Episode 127 - COVID-19: The Science, How To Help, and Handling The Stress

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hey everybody michael gunger here it's a crazy week in the world right now with covet 19 and everything that's going on and so we thought we'd take a little break from our normal format of season six which is pulling apart the stories that pull us apart and just kind of sit down and talk about what's been going on we're thankful to have science mike back on the program this week so it's william hillary science mike and i all in our respective homes all social distancing are talking about covid19 and how it's affecting us what we can do what the future might look like and um while the topic is heavy i will say it's just nice to be with each other and talk and i hope this episode makes you feel a little less alone a little more equipped and informed and ready to do this together welcome to allergist podcast everybody fans back together we are the we are the picture of social distancing it's yeah it is pretty wild this is not this is not the way it envisioned us all getting back together it's true yeah feels nice nonetheless to see all of your faces so little thing going on in the world how are you guys feeling i fluctuate emotions i like i go from feeling fine and like you know yeah i'm i'm a homebody anyway so i'm used to just being home into like panic into anxiety into oh yeah i'll we'll be fine this is going to be okay we're going to make it through like you know i feel like i fluctuate through all those emotions and it's it can happen over the course of like an hour or two right i just feel like the waves of this are you being good with social distancing no well i just i just i have to work on uh a project so i i have an editor coming over my house every day so i'm not technically social distancing but we're kind of social distancing or quarantining together so that's how i see it i i would say on behalf of the as i understand what public health officials would like to see happen getting together with one other person to work a day falls well within the current guidelines for social distancing we weren't we aren't at like an absolute self quarantine or shelter in place uh in most of uh the world right now actually and that includes most of the united states so that that sounds well within the bounds of social distancing okay i feel better i feel better then is your editor being good though yeah yeah yeah that would be the yeah yeah he's pushing he's pushing me to be better because i i have food but i haven't like stocked up beyond a week and so he's like you need to go to the grocery store and like get more stuff i tried to like do amazon prime but then those deliveries here in la are like days out like you can't order anything on amazon prime because they're like we're booked out for three days in advance try again uh so i'm like okay i gotta actually physically show up to a grocery store but around the city there's like lines everywhere he was telling me because he went a couple different times he actually found the smaller grocery stores people weren't going to like all the bigger ones had like lines outside the door even like well before the store opened so that's that's my next move go to the store how about you all how are you feeling oh gosh you know i i'm very concerned and my concern is that the ways we are naturally responding to the news and information of this disease are causing us collectively to almost universally do the wrong things on the one hand knows that people are tending to minimize or ignore the impact of the disease on the other extreme people are treating it as if it's going to be a mass extinction event and neither of those things are true and that means people are are doing strange things people who are in their teens and twenties are gathering in large numbers all the time even in places where that's currently illegal and other people are hoarding food and bottled water and toilet paper when food supply chains are not disrupted in any country including the countries where covet 19 has is in its most advanced states so we have a specific set of things that we'd like the public to do and instead part of the public uh which is kind of the infection vector part of the public is ignoring guidelines and also some religious conservatives in the united states and on the other hand we have people standing in very long lines and grocery stores buying everything they can find and creating an artificial scarcity that's not necessary and that's why i have such concern i've gotten into some very dark places emotionally personally as i've kind of preemptively grieved over what the consequences for society could be of botching this right now these these crit the first days of a pandemic are actually the most critical in what the overall distribution of spread looks like and right now as a society we're not doing a great job and that concerns me so your concern it sounds like is really really mediated by noticing the lack of response or lack of appropriate response yeah well and then it's the personal stuff right so we're already seeing tremendous economic impacts uh as we practice social distancing that has an incredible economic impact some number preliminary numbers this morning are saying that perhaps at the next job report the united states could be down between 800 000 and a million jobs that even immediately if this only lasts for 30 days perhaps as many as 10 of small businesses that have closed their doors right now will never open again so we're seeing this ripple effect go out through the economy already and this is all very complex we need to have social distancing to preserve lives but social distancing has economic impacts that most societies aren't structured to mitigate and which is meaning we have to not only respond to the disease as even as we're doing that we have to collectively organize and respond to the responses to our response to the disease to make sure that people who are economically disadvantaged aren't left behind and we don't face a serious recession mass job loss and lack of material security for people who are in vulnerable or at-risk populations yeah and not to mention the just the other societal fallouts of economic downturns i mean i we watched we watched contagion the other night for some sick reason why you're not the only person that did that somebody just told me it's been like a top rental for like a month in itunes some of us are sick in the head i i don't i don't know we watched it we did i don't know what to tell you that's what happened i wouldn't recommend it necessarily especially if people are really nervous already they kind of messed with lisa i i i didn't feel more panicked afterwards but i was noticing um and especially living in la in the in the movie it kind of shows a lot of the the human impact of people just being afraid and not having resources and that's you know riots and looting and whatever that can happen from people when you know hungry humans are dangerous animals so living in l.a i was like oh man uh yeah what happens with when a lot of people are afraid that's kind of a scary thing and then i had i went into this season with a bad cough or i had the flu or something like for a month and a half i had been coughing so right as the coronavirus stuff really started hitting in the states more as far as like people being aware of it and i already had a cough so i was really paying attention to the other symptoms and fever and stuff like that but i never i didn't have any of that but one of the one of the nights it was particularly bad and i had a bad headache that night and i was like i guess i've got it and that was a little i just sat with that and meditated and is again my kind of strange mentality towards the world i tend to be a person that