Snapping Back to Cultural Normatives Post-COVID

"We're social creatures from birth. There's no other animal that needs to be with others of its kind for as long and as closely as we do. It is our go-to strategy when we're feeling stress or danger or threat. We go to another human being and connect with them emotionally."

"Emotion wins. Our core, basic, reptilian kind of brain often dominates everything else."

"We're always talking to the frontal lobes of everybody. We're giving them data and facts and projections and rules. But it's our emotional centres that really dictate how we behave, and I'm surprised more of the messaging isn't talking to our emotional centres."

"As soon as we do all feel safe -- in fact I think we've jumped the gun a few times and we're seeing people jump the gun in various places -- we do want to be together and I think we will be together. If people thought it could safely happen a week from now, I think it would happen a week from now."

"Part of the great snapback will be this relaxation, that we can stop inhibiting and we can just be who we are or who we feel like we are. I wouldn't be surprised to go back to Holland two years from now and see them close talking again."

Steve Joordans, professor of psychology, University of Toronto

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"[We're all aware] when that personal space is violated -- in many western cultures it's about four feet -- then you start feeling uncomfortable."

"Personal space has multiple functions. One is control -- you control threats. And that's something that is very relevant in the context of the COVID pandemic."

"You have this awkward interaction. You try to avoid this person because they're waking toward you, and they're wearing a mask or maybe they don't wear a mask and they just don't care. And so they just walk straight toward you and you really feel uncomfortable, and you're probably cursing inside."

"For it to become habitual and enduring [to return to the old normal before COVID] depends on how long the state we're in will last. If it will last just a few more months we are more likely to bounce back than if it lasts a few more years."

"If we start building sidewalks wider, if we provide in public spaces greater opportunities for separation, then that may again create greater distance that then becomes the norm."

Igor Grossmann, professor, Department of Psychology, University of Waterloo; director, Wisdom and Culture Laboratory

Reuters

 

We've become wary of close physical contact with anyone, over the space of this last year of the SARS-CoV-2 virus that has caused the COVID-19 global pandemic. It has become one of the cardinal rules of self-defence against contracting the pathogen, and also in prevention of passing the disease on to others if one happens to be non-symptomatic and infectious. Experts have hypothesized that social distancing will become ingrained and habitual, part of the routine of social interaction -- at a safe remove.

Pointing out that once COVID has been neutralized through mass vaccination it will have taught us a lesson in viral transmission avoidance, one that will come in handy in future years because, we have been warned, there will be other viruses that emerge to cross the species barrier from animal carriers to humans and the world will be assailed time and again, and better become accustomed to one of the most vital protective elements in warding off the virus. But wait ... viral pandemics aren't new to human experience, and in the past social distancing was also practised during these times ... guess we kind of forgot...

Now, other voices have lately been taking exception to that message. Not necessarily that we won't have to remain vigilant and prepared to re-enact social distancing rules, but that when at some not-too-distant point -- if all goes well -- COVID has been tamed, society will make a fluid move back to closer physical contact; not only as we are accustomed to doing, but in response to our natural draw toward one another as naturally gregarious creatures.

Dr. Joordans for example, from his professional standpoint recounts his reaction at the start of the pandemic that distancing would inevitably become the social norm and remain there. As time went on, he began to have second thoughts, and he now feels convinced that once the danger of infection has passed, our physical responses will revert to what has been the social norm. In his interviews with people who frequently travel in their profession, he noted the concern voiced of the potential danger of the virus spread. Those same people, however, professed a deep desire to remain in close contact with their loved ones.

 

We've been advised to stand six feet apart from others to lower our risk of getting infected with the coronavirus. But how can we tell whether we're standing just far away enough from people, or if we need to tell them to back up a little bit more? (Max Pepper, CNN)

 

These conflicting emotions and attitudes are hardly surprising. That we are aware of distancing in the presence of strangers, but chafe at the need to distance when we're in proximity to friends and family. The government best-practise instructions to remain two metres-distant from one another is targeted to our rational intelligence which intellectually understands the need to practise awareness and distancing. Dr. Joordans' argument is that those messages connect only to our rational brains, bypassing our emotional brain, failing to make a vital contact.

Epidemiological data is important to make note of, as is an edict in the public weal by an national administration -- but personal space is a very personal matter. On the other hand, Professor Joordans points out the cultural element in distancing, where in some areas of the world close distancing is more common than in others. A survey of people from 42 countries undertaken in 2017 found two extremes, in that Saudi Arabians prefer extended space between themselves and others, while people in Argentina tend to observe a more intimate distance between close persons and a wider one between strangers.

