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social, health, political imagery through the lens of G J Huba PhD © 2012-2021

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Why didn’t we realize that superb medical care by motivated and brilliant health care professionals would not be enough to tame the COVID-10 pandemic? We have the largest, most expensive, state-of-the healthcare system in the world.

But our healthcare delivery system is not designed to seamlessly prevent or counsel or treat such effects from a pandemic as PTSD (post-traumatic stress disorder), anger, anxiety, fear, excessive drinking, drug abuse, domestic (or other) violence, case management, food security, help to obtain income replacement, and guidelines for planning the future.

While our healthcare system can provide state-of-the-art medical care with state-of-the-art equipment and state-of-the-art professional training and state-of-the-art pharmaceutical interventions, it cannot get people to wear face masks during a respiratory pandemic or to rechannel fear into positive actions or put societal concerns above personal concerns at time when collective consensus is needed to improve the health of individuals.

If you want people to wear masks, you need to help them get over the psychological toll of the pandemic so they do not respond in anger.

Many terrified people cannot deal effectively with getting a new job unless you help them deal with the trauma from the pandemic that is “freezing” their inactions.

Our healthcare system has traditionally not included integrated counseling and psychotherapy, support groups, case management, food assistance, payment of medical bills, transportation, child care while ill with COVID or at a doctor appointment or job, homeschooling, and many other needed services.

If we cannot provide such social services we cannot expect people to follow guidance from public health officials about how to control the pandemic. Everyone needs and should have help to recover from the psychological and financial trauma and uncertainty in our lives. Unfortunately, our healthcare system is not designed to provide social services and these huge needs are not being addressed by our government.

We need to bring social and psychological services into the medical continuum of care now being used. And there is no way we can avoid doing so if we want the pandemic to come under control and to regain our lives.

The following mind map shows my thoughts on what the continuum of services is missing. Click the image to expand it.

The World Health Organization is supposed to be collecting donations of money and covid-19 vaccine doses from large-rich countries and distributing them to small-poor countries.

Is the World Health Organization or WHO or ??? doing a good job?

C+ at best.

But they are good at nagging and blaming large-rich countries that are donating medical supplies and vaccine doses and healthcare supplies and food and water and $s.

WHO should be doing a much better job than it has during the past 18 months. They need to stop whining and writing academic papers and get their staff doing the heavy lifting in getting the vaccine doses they are receiving out to where they are needed most.

Click to expand the mind map.

The pattern of the overall service needs of individuals who become (or became) infected with COVID-19 is very complicated. This group probably requires continued medical monitoring for continuing or new symptoms of COVID, psychological counseling, they may need to be in a support group to help them deal with the trauma of treatment or having friends and family die, they may need help in dealing with basic needs (food, shelter-rent, childcare, and many other things). They might also require help getting a job or requesting unemployment or child care or healthcare payments from government and (former) employer services.

What would case management system look like when applied to helping those needing COVID-related help. Take a look at the figure above.

The next tweet deals with setting up an appropriate service system.

Let’s be real. Most of the population of the world is suffering from the psychological consequences of dealing with the huge phenomenon of the covid pandemic. It is conceivable that the pandemic may last for several more years.

See your primary care doctor or a mental health specialist for help with the psychological consequences of living through such a stressing time. Psychotherapy, counseling, peer support groups, and/or psychiatric medications may be able to help you go back to being you.

2020 and 2021 contained huge shocks for everyone on the globe. We are all feeling confused, apprehensive, and out of control. Try to use the available resources in your community.

For emergencies virtually every community has 24/7 mental health and suicide prevention hotlines. Any hospital emergency room can also provide immediate help.

Please use the resources you need.

 

For the last 15 years of my professional career, I coordinated consensus processes to build new local health and social services policies.

It was the best work and most fun I experienced during my career.

I was lucky to work with more than two thousand participants (in aggregate) helping to develop services for drug abuse, mental illness, social isolation, education, child care, medical services, domestic violence, HIV/AIDS, and more.

Here is a diagram of what I believe to be key parts of developing consensus public policy.

Click on the mind map to expand it.


Had various government agencies used a model like mine, they would have been able to get a higher percentage of the population agree to be vaccinated.

