How Social Distancing Can Impact Your Mental Health

Social distancing and isolation can be hard, as New York Gov. Andrew Cuomo recently pointed out during a daily briefing on the status of COVID-19 in his state. “Don’t underestimate the personal trauma, and don’t underestimate the pain of isolation. It is real,” Cuomo said. “This is not the human condition — not to be comforted, not to be close, to be afraid and you can’t hug someone. … This is all unnatural and disorienting.”  Experts already know that years of loneliness or feelings of isolation can lead to anxiety, depression and dementia in adults. A weakened immune system response, higher rates of obesity, high blood pressure, heart disease and a shorter life span can also result. A Pittsburgh Public Works employee removes a basketball rim from a city court in an effort to encourage social distancing, March 30, 2020.Children who have fewer friends or are bullied or isolated at school tend to have higher rates of anxiety, depression and some developmental delays. But when it comes to a global pandemic like COVID-19, there is no documentation to which medical experts can refer.  “The studies that we have are more about forced isolation and no support,” said Elena Mikalsen, chief of the Psychology Section at Children’s Hospital of San Antonio. “The situation we’re in now, there’s a lot of social support … and social support is one of the big predictors of good health and mental health outcomes.” She adds that it is helpful that the entire world is basically in the same situation, a commonality that is leading to the rapid development of coping strategies from multiple sources, including friends, schools and businesses.  Playground equipment is wrapped in crime scene tape to prevent its use as part of the effort to slow the spread of the coronavirus March 31, 2020, in St. Louis, MIssouri.During this period, Mikalsen is advising her patients to stay connected with people,  exercise regularly, and keep to a schedule so that everybody in the household has some sort of purpose in their day. Waiting around and worrying about getting sick can lead to increased anxiety. A key factor driving people’s decisions on whether to isolate could come down to personality.  “Extroverts have this strong need to always be around other people. … The idea of being in a quiet place with no entertainment is extremely anxiety provoking,” Mikalsen said. “Versus, you know, an introvert is perfectly happy in a tiny little room with nothing. You can lock up an introvert in a New York City apartment and have them not come out for two months and they’ll be perfectly happy.” New York Gov. Andrew Cuomo with daughter, Cara Cuomo, in Mt. Kisco, N.Y., Nov. 6, 2018.Meanwhile, Cuomo told reporters that he is focusing on the positives in the current situation, like having his grown daughter, Cara, 25, working with him during the crisis.  “They’ll come for the holidays. They’ll come when I give them heavy guilt,” he said of his three grown daughters. “But I’m now going to be with Cara, literally, for a few months. What a beautiful gift that is, right? I would have never had that chance, and that is precious. … This crazy situation, as crazy as it is, gave me this beautiful gift.” 

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Vendors Return in Wuhan as China Prepares Virus Memorial

Sidewalk vendors wearing face masks and gloves sold pork, tomatoes, carrots and other vegetables to shoppers Friday in the Chinese city where the coronavirus pandemic began, as workers prepared for a national memorial this weekend for health workers and others who died in the outbreak.  Authorities are easing controls that kept Wuhan’s 11 million people at home for two months, but many shops are still closed. Shoppers and sellers in the Minyi neighborhood on the city’s southwest side had to do their business over high yellow barriers, as access to the community is still controlled. 
“I don’t feel safe going to a supermarket,” said Zhan Zhongwu, who wore two layers of masks and was buying pork for his wife and grandchild. “There are too many people,” he said. “Many infections happened in the supermarket.”
Residents have been relying on online groceries and government-organized food deliveries after most access to the city was suspended Jan. 23 and restaurants, shops and other businesses shut down.
Wuhan and the rest of China are preparing for a nationwide three minutes of silence on Saturday in honor of the 3,322 people who officially died of the virus, including doctors, nurses and other health workers who have been declared martyrs.They include Li Wenliang, an eye doctor in Wuhan who was reprimanded in December for warning about the virus and later died of the disease. He became a symbol of public anger at the ruling Communist Party for suppressing information about the coronavirus, possibly worsening its spread, before it took action in late January.  The party rescinded Li’s reprimand and declared him a hero as part of a propaganda effort aimed at deflecting criticism of the official response.  On Saturday, national flags will be lowered to half-staff at 10 a.m. while air raid sirens and the horns of cars, trains and ships will “wail in grief,” the official Xinhua News Agency said.
 