Everyone, however has experienced the personal discomfort of compromising circumstances when being too close to another person has been extremely uncomfortable. In the age of COVID, just about everyone recognizes that discomfiting feeling of circumstantial physical closing-in while attempting to maintain a requisite social distancing. Shared cultural normatives in observing physical spaces between people whether strangers, acquaintances or family, have been upended by the appearance of the pandemic.

Professor McIntyre recently wrote a paper titled "The Effect of Loneliness on Distinct Health Outcomes", outlining that people who tend to report feeling lonely tended as well to report poor physical and mental health. Loneliness and social distancing, he points out, do not of necessity go  hand-in-hand. Society has become accustomed to spreading itself: "It seemed a little awkward initially, now it's feeling a little less awkward. As animals, the distance you're creating is a balance between the need for attachment to your herd or your group, and perceived or real threats. This is why we generally walk closer to our families than we do to strangers."

Dr.Joordans, of Dutch derivation, describes his first visit to the Netherlands to deliver a lecture. The cultural difference in social distancing pre-pandemic struck him: "It would really freak me out. People would walk right up so close to me. In Canada, that would be the beginning of an embrace or a kiss or something like that. Whereas in this country that's just the way they chat. Every conversation I had in the back of my mind this desire to step back, but which makes you feel like you're being rude."

"Social isolation is often equated with loneliness, but it's not the same thing. Social distancing is not in itself hazardous to your emotional health."

"The more social distancing you have, the more likely it is that people will report loneliness. There's a mismatch between what you truly desire and what society allows for you."

Roger S. McIntyre, professor of psychiatry and pharmacology, University of Toronto

COVID Receding ... COVID advancing

"There are many countries thankfully where that [downward trajectory] is happening. And there are many countries in which that downward trend is not being achieved."

"What we do know in countries that are applying persistent and consistent measures in terms of public health and social measures and individual behaviour that that is affecting the trajectory of all variants."

"[While they -- variants -- have a propensity for higher levels of transmission], what is clear is that the control measures ... are effective in driving that down."

"It's a lesson for all of us [in view of infections rising in some countries] that this is not over. It's not over for anybody. And any relaxation of our resolve is dangerous."

"We need to be very aware. This virus still has a lot of energy and if the measures we apply are not persistent, comprehensive and aimed at continuing to suppress transmission while introducing vaccines, we will pay a price."

Dr.Mike Ryan, director general, emergency program, World Health Organization

Some countries, such as the UK and Israel, have begun mass COVID vaccination programs. But it’s probably too early to see widespread impact. Joe Giddens/POOL/EPA/AAP

Globally there is good news about COVID-19; the number of confirmed infections with the SARS-CoV-2 virus is dropping. Case numbers have been reduced from over five million a week in January to the current 2.5 million in mid-February. Unfortunately this is neither universal nor uniform in countries all over the world. Some have had better 'luck' in their efforts to control the omnivorous virus than have others. Brazil, for one example of a country hit hard in the first wave of infections, and continuing to see runaway numbers, surpassed a quarter-million COVID-related deaths this week, ranking as the second-highest death toll in the world, behind that of the United States.

Five states in India with its vast population centres, see surging cases of the novel coronavirus. Mosques and schools in Iraq are closed and nighttime and weekend curfews have been imposed. In Mexico, hospitals are desperate for oxygen supplies, and it isn't the only low- and middle-income country to find itself in that position of desperation. In the country with, to date the worst record of deaths resulting from the virus, a steep fall in cases has occurred in the United States, where 73,400 new cases have been diagnosed in comparison to early January when 250,000 cases per day were registered, leading to suggestions the epidemic may be levelling off.

 

Village and community health volunteers are the eyes and ears of Thailand's disease control system, contributing greatly to the country's effective COVID-19 response.  WHO

The new concerns in health circles around the world rest with "variants of concern", highly contagious viruses (VOCs) taking root everywhere. The number of global cases fell for the sixth consecutive week last week, representing an 11 percent decline, in comparison to the previous week, according to a World Health Organization situation update released on February 23. New deaths reported at 66,000 also fell, by 20 percent week-over-week. 

Globally, Friday's figures read 111 million confirmed cases with 2.5 million deaths around the world. The United States, Brazil, France, Russia and India are the countries reporting the highest number of new cases yet some of the steepest declines puzzlingly have been in some of those countries the hardest  hit last year; among them the United States, United Kingdom, South Africa, Israel and Portugal. COVID alert level in Britain declined a notch, reflecting that hospitals no longer see themselves at risk of being overwhelmed.

A three-week lockdown beginning March 8 to stem a surge in cases has been ordered in Finland, which boasts the third-lowest infection rate in Europe, after Iceland and Norway, with 590 reported this week, representing the highest number since the pandemic's start. According to experts, "patience, prudence" and vaccines are beaming a ray of hope for a reprieve from COVID. 