During the past covid “pandemic” year (March 2020 through May 2021), have you woken  up every day feeling “lost” or “confused” or “depressed” or “anxious” or ” numb” or like something is “wrong” or “inescapable” or with any of hundreds of more negative feelings?

It is my guess that virtually no one has escaped these feelings during the global fight against covid-19 A lot of the feelings originating from situations occurring during the covid pandemic are visible to everyone. News outlets inform us daily that cases of suicide and violence and most major mental illness and drug abuse and murders are at very high levels compared to historical norms. We can often recognize these major interruptions to “normal life” and hopefully many professional services to combat major stress-induced illnesses and condition can be offered.

We probably — as a global community — have a “fighting chance” of protecting and or preventing the outbreaks of mental illness and stress  breakdowns among many because we recognize these conditions as medical ones that are then referred to qualified physicians or social workers or psychologists to handle.

More insidious and of great longevity are issues like continuous rage or feeling numb and defenseless or apathetic or unable too motivate yourself too walk out the door and deal with issues in the larger real world that you could avoid when hiding inside from covid. Your friends and family might see many of these huge, chronic problems are not rising to a level of concern to be considered a medical condition. Most physicians will also have a lot of difficulty in deciding whether it is appropriate to treat these “reconnection” as medical conditions and with pharmaceuticals they will need to repurpose for conditions are less defined and more chronic than many of the psychiatric-psychological problems they traditionally saw.

Diagnostic categories and conditions are going to have to be significantly revised when Americans start to engage with the old reality or refuse to even try to do so.

What is the United States and all of our sister countries in the global community going to be facing? The mind map below starts to summarize what we are all going to be facing as we restart countries in a year or two when vaccines are provided to all.

Click on the mind map to expand it.

XMIND is a mind map app available for all major notebook computers and all major smartphones. You can use the app with the defaults and get good results after a few hours and very good results after a day. There is a free trial period.

I consider this app to be the #1 choice for beginners and intermediate users. Most users of mind maps will find it does a great job and have no need to move up to the two more advanced apps available for expert users.

I also find that XMIND by default produces mind maps that communicate very well with other mind map users.

You can click on the mind map if you want to expand it.

Let me start off saying that there is no official COVID Pandemic Syndrome in either the psychological or psychiatric literature that I and google are aware of.

There is a paper on “COVID Stress Syndrome” that I found while doing a google search after I was starting to upload this post to the Internet. The closely named paper that can be accessed HERE is a different conception than mine but of equal interest and equal importance as my comments.

The general approach I am taking is that the COVID pandemic has elicited a number of psychological reactions (different in inclusion, importance, and intensity for specific individuals) for most.

In other words, my approach is to point out that exposure to the pandemic over a period of a year or more has resulted in many people experiencing the psychological states, symptoms, and conditions shown in the mind map below. From my observation, many of us have and continue to experience these states probably because of extreme exposure over a long period of time to the conditions of the pandemic. As we know from decades of competent scientific research by tens of thousands of well-trained and smart mental health professionals on grief, anxiety, depression, anger and the other states in my diagram, these problems for most will not go away without some types of psychological intervention for most people. Depending upon the psychological problems an individual is experiencing, proven pharmaceutical-medical and/or behavioral-cognitive interventions are available they will need customized mental health services.

It would be very naive to assume that we need to vaccinate the entire world to finally control the spread of the novel coronavirus without also providing psychological-psychiatric services to those who do and will need them. If such services are not offered at minimal (or no) cost globally, hundreds of millions of people may suffer with depression and anxiety and alcoholism and drug abuse and domestic violence and deeply felt anger for the rest of their lives.

Let’s not forget about the COVID Pandemic Syndrome that is happening to most of us to varying degrees. If we don’t solve the psychological problems caused by the pandemic now, many will not fully recover. Mental health and medical interventions should be available to everyone living through the pandemic or its sequelae if we want the global population to recover and not expose the unborn babies and children of our future to these horrible psychological conditions.

Click on the diagram to expand it.

 

In a follow-up post I am going to provide links to a number of relevant and technically sound studies and speculations on the psychological consequences of the coronavirus.

We need a plan and resources, NOW.

Starting on June 1, US schools should be allocated money from the federal government to provide remedial in-class and online summer classes and counseling services at their school or online. The funds allocated should be for student educational services and not for general school overhead such as building improvement or teachers and resources that are not integrally to these special programs. Services should be provided for 24 months from the time that a school district starts special programs.

