. . . because much of the content relates both to Washington, D.C., and "outside the beltway" -- the heartland, specifically Iowa -- and because after going from Iowa to Washington via Texas and California I subsequently returned, From DC 2 Iowa.
Your Risk Isn't Just COVID-19 Symptoms, It's What Comes Later
Do you know the long term harms COVID-19 may do to your brain, lungs, heart, kidneys and the rest of your body?
Over 500,000 persons worldwide have died from the disease -- and one quarter of them used to live in the United States. But there is now increasing evidence that may be only part of the damage the disease can do.
There has been a recent upsurge of young people becoming infected.
Unfortunately, if they are willing to ignore their moral obligation to avoid infecting others -- as apparently many are -- their use of analytical tools such as risk assessment, benefit-cost, and opportunity cost could rationalize their ignoring masks, social distancing and hand washing.
What's the worst that could happen? How serious would that be? How likely is it to happen? They may not become infected. If infected they may have no symptoms. If they have symptoms they may be mild and quickly pass. So the benefit of masking up is relatively small, and the cost of avoiding crowds, the opportunity cost of missing out on social opportunities at parties and beaches, is (in their minds) very high. Their behavior -- if one can overlook their selfish disregard of others -- is marginally understandable.
Videos of hundreds of young folks without masks gathered shoulder to shoulder, ignoring the warnings, makes it seem hopeless. How can their behavior be changed?
What if we were to significantly increase the "cost" side of their equation? And how might we do that? We could "start spreading the news" (to borrow a line from Sinatra's "New York") of the serious after effects of COVID-19 infections -- starting with the human brain and cognitive function (to focus the attention of college students).
In the years to come, it may well be medical professionals who focus on the brain and cognitive function who are seeing and helping many post-COVID patients. The reason is that hypoxia, cardiac dysfunction, blood clots, strokes and similar conditions — all of which have been observed, to one degree or another, in those suffering COVID-19 — can all have long-term effects on brain function and cognition.
For Julie Helms, it started with a handful of patients admitted to her intensive care unit ...and it was not just their breathing difficulties that alarmed her. "[M]any had neurological problems – mainly confusion and delirium,” she says. “this was completely abnormal. It has been very scary, especially because many of the people we treated were very young – many in their 30s and 40s, even an 18-year-old.” [T]he neurological symptoms in their Covid-19 patients, ranging from cognitive difficulties to confusion ... are signs of “encephalopathy” (the general term for damage to the brain) ...
Now, more than 300 studies from around the world have found a prevalence of neurological abnormalities in Covid-19 patients, including mild symptoms like headaches, loss of smell (anosmia) and tingling sensations (arcoparasthesia), up to more severe outcomes such as aphasia (inability to speak), strokes and seizures. This is in addition to recent findings that the virus, which has been largely considered to be a respiratory disease, can also wreak havoc on the kidneys, liver, heart, and just about every organ system in the body.
“In fact, there is a significant percentage of Covid-19 patients whose only symptom is confusion” – they don't have a cough or fatigue, says Robert Stevens, associate professor of anaesthesiology and critical care medicine at Johns Hopkins Medicine in Baltimore, Maryland. “We are facing a secondary pandemic of neurological disease,” says Stevens. “We’ve now learned that the disease affects many different organ systems: patients can die not only from lung failure, but also neurological manifestations. If you had asked me a month ago if there was any published evidence that Sars-CoV-2 could cross the blood-brain barrier, I would have said no – but there are now many reports showing that it absolutely can,” says Stevens.
In fact, some scientists now suspect that the virus causes respiratory failure and death not through damage to the lungs but through damage to the brainstem, the command centre that ensures we continue to breathe even when unconscious. ... The brain is normally shielded from infectious diseases by what is known as the “blood-brain barrier” – a lining of specialised cells inside the capillaries running through the brain and spinal cord. These block microbes and other toxic agents from infecting the brain. If Sars-CoV-2 can cross this barrier, it suggests that not only can the virus get into the core of the central nervous system, but also that it may remain there, with the potential to return years down the line.