According to Harvard University epidemiologist Michael Mina, vaccines are playing a part in raising hopes as confirmed case numbers are slowly dropping, along with deaths from t he virus, butit is tighter restrictions that can for the most part be attributed to the hopeful signs that COVID may yet be beaten  in shorter order than prophesied by a worn medical community. Across England, as an example, infections have dropped by two-thirds since the lockdown that was initiated in January.

“No one likes lockdowns, they’re terrible and devastating, but they work. If you have a lot of cases in an area with a lot of people and you lock it down you are going to see cases go down and we see this time and time again.”

"[Other measures, such as people wearing masks indoors, are] extremely helpful [in bringing new cases down but we] can’t discount the seasonality [of COVID-19 being a factor in fewer virus transmissions].

We still don’t know enough about it, but that may be a factor."

"We don’t have a cure. We have treatments which are fine but no cure. We know that younger people who are included in clinical trials are unlikely to die because they’re young, but people are still getting pretty sick – and in addition we know there are long-term symptoms from this virus.”

“We have to respect the variants of concern, we don’t know enough about them, we know that some are more transmissible – we saw one COVID-19 mutation get married to another COVID-19 mutation – we still don’t know how that will work, that’s the recombinant virus."

"While we have to be open-minded to new data, as things are reopening we need to approach with caution so we don’t get a third wave."

Toronto infectious disease specialist Dr. Isaac Bogoch  

EPA/Mauricio Duenas Castaneda

"One, we came off of really high numbers from the holidays."

"Second, there is pretty good evidence that people are doing a better job of social distancing and mask wearing."

"Third, I think in a lot of communities, we've had so much infection that you have some level of population immunity. Not herd immunity, but enough population immunity that it is causing the virus to slow down."

Dr. Ashish Jha, dean, Brown University School of Public Health.

The Mysterious COVID 'Long Haul'

"The Government of Canada is increasingly adopting the term 'resolved' ... as this better describes the public health implications of the case status, while allowing for the fact that the individual may not be recovered in terms of symptoms or longer-term health effects."

Health Canada

"A large percentage of this cohort of 'recovered' people are still suffering, and calling them 'recovered' is inaccurate, misleading and insensitive."

"We need to start counting long-haul COVID cases."

"We are not recognized and there seems to be no real urgency in dealing with us. We don't qualify for financial support because we're not actively looking for work and our EI sickness benefits are dried up."

"We're being forced to start selling homes and other assets. I haven't had benefits since before Christmas."

Susie Goulding, founder, COVID Long-Haulers Support Group Canada, Oakville, Ontario

"You actually have to be able to define it [before any decisions can be reached whether a disease should be prioritized and resources mobilized against it]."

The first step is going to be to say, OK, what precisely is this long COVID syndrome we're talking about. Are there actually several different conditions, or a single condition?"

"What's really interesting to me about long COVID is that it's clearly different from the consequence of simply having been gravely ill."

"[Changing] recovered [to] non-infectious [is a] great suggestion."

Dr.John Marshall, trauma surgeon, St.Michael's Hospital, Toronto

Novel coronavirus (COVID-19) symptoms can last weeks or months for some people. These patients, given the name "long haulers", have in theory recovered from the worst impacts of COVID-19 and have tested negative. However, they still have symptoms. There seems to be no consistent reason for this to happen.

 

British and U.S. researchers conducted a web-based survey involving over 3,700 people who had suspected or confirmed COVID-19 -- the effects of which were seen to be prolonged over more than 28 days. And out of that survey no fewer than 205 symptoms were categorized in ten organ systems.One-third of respondents with lab-confirmed COVID-19, part of a study published this week in JAMA Network Open involving 177 people, experienced lingering symptoms persistently continuing for a median of six months. This, even among those people who had experienced mild illness.

 

Professor Daniel Altmann specializing in immunology at Imperial College London, estimated the number of those affected by long COVID in the United Kingdom "is  roughly equivalent" to the number of people in the U.K. with rheumatoid arthritis. Professor Altmann and Rosemary Boyton stated that at least ten percent of people with symptomatic COVID-19 can leave a "lingering trail" of changes visible on CT scans of the lungs. The virus causing inflammation of the heart muscle, by attacking the same receptors in the heart, they wrote in the British Medical Journal.

 

Drs. Altmannn and Boyton wrote that gastrointestinal biopsies taken four months following an infection "show persistent live virus in about a third of individuals", in line with some studies that suggest SARS-CoV-2 virus can persist in the liver and spleen. What puzzles them is whether this indicates that people haven't managed to clear the virus, or some other underlying cause yet to be determined is involved. 

