Living in COVID times
Rarely in human history has an invisible pathogen had so much publicity.The COVID-19 pandemic has devastated lives and livelihoods. Some 12 months after its declaration by the WHO, COVID-19 has left over 105 million people infected and more than 2 million dead, around 450,000 of these in the USA alone. Australia has been fortunate. We are an island, our leaders have listened to and largely acted on the science, and our population responded.
Leon Piterman may be a general practitioner by training but he is a philosopher, healer and humanitarian by nature. In Living in COVID Times Leon takes us on a fascinating journey in time and also perspectives. He helps us to look from every angle at the experience of living through the extraordinary events of the 2020 pandemic as they unfolded. Leon explores our individual and shared experience with compassion, wit and wisdom. It would be hard to read this book without feeling both better informed about the pandemic, but also comforted and inspired. These are the kinds of stories we will proudly share with coming generations one day when we try to communicate what it was like to live through these 'unprecedented times'.
Associate Professor Craig Hassed
As one of the world’s leading GP educators and a practising GP with extensive mental health experience, Leon Piterman insights span the everyday experiences of individuals, their fears, and concerns, through to the ethics of the unprecedented political and public health pandemics
Dr Grant Blashki, Lead Clinical Advisor, Beyond Blue
…read this book. It will allay your fears because it reveals how self-aware, alert and compassionate doctors must strive to be.
Phillip Siggins The Weekend Australian
Transitioning to and from Uncertainty in the COVID Era
From kindergarten to primary school to secondary school to higher or technical education and into the workforce, friends are made and lost, relationships are formed and broken, success is achieved and failure is confronted. There is an element of certainty attached to these transitions which is met by rites of passage. It is anticipated that as we grow older we will move through the education system, then through one or more jobs or even several career changes. It is anticipated that we will partner with one or more individuals, perhaps raise a family, purchase a house, save money directly or through superannuation so we have enough to eventually retire. There is of course no guarantee or certainty that any of these things will happen.
When these transitions occur they do so over a period of time rather than overnight. The current Corona crisis has occurred almost overnight and has left all of us unprepared emotionally for its impact. Transitions may be glacial but the transitions brought about by COVID-19 are lightning fast. From freedom of movement to lockdown, from mass gatherings to isolation, from employment to unemployment, from financial independence to seeking handouts, from school and higher education on campus to learning online and at home.
The human condition needs a level of predictability to thrive and survive. Remove predictability and create uncertainty and we be-come fearful, anxious and then depressed, even chronically so. Many of us are now fearful of permanent loss of employment, loss of savings, loss of meaning, loss of health and loss of life.
Professor Myrna Weismann, a Clinical Psychologist who developed Interpersonal Therapy as a means of treating depression, believed that certain trigger factors underpin the onset of this condition. They include loss or grief, transition, interpersonal conflict.
It seems that the current crisis may contain all of these trigger factors, whereas normally there may only be one or two triggers. We are witnessing loss on a monumental scale including of course, loss of thousands of lives. This leads to grief. We are now grieving for and longing for a past we took for granted. It was a past with some certainty, knowing consciously or unconsciously that apart from taxes and death the only other certainty in life is change, and change is what we are experiencing.
We planned and looked forward to coffee or meals with friends, family gatherings, attending sporting events and theatre or simply going to the local playground with children. These pleasures have been stripped from us. Coffee over Zoom is not the same. And those who have lost their job, grieve for the loss of security as they face an uncertain future.
Transitions that I have mentioned have occurred on a massive scale and with electrifying speed. When we add loss and grief to transition and place them in the incubator of a lockdown we face the possibility of interpersonal conflict. Adding all of these factors, we have the makings of a pandemic of depression, more than an adjustment disorder, with the potential for domestic violence and even civil unrest as the lockdown is extended. Our leaders and society at large are confronted with an enormous challenge. Keep the lockdown going and delay or prevent spread of the virus, or ease the lockdown and prevent economic meltdown, mental illness and social unrest.
As we are still in the early phase of the lockdown, with pending school holidays, we may feel comfortable in maintaining lockdown, but what will it be like in two or three months’ time? We are confronted with uncertainty on many fronts, importantly the decision and timing to ease the lockdown and then encourage return to work, whilst avoiding a second wave. This will require the judgement of Solomon. Let us hope our leaders, acting on best available evidence, have the capacity to act wisely.
In the meantime, we need to bring a measure of certainty into our lives. Setting goals for each day, enjoying the outdoors for a limited time, maintaining an indoor physical fitness regimen, undertaking mindfulness and mediation techniques to focus on the present, catching up on domestic chores that have been postponed, reaching out to friends by phone or digital media, seeking psychological support when needed, and always being vigilant with hand hygiene and social distancing. We need to maintain faith in our health system and our public health measures. Morbidity and mortality in Australia are still relatively low.
We must turn despair into hope and hope into joy in the firm belief that this too will pass.
7 April 2020