Be Afraid, Be Very Afraid

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.

Wilfred Van Gorp, "Wave of cognitive disorders in young people from COVID-19," The Hill (Dr. Gorp is the former president of the American Academy of Clinical Neuropsychology.)

Here are some more excerpts, this time from the BBC: Zoe Cormier, "How Covid-19 can damage the brain; Some scientists suspect that Covid-19 causes respiratory failure and death not through damage to the lungs, but the brain – and other symptoms include headaches, strokes and seizures," BBC, June 22, 2020

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."

See also, Julie Helms, et al, Strasbourg University Hospital, Strasbourg, France, "Neurologic Features in Severe SARS-CoV-2 Infection," Letter, New England Journal of Medicine, June 4, 2020.

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

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Thoughts on Eating Living Things

"Almost a third of Americans, 32%, believe animals should be given the same rights as people, while 62% say they deserve some protection but can still be used for the benefit of humans. The strong animal rights view is up from 2008 when 25% thought animals' rights should be on par with humans'."

Rebecca Riffkin, "In U.S., More Say Animals Should Have Same Rights as People," Gallup.com, May 18, 2015

My wife, Mary, has discovered cooking for family gatherings is not what it once was.

In my youth it was simpler. My father, who taught general semantics, believed "food dislikes" were a symptom of ignorance of general semantics principles. If someone might say, for example, "I don't like spinach," he would respond, "But you haven't even tasted this spinach; you're just reacting to the word, the label. Taste what's on your plate and see; maybe you'll like it."

After months of "tasting" everything on our plates our food dislikes diminished and then disappeared -- which created another problem. We very rarely went to a restaurant, but a family story is told of one such occasion before I was 10 years old. After everyone else had ordered, I was still studying the menu. Urged to hurry up, I blurted out, "That's what you get, Dad, for teaching us to have no food dislikes!"

A doctor gave me an allergy test, and reported I was allergic to a dozen or more items -- including corn (hard to avoid in Iowa) and wheat (requiring my loving mother to bake rye bread for the family). After a summer on my aunt and uncle's farm, playing in the corn bin and eating wheat bread, with no apparent ill effects, that was the end of my allergies.

No one I knew refused to eat GMO food, was on a "gluten free" diet, "lactose intolerant," or allergic to peanuts (we lived on peanut butter sandwiches).

To borrow Garrison Keillor's phrase, our mothers just "put the hay down where the goats can get it." "Food" was cooked, put in bowls on the table, transferred to our plates, and consumed -- usually meat, potatoes and gravy, two or three vegetables, and a little salad -- dessert if we'd been good, and were lucky.

When we were young there were few, if any, vegetarians, let alone vegans, among the children of beef, hog, dairy and chicken farmers. Now our family gatherings include representatives of virtually every food preference group, each with their own special meals. (This includes the "lactose intolerant" and "gluten free" at our table.)

Of course, those with real medical problems must be respected. But the varieties of beliefs about eating once-living things also need to be respected.

I'd extend this to attitudes about abortion. If someone truly believes that aborting a fetus is "murder," it makes their "right to life" opposition to abortion more understandable -- especially if they only apply the belief to themselves and do not insist the government impose it on everyone else.

I'd also be tolerant of what superficially, initially, appear to be inconsistencies: those who favor the availability of abortions, but believe it is morally reprehensible to eat a fish; or those who believe no one should be permitted to abort a fetus, but join the 62% of Americans (87% of Republicans) who favor the death penalty for adults. ["National Polls and Studies; Huffington Post, January 2014," Death Penalty Information Center.]

"China, together with Iran, North Korea, Yemen and the US (the only G7 country to still execute people) carried out the most executions last year." "Death Penalty Statistics, Country by Country," The Guardian. Only 58 of the 195 U.N. nations still have the death penalty. "Capital Punishment by Country," Wikipedia.org.

We come by our beliefs regarding diet, including eating once-living things, from our parents, experience, culture, religion, education; also our moral, philosophical and ethical beliefs. And so long as our beliefs and actions don't have an adverse impact on others we are all stronger for this diversity. [Photo credit: unknown; beef cattle feedlot]

I started down the road now revealed in this blog post as a result of a conversation today regarding vegetarians and vegans. It seemed useful for me to try to think through where I come out.

I am neither a theologian nor a research scientist. All I know -- or suspect or believe -- is what I have been reading in books like, Frans de Waal, Are We Smart Enough to Know How Smart Animals Are? (2016); Jonathan Balcombe, What a Fish Knows: The Inner Lives of Our Underwater Cousins (2016); Jennifer Ackerman, The Genius of Birds (2016) -- and even, most recently, Peter Wohlleben, The Hidden Life of Trees: What They Feel, How They Communicate (2015). There are undoubtedly research scientists who attempt to refute the assertions of these authors; if so, I have not read their works. After all, I'm just reading books that interest me; I'm not engaged in research for a doctoral dissertation.