 

Dr.Marshall, on the other hand, theorizes that in most long-haul instances symptoms may be consistent with an autoimmune disorder -- itself caused by the body's widespread inflammatory response to the virus when someone's immune system goes completely out-of-whack, over-compensating harmfully to the viral intruder.

 

An international effort is now underway for doctors to explore the situation rigorously in an effort to arrive at a global consensus regarding what "long COVID" represents in an effort to explicate its cause. The lingering effects of COVID-19 has been afflicting quite a large number of post-COVID individuals left anxious and depressed; even while the medical community considers them to be 'recovered', they suffer from lingering effects of the virus, post-infection.

Most people undergo mild and short-lived effects from the coronavirus yet increasing numbers of other people report a puzzling array of symptoms, including breathlessness, exhaustion, tingling throughout the body, anxiety, brain fog and memory problems going on for weeks, even months after what appeared to be a mild infection. Health Canada considers 'recovery' to be consistent with the passage of at least ten days since the start of symptoms at which point infectiousness has passed, there is no longer fever, and "their symptoms have improved (even if not yet fully resolved)".

"It's a whitewash that conceals the fact that a large percentage of people are not recovering in 14 days", scoffs Susie Goulding. To which Dr.Marshal, a trauma surgeon, responds "You have to be able to define it". Recently Dr.Marshall co-chaired a World Health Organization group tasked with developing criteria for a working diagnosis for what the WHO calls the Post COVID-19 condition". And what Dr.Marshall looks for, is answers to:What's the epidemiology -- how common are the different symptoms: How many who've had COVID get it? Are there risk factors for acquiring it?

 

 Canadian Researchers looking into COVID "long-haul" effects.  Maeve Gamble

Older people and people with many serious medical conditions are the most likely to experience lingering COVID-19 symptoms, but even young, otherwise healthy people can feel unwell for weeks to months after infection. The most common signs and symptoms that linger over time include:

• Fatigue
• Shortness of breath
• Cough
• Joint pain
• Chest pain

Other long-term signs and symptoms may include:

• Muscle pain or headache
• Fast or pounding heartbeat
• Loss of smell or taste
• Memory, concentration or sleep problems
• Rash or hair loss

Mayo Clinic

Experimentation on Live Animals vs Animal Computer Modelling

"There have been very serious welfare concerns raised about the living conditions of these monkeys in Cambodia and nearby countries, as well as concerns about misleading information being provided from sellers over there. And I think for Canada to be complicit in that is potentially quite concerning."

"Cambodia, Laos and Vietnam are pretty notorious for monkey breeding and taking monkeys from the wild, putting them in facilities and breeding."

"My biggest concern about animal research in Canada, and specifically this situation, is that it's completely non-transparent, and not overseen by public authorities."

"What people deserve is the ability to know about the experiments that are being done, and judge for themselves if they think that that's acceptable or not. But with this system that is as opaque as it is right now, the average member of the public mostly has no idea about any animal tests that are going on in Canada."

Camille Labchuk, executive director, Animal Justice

"This is a serious concern in terms of maintaining a healthy wildlife population in Cambodia for macaques."

"This has great implications in terms of the population numbers and the health of the population and the countries that they're getting them from."

"These animals might have been imported to be used in the COVID-19 vaccine development or there might be another company who [sic] is doing drug trials and requires primates as part of those trials."

Liz White, head, Animal Alliance of Canada

Macaque monkeys used for research, at a breeding centre in Thailand. Photo by Mladen Antonov/AFP via Getty Images/File

According to a 2008 investigation by the British Union for the Abolition of Vivisection, up to 80 percent of macaques trapped in the Cambodian wild die due to trauma or poor treatment, even before they reach a laboratory. In the United States, CBS issued a report in 2010 noting that 30 monkeys had been cooked alive in a Nevada research laboratory, having been erroneously placed through an automatic cage washer.

The government of Canada in 2020 approved importation of 1,056 macaque monkeys of a type called macaca fasicularis. They were imported from Cambodia for "scientific and research" use by private interests. According to documents associated with the recently released story, this is the first time such imports have been permitted after being allowed since 2016. 

It was also revealed that part of the total and possibly all of them were brought to Quebec for use by Charles River Laboratories, a major American importer of non-human primates to be used for breeding and scientific experimentation. The company has a number of laboratories across the province. Canada's government approved the import of about 2,500 non-human primates yearly from the United States, to be used for research testing within the past five years.

It was only in 2020 that an additional number of primates were imported from Cambodia. Animal protection organizations have frequently alleged mistreatment of the animals within Cambodia. The sudden increase in the number of macaque imports to Canada signal to both White and Labchuk that the animals are being used to test potential COVID-19 vaccines and treatments in Canada, based on multiple media reports and documents emanating from pharmaceutical companies indicating vaccines were tested on macaques.

