The Great Pause Week 21: Coronation Part II
“It will go away like things go away.”
— Donald Trump
“Nothing ever goes away until it has taught us what we need to know.”
— Bhikkhuni Pema Chödrön
Last week we looked a the physical side of Covid. This week we’ll explore the mental side. According to a study published in Lancet Psychiatry, 39 of 125 hospitalized Covid patients in the UK had altered mental status, although only 16 showed brain inflammation or swelling. Of those with no physical signs of brain damage, 92% were new psychiatric diagnoses: 43% had new-onset psychosis, 26% had a neurocognitive, dementia-like syndrome, and 17% had an affective disorder. While most of those who experienced a stroke were over the age of 60 (82%), about half with an altered mental state were under 60 (49%). About 26% of patients with new-onset neuropsychiatric disorders were in their 20s, 30s, and 40s.
In another study in Spain neurologic manifestations were seen in 57.4% of 841 patients hospitalized in March and 4.1% of their deaths listed neurologic complications as the primary cause. Disorders of consciousness (hallucinations, loss of senses, or cognitive deterioration) were nearly twice as high (38.9%) among patients with severe Covid-19. 14.9% had delirium and 9.4% went into coma. While coma and stroke emerged in later stages of the progression, decaying neurologic symptoms emerged throughout all phases of infection.
The Economist reported:
The mere fact of being in an ICU can also lead to cognitive impairment. The effect of more than a week in intensive care is comparable to that of a major head injury. The problems are linked to the delirium people often fall into when severely ill and heavily sedated in an unfamiliar environment. Delirium is a particular problem with Covid-19, says Dale Needham of Johns Hopkins University. Patients spend a long time in the ICU during which they see no one they know — and the strangers caring for them in heavy-duty protective wear “look like aliens.”
The mental impairment brought on by Covid compounds the problems of coping with the pandemic, and also with the many other crises that pre-existed Covid. It is similar to the compounding problem of lead poisoning in Ancient Rome that reduced mental capacity at a moment when the Empire was increasingly under siege. High-born Romans sipped beverages cooked in lead vessels and channeled spring water into their homes through lead pipes that likely increased lead body burdens by hundreds of times. This disproportionately struck the wealthy, Senators, courtiers, and others of elevated social rank. By making their leadership stupid, the Romans essentially decapitated themselves. From about the first century BC, the culture lost its progressive edge and fell into wine, orgies, and watching cooking show reruns on TV.
In the United States in 2020, Covid struck a population in which fewer than half of the 47 million adults with a mental illness—22 percent of all women and 15 percent of all men over the age of 18—were receiving treatment. The severity of a mental illness often depends on social circumstances, which can limit access to treatment, counseling, and medication. Social support failures and institutional shortcomings can aggravate individual and collective psychiatric conditions, producing effects of greater severity, including comorbidity to infectious disease and widespread social disorder.
Various cultural critics have associated the start of the USA’s social collapse with Ronald Reagan’s dismantling of the fairness doctrine at the FCC, allowing Fox Corp, MSNBC, and other agenda-driven “news” outlets to ramp up fake news into ubiquity. How often have you had to endure a propaganda stream worthy of North Korea while sitting in the waiting room of your dentist or a public health clinic?
Other historians have flagged Newt Gingrich’s Contract With America that brought scorched earth policies to the Grand Old Party and replaced collegial compromise with Mitch McConnell. Costly government shutdowns for no apparent reason apart from a test of wills became de rigueur rituals of manliness. Governance by uncompromising partisanship was, to governance, “as miniature golf is to golf,” a senior congressional reporter said at the time.
For my part, I’d place the USA’s descent into the present internecine bloodbath squarely along the timeline of any post-classic civilization at that precise point where a gentle glide path from complexity to simplicity becomes Lord of the Flies.
Enter the plague. How an organized, well-educated, science-based culture deals with a relentless zoonotic outbreak is very different from how a pack of gibbering Spring Breakers or Xanax-swigging couch potatoes do.
The seeds of American dysfunctionalism were planted when English settlers arrived in Jamestown and Plymouth and later took the remaining parts from the Dutch, French, Spanish and Russians, oh, and not to mention the indigenous peoples. Their perverted strain of brutal exceptionalism has been described with an equal measure of admiration and horror by historians from Alexis de Tocqueville to Sarah Vowell.
But the cancerous product of digital media we see today is not confined to the US. It’s spreading seen and unseen everywhere, even to Wuhan. Social media, going back to the Zuckerberg/Winklevoss origin story from Harvard in the 00s, is based on remorseless, non-human algorithms that exploit confirmation and normalcy biases, tribalism, discount factors, and hunger for approval, to generate ad-revenue-generating page-views.
