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Your Health Checkup: Be Compassionate, Be Generous, Be Thankful

“Your Health Checkup” is our online column by Dr. Douglas Zipes, an internationally acclaimed cardiologist, professor, author, inventor, and authority on pacing and electrophysiology. Dr. Zipes is also a contributor to The Saturday Evening Post print magazine. Subscribe to receive thoughtful articles, new fiction, health and wellness advice, and gems from our archive.

Order Dr. Zipes’ new book, Bear’s Promise, and check out his website www.dougzipes.us.

I was tempted to write a follow up column to the one I wrote six weeks ago, “What You Need to Know About the Coronavirus,” but thought better of the idea since I am sure readers have been deluged with COVID-19 information. I know I have.

Instead, I’d like to share a story written about the famous anthropologist, Margaret Mead, as told by Ira Byock in his book The Best Care Possible: A Physician’s Quest to Transform Care Through the End of Life (Avery, 2012).

Someone once asked Margaret Mead what she considered to be the first evidence of civilization. She answered that it was not tools for hunting or religious artifacts or primitive forms of communal self-governance. Rather, it was a human thigh bone with a healed fracture found in an archaeological site 15,000 years old.

How could that be?

She reasoned that in the animal kingdom, if an animal broke its leg, it would soon die since it could no longer hunt, walk to get water, or defend itself. So, for a person to have survived a fractured femur, others must have provided shelter, protection, food, and drink over an extended time period long enough for the bone to heal. She concluded that helping someone through difficulty is where civilization begins.

Let us hope we act as a civilized nation during this horrific pandemic crisis. We need to show collective compassion for others, for those who have become sick or lost loved ones, for people who have lost jobs and savings and are living hand-to-mouth. We need to be generous and share our good fortune as much as possible. And we need to give thanks to those on the front lines, the health care workers risking their lives to save ours, and those in the work forces that keep us fed and healthy.

We can all profit from — and try to emulate as much as possible — an aphorism usually applied to physicians, but very apt for all of us today as we hunker down to fend off this virus: “To cure sometimes, to relieve often, to comfort always.” Let us provide as much comfort as possible to those in need.

COVID-19 has challenged us like no other calamity, and the end seems a long way off. But we will get through it as a nation of Americans helping each other, dispelling feelings of hopelessness and fear. It will not be easy, as the number of infected people grows, deaths increase, and financial markets crumble.

I don’t underestimate the seriousness of our present situation, but we will prevail. We must.

Footnote: I thank my son David for pointing me to the Mead story.

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Crisis to Opportunity — Survival or Thrival with COVID-19

We humans like to think of ourselves as highly evolved beings at the top of evolutionary hierarchy and clearly different from the animals we came from. Unlike our animal ancestors, we have a part of our brain called the cerebral cortex that enables us to think, evaluate, organize, and plan our actions. But when faced with a crisis, are we really so different from those creatures lower down the evolutionary ladder?

“In the animal kingdom, the rule is, eat or be eaten. In the human kingdom, define or be defined.”

-Thomas Szasz, noted professor of psychiatry

The part of the brain that often reduces us to animal-like behavior when confronted by a crisis is the amygdalae, two small, almond-shaped chunks of gray matter, located at the base of our brain (the area commonly referred to as the primitive brain). 300,000 years ago, when early Homo sapiens were faced with a crisis, such as a saber-toothed tiger or a rival tribesperson with a really big club, the amygdala processed this life-threatening information instantly, bypassed our higher-order thinking ability (no time for that!), and immediately triggered emotional, psychological, and physical changes that mobilized action in the name of survival.

Now this reaction may still be useful in the 21st century when confronted by, say, a mugger on a dark street or a mountain lion while on a hike. But the activation of the amygdala produces changes in our brain and body that are less effective for managing many of the crises we are facing these days including the current COVID-19 crisis.

This rest of this article will focus on the specific ways in which our amygdala impacts our thoughts, emotions, and reactions to a crisis. It will also introduce you to the forks in the road that you can take to gain control over your amygdala. We will use what makes us a more evolved species to respond in ways that will work when faced with the COVID-19 crisis instead of what worked many millennia ago.

Instincts: Primitive or Evolved?