goes fully into a fear rather than like trying to avoid it so i just gotta let my self imagine and go into okay i might have it might die and went into that zone for a minute and so it's been a wild that's a wild thing to watch what's happening around us and yes i share a lot of the concerns about culture and other people as well but i also have kids and parents you know we all as we all so many of us have people that we love that probably might be more immuno compromised than you know some of us and so it's just a lot it's a lot going on how do k how does it um affect kids um because i've actually thought about that but i haven't heard anyone specifically address what happens for children uh who contract the virus yeah well i was more thinking about lucy because she has down syndrome and and might have immune immune deficiencies but actually most kids mike you can speak to this but from what i've seen kids actually seem to be not very affected symptomatically by it but they can still have it and spread it yeah children under 9 so far tend to have very mild or no case presentation of the disease the mortality rate among children under 9 is so low that we can't measure it so far so very young children contrary to most flu-like disorders really don't have a bad time with covid19 which of course is the name of the disease while sars cov2 is the name of the virus that causes the disease as you move into teenagers though you do start to see a higher mortality rate i want to be clear that right now because this is a novel virus and it's very new we don't have actual specific concrete numbers on infection rates uh case fatality rates mortality rates overall because these this is unfolding there are more people who have coveted 19 right now than have gotten through it that's the nature of a new pandemic but with the numbers we have the kind of early data we're seeing once you get past nine years old the fatality rate is some multiple of the rate you see with the seasonal flu so while the mortality rate is very low for teenagers and people in their 20s and even their 30s it is many times perhaps as much as a hundred times more deadly than the seasonal flu even for those age groups and you have a higher chance of what we would call a severe presentation of the disease than you would with a flu a severe presentation is one that likely requires a hospital stay for you to make it successfully through the infection you require some kind of ongoing medical care beyond the traditional bed rest and then of course when you get into older groups it gets a lot higher you have a spike in mortality at 50 and at 60 plus this virus gets very very dangerous and has a high risk of severe presentation and death and then we also see that complicated by other health conditions things like cardiovascular disease pulmonary disorders hypertension diabetes obesity and other similar effects causes a significant risk of both severe disease presentation and mortality so on the one hand it seems a lot safer for children perhaps even immunocompromised children than other diseases but for people who are older who have other health conditions this this is a very potentially the most uh deadly disease that we've seen in a pandemic fashion since 1918. it has a disturbing combination of factors one it has kind of an extended period of incubation for three to as many as 20 days people can not have symptoms but shed the virus and spread it and that's one problem two it's very tough on surfaces it can last up to 72 hours or more on surfaces it can float in micro droplets of saliva in the air for up to three hours which is very high so that increases that infection rate and then it's got a relatively high mortality rate for something so contagious usually germs viruses that are very very contagious aren't very deadly and things that are very deadly tend to not be as contagious because if you're a virus that's a really bad reproductive strategy that evolution doesn't reward covet 19 being a novel virus that made a jump from a different species seems to be pretty well calibrated to cause a significant disruption in a species like ours so i'm currently 39 weeks pregnant preparing to give birth in a couple of days and i am dealing with the anxiety of such a surreal moment in time by writing i'm in isolation right now because i have coronas but what i do is when i feel anxious or sad or when i lose hope i try to encourage others so i if i'm really sad i would i will write an email or something else so that i can shift my focus from inside to the outside i feel like i really can't go outside or if i do i have to distance myself from so many others like hourly this thing is changing and it's really discouraging to be quite honest and i've learned for myself that in the craziness and when life feels like it's flipped upside down and something like this we have to take moments to find join hope and so i feel like there's definitely people in my life where it is encouraging to have these conversations i'm trying to be hopeful even when it's hard i'm a teacher and my school just got shut down and my expectation from my bosses is that i need to remote teach to all of my students but my own kids are at home and so i need to also take care of them and manage like how we talk to them about a pandemic i mean they're little kids so they're really struggling with all of these changes that are so far out of their control um and i just feel like bilbo baggins like butter scraped over too much bread um so i'm not sure how we're gonna make it through this just emotionally i'm just i'm using this extra time that i have to make changes in my life that i wasn't doing before because i was so busy doing all these other things so although it's uh it does feel depressing at times uh i'm really just trying to make the best of it we're out here and we're struggling it's gonna be a long few months i think and the most frustrating part is having people who don't know an immunocompromised person not taking it seriously so they say it's not a big deal that they'll get over it and they don't understand how their small actions could be the thing that kills someone that somebody else loves as someone with invisible disabilities having our culture be so much more understanding and accommodating of individuals needs is blowing my mind when we eventually make it through this i hope we can bring some of that accessibility support and kindness towards vulnerable communities with us to the other side i started to feel really overwhelmed when our governor in washington issued a ban on groups meeting in 50 people or more and my work although we're all set up to work remotely had yet to say that we were allowed to not come into the office i felt this really big pull on my morals about not wanting to contribute to the curve but thankfully people are taking it more seriously now and we are all working remotely and i'm starting to feel a little bit more hopeful that maybe we can reduce the number of people that get coveted 19. so i own a small business in texas with about 10 employees and we have had to have some really hard conversations about what payroll is going to look like in the coming months and the very real possibility that there won't be a payroll and it won't cover all of us and instead of just a few people getting to keep their normal amount of pay we decided we would be better off and that we wanted to all of us just to take less so that everybody could have something and i thought that that was so beautiful and hopeful one of the things that i'm seeing is how this is changing our use of media how we are drawn in some ways to seeking information or using media as a distraction tool or finding ourselves kind of compulsively checking news sources and and even for what you were saying michael about watching the movie that movie