People have been told to avoid cemeteries on Saturday, the start of a three-day holiday when families traditionally tend the graves of ancestors.  While the United States and other governments tighten controls and shut down businesses, Chinese leaders are trying to revive the world’s second-largest economy after declaring victory over the outbreak.  Still, local authorities have orders to prevent new infections as millions of people stream back to work in factories, offices and shops. Passengers on planes, trains, subways and buses are checked for fever and employers have orders to disinfect workplaces regularly.  Vegetable vendor Xie Lianning said she picked up supplies at a wholesale market at 5 a.m. and drove to Minyi. She was checked for fever at the neighborhood entrance.  Xie set up shop on a sidewalk in front of closed shops that were covered by roll-down metal doors. The block was surrounded by the head-high yellow barriers installed to keep residents inside during the quarantine.  “Our business is not bad. Here is definitely better than indoors,” said Xie. “Nobody wanted to go inside. People are willing to buy things outside.”  Wuhan accounts for three-quarters of China’s virus deaths but has reported no new cases for a week. Despite that, controls requiring official permission to enter or leave the city are to stay in place through Tuesday.  Xie said she still was worried about the virus but had to get back to work.  
“We have no choice,” she said. “There are old and young in my family living with us. We have a heavy financial burden.” 

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Prince Charles Opens Fast-Tracked London Hospital

Prince Charles on Friday remotely opened the new Nightingale Hospital at London’s main exhibition and conference center, a temporary facility that will soon be able to treat 4,000 people who have contracted COVID-19.
Charles said he was “enormously touched” to be asked to open the temporary facility at the ExCel center in east London and paid tribute to everyone, including military personnel, involved in its “spectacular and almost unbelievable” nine-day construction.
“An example, if ever one was needed, of how the impossible could be made possible and how we can achieve the unthinkable through human will and ingenuity,” he said via video link from his Scottish home of Birkhall.
“To convert one of the largest national conference centres into a field hospital, starting with 500 beds with a potential of 4,000, is quite frankly incredible.”
The new National Health Service hospital will only care for people with COVID-19, and patients will only be assigned there after their local London hospital has reached capacity.
Charles, who earlier this week emerged from self-isolation after testing positive for COVID-19, said he was one of “the lucky ones” who only had mild symptoms, but “for some it will be a much harder journey.”
He expressed his hope that the hospital “is needed for as short a time and for as few people as possible.”
The hospital is named after Florence Nightingale, who is widely considered to be the founder of modern nursing. She was in charge of nursing British and allied soldiers in Turkey during the Crimean War of the 1850s, her selfless care earning her the reputation as the “Lady with the Lamp.”
Natalie Grey, the head of nursing at NHS Nightingale, unveiled the plaque formally opening the hospital on the prince’s behalf.
Further new hospitals are being planned across the U.K., including in Birmingham, Glasgow and Manchester, to alleviate the pressure on the NHS during the coronavirus pandemic.
“In these troubled times with this invisible killer stalking the whole world, the fact in this country we have the NHS is even more valuable that before,” said Health Secretary Matt Hancock, who also contracted COVID-19 and only emerged from his self-isolation on Thursday.
The number of people in Britain dying after testing positive for COVID-19 has been increasing sharply over the past couple of weeks. The latest U.K. figures showed that the number of people to have died increased in a day by 569 to 2,921.
Like many other countries, Britain is in effective lockdown, with bars and nonessential shops closed in order to reduce the rate of transmission, the hope being that it will eventually reduce the peak in deaths. Hancock would not be drawn across several interviews about when he expects the peak to be, beyond that it’s likely to occur in “coming weeks.”