Though rare, this Lazarus-like behaviour is not unknown among viruses: the chickenpox virus Herpes zoster, for example, commonly infects the nerve cells in the spine, later reappearing in adulthood as shingles – roughly 30% of people who experienced chickenpox in childhood will develop shingles at some point in their lives. ... David Nutt, professor of neuropsychopharmacology at Imperial College London, says he himself treated many patients in the 1970s and 1980s who had suffered from severe clinical depression ever since the 1957 influenza pandemic in the UK. “Their depression was enduring and it was solid – it was as if their emotional circuits had all been switched off,” he says, warning that we could see the very same thing happen again, but on a much larger scale. “People who are discharged from the ICU with Covid-19 need to be monitored systematically long-term for any evidence of neurological damage – and then given interventionist treatments if necessary.”
And in Pittsburgh, through the Global Consortium Study of Neurological Dysfunction in Covid-19, Sherry Chou, a neurologist at the University of Pittsburgh, has coordinated scientists from 17 countries to collectively monitor the neurological symptoms of the pandemic, including through brain scans. ... Although the virus’s impact on the lungs is the most immediate and terrifying threat, the lasting impact on the nervous system may be far larger and far more devastating, says Chou. "Recovery from neurological injuries is often incomplete and can take much longer compared to other organ systems (for example, lung), and therefore result in much greater overall disability, and possibly more death,” she says.
The final sentence reads, "Patients experiencing lung failure can be put on a respirator, and kidneys can be rescued with a dialysis machine – and, with some luck, both organs will bounce back. But there is no dialysis machine for the brain."
There may be a subsequent blog post regarding the other medical conditions that can be triggered by COVID-19 infections. Until then, here's a Fortune magazine article that groups the potential consequences by areas of the body: Blood, Brain, Eyes, Gastrointestinal tract, Hands, Heart, Limbs, Liver, Lungs, Kidneys, Nose and tongue, Skin, and Toes. "What are the potential long-term effects of having COVID-19?" Associated Press, Fortune Magazine, June 16, 2020
Olivia White, an adventurous 21-year-old woman from Tasmania who came to visit America, also took a look at Iowa. But she liked what and who she saw, decided to stay, and wrote about it recently in the local press this way:
I have now adventured and worked in more than 15 states . . .. I have seen the sites of Manhattan, D.C., L.A. and San Francisco. My travels have taken me to the Big Sur Mountains of California . . .. [T]he Kenai Peninsula of Alaska . . .. I volunteered for a ministry in the Bible Belt of America . . .. I have explored Amish country and enjoyed dreamlike summer buggy rides with the Amish people. I worked on a horse ranch . . . on the Meramec River in Missouri . . .. Finally, I found Iowa — what I would describe as the epitome of “fair dinkum” (Australian slang for “real” and “genuine”). . . . The way in which I found my way to Iowa truly encapsulates my feelings toward Iowa and its wonderful people. . . . I came across a couple outside their cabin [at the Missouri horse ranch]. . .. We chatted for half an hour or so comparing and contrasting Tasmania and Iowa and just enjoying some friendly banter. When the couple departed the next day, a note was left behind with information and an invitation for me to come visit them in Iowa. . . . Upon arriving in Cedar Rapids, I only expected to visit for several weeks. I did not want to take advantage of such a hospitable invitation. However, my new family encouraged me to stay longer and I realized that I was by no means ready to depart my new home.
Olivia White, who is among other things an accomplished swimmer, is now a Cedar Rapids Kennedy High School's swimming coach.
Of course, I am pleased that Ms. White, having taken a pretty good look at what America has to offer, chose Iowa for her home.
But I wouldn't continue to write on the subject if she was just one more of the three million souls who have also looked at Iowa, liked what they saw, and chosen to live (or continue to live, or to return) here.
No number of accomplished and enthusiastic Iowans will ever change the minds of those who are blind to what the three million can see so clearly.
How to explain this difference in perception?
In my response to Stephen Bloom's mean-spirited screed attacking Iowa I noted, "[M]ost everything we say, or write is little more than an indication of what's going on inside that electro-chemical sensory processing soup we call our brain. . . . When we say the view of [a] . . . mountain range, river valley, ocean [or] desert [is] 'beautiful,' that 'beauty' is of our own making. It lies inside of us, not in the molecules that make up the physical stuff we're looking at." Nicholas Johnson, "Taking the Bloom From My Rose; Another Perspective on Stephen Bloom's Iowa," December 16, 2011.