has been out for a while and yet it's because of this that you clicked on it and you decided to watch it and so there's something going on for us around media use and i can i can kind of talk to that a little bit later but i'm just kind of curious if any of you have noticed media use changing either as a coping strategy as a distraction tool as a way to resource yourself um has there been compulsion around it have you noticed screen time go up just tell me tell me how you've seen that shift in your behavior oh i was already addicted before this so it didn't change for me there's been no material change in fact i've actually turned it down a lot more and or less and been like playing music around the house a lot more just very much let me yeah because i'll turn on like cable news for a second watch for like 30 40 minutes and i'm like okay i'm done i can't like i got to stop um and then yeah so and funny for me it's been a little bit of the it's either stayed the same or been a dip for me right right maybe even more boundaries in a way to take care of yourself yeah i mean i definitely went into five uh collecting information zone last week enneagram five like give me the information that's what'll keep me safe so did a lot of reading and figuring out what was the best course of action at that time so we we started so we started social testing last wednesday but then i noticed i did notice the more i was especially looking at like social media and some news things certain kinds of media that weren't necessarily about equipping youtube to be wise but we're more just like sensational or right emotional i noticed yeah that went kind of hand in hand with that night that i was feeling a little bit more oh no i think i have this and that some of the emotion that was in that and i was like i just need to i started watching more what i was what i was paying a lot of attention to in my day and did notice a shift when i yeah so i'm i'm my screen time i'm sure is up yeah but this week it's more i'm connect i'm trying to more consciously connect with people that i love um i'm looking at the news but i don't spend a lot of time looking at that and and kind of trying to have fun where we're as our our family we're like trying to consciously do things that are fun we're having a lot of dance parties whatever we can do to kind of good for discharging the mobilization tendency because of the stress response move that anxiety through your body yeah one of the things that's things that's really interesting to note about behavior and media use and information seeking is that it seems to persist in spite of hitting a threshold where you know everything you need to know in order to keep yourself safe that people are they they've understood you know maybe in a provincial or a statewide update they've received that they've got all the information they need about how to keep themselves and the people in their life safe and healthy as far as you know they're able to and yet the information seeking persists that we built people are still looking and still checking and there's more sources and there's more things that we're dipping into that maybe tell us that this isn't really about information seeking right that this is our way of managing our distress and trying to kind of regulate the intense emotion that we're having because of what feels so foreign so absurd so scary so unprecedented that in a space of unknown and uncertainty especially in a highly cerebral context where we have been prized for information seeking or information distributing we're using that as a tool to regulate ourselves and yet at some point we're past the point where we have enough information that could be helpful for us and yet we're still information seeking and it what's fascinating about how that kind of behavior impacts our neuroanatomy long term is it can rewire our reward circuitry in such a way that we engage in compulsive behavior without even thinking about it and can sometimes even start to notice a kind of dopamine withdrawal if we're not looking at information things can feel boring or we can feel even more lost and that there's somehow this anxiety regulation mechanism that we're engaging in even though it's do you do you think though that i don't know how the news uh works in canada but here in this country even though we have some information like from the cdc or the world health organization i like the federal government in our country has really failed to inform people of of what to expect what this actually is so i wonder if so much of that people like searching for information is still like like for instance i didn't really know what this virus is or how it would impact me like i didn't i hadn't heard any examples of people who had gotten it and what their actual symptoms were so like i found myself scrolling trying to find like what is the act like not just maybe the cdc telling me but like actual people who have been infected like and there's a ton of people on twitter that have like posted pictures of me like i got infected and they're like updating their twitter threads and saying like you know uh here's what symptoms are here's you know um it feels like respiratory pain it feels like lung pain it's this or that but i just wonder too like when governments aren't giving proper information to people how much like what you're saying i wonder how much that spikes it too because people feel like the information they are getting either isn't trustworthy isn't helpful or doesn't really give the whole picture so i wonder if people are still searching for like a real sense of like what this virus is how it'll actually impact them and what are real symptoms yeah so think about what it's like when your government doesn't give you the information you need tell me if you can as categorically as possible what the emotion is for you when that happens fear yeah right so there's fear and what do we do with fear right and that's kind of what i'm saying is that there are so many things that we can do with fear but fear has this gives us creates this intense neurophysiological response in our body and and one of the things that we can do yes is educate ourselves but there's a point at which we're not educating ourselves anymore we're engaging in a kind of like defensive strategy to try to keep the fear at bay but all it's doing is creating more fear and the loop gets closed because we're not getting information that actually satiates us and we're not turning our phones off or turning the news off we're engaging in content that provokes more of a fear response and then if our if our way of managing that is to information seek and the information seeking creates more fear you could see how this loop would close and it would get tighter and tighter and tighter and the compulsion would show up and so yes we need information and that's probably part of why we're doing this podcast even is to say here here's some things that you need to know but also if we are going to be healthy people in a context which is highly uncertain and stressful we also need to have other ways of responding to fear and there is going to be a point at which expecting the government to educate us isn't going to be the thing and then going to seek information about that isn't going to be the thing that actually helps our nervous system rest um that's actually my kind of biggest concern right now i think the lack of communication and societal space for processing feelings for having emotional awareness is standing in the way of our capacity to meaningfully respond to important and necessary information about this disease every time i've talked about it so far publicly i've tried to start with a check-in on people's feelings validating that these times are frightening and feel uncertain and then reminding people that even if we