A Compassionate Guide to the Pandemic:
In which, Odin provides an evidence-based approach to living a good life in the pandemicine.
That we would experience a pandemic this half of the 21st century was always a sure bet.
Not this pandemic, perhaps—but a pandemic.
In a 2020 research paper, Why were the UK and USA unprepared for the COVID-19 pandemic?, the authors present the argument that “decades of deregulation and privatization due to neoliberal, free-market economics” led to some of the worst responses to the crisis (p. 9). While the pandemic proved that no country could handle a pandemic well, it decidedly upended the West’s illusion of control.
Some years ago, I remember watching an informational video about antibiotic-resistant “superbugs” — infections that resist our attempt to kill them. The overuse of antibiotics has fueled the rise of devastating bacteria that are immune to even the most potent weapons we can throw at them. Furthermore, conflicts like Russia’s war of aggression on Ukraine and, earlier, the United States’ attacks on the Middle East, have fueled the rapid rise of drug-resistant disease.
Modern technology has saved countless lives, and created a world where our species can thrive. But, modern styles of living have also created untold damage to our complex ecosystems and therefore created a world where our apparent thriving is cannibalistic. Our wars have evolved better viruses and bacteria. Our systems of trade have clotted our oceans with plastic and our atmosphere with excess heat.
How can we, then, deal with the simple experience of being alive?
How can we live a good life amid such monumental struggle?
The future is a postmodern landscape. A hall of illusions (“Everything is getting better and better!”) that leaves the complexities of reality out of the picture.
But this is not just another article about the unwinnable war against Covid.
My goal is to inform, but also to provide what I hope are hopeful solutions for actually living in the pandemicine phase of the Anthropocene.
It is not enough to be informed if being informed makes it impossible to live your life.
Any information we receive must allow us to build communities.
Being informed must lead to the fomentation of change in the political world.
Do you just want to explore the resources for yourself?
I present my full list of references at the bottom of this article. There are also two excellent resources I’ve used as starting points to explore this issue:
This updated article from [Open-Source Eschaton], “:a magazine for open-sourcing the end of the known world.”
This article from Jessica Wildfire over at Ok Doomer: "A Heightened Sense of Risk": A Covid FAQ with 300 Sources
There are also the CDC science briefs, though these are not as comprehensive as I would like, and their information may have biases that are not fully corrected for. Likewise, these briefs are not comprehensive and some of the studies they cite have been partially superseded by later evidence.
Masking (including a report on lack of negative effects)
For my research, I used a number of databases, and my primary search tools were Brave Search, Google Search, The San Jose State University Library’s full database and catalog (via OneSearch), and Google Scholar.
I limited my search queries based on time to locate articles pertinent to specific times (i.e. “This Year,” or “The Last 7 Days”). I used boolean search features, primarily “AND” to link search terms together (i.e. Covid-19 AND Europe AND Pregnancy).
How can we meet the future with compassion?
When we are confronted with all the fears of the world, it is easy to become lost, to flounder like someone drowning at sea. There are mitigating factors we can, and must, take in order to protect ourselves and one-another. But there are also serious problems at play in this area.
For instance: we absolutely need to encourage a culture of masking to promote safety (not merely against Covid-19, but against the myriad current and future airborne diseases our society must face). And yet, we must have compassion for the inherent problems that this presents.
A powerful social barrier is formed by wearing masks, and in many places there is even an antagonistic reaction to those who wear masks. Psychological, physical, and social experiences blend to create our reality, and all dimensions must be cared for.
So, how can we enter this inherent space of confusion and conflict with compassion?
We must have compassion for those who do not take precautions.
We must have compassion for those who do.
And, most of all, we must hold a space of compassion for ourselves as we try to walk an intelligent line.
Cultivating a practice of mindfulness in life has been an in vogue experience during the last decade, but its popularity has been backed by thousands of years of experience, and modern research studies. We know, for instance, that meditation can work as well as popular drugs for curbing anxiety and depression (Fulton, 2022).
It makes sense that a philosophical practice, like that of meditation, would be helpful for the fears we experience in the middle of a pandemic. But we also know that Covid-19 itself has potent psychological consequences. Fear itself, too, has consequences.