That's why I'm bringing Olivia White to my attention, and yours. It's not that she just appreciates Iowa and Iowans. It is that this young lady has learned at her age that there is something to appreciate everywhere -- Manhattan, D.C., L.A. and San Francisco, Big Sur, the Kenai Peninsula, the Bible Belt, Amish country, and Missouri horse ranches.
Whatever it is that is going on in her own personal brew, that "electro-chemical sensory processing soup" that is her brain, is obviously a delightful place to be. That's why she can see what Stephen Bloom cannot. That's why everyplace is, for her, a delightful place to be, and why, of all those places, she's chosen our place to live.
And though I've never met her, I rather imagine it's also why the places she chooses to be become, as well, delightful places for those who share those places with her.
Now listen to what Louis Armstrong sees when he looks at the world:
I see trees of green, red roses too I see them bloom, for me and you And I think to myself What a wonderful world
I see skies of blue, and clouds of white The bright blessed day, dark sacred night And I think to myself What a wonderful world
The colors of the rainbow, so pretty in the sky Are also on the faces, of people going by I see friends shaking hands, sayin', "How do you do?" They're really sayin', "I love you"
I hear babies cryin', I watch them grow They'll learn much more, than I'll ever know And I think to myself What a wonderful world
Yes, I think to myself What a wonderful world Oh yeah
And, finally, the full text of Ms. White's article:
As a young girl growing up on the island of Tasmania, just off the coast of South East Australia, I would often dream of the day that I could take flight on my own and travel across the United States of America.
Doing what, I wasn’t entirely sure, but that was the whole point. I would take time to broaden my horizons, to excite my senses and to experience life as I didn’t yet know it.
Now, as I sit here in Cedar Rapids writing an article for the local newspaper, I realize I am indeed living my dream.
I grew up in a family of six children with an American father and an Australian mother. It was this cross-cultural influence that first sparked my desire to know my father’s country as well as my mother’s.
At 21 years old, I have now adventured and worked in more than 15 states across America. I guess one could say I have come to quite enjoy the itinerant lifestyle. I have seen the sites of Manhattan, D.C., L.A. and San Francisco.
My travels have taken me to the Big Sur Mountains of California where I worked on a goat farm, hand-milking goats and making fresh cheeses. On the farm, I lived without electricity in a Mongolian tent and bathed on a cliff face overlooking the Pacific Ocean. It was a rugged yet spectacular lifestyle.
I spent a summer on the Kenai Peninsula of Alaska deep sea fishing, bear spotting and exploring the wild Alaskan coast. I volunteered for a ministry in the Bible Belt of America where I became accustomed to chiggers, fried chicken and okra, and of course that wonderful southern drawl.
I have explored Amish country and enjoyed dreamlike summer buggy rides with the Amish people. I worked on a horse ranch located on the Meramec River in Missouri, where I rode horses and cleaned stables, foraged for morel mushrooms and escaped tornadoes.
Finally, I found Iowa — what I would describe as the epitome of “fair dinkum” (Australian slang for “real” and “genuine”).
I can’t say how many times I have been asked, “But why did you choose to come to Cedar Rapids, Iowa!?” I get the feeling the locals perceive me as a little crazy for willingly choosing such a location, not to mention enjoying it so much. I just smile and patiently deliver my (very familiar) spiel, as if it is the first time anyone has ever asked.
The way in which I found my way to Iowa truly encapsulates my feelings toward Iowa and its wonderful people.
While I was in Missouri working on the horse ranch in May of 2011, I happened to meet a couple who were vacationing on the ranch for several days. Late one afternoon, after finishing work for the day, I decided to try my luck foraging in the woods for the much-prized morel mushrooms. While walking down the gravel lane I came across a couple outside their cabin attempting to wrap up some grapevines. We chatted for half an hour or so comparing and contrasting Tasmania and Iowa and just enjoying some friendly banter.
When the couple departed the next day, a note was left behind with information and an invitation for me to come visit them in Iowa. Our chance meeting on the horse ranch was not only the beginning of my sojourn in Iowa, but the first of many connections that have all seamlessly fallen into place since walking down that gravel lane.
Having always been drawn to the folklore of the prairie and the old Midwest, I was excited by the offer to go to Iowa. My dad’s stories of his youth and spending his early years in Nebraska had always stirred my curiosity. Upon arriving in Cedar Rapids, I only expected to visit for several weeks. I did not want to take advantage of such a hospitable invitation. However, my new family encouraged me to stay longer and I realized that I was by no means ready to depart my new home.
I determined that if my visit was going to turn into something more permanent, I had better make myself useful and start working. I decided to rely on what I know best, swimming.
Swimming has always played a significant role in my life. My father is a swimming coach and my mother a swimming instructor. They built a 25-meter indoor swimming pool at our home in Tasmania, where they have owned and operated their own aquatic business for 15 years.
Naturally, all six of the children became competitive swimmers, succeeding at a state level as well as competing in national competitions. My own competitive swimming background and my parents’ expertise prepared me well and by age 14 I began teaching classes solo for my parent’s successful business. By age 18 I was a fully qualified swimming instructor teaching children and adults of all ages, as well as coaching competitive swimmers.
When I arrived in Cedar Rapids in the spring of 2011 the timing was perfect to become involved with a local swim team. Due to a friend’s recommendation, I inquired about a coaching job at the nearby Elmcrest Country Club. I met with the pool supervisor, dropped off my resume, and was offered a job coaching with their swim team; another seamless connection falling into place.
Elmcrest staff and club members were both friendly and welcoming and the flexibility of my role allowed me to work with the kids according to their needs, developing their strokes and focusing on some of the more technical aspects of swimming.
I think for the kids, it was a bit of a novelty to have an “Aussie swim coach”. There were a lot of questions: “Do I keep kangaroos as pets?” “Why do I talk funny?” and “Do we drive cars in Australia?” Our conversations would always bring about some good laughs and the kids would leave knowing something new about the “land down under.”
As a result of my involvement with the swim team at Elmcrest, I was offered an assistant coaching position at Kennedy High School, the third seamless happenstance. I was honored to coach alongside John Ross, Rick Forrester, Holly Broadwater and Leslie Nelson. I sought my Iowa coaching certification at Kirkwood Community College, which allowed me to coach for schools in Iowa. For me, this was yet another excellent opportunity not only to contribute and be a part of local swim team, but also a chance to gain more experience coaching at a competitive level alongside veteran coaches such as Ross and Forrester.
Both swimmers and coaches worked hard throughout the season and reaped the benefits. Kennedy placed first at the sophomore Mississippi Valley Conference meet while also winning our division at the varsity level.
Kennedy hosted a very exciting regional meet with our team missing first place by just one point. We took a tenacious team of 10 swimmers to the state meet in Marshalltown and finished a very respectable 12th place, up from 16th place in 2010. Our freshman class was extremely strong throughout the season contributing to our success while holding promise of a very bright future for Kennedy swimming.
Assuming I survive the harsh winter here in Iowa — Tasmania’s lowest temperature dives to a shivering 32 degrees — I plan to return to Elmcrest and Kennedy for another swimming season in 2012. I am both excited and motivated to develop as a coach and see “our” local swimmers continue to improve.
I will always remember and cherish my time here in Cedar Rapids. The friendships I have made will last a lifetime and I will never forget the incredible feeling of being a stranger who found a home in a foreign place.
So that's why I modify the heading on this blog entry ("Reading This Blog") with the sub-head ("Searching the Internet"). Most of those reading this blog have come to it directly. But the next largest group have come as a result of a Google (or other) search. And it is this searching and surfing that UCLA's Gary Small, Susan Y. Bookheimer and Teena D. Moody say is expanding the mental capacity of especially older Internet users. Rachel Champeau, "First-time Internet users find boost in brain function after just one week," UCLA Newsroom, October 19, 2009.
I would guess, however, that even those of you who are coming to the blog directly are relatively heavy Internet users -- one of the groups including in the UCLA research: "The UCLA team worked with 24 neurologically normal volunteers between the ages of 55 and 78. Prior to the study, half the participants used the Internet daily, while the other half had very little experience. Age, educational level and gender were similar between the two groups."