Our most important resource — our future generations — should receive full educations and not be penalized because a natural disaster occured during their school years.

Students from communities that have traditionally been underserved either intentionally or inadvertently should have priority to participate in the earliest programs. As possible the same programs should be rolled out to all public school districts.

Click the image to expand it.

 

We are incredibly fortunate to have Tony Fauci in charge of scientific efforts to control and eradicate and inform the public about covid-19.

Clip on the image to increase their size

One of the reasons that the USA has had 568,560 people die from covid-19 is that STOOPID politicians posture in front of the television cameras and say incredibly dumb things and frequently misquote data. Of they pick the “experts” they want to listen to by their politics rather than their expertise.. In a democracy like our, you have to let every idiot elected official say what they want to. BUT YOU DO NOT NEED TO BELIEVE IDIOT POLITICIANS. DO BELIEVE CREDIBLE AND HIGHLY SKILLED HEALTH SCIENTISTS LIKE DR. FAUCI.

For entertainment value and to see what Dr. Fauci and other reputable scientists have to deal with from about half of the US Congress and about 40 percent of the US population, all you need to is watch the news or look on YouTube.

 

 

 

For the first 9 months of the covid pandemic, I used to consult one of the covid information websites about cumulative deaths at least hourly. I looked at about a half dozen of these sites to see how their models of future deaths diverged from one another. I understand how most of the math models work, whether the data used is of “excellent” or “bad” quality, and how to present the results so that they were accessible to most people.

Now I do the statistics exercises every couple of days. The numbers sometimes numb you so that you loose sight of the fact that every person counted is a soul who had a family and friends, worked often for the common good, loved many of the people they knew, had a great laugh in happy times, and in most cases went out of their way to help others out.

We need to honor and remember all of those who died from covid. Most were good people who were quite simply the victims of a virus that our scientists learned to control and our politicians ignored. Probably at least two-thirds of those who died would not have done so if our politicians had done their jobs and protected their constituents in ways public health and medical scientists recommended.

Rest In Peace. May those of us who survived covid always remember to honor those who did not by applying the knowledge we have gained about how to manage a pandemic in the future.

A comprehensive continuum of care is needed to provide services needed for many, if not all, infected by COVID-19 and their families. Not everyone will need all of the services shown in the mind map but many will require a large subset of these in addition to medical care. Case managers help link patients to both the medical and the social care they need to combat Post Traumatic Stress Disorder, a loss of income, stress on their families, child care for families with children, and many other services provided by most counties in the United State or through non-profit integrated care facilities, or charitable groups with many communications. The case manager will also follow up with all of the agencies helping the client (patient) to ensure they all have the same information and are communicating with one another in an integrated way.

Anthony Fauci has offered the American public and healthcare professionals his sage advice about COVID-19 prevention, treatment, and research. It is incredibly sad to see Trump trying to jail Dr. Fauci in a prison of Trump’s fantasies and anti-science views and false public opinions.

Remember,

Let’s

March 18, 2021. I published the blog entry below exactly one year ago (March 18, 2020) as the pandemic was just starting to be acknowledged in the USA. There are days I hate to be correct in my predictions. This is one.

It is very clear that in the United States, some of the money in the large Biden Covid Recovery bill must be spent trying to cut the pandemic-driven and all other domestic violence that has spread without check over the past year. The same psychological conditions that drive domestic violence also drive the racial hate that is out of control in the USA and the escalating hatred between Trumpists and other Americans. Just as the coronavirus is an escalating problem so are pandemics of domestic violence, psychological distress and disease, and hate. If the elected national officials of all political parties can rein in their dogmatism and hatred and promotion of social unrest, that could also help.


Isolating someone in their home with another person is a possible recipe for domestic violence. Keep them there for weeks-months, add in the use of alcohol and/or psychoactive drugs and the likelihood of domestic violence increases. Add in a possible gun and the violence can easily become fatal.

And during the coronavirus pandemic, police intervention will be less available to end an out-of-control episode.

There appears to be no real alternative to sheltering large numbers of the public in place during a viral pandemic. The long and intense frustrations of being sheltered in place do not mix well with alcohol, psychoactive drugs, and guns. During a viral pandemic, you can die from more things than just the virus.