One study showed that “anxiety and depression increase the risk of self-reported adverse reactions to COVID-19 vaccine. Consequently, appropriate psychological interventions before vaccination will help to reduce or alleviate symptoms of vaccination” (Zhou et al., 2023). This means that our fear itself can exacerbate our responses to the world.
Later in this article, I have plenty of depressing peer-reviewed evidence for the effects of Long Covid (betcha can’t wait for that, huh?).
For example, one of those Long Covid effects can be dramatic disruptions to a person’s sleep pattern. But, research also shows that there are well-established ways to secure your sleep habits against this disruption. Reviews of numerous studies have shown evidence that meditation offers benefits “ranging from improved sleep and life quality, reduction of sleep-related problems, positive interference with psychological problems, memory, and concentration” (Gobbo et al., 2023, p. 8).
It is possible to create an experience of life that allows us to survive, even thrive, in the middle of even the greatest devastation.
The “risk factors for an individual's mental wellbeing” during pandemic conditions are severe, as individuals deal with circumstances “ranging from being confined to a limited space for an extended period, not having certainties about the future, the possibility of losing one's job and being unable to reach a social environment are just the few examples” (Fazia et al., 2022, p. 11).
Despite this, a study of “high trait” anxiety sufferers during the middle of Lockdown in Italy showed something remarkable.
“Despite the impossibility to come in direct contact with the meditation group, participants showed improved outcomes on anxiety and mental wellbeing measures, even after a relatively short period of 9-week meditation training, and this happened in the high trait anxiety group.” (Fazia et al., 2022, p. 11)
I want to highlight that this is not some sort of panacea.
We cannot wish-fulfill away the pandemic, nor any of the other stressors and pains in our lives.
But we can learn to live differently with those stresses.
As the great Zen teacher Thích Nhất Hạnh wrote:
“Suffering is not enough. Life is both dreadful and wonderful...How can I smile when I am filled with so much sorrow? It is natural--you need to smile to your sorrow because you are more than your sorrow.”
The ancient Stoic philosophers understood this principle as well. “Often dumbed down to refer to having a stiff upper lip, or emotional reserve, Stoicism is actually a deep philosophical framework, useful in providing an ethical scaffold for both everyday life and in times of difficulty” (Delaney, 2020).
Seneca wrote, in a letter to his friend Lucilius, “There are more things … likely to frighten us than there are to crush us; we suffer more often in imagination than in reality. … some things torment us more than they ought; some torment us before they ought; and some torment us when they ought not to torment us at all. We are in the habit of exaggerating, or imagining, or anticipating, sorrow” (TheStoicLife.Org - XIII - On Groundless Fears, n.d., Para. 12).
And yet, within this, framework, the stoics believed that we owed everything to our fellow human beings—that, as social creatures, we were indebted to one-another for our wellbeing. This means that we have a responsibility to try to do good and try to avoid doing harm.
This is true in the middle of a pandemic.
This is true in flu season.
This is true in life.
Therefore, going forward, we must learn to compose ourselves in such a way that we can live joyfully within, and as part of, the world. Whilst, at the same time, mindfully assessing the weight of our actions on an ethical frame: how can we do the most good and prevent the most ill? From a Stoic mindset, decreasing the risk of spreading disease is an easy ethical choice: you have a responsibility to avoid causing harm. Yet, at the same time, this must not be a byproduct merely of fear.
If we are ruled by fear, we will spread fear.
If we are ruled by compassion, we will spread compassion.
If we are ruled by social distress, we shall be a part of that distress.
If we are ruled by reflective judgement, we shall aid others in their own reflection.
Originally, I thought that I might place this entire section at the end of the article, as a sort of “but things can be positive!” culmination. I decided against that. I want you to go into this article with a clearer mind, knowing that there are ways we can face the challenges ahead. Knowing that we can make a difference in our own lives, and in the world, by being more present in our lives within the world.
There’s a lot that can be scary.
But there’s so much that’s beautiful.
And, while change can be hard, it is also an open door. What lies beyond that door is, at least partially, up to us.
Biased towards unbiased data
Did you know that human beings are biased toward optimism? About 80% of the population, according to estimates from numerous studies, display an optimism bias (Sharot, 2011).