Not incidentally, the results from their functional magnetic resonance imaging (fMRI) scans indicate there is much greater brain activity (at least activity in more areas of the brain) from Internet searching than from reading -- as indicated in the photos at the top of this blog entry. Admittedly, the participants were between 55 and 78. But there's no intuitive reason to believe that the results would not be similar among young children -- the next group the researchers plan to study.
So those parents and teachers wishing students would read more may want to apply the old adage, attributed to numerous sources, that you should be careful what you wish for because you may get it. Perhaps their concern should be addressed to to those students who are spending excessive time with books and too little time with the Internet.
Of course, I'm only half serious. (1) At a minimum students need to be able to do both; and if I had to choose I'd pick reading skills over searching skills -- though I'd prefer not to have to make that choice. (2) Once the Internet search is over, and you find the relevant document, literacy is still a useful skill. (3) Not all interaction with computers involves Internet searching. At least this research did not address the neural consequences of consuming streaming audio or video, playing video games, text messaging, conversing over Skype, or looking at photos. (4) Internet searching can be a form of procrastination that has the opportunity cost for students of falling behind in homework or other obligations. (5) Worst case, there is such a thing as Internet addiction that really needs to be tended to.
Subject to those caveats, however, Dr. Small and his associates do seem to have come up with something we need to add to nutrition, exercise, sleep and stress reduction as elements of healthy living: Internet searching.
_______________
Gary Small, M.D. is the Director of the UCLA Memory & Aging Research Center at the Semel Institute for Neuroscience & Human Behavior and the author of iBrain: Surviving the Technological Alteration of the Modern Mind (2008) (Amazon offers the usual table of contents, excerpt, and index here); but see the Kirkus review on the Google Books site). The Gary Small and iBrain Web site has a link to streaming video of a CBS interview.
You can teach an old dog new tricks, say UCLA scientists who found that middle-aged and older adults with little Internet experience were able to trigger key centers in the brain that control decision-making and complex reasoning after just one week of surfing the Web.
The findings, presented Oct. 19 at the 2009 meeting of the Society for Neuroscience, suggest that Internet training can stimulate neural activation patterns and could potentially enhance brain function and cognition in older adults.
As the brain ages, a number of structural and functional changes occur, including atrophy, reductions in cell activity and increases in deposits of amyloid plaques and tau tangles, which can impact cognitive function.
Research has shown that mental stimulation similar to that which occurs in individuals who frequently use the Internet may affect the efficiency of cognitive processing and alter the way the brain encodes new information.
"We found that for older people with minimal experience, performing Internet searches for even a relatively short period of time can change brain activity patterns and enhance function," said study author Dr. Gary Small, a professor of psychiatry at the Semel Institute for Neuroscience and Human Behavior at UCLA and the author of "iBrain," a book that describes the impact of new technology on the brain and behavior. . . .
The first scan of participants with little Internet experience demonstrated brain activity in regions controlling language, reading, memory and visual abilities, which are located in the frontal, temporal, parietal, visual and posterior cingulate regions, researchers said. The second brain scan of these participants, conducted after the practice Internet searches at home, demonstrated activation of these same regions, as well as triggering of the middle frontal gyrus and inferior frontal gyrus — areas of the brain known to be important in working memory and decision-making.
Thus, after Internet training at home, participants with minimal online experience displayed brain activation patterns very similar to those seen in the group of savvy Internet users — after just a brief period of time.
"The results suggest that searching online may be a simple form of brain exercise that might be employed to enhance cognition in older adults," said Teena D. Moody, the study's first author and a senior research associate at the Semel Institute at UCLA.
When performing an Internet search, the ability to hold important information in working memory and to extract the important points from competing graphics and words is essential, [Teena D.] Moody noted. . . . _______________ * Why do I put this blog ID at the top of the entry, when you know full well what blog you're reading? Because there are a number of Internet sites that, for whatever reason, simply take the blog entries of others and reproduce them as their own without crediting the source. I don't mind the flattering attention, but would appreciate acknowledgment as the source, even if I have to embed it myself. -- Nicholas Johnson