go on the very worst statistical outcomes of what's ahead of us this is not a thing that's going to end human civilization the vast majority of people who get coveted 19 are going to be okay and what i found is like there's there's some people who are so afraid that you have to remind them of of the greater reassuring arc uh that's out there and then on the other hand you have people who are perhaps breaking the irresponsible yeah spring break in florida you have people who are ignoring all of the guidelines and going out and then those people coming in a message that's like wait a second what you're doing right now could take the number of loss the losses the loss of life in your community and increase it by a factor of 5 or 10 or 12. so it's so complicated because some people are hyper vigilant they're concerned they're obsessed they're focused as is totally understandable psychologically that does it completely i'm not saying that is a a bad thing to do that is a very understandable thing to do and on the other hand you know i read i read a quote today they have people in france where it is now illegal to gather and people in their 20s are having illegal almost speakeasy type club gatherings and when interviewed and asked why they're saying it's not going to kill me why should i care and that will result in a significant loss of life as health care systems are overwhelmed and to trying to thread that needle from a public policy perspective is very very challenging on that note i'm curious i'm curious if either any of you and i'm happy to share too have strategies around managing fear that have been helpful for you i know william you'd said you've been playing a lot more music but what have been the things that have felt like they've switched the neurophysiological switch off maybe or have i've kind of turned the dimmer down on the stress response for you yeah playing music i'm playing a lot of instrumental music too just something that's calming also too humor has been i mean humor is the way i cope with everything hillary give us some good stuff oh you okay you want to give us some of that good stuff you want to mainline some self-care yours wasn't good william i just i want the therapy what i will say okay everything on my list would was what william was suggesting um what i will say is that there's been something so interesting in my response to this that i've been noticing and i think it it has been oriented around my particular training and skill set being of particular use at this time and feeling like one yes i have a responsibility to engage in dialogue which help help people process and make space and heal but that for me has felt like i have a sense of purposeness and usefulness in a way that has been managing my anxiety and so one of the things that's important to note about emotion is that it mobilizes us it's meant to one tell us what's important for our survival but also help us do something in fact diana fosha a really well-known researcher that has has done a lot of clinical and research work around affect or emotion and how it shows up and how it's important for us has said that emotion is the experiential arc between the problem and the solution that when we stay with emotion that it tells us what matters to us and what we need to do and so when we're afraid of losing people what that can tell us sometimes is those people matter and i need to connect with those people or you know if if we're having a feeling of sadness we notice something in our body and that tells us what is missing what's gone what we need to grieve and also maybe how we need to seek comfort and what where the wound is so i like to think about caring for ourselves in ways that are specific to the emotion that we have if we're feeling afraid we might need to do something different than if we're feeling sad so all of this really starts with paying attention what is going on for me and i want to take a moment before i give you some practical strategies just to note that in the same way that information seeking can be a way for us to manage our distress internally so can blaming other people so can controlling other people so can being in judgment of other people in a way that isn't necessarily actually helpful for us so i always invite people to remember if you're having a reaction to something even the toilet paper situation to ask ourselves what is our outrage what is our anger what is our frustration and confusion tell us about our value system and if you're noticing feeling outraged about that you probably have a high degree of sensitivity towards equity and justice issues because you want people to have access to resources so your response isn't bad but if it stays about other people you miss the insight that comes from paying attention to what that tells you about who you are and that is something you can do something with and that in addition is something that may even come with some insight maybe even some joy maybe even some release of wow in the midst of this i got a chance to encounter or know something about myself so it's not even really about other people or the the virus in that moment it's about you and your growth which to take this back to where i started can help us feel a sense of purpose or meaning so there are a few things that we can do noticing our social media use noticing our media consumption in general and for a lot of people that i've been seeing clinically this week in my practice we've had conversations about the mindless media use and the possibility of maybe maybe setting some limits for ourselves like not having not watching not engaging with stuff for more than an hour a day or 20 minutes at a time setting timers for yourself things like that it's also really important to think about how we discharge stress from our body so that it doesn't stay in our systems long term so movement right there is no ban on you having a dance party in your house like oh there's no ban on being in open spaces where there aren't people around where you could get some exercise go for a hike in the woods doing jumping jacks i know some friends of mine are having push-up contests at home on their gotta get those summer body ready well you know i got feelings about that but yes if that was a value of yours then you could continue to engage in that behavior even at this time i i'm currently working on my summer body uh and it looks exactly like my all year body which is just fine as it is um so moving getting stress out of our body being creative so another way of expressing things is allowing them to be released from our body drawing making music making food coming with ideas writing telling a story anything that again discharges kind of some existential energy to move it through us and to help us feel like we made something we can look at that is really helpful as well as mindfulness practices again helping our brain know that we're here and here in this moment is totally manageable is totally safe is totally okay and calling some of our attention back from the places that are are scary and uncertain and also not not yet those are some of my my main ideas for now so good thank you mike can i ask you where are we at with the smart prescripted amount of social distancing right now i know you mentioned to william before you know one person as well within the realm of what people are suggesting as far as you know if you you live alone you have somebody that's also being safe that you're either working with or have you know have your dance parties together what is the number of people and do you have any recommendations because you know being absolutely totally isolated as a person for the next three months might not be might not be the best way to live your life and and manage some of the the mental health and emotional health and all the rest of it even