Instincts lie at the heart of a crisis mentality. They are the starting point for all of the reactions that we have toward a crisis. Instincts are a complex, genetically hard-wired action that serves a specific purpose in our lives related to survival. Examples include fear, suckling, and sex. For us to gain control of and, if necessary, override our instincts when confronted with a crisis, it is essential to understand the role that instincts play in how we respond to crises.

Is there any more important situation than a crisis, when we need to have all of our most highly evolved capabilities firing on all cylinders? As an immediate and disturbing example, the COVID-19 crisis that the world is now confronted with is highly complex and largely outside of our control (though there are steps we can take to help). As a result, the COVID-19 crisis is not solvable by way of immediate physical action, which is why our primitive instincts can prevent us from responding effectively to and overcoming the crisis that has almost paralyzed our daily lives.

“The wise are instructed by reason; ordinary minds by experience; the stupid, by necessity; and brutes by instinct.”

-Marcus T. Cicero, Roman philosopher & statesman

Fork in the Road

Many of us fall victim to a crisis mentality because it’s our natural instinct. By working to instill what I call an “opportunity mindset,” you will increase your awareness of constructive forks in the road and the probability that you will take the good road as you face the COVID-19 crisis and other crises that will inevitably arise in the future.

Survival

Our emotions have evolved to be of great benefit to our survival. So-called “hot” emotions, such as fear and disgust, are experienced instantaneously and powerfully. These emotions signal an imminent threat to our survival (e.g., an attacker or rotten food), which initiates urgent action that increases our chances of survival. In contrast, “cool” emotions, like joy and or pride, typically take longer to be felt and are usually less intense initially. Simply put, there isn’t a pressing need to experience “cool” emotions strongly or right away because they don’t signal a threat to our lives and don’t require an immediate response.

Unfortunately, in an odd sort of way, our primitive survival instinct — including these hot emotions — has become outdated for many aspects of our modern lives.

Survival in the 21st century has taken on new meanings that require a different understanding of survival and an evolved survival instinct that focuses on modern-day crises such as COVID-19. In this current crisis, the dangers include loss of a job, a significant decline in retirement portfolio, social isolation, and the inability to engage in enjoyable activities due to “Shelter in Place.” (e.g., failure). Even though illness is a possibility, the threat is not imminent or severe for most of us. This new conceptualization of the survival instinct demands a very different set of responses than those triggered by the “old school” fight-or-flight response.

Thrival

Our understanding of and means for ensuring this new form of survival in the 21st century has changed significantly compared to primitive times. A more appropriate definition of survival for modern times may be: “The state of continuing to live one’s normal life, typically in spite of an accident, ordeal, or difficult circumstances.” Rather fitting given COVID-19, wouldn’t you say? In other words, the ability to get by or maintain the status quo despite challenging conditions.

Another instinct that is more aligned with our times has risen to the forefront and is what I call our “thrival” instinct (yes, it is actually a word). Derived from the word “thrive,” thrival can be defined as “to prosper; to be fortunate or successful; to grow or develop vigorously; flourish.” In other words, to want to feel better, do better, and live better. The thrival instinct drives us to seek out our limits and to expand the world in which we live.

Conflict between Instincts

The problem with these two instincts — survival and thrival — is that they are fundamentally in conflict with each other. Our survival instinct demands that we seek out safety, security, certainty, familiarity, predictability, routine, comfort, and control. In contrast, our thrival instinct drives us to seek out risk, novelty, uncertainty, insecurity, discomfort, and stress.

This conflict is inherently connected to the difference between a crisis mentality and an opportunity mindset, with the former being grounded in our survival instinct and the latter woven into our thrival instinct. As I will be showing throughout this article series, rejecting our survival instinct and embracing our thrival instinct is essential to shifting from a crisis mentality to an opportunity mindset. With COVID-19 crisis, the qualities of the thrival instinct will better serve your efforts in responding to their challenges and enable you to adopt an opportunity mindset.