Members of the public who quail at the very thought of subjecting helpless animals to experimentation in laboratories dedicated to the discovery of new medical protocols and therapies have often salved their feelings in the belief that animal computer modelling is advancing to the point where there will be a complete elimination of the use of living, feeling animals for research purposes. A practise that causes immediate revulsion in any animal-empathetic mind.

 

The theory is that science has come a long way since Banting and Best at their utilitarian laboratory at University of Toronto used dogs in their search for a cure for diabetes.

Insulin turned out not to be a cure, but a lifeline for people with diabetes to be able to treat their condition where their pancreas' islets of Langerhans no longer produces insulin, through injecting insulin to enable the body's uptake of sugars, moving it to body tissues for the blood glucose to be converted to energy. Simply put, without injectable insulin, people with Type 1 diabetes would die a painful death; before the advent of the Banting and Best discovery, the diagnosis of insulin-dependent-diabetes was a death sentence. 

 

Similarly, the vaccines produced for the SARS-CoV-2 virus that causes COVID-19 is not a cure, but a therapy, and COVID, like diabetes is managed, not cured. The entirely separate issue of animal cruelty with respect to the handling of these living, feeling monkeys and other research-bound animals that science uses in research and experiments is one that is concerning and requires attention. Countries like Cambodia should be made aware that ill-treatment of animals will lose their custom.

"The importation of macaques occur on a regular basis and is not an unusual event."

"Due to reasons of privacy and confidentiality, the Canadian Food Inspection Agency is not authorized to share personal or confidential information with third parties about importers."

Canadian Food Inspection Agency

 

"Charles River Laboratories is deeply committed to animal welfare and exceeding international standards for the care of research models under our stewardship."

Sam Jorgensen, spokesperson, Charles River Laboratories 

"The advancement of computer technology in the information revolution has been so amazing that we have become convinced that there is nothing an advanced computer can’t do. That is why it is so easy for animal rights organizations to convince the public that we can eliminate animal research and replace it with computer models. Even organizations that supposedly defend animal research have helped this misconception by promoting the idea that eventually it will be Replaced (one of the three Rs) by computer models, in vitro research or clinical trials. That is simply not true. As I have shown here, as scientific productivity increases, so does the use of animals. It has not decreased, we are just using fewer animals of some species (dogs, cats, rabbits, primates) by using more animals of other species, like mice and zebrafish. And, as Figure 4 shows, research using computer models is relatively small and is not growing fast enough to ever catch up with animal research."

"In conclusion, computer models are not replacing and likely will never replace animal research. Computers can do amazing things, but they cannot guess information that they do not have. There are limits to what is possible, and this is one of them."

Juan Carlos Marvizon, Ph.D., David Geffen School of Medicine at UCLA, VA Greater Los Angeles ... Speaking of Research, January 7, 2020

"Monkeys are used in animal research only if a particular phenomenon cannot be studied on any other species of animal, such as mice, fish or fruit flies. In the course of evolution, similar structures and functional principles have developed in the brains of monkeys and humans. Such structures and principles are not present in other mammal groups. Neuroscientists can therefore only research complex cognitive functions relating to perception, attention, memory formation and awareness on monkeys."

"Because they are biologically so similar to humans, the potential for applying research results to humans is very high. They are therefore used primarily for the final drug safety tests on new medicines before they are used on humans. Moreover, scientists use monkeys to study important fundamental questions on how a healthy organism functions or how to cure fatal illnesses (e.g. Ebola) or severely debilitating disorders (e.g. Alzheimer’s). Monkeys therefore play an important role as laboratory animals in infection research and in the neurosciences."

Max-Planck-Gesellschaft

Physician Burnout Versus Incoming Student Idealists

Medical school applicants Photo by Gustavo Fring, Pexels

"We're consistent with across the country and across North America, with what has been observed this cycle, which is a 20 percent increase in the number of applications."

"They see these individuals as people that have, you know, skill sets and things to not only save lives, but also are people that are willing to sacrifice for the greater good."

"These are individuals who are normally applying to ten, twelve medical schools across the country and potentially in North America. In this situation, we're able to do it [remote interviews via Zoom] where they are in their homes."

Sita Gourishankar, assistant dean of admissions for undergraduate medical education, University of Alberta

"This large of an increase is unprecedented when considering that the number of applications has been rising by an average of 2.5 percent over the past twenty years."

"Some students may have been motivated by seeing heroic doctors on the front lines of the COVID-19 pandemic. Some aspects of the application process also became easier as some medical schools extended their deadlines."

"We survey incoming medical school students every year and will learn more next fall about why this year's applicants decided to apply."

