutely suffering, I would suggest reaching out to a mental health professional.

7 ways to take care of your mental health during lockdown

1. Change the Perspective

One of the severest forms of punishments is solitary confinement in jails. Those of us who are at home or in familiar surroundings with our loved ones by our side will do well to remember that this is not a punishment. We should stop comparing this lockdown with being locked up in prisons. In fact, you could change your view of the lockdown and think of it as a noble act for the sake of humanity because your staying at home is not just for your own benefit but also for the welfare of your fellow beings.

2. Have a routine

I cannot overemphasize enough the importance of having a daily routine. Sure, it requires self-discipline and determination but the effort is worth it. Little things make a big difference: waking up at a same time each day, eating meals around the same time, limiting time for news and social media, allocating time for leisure/hobbies, exercising and meditation. Starting and finishing your workday at an appointed time even if you are working out of home is another important aspect of following a routine. Doing this will make you feel productive and engaged with life. Without a routine, your days will become chaotic and unproductive and lead to overthinking and anxiety.

3. Stay connected

While the fears of excessive internet usage are real, smart use of technology can enable us to remain connected with our near and dear ones when we are being deprived of their physical presence. Having said that, we ought not to forget those loved ones who we live with under the same roof. Being together 24×7 has its challenges—for instance, since the lockdown began reports of increased domestic violence and spousal abuse are coming from around the world including India. It is crucial that each of acts as a source of comfort to those around us, giving them the right amount of attention while at the same time providing them their own space. One practical way to create joy at home is to help in household chores and do activities like cooking and cleaning together.

4. Stay active

Physical exercise is essential for your overall wellbeing—physical, mental and emotional. It is well-established that moderate exercise releases endogenous peptides called “happiness hormones” that cross the blood-brain barrier resulting in improved mood. Besides, regular exercise enhances your immunity and helps you fight infections—something we all want during a pandemic.

5. Engage in something new

All of us, at some time or the other, have felt like learning something new but the busyness of life prevented us from ever seriously pursuing it. Consider this lockdown as an opportunity to fulfil your heart’s desire to take up a hobby or acquire a skill. Whether you want to start gardening, learn a new language, write a book or try your hand at playing the guitar, this is the time to do it.

6. Finish a pending endeavour

This is an extension to the previous point. You may have started something but were compelled to leave it unfinished because of other priorities. Perhaps it was something important like finishing the half-written will or arranging your financial records. Or it could be something as simple as calling up that friend you have been meaning to get in touch with.

7. Cultivate positive emotions

As we grow, we begin to take ourselves too seriously. We get preoccupied with work pressures, family obligations, health issues and other such matters, in the process losing touch with the lighter side of life. But a sense of humour and the ability to laugh at oneself is a quality that can take the edge off all the hardships we face. During this lockdown, make it a point to spend some time each day watching or reading something funny and share jokes with your family and friends.

The above 7 ideas are meant to make it easier to endure the undue strain on your mental health during lockdown. But I strongly recommend that you continue following these suggestions even after the lockdown is relaxed or lifted as they will raise the quality of your life.

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For example, cattle suffer from the cowpox virus, but appear to have a species immunity to the closely related smallpox viruses, whereas in humans, smallpox is a deadly disease while cowpox is a mild localised skin infection. Humans are susceptible to the HIV virus, but most of our related primates are immune to HIV, though they do suffer from HIV-like viruses to which we appear to be immune.

The bat coronavirus, quite surprisingly, underwent a mutation [tweaking of its genetic code to modify its antigenic structure] in a highly specific, intelligent and programmed manner. Two highly specific surface antigens that prevented its entry into the human host cells inexplicably altered themselves in a manner that opened the gateway to the cells of mankind and his nemesis.

Conspiracy theories and speculations

There’s been endless speculation and the conspiracy theorists are having a field day about the origins of this zoonotic [originating from other species] disease.

Could this be the hand of God, or then the machination of an eccentric scientist working at the behest of a regime that will stop at nothing in its relentless pursuit of wealth and power? It’s nearly impossible for anyone to know the truth. The fact remains that the Pandora’s Box was opened, and the question of who opened it is totally superfluous.

Is this the World war III?