physical health so where are we at with you know the numbers seem to keep shrinking started with like no no no gatherings above 250 people and it's not 50 and then it's not 10. so where are we at now and where should what's what's a smart way of practically going about social distancing sure i'd love to i'd love to talk about that thank you i think i'd start with this let's understand why we're social distancing and why answering the question real specifically is challenging whatever country you live in in the world right now i want you to imagine for a moment that a hundred people live there just a hundred and now i want you to imagine that with everything we understand about covid19 that it's pretty inevitable that 60 of those 100 people are going to get it and maybe as many as 80. now we've talked earlier in the episode that not everyone's affected by covid 19 in the same ways but people in every single demographic have some risk of having a severe disease presentation that will require hospitalization so of those 100 people who live in your country let's imagine for a moment that there are four hospital beds total and that at any given time two to three of those hospital beds are taken by people who do not already have covet 19 they have something else going on in their life you see the problem now even if only a third of those 80 people or a quarter of those 80 people will need to be hospitalized we don't have nearly enough beds for all 60 or 80 people to get sick at the same time with covid19 we cannot affect the number of people who will ultimately get it it's a novel virus we have no herd immunity but we can absolutely affect how many people die from it the mortality rate is in our control and that comes to how many beds how many nurses how much iv lines how many ventilators how many points of intervention we have to offer so the reason you're seeing the social distancing guidelines change is because we get more data from the medical community about what the epidemiological curve looks like in terms of fatalities known cases and a projection of unknown cases the reason you're seeing things change so dramatically in the united states is at the most critical time we needed to be responding we were doing nothing and in that time period a significant number of people contracted covet 19 without knowing it because you have two weeks that are pretty much invisible and then maybe three to five days where you think it might be the cold or a flu in some cases and that's why you're seeing these guidelines change so quickly so anything i tell you on this podcast about the particular number of people that are okay for social distancing will be out of date by the time we release this podcast including if we release that podcast today okay so what i want to communicate instead are the general ideas around social distancing to equip people to make their own judgments and make their own discernments as they hear updates coming in news media social distancing involves three simple ideas you see fewer people you see people less often and when you see people you stay physically farther away from them okay so if you get together today with 10 people or less and nobody touches each other that's considered a relatively low risk or enough to slow down the infection rate in the united states in particular i as someone who has heart disease i'm pretty much in total isolation at this point i'm not leaving my home i'm not having guests over my family is not interacting with other people because i if i get covenant 19 there's a good chance i will need a hospital bed and right now i want someone else to get a hospital bed who is 80 years old or has hypertension or has diabetes and has an even more severe case presentation than i do our ultimate goal is to make smart decisions so what we know is that you shouldn't be going anywhere where you can't keep a six foot bubble around you that's kind of the the real risk for immediate infection spread if you still have to go to a physical office space and work with other people that's okay you want to continually sanitize common surfaces like doorknobs light switches and working surfaces you want to frequently wash your hands well that's 20 seconds in a routine that you can probably find on youtube and you also don't want to touch your face because the mucous membranes of your eyes nose and mouth acts as portals into your body for viruses they're very small they get in easily through those body openings that component there if you have to be around people the sanitation is important otherwise telecommuting helps otherwise avoiding large gatherings help and the kind of thing we're doing now you know my screen time is way way way way up but it's not because i'm looking at a lot of media it's because i'm spending a lot of time with friends in a virtual capacity and that's really i mean i was joking before we started uh the recording that i've been rehearsing for covid19 my whole life i'm much more comfortable interacting with people on video chat and we've been playing a lot of dungeons and dragons games in the literatures group i'm having a good time but i'm physically distancing myself at the same time i'm probably hugging my wife and children more than i ever have because for people who live in your household with you if someone gets coveted 19 everyone in that household who can get coveted 19 will get co-fit 19. so i i would encourage people that if you live with people really rely on the people you live with for those those physical connections that we need with human people and if you live alone again these guidelines are ten or few people i think if we create kind of hermetically sealed webs of activity you should have friends over you should be able to give people a hug but anyone you're not really really close to or seeing regularly i've been recommending people do the vulcan move and they tell people live long and prosper because we can't handshake and we can't hug and we shouldn't handshake and we should not hug but we don't want to awkwardly or woodenly woodenly not acknowledge the way that we value other people and so we we want to look for those replacement mechanisms that allow us to continue social distancing seeing fewer people less often and when we are together physically at a greater physical distance hey mike can i come over for dinner no mike i want to i want to get into your six foot bubble nope not a chance mike i want you i want you in my six foot bubble right now so look at those boundaries someday yeah how long yeah good job good job how long mike how long does does this gosh that's the question that's the big question that no one can answer anyone who claims to be able to answer that definitively is lying based on it all comes down to our actions if if we don't pay any attention it's going to be over quickly and there's going to be a lot of deaths but this very feasibly this period of social distancing could extend well into summer may june july even august again and what we're trying to do hospitals are already almost full we have seen in italy we have seen in china what happens with that gets out of control there aren't enough beds and the death rate gets very very high and so these personal acts of hygiene and sanitation and social distancing are basically only effective tools we have right now to save potentially literally millions of human lives so there aren't any indicators that warm weather will help well it is it is uh they have summer weather right now in australia and coven 19 is taking off with no problem in australia so no we don't have any data there's some hope based on other viruses but again this is a novel virus this is a virus that didn't exist in human populations you know in summer of last year there's so many questions to science and i just want to speak to that like this isn't