We assume we will enjoy our vacations.
We assume that we won’t get into car accidents.
We assume that we won’t get sick from an invisible disease.
Ironically, the very thing that has made portions of my life a living hell—my proclivity toward depression—makes me less likely to have an optimism bias!
Hashtag #Blessed, amiright?
While “healthy humans expect the future to be slightly better than it ends up being, people with mild depression show no bias when predicting future events” (Sharot, 2011). In fact, my problem has been conditioning myself to expect things to be better and not worse than they are likely to turn out to be.
Optimism bias is not alone.
You, me, and everyone else experience various cognitive biases whenever we attempt to make decisions in the world (Davenport, 2020).
Unless we’re very careful to cultivate self-reflection, it becomes really hard to parse these biases from our moment-to-moment decisions.
Hard, but not impossible.
Studies have shown that “meditation can improve automatically activated, implicit attitudes toward stigmatized social groups” (Kang, et al., 2014, p. 1), although “successful meditation-based intervention requires the theoretically guided selection of the best-suited technique” (Hommel & Colzato, 2017, p. 1).
So, we can get better at making decisions that overcome our biases.
As I mentioned earlier, my own bias traditionally skewed in favor of that 20% of the population that experienced a “pessimism bias,” but I’ve learned how to smooth out that instinctive response (and live a better life for it).
The problem is that our society does not provide training in overcoming biases.
If you’re depressed and anxious, it makes sense to go to a psychologist and say, “Hey, Doc, I can’t stop imagining bad things happening, and I’m starting to feel like I don’t care about anything anymore.”
But it doesn’t seem to make as much sense to go to a psychologist if you walk around thinking, “Gosh, I just know tomorrow is going to be an amazing day, there’s nothing that could ever bring me down!”
The problem, here, is that the skills that people who are mildly depressed develop to recover balance are the same skills everyone else needs as well.
We all need to learn how to better reflect on the source of our state of mind.
When it comes to something like a pandemic, our biases are going to be wildly important in swaying our reactions. That means that we need to be extra careful to try to correct our experience in the opposite direction of our bias!
We can return to Seneca for an example of what this looks like. He wrote, “counter one weakness with another, and temper your fear with hope. There is nothing so certain [than that the] things we dread sink into nothing and that things we hope for mock us … Accordingly, weigh carefully your hopes as well as your fears” (TheStoicLife.Org - XIII - On Groundless Fears, n.d., Para. 12-13).
Which leads me to the central point of this article.
Covid-19 is still a problem, or: how diseases actually work
Between the 1860s and 1950, Australia attempted to kill a fuck-ton of rabbits using plague.
Australia has fought some interesting wars.
Like the time that their army lost a war against 30,000 emus.
Anyway, the rabbit plague eventually worked—it killed almost all of the rabbits. But then, the rabbit population that survived appeared to be less effected. This appeared to support conclusions for “avirulency” an idea partially popularized by a pathologist named Theobald Smith who observed that cows, when bitten repeatedly by ticks, appeared to develop less-severe infections over time.
The myth goes like this: viruses that kill their hosts can’t reproduce. Therefore, viruses tend toward a pattern of contagion without death to better their chance for survival.
But there is a problem with this theory.
Viruses aren’t conscious, intelligent, decision-makers.
The “avirulence theory beguiles our desire to anthropomorphize the billions and billions of viruses on our planet” writes Johnathan Jarry in an article from McGill University (2021). “Viruses can become more or less virulent over time-based on a number of pressures that act upon them” (Jarry, 2021).
Okay, fine—but why the hell am I telling you all this?
Because of this passage in a June 2023 article from the well-respected peer-review journal Cureus:
“Extrapolation to the next putative Omicron subvariant suggested that the CFR should be in the vicinity of 0.04, which would make it more dangerous than the Alpha variant and 60% as lethal as the original Wuhan strain. Though we hope that this does not come to pass, caution is yet warranted at this time” (DeGrasse et al., 2023, p. 5).
Put plainly, there is a likely (though by no means certain) trend in the mutations of one of the most prevalent variants of Covid-19 that is trending toward a deadlier virus, not the reverse. This tracks with how live samples of the disease are handled when being studied. Both the CDC and WHO “consider SARS-CoV-2 a biosafety level 3 pathogen — the same level as measles and tuberculosis” ([Covid Fact Sheet], 2023).