Dr.Geoffrey York, senior director, student affairs and programs, Association of American Medical Colleges

"There were some challenges related to the online interview and I definitely interact much better, I would say, in person."

"For example, in reading body language, that sort of thing, so those were sort of unique challenges, but everyone was in the same boat."

"It interests me, I guess, being able to be in that field and help people out. During COVID when people are sitting in isolation, sometimes I feel kind of helpless or useless in the sense that I can't be out doing something."

Sarah Veber, prospective medical student, Newfoundland

Medical workers in protective clothing move the body of a deceased patient to a refrigerated holding centre. © 2020 Bloomberg Finance LP

The current situation that is stretching the patience, perseverance and knowledge of health-care professionals across the globe, leaving doctors and nurses exhausted in the never-ending call upon their professional expertise during the SARS-CoV-2 virus pandemic appears to have appealed to the idealist in young aspirants to the medical field, expressed in the fact that medical school admission applicants have been steadily rising of late. A hopeful sign, that the young and medical-service-inclined are prepared to replace the profession's older physicians on the verge of exhausted collapse.

Medical schools across North America are now experiencing a surge in applications for the 2021-22 academic year that is viewed as unprecedented in its overall response to the global pandemic. Both in Canada and in the United States, applications to medical schools have risen by about 18 percent  overall. Medical schools in Ontario are working around a 10.9 percent greater number of applications in comparison to last year, while nursing programs in the province have seen a large boost of 17.5 percent. No one really quite understands what the increased interest can be attributed to.

At Washington State University, the senior associate dean for admissions and student affairs, Dr.Leila Harrison states that despite no conclusive research behind the increase, indicators point toward the pandemic contributing to the rise by inspiring young people to want to do something worthwhile for their communities, giving them a sense of mission to aspire toward. "It's just the idea that potentially seeing Dr. [Anthony] Fauci [the U.S. government's top medical adviser], all the impact he's made in his expertise in this pandemic, that maybe has inspired hopeful doctors to say, 'You know what, I'm gonna go for it this cycle'."

Entry processes have undergone a change as well, linked to COVID-protective measures that have become universal in an effort to contain the spread of the coronavirus, with medical schools adapting to the new situation. Select students receive invitations to attend interviews -- remotely -- which result in some prospective students receiving letters of acceptance. Virtual interviews have their place in the process; a plus for distancing; a minus for communicating person-to-person other than virtually.

 

A doctor checks on a Covid-19-infected patient connected to a ventilator. Getty

Like every other facet of society, communications, and work, it seems likely to Ms.Gourishankar in her professional capacity, that virtual interviews will become normalized and acknowledged as a positive tool in the process of welcoming new medical students. It is an option offering greater flexibility in the interview process since it can be conducted from anywhere to anywhere. And that convenient option may act as a spur for more potential medical students to explore all avenues since travel is no longer involved.

 

And then there is the issue of physician burn-out. "I think there's a lot of doctors right now who are looking at different careers. To see your patients die and you know what's going to happen is a really hard thing for any health care workers to have to continue to put up with", explained family physician Dr.Kate Bisby, who worries that ultimately communities across Canada may be affected, with fewer primary care doctors, as more opt to retire early, exhausted from overwork. 

 

Doctor Burnout   Getty

In September, a study was released in the United States by the Primary Care Collaborative which showed that 19 percent of physicians they surveyed believed a doctor in their clinic had, or was planning to retire early as a direct result of how the COVID-19 pandemic impacted on them. Another study released in February indicated that though burnout was increasing among family doctors, none those the study surveyed planned to retire early, as a result of exhaustion.

 

A study published by the Cambridge University Press Public Health Emergency Collection discovered that a large number of emergency medicine physicians in Canada had one symptom at least of burnout before the advent of COVID, while a separate study looking at past health emergencies found burnout among doctors is bound to increase during a pandemic. While 81 percent of physicians reported high emotional well-being through findings by a 2018 Canadian Medical Association report, 26 percent reported "high emotional exhaustion" and thirty-four percent of respondents screened positive for depression.

"We are very concerned about the impact this pandemic is having on our health workforce -- an impact  that will be felt for years to come."

"It is therefore important that we have serious conversations about our health-care system, so that we improve access to care while ensuring the well being of those who deliver care to Canadians."

Dr.Ann Collins, president, Canadian Medical Association

"It's been pretty crazy in the sense that it's both really difficult, but it's also kind of a very rare and interesting unique fortunate learning opportunity for us. It's tough, because obviously, it's a pandemic, and it's difficult for everybody, especially health-care providers."

"We all presumably went into medicine in the first place [to] make a difference and make a positive impact in our communities, and, you know, advocate for vulnerable people who weren't always able to advocate for themselves."