hysteria scientists are sober-minded people public health officials they don't tend to hit the panic button right we've had pandemics recently that we managed when you're seeing this level of coordinated activity in the global health community it's because the threat presented by this virus is genuinely significant and i want you for a moment if you're listening to me to check in with your body like that might be scary that might feel overwhelming and i'm not telling you this to overwhelm you if you're listening and you care you're already paying enough attention the reason i speak to the potential loss of human life is not to scare those who are paying attention but to rattle into immediate action those who are not and if you're one of those people who right now feels like this is overblown or a liberal conspiracy uh or you're young and it's okay you'll get through it i want to tell you the data doesn't support those conclusions and you have a responsibility to help protect other living people by engaging in social distancing starting right now i think there's a part of this too that i'm just gonna go there because it matters who we elect is our public officials matter because our response to crisis like this depends on the type of leadership the type of moral character that we have leading us and right now we do not have an administration that is actually really leading us as much as they've done so much to create fear around this event and to create conspiracy theories so even some of those things you're saying mike about people believing this to be a liberal hoax that was directly said by the president of the united states no more than a week and a half ago a week and a half ago we were told by the president this was a liberal hoax created by democrats and i don't know as somebody that has been an outspoken critic of this administration and this president from day one and even before he took office to me this whole issue underscores why we need competent sane leadership why presidents matter why administrations and the teams they put into place matter because right now america is far behind because we have an incompetent president as well as an incompetent administration that has not listened to the experts that aren't listening to the people and now they're starting to try to do that they're trying to play ball and trying to listen to the cdc in the world health organization slowly but that's really only been in the last couple of days and we could have been far ahead of this and that is one of the things that i think as well as caused sadness for me is the recognition that we could have been farther ahead of this we could have really alerted the public and really created measures to quarantine this virus way early on if we had competent leadership i'm hearing i'm hearing your grief and your sadness and your frustration william yeah i mean it's not this isn't theoretical this isn't games oftentimes we look at politics of sport and it's not sport people's lives are on the line people will die because of this because the government's lack of concern and the lack of taking seriously what uh health officials have been telling us even even this white house to some level dis evolved its pandemic response team in 2017 because they didn't think it was necessary trump even said out of his own mouth that you know he didn't want to pay for something when there wasn't an outbreak i mean that's like that type of ignorance and that type of recklessness is why we're now in fear of our loved ones dying and that matters too and so it's not just political to say oh you're just being political it's actually about our capacity to care for one another and government represents that and when government fails in that way i mean we saw this type of failure with hurricane katrina too we saw with the bush administration how they failed to respond well to that disaster and we watched this current administration fail multiple times now it's such a way that our we're now actually in a recession economically because of it and like you said earlier millions of jobs are going to be lost businesses are going to be lost workers are going to be out of work people are not going to be able to pay their rent a lot of people with this are not even concerned about getting sick they're like how can i afford to pay my rent how can i afford to to buy food most most americans live paycheck to paycheck they don't live you know with you know thousands of dollars in the bank ready to go for an emergency like most americans are one emergency away of going filing bankruptcy and now as of today the government is saying well we we're going to try to maybe you know create a stimulus package to give a thousand dollars to every american and and that's still woefully inadequate to the the impact economically financially and that's also causing a lot of this fear that everyone's feeling is like i can't pay my student loan debt i can't pay off my credit card i can't pay like what am i going to do if i can't go to work what am i going to do like a lot of us are artists and speakers and writers like how do we survive financially through this when conferences are getting canceled when you know book signings are getting canceled when concerts are being canceled that's that's going to be pretty major and i still don't think we've we've really wrestled with the actual day-to-day impacts of how this pandemic is affecting us but also like i said the incompetence of how our government hasn't cared to to handle this well to actually take this seriously and so i just think a lot of our high stress and anxiety is is really coming from that um to me this highlights this tension between individual and collective and our sense of how we identify ourselves if we see ourselves as the lone wolf or like you were saying about people in other countries if if i'm not sick or i'm not worried about sick then i don't have to respond or if my finances are okay then i don't have to worry about other people's finances i think that there is something collective and global and i would say existential spiritual an invitation for us here to see to see our individualism for people who have had a particularly individualistic mentality for us to think about our ourselves as part of the family i had a conversation with someone really close to me recently about shifting the definition of care even right now and saying no i don't think it's a good idea for you to go visit that person in the hospital because you don't know if you're sick right now and the person close to me said but but no one is visiting them and i said but care needs to look different right now and i'm curious about what that means for us again in terms of identity but as people perhaps who are thinking about well i want to see the collective i want to be a part of this bigger family of things and realize i'm not alone in this and my actions impact other people we also have to be smart about which actions we take what we do with our money which businesses we're supporting who we're seeing who we're not seeing and that means creating a new map that most of us don't have right now and so i just want to name it's okay to be confused and it's okay to do what you think is the right thing today and then you get more information and the right thing looks different tomorrow [Music] i've thought about that a lot like we have a real triage situation right now and right now my belief as a science educator and a public communicator is that all efforts and all focus should be on the preservation of human life that means two things that means first people who stand to die from a disease or diseases due to our health system capacity those are not the only human lives that we could lose to covet 19. closing schools impacts economically disadvantaged children there are people right