Long Covid
The risk of “Long Covid” symptoms increases every time you get infected.
Like a shitty game of viral Russian roulette, you never know when your luck will run out.
But what is Long Covid? How can we understand its effects when so much contradictory language has been used, and when the mechanisms for Long Covid are not well understood?
First, we need to be grateful to all the sufferers of Long Covid for speaking out, loudly, and demanding that their symptoms be taken seriously. Seriously, you people are unsung heroes, because of your early warning, research started into Long Covid much faster than it might have. And that gives us all a better chance of surviving and thriving in the years ahead.
As for what Long Covid is, let’s turn to a 2023 study that attempts to analyze the mechanisms by which the disease causes damage:
“infection by SARS-CoV-2 leaves a lasting imprinting of variably apparent, radiologically detectable end-organ damage, including in the CNS, as well as immune subset perturbations, enhanced cytokine levels, including CCL11, and a range of pathologies relating to coagulopathy. There are possible roles also of EBV reactivation, persistent SARS-CoV-2, microbiota dysbiosis and low serum cortisol.” (Altmann et al., 2023)
The researchers don’t hold back from there, either. They go on to state that:
“the oncoming burden of long COVID faced by patients, health-care providers, governments and economies is so large as to be unfathomable, which is possibly why minimal high-level planning is currently allocated to it. If 10% of acute infections lead to persistent symptoms, it could be predicted that ~400 million individuals globally are in need of support for long COVID.” (Altmann et al., 2023)
Why isn’t this a bigger deal?
Part of the problem goes back to our human biases. We have a hard time connecting the dots to reality—more often than not, the picture we build of the world is one made of dots we placed ourselves.
But the symptoms of Long Covid are there. You may even be experiencing them without realizing it. Have you been experiencing problems with sleep, for instance?
In a 2023 study published in the Journal of Sleep Research, researchers “observed a high frequency of long-lasting sleep disturbances characterised by difficulty falling asleep or staying asleep and excessive daytime sleepiness in C-19 cases, which contrasts with previous studies that have failed to assess the frequency of sleep symptoms” (Merikanto et al., 2023, p. 5).
A detailed report on the treatment of chronic pain sufferers from Committee on Advancing Pain Research, Care, and Education from the United States Institute of Medicine offers some insights into our problem.
Health professionals may hold negative attitudes toward people reporting pain and may regard pain as not worth their serious attention,” write the researchers (2011, Barriers to Effective Pain Care Para. 3).
This disconnect can be partly due to guilt on the part of the medical practitioners, who have been trained to “cure” rather than “care.” But it goes further, Patients “can be at a particular disadvantage if they are members of racial or ethnic minorities, female, children, or infirm elderly. They also may have less access to care... if they have, or are perceived to have, mental health problems” (2011). This sort of dismissal, incidentally, is one of the problems Long Covid sufferers face (Payne, 2022).
Long Covid is finally being recognized more widely, but millions (especially the poor, women, and cultural minorities) are still going to be suffering in silence or obscurity.
But, steps are not being taken to ensure that more people don’t experience Long Covid symptoms in the first place. That’s a problem we need to start addressing.
Covid-19 and children
Birth defects and mortality for mothers
Research into the effects of Covid-19 on pregnant people and children is still forming, in part because this data is harder for researchers to acquire. Researchers also won’t start to have a fuller picture of potential serious consequences (like birth defects) until a higher number of children whose parents were infected become old enough for impairments to become recognized.
But, we do know is that the rate of birth defects appears to be higher in children whose parents were exposed to Covid-19, perhaps by as much as double the percentage (Edlow et al., 2022). As one limited 2022 study showed: “Our findings identifying an association between prenatal SARS-CoV-2 exposure and neurodevelopmental diagnoses at 12 months are consistent with a large body of literature… linking maternal viral infection and maternal immune activation with offspring neurodevelopmental disorders later in life” (Edlow et al., 2022, p. 6).
Basically, if a pregnant person’s immune system activates while pregnant, there’s a well-known increased likelihood of development problems for the child.