Steps for Moving from Survival to Thrival

1. Don’t resist your initial reaction

First, as I’m sure most of us have experienced with COVID-19, when a crisis strikes and you experience the first wave of a crisis mentality, don’t attempt to resist it. The fact is that you can’t, because it has millions of years of evolution driving the instinct through you. Instead, acknowledge and accept that it is your survival instinct responding naturally to the perceived threat. This acceptance will dull the intensity of your survival instinct’s actions by not adding unhelpful emotions (e.g., frustration, anger) or physiological reactions (e.g., more adrenaline) to the situation. It will also allow you to let the psychological, emotional, and physical wave to pass more readily and more quickly.

2. Invoke your thrival instinct

Second, the initial shock of your survival instinct and crisis mentality will either ebb to a more manageable level or mostly run its course. Then, you can invoke your thrival instinct by recognizing that its attributes are better suited for 21st century crises including COVID-19.

3. Understand this shift will be uncomfortable

Third, expect and acknowledge that this shift from survival to thrival and crisis psychology to opportunity mindset will be uncomfortable. In fact, millions of years of evolution will be screaming at you to not go there. But you must go there because the thrival instinct and an opportunity mindset give you the best chance of coming out of the COVID-19 crisis as intact as possible.

4. Commit to your new instincts

Finally, make a commitment to your thrival instinct and your opportunity mindset. Stay conscious and vigilant to your survival instinct and crisis mentality creeping into your mind and body and attempting to kidnap you back to your primitive self. Then, use that commitment as the foundation which you can then apply to the COVID-19 crisis that we are all now facing.

Want to learn more about how to respond to the COVID-19 crisis in healthy and constructive ways? Read Dr. Jim Taylor’s new book, How to Survive and Thrive When Bad Things Happen: 9 Steps to Cultivating an Opportunity Mindset in a Crisis, or listen to his podcast, Crisis to Opportunity (or find it on Stitcher, Spotify, iTunes, or Google).

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Con Watch: Coronavirus Scams

Steve Weisman is a lawyer, college professor, author, and one of the country’s leading experts in cybersecurity, identity theft, and scams. See Steve’s other Con Watch articles.

Scammers are adept at manipulating anything that has captured the attention of the public and turning it into an opportunity to scam people. With the attention of the world focused on the rapidly spreading coronavirus, related scams are increasing at an even faster rate.

Here are two of the more common scams.

Pump and Dump

Everyone would like to be able to invest in a stock while the price is still low, but predicted to rise dramatically. This desire for a quick buck is exploited in a scam called the “pump and dump.” In this scam, you hear about a company with a stock price that is currently low, but about to rise tremendously. You may hear about this great deal by email, phone call, or text message, or even in chat rooms or on social media. The advice almost always comes from someone you don’t know. Most often these companies are small capitalization companies, often referred to as penny stock companies. These stocks are often thinly traded.

The victim buys the stock, and sure enough, the stock price promptly rises. But then without warning, the stock plummets in value, and the investor is left with a poor investment. This scam is created by criminals who buy the stock themselves at a low value and then influence others to buy the stock. Once the stock has shot up in value, the criminals sell their stock, make a profit, and leave the victims with losses when the stock reverts to its true, lower value.

The Securities and Exchange Commission (SEC) has warned of “a number of Internet promotions, including on social media, claiming that the products or services of publicly-traded companies can prevent, detect, or cure coronavirus, and that the stock of these companies will dramatically increase in value as a result.” In regard to the coronavirus, the World Health Organization has strongly indicated that there are currently “no known effective therapeutics” available to prevent or treat the coronavirus.

Protecting Yourself from the Pump and Dump Scam

Always consider the sources of any investment advice. How reliable is the source? What are the credentials of the people advising you? What do they stand to gain? Some particular red flags that a stock offer is a scam include unregistered investment advisers approaching you. You can find out if a particular investment adviser is registered by going to the SEC’s Investment Adviser Public Disclosure database.

Also be wary of promises of huge profits with little or no risk.

Finally, be skeptical when you receive a stock solicitation through an email, text message, phone call, or any other communication that you have not initiated. Be particularly skeptical if the promoter of the stock tells you that they have inside information, because trading on inside information is a criminal offense.

Phishing Emails

In another coronavirus related scam, cybercriminals send phishing emails to lure people into downloading malware-infected attachments. The malware might be keystroke logging software that can steal personal information from your phone or computer and use that information to make you a victim of identity theft. In other instances, it could be ransomware malware that will hold your data hostage until you pay the criminals.