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Ships With Coronavirus Patients Dock in Florida

A cruise ship where at least two passengers died of coronavirus while barred from South American ports finally docked Thursday in Florida after two weeks at sea and days of negotiations with initially resistant local officials.
The Zaandam and a sister ship sent to help it, the Rotterdam, were allowed to unload passengers at Port Everglades after working out a detailed agreement with officials who feared it would divert needed resources from a region that has seen a spike in virus cases.  
Broward County officials and Holland America, the company that operates the ships, announced the agreement shortly before the ships pulled into port.  
Holland America initially said 45 people who were mildly ill would stay on board until they recovered, but the docking plan released later Thursday indicated that 26 passengers and 50 crew members were ill. The plan noted that the company had secured access at two local hospitals for 13 passengers and a crew member who needed medical care.  
For nearly three weeks, passengers have not been able to step on dry land. Four elderly passengers died on the Zaandam, at least two from COVID-19, said William Burke, chief maritime officer for Carnival Corp., which owns the ships. Nine people had tested positive for the new coronavirus, Burke said earlier this week.
There were 442 guests and 603 crew on the Zaandam, and 808 guests and 583 crew on the Rotterdam. The Rotterdam was sent last week to take in some of the passengers and provide assistance to the Zaandam since it was denied permission to dock at ports in South America.
 
About 250 people have reported influenza-like symptoms since March 22, including 17 aboard the Rotterdam, according to the docking plan.
Originally firmly opposed to the ships’ arrival, Florida Gov. Ron DeSantis said Wednesday that he had a change of heart after realizing many passengers were U.S. citizens and about 50 of them Floridians.  
He went further on Thursday, telling Fox News that allowing the ships to dock and transferring critically ill patients to hospitals was “the humanitarian thing to do.”  
“I think the accommodations have been made, and I think that things are going to be done very thoughtfully,” he said later at a news conference. “It’s going to be a very controlled exit from these ships.”  
The docking plan indicated that Florida residents would leave the ship first, with the disembarkation of all passengers not concluding until Friday night.  
Passengers who have no symptoms of the virus will be bused to airports and put directly on charter flights without passing through the terminals, DeSantis said.  
Emily Spindler Brazell, of Tappahannock, Virginia, was still in her cabin waiting for instructions from the Rotterdam’s captain but said she was relieved to be back home.  
“People greeted us, came out to their balconies, blew air horns and shouted, ‘Welcome home!'” she said. “It was surprising. We went to many countries that said, ‘We are not going to talk to you.'”
Passenger Laura Gabaroni, of Orlando, said she would not be comfortable until she disembarked. She was transferred to the Rotterdam last Saturday, along with husband Juan Huergo and other passengers not showing signs of illness.
“Many broken promises so far, so I’ll believe it when I see it,” she told The Associated Press via a WhatsApp message.

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Medics: Iraq has Confirmed Thousands More COVID-19 Cases Than Reported

Iraq has thousands of confirmed COVID-19 cases, many times more than the 772 it is has publicly reported, according to three doctors closely involved in the testing process, a health ministry official and a senior political official.
 
The sources all spoke on condition of anonymity. Iraqi authorities have instructed medical staff not to speak to media.
 
Iraq’s health ministry, the only official outlet for information on the COVID-19 disease, could not immediately be reached for comment. Reuters sent voice and written messages asking its spokesman if the actual number of confirmed cases was higher than the ministry had reported and if so why.
 
The ministry said in its latest daily statement on Thursday that the total recorded confirmed cases for Iraq were 772, with 54 deaths.
 
But the three doctors, who work in pharmaceutical teams helping test suspected COVID-19 cases in Baghdad, each said that confirmed cases of the disease, based on discussions among fellow medics who see daily results, were between about 3,000 and 9,000 although they each gave different estimates.
 
The health ministry official, who also works in testing for COVID-19, the disease caused by the new coronavirus, said that there were more than 2,000 confirmed cases from eastern Baghdad alone, not counting the number in other areas or provinces.
 
The political official, who has attended meetings with the health ministry, also said thousands of cases were confirmed.
 
The new coronavirus has hit Iraq’s neighbor Iran worse than any country in the region. Iraq has close trade and religious ties with Iran and a large border, which Iraq shut in February over fears of the spread of the infection.
 