Whichever way the mutation might have occurred—whether spontaneously or genetically engineered in the lab—it does seem to be an act of retribution. By the “almighty” if spontaneous or then by the worst enemy of mankind—man himself. This pandemic has metamorphosed into a war, possibly World War III.

The earlier two world wars were also mired in stories of vendetta, but they were limited to the destructive capabilities of the armamentarium of the aggressors. The armamentarium of this war, though, is limitless; the virus can multiply ad infinitum, and has no known antidote. It is loosening the soil into which the roots of existence were firmly anchored. It is a silent, merciless predator, that destroys not just the lungs of the victim but the lungs of civilization—the economy.

As things stand, we are powerless against this act of vengeance. An ultra-microscopic strand of DNA, that has the genetic program to exterminate the entire human species—it is really hard to comprehend and imagine.

The road ahead

The road ahead looks bleak and fraught with grave dangers. A war with no end. A war that ridicules the stockpiles of arms and renders them totally impotent. A war that will be fought by a brigade in white. A task force, that works in the microscopic domain.

A war, where protection is not afforded by deep underground bunkers but by a thin veil of impenetrability at the level of microns. This microbe has certainly rendered futile the advances and accomplishments of technology. It has forced mankind on the back foot and firmly rubbished claims of its abilities to control and subjugate the environment. This just might be a quantum virus, the likes of which we have never encountered before. Quantum because it is simultaneously inflicting both mind and matter. Also because it has reduced mankind to a Shrodinger’s cat—simultaneously dead and alive.

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For humans, apart from the obvious health concern, there are multiple other dimensions to the coronavirus “story” such as financial repercussions, social dynamics, religious and spiritual values and so on. The meaning we give to each of these will decide where we will go as a species.

Will we expand or shrink?

There have been many memes circulating about how a tiny, seemingly insignificant coronavirus has made the greatest of species feel vulnerable and totally powerless. There is a fundamental delusion in viewing any disease-causing virus in this manner. But then humans have been storytellers from time immemorial…and one of stories we have told ourselves is that of being distinct creatures separate from other beings and the planet itself. The reality is that life flows seamlessly through all of existence. Creation/destruction of forms are personal from the limited perspective of the individual perceiving consciousness. But from the perspective of life itself, which you may call “the greater intelligence”, it’s just life as usual.

If the story we weave around this crisis is self-centered, we will:

1. Project panic and fear
2. Blame and condemn or feel guilt and regret
3. Act selfishly, concerned only about personal safety and the safety of our family and loved ones

Reacting this way, we may contract and shut down; we will isolate ourselves emotionally and quarantine our love and compassion — a sure-shot prescription for individual and collective suffering.

If, however, we choose to project an expansive meaning to this crisis, the outcome would be quite different:

1. We will look at this as an opportunity to reflect and re-evaluate our priorities
2. We will realize how each of us has contributed directly or indirectly—not only to the present crisis but to all the excesses in the world that are the cause of much of what is wrong in our world today.
3. We will notice how our ruthless ambitions and our lust for “more” is causing much suffering in the world—and we cannot isolate ourselves from that suffering because, as we have already established, we are inextricably linked; indeed, we ARE the world.

Let us mend our ways to bend this reality

Coming back to storytelling, since we are free to give any meaning to the present situation, how about looking at this crisis as a wake-up call to mend our ways? Each of us needs to do our best to successfully meet not only the coronavirus pandemic but also other challenges that humanity faces.

Climate change, for instance. Like the coronavirus, climate change too will not discriminate on the basis of wealth, social status, nationality or religion. The only way for us to respond to these challenges is to act from the knowing that each of us affects the reality that is experienced by all of us.

A commitment to conscious living

How about making a commitment to living with this awareness?