Click on the image to expand it.

May 21. 2020: it has been 47 days since I wrote this post. It is as true now as it was on April 4, 2020.

Every time I watch one of Donald Trump’s coronavirus briefings it makes me want to cry. We have 100s of thousands of superbly trained, highly competent, deeply committed healthcare workers every day who work on saving people who have contracted COVID-19 infections while not having a clean face mask to put on, a clean protective gown, simple hospital supplies like nasal swabs, and a test to diagnose whether someone has contracted the disease.

The national stockpile of relevant equipment is either empty because the Executive Branch of the federal government forgot to purchase needed items or the federal government is hoarding it. Our non-functional national stockpile of medical supplies and equipment is now being managed by the President’s son-in-law, an individual with no healthcare training, and who has engaged in various shady financial dealings in the past 10 years.

The level of incompetence is so high it is unbelievable. The president announces a new voluntary CDC recommendation to wear a face mask and then states that he will not look good while he is sitting at his Resolute Desk meeting with kings, queens, and dictators so he will not wear one. He tells us megarich individuals who own professional sports teams want us to come out to their mega-stadiums and sit shoulder-to-shoulder.

Trump always fails to explain how special our healthcare workforce is and never expresses the truth that he has asked them to work in very hazardous conditions by not purchasing medical protective clothing and shields.

We need to issue presidential orders to make needed protective and treatment equipment and supplies by a specified deadline or go to jail. Make companies who fail to produce needed supplies and equipment ineligible for any emergency funds or rebuilding assistance. The basic logic is that if a company refused to make need equipment and supplies need to save patients and healthcare workers they are ineligible for financial assistance.

The mind map shown provides a status report on where we are today, April 4, 2020.

February 4, 2021

Trump is preparing for his second impeachment trial and still denying Biden is president. Biden is doing an excellent job fixing the huge mistakes Trump’s policies and incompetencies caused.

Help has started. Biden has had to spend the first weeks of his presidency fixing up all of the major problems Trump’s political views and incompetence created for his successor. Within the next two weeks a funding bill for Biden’s new policies and fixes to Trump’s disastrous mistakes will be passed.

Know that the immediate changes President Biden is making to the American response to covid-19 is stronger and much more scientifically correct than the 2020 response of President Trump. You and your surviving fellow citizens have a much better chance to avoid coronavirus and if you contract it, to survive the disease. You are finally hearing the truth from your president (Biden) instead of the lies from his predecessor.

Wear a mask. Socially distance. Don’t touch your face. Wash your hands.

Get vaccinated as soon as you are eligible.

COVID is not a political issue. It is a question of how many die. Do what it takes to save your friends, family, all others, and yourself.

2020 was one heck of a year. I documented my year in terms of themes and have shared them as blog posts with mind maps on this site.

Looking back, I should have also documented parts of the year as a visual diary.

I have started to look through my huge collection of Field Notes Books and my mind maps and my blog post and even tweets I sent out to recreate the year.

You will see the whole story later in this blog.

Here is a mind map of the kind of data I am collating from my personal observations over the course of 2020.

 

The healthcare professionals and those that support them are an incredible team.

They have the hardest jobs to do during the pandemic. Let’s give them the support they deserve. Every one of us must try as hard as possible to not force these over-tired people to have to do even more heroic acts.

Wear a mask.

Socially isolate.

Wash your hands.

Stop acting like a spoiled baby. Stay well, don’t overload our hospitals, protect our All-Star Team. We owe it to them.

Let’s help them win this war.

If other words come to mind that you would like me to try to add to the mind map, please tweet them to me at @DrHubaEvaluator or post them here.

Click on the mind map below to go to a highly related post that discusses the individual positions people in our All-Star team play. The full, additional post will appear in a new window and contains a description of the mind map.

 

January 20, 2021

Trump fled the capitol today.

Help is on the way. Biden came to the capitol and the first thing he did was to hold our first national memorial service for our 400,000 fallen friends, family members, acquaintances, and fellow Americans.

Rest in peace knowing that the immediate changes President Biden is making to the American response to covid-19 is stronger and much more scientifically correct than the 2020 response of President Trump. Your surviving fellow citizens have a much better chance to avoid coronavirus,

:)