These phishing emails purport to provide important information about the virus. Often these emails appear to come from the Centers for Disease Control or the World Health Organization, which are two legitimate organizations leading the fight against the coronavirus. These phony emails may even contain the official logos of these organizations.

Protecting Yourself from Phishing Emails

Any time you get an unsolicited email that asks for personal information or instructs you to click on a link or download an attachment, you should be wary. Remember my motto, “trust me, you can’t trust anyone.” Never provide personal information, click on a link, or download an attachment unless you have absolutely confirmed that the email is legitimate.

You should also make sure that your phone, computer, and any other devices are protected by security software, and be sure to update that software with the latest security patches as soon as they become available. It is important to remember, however, that the most up-to-date security software will always be at least 30 days behind the latest strains of malware, so you cannot depend on your security software to be 100 percent effective.

Some Final Advice

There is a lot of misinformation about the coronavirus, so if you want information you can trust on this subject, go to a legitimate source such as the World Health Organization or the Centers for Disease Control.

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Wit’s End: 6 Coronavirus Life Hacks

Read more from Maya Sinha’s column, Wit’s End.

We’re a few weeks into the coronavirus era, and from where I’m sitting, it looks pretty serious. As I write this, a cruise ship is quarantined off the coast of California — I can see it from my house — where 3,500 people await test results from a San Francisco lab after the National Guard dropped test kits down on them by helicopter.

“No one will be allowed to disembark until all test results are received,” the cruise ship company has announced, like that nightmare where you’re trapped in a classroom with a trigonometry final in front of you, and there’s no way to say: “There must be some mistake. I passed this class 25 years ago! Please, let me out.”

The governor of California has declared a state of emergency, and up the coast in Seattle, schools and workplaces are shutting down to prevent the virus’s spread.

Every kid in America is now told several times a day to wash their hands, but after the three o’clock school bell rings, you catch them reaching into their own mouth to extract a loose tooth.

“Did you wash your hands first?” you ask nervously, missing the days when they could just catch lice or pinkeye from a classmate.

“Yeah. I think I washed them this morning.”

Then you clutch your forehead with anxiety, inadvertently touching your own face. Oh no!

Though everyone is understandably on edge, there must be some upside to a new, intermittently deadly global virus. In the spirit of never letting a crisis go to waste, here are some possible ways to improve your life in the coronavirus era:

Stop going to work. For anyone tired of driving in commuter traffic to sit at a desk, now is the perfect time to lobby for a telecommute option. If your company is on the fence about letting everyone work from home, move things along at the next meeting by coughing a lot, then reaching for a donut out of the box in the middle of the conference table. Later that day, locate a fresh pair of pajamas, which you’ll be working in for the foreseeable future.
Pull the kids out of school. Delight your children by keeping them home on a “corona-cation” of indefinite length. If they’re still in the lower grades, it’s going to be a real monkey house, but if they can read chapter books and do simple math, they are already the equivalent of many functional adults. Homeschool them by announcing once, in the morning: “Please keep it down in there. I’m working!” Then let them surf the Internet about whatever subjects catch their fancy. They will learn some interesting things that will surprise you.
Opt out of all extra-curricular activities. Now is the time to look into your heart and ask: “Does my four-year-old really need to play organized soccer?” “Will my pony-obsessed daughter honestly miss coding camp?” “Does my husband truly want to take a cooking class with me on date night, or is he secretly hoping we just order pizza and stay home?” Probably no one wants to do any of those things, and thanks to the coronavirus, your family has an honorable excuse to skip them. It’s about staying healthy!
Quit cooking. A few days into the coronavirus panic, I casually filled a shopping cart with nonperishable foods and medicines. I was no wild-eyed prepper, just someone who could always use an extra four jars of shelf-stable marinara sauce. I stacked these “emergency supplies” in a big plastic tub, planning to store it in the garage. What actually happened was that I didn’t go shopping or cook for a week. When someone got hungry, I just filched from the tub, filled with easy comfort foods like canned soup, shells-and-cheese, tuna, and energy bars. Everyone enjoyed the break from fresh vegetables, fruit, and meat. But the grocery stores stayed open, so eventually I had to go back and buy some real food.
Appreciate the old people in your life. Americans have mixed feelings about the elderly as a group. In 2018, Forbes reported that people born before 1942 have made out like bandits, possessing “roughly 1.3 times the amount of wealth as Boomers, more than twice that of Xers, and 23 times that of Millennials.” In addition to being richer than everyone else (thanks to huge increases in housing and education costs), septuagenarians still want to be in charge: Witness the 73-year-old, 76-year-old and 78-year-old battling it out for President in 2020. Still, we don’t want Grandma and Grandpa succumbing to the coronavirus. Now is a good time to phone that older relative, ask how they’re doing, and offer to help in any way you can. If there’s a lull in the conversation, you can say: “Tell me the story, again, of when a family could have a comfortable middle-class life on one income? Wow.”
Cash out of the stock market and hoard gold. Till about two weeks ago, 401(k)s were boring. But when the coronavirus hit, retirement funds became an exciting roller coaster: Watching the market rise and tank, then soar to dizzying heights, then plummet within 24 hours to record lows, was suddenly an engrossing pastime. “Get yourself a PowerBar out of the emergency tub, kids! I’m sweating bullets trying to figure out whether Dad and I will ever be able to — whoop! There it goes again.” Perhaps it’s time to pull your money out of stocks and spend it all on gold doubloons. Buy a big white shirt and some tall boots while you’re at it! In this new “pirate” phase of retirement planning, you’ll need a strongbox with a heavy lock, a shovel, a parrot, and a loyal crew: Use your own children, who now spend their days hanging around the house doing nothing. Tell them to bury the box somewhere in the yard, draw up a treasure map, and fetch you a tankard of ale! Everyone will be happier than in their old, pre-virus life. Let’s hope so, anyway.