now who face a highly elevated risk of malnutrition compared to what they faced two weeks ago so we have to take our first hardest look has to be at the preservation of human life and the responses we make in the next 14 to 21 days will make the biggest difference in the preservation of human life as this pandemic unfolds but the actions we take to preserve human life in these 21 days well those will cause other consequences the kind of economic livelihood we're talking about the mental and emotional health social distancing is going to have a cost in people's mental health uh people who are depressed or are suicidal being physically distanced from everyone that's not a great intervention strategy so even as we grieve and even as we start to take actions to preserve human life we all have to begin to imagining together about how to then bring back some degree of resilience in our society in our community and in our economies economies are made up of moving capital and when people get afraid they tend to stop spending and they start to hold things and they feel afraid and for some people that's a wise strategy i i'm one of those people who's lost something like 50 of their income in something like four days but for people who are able you should continue to support business you should continue to do business you just need to migrate it to online settings and continue the economy functioning and we people who are able should be in constant communication with our elected officials that we refuse to allow society in its collective form we call government to stand by as people become homeless as people default on loans and as people have difficulty maintaining their basic material needs and then eventually we're going to have to have a conversation about political leadership and about who's accountable and who did what poorly and how much of that was wildly negligent how much it was misinformed we need to do those things as well but for me i put that even a tier below preserving lives restoring economic and communal activity and then kind of this macro discussion about how things are governed right now i do not care about anyone's political ideology myself included now is a time for dramatic and direct action to preserve people's lives and preserve people's livelihoods [Music] [Music] i definitely feel like one of the things we're able to do is to really like you said contact our leaders to begin to get them to create an action plan for how do we mitigate this damage because we have a lot of that power as people like so you're right it's preserving life and then it's okay how do we how do we sustain to some level our economic life because that has real consequences for for real people and also people's like you said mental and emotional health so we're having conversations now about what does it mean to have universal basic income quickly now like people are talking very quickly about universal basic income now as a way to mitigate this disaster and we're talking about what it like i know france for instance has halted you know rent payments and uh loan payments and actually just put a hold on all that and i think we need to really be talking about that as well in in this country as we start to understand the impact of this virus here's what we know we know there's enough food we don't have a disruption in our food supply lines in any country we also know that in most countries there actually is sufficient housing and so kind of to illustrate your point more deeply william government policies right now should be focused on ensuring the continuing distribution of the food we definitely have yeah and preserving people's basic physical need for shelter during this pandemic and we're seeing some of that start to happen even the united states in los angeles they have talked about uh an eviction moratorium they have talked about suspending interest or even mortgage payments altogether and those kind of drastic interventions will probably be necessary some economists believe already that there's been as many as a million jobs lost in the united states that is a staggering staggering number and the kind of talking points we tend to have in election year really fall flat when we start talking about mass homelessness yeah we start talking about potential starvation i think it helps us all focus more clearly on what's important and to what hillary said earlier what we value what i have to believe is that no matter what people's political orientation is it's primarily a means of emotionally coping with their reality is that the vast majority of people in the united states and in other countries do care that people have access to basic necessities like food clean water and shelter and what kovid 19 offers us is an opportunity to work together and demonstrate what our real values are right what are you thinking michael well i was just also thinking about how religion has gotten involved in this in ways and you have the good sides of religion that do teach for us to take care of each other and you know make sure that we're loving each other and and these values of putting human life and and thriving and basic needs as a primary motivating factor religion sometimes does a good job at that but then you also see churches still meeting in places and you see some people like talking about how god has this in control and we don't need to worry about this kind of thing and this is you know just trust god and we're coming together and and you you see sort of all of the the reasons that things that seem like seem esoteric you know we talk a lot about things like epistemology on the show and these philosophical issues how do you how do you know what you know and how do you determine these things and why do you ask the questions of deconstruction all the things that we talk about that seem like right now in an emergency seem kind of like silly things to talk about but this is this is where the rubber meets the road in these kind of situations like how do i know what i know to be true and if i don't know how to when the preacher says no it's okay come together and we're going to trust god if i haven't learned how to question that guy if i haven't learned to to use some critical thinking skills and know where my news sources why which news sources develop all the stuff that we've talked about for so long it all has consequences it has real consequences on how we think how we make our decisions what our value systems are that make us either go to that spring break vacation in florida or not whether we attend that church service live or online it all uh there's like all these philosophical and theological underpinnings that are like man this is you can we're seeing some reasons why learning to question and learning to value science and learning to critically read and think and and parse through our news sources and all that it really does have consequences though i was feeling all that that reminds me of the the other angle of it too which is love your neighbor right and and thinking about when we are both questioning and which principles really could be guiding for us underneath it all which when when we take everything as black and white instead of i mean william song plug here stay in the gray i was like where is your reaction to that i was expecting a big one you know i didn't want to be uh you know like that yeah that that we we miss the complexity of faith and religion which is how do we stay critically thinking and be connected to the deeper values that allow us to see ourselves as part of the human family and the story of things and love love well and i uh i say this with a very heavy heart i take no joy in this the kind of reckoning we've experienced in our society as new means of access to information and new forms of media have allowed us all to craft our own bubbles