With more specific regard to the effect COVID-19 infection has on the pregnant person themselves, a 2023 meta-study, collecting data from studies across the planet, provides this harrowing conclusion: “This analysis indicates that SARS-CoV-2 infection at any time during pregnancy increases the risk of maternal death, severe maternal morbidities and neonatal morbidity” (Smith et al., 2023). Preterm babies are increasingly likely as well for Covid-infected parents, and the outcome of such cases is largely contingent upon class-based financial resources. Poor people will lose more children than those with the resources to provide the best care.
Effects of Covid in older children
It’s not just within the earliest phases of life that we see a significant problem emerging, either. With one in six children showing post-Covid effects that cannot be else wise explained, the risk of infection is not insignificant (Jiang et al., 2023). There is some limited suggestion that kids with post-Covid symptoms improve over time (Pinto Pereira et al., 2023), but that data still runs up against the established dangers of repeat infections and the still significant portion of the population that does not see full recovery.
Even more alarming is research that suggests that children’s immune systems don’t learn from, and adapt to, Covid-19 properly.
“Children have largely avoided severe COVID-19 symptoms because they have a strong initial 'innate' immune reaction that quickly defeats the virus. And now, researchers led by scientists at the Garvan Institute of Medical Research have uncovered what this might mean for the immune system. Unlike those of adults, children's immune systems don't remember the virus and don't adapt, so when they're next exposed to SARS-CoV-2, their body still treats it as a new threat.” (Children’s Immune Systems Do Not Develop ‘Adaptive’ Memory to Protect against Second Time SARS-CoV-2 Infection, 2023)
The short of the long (TLDR)
Long Covid is a biologically verifiable product of infections by Covid-19, with increased risk coming from repeated infections. The disease has the potential to exacerbate or initiate a wide range of comorbid conditions that will drastically affect an individual’s wellbeing. Pregnant people are disproportionately at risk of death if they catch Covid, and there is a likelihood of increased birth defects in children (especially male babies) if their parent contracted Covid late in the pregnancy. Just as alarming is the information that kids aren’t as resilient to this disease as originally assumed.
The psychological factor
“People tend to join together to either rejoice or commiserate about significant life events, such as a wedding, the arrival of a new child, or the death of a member of the family. Therefore, attending community events must inevitably become a regular part of one’s life” (Mohanraj & Singh, 2023). We know that people need socialization to be healthy—we know that mental health affects physical health; human beings are holistic entities.
So, what does this look like in the face of a pandemic, especially when Long Covid is now the third leading neurological disease in the United States.
Perhaps even more pressing, how can we unite against wealth-backed health policies when we’re afraid to be in the same room with one-another?
There isn’t a great answer. The best that I’ve come up with is this: talk to your friends and family about the realities of Covid. Talk to them until they’re sick of hearing about it, then keep talking to them until they start talking about it as well.
Model good masking habits. Make a point of thanking your friends and family for wearing masks. Encourage good behavior in your social group regarding self-quarantining when possible exposures occur. Avoid large gatherings with random groups and concentrate on building strong, regular meetings with smaller groups of trusted friends.
We need to start working on this now… because Covid-19 isn’t the last pandemic we’re going to see in our lifetimes.
The next pandemic or: how we can change habits in order to outlast and overwhelm the rich bastards who are profiting off our misery
As we create further damage to the Earth’s ecosystems, this destabilization will make room for more unique diseases. Rising heat, worsening living conditions (disproportionately for the poorest humans), and the destabilization of predatory ecosystems will all lead to more diseases, not fewer.
The Global Health Security Index measures one-hundred and ninety-five countries for their preparedness for further pandemics.
Of those 195 countries, how many do you think are prepared?
Half?
A couple of dozen?
What if I told you that the answer was “none.” That not a single country on the planet is capable of effectively handling another pandemic—especially not one that is worse than Covid-19.
This is a problem that goes beyond the United States then, clearly—modern society itself, fractious and fraught with infighting, is the weak-point. And yet, let us consider what Deborah and Rodrick Wallace write in their 2021 book, COVID-19 in New York City: An Ecology of Race and Class Oppression. “Social epidemiologists,” the authors write, “who study disparities of morbidity and mortality often ascribe the generation of the conditions that produce these disparities to capitalism and to the class and race/ethnic bigotry on which capitalism depends” (Wallace & Wallace, 2021).
As we can see from some early explorations of China’s initiatives to halt the spread of Covid, “implementing strict control measures over the movements of residents might effectively reduce the transmission of the virus in rural areas and likely help to contain the infection,” (Wang et al., 2021). These gains did come at significant cost to the economy—which translates to economic hardship and poverty for low-waged workers without implementation of “relief programs from the government” (Wang et al., 2021).
Economic strength only means something if it promotes the general good. As we can see, China attempted to mitigate deaths at the expense of economic surety. This has certainly had cascade effects (that extend beyond the scope of this article), but the initial goal has to be admired. And, what’s more, the focus on saving lives—especially the lives of the most disadvantaged in a society—must be foregrounded when we deal with the pandemics that await us in the years ahead.
Of course, we have a significant problem here: because your government doesn’t currently prioritize your life over profit generation.
How do I know?
Well, the fact that the California Supreme Court ruled that employers have no “duty to care” is a pretty big clue (Mitchell, 2023). This means that if you catch Covid while at work, then go home and spread it to your family, your employer cannot be held at fault.
That seems pretty terrible to me.
What can we do now? Or: General safety measures we need to normalize
If Covid-19 is still a problem, if there are other airborne diseases (like R.S.V. and influenza) that we need to be wary of, and if there will likely be more such illnesses in the decades ahead… what can we do?
We know that Long Covid is real, and has potentially drastic consequences. For instance, for “up to a year after a case of COVID-19, people may be at increased risk of developing a new heart-related problem, anything from blood clots and irregular heartbeats to a heart attack –- even if they initially seem to recover just fine” (Neergaard, 2023). We also know that repeat infections create an ever-increasing likelihood of severe consequences.
We also know that a “tri-demic” will be hitting us hard again this winter.
“CDC Director Mandy Cohen told NBC News this week the agency is preparing for another “tri-demic” this winter — with Covid, influenza, and another respiratory virus, RSV, circulating widely — that could challenge the US health care system. “We need to make sure the American people understand all three and what they can do to protect themselves,” Cohen said” (Scott, 2023). These other illnesses come with their own host of complications, and should not be ignored just because Covid-19 is a novel virus.
With infections trending upwards over the last four weeks (Mandavilli, 2023), public health experts believe that there are still plenty of reasons to be concerned. Katelyn Jetelina, who writes the Your Local Epidemiologist newsletter, had this to say:
“We are in a very different place, but Covid is still a thing. … I think we do the public a disservice by saying that it’s over and let’s move on, because it is going to be disruptive this winter, and it will cause a number of people to die,” she added. “That’s just not acceptable to the public health world, especially since it’s preventable.” (Mandavilli, 2023)
We need governments that prioritize human life, and ecosystem homeostasis, over all other concerns. But, while we work toward a different type of social structure and priority, what can we do?
Quite a lot, actually.
First: find a way to get involved in your local political scene. Personally involved, not just through an online petition or a donation. Who is responsible for Covid policies in your workplace, in your library, in your hometown, or in your favorite shops? Who in those organizations might be willing to work toward positive changes? Can you communicate with them, effectively, to build a network of allyship for positive change?
Change is a matter of widespread solidarity, so we need to come at this crisis from the mindset of togetherness, not “otherness.”
Secondly, we must follow best practices regarding health and safety hygiene.
Effects of masking
Are we going to be stuck masking up forever? The short answer is: “We always should have been masking up during peak flu seasons” (Masking and Social Distancing During Pandemic Stopped Spread of Flu and RSV During 2020 Cold and Flu Season, 2021.).
Masks dramatically decrease the likelihood of catching or spreading Covid-19 (or most other airborne illnesses (Walkinshaw & Horstman, 2023)). Any masks are better than nothing, but high-quality masks made from plastic have an innate static charge that adds to their effectiveness. Oh, and no, breathing through masks doesn’t cause problems for the vast majority of wearers (CDC, 2021).
We know that masks are effective at reducing the transmission of disease (Acosta, 2023). We also know that masking up doesn’t carry any risks for the majority of the population (unless you have severe medical conditions that make breathing difficult, or are exercising at an absurdly high level, it’s not something to be concerned with) (CDC, 2021).