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In a Word: How Long Is a Quarantine?

Managing editor and logophile Andy Hollandbeck reveals the sometimes surprising roots of common English words and phrases. Remember: Etymology tells us where a word comes from, but not what it means today.

It’s never a good time when the word quarantine starts to appear regularly in the daily news. In attempts to stymie the spread of the coronavirus, some quarantines have been put in place to contain people who have been exposed to the virus. But how long should a quarantine last? The coronavirus is believed to have an incubation period of 14 days, so 14 days without showing symptoms of infection has seemed a good guideline for quarantine length so far.

But there’s a specific length of time embedded in the word quarantine itself.

As far back as the fourteenth century, ships coming to Venetian ports from countries thought to be stricken by plague were ordered to remain off the coast for quarantina giorni — literally “a space of forty days” — from the Latin quadriginta “forty.” Most who contracted the bubonic plague would have been killed by it within a week, but the extra time made sure there were no latent cases still aboard.

In French, this concept was called quarantaine, which was altered in English to quarantine, referring to any stretch of forced isolation for medical reasons, by the mid-1600s. But even before then, English law had the concept of a widow’s quarantine, referring to the time — again, often 40 days — that a recent widow was allowed to live on her dead husband’s estate rent-free. After that, the estate would be seized and distributed according to the law of the time.

These days, medical quarantines can last for any length of time, regardless of the word’s etymology. And the recognition of women’s sovereignty has made the widow’s quarantine more or less obsolete.

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What You Need to Know About Coronavirus

Order Dr. Zipes’ new book, Bear’s Promise, and check out his website www.dougzipes.us.

Unless you have been living on another planet these past few weeks, you have been deluged with daily updates about the new coronavirus, 2019-nCoV, the seventh member of the family of coronaviruses that infect humans. The information, depending on its source, is at times reassuring and at other times frightening. At the very least, it is unsettling, especially as we read about the impact the virus has had in China, particularly in Wuhan where it began, perhaps transmitted by camels, bats or the pangolin, an animal used in traditional Chinese medicine. Infection has spread to over twenty countries, mostly in Japan, Singapore, Thailand, Hong Kong, and other Asian countries.

The purpose of this column is to provide readers with some facts as we know them today, and to offer reliable sources where readers can obtain valid information, such as from the Johns Hopkins website, the World Health Organization, or the American Medical Association that deliver expert information about the impact and extent of nCoV.