of epistemology our own different ways of deciding what is and is not true a global pandemic will act as an incredible reckoning to what is true and what is not true and i believe sincerely and with a deeply grieving heart that in the next two to four weeks some people who have been using alternate epistemologies as a mean of psychologically coping with a changing world will face the most intense reckoning possible as people that they know and love fall ill with a disease that hospitalizes some lives and ends others and unfortunately based on the distribution we are seeing in these case loads and in these mortality curves in many cases the precise communities that have been most enthralled by these alternate epistemologies will also face the most devastating loss of life i take no joy in that but i think that the current detachments of religious fundamentalists anything short of an actual cult we'll find themselves more in tune with the rest of us in as little as three months from today we're gonna have to get really good at grieving grieving ideas grieving people grieving systems grieving the ease with which certain things used to happen the complexity or the thoughtfulness that we need to take now where we could be thoughtless or kind of automatic before but i think about my work and the way that i have spent time studying particular elements of being human and being on this journey of life together and i think about how big of a role grief will and will need to play and how we move forward together to be able to name the pain of that to be with the pain right now even as you're saying that this is our great strength in the great tree of life our species has survived this is not the first and will not be the last nasty pandemic we face i am so comforted by the wisdom and power of our bodies our bodies will do a better job of fighting covet 19 than any other human system or construct is capable of and i am deeply saddened deeply saddened by what has already happened and what will happen in just the next few weeks i'm not good with time people who have listened to the show long enough to know me know that but sometime in the last couple of years our dog max had cognitive dementia and became dangerous and violent and we had to face the decision to euthanize a beloved family pet and what i remember was the overwhelming grief more intense than any i had felt in my entire life as we waited for a day on the calendar to arrive and sometimes scary things that we know are coming but have not yet arrived create the most intense grief reactions of all and what i would remind everyone listening right now is part of our fixation with media part of the emotional cycles we're all on the anxiousness the fear the the irritability the conflict we have with friends and family uh the frustration we feel with other people in society taking actions that we view as unwise all of these things are connected to the very real and natural human response of preemptive grief at some level most of our bodies know what is yet to come and the more space that we make in our lives to accept and listen to and to process that grief the more resiliency we will have as the crisis itself unfolds and the more access to our true strengths we will have to support each other throughout this process if there is anything that i believe it's that i believe humanity is capable of working together to love and support each other through this pandemic in a way it protects lives and protects livelihoods and thinking about what we can do as the liturgists tanner i've been talking about this but i just i guess i'll go ahead and tell everybody like i during this time like we we always do meditations we do this thing called the sunday thing and it seems like right now being online together and as as together as we possibly can be is super important right now and this is like we actually have a strength in that because we've been doing it for a while but so a lot of the stuff though has been just for patrons and we just want to open it up so we're just going to like take away the walls for any of you if you can't afford to be a patron but you want to be able to engage in our meditations or the sunday thing or whatever we just want to invite any of you that need a place an online space to have a home right now as much as you can without needing to pay for it so letting all you know about that get involved with each other online let's let's be with each other let's grieve with each other let's give each other hope and wisdom and strength through all of this [Music] i'd love to see people's art for the people who create out of this to be able to share that and for us to celebrate in the beautiful things that are made in the midst of our pain i wonder if that's something that we could even do in this community i know that there's lots of groups online for people who meet as liturgists and one of the ways that we can encourage each other to to be supported to support our nervous systems is to express to move things through us to to make something and so just for those of you who have been waiting for an invitation who normally write but haven't found the time who normally draw but haven't made it a priority if you make something and you share it in in a liturgist group i will be so excited to see that and that will give me hope and make me feel connected to you and in that way we can remember we are not alone right the thing the thing that will hurt us maybe even more from a from a biopsychosocials perspective maybe even more than the virus will be or just as much will be our loneliness will be our our fatigue and our fear and the ways that we keep that inside of ourselves and keep ourselves disconnected from each other so please know i'm excited to see what you make what you create what you build it's going to give me so much hope and help me see you in the midst of this thank you uh you three years lovely just being with you today and then we're good yeah yeah that's really nice it feels so special for me to be here with you all today i've had a challenging season of mental health and discovery and growth and that has necessitated me making some big changes and and uh being relatively private and withdrawn for a season and i was reflecting even as we were recording just how good and how relieving it was to see all of your faces how i've missed you and missing you together although i have listened to the podcast like everyone else it is awful special to be able to to speak to you all and not just listen and i'm so thankful to have had time with you today oh it's so good to have you on here mike and while you're here tell her we should tell everybody that your book they'll have plenty of time it comes out next month so and it's actually kind of a great topic for what everyone's probably going to be needing to to read that's true at that time well great two years ago you who made the decision yeah it's called you're a miracle and a pain in the ass embracing the emotions habits and mystery that make you you and it's about why we so often don't understand our own thoughts and feelings and behavior and what we can do about that uh especially in how we relate to other people oddly pressing it's kind of perfect yeah and it's a great it's a beautiful book and it has tons of uh behind the scenes stuff about how much i love michael and william and hillary so if you're into that part of the podcast uh that's in the book there too we're in the book it's true i didn't know that it's a tell-all oh my god you can't tell from the topic all my secrets are in the book here's how much of a miracle the pain in the ass william is just you do it will not surprise you that i speak of the three of you with great affection lies all of it lies all right well thanks everybody uh everybody stay safe love you all yeah love you all too