1. Covid-19: Pandemia or Global Hysteria?

March 21, 2020 Minding Corona No Comments

Nothing worse than a false sense of security. Please, take every measure of precaution. Then, read on.

March 18, 2020

This article is dedicated to Dr. Li, not because he stood up to Chinese authority but because he stood up. There is hope for humanity as long as there are individuals who are brave enough to stand up, be it in America, in Europe, in Russia, in China or anywhere else.

WARNING: If the psyche is not properly taken into account in this epidemic, we run the risk that this negligence will demand much surplus health-related suffering, many bankruptcies, and a large death toll in the near future. Action should be taken by studying this as a serious possibility.

At the moment, the world has turned corona. Everybody knows ‘the virus.’ Covid-19 stands for COrona-VIrus Disease, 2019. This tiniest organism gives a beating to the masters of the universe; namely, us.

It started in Wuhan. It is taking the world. Lots of people are dying. Western economy may go down the drain. The future will be post-corona. Generations from now, people will associate this time with this virus. Nevertheless, might the issue, including its physical effect (influence mind-body), be substantially infested by – with all due respect – ‘mass hysteria’?

Of course, this is not about the rate of infection, but about the evolution from infection to disease. Since it is global by now, it may be the first case of such global hysteria. Let it be clear that I do not claim that this hypothesis is correct. But it might be, as absurd as it may seem at first sight. Likewise, the earth is not flat, and it’s not the center of the universe, although both were once preposterous hypotheses.

Causality is tricky to pinpoint. It’s like water leaking through your roof and you don’t know where the leak is. It may be something you didn’t expect, not what you took for granted at first sight. Might the 2020 Corona pandemic be a giant leak through humanity’s rooftop at an unexpected place?

Meanwhile, we should continue on the track of extreme caution. Very much is at stake: many people’s lives and livelihoods. Therefore, we should investigate every possibility. This is no time for cowardice. This article is not a discussion for being right or wrong. It is a plea for not leaving any possibility blank.

Global hysteria may seem a strictly negative term. There is no reason to this, unless you see anything related to ‘non-conscious mental processing’ as basically negative. But of course, hysteria is not fear (cause being rather conscious). It’s anxiety (final cause being non-conscious). It is not rational. It’s irrational. The panic that we see now may come from our living above an underground sea of anxiety. It is a broader lesson we should take from this happening, since it will return in many ways if left unmanaged.

This has a further consequence: people are not guilty for getting the disease after being infected, even while the mind would appear to be deeply involved. Talking about ‘guilt’ may hinder one’s taking responsibility. ‘Guilt’ should be avoided at all cost! And rationally seen, that is also correct. Moreover, the feeling of responsibility may slow down the progression from infection to disease as it does in others.

This would not be the first example of mass hysteria with an adverse effect on health. Such an outcome is called a ‘nocebo.’ The mechanism is comparable to that of a true placebo: thoughts influence health and healing, possibly to a huge extent. We see amazing things in the world of placebo, including more and more even in surgery and with objective outcomes. Nowadays, placebogenic effects are being visualized within the brain. Intriguingly, when a person believes in some cure, we see a degree of placebo. When his physician also believes in it, we see more placebo. When the whole environment believes in it, the effect is highest. What if the entire world gets into a craze?

Cases of mass hysteria with consequences on health have been reported from the Middle Ages onward and well into recent years. For instance, in October 2019, at Starehe Girls Centre, Kenya, 68 students were isolated, showing symptoms of cough, sneezing, and low-grade fever, later concluded to be a case of mass hysteria. Another example is the Emirates Flight 203 case in September 2018, in which 106 of 521 passengers on a 14-hour flight from Dubai to New York reported symptoms of coughing, sneezing, fever, or vomiting. The plane was quarantined in New York; only a few passengers turned out to have a common cold.

During 1400 years, in the Western world, the whole of authoritative medicine strongly believed in Galenic theories: four humors, blood suckers, venipunctures, scarifications and weirder stuff, until +/- AD 1800. Fortunately, we live in more scientific times but still far from the optimum. So, imagine going back 300 years and trying to convince the medical world that they are wrong in total within some subdomain. Good luck.

Of course, this imaginative exercise proves nothing. It lets you feel something. Follow common sense, not necessarily common assumptions.

Mathematical models show a predictable curve of Covid cases within several countries. Does this contradict the hypothesis? I don’t think so. Of course, there is infection. No doubt about that. A virus is a virus. The number of infections by this virus is not the core of the ‘Mind over Covid’ hypothesis. There is no contradiction. Crucial is why and how many of these infections lead to illness and up to fatality. Moreover, in cases of (post)traumatic stress – somehow also being a kind of hysteria – over an entire population, one can see a curve that waxes and wanes much like the models of the coronavirus show. An example is the number of heart attacks related to the scud rocket strikes by Iraq on Israel in 1991. As always, due to exceptions, any models of this kind should be taken with ample reservation.

Hysteria can spread. Can it spread globally? Possibly, mobiles and mobility play a role. Social media can hype anything and to a huge degree. Air travel brings many people closer to each other, also heightening the idea of global vulnerability.

To many people, it may seem absurd that the mind would have such a profound influence on the body. The idea of ‘Mind-Body Divide’ still plays a huge role in the acceptance of such. Well, scientifically, we are way beyond that. Absurdity has given way to reality. There is no such divide.

Also, the mind can kill. You don’t need voodoo for that. For instance, we know scientifically that psychosocial stress has a substantial effect on cardiovascular disease (Interheart study, 30.000 subjects, published in the Lancet 2004, showing a ratio of 2.67 increase) and definitely may lead to a heightened grade of premature cardiovascular deaths. We also definitely know that the mind can influence the immune system. There is no doubt about such things. We should have much respect for our minds! After all, isn’t that great?

So, can it kill? Yes, and even more if you look at it this way: Within a population, there are always gradations of vulnerability, shades of gray instead of black and white. This includes pneumological and immunological vulnerability. If something lifts the whole curve just a bit higher towards serious disease and fatality, then we see additional cases. Note that raising the curve a little for many people is all that is needed. Can global hysteria do that? This begs for mathematical confirmation.

Of course, people don’t ‘just die from hysteria.’ They may die from a compound of factors in which the mind plays some role. Even with a little role but over a large part of the population, statistical numbers may be substantial. Likewise, while the media talk about ‘corona deaths,’ people don’t just die from corona but from a compound of factors. Within this complex compound, what is the role of corona and what is the role of mind? These are the questions of this article. In any case, I see no proof that corona plays the bigger role. A small sentence. A gigantic consequence.

In many cases in which corona-infected people die from pneumonia complications, the prime killer is not the virus but the immune reaction against it. This causes what is called a ‘cytokine storm.’ Cytokines are small molecules that are part of the immune response. The storm may damage lung tissue, produce coughing and even lead to pneumonia. Little children do not yet produce many cytokines, which is probably why they usually don’t get very sick from the virus.

Scientifically, we know enough about the influence of the mind on immune functions to see a correlation up to mortality. For instance, from HIV-infection to AIDS disease, it is scientifically known – repeatedly proven – that the psyche plays a substantial role. Very likely, it also plays a role in the Covid-case (from real infection to real symptoms and fatality). We have no idea of how significant this role may be.

The panic is a certainty. The media are sowing dire news every minute of the day. Social media are pushing the alarm through the rooftop. ‘The virus’ is the enemy, the unknown killer. The symptoms of a low-grade Covid-infection are very unspecific. Almost everyone has such symptoms at least once a year. So, everybody is attentive to oneself and others. The incubation period of up to 13 days adds to the unknown. Shops are closed. Bars are closed. Elite scientists are convinced. Everybody is convinced.

How, then, could it have started? One guess. Wuhan is a highly air-polluted region with many people’s airways already damaged, thus vulnerable to viruses and more. With the fear of ‘new SARS, only much more infectious’ also being a topic in medical circles, the stage was set. Note that in other cases of mass hysteria, the origin can be pinpointed to one or a few people. It needs the right circumstances.

The fatality rate has been much higher in Wuhan than in the rest of China. One reason may be that this is precisely the reason why this mass hysteria has become a global hysteria. This is: because the energy was so high in Wuhan, it could spread so violently. Most unfortunately, the 34-year-old Dr. Li, who blew the whistle but was subdued at first, tragically ‘died from corona.’ His death was highly mediatized.

Soon, the media took it to heart, showing people being treated by something like spacemen. The most dramatic pictures are the most successful ones: a poor older woman surrounded by several spacemen. Very impressive! Different media feel that, after all, the scarier the news, the more they sell. It’s a mechanism. Also, how does the woman feel by this? I would be ‘scared to death’ in her place. In any case, it’s a perfect environment for high nocebo.

If indeed hysteria is involved, then the global character is utterly amazing. At the same time, it is this global character that may, at present, be fueling the hysteria. We are all subject to draconian measures. It is continuously in the news. The economy might go down. Soon, most people might be in social isolation. It is a perfect environment for global hysteria.

Most important may be to know not who gets the disease, but who doesn’t. Due to limited testing material, people at risk (symptoms, contacts, vulnerability) are tested exclusively. A number of them test positive and are treated as Covid-19 diseased. How many of these are infected and have symptoms but with no relation between infection and symptoms? We don’t know.

The spread of the disease occurs very quickly. This may be caused by modern human mobility. It may also be because the virus is already globally present, as are its siblings. The future will tell, when we can examine many people’s saliva and tissues from before the virus had reached their habitat. The present testing – by way of genetic sequencing – is performed mostly on symptomatic people. Many tests are negative. Some are said to be false negative, which is normal. Unfortunately, we cannot test everyone for the presence of the virus.

Let’s hope there will soon be an antibody test. If this shows many people to be immune already, it may attenuate the panic. At present, there is no such test. We advise putting huge resources into developing one.

Why is there still little spread of the disease in Africa, even in spite of much air traffic from China? Natural immunity? Lack of testing? Young population? