The large windows in the kitchen of my new home let in the perfect amount of sun for plant-rearing. So, after some meandering in the garden section of a big-chain hardware store, I bought a yucca and placed it next to one of the kitchen’s bay windows. After a few days I added a lily on the windowsill next to it and the two were fast friends, both leaning toward the glass to catch the brunt of the light when the kitchen was at its brightest. Soon I found myself preoccupied with watering them and watching them flourish, even as I accepted that I did so to distract myself from the news cycle at the time, which mainly featured a few benign fluff stories, the weather, and the national and worldwide death toll from the pandemic. In this way, the plants served their unwitting purpose. Then, the watering schedule I’d set for them shifted from a pleasant distraction to a full-blown mania that resulted in overwatering.

That, coupled with the right cocktail of gnat eggs and direct sunlight soon transformed the top layer of the yucca’s soil into a hatching pod. My kitchen, so bright with its area of exposed brick painted white and its backsplash above the stove, was now besieged with fruit fly larvae. Then, just as the last lily buds on the yucca’s neighbor began to open despite the chaos around them, my older brother called to tell me that our father’s cancer had spread to his bones. My father, the first person who told me that the simplest way to learn about the cycles of life and death was to observe it all around me in nature, was finally nearing the end of his own path. Moreover, daddy was right; nature, albeit a fraction of it that I accidentally cultivated in my own kitchen, was about to teach me about ephemerality, grief, and death.

My brother adjusted his tone as he explained to me what was happening to my father, and I recognized the shift in his inflection as one he often used for his youngest, most inquisitive daughter. As gently as he could, he told me that there would be no more chemo. After the call, I spent the next few days slowly processing the words “spread to his bones.” During that time, I also waged war on more invertebrate sunbathers, which were now no larger than grains of rice, enjoying the warmth of my kitchen floor. I thought of my father all the while, and the rule of threes that the eldest womenfolk in my family had always told me about when I was little. The crux of their superstition stated that many important things in life came in threes: death, calamities, successes–all in threes. I had always hated that bit of family-fueled lore and the way that each generation of women on my mother’s side kept reviving it, imbuing it with new strength by grouping all the joys and hardships of our family into neat triad bundles, but I also had to admit to myself in this instance that my father’s war was tiered that way too, with three battles rolled into one. First came his early scrimmages with addiction. Then, with his mental illness. Finally, prostate cancer entered the arena as an armor-clad champion, and how he fared throughout that battle was inextricably tied to the resolve he’d earned battling the other two.

I’m sure I could have viewed the infestation differently if I hadn’t lain eyes on the larvae while I was mourning the impending loss of my father. I had always been that type of child growing up, grasping insects by their wispy legs to move them from harm’s way, and crouching to observe brightly colored caterpillars. It also helped that the nature shows I watched back then often described writhing, translucent piles of larvae with terms like “burgeoning new life” and “resilient young.” But, in the midst of losing my father, I was too jumbled inside to think that way. The spider-dangling child who had merrily let all things live was buried in her grief, and I called the pest company the day the infestation began. My hopes were dashed during that call though, as I was cautioned against having high hopes about eradicating them in one treatment. Even the service representative’s words were triggering for me as my mind again clamped onto certain words as she spoke and a memory tunneled me back to where I had heard similar, like “impossible to eradicate with one treatment.” Bitterly, I remembered exactly where I’d heard them; it was during one of daddy’s first diagnostic visits. But I did perk up slightly when the rep told me that the larvae hated the cold and resolved right then to freeze them out.

My family rendezvoused at the hospice center in Bethesda to see my father and took turns going in to visit because of the facility’s Covid-19 restrictions. When I entered his room and saw how small he’d become, I decided to record our conversation. Because he was also aware of how, little by little, parts of him were dissipating (evaporating? I hate the term “wasting away”), he spoke to me as if he also knew it would be our last. I held onto each word he told me in his strained voice, which he pushed out between breaths that caused his swollen brown belly to bow upward and his too-visible ribcage to rise and fall dramatically, though some of it I wasn’t prepared to hear. He imparted bits of wisdom about my failed marriage, the ebb and flow of my iman—the word he used for my faith as a Muslim—and chiding me about my undone tasks and how I had less time to do them than I thought. I felt pangs of guilt when he was done and felt even worse when I returned to my icy home alone with a deeper hatred of the larvae than before. If my daddy wouldn’t be allowed to thrive, why should they? Invertebrate scum. They had no bones for cancer to spread to, causing pain excruciating enough to push a recovering addict’s mind to thoughts of needles and vials. They possessed no fingers to play the saxophone, or callused hands to pat the hijab-covered heads of their daughters. None had vocal cords to recite the long, rhythmic Sufi prayers that my daddy knew by heart. In fact, they had no hearts at all. They simply existed to multiply and consume, like cancer.

After the visit, my mom and siblings flooded our family group chat with updates from his doctor, but the constant pinging sounds became unnerving, so I silenced my phone entirely. I knew that a portion of them were concerned texts from my mother, who was concerned with my extermination method and wondering how I was faring in the cold. I also knew that there was a simpler way to mute their texts, but I wanted to do more than that. I wanted to mute everything around me—the omnipresent whir of my air conditioner, sporadic clatter from the icemaker in my fridge, and the moan of the wooden floorboards under the large feet I inherited from my now-fading father. It took three days to freeze all of them, and each night was spent bundled against the cold, phone in hand as I replayed clips of my father playing his saxophone or smiling proudly with his arm slung around the shoulders of one of his many grandchildren. When morning broke after each chilly night prior, I’d rise and sweep the frozen ones into my dustpan. Once lively and determined in their trek across my linoleum, the cold had since left them discolored and shrunken. By the fourth day their short lives were done, and father’s life was too, leaving me with a clear kitchen, but clouded mind. I turned up the heat and let the warmth return to my kitchen, which I paced as I contemplated the life of both the prospective fruit flies, and my father’s. Standing in the fully restored kitchen on the morning of his janaza, or funeral, with its floor tiles warm against my feet, I decided that what nature taught me about fruit flies and my father was that they were both fragile creatures who had, however briefly, enjoyed their time in the sun. I also decided that surviving my grief and allowing myself some joy again meant reviving the wisdom of my foregone womenfolk and looking at my father’s life in a different light. His battles came in threes, but his blessings did too: bones that bore the weight of his seventy years, callused hands that patted the heads and wiped the tears of his six children, and the skilled fingers that told stories through his horn so vividly that sometimes, I still hear them in my dreams.

“The fool’s heart is on the tip of their tongue; the wise’s tongue is in the extreme bastion of their chest.”
M. Fethullah Gülen [1]

Throughout human history, numerous writers, philosophers, scientists, and religious scholars across different eras, geographies, and cultures have arrived at a common point about interpreting society and people. This finding—long known as the “audacity of ignorance”—has only recently been addressed scientifically.

Two American social psychology professors, David Alan Dunning and Justin Kruger, conducted social experiments to scientifically prove Charles Darwin’s theory “Ignorance augments one’s self-confidence more than true knowledge.” In Dunning and Kruger’s experiments, participants were given four tests in the areas of humor, grammar, and logic. They were then asked to evaluate their own performance and estimate how many questions they would have answered correctly. The results revealed that participants who performed poorly on the tests rated their own performance above average. The researchers called this the “double burden” of unskilled people and stated that it was due to the individual’s lack of ability to evaluate their own knowledge and experience. According to them, the main problem was that they were “unskilled and did not know they lacked proficiency” [2].

Dunning and Kruger formulated their results as follows:

1. Incompetent people always overestimate their own abilities.
2. They do not realize the extent of their own inadequacies.
3. Because of their ignorance, they do not feel the need to improve their knowledge and skills.
4. They consistently underestimate the superior qualities of others.

The study also found that the best performers were the humblest who underestimated their knowledge and abilities [3].

The Dunning-Kruger Effect is two-sided: Unqualified people exaggerate their own knowledge and abilities; and on the flipside, people who are truly experts in their field tend to behave humble and downplay their experience and abilities [4].

Since experiments in the positive sciences have measurable parameters, their results are more reliable; human psychology is much harder to study, as the number of variables affecting the outcome is exceptionally high. Therefore, research in this field must be more extensive and eliminate the parameters that affect the outcome by deploying objective criteria.

In a study on the Dunning-Kruger effect in Southern Illinois University aviation students, students were tested on both grammar and piloting knowledge. The results of the study supported the DK effect and revealed that students with low scores overestimated their abilities, while students with high scores underestimated their abilities [5].

In a 2018 study examining the development of overconfidence in new hires, it was observed that the self-confidence of people who exhibited a humble attitude at their hire was far ahead of their performance with little experience. As they continued to gain experience, their self-confidence first fell and then surged again in proportion to their performance [6].

In 2021, another study attempted to prove the existence of the Dunning-Kruger effect using electroencephalography (EEG), which records the electrical signals in the brain. Participants in the bottom quartile overestimated their percentile and participants in the top quartile underestimated their actual scores. In the experiment, where the reaction times of individuals at these two levels were also measured, it was found that those in the lower quartile reacted faster, while those in the upper quartile reacted slower. It was also observed that dissimilar mental processes occurred in the brains of these two groups during the evaluation [7].

In another recent study, the existence of the DK effect was tested under the conditions of the COVID-19 pandemic. The study surveyed 2,487 participants, asking them about their level of education, sources of information, and COVID-19. Finally, the participants were asked how many questions they could have answered correctly. Poor performers’ self-estimates were disproportionate to their actual level of knowledge and much higher than the overall average. They were also found to have lower levels of education than other participants and to prefer social media and mass media as sources of information [8].

If the person under the Dunning-Kruger Effect realizes their ignorance and gains knowledge and experience, they can overcome the negative effects of the phenomenon. There are four main periods of self-confidence in this process:

Mount Stupid: This is when the Dunning-Kruger effect is at its peak, when people are pretentious in their own knowledge on a subject about which they have meager information.

Valley of Despair: This is the stage when one faces the inadequacy of one’s existing knowledge. When one realizes how little they actually know, their self-confidence sinks. The sentiment, “I know everything,” is replaced by, “There is much more than I know.”

Slope of Enlightenment: The person who has fallen to the lowest point of despair pushes themselves to increase their level of knowledge and skill and makes progress. From the Valley of Despair, they gradually climb towards the Slope of Enlightenment. This is the stage where real learning begins.

Plateau of Sustainability: This period does not imply that the person has mastered all knowledge. The person can now clearly draw the boundaries of their level of knowledge on a certain subject. They can clearly identify what they do not know, and make an effort to do so. Self-confidence rises again, but the tendency to be modest may also increase [9].

Conclusion

This phenomenon, which has always been controversial, continues to tempt both supporters and opponents with new research. As of today, the Dunning-Kruger Effect is not recognized in the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5). It is still recognized as a psychological phenomenon rather than a pathological condition. However, it is sad that the phenomenon described is visibly common in society. When we think about it, it is not hard to find people under the influence of the DK effect in business, education, politics, sports, and arts. Especially during the COVID-19 pandemic, we sadly witnessed those with little knowledge on the subject make statements on social media and mass media and pass laid-back judgments in contrast to the experts.

In an interview, Dr. Dunning said, “The key mistake people make about the Dunning-Kruger Effect is about who falls victim to it. The effect is not really about others; it is about us. The lesson to be drawn is how humble and cautious we should always be about ourselves.” The Dunning-Kruger effect affects not only ignorant or unskilled people. It impacts us all about the things we are yet to learn [10].

From a different perspective, “ignorance” has always been a major human weakness traditional scholars have addressed throughout history. Fethullah Gülen explains that there are three degrees of ignorance. “Simple ignorance” is when a person does not know; “double ignorance” is when they do not know that they do not know; and “triple ignorance” is when they think they know, although they don’t. In relation to this Gülen said, “The Arabic word muq’aab means “three-dimensional” and ignorance at this level is almost impossible to eradicate. It leads people to diverse delusions; sometimes into tyrants, sometimes into the likes of Yazid ibn Muawiya or Hajjaj ibn Yusuf, and sometimes into a Führer, down every path except the straight one” [11].

Bediuzzaman Said Nursi also draws attention to the connection between knowledge and humility: “In society as a whole, everyone has a window, known as rank, through which to see and be seen. If the window is higher than a person’s stature, he will grow taller through arrogance, but if it is lower, he will bow down out of modesty to see and be seen at that level. The measure of greatness in man is smallness, that is, modesty. The scale of smallness is bigness; that is, arrogance” [12].

Notes

1. M. Fethullah Gülen, Ölçü veya Yoldaki Işıklar, [Pearls of Wisdom] Istanbul: Nil Yayınları, 2011, p. 126.
2. J. Kruger, D. Dunning, “Unskilled and unaware of it: how difficulties in recognizing one’s own incompetence lead to inflated self-assessments”, Journal of Personality and Social Psychology, 1999; 77:1121–1134.
3. Brian Duignan, “Dunning-Kruger effect”, www.britannica.com/science/Dunning-Kruger-effect
4. Jochen Mai, “Dunning-Kruger-Effekt: 4 Phasen der Selbstüberschätzung”, karrierebibel.de/dunning-kruger-effekt
5. S. R. Pavel et al. “The Dunning-Kruger Effect and SIUC University’s Aviation Students”, Journal of Aviation Technology and Engineering, 2013, s. 125–129.
6. C. Sanchez, D. Dunning, “Overconfidence among beginners: Is a little learning a dangerous thing?”, Journal of Personality and Social Psychology, 2018; 114(1), 10–28.
7. A. Muller et all. “Neural correlates of the Dunning-Kruger effect.”, Eur J Neurosci, 2021 Jan; 53(2): 460–484.
8. A. Claessens et al. “Self-Illusion and Medical Expertise in the Era of COVID-19”, Open Forum Infectious Diseases, April 2021, 8/4.
9. Joshua Render, “The Dunning-Kruger Effect”, agile-mercurial.com/2019/07/12/the-dunning-kruger-effect
10. Jonathan Jarry, “The Dunning-Kruger Effect Is Probably Not Real”, www.mcgill.ca/oss/article/critical-thinking/dunning-kruger-effect- probably-not-real
11. M. Fethullah Gülen, “Sevgi İksiri ve İmanın Tadı” [Elixir of Love and Taste of Belief], 1/10/2015, www.herkul.org/herkul-nagme/485-nagme-sevgi-iksiri-ve-imanin-tadi/
12. Bediüzzaman Said Nursi, Mektubat, [The Letters] Istanbul: Şahdamar Yayınları, 2010, p. 536.

If there’s one thing I learned as a medical trainee who deals daily with death, it’s that humans want to be remembered. We want to survive the tides of the future. We want to survive death. All our lives are devoted to doing something, to leaving a mark on this earth. Too often, however, all we manage to leave is a scar.

As John Green once put it (in his novel, The Fault in Our Stars), we are like a bunch of dogs squirting on fire hydrants. We poison the groundwater with our toxic urine, marking everything as mine in a ridiculous attempt to survive our deaths.

Nowadays, this phenomenon has grown exponentially. Especially in the eyes of the younger generation, being famous is the equivalent of being alive, successful, and happy. And by constantly living on social media, eyes locked on these “superstars” and their viral videos, they convince themselves that this is what life is all about. But it is not. What truly matters is not how many people know you. It is what you are known for by those around you. Spread love and do good, and you won’t need to be a star to shine. Just like Maria.

And this is why I want to tell her story.

Maria was different. She walked lightly upon the earth. Maria knew the truth: We’re as likely to hurt the universe as we are to help it, and we’re not likely to do either. People will say it’s sad that she left a lesser scar, that fewer remember her, that she was loved deeply but not widely. But it’s not sad. It’s triumphant. It’s heroic. Isn’t that the real heroism?

April 14, 2020. Italy.

On this particular Tuesday, I was making the last round on my patients before my 16-hour shift ended. In medicine, we are used to working long and tiring shifts; however, with the novel Coronavirus pandemic in full swing, we had reached new heights. But we were all clenching our teeth and working hard to keep our healthcare system afloat. At the time, the situation was overwhelming in Italy. The sad truth was that, often, we had to make deliberate decisions on who we wanted to save and who we were going to let die because we couldn’t give them proper and timely treatment.

The heaviness of knowing that your decisions may cause the death of someone is agonizingly painful. It’s like an ocean crashing on you, letting you come afloat just to take a quick breath, before pulling you down again. It’s not easy to ignore the pleas of the families to save their loved ones. Truth to be told, it’s depressing, and I don’t think there are words that can properly express the sense of hopelessness that one goes through.

As Virginia Woolf once wrote:

English, which can express the thoughts of Hamlet and the tragedy of Lear, has no words for the shiver and the headache… The merest schoolgirl, when she falls in love, has Shakespeare to speak her mind for her; but let a sufferer try to describe a pain in his head to a doctor and language at once runs dry. And we’re such language-based creatures that to some extent we cannot know what we cannot name. And so we assume it isn’t real. We refer to it with catch-all terms, like crazy or chronic pain, terms that both ostracize and minimize. The term chronic pain captures nothing of the grinding, constant, ceaseless, inescapable hurt. And the term crazy arrives at us with none of the terror and worry you live with. Nor do either of those terms connote the courage people in such pains exemplify.

On the other hand, the pandemic has also restored my faith in humanity and brought to light some amazing stories. For example, the story of Maria. She was an 82-year-old woman who had been admitted to the hospital one week before, in the intensive care unit. On that Tuesday, I was checking on her to see if her condition was improving or not. She shared her room with two other patients. When I came around her bed, she had her eyes slightly open. Her heartbeat and systemic pressure were perfectly normal for a person of her age, even though she had great trouble breathing properly.

“Hey, Dr. Ahmet, how are you doing?” she said, managing a smile.

I smiled back. Typical of Maria: even though she was the one in a hospital bed, she always asked me if I was doing fine first.

“I’m good. Thanks. How about you?”

“I’m doing alright…” Her voice trailed off. “Actually… it’s a bit depressing, to tell you the truth. All these white walls and gloomy faces.”

“For the white walls, I could ask someone to move you to another room. Just tell me which color you prefer. And you are right. We should paint them.”

“Nah, the walls are not a big problem. It’s the gloomy faces that I would like to change…”

I tweaked the valve of the oxygen canister. “You are asking me to do something really difficult,” I said. I was completely exhausted, both physically and mentally. It had been almost a month since we began working non-stop, and at times it seemed all in vain.

“Why?” she sounded surprised, “Being happy is not supposed to be that difficult. You know, dear, I remember the old times, when we used to dance mindlessly and laugh together. I loved it. And dancing really washes away all stress.”

“But you didn’t have to deal with a pandemic,” I said, scribbling her physiological measurements on the clinical report.

Maria laughed. “Ahmet, we had to deal with a deadly war, don’t underestimate the oldsters. But you know what, it isn’t the situation you’re in that should determine your happiness. It’s you. Being positive is a choice.”

“Maria, you could be a motivational speaker.”

“I know. ”

When I was completing my round, I kept thinking about Maria’s words. It was true: happiness came from within. But sometimes it was so hard to find.

Maybe we were not even trying. For my part, I thought it would be careless to be happy among all the pain and affliction. However, Maria’s words made me think that with my depressed mood and dispirited face, I might be one of the causes of that suffering.

I would definitely not be able to fully eliminate it, but I could at least try to alleviate it. I had to. But how? It felt like wandering in a room full of darkness: you know there is a switch somewhere, but the true challenge is finding it.

The next day, I came into her room for the usual check-up routine.

“Don’t I look like a zombie?” she said as soon as I entered the ward, pointing at the tubes that ran from the ventilator to her smiling mouth.

“Not at all,” I answered, glancing briefly at her clinical report. “120/80 mmHg blood pressure, regular heart rate at 75 beats per minute, osmolarity of 295 mOsm/L. You are doing superbly. A few more weeks and you’ll be out of here.”

The smile on Maria’s face faded, washed away by something I couldn’t see. “A few more weeks?”

“Yup. And then you will be able to get back to your children and nieces.”

“Ahmet.” Her voice sounded strangely serious. Usually, Maria was the one who brought laughter to her ward. After all, she was the one who told us to always stay positive. “I have to ask you for a huge favor. ”

“Tell me; I’ll do my best to help you.”

“Look… I’ve been following the news recently…and I know how many hardships you are all enduring.”

“It’s nothing. Really. We do it because it’s what we want to do.”

I meant it.

“I know. I know,” said Maria, crisping her lips in an irritated line. “But I also know that there are too many cases and too few ventilators. You have to choose between who you will save and who you will let die.”

I didn’t answer. My throat felt like a tender patch of heat.

“Well…” continued Maria. “The favor I want to ask you is that you give my ventilator to someone else. Just let me see my children this evening and then I’ll be ready to go. And, oh, don’t tell them about this. Tell them that I couldn’t make it. This will be our little secret.” She winked at me, her big blue eyes glittering.

“But… in a few weeks, you will be out of here,” I protested, pursing my lips and exhaling slowly, to calm myself. “Why are you choosing to die?”

“Oh, my dear. Look… as Steve Jobs put it ‘death is the destination we all share. No one has ever escaped it and that is as it should be because death is the single best invention of life. It’s a life-changing agent; it clears out the old to make way for the new.’ I am old now.” And here she pointed at her wrinkles, smiling again. “And I want to give the gift of life to someone younger than me. I want to give them their second ticket to life, so that they can get to live pursuing their passions and with no regrets. Just as I did. This is my last wish. If you grant me this, I can leave this Earth in peace. And the only thing you have to tell the person who will take this bed is to not be scared of death because it will make you miss your life. You can’t beat the Reaper by living longer. You can only beat it by living well and fully. Do the things you want to do before the Reaper shows up. Because it will be too late then.”

And these were the last words I heard from her.

That evening, after her children went away, she unplugged the ventilator herself, and when I came into the room she was lying on the bed, with a peaceful smile on her face.

*Maria is a pseudonym used for privacy concerns.

“Nearly 1 in three public health employees say they are considering leaving their organization within the next year … More than half of public health employees report at least one symptom of post-traumatic stress disorder … More than 9 in 10 employees say their work is important and they are determined to give their best effort every day.”
“Rising Stress and Burnout in Public Health”, March 2022

In public health, we tell the story of a farmer who lives at the foot of a waterfall. One day, while working her fields, she spots a man struggling in the river downstream. She throws a line to pull him to safety. By the time he makes it to shore, he is near death.

The farmer tells her neighbors, “We must keep a close watch to rescue others who are swept over the falls.” So they do.

Day after day, the farmer and her neighbors pull half-drowned people out of the water. They weave nets to cast across the river to catch the desperate swimmers. They keep blankets to warm them and medicines to nurse them back to health. When the water runs high and fast, they post watchers further downstream to catch any who slipped past the lookouts.

Though the villagers save many lives, they cannot save them all. Their efforts leave them weary and worn, with little time to tend to their fields.

“We must try something new,” says the farmer. She climbs to the cliffs above the waterfall and, for some distance upstream, builds a fence along the water’s edge.

From that day forward, no more swimmers are swept over the falls.

The moral of the story, and our guiding principle in public health, is that it is better to save lives upstream than to chase bodies downstream.

I wake in a dead sweat.

Two years into my department’s COVID-19 response. Two years standing waist-deep in rushing water, weaving nets and counting the dead.

I tell my husband for the third morning in a row that I can’t do it any more. I tell him — this, for the first time — that I am going to quit the public health job I fought for and believed in and, once upon a time, loved.

The pandemic beat me.

Time to move on.

He talks me off the ledge, but I promise myself that if things don’t get better, I will leave the department I thought would be my home for the rest of my career.

I’m scheduled today to give a presentation to a small group of first-year medical students. An hour before, my mom tells me to watch what I say. “Don’t go off on your doom-and-gloom talk,” she warns.

It’s fine. I’ll do it off the cuff.

“That’s what I’m worried about,” she says.

I put on my tweed blazer and log on. Twenty faces look back at me. The students smile and wave.

No teacher.

Am I going to run this session alone?

“What are we talking about today?”

Your life as a public health physician.

“And long is – how much time do I have?”

Ninety minutes.

“Um. Do you have questions for me?”

No.

According to my business card, I am the Medical Director of Public Health Preparedness. “Well,” I say, “I am prepared for this –” but I’m not, obviously — “and now it is the time to talk about my career.”

I tell them that my department started the pandemic with a skeleton crew. We’ve operated for years in a hiring freeze, which means that any time we lose someone, their job responsibilities get distributed to one of us who stayed behind.

I tell them when the pandemic hit we worked seven days a week for the first year. Six days a week the second year. And we’re hemorrhaging employees to better-funded health departments, to retirement pensions, to the private sector, to death.

The students are staring at me.

Oh God, I thought. This is exactly what Mom told me not to do.

But I can’t stop.

So I tell them about in the early days of the pandemic when we killed ourselves trying to build the fences upstream — distancing, masking, quarantining — and were stymied at every turn.

I tell them about the downstream work I’ve been doing now that the fences at the top of the cliff got scrapped. I tell them how it brutalizes the public health soul to spend the whole pandemic casting nets to catch broken bodies that have already been swept over the waterfall.

I tell them how, at first, the members of our emergency operations center took turns waiting for the bathroom to cry. How it got easier when we went remote because you could crawl under the covers between calls.

I tell them this is what happens when you blow through a career’s worth of passion in a single year. I thought it couldn’t happen to me but it did.

After, like, 89 minutes, I stop for questions.

One student raises his hand and thanks me for coming. He announces he never, ever wants to join public health.

It breaks my heart, but I try to laugh it off.

I tell him I feel that way too sometimes. This job gets you hooked on the possibility, however remote, that you can help make things better in a big way. I reminisce about our mass vaccine sites, which I describe as “an eighth wonder of the world.” I tell them about the surveillance systems we designed and built from scratch. About knitting our patchworked hospital systems together so they function as one.

And I end by telling the students that even if none of them go into public health, they can still help us work toward large-scale change. Every jurisdiction – state, county, tribal – relies on brilliant, community-driven physicians for ideas and expertise on the next public health threat.

So that’s it.

Afterwards I call my supervisor and tell her I shouldn’t be talking to medical students any more. “Maybe I should just quit,” I say, pretending it’s a joke. She gives me a sidelong look, not laughing.

And then there’s something in my inbox from one of the medical students. He thanks me for my talk. Says it reminded him of why he’s in medical school in the first place: to tackle huge problems, broker meaningful partnerships, help the vulnerable. He says after my talk he’s going to go into public health.

Well, I broke even. Lost one, got one.

A couple weeks later, my supervisor tells me she’s putting in her notice. She got an offer from the private sector that promised her resources for upstream work.

What can I say?

I want to tell her about the bottomless love I feel for her and everyone on our team, the ones who have been in it together from the beginning – the ones who have blown through their breaking points time after time but somehow still keep the faith.

Instead I tell her I understand. That the fight won’t be the same without her. 

And then, like true believers, we start talking about plans for new fences to pitch upstream.

Lisa Villarroel, MD MPH, is the Medical Director of the Division of Public Health Preparedness at the Arizona Department of Health Services. The views expressed are her own and do not necessarily represent the views of the Department. Her brother, Matthew Jager, is a public health writer.

References

1. de Beaumont. Rising stress and burnout in public health: Results of a national survey of the public health workforce stress and burnout. March 2022 (https://debeaumont.org/wp-content/uploads/dlm_uploads/2022/03/Stress-and-Burnout-Brief_final.pdf)

The 91-year-old man who is my father is slowly going insane. His conversation is rambling, his ideas are fractured, he is jumping from one subject to another, he is telling me a story he already told me two minutes earlier.

The 91-year-old man who is my father has now been locked down (or do I mean locked up?) for nearly a year. The walls of his two-bedroom flat have become his cell. There is a world outside those walls, but he is afraid to step beyond them – afraid because that world could kill him. He is choosing a prison sentence over a potential death sentence. What a choice.

We had less than 24 hours’ notice that the assisted accommodation where my father has his flat was to lock down and the restaurant to shut. At the local supermarket, I stared in dismay at empty shelves where bread, tissues and toilet roll had sat. But I gratefully collected seven mismatched ready-meals. At the till, the teenage assistant said ready-meals were limited to two-per-shopper. I explained and I begged and the middle-aged woman on the next till leaned over and said, “that’s fine, special circumstances.”

The younger man who was my father lived life to the full. He managed a company, he brought up a family, he had friends, hobbies, a season ticket to Wolverhampton Wanderers, he loved to play cards, he collected stamps, he listened to music, he read books and newspapers.

Today, his stamp albums sit in drawers and his books are in boxes because he can’t concentrate, his music is silent because he can’t work the CD player, his friends can’t visit because they’re also locked down, he is banned from football stadiums and his family is banned from visiting him.

Day after day, the 91-year-old man who is my father looks at the television. He watches quiz contests, he watches sport, he watches antiques shows, he watches the news.

He asks again and again, “How many have died today? I saw it on the news, but I can’t remember. The numbers keep going up.”

It’s all about numbers, 1,000; 10,000; 100,000, like the winnings of one of his quiz games or the football scores. The numbers keep climbing the more we keep guessing. But this isn’t a numbers game – this is a people game. Every one in that 1,000, 10,000, 100,000 is (was?) a human being like the 91-year-old man who is my father. A human being with a name, a face, a personality, a family, friends, hobbies. Did they leave behind a stamp collection, boxes of paperbacks, their favorite CDs, loved ones they hadn’t seen for months?

Television brings faces, people, color and life into the flat of the 91-year-old man who is my father. People talk to him, they share their stories, they play their games with him, they kick their footballs into his lounge. News presenters become his confessors, quiz show hosts his experts, football managers his wisdom. Who could be alone with hundreds of faces on the small screen?

My father is allowed outside so we celebrate his 91^st birthday in the car park. It’s a warm afternoon in May and we sit in two deckchairs, with diet cola and chocolate cake passed over a two-metre space between us. He’s given up wearing a hearing aid and e had the traffic noise means he can’t hear what I say. He has no stories for me to listen to, so we become silent. He soon tires and wants to go back inside, to the safety of his four walls. I wrap up a piece of chocolate cake “for later, or tomorrow” and pack the deckchairs back into the boot.

We have a couple of outings for his hospital appointments. I make him sit in the back of the car “two metres apart, Dad,” and keep the window open, anything to minimize the risk. At the hospital, the floodgates open and he talks to the nurses and doctors in a torrent of words where facts and symptoms become confused with memories, stories and complaints. Still he talks and the kindly staff don’t try to dam the flow, they just allow it to wash around them. They have become used to this.

There is a time for hope. In the summer the prohibition is lifted and this 52-year-old daughter enters her father’s flat after four months of banishment. I find four months of post, piled up and overflowing on the sofa, four months of dust on the mantelpiece, four months of ice built up in the freezer. There has been four months of isolation, desolation and incapacity. In the grip of a depressive listlessness, the 91-year-old man who is my father hasn’t done things. The post, the dust, the ice have sat, like him, immobile in front of the television.

Like the proverbial new broom, I sweep in – dusting, vacuuming, scrubbing, changing dead batteries and light bulbs, sorting post into piles, throwing away out-of-date letters and out-of-date food. Chatting, sharing, filling the flat with action, movement and interaction. But not touch – with gloves and masks we sit on opposite sides of the room and every time the 91-year-old man who is my father tries to approach I back off, keeping the essential two metres between us.

He has other visitors. My 50-year-old brother (whose birthday celebrations have been put on hold) lives nearby and can now pop in. My 54-year-other brother lives ‘Up North’ and drives down to see our father while he can. For a short time, the 91-year-old man who is our father is cheerful and hopeful.

We think the worst is over.

We are wrong.

Again, we have a day’s notice to lockdown but we are old hands at this now and I spend those last few hours doing all I can to lockdown-proof the flat. I teach the 91-year-old man who is my father the purpose of bleach, I update the list of daily medicines, I ensure every letter is in a colour-coded folder.

And now it’s winter and the confinement and the loneliness are even worse to bear. The nights draw in and darkness takes over. Entire days pass when the 91-year-old man who is my father does not see a soul. There are Covid cases at his flats. Lounges, dining areas, communal spaces – all are closed and residents (inmates, as my father calls them) are asked not to visit the office, to phone if they need anything.

There’s the one-day Great Escape when the 91-year-old man who is my father comes to our house for Christmas. We drive past my brother’s home so my father can wave to his grandchildren and they can shout “Happy Christmas Grandpa.” At ours, my 54-year-old husband cooks beef goulash and serves it with a glass of red wine.

“I will never be able to eat all of that,” says the 91-year-old man who is my father. He eats all of it and then asks for Christmas pudding and mince pies.

We open presents.

“You don’t need to buy me anything, I don’t need anything,” my father says. But when he carefully cuts open the gold wrapping paper to reveal new flannel pyjamas, he admits “except pyjamas, mine have seen better days.”

We do Christmas quizzes and the 91-year-old man who is my father can’t remember a single answer.

“I know this one…” he says time and again.

My brother who lives “Up North” telephones to say Happy Christmas. My father tells him: “This is the best day I’ve had all year.”

He doesn’t want to return to his flat. “It’s like a prison,” he says. “It’s so lonely, I don’t see anyone from morning until night.” But he’s too afraid to stay so when the evening comes, I drive him back. “You know you could come here again at New Year if you want,” I say. “I can come and fetch you.” I watch him, hunched over his frame, as the glass doors close behind him.

He decides against coming for New Year, it’s become too dangerous. The numbers of diagnosed and dying are rising again and the 91-year-old man who is my father is frightened again. We telephone on New Year’s Eve. He’s going to bed early, there’s no reason to stay up.

Last year we went to a party at his flats, my father, my husband and me. Residents ate sandwiches and cake, they drank wine and non-alcoholic drinks, they danced in the dining room as a singer performed requests. I asked for Abba and the man on the table next to me wanted Elvis Presley. We all held hands at midnight and sang Auld Lang Syne.

Every evening I speak on the telephone to the 91-year-old man who is my father, but the calls become shorter as he has less and less to say.

“How was today?”

“The same as yesterday, and the day before, and the day before.”

I try to be encouraging.

“Why don’t you try doing a sudoku, or maybe read a book, call one of your friends – that might cheer you up.”

But the next night he’s done none of those things. And the next night, and the next night, and the next.

The 91-year-old man who is my father is slowly going insane. His conversation rambles, his ideas are fractured, he jumps from one subject to another, he tells me a story and begins to tell it again minutes later. I lose the plot of what he’s saying and give up trying to follow, I allow the words to keep coming but I no longer understand what he means. And neither does he.

Sometimes he tells me he can’t carry on, he tells me he’s had enough, he tells me this is worse than prison. He cries.

I’m afraid he will die still locked down. That these terrible twelve months will have been the last year of his life. That after all he did, all he achieved, all the hopes and dreams for his 91 years of life, it will have ended in loneliness, confusion and fear.

He has The Jab; my brother takes him on a Saturday morning to a local gym. There they join hundreds of other elderly and vulnerable men and women on their first step to freedom. But then we learn of a friend who has died despite having the vaccination and we learn of delays for the second jab and we learn the vaccinations may not be wholly successful against the new variants sweeping the country.

The 91-year-old man who is my father is waiting for his flat to come out of lockdown. He is waiting to see human beings face-to-face. He is waiting for visitors. He is waiting to hug people, to kiss people, to touch people.

Although he is so lonely, the 91-year-old man who is my father is not alone. He is one of thousands of 91-year-old men who are fathers, 73-year-old women who are mothers, 86-year-old men and women who are grandparents isolated and desperate. They are dying to see the people they love yet afraid that seeing them will cause them to die. It’s what we value most, human contact, which has become their gravest danger.

This year can never be re-run, this time never be recaptured, this loss will never be forgotten. Those who survive, whatever the number in their age, will carry the trauma. Of babies not held, of aged relatives dying alone, of loved ones separated. We will all bear the scars of our Covid-19 stories.

It was December 31^st, 2019 when Wuhan Municipal Health Commission, China, reported a cluster of cases of pneumonia seen in Wuhan, Hubei Province. Later, we’ve learned that it was due to a new virus initially found in a seafood bazaar within the city. The virus was a type of coronavirus, a category of respiratory viruses that are known to cause severe acute respiratory syndrome, also known as SARS. (CDC, 2019). Because the original virus that is responsible for the Covid-19 Pandemic was similar to SARS-CoV it was named SARS-CoV-2 (CDC, 2019). To be precise, the virus’s name Covid-19 is an acronym of CO (corona), VI (virus), D (disease), and 19 (last two digits of the year it was found) (CDC, 2019).

Nobody in the United States where I live in, including myself, paid much attention to the news about this new coronavirus incident because we simply thought we did not need to worry about a virus that had appeared so far away from home.

However, in March 2020, the director general of World Health Organization (WHO, 2020) declared Covid-19 as a pandemic after assessment of the rapid spread and severity of the virus across the globe. The organization then warned people with additional precautions of using face mask and social distancing in public in the hopes that it might help curb the spread of the pandemic (Red Cross, 2020). This was just the beginning, and nobody had no idea about unforeseen policies and applications in peoples’ lives all over the world. Then, most governments dictated global physical closures of businesses, sport activities, schools, and pushed all institutions to migrate to online platforms (Adedoyin & Soykan, 2020). Online learning meant the use of the Internet with some other important technologies to develop materials for educational purposes, instructional delivery, and management of programs (Fry, 2001).

In the following sections, I will summarize some of my readings about the effects of COVID-19 on our lives; especially on K-12 education settings.

The new normal: Online education

According to the United Nation’s (UN) August 2020 report, the Covid-19 pandemic has caused the largest disruption of education systems in history, affecting nearly 1.6 billion learners in more than 190 countries (UN, 2020). Impacts of school closures across the world affected all children but in different degrees depending on country/region where they live, their ages, family backgrounds, gender, and such. These children were deprived from daily access to school, the basic support schools provided for them, group activities, team sports, and recreational options such as pools and playgrounds. Unfortunately, the crisis has exacerbated pre-existing educa­tional inequalities by reducing the opportunities for many of the most vulnerable children, youth, and adults.

As a result, the education we have known and provided has changed dramatically and online e-learning, or digital learning, have become the new normal. Teaching was undertaken remotely and on digital platforms (Li, & Lalani, 2020). However, this was far from perfect and it came with some challenges associated with several benefits.

Benefits of online learning

One major silver lining that resulted from the Covid-19 pandemic is a much greater appreciation for physical schooling and the pivotal roles that teachers play in society (Vegas, & Winthrop, 2020). Indeed, as a parent I know firsthand that we struggled to work with our children at home due to school closures which led much more public recognition of the essential caretaking role schools and teachers play in. This is especially true for teachers because younger students struggle to learn from home, especially when their parents are not available to help them. This let us to multiply our gratitude for teachers, their skills, and their invaluable role in student well-being.

The pandemic has also shifted who is involved in our children’s education (Quilter-Pinner, & Ambrose, 2020). Although formal learning primarily involves students and teachers, Covid-19 has given parents some extra and daunting but much more active and important roles in their children’s education. In other words, parents are back to being their kids’ teacher again but this time there was one difference because they have literally become a teacher of their kids.

Research suggests that online teaching has helped students learn better and faster within a short time compared to education that takes place in classrooms (Li, & Lalani, 2020). This is especially true for those who have the right technology and internet. Some research has found that students retain 25-60% more material when learning online compared to only 8-10% in a traditional classroom. This is mostly due to the flexibility that it gives students in learning such as learning at their own pace, going back and re-reading, re-watching, and skipping content. These findings, and others, all indicate that the changes the pandemic brought about might be here to stay.

Cons

The pandemic has affected us all globally not only in terms of our social, economic, and political lives, but also emotionally and psychologically (Miller, 2020). For example, Jansen (2020) pointed out that, “Our biggest mistake would be to treat children as cognitive machines that can simply be switched on again after the trauma of Covid-19.” Health experts indicates that students, parents, and teachers might have been going through a great deal of anxiety and stress (Centers for Disease Control and Prevention, 2020) and transition back to normal might take longer than expected.

In online learning, learners do not have much choice on the platforms they sign up to use if they want to continue their education. User data and digital footprints are the new oil for companies in terms of marketing (Kerres, 2020), because they are being collected, analyzed and, in some cases, sold to third parties (Prinsloo, Slade, & Khalil, 2019).

In other cases, there is a need for better cyber security as user data can potentially be hacked or leaked (Davey, 2020). Safety and security while in virtual calls has also been an issue due to “bombers” that hack in and display rude or inappropriate messages (Manskar, 2020). The use of online proctoring services has also surged during the pandemic to prevent cheating and academic dishonesty, which raises some serious concerns about student privacy and test anxiety students feel as a result of being surveilled.

Digital divide

With the majority of schools closed due to Covid-19, many emergency remote education approaches have depended on access to the Internet in addition to data and devices to provide continuation of teaching and learning. This shift to online has highlighted the stark digital divide between those who have access to electricity, internet infrastructure, data, and devices and those that do not. For example, as of 2019, only 39.6% of Africans have internet access compared to 87.7% of Europeans and 95% of North Americans (Internet World Stats, 2020). Where there is access, there are further inequalities in bandwidth distribution, data prices, and internet speed, which are further shaped by socio-economic factors of gender, age, employment, educational background, neighborhood and household income (Rohs, & Ganz, 2015).

Similarly, there are also differences in access to laptops, smartphones, feature phones, TV and radios between high-, middle-, and low-income countries and populations within countries. Even when these devices are present in households there are often not enough devices to accommodate the simultaneous educational needs of multiple children, as well as parents, who may need them for remote working.

Inequity and social justice

The digital divide between communities has become more explicit and stronger with Covid-19 than ever before. The material, cultural, and geopolitical inequalities are now clearly visible through the lens of Covid-19. During the epidemic, wealthy people have been able to supply food, safely self-isolate, and purchase cleaning products, yet lower income citizens often have not had access to the same necessities. Many workers in service industries have lost their jobs due to lockdowns and have had no source of income to support their families, while others have put their lives at risk every day because they have had to work outside the home.

This has been pretty much similar for education all over the world. While high-income groups have afforded alternative means to support their kids, including but not limited to buying laptops, faster internet services, and paying for private tutoring, many low- and middle-income populations have had to suffice with whatever learning options that were provided for them. Some children did not even have access to food programs that provided them with some level of basic nourishment.

Gender issues

While shutting down schools and forcing people to do homeschooling were key to slow down the spread of Covid-19, this had some negative effects for others especially adolescent girls and women (Mutavati, Zaman, & Olajide, 2020). Many countries have reported increases in domestic and sexual violence (ibid.). For instance, a study directed in times of Ebola showed that school closures led to increased gender-based violence, teenage pregnancies, child marriage, exploitation and other forms of abuse against adolescent girls (Bandiera et al., 2019). The Global Partnership for Education (2020) warns that “the impact of Covid-19 on adolescent girls is likely to surpass that caused by the Ebola epidemic.”

In addition to domestic and sexual violence, Covid-19 has also disproportionately affected women, particularly mothers and those in care-giver roles. Women had already spent a lot more time, compared to men, in handling domestic tasks such as laundry, grocery shopping, cleaning, and taking care of kids (Medina & Lerer, 2020). This imbalance has increased exponentially during the crisis where women’s professional careers have taken the greatest hit (ibid.). What’s more, it was usually mothers who have had to take on the role of teacher in out-of-school learning, women have been asked to take time off their jobs so their husbands could continue working through Covid-19 unimpeded.

Implications

The pandemic has highlighted what skills and competencies are needed to be prepared for a crisis like Covid-19. The need for digital literacy for students, parents and teachers arose as most critical in emergency remote education.

The pandemic has also emphasized the need for educators to become familiar and trained in online pedagogies because of differences in income and constraints between online and in-person learning environments. In low- and middle-income countries, familiarity with how low-tech solutions can be used to support learning is needed for teachers. Thus, as suggested by Koehler and Mishra (2009), the need to redesign the curriculum for technological knowledge in addition to pedagogical and content knowledge was obvious and teacher professional development needs to be expanded to cover this deficiency.

Beyond the skills that are needed to survive a crisis, the pandemic has also shown us many skills that can be carried forward when we return to a new normal. The pandemic has shown the need for a pedagogy of care in addition to integrating digital teaching to their curriculum. Now more than ever before educators are thinking about their learners beyond their roles in the classroom such as the difficulties they may be facing in their personal lives. The pandemic has also reminded us one more time of the need to shift to more student-centered practices and pedagogies that emphasizes the process of learning, student experience, and engagement online.

Another lesson we can learn from this pandemic is that increased parental engagement leads to better learning outcomes. Therefore, governments should better develop programs and provide funding to strengthen the relationship between schools, parents, and their children.

Finally, for those that have been facing injustices prior to Covid-19, the hope is not to return to normal but to use this crisis as an opportunity to fix an education system that was already broken to begin with (Black, 2020).

Shortly, the Covid-19 pandemic and its effects will have lasting outcomes on educators, students, their parents and on whole country, especially on women.

Back to school

Schools returned to 100% in-person education as it was before the Covid-19 in fall 2021. Governments and school districts have taken protective measures in school settings to prevent transmission of the Covid-19 viruses including social distancing, correct use of masks, handwashing, and respiratory protocol.

The outcomes of the education with Covid needs a separate article to discuss. Now, I will briefly touch upon some of the results from most current research on our students’ learning after a year of online education.

Researchers were expecting educational disruptions caused by the pandemic in the form of weakened student learning (Kuhfeld et al., 2020; Hamilton et al., 2020). However, early results of research on student learning yielded mixed results. For example, Renaissance (2021) examined at a large sample of about 3.8 million 1^st through 8^th grade students who had taken their Star assessments in math or reading during the winter of the 2020-2021 school year. They compared students’ scores for those who also took fall 2019 and fall 2020 tests. Overall, they found that students’ scores rose during the first half of the 2020-2021 school year in the amount of what Renaissance (2021) would expect in a non-pandemic school year. In another research, however, Pier et al. (2021) found that California students’ learning during the Covid-19 school year caused them slower academic growth where they lost around 2.6 months in English/Language Arts and 2.5 months in math compared tp regular school years. It seems that we need more and comprehensive research to see how our students’ academic learning are affected by online education.

Qualitative research regarding students’ experiences of online learning revealed that most of the students, regardless of age, want to return to physical schools for their education (Sahin & Matteson, 2021). Younger kids are especially more interested in in-person instruction than older kids do (Sahin & Matteson, 2021). This might stem from the fact that younger students are still children and miss their friends and teachers more for socialization and fun. Similarly, high schoolers are more likely to be in hybrid or online instruction model than younger learners (Henderson et al., 2020). Clearly students missed the physical social interaction and engagement with their friends and teachers instead of being isolated at home a whole year.

References

• Adedoyin, O. B., & Soykan, E. (2020). Covid-19 pandemic and online learning: the challenges and opportunities. Interactive Learning Environments, 1-13. https://doi.org/10.1080/10494820.2020.1813180
• Bozkurt, A. et al., (2020). A global outlook to the interruption of education due to COVID-19 pandemic: Navigating in a time of uncertainty and crisis. Asian Journal of Distance Education 15(1), 1-126.
• Li, C., & Lalani, F. (2020). The COVID-19 pandemic has changed education forever. Retrieved from https://www.weforum.org/agenda/2020/04/coronavirus-education-global-covid19-online-digital-learning/
• Centers for Diesease Control and Prevention (CDC). (2020). Coping with stress. Retrieved from https://www.cdc.gov/coronavirus/2019-ncov/daily-life-coping/managing-stress-anxiety.html
• Devercelli, A. (2020). Supporting the youngest learners and their families in the COVID-19 (Coronavirus) response. World Bank. https://blogs.worldbank.org/education/supporting-youngest-learners-and-their-families-covid-19-coronavirus-response
• Henderson, M. B., Peterson, P. E., & West, M. R. (2020). Pandemic parent survey finds perverse pattern: Students are more likely to be attending school in person where covid is spreading more rapidly. Retrieved from https://www.educationnext.org/pandemic-parent-survey-finds-perverse-pattern-students-more-likely-to-be-attending-school-in-person-where-covid-is-spreading-more-rapidly/
• Sahin, A. & Matteson, S. (2021). Impact of online learning and students’ personal factors on students’ NWEA scores. Submitted for publication.   
• Vegas, E., & Winthrop, R. (2020). Beyond reopening schools: How education can emerge stronger than before COVID-19. Retrieved from https://www.brookings.edu/research/beyond-reopening-schools-how-education-can-emerge-stronger-than-before-covid-19

It was YOU – 2006 Person of the Year according to Time magazine. You – meaning user who contributes to the Internet. Homo Interneticus, in other words. You could even see your face in the glossy mirror surface on a magazine cover. And, here’s the trick – YOU should have been chosen as 2020 Person of the Year, though with a different status quo now – Homo Covidicus. You too can see yourself in all the reflective surfaces: a face covered with a mask. A similar mask underneath a similar face. A faceless human in a bedsheet bag, breathing through it, talking through it, kissing through it. Just like Magritte’s famous paintings.

Talk to me, Homo Covidicus. Tell me your stories to share with our next generation – Homo (hopefully) Post-Covidicus.

– I am tired of this endless medical treatment, dear. Please let me go.

When it all started, nobody was ready to accept this new reality that reminds you more of an anti-utopia. “It’s far away, on another hemisphere of the planet,” some of us thought. “It’s all fake news and provocation,” others calmed themselves down. “Isn’t it a new TV show?” It was not. The global village, as Marshall McLuhan called our digital mobile world, appeared to be small indeed. In this teeny-tiny world, a biological virus can affect all of humanity in two shakes. Like a computer virus – in two clicks.

– Mom, why do all people “muzzle” their faces like doggies?

So, our global village was not ready for such a new challenge. Neither governments with international organizations, nor the medical sphere with world scientists. It was out of the blue and beyond human comprehension. A new protective dress code was not enough. There was a need for a new life code. And for a new way of thinking in particular. Still, as we all perfectly know now, it was not a matter of one day. Of one lost life. (Unless it’s your life, of course, or the life of your loved ones.)

– Have you ever seen so many wild rabbits peacefully walking on the city streets? They aren’t even afraid of the clamorous echoes of ambulance sirens!

A new life code required a new language to explain phenomena that emerged. Like George Orwell’s Newspeak in his 1984 novel. Covid dystopia needed some kind of Covidspeak. A new lexicon appeared instantly and was spread virally from mouth to mouth, easily overcoming masks, protective shields, walls, and quarantine lockdowns, like a bio virus itself. Soon, we all got used to those strange frightening words such as antigen test, PPE, Coronavirus, pandemic, quarantine, self-isolation, SARS-CoV-2, super-spreader, transmission, viral shedding, and many more. Sounds like a transcript to the sequel to Alien, right? Alas. It’s been a scenario based on real, ongoing facts with you us as protagonists.

– Let’s do a covideo party! I’ll have a beer… hm…“Corona Extra”! And you?

To euphemize a severe reality, Homo Covidicus started coining funny neologisms and paraphrases in one’s native languages (some of them available on #ReframeCovid.) For example, “covidiot” (someone who ignores public health advice), “covideo party” (online party via Zoom or Skype), “covexit” (a strategy for exiting lockdown), “zoomby” (Zoom user), “zoombombing” (hijacking a Zoom video call), “WFH” (working from home), “quaranteams” (online teams created during lockdown), etc. Nevertheless, it’s hard to laugh in the face of “covidance.”

– Excuse me sir, your temperature is higher than normal. I’m afraid I can’t let you in.

Communication itself has become different. First and foremost, because of mediation. The word online became so ordinary that we somehow didn’t notice when an authentic word live was replaced into the artificial offline. Foci have been changed. Our conversations have turned into zoomversations. With a comfortable option to turn off your video camera, to mute yourself, to become just a black Malevich square on somebody’s monitor. To stay invisible but still present. Or vice versa – to pretend presence while you are absent. A new way of digital mimicry. Zoomversation as a nonversation. Homo Covidicus, you we are true virtuosos in this craft! Hence, speaking into the monitor has become speaking into the air. In the meantime, speaking into the real air has taken on a new semantic shade and nostalgic taste.

– All of them… they die in complete loneliness in their wards. Relatives are not allowed to take care of them during their last hours. No one holds their hands as they pass away.      

Technology. It has become deeply rooted into our bodies, converting into extensions of our body parts. It was actually predicted by media and communication research half a century ago (M. McLuhan, N. Postman, G. Sartory, etc.). Homo Covidicus has been becoming transformed into such a Techno Centaurus – with technology instead of part of a horse. With a third digital arm or a third organic ear, like in the anthropo-digital experiments of the Australian performer Stelarc. All those smart phones, tablets, monitors, our faithful slaves, our true angels, our digital bodyguards gradually and unnoticeably have been turning us into their slaves. “Oh Ford!” – we can revoice Aldous Huxley’s heroes from Brave New World. Our world, though, has no arguments to declare itself brave any more.

– Hello? Please help me. I’m… ummmm… a victim of domestic abuse. I have no place to escape from this lockdown cage… I need legal assistance.

And so, we have started to appreciate simple things again. Open faces. Scents and touches. Smiles and kisses. Handshakes and hugs. It appeared that communication online loses its main features: affinity, intimacy, closeness, inner light, half-tones, micro-moves. The main optics and micro-proxemics in a true relationship. True signs of love. Thus, Homo Covidicus got tired of the necessity of being connected without true connection. Of being mobile without true motion. Of staying tuned without real engagement. Tired from all that complete simulacrum. Seems like a materialization of the Wachowskis’ The Matrix, isn’t it? The main difference here is – we all realize our condition. And that very insight brings even more drama into our lives.

– My apology ma’am, your Covid test is positive. You can’t cross our border. Our officer will escort you to Gate 57 now, and you will be immediately sent back to your country on a special emergency flight.

Homo Covidicus started to treasure its life space by means of its functionality. We used to recognize things only when we would lose them. The same thing here: we started to treasure home only after it had become our office, our daily working space. Not a place to escape from daily routine, deadlines, colleagues, and duties, not a comfort zone anymore. Not a reliable shelter to hide from this fussy world. Homo Covidicus has missed its own home at home.

– Dear, should we order pizza or go to the nearest McDonalds drive-through?

Our daily routine has been utterly changed. We now need to share space with other family members, organize our working place taking into consideration all things that might happen and do usually happen everywhere at home (especially pop-in-pets, pop-up-kids, anything that can unexpectedly break through your defense.) On the other hand, we are trying not to cross someone else’s work frontier. Therefore, we need to correlate our schedules and Zoom-meetings in advance, arranging beforehand who will guard the relative quietness on each other’s backstage, who will carry all those things on his or her shoulders like Atlas. Until it’s finally your turn for Zoom, and now you can shrug with relief.

– Mom, dad fell asleep and I need to pee… hey! [waiving hello to mom’s colleagues via the unmuted Zoom].

Homo Covidicus became similar to the Ancient Greeks and Romans who gave the instruction Memento Mori! (remember your mortality) and Carpe diem! (seize the day). Now, Homo Covidicus does count every day of his/her life, does remind him/herself of the inevitability of death. One by one losing his/her relatives, friends, colleagues, neighbors, lovers, teachers, favorite movie actors, football players, musicians, and… maybe even themselves. There is not a single Homo Covidicus who would not lose a loved one. Otherwise s/he cannot be a true Homo Covidicus.

– My oxygen saturation has rapidly gone down; I can hardly speak now. I’ve sent you all the passwords to my credit cards and accounts. Don’t cry. Save them. Just in case…

Just in case – is the most common phrase, if not on the tips of our tongues, then in between our lines. During the pandemic, our relatives have become as close to us as they have never been before. Paradoxically, these walls make people closer. More sensitive, kind, caring, thoughtful, religious, and prayerful. More open and empathic. More human. Homo Covidicus has re-identified (Covidentified?) him/herself first and foremost as homo.    

– Tell me how she died, dad, tell me everything in detail. Take pictures at her burial, of her lying in the coffin. Promise me! I need to have it in my memories too, in my mind, as if I were there with you, across the Atlantic.

The New York Times published “An Incalculable Loss” on 24 May 2020. Its first page was fully covered with names and brief descriptions of the “grim milestone” of 100,000 Americans who had died from coronavirus. A new tragic chapter in a new history. A new way of paying tribute to victims. A new way of storytelling: Marion Krueger, 85, Kirkland, Wash. Great-grandmother with an easy laugh. John-Sebastian Laird-Hammond, 59, Washington D.C. Member of a Franciscan monastery. George Freeman Winfield, 72, Shelburne, Vt. Could make anything grow. Kious Kelly, 48, New York City. Nurse in the Covid fight. Wanda Bailey, 63, Crete, Ill. One of nine siblings. Skylar Herbert, 5, Detroit. Michigan’s youngest victim of the coronavirus pandemic (…)

– Can you write there simply: Loved her children? That’s all I want.

My seven-year-old daughter asked me once what number COVID is. I didn’t understand her question until she explained it to me. At school, they had just learned numbers written in Roman numerals. And, if to look at the word COVID from that prospective, you can identify many Roman numerals there. Indeed! “It’s a tricky word,” I answered my daughter. “Because nobody knows its exact number. The number of people it would stop on.” Then she told me that this number-word should be positive no matter what, because it had her favorite V within it. Her favorite V reminded her of a flying bird.

– Can you take care of my Brisko, if… if… you know what I mean. Would you?

Now I, too, see a flying bird in this frightening number-word. I see how much we have all learned from this “lesson.” How devotedly we can fight for those whom we love and for those whom we see for the first time in our lives. How cohesively we can support each other by singing all together from our condo balconies or buying and leaving groceries near our neighbor’s doors. How inventive we have been to unlock this lockdown with omni-purpose keys of love, faith, and humanity.

“Sometimes / the iron in a lock / must be thinking / why was I moulded / into something as such! / A life that came / with boldness /got swept into / isolation — by the tongue / of a melancholic rust / hanging like a slave / to the will of the key / and fingers.” [“Locked” by Sonnet Mondal].

So, who are you – Homo Covidicus? Who are we? Bones of Bones, flesh of Flesh, homo of Homo? “Moulded into something as such.” What is your mission on this Earth? What is your fate? What is your covidentification? For how long will your shadow be shrouding your light ahead? What is your swan song, Homo Covidicus? What is your main story among all of them? I cannot choose – all of them reveal your our soul.

– Can you smell the coffee? Are you sure? Thank God.

A pandemic (from Greek, pan, “all” and demos, “people”) is an epidemic of an infectious disease that has spread across a large region, for instance multiple continents or worldwide, affecting a substantial number of people. A pandemic is an epidemic occurring on a scale that crosses international boundaries, usually affecting people on a worldwide scale. A disease or condition is not a pandemic merely because it is widespread or kills many people; it must also be infectious. For instance, cancer or other chronic diseases such as diabetes or hypertension are responsible for many deaths, but they are not considered a pandemic because the disease is neither infectious nor contagious.

How about the solutions to the pandemic? While protective measures at the individual level are crucial, real solutions come with collective action. Pandemics affect “all people,” so should the solutions be. “Every sheep is hung by its own leg,” says the Turks, meaning that everyone pays for their own mistakes, not for the mistakes of others. In the case of pandemics, mistakes are paid for by all. Nevertheless, when the threat is big and resources are limited, individuals, as well as nations, may choose to act on their own instead of globally.

There is a tale which gives many lessons to us based upon this proverb. Bahlul Dana was a well-known judge and scholar who lived at the time of the mighty Caliph Harun al-Rashid. Bahlul advised people to avoid doing wrong things and invited everyone to be kind and wise. Some people did not like his warnings and they went to Harun al-Rashid. They complained about Behlul Dana and said that “My sultan, tell him to leave us alone and not to warn about everything. Each sheep is hung by its own leg.” Upon these complaints, Harun al-Rashid summoned him to his court and warned him not to disturb people with his warnings. Bahlul Dana left the palace without saying anything. He slaughtered a few sheep and hung them from their legs on a corner of the street and told people not to touch them. As days passed, the hanging carcasses started smelling very bad. When the smell became unbearable, the same people went to Harun al-Rashid again. “We cannot stop the smell of the sheep Bahlul hung. It bothers us very much. Tell him to dispose of them!”

Harun al-Rashid wondered why Bahlul did such a thing. “Bahlul, why did you do such a strange thing? He answered: “I did not do anything. I just hung each sheep by its own leg. But it seems that even if each sheep is hung by its own leg, it still disturbs the whole environment and harms everyone. A villain does not hurt only himself; he harms everyone.”

The story gives an important lesson: Sometimes the consequences of our ignorance and selfish behaviors may harm other people first, and we may choose to ignore them; however, as selfish as it is, we rarely can do away with selfish behaviors, not least when the consequences are global as in a pandemic. When we look at the pandemics throughout the history, we can see the same perspective. During human history, there have been a number of pandemics which have affected millions of people and which probably could have been curbed if people could have acted collectively.

Pandemics in history

Antonine Plague (165 AD): The Antonine Plague (Plague of Galen) was an ancient pandemic that affected Asia Minor, Egypt, Greece, and Italy, and is thought to have been either Smallpox or Measles. This unknown disease, which was brought to Rome by soldiers returning from Mesopotamia around 165 AD, was the cause of high death toll: 5 million people dead and the Roman army was literally decimated.

Justinian Plague (541-542): The Plague of Justinian was an outbreak of the bubonic plague that affected the Byzantine Empire and Mediterranean port cities. It was carried over the Mediterranean Sea from Egypt. The plague decimated Constantinople and spread like wildfire across Europe, Asia, North Africa and Arabia, killing an estimated 25 to 100 million people, perhaps half of the world’s population. It was spread was by infected fleas and perhaps body lice. Its mortality rate was around 10% with treatment, up to 90% without.

The Black Death (1346-1353): Another outbreak of Plague was seen in Europe, Africa, and Asia, with an estimated death toll between 75 and 200 million people between 1346-1353. In the 14th century the world’s population was estimated to be 443 million. That means the Black Death killed between 17-45% of the entire global population. This plague is estimated to have resulted from the increased rat populations and fleas.

Ports were major urban centers at the time and they were the perfect breeding ground for these rats and fleas. To stop the spreading of the disease in the Venetian-controlled port city of Ragusa, they decided to keep newly arrived sailors in isolation until they could prove that they weren’t sick.

At first, sailors were held on their ships for 30 days, which became known in Venetian law as a trentino. The Venetians increased the forced isolation to 40 days or a quarantino, which is the origin of the word “quarantine” after which its practice started in the Western world.

Third Cholera Pandemic (1852–1860): There have been seven cholera pandemics in history and the third cholera pandemic has been considered the deadliest one. It lasted from 1852 to 1860 and it originated from India, spreading from the Ganges River Delta to Asia, Europe, North America and Africa. Around one million people died during this pandemic.

Flu Pandemic (1889-1890): The “Asiatic Flu” or “Russian Flu” was thought to be an outbreak of the Influenza A virus subtype H2N2 or Influenza A virus subtype H3N8, which are subtypes of influenza A viruses. These viruses are divided into subtypes on the basis of two proteins; hemagglutinin (HA) and neuraminidase (NA), which are present on the surface of the virus. There are 18 known HA subtypes and 11 known NA subtypes. Many different combinations of HA and NA proteins are possible and different subtypes of influenza viruses caused many pandemics during history.

The first cases of this pandemic were observed in 1889 in three separate and distant locations: Bukhara in Central Asia (Turkestan), Athabasca in northwestern Canada, and Greenland. Rapid population growth of the 19th century in urban areas helped the spread of the flu, resulting a death toll of about one million people.

Sixth Cholera Pandemic (1910-1911): It originated in India and killed over 800,000 people. It had spread to the Middle East, North Africa, Eastern Europe and Russia. It was the last American outbreak of cholera between 1910–1911. American health authorities quickly took precautions and isolated the infected. By the end of the pandemic, only 11 deaths occurred in the US, which showed the importance of precautions and preparedness.

Spanish Flu (1918): Between the spring of 1918 and the summer of 1920, a deadly outbreak of influenza tore across the globe, infecting over a third of the world’s population (500 million) and ending the lives of 30-50 million people. The mortality rate was estimated at 10% to 20%, with up to 25 million deaths in the first 25 weeks alone. It was caused by the H1N1 influenza A virus and transmitted by airborne transmission from coughing, sneezing, and breathing. Although previous flu pandemics killed juveniles, the elderly or already weakened patients, Spanish flu affected completely healthy young adults. Modern advancements in transportation and troop movements during World War One helped its spread. The true origin of the virus could be France, England, China, and the United States and it is estimated that the virus originated in birds, and either jumped to humans directly or used pigs as an intermediary before jumping to humans.

Asian Flu (1956-1958): It originated in China in 1956 and lasted until 1958. In these two years, the Asian Flu traveled from the Chinese province of Guizhou to Singapore, Hong Kong, and the United States. It was a pandemic of Influenza A of the H2N2 subtype and World Health Organization believe it caused approximately 2 million deaths, around seventy thousand in United States alone.

Hong Kong Flu (1968): The flu pandemic in 1968 was caused by the H3N2 strain of the Influenza. The first case was reported on July 13th, 1968 in Hong Kong, and it took only 17 days before outbreaks of the virus were reported in Singapore and Vietnam. Only after three months it was seen in the Philippines, India, Australia, Europe, and the United States. Although it had a low mortality rate (0.5%), it still resulted in the deaths of more than a million people, including 500,000 residents of Hong Kong, approximately 15% of its population at the time.

Recent pandemics

Swine flu (2009-2010): It was an infection caused by one of several types of swine influenza viruses. This virus is any strain of the influenza family of viruses that is endemic in pigs. Transmission of the virus from pigs to humans is not common and does not always lead to human flu, often resulting only in the production of antibodies in the blood. If transmission does cause human flu, it is called zoonotic swine flu. People with regular exposure to pigs are at increased risk of getting infected by swine flu.

It is estimated that in the 2009 flu pandemic, there were 18,449 confirmed fatalities from swine flu. However, in a 2012 study, the Center for Disease Control (CDC) estimated more than 284,000 possible fatalities worldwide, with a range from 150,000 to 575,000 deaths. In August 2010, the World Health Organization declared the swine flu pandemic officially over.

Severe Acute Respiratory Syndrome (SARS): It is a viral respiratory disease caused by a SARS-associated coronavirus. SARS was first reported in Asia in February 2003. The illness spread to more than two dozen countries in North America, South America, Europe, and Asia before it was contained the same year.

SARS is an airborne virus and can spread through small droplets of saliva in a similar way to the cold and influenza. It was the first severe and readily transmissible new disease to emerge in the 21st century and showed a clear capacity to spread along the routes of international air travel. SARS can also be spread indirectly via surfaces that have been touched by someone who is infected with the virus.

Most patients identified with SARS were previously healthy adults aged 25–70 years. A few suspected cases of SARS have been reported among children under 15 years. The case fatality among persons with illness for probable and suspected cases of SARS is around 3% and 770 people died from SARS. No cases of SARS-CoV have been reported worldwide since 2004. As of 2020, SARS is considered eradicated in humans, but considering that the virus also infects animals it is possible that it will re-emerge in the future.

Ebola Virus Disease (EVD): EVD is a rare and deadly disease seen in humans and animals like bats, monkeys, gorillas, and chimpanzees. It is caused by viruses located mainly in sub-Saharan Africa. People can get EVD through direct contact with an infected animal or a sick or dead person infected with Ebola virus.

The disease was first identified in 1976, in two simultaneous outbreaks: one in South Sudan and the other Democratic Republic of the Congo. EVD outbreaks occur intermittently in tropical regions of sub-Saharan Africa. From 1976 to 2012, the World Health Organization reports 24 outbreaks involving 2,387 cases with 1,590 deaths. The largest outbreak to date took place in West Africa from December 2013 to January 2016, with 28,646 cases and 11,323 deaths. It was declared no longer an emergency on 29 March 2016.

Middle East Respiratory Syndrome (MERS): It is an illness caused by a virus (more specifically, a coronavirus) called Middle East Respiratory Syndrome Coronavirus (MERS-CoV). It is a virus transferred to humans from infected dromedary camels (zoonotic virus). It is contactable through direct or indirect contact with infected animals. MERS-CoV has been identified in dromedaries in several countries in the Middle East, Africa, and South Asia. Health officials first reported the disease in Saudi Arabia in September 2012. A total of 27 countries have reported cases since 2012, leading to 858 known deaths due to the infection and related complications. About 3 or 4 out of every 10 patients reported with MERS have died.

Zika: Zika virus is a mosquito-borne flavivirus that was first identified in Uganda in 1947 in monkeys. It was later identified in humans in 1952 in Uganda and Tanzania. From 2007 to 2016, the virus spread eastward, across the Pacific Ocean to the Americas, leading to the 2015–2016 Zika virus epidemic. In 2015, and strongly intensified throughout the start of 2016, with more than 1.5 million cases across more than a dozen countries in the Americas. The World Health Organization warned that Zika had the potential to become an explosive global pandemic if the outbreak was not controlled. Zika is spread mostly by the bite of an infected mosquito. Zika can be passed from a pregnant woman to her fetus, and an infection during pregnancy can cause certain birth defects. There is no vaccine or medicine for Zika yet but there are several clinical trials going on.

Ongoing pandemics

Although we are primarily focused on the COVID-19 pandemic nowadays, there is another major pandemic that has been going on for many years.

HIV/AIDS: HIV originated in Africa and spread to the United States via Haiti between 1966 and 1972. AIDS is currently a pandemic in Africa, with infection rates as high as 25% in southern and eastern Africa. In 2006, the HIV prevalence among pregnant women in South Africa was 29%. Currently there are between 31 and 35 million people living with HIV, the vast majority of those are in Sub-Saharan Africa, where 5% of the population is infected (21 million people).

Since its clinical discovery in 1981, approximately 32 million people died from HIV/AIDS – around 865,000 people on average each year – ranking it as the fourth-leading cause of death. Although extensive research on HIV has been conducted there is unfortunately no vaccine yet.

COVID-19: Coronaviruses have been known to exist for many years, but a new strain of coronavirus was first identified in the city of Wuhan, China, in December 2019. It has caused a cluster of cases of an acute respiratory disease, which is referred to as coronavirus disease 2019 (COVID-19). It was characterized as a pandemic by the World Health Organization on March 11^th, 2020. As of February 26, 2021, more than 113 million people were infected and nearly 2,5 million people lost their lives.

When COVID-19 first started, it spread rapidly worldwide within months between people because no one on earth had any immunity to Covid-19. It was a novel virus that took the entire world by storm. Now after a full year, and after a number of vaccines have been introduced by the end of 2020, many nations still impose measures like social distancing and stay-at-home orders as schools and businesses are mostly closed.

Although several vaccines are in the market and have started to be administered, it is still hard to predict the consequences of this pandemic at the time of writing this article. But we can learn from pandemics in history to determine our best courses. The main goal is to achieve herd immunity, which means that enough people in a community are protected from getting a disease because they have already had the disease or they have been vaccinated. Herd immunity makes it difficult for the virus to spread from person to person, and it even protects those who cannot be vaccinated, like newborns. The percentage of people who need to have protection in order to achieve herd immunity varies from disease to disease, and at this point we still don’t know this percentage for COVID-19 – this means we may have long way to go.

Every shortcoming or failure to comply with measures only brings more harm towards our collective health. We have to keep in mind that we are living in a global world that is akin to a village now. National crisis plans are not enough, and international collaborative plans should be available for the management of any pandemic. Nations need to collaborate by taking precautions jointly, and countries who are under the heavy effects of the pandemic should be supported. A fair distribution of vaccines or other possible treatment options is necessary. We can overcome this type global threats if we can act collectively with all nations.

• WHO Statement Regarding Cluster of Pneumonia Cases in Wuhan, China”. WHO. 31 December 2019. Retrieved 12 March 2020.
• Stawicki, Stanislawp; et al. (2020). “The 2019–2020 novel coronavirus (Severe acute respiratory syndrome coronavirus 2) pandemic: A joint american college of academic international medicine-world academic council of emergency medicine multidisciplinary COVID-19 working group consensus paper”. Journal of Global Infectious Diseases. 12 (2): 47–93. doi:4103/jgid.jgid_86_20
• https://www.worldometers.info/coronavirus/
• https://en.wikipedia.org/wiki/Pandemic
• https://www.visualcapitalist.com/history-of-pandemics-deadliest/

It has been over half a year since Covid-19 swept across the world and forced many countries into quarantine. Hopes of a quick resolution of the disease in many countries have since been, unfortunately, proven to be wrong, and it is evident that the virus is here to stay for a while [1]. The virus is so difficult to deal with considering it can be transferred from person to person even if the carrier does not outwardly display symptoms. Even animals, ranging from mice to tigers, can contract and transmit it to humans [2, 3], and we cannot quarantine or force them to wear facemasks. The virus will eventually hit each person; it is just a matter of time. The virus may additionally arrive in multiple waves, as it is possible to be reinfected [4]. COVID-19 will most likely have a lifespan of a few years, much like other major virus outbreaks of the past such as the swine flu in Hong Kong or Spanish flu. It will probably come and go like a common flu in never ending waves. So, each of us need to be ready until a successful vaccine is developed, and the wisest action for each person to be ready would be to boost our immune systems and practice effective social distancing and sanitation measures, while we deal with this virus for however long it may last.

Vaccines are critical for stunting the development and spread of viruses; however, they can be costly, time-intensive to develop, and not always perfect. It is worth exploring alternative methods to help protect our bodies from these pathological invaders while vaccines are being researched. As it so happens, the best method of prevention to date for HIV infections is not a vaccine, but is instead a tradition that is as old as thousands of years: male circumcision [5]. To give a comparison, the current widely popular and heavily promoted influenza vaccine is considered “50% effective against influenza B/Victoria viruses and 37% effective against influenza A(H1N1)” [6]. On the other hand, according to an article published in the prestigious medical journal, The Lancet, circumcision is up to 88% effective in preventing heterosexual transmission of HIV [7]. Male circumcision does not have any medicinal side effects, and the only risks that are involved are those related to any minor surgery – bleeding and infection.

In the 1980s, when I first heard of HIV, I remember reading articles which claimed, quite arrogantly, that vaccines and cures for the condition would be found within two or three years [8]. Forty years later, and after spending many billions of dollars on research, we are still nowhere near an HIV vaccine. At best, we found treatments which helped keep the HIV virus at bay [9]. To date, only two people have been fully cured with a method far too expensive to be applied to the general public [10]. In the meantime, at least 30 million people have died with more than half a million in the year 2019 alone [11]. While vaccines are critical for helping to eradicate viruses, putting all of our eggs into that basket alone can be a risky public health strategy due to how difficult and time consuming they are to discover, verify, and distribute. It is impossible to know for sure how long it will take to develop a vaccine for the coronavirus. In the meantime, communities should heavily consider following the instructions of their local health officials which often include social distancing, limited size gatherings, and frequent hand washing as these methods are already proven to help reduce the spread of the virus.

Development, and even the rushed development of a vaccine, is always a very tedious and dangerous process. The science behind them is exceptionally complex, and imperfect results can have disastrous consequences upon thousands of people. This is further complicated by the fact that phase 2 and phase 3 trials can have quite diverging results [12]. In the USA, AstraZeneca’s COVID-19 vaccine trials were stopped after trial participants fell ill [13]. Third phase trials, which encompass thousands of people [14], still can give little indication of the long-term side effects to any vaccine. Besides, even though there is human life at risk, the vaccine has already become an instrument for many political and economic disputes and conspiracy theories. Some governments claim they have already developed a vaccine, while others find them unreliable, or try to lure a foreign company to work for themselves [15]. In August of this year Russia rushed registration of an unproven Coronavirus vaccine and named it, in Cold-War-like fashion, the “Sputnik V” [16]. The announcement was made by none other than Vladimir Putin himself. It was offered to the USA, but was rejected due to safety concerns stemming from a belief that the drug was not adequately researched and developed [17]. In the meantime, Russia announced the development of a second vaccine [18]. Surely enough, it was dismissed and downplayed by the West as unproven and unreliable. On the other hand, a vaccine developed by a Chinese company Sinovac proved to be the most successful in its phase 3 trials in Brazil [19]. Sao Paulo Governor João Doria purchased 47 million shots of the vaccine. However, the transaction was stopped, arguably for political reasons, by the Brazilian President Jair Bolsonaro [20]. Bolsonaro’s comments when rejecting the purchase of the Sinovac vaccine on the basis that “the Brazilian people will not be anyone’s guinea pig” are not totally without merit. Recalls of “proven and tested” vaccines have happened in the past [21].

It is important for all people to continue exploring methods to develop their immune systems and prevent the spread of the virus while we wait for a vaccine. In an article I had previously published, I discussed the benefits of fasting, vitamin C, and Wim Hof breathing methods to help protect the body from disease [22]. All of these methods are well known and quite benign with respect to side effects, however they are unable to cure Covid-19 or prevent its spread. Additionally, the Center for Disease Control (CDC) has heavily stressed practices included social distancing and the wearing of non-ventilated face masks. Our hope is that going above and beyond to protect ourselves and our neighbors will give scientists the time that they need.

One way of giving that time to scientists is fasting. Fasting, like circumcision, is a tradition that is thousands of years old. In recent studies, a three-day water fast has been shown to reset the immune system of elderly people to the level of a twenty-year old’s [23]. At this current level of emergency in the world it would be very easy to find thousands of willing volunteers to trial monthly three-day water fasts and/or to take extra doses of vitamin C, not as a cure, but as a shield against COVID-19. This kind of study would not pose much risk and would definitely be very cost-effective. We could dive straight into the third phase of trials, for any side effects of fasting are already well known. And finally, if proven effective, its uptake by the population at large would be basically cost free and readily available across the whole world.

Our world has been enduring a difficult and challenging period for the better half of a year now. Time has given us the ability to learn more about the virus, how it disrupts our bodies, and how it spreads. This knowledge has, in turn, allowed us to research it and develop effective social guidelines for limiting its spread. Still, there is much work to be done. Hysteria and haste are not conducive to producing a vaccine that is thorough, effective, and efficient. It should be the responsibility of every able-bodied citizen to do what they can to learn more about how they can protect themselves from the virus and thus prevent it from spreading even more while we wait for a vaccine.

1. https://www.wuky.org/post/beshear-next-few-weeks-will-be-critical#stream/0
2. https://www.washingtonpost.com/science/2020/09/03/coronavirus-deer-mice-spread/
3. https://www.cdc.gov/coronavirus/2019-ncov/daily-life-coping/animals.html
4. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7326402/
5. https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(99)03421-2/fulltext?_eventId=login
6. https://www.aafp.org/news/health-of-the-public/20200226interimfluve.html
7. Halperin, D. T., & Bailey, R. C. (1999). Male circumcision and HIV infection: 10 years and counting. The Lancet, 354(9192), 1813-5. doi:http://dx.doi.org/10.1016/S0140-6736(99)03421-2
8. https://www.immunology.org/publications/bsi-reports/60-years-immunology-past-present-and-future/the-hunt-for-hiv-vaccine
9. https://www.cdc.gov/hiv/basics/livingwithhiv/treatment.html
10. https://www.medicalnewstoday.com/articles/2nd-person-cured-of-hiv-thanks-to-stem-cell-transplant
11. https://www.unaids.org/en/resources/fact-sheet
12. https://www.fda.gov/media/102332/download
13. https://www.usatoday.com/story/news/health/2020/09/09/covid-vaccine-astrazeneca-trial-hold-what-does-mean/5757590002/
14. cancer.org/treatment/treatments-and-side-effects/clinical-trials/what-you-need-to-know/phases-of-clinical-trials.html
15. 15 https://www.nytimes.com/2020/03/15/world/europe/cornonavirus-vaccine-us-germany.html
16. https://www.theverge.com/2020/8/11/21363135/russia-coronavirus-vaccine-unproven-registration
17. https://www.techtimes.com/articles/251792/20200814/covid-19-us-says-no-to-russias-vaccine-sputnik-v-saying-theyll-never-use-it-on-monkeys-let-alone-people-vietnam-and-philippines-say-otherwise.htm
18. https://abcnews.go.com/Health/wireStory/russia-approves-2nd-virus-vaccine-early-trials-73614460
19. https://fortune.com/2020/10/20/covid-vaccine-china-brazil-testing-ground-safest-most-promising-sinovac/
20. https://apnews.com/article/virus-outbreak-brazil-state-governments-health-sao-paulo-b7b5b620ba54f402dbf803e26fe6b842
21. https://www.cdc.gov/vaccinesafety/concerns/recalls.html
22. https://medium.com/@arasweb/surviving-the-pandemic-370b47120d8d
23. https://news.usc.edu/63669/fasting-triggers-stem-cell-regeneration-of-damaged-old-immune-system/

Cell-based therapy may be used to treat obesity and diabetes

Wang CH et al. CRISPR-engineered human brown-like adipocytes prevent diet-induced obesity and ameliorate metabolic syndrome in mice. Science Translational Medicine, August 2020.

Obesity is the main cause of type 2 diabetes and related chronic diseases that will be the cause of death for more people across the globe this year than Covid-19. Scientists recently have developed a proof of concept for a novel cell-based therapy against obesity. The potential therapy for obesity would transplant HUMBLE (human brown-like) fat cells, or human white fat cells that have been genetically modified to become similar to heat-generating brown fat cells.

Brown fat cells burn energy, instead of storing energy, as white fat cells do. In this process, brown fat can lower excessive levels of glucose and lipids in the blood that are linked to metabolic diseases such as diabetes. However, people who are overweight or obese tend to have less of this beneficial brown fat. The transformed HUMBLE cells are expected to overcome this problem.

The research team first generated HUMBLE cells from white preadipocytes and then used a variant of the CRISPR-Cas9 genome editing system to stimulate the expression of a gene called UCP1, which can transform white preadipocytes into fat brown cells. When these HUMBLE cells were transplanted into mice, they then remarkably functioned as the mice’s own brown fat cells. On a high-fat diet, the mice that received HUMBLE cells showed a much higher sensitivity to insulin and the ability to eliminate glucose from the blood than the mice in the control group. They also gained less weight. These results from animal studies are very encouraging for researchers. The hope is to generate HUMBLE brown cells for individual patients soon. Such a procedure would involve taking a small number of white preadipocytes from a patient, isolating the precursor cells, modifying these cells to stimulate UCP1 expression, and then re-transplanting the resulting HUMBLE cells to the patient. However, one foreseeable challenge is that this individualized approach can be very complicated and costly. An alternative solution could be to use unadapted cells, which would then be encapsulated with biomaterials that protect the cells from being rejected by the patient’s immune system.

The other option would be to apply gene therapy approaches that directly express the UCP1 gene in white fat progenitor cells in the body so that those cells acquire HUMBLE-like properties. Employing cell-based, or gene, therapies to treat obesity or diabetes used to be science fiction. Now scientific advances, such as CRISPR gene-editing technologies, will help us to improve the metabolism, body weight, quality of life and overall health of people with obesity and diabetes.

Even fake smiling can trick the brain to be positive

Ramos FM et al. Your Face and Moves Seem Happier When I Smile. Experimental Psychology, May 2020

Can a smile truly make everything better? Is there a scientific backing to this claim? A new study shows that even if you do not feel like smiling, faking one can have positive impacts. These findings could not be more timely with the world in crisis amid the Covid-19 pandemic, which is causing disturbing spikes in anxiety and depression cases globally. The study examined participants that held a pen between their teeth, forcing their faces to use the same muscles as a smile. The results showed that facial muscular activity not only alters the recognition of facial expressions but also bodily expressions, with both generating more positive emotions. Forcefully practicing smiling stimulates the amygdala, the emotional center of the brain, which releases neurotransmitters to encourage an emotionally positive state. For mental health, this study has interesting implications. If we can trick our brains into perceiving stimuli as “happy,” then we can potentially use this mechanism to help boost our mental health. These findings suggest that there is a strong link between action and perception. Perceptual and motor systems work together when we emotionally process stimuli. A “fake it ’til you make it” approach could be more realistic than people think.

FOMO impacts people of all ages

Barry CT et al. Fear of missing out (FoMO): A generational phenomenon or an individual difference? Journal of Social and Personal Relationships, August 2020.

In the last few years, the phenomenon of FOMO (Fear of Missing Out), has afflicted many of us at one point or another. In the age of social media, we may find ourselves making comparisons to our friends, family, or even celebrities. What others have, or what they are doing that we are not, may make us feel negatively about ourselves. This can lead to anxiety, sadness, jealousy, or anger. A new study showed that FOMO, once thought to be a teenager or young adult problem, can actually have an impact on anyone irrespective of their age.

Scientists conducted a survey of more than 400 people across the United States from ages 14 to 47 and asked a range of questions related to self-perception, life satisfaction, and social media use. Experts were expecting FOMO to be higher among younger groups since teens experience so much social development in such a short space of time, but the results showed a more uniform distribution across all ages. Moreover, they suspected social media to play a large factor in FOMO but quickly found that it was not a good predictor of the condition. For instance, two people with the same social media engagement may be affected quite differently: one might feel bad seeing their friend’s activities while the other might find it upsetting. Instead, social media was found to amplify those anxieties in people that already felt as though they were missing out. Finally, it was neither their age nor social media usage but rather self-perception that shaped to what degree FOMO affected the participants Researchers say that loneliness, low self-esteem, and low self-compassion may substantially contribute to feelings of anxiety. The study concludes that one major solution to FOMO-driven anxiety would be limiting your social media usage or even cutting it off for a time. Additionally, reaching out to professionals to get support to address negative self-perceptions, perhaps by contextualizing “faults” or “flaws” as challenges to overcome.