Positive feedback mechanisms are always dangerous because they can and will spiral out of control. Pandemics, defense budgets, and climate change share this attribute with Twitter, Face, WeChat, WhatsApp, Instagram, and all the rest. They are gremlins that should never be fed after midnight. But clandestine social engineering, intended or unintended, corrupts the foundations of the growth that sustains it. It gnaws away at human potential and faith in empiricism the way acid rain erases hieroglyphs in Egypt.
Covid is swarming with positive feedbacks. A dearth of tests allowed unconfirmed cases to create still more cases, defeating contact tracing and flooding hospitals, which ran out of beds, masks, and protective gowns. Social media amplified Trump/Johnson/Lopez-Obrador/Bolsonaro misleading messages, which elevated fear and anxiety, which caused people to spend more time scouring for information on social media, much of it false or misleading.
In some warped sense, digital mass communication might be viewed as a balance nature has supplied that will eventually restore the proper order of things: an over-arching negative feedback. Whether it ends the world by zoonosis or by a nuclear exchange based upon divergent readings of the footnotes in the Mueller Report is not yet knowable.
Ed Yong, in “How The Pandemic Defeated America” in The Atlantic, wrote:
Clear distribution of accurate information is among the most important defenses against an epidemic’s spread. And yet the largely unregulated, social-media-based communications infrastructure of the 21st century almost ensures that misinformation will proliferate fast. “In every outbreak throughout the existence of social media, from Zika to Ebola, conspiratorial communities immediately spread their content about how it’s all caused by some government or pharmaceutical company or Bill Gates,” says Renée DiResta of the Stanford Internet Observatory, who studies the flow of online information. When COVID‑19 arrived, “there was no doubt in my mind that it was coming.”
Sure enough, existing conspiracy theories — George Soros! 5G! Bioweapons! — were repurposed for the pandemic. An infodemic of falsehoods spread alongside the actual virus. Rumors coursed through online platforms that are designed to keep users engaged, even if that means feeding them content that is polarizing or untrue. In a national crisis, when people need to act in concert, this is calamitous.
Now add to that mix unemployment, eviction, medical bills, anguishing loss of loved ones, anger at growing inequity, a latent belief in aliens and angels, and those alien strangers standing over your bed in surreal plastic wear, and you have assembled the ingredients for collective hysteria.
Hysteria and pandemics go together like witch trials and moldy bread. In 1900, health officials in San Francisco strung a rope around Chinatown to contain the bubonic plague. Only non-Chinese people (and rats and fleas) were allowed to enter or leave. During the cholera epidemics from the 1830s to 1860s, people attacked Irish immigrants. In the 1918 influenza, they blamed Spaniards. Syphilis was termed the “French disease” by Neapolitans, but the French called it the “Italian disease,” the Dutch called it Spanish, the Russians pointed the finger at Poland, and the Turks decided it was a “Christian disease.” When polio arrived in the 1950s, African Americans and the poor were targeted. In the 1980s, HIV/AIDS was blamed on gays, junkies, and prostitutes.
Thanks to the communications revolution, false stories about CoV-2 coming from a Chinese bioweapon lab or masks causing coronaviruses to spread could race around the world before the truth had its foot in the stirrup.
Anne Applebaum, in Twilight of Democracy, argues that autocrats with radically simple beliefs are inherently appealing. All the more so when the populace has been dumbed down and craves only simple choices. Applebaum describes how political parties use conspiracy theory, polarization, cognitive triggers, and nostalgia to school their base like dogs being trained to fetch a newspaper, heel, or beg.
Yong continues:
Science famously self-corrects. But during the pandemic, the same urgent pace that has produced valuable knowledge at record speed has also sent sloppy claims around the world before anyone could even raise a skeptical eyebrow. The ensuing confusion, and the many genuine unknowns about the virus, has created a vortex of fear and uncertainty, which grifters have sought to exploit. Snake-oil merchants have peddled ineffectual silver bullets (including actual silver). Armchair experts with scant or absent qualifications have found regular slots on the nightly news. And at the center of that confusion is Donald Trump.
During a pandemic, leaders must rally the public, tell the truth, and speak clearly and consistently. Instead, Trump repeatedly contradicted public-health experts, his scientific advisers, and himself. He said that “nobody ever thought a thing like [the pandemic] could happen” and also that he “felt it was a pandemic long before it was called a pandemic.” Both statements cannot be true at the same time, and in fact neither is true.
A month before his inauguration, I wrote that “the question isn’t whether [Trump will] face a deadly outbreak during his presidency, but when.” Based on his actions as a media personality during the 2014 Ebola outbreak and as a candidate in the 2016 election, I suggested that he would fail at diplomacy, close borders, tweet rashly, spread conspiracy theories, ignore experts, and exhibit reckless self-confidence. And so he did.
No one should be shocked that a liar who has made almost 20,000 false or misleading claims during his presidency would lie about whether the U.S. had the pandemic under control; that a racist who gave birth to birtherism would do little to stop a virus that was disproportionately killing Black people; that a xenophobe who presided over the creation of new immigrant-detention centers would order meatpacking plants with a substantial immigrant workforce to remain open; that a cruel man devoid of empathy would fail to calm fearful citizens; that a narcissist who cannot stand to be upstaged would refuse to tap the deep well of experts at his disposal; that a scion of nepotism would hand control of a shadow coronavirus task force to his unqualified son-in-law; that an armchair polymath would claim to have a “natural ability” at medicine and display it by wondering out loud about the curative potential of injecting disinfectant; that an egotist incapable of admitting failure would try to distract from his greatest one by blaming China, defunding the WHO, and promoting miracle drugs; or that a president who has been shielded by his party from any shred of accountability would say, when asked about the lack of testing, “I don’t take any responsibility at all.”
Trump is a comorbidity of the COVID‑19 pandemic.
But Trump is just a single virion. Infectious messenger RNA is carried by Bolsonaro, Modi, Putin, Johnson, Lopez-Obrador and others. Political populism is borne of the same kinds of confirmation bias and tribalism as the resistance to vaccination and masks. The formula cited by Applebaum or Yong now spreading a pandemic beyond control — dishonesty, xenophobia, racism, and narcissism — is the same elixir that drove Hitler, Mussolini, Napoleon, Alexander, and Caesar.
When I said the US social capital decline likely began with the Vietnam War, I was placing it at that point when the Cold War could have turned and ended but instead pressed the nitro button and went ballistic. In his Cross of Iron speech on the death of Stalin, President Dwight D. Eisenhower urged:
Every gun that is made, every warship launched, every rocket fired signifies, in the final sense, a theft from those who hunger and are not fed, those who are cold and are not clothed.
That speech echoed his homecoming address to Abilene Kansas in 1945, when he said:
The cost of one modern heavy bomber is this: a modern brick school in more than 30 cities. It is two electric power plants, each serving a town of 60,000 population. It is two fine, fully equipped hospitals.
It is difficult to recall when the US military budget could still be measured in millions, not millions of millions. The cost of a new Long Range Strike-Bomber (LRS-B) is today 3,660 modern brick schools or 1,000 state-of-the-art hospitals.
When Kennedy won election on a faked missile gap, when Johnson and Nixon expanded the (secret) War in Indochina, using anti-civilian napalm, cluster bombs, bouncing Bettys, and Agent Orange, and when every Congress after them basically doubled down, you get an exponential function. The exponent on the ascent is guns, warships and rockets. The exponent on the descent is schools and hospitals. And so, the US set up its health care system to be irrationally surge-vulnerable. It set up its school system to produce a population where just under half of USAnians believe aliens from outer space are living among them and a quarter say they would not be vaccinated for Covid under any circumstances.
Stanford researchers examining middle school, high school and college students in 12 states were “shocked” by how many students failed to effectively evaluate the credibility of information. The students displayed a “stunning and dismaying consistency” in their responses, the researchers wrote, getting duped again and again. They weren’t looking for high-level analysis of data but just a “reasonable bar” of, for instance, telling fake accounts from real ones, activist groups from neutral sources, and ads from articles.
What do you do when an entire county is too big to confine for its own protection? How do you undo in a short time what has been inculcated into a culture over half a century, if not longer?
The cure for discontent is contentedness. The cures for dishonesty, xenophobia, racism, and narcissism are truthfulness, openness, empathy, and selflessness. We have that capacity. We have to believe we have not abandoned it altogether.
Only after learning our lesson will all this pass.
This is the 2d of multiple parts.
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Comments
As somebody who has done a couple of overnights in Intensive Care Units, yes, they are crazy-making, and I am surprised that anybody's condition improves in them. One is hooked up to so many devices, with flashing lights and beepers, and one's condition is being monitored by so many nurses-in-a-hurry, that it is impossible to relax, much less get any sleep, in an ICU--unless one is loaded up on the kind of drugs that put a person out cold--which has the appearance of sleep, but lacks its healing qualities. I voiced this to one of my ICU nurses, who responded, with irony that indicated a shared awareness of the problem, "nobody sleeps in the ICU."
While I share your concerns for untreated mental/psychological conditions, I have two reservations to express. The first is that our society's methods of treating these "disorders" are so crude and ineffective that I think it is entirely reasonable and understandable for people to avoid such "treatment." The second concern is that those crude, ineffective treatment methods are accompanied by crude, biased standards of diagnosis that tend to treat dissent from an insane society as a mental illness, and that seek to expand the definition of "mental illness" in the interests of creating more revenue from selling the pharmaceutical "treatments" for them.
I think that putting Pema Chodron, or somebody like her, in charge of the country's psychological health, and spreading the knowledge and skills of self-awareness and self-regulation, including a complete reform of our "educational" young citizen conditioning system, would be a step in the right direction, but I don't expect it from the Biden administration.