I am even less well educated about the human biome, but further humbled and fascinated with the idea that I am carrying more cells of microbes and bacteria in and on my body than human cells (perhaps 100 trillion of theirs to 37 trillion of mine).

"As of 2014, it was often reported in popular media and in the scientific literature that there are about 10 times as many microbial cells in the human body than there are human cells; this figure was based on estimates that the human microbiome includes around 100 trillion bacterial cells and an adult human typically has around 10 trillion human cells. In 2014 the American Academy of Microbiology published an FAQ that emphasized that the number of microbial cells and the number of human cells are both estimates, and noted that recent research had arrived at a new estimate of the number of human cells at around 37 trillion cells, meaning that the ratio of microbial to human cells is probably about 3:1. In 2016 another group published a new estimate of ratio as being roughly 1:1 (1.3:1, with 'an uncertainty of 25% and a variation of 53% over the population of standard 70 kg males.')" Human Microbiome Project," Wikipedia.org. See also, NIH Human Microbiome Project; Karen Weintraub, "Findings From the Gut -- New Insights Into the Human Microbiome," Scientific American, April 29, 2016.

Frans de Waal (Are We Smart Enough to Know How Smart Animals Are?) argues (if I read him correctly) that humans are mistaken to evaluate how "smart" animals are by comparing their cognitive abilities with our own.

Webster's defines "cognitive" as "activity such as thinking, reasoning, or remembering." "Definition of Cognitive," Merriam-Webster. Thus, Jonathan Balcombe's (What a Fish Knows) observation that "A small squid can learn mazes faster than dogs do, and a small goby fish can memorize in one trial the topography of a tide pool by swimming over it at high tide -- a feat few if any humans could achieve" could be considered examples of "cognitive ability" in animals.

Actually, other species can often best our ability to do something. As I have written of squirrels, "Much as we may squirm to avoid admitting it, an honest evaluation of the data compels the conclusion that squirrels do, in fact, have a superior intelligence to humans. They also have more patience and determination. More willingness to work at, and stick with, problem solving. More commitment to scientific experimentation. And, not incidentally, an athletic prowess -- not to mention courage -- that puts our Olympic athletes to shame by comparison. As the clerk put it to me with commendable candor when I asked about a squirrel-proof bird feeder, 'Look, mister, there ain't no squirrel-proof bird feeders. There are just squirrel-resistant bird feeders.'" "The Natural Superiority of Squirrels" in "UI Held Hostage Day 498," June 3, 2007

Mammals, fish, birds, insects, microbes -- and trees -- may need to communicate (and do); they do not need to speak English or solve the New York Times' crossword puzzle. The standard he says we should use is to ask, "Are their cognitive abilities sufficient to insure the survival of their species?" (not a direct quote).

Measured by de Waal's standard, any honest, open minded inquiry into the cognitive and other abilities of species other than our own will leave the reader humbled, in awe, and filled with respect for the wide range of abilities of our plant and animal "cousins." Sufficiently so -- at least for me -- that when it comes to what I will and won't eat, I am unable to distinguish between the life force present in a chicken and a fish, a carrot and a shrimp.

Which, of course, brings me back around to the oft-heard inquiry, "So, what's for dinner?"

If one wishes to avoid killing and consuming plants and animals that possess not only a "life force" but sufficient cognitive ability to keep their species alive for millions of years, there is virtually nothing left on the menu.

No one needs to live to eat, but everyone needs to eat to live. The variation of "necessity is the mother of invention" is that "mother is the invention of necessity." Eating is also the invention of necessity. Confronted as I am with the necessity of eating, what should I do?

I have finally come around to the wisdom of many of the only true "Americans," those who were here when our ancestors arrived. I may have romanticized the teaching I received from a Meskwaki elder, but not by much. Without disclosing any of the details he shared in confidence, the general idea involved a respect for the Earth and living in harmony with all of its plant and animal inhabitants. One imposes as light a footprint as possible on the Earth, taking only the minimum one needs for food.

So that will be my creed. Eat only what I need (which, as a side benefit, won't do my waistline any harm), going especially light on eating anything I would not have been willing to kill, and insofar as possible not contributing to that 40% of the food Americans buy and then throw away.

I'm neither advocating this analysis for others nor criticizing others' different choices. It's a personal matter everyone can think through for themselves (or not). Moreover, I may change my mind. But, for now, these are my "Thoughts on Eating Living Things."

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