"And so I'm still super excited to be able to do that. And the pandemic really doesn't change anything about that."

Nick Taylor, second-year medical student, University of Alberta

Environmentally Green Diamonds

Demand for diamonds is declining in many parts of the world at a time when the industry has an oversupply of the gemstones (Credit: Getty Images)

"Mined diamonds I think are very time-limited now -- the industry will come to an end, it's a question of when."

"We no longer need to mine the earth to make diamonds, because we can mine the sky."

Dale Vince, founder, Ecotricity Plc

 

"Marketing spend, by not only the man-made diamond industry but also the natural diamond industry is likely what will ultimately determine the success in the long run."

"If you're trying to be the lowest-cost producer you don't care about using hydropower as you aren't going to get a premium for it."

"You need to be able to sell it at a premium or build it as a brand."

Paul Simnisky, diamond analyst, New York

 

"I believe in the next 12 to 24 months we will see a major shift in consumer mindset which will force this industry to ensure that everything that is passing through is a low-carbon product."

"And the lab-grown guys will push ahead."

Amish Shah, ALTR Diamonds

 

"It's very confusing today, there are a lot of companies that are talking about sustainability and being carbon-neutral but they can't really put proof to the claim."

"When you see a new product coming into the market it's kind of a free-for-all -- there are no rules or regulations."

"But now you're seeing consumers asking questions, the same questions they are asking about natural diamonds: what is the source?"

Leon Peres, CEO, SCS Global Services

 

SCS Global Services is in the process of certifying through audit the sustainability footprint of lab-grown diamonds produced by Green Rocks Diamonds, based in Israel. These are the diamonds of choice for lab-grown jewelry retailer Kimai whose eco-conscious customers want to be assured that the precious gems they're prepared to put out big money for are green sustainability products. According to Jessica Warch, co-founder of Kimai, clients are wary of goods coming out of a big hole in the ground.  

 

"From the perspective of sustainability it isn't just being carbon neutral", she explains. "There's much more to it. There's the environmental and social perspective that's rarely taken into account when people talk about carbon neutrality, which to us is the most important part." Production facilities in India where ALTR Diamonds are produced, is capable of switching to solar power for energy to complement its source of methane; cow dung, according to Amish Shah.

Diamond mining can involve the removal of vast amounts of earth and rock which creates holes so big they can be seen from space (Credit: Alamy)

Lab-grown diamonds are virtually indistinguishable from natural diamonds. The big difference between natural and lab-grown rests with the traditional extraction methodology in pulling diamonds out of the earth. It is a lengthy, energy-intensive process which leaves a significant carbon footprint. Lab-grown diamonds are focused toward energy neutrality, to appeal to a rising number of consumers for whom environmental consciousness is important.

The diamonds themselves have identical compositions such that manufactured stones now pose a competitive rivalry to their naturally formed counterparts. Leading jewelry retailers now find it worth their while to serve their clients the stones they specifically enquire about and increasingly that means diamonds from eco-sensitive perspectives of production. 

 

Diamonds are among the hardest materials on the planet, which means the only way to polish a rough diamond is with another one (Credit: Getty Images)

 

There are two means by which lab-grown stones are produced; by mimicking natural formation with the use of high pressure and heat, or through a process known as chemical vapour deposition. CVD begins with a single-crystal diamond seed, placed in a chamber filled with hydrogen and a carbon-containing gas like methane; heated to 1,200C. The seed is built up by the carbon which forms the diamond crystals. Much like an oyster irritated with the presence of a tiny mineral, and that reacts by covering it in layers of  nacre -- and a pearl is formed over time.

Ecotricity Plc. creates its own methane, that greenhouse gas resulting from a combination of carbon and hydrogen, by splitting hydrogen from water with the use of electrolysis pulling carbon from the atmosphere. The production of lab-grown diamonds is on the increase though the industry has a long way to get there yet before it catches up to mined diamonds; 7m carats were produced last year; in comparison the mined process produced a volume of 111m carats in the same period.

A polished one-carat lab-grown stone now sells for a third less than a polished mined diamond. But there's no getting away from the use of renewable energy like hydropower as a challenge to the traditional mining method to the newer lab-produced diamonds. A growing number of rival producers in India and China remain fixed within old mining practices, despite that 50 percent of the world's lab-grown diamonds are now being turned out in China.

 

Diamond mining provides employment in developing countries but is also surrounded by humanitarian concerns (Credit: Getty Images)

Increasing Longevity and Fending off Chronic Disease ... Reasonable Exercise Protocols

"The key findings from this review are: (1) male and female elite athletes live longer than the general population; (2) male athletes have a lower incidence of cardiovascular disease and cancer mortality than the general population; (3) power sport athletes' all-cause and cardiovascular disease mortality were not significantly different to the general population; (4) endurance athletes' cancer mortality was not significantly different to the general population."