In a review of school conditions in Switzerland, masks were shown to be the most effective method of reducing spread (Banholzer et al., 2023).
Air purification
The CDC has set an air exchange of five full exchanges per hour as a federal baseline to reduce exposure to viral contamination (Goodman, 2023). However, research shows that both the placement of the air purification system (if not a built-in HVAC) as well as other factors, like the number of people in a room, must be taken into account. This research suggests that a rate of 6-12 exchanges per hour is ideal for reducing exposure to all airborne illnesses, and that placement of air purifiers closest to the source of exposure can reduce the risk significantly even when the source is unmasked (Srikrishna, 2022).
A 2023 review of numerous papers found that the “use of natural ventilation or a combination of mechanical and natural ventilations was found to be highly effective” at reducing the spread of the disease (Saeedi et al., 2023).
Ensure that you are working and living in well-ventilated spaces. Your employer should install strong HVAC systems with HEPA or better purification. Failing that, we know that placing portable HEPA air filters strategically limits the spread of airborn infection significantly (He et al., 2021; Walkinshaw & Horstman, 2023).
The CDC guidelines on air filtration should be required reading.
I found this handy guide from the Rhode Island Department of Public Health that provides specific guidelines for proper ventilation (extra important to read this if you work in a classroom or other setting where people congregate for long periods of time).
All of this stacks up with other research out there, pointing to an insoluble fact: clean air is one of the most fundamentally important things for combatting the spread of illnesses like Covid, the flu, and RSV.
Hand-washing
While this is not a major transmission vector, there have been reports of Covid contraction through the eyes. Washing your hands is especially vital in conjunction with masking (any time you touch your mask, sanitize or wash your hands!).
TLDR
Source-control is the most effective method of stopping the spread of disease (if you are sick, don’t take your mask off around other people!).
Following this, general masking in all public settings, especially when indoors, is the next best thing. High-quality N-95 (or the generally more comfortable KF-94) (Lewis, 2021), are your best bet, though multi-layered cloth masks are better than nothing at all.
Air exchange is a vital component of avoiding transmission. Air must be cycled through a high-efficiency filter (and not simply moved throughout a series of rooms).
HVAC air purification that is fed through MERV-13 or HEPA filtration is one of the best options, but few buildings have implemented this.
Localized portable air purifiers are effective at combatting spread of infection, but you need to pay attention to their manufacturer’s posted rate of air change per hour. You will likely need two, even for a relatively small space, in order to ensure that source control is provided.
Washing your hands and strong general hygiene is an essential component, even if this isn’t the main vector of transmission.
Limit exposure: This is probably the most difficult thing to build a habit for. What it essentially boils down to, though, is an intelligent calculus between these factors:
your psychological needs,
your community transmission rate,
the type of gathering you’re attending,
mitigating measures taken.
For me, risks associated with contact with friends in non-public settings generally pass through as acceptable. But I live in a low-transmission area. I’ve been attending a few more public experiences lately, but my calculations for those experiences have included psychological needs and mitigation factors (wearing a mask and sitting near ventilation). I’m not immune to optimism bias, either—and, sometimes, the weight of needing to have fun with friends outweighs a lot of other considerations.
But, I always come back to a baseline that urges caution.
Why?
Because my life is worthwhile, and the lives of those I care about are worthwhile, and I want to defend those lives in any way I can.
I know that all this limits our choices in life, and I’m so sorry for that. But I want to save as many of you reading this from potential, and relatively easily avoided, suffering. If some changes to how you socialize are required to avoid potential long-term Covid-19 effects (or to save someone you know and care about from such effects), maybe it’s not too high a price to pay.
After all, Long Covid can impair quality of life more than cases of advanced cancer (Hall, 2023). That seems like something worth avoiding.
At the same time, don’t forget what I wrote earlier in this article: our practices of mindset are a vital component to riding out this pandemic, and any pandemics yet to come. Taking the time to build a meditative practice, even for as short a time as four weeks, can help you deal with the trials of life (Gregorian, 2022)
We must move forward with compassion, diligence, ethical considerations, and self-care.
References
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