Here are a few ideas to get you started:

1. Start cutting down on consumption — we now know we can easily live with a lot less, so let us stop equating more with better
2. Let your motto be “Live and let live”. The planet has enough to satisfy everyone’s need but not enough to satisfy even a single person’s greed.
3. Focus on feeling alive now instead of imagining a happier tomorrow
4. At every opportunity, look for the obvious and not-so-obvious ways in which you are connected to beings near and far; for instance, notice how every morsel of food you ingest has reached you thanks to thousands of people, both past and present; both near and far
5. See how much in common we have with every single human being on the planet
6. Slow down and start appreciating life in its natural form, devoid of all that is man-made
7. See how joyous family time can be; also enjoy solitude every once in a while
8. Look for everyday miracles around you like a flower blooming, a bird flying, a cloud floating, wind blowing, the stars in the infinite sky…
9. Make it a point to connect with life in its purest form—spend more time in Nature. Be among trees, lakes, mountains, seas—just be with them without any agenda or purpose such as adventure or picnic or experiences etc.
10. Strive to awaken the true potential lying dormant in you—not the potential for material success or power etc. but the potential for love, peace and joy
11. Adopt mindfulness as your default setting; see how gratitude arises from within spontaneously when you are mindful. You will realize that there’s much to be thankful for and that our feelings of neediness and inadequacy are nothing more than a collective delusion.

Edited on 23^rd March 2020

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As one of the simplest and most effective of health rules, the importance of washing hands has surprisingly been under-rated all these years. Apart from preventing minor infections such as fever, flu and cold, which spread very rapidly from hand-to-mouth/nose contact, the simple act of washing your hands can offer protection from major illnesses ranging from hepatitis-A to Severe Acute Respiratory Syndrome [SARS] and now the coronavirus. The severe outbreak of COVID-19 across the world has only re-enforced the urgency of this key act of hygiene.

Soap and Water Are More Effective Than Hand Sanitizers

A few years ago, researchers at the University of North Carolina-Chapel Hill, US, compared the effectiveness of old-fashioned soap and water to the latest alcohol-based anti-microbial rubs and hand-wipes commonly found in hospitals.

The results published in The American Journal of Infection Control prove that soap and water work better with repeated use because water removes the germs more effectively and completely.

Emily Sickbert-Bennett, a public-health epidemiologist for UNC Hospitals, who helped letter the study, says: “[With] the waterless rubs and wipes, you never rinse your hands. You are just rubbing a chemical into your hand and letting it dry.” You are, therefore, never completely rid of the germs in this approach. They are always on the surface, albeit curtailed by the chemicals in hand sanitizers. Emily says hand sanitizers are less effective if hands are visibly soiled, citing a recent case in North Carolina, where children became violently sick by a strain of E coli bacteria, which they contracted after petting animals in the zoo.

One study actually found that using alcohol-based hand sanitizers for routine hand hygiene actually increased the risk of outbreaks of novovirus, the highly contagious virus that causes most cases of acute gastroenteritis.

Well, if you have just done a heavy bout of handshaking and there is no sink in sight, a gel or hand sanitizer will reduce your chance of contracting an infection. The natural ways are best, though!

The results of the study just didn’t bring home the importance of hand-washing to ordinary folks alone; it also highlighted the need for doctors, people handling food on a daily basis in the service industry across the world, and even baby-sitters, teachers and others, who have close contact with children, to adopt the hand wash approach to ridding oneself of germs. The best part – your hands also continue to be clean longer, even when the last traces of soap is washed off.

Prevention Is Your Best Bet Against Diseases

When new diseases surface, prevention is our best bet and washing hands continues to be the best way to completely avoid picking infections from contaminated surfaces.

Flushing the micro-organisms that cause disease down the sink, rather than into your stomach, not only saves you the trauma of pain and unnecessary expense, it also ensures that you remain in the pink of health and productivity for a longer time as well. Ultimately, it helps build a strong body and a robust immune system.

The Right Way to Wash Your Hands

In order to maintain proper hygiene, you should wash your hands thoroughly before meals, after you use the toilet and when you come home after visiting a public place [for instance, a shopping trip or a day at the mall or your office].

Don’t forget to lather in hard to reach corners [between every finger and the palm of your hand.] And don’t just lather and rinse in a few seconds. If you want the germs to truly die, you have to spend a few minutes over your hand wash routine. Hunger or a severe lack of time may have you rushing through it, too quickly. As a rule, sing “happy birthday” to yourself rapidly, three times in succession as you work up lather and rinse.

Remember – when it comes to the building blocks of health and wellbeing, your mother knows best!

This article was last updated on 1^st July 2023

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