As I have written previously, due to deficiencies in worldwide health care, unfounded distrust of vaccinations and health services, and poor health infrastructure, our planet is ill- prepared to handle a pandemic of coronavirus proportion. At the time of this writing, there are around 40,000 confirmed cases of 2019-nCoV infection — the vast majority concentrated in China — and more than 900 deaths, for about a 2 percent mortality. One of the deaths included the unfortunate Chinese physician who first called attention to the new virus. Twelve cases of nCoV infection have occurred in the U.S. (nine people had been in Wuhan) with no deaths to date, although a 53-year-old American man has recently died in China. Thousands of people have been trapped on three cruise liners in Asia due to fears of contagion. Human-to-human transmission has been documented, leading the World Health Organization to declare a public health emergency on January 30, with a similar declaration by the U.S. a day later.

Coronavirus outbreaks are nothing new. The Severe Acute Respiratory Syndrome (SARS) virus was another coronavirus originating in China in 2003, not as contagious as nCoV, though more lethal. SARS infected over 8,000 people, killing almost 10 percent of infected people before it was contained. The Middle East Respiratory Syndrome coronavirus (MERS) was also a coronavirus stemming from animal reservoirs such as bats, perhaps with intermediate hosts. MERS infected 2,494 people and caused 858 deaths (34 percent mortality rate), the majority in Saudi Arabia.

In comparison, the influenza virus kills less than one person per thousand infected (0.1 percent), but about 200,000 people are hospitalized with the virus each year in the U.S., leading to about 35,000 deaths.

The SARS pandemic cost the global economy an estimated $30 billion to $100 billion. The full economic impact of nCoV is yet to be felt, and while the Chinese economy is likely most affected, the impact will be worldwide as it upends manufacturing, shipping, travel, education, and other activities.

Such respiratory viruses travel through the air in tiny droplets produced when an infected person breathes, talks, coughs or sneezes. This coronavirus is moderately contagious, harder to transmit than measles, chickenpox, and tuberculosis, but easier than H.I.V. or hepatitis, which are spread only through direct contact with bodily fluids. Face masks may help prevent its spread, though that has yet to be established.

The incubation period after being infected before symptoms manifest appears to be 2-14 days (more likely 5-6 days), raising the possibility of transmission before a person knows they are infected, though transmission by symptomatic persons is more probable due to a greater viral load at that time. Older men with other health issues seem more likely to become infected and young children less likely.

Symptoms can include fever, cough, shortness of breath, muscle ache, confusion and headache, sore throat, and GI problems such as diarrhea, nausea, and vomiting. Pneumonia has been documented in the majority of hospitalized patients and when severe, is probably the cause of most deaths. The median time from first symptoms to becoming short of breath is five days; to hospitalization, seven days; and to severe breathing trouble, eight days.

Additional information about 2019-nCoV is needed to better understand transmission, disease severity, and risk to the general population. Public health measures to quarantine infected individuals and prevent spread have been instituted worldwide.

Management of people with 2019-nCoV is largely supportive, although antiviral medications have been used, as have antibiotics in patients with superimposed bacterial infections. The effectiveness of antiviral medications is unproven, although they may have been effective in treating SARS. Interventions that will ultimately control nCoV are unclear because there is currently no vaccine available and one is not likely for a year or longer.

Staying home when ill, handwashing, and respiratory care including covering the mouth and nose during sneezing and coughing, were effective in controlling SARS and should be advocated for treating nCoV as well.

Presently, there is no reason for panic in Western countries. We need to follow updates and hope containment will eliminate the threat of this new nCoV pandemic over the next month or so. Remember that the virus is transmitted by humans during sneezing or coughing. Avoid such individuals or wear a face mask if in contact. The CDC does not recommend widespread use of masks for the healthy, general public at present.

If you sneeze or cough, do so into a disposable cloth or paper. A fist bump greeting rather than a handshake might be wise. For viral particles that have settled on the floor, table, and other objects, hand contact then brought to your face can transmit the infection. So, wash! wash! wash! your hands with antibacterial soap after contacting such surfaces and before touching your face. Alternatively, use an alcohol-based hand sanitizer containing at least 60 percent alcohol. Green leafy vegetables and other sources of vitamin C can help the immune system fight off disease.

If we all pay attention to these simple measures, we will help contain the virus and it will eventually die out, particularly as warmer weather approaches.

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