Iraq’s healthcare system, among other infrastructure, has been stretched by decades of sanctions, war and neglect, one among several problems that spurred mass anti-government protests in recent months.
 Pilgrims
 
Governments across the world have struggled to cope with the COVID-19 pandemic. The United States, Italy and Spain are the countries worst hit by the disease, which has infected nearly a million people worldwide and killed nearly 47,000.
 
The three Iraqi doctors and the political official said national security officials have attended health ministry meetings and urged authorities not to reveal the high figures because it could create public disorder with a rush on medical supplies, and make it harder to control the disease’s spread.
 
The health ministry did not immediately reply to a request for comment on any such discussions.
 
One of the doctors said the death toll was also likely higher than the official toll, but not by much. “On Saturday last week alone, about 50 people were buried who died from the disease,” he said. At that time the official death toll was 42.
 
Testing facilities are limited and Iraq has publicly acknowledged that the actual number of cases must be higher than the number of confirmed cases.
 
Many doctors blame the accelerating spread of the disease on people refusing to be tested or isolated and on the flouting of a nationwide curfew, including by thousands of pilgrims who flocked to a Shi’ite Muslim shrine in Baghdad last month.
 
The three doctors and the health official said many new cases were from eastern Baghdad where those pilgrims live.
 
Separately, some Shi’ite pilgrims returning to Iraq from Syria have tested positive for coronavirus, a senior Iraqi official and health officials said on Sunday.

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Israel’s Health Minister Has Virus, Top Officials to Isolate

The new coronavirus is forcing more top Israeli officials into isolation after the country’s health minister, who has had frequent contact with Prime Minister Benjamin Netanyahu, tested positive, the Health Ministry said Thursday.
 
The Middle East has over 81,000 confirmed cases of the virus, most of those in Iran, and over 3,600 deaths. Iran’s Health Ministry said Thursday that the new coronavirus killed another 124 people, pushing the country’s death toll to 3,160.
 
In a rare acknowledgment of the severity of the outbreak by a senior Iranian official, President Hassan Rouhani said the new coronavirus may remain through the end of the Iranian year, which just began late last month, state TV reported Thursday.
 
“The corona issue is not an issue that we can say it will be ended (on a specific) day. It is possible corona will be with us for the coming months. It is possible it will be with us by the end of the year. We always have to follow healthy protocols provided by the health ministry,” Rouhani said.
 
In Lebanon, the Philippines ambassador, Bernardita Catalla, died of complications from the coronavirus Thursday, the Philippines said. Lebanon has recorded 479 cases, including 14 deaths.
 
Israeli Health Minister Yaakov Litzman and his wife, who also contracted the virus, are in isolation, feel well and are being treated, the ministry statement said.
 
Shortly after the announcement, the prime minister’s office said Netanyahu returned to self-quarantine because of his contact with Litzman. Netanyahu had previously been in isolation after a top aide tested positive for the virus. Netanyahu has tested negative.
 
Hebrew language media reported that the head of Israel’s Mossad spy agency and the National Security Council were asked to self-quarantine because of their interactions with Litzman.
 
The Health Ministry director and Litzman’s staff also self-quarantined, and the ministry said that requests to enter isolation will be sent to those who came in contact with the minister in the past two weeks.
 
Israel has gone into near-lockdown to try to contain the virus outbreak. The country has reported just over 6,200 confirmed cases and 29 people have died of COVID-19, the illness caused by the virus.
 
Israel’s large, insular ultra-Orthodox community, of which Litzman is a member, has been particularly hard hit by infections. In the early phases of the outbreak, some rabbis had pushed back or ignored government-mandated movement restrictions, but resistance appears to have diminished.
 
On Wednesday, Netanyahu ordered a police cordon around the largely ultra-Orthodox city of Bnei Brak, east of Tel Aviv, to limit movement to and from the city. Bnei Brak has the second highest number of coronavirus cases in Israel.
 
For most people, the coronavirus causes mild or moderate symptoms, such as fever and cough. But for others, especially older adults and people with existing health problems, the virus can cause severe symptoms like pneumonia or death. 

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