"Former athletes smoke less, drink less and engage in more long-term physical activity than the general population, all of which significantly contribute to cancer risk and mortality."

U.K. research team

Nicole Forrester, seen here competing at the 2008 Summer Olympics in Beijing, didn’t start high jumping until she was 18 years old. THE CANADIAN PRESS/Ryan Remiorz

"Aging is a natural and complex physiological process influenced by many factors, some of which are modifiable. As the number of older individuals continues to increase, it is important to develop interventions that can be easily implemented and contribute to “successful aging”. In addition to a healthy diet and psychosocial well-being, the benefits of regular exercise on mortality, and the prevention and control of chronic disease affecting both life expectancy and quality of life are well established. We summarize the benefits of regular exercise on longevity, present the current knowledge regarding potential mechanisms, and outline the main recommendations. Exercise can partially reverse the effects of the aging process on physiological functions and preserve functional reserve in the elderly. Numerous studies have shown that maintaining a minimum quantity and quality of exercise decreases the risk of death, prevents the development of certain cancers, lowers the risk of osteoporosis and increases longevity. Training programs should include exercises aimed at improving cardiorespiratory fitness and muscle function, as well as flexibility and balance. Though the benefits of physical activity appear to be directly linked to the notion of training volume and intensity, further research is required in the elderly, in order to develop more precise recommendations, bearing in mind that the main aim is to foster long-term adherence to physical activity in this growing population".

Science Direct

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There are studies that suggest a too-rigidly focused (extreme) attitude on exercising may compromise the protective effect of physical activity on heart health. Overdoing it, leading to an opposite health effect than that anticipated. Proving that old adage that moderation is the key to all things leading to success; known as the golden mean. It has an ancient lineage; well known for thousands of years that any type of extremes lead to malfunction of outcome. So how much exercise is too much exercise? No matter who you ask, the answer won't be forthcoming. 

 

It's a matter of knowing your limits; personal discretion.

As in: listen to your body, pay attention, be mindful of its messages. These are studies suggesting a decrease among endurance atheletes of health-protective benefits relating to overtraining of athletes, over-taxing the heart, depressing the immune system, increasing risk of injury and negatively impacting mood and sleep patterns. Long-term health of those overstretching their limits in physical exertion may lead to negative impacts.

 

A team of researchers fromt the United Kingdom set out to discover some truths about the relationship between chronic intense exercise and longevity; whether some physical activities or sports can offer protection and those that may not. They compared all-cause mortality and cardiovascular and cancer-related deaths of elite athletes as opposed to those issues linked to recreationally active counterparts.

 

24 studies with a data set totalling 154,033 athletes formed part of the review basis. The study group was divided into three groups: endurance (middle- and long-distance runners, . rowers, cross-country skiers, ice skaters and Tour de France cyclists); team sport (football, baseball, soccer, hockey and basketball); and power athletes (boxers, wrestlers, weightlifters, and track and field). The conclusion was that elite male and female athletes were linked with a 31 and 49 percent lower risk of all-cause mortality respectively, as compared to members of the population who are less physical active.

Not all sports and activities however, offer a similar level of long-term health benefits. The greatest boost in longevity fell to male endurance athletes; and in comparison to the general population, marathon runners, Tour de France cyclists and Olympians competing in endurance sports added four, eight and six years respectively to their life expectancy. To a lesser degree team sport athletes benefited as well from a bosft in life expectancy.

Superior cardiovascular fitness reflecting better heart health. Which explains why endurance athletes live longer than team sport and power athletes and was resposnsble for much of the added longevity. It was recognized by the researchers as well, that other lifestyle habits also render significant contributions to the longevity of elite athletes. The educated hypothesis that lifestyle is a powerful predictor of overall good health has a pedigree.

 

The review of elite athletes in this particular study reflects that recreational athletes and ordinary people alike benefit from the awareness that a healthy, active lifestyle has vital consequences in extending longevity and warding off chronic disease. A bit of a conundrum raises itself where researchers cannot quite point to lifestyle or training as having the superior advantage, leaning on the impression that it is a combination of both that confers the greatest rise in long-term health and overall wellness. 

Most people in any given population will never gravitate to the exercise habits of elite athletes, yet they can understand that a greater dedication to regular exercise will result in consequential benefit; ample reason to incorporate more than the recommended 150 minutes of physical activity weekly into a personal commitment. By the simple expedient of focusing on an activity that is personally appealing, commitment to exercise can be assured.

 

The basic goal being to reach the longevity-increasing benefits of exercise and that requires working at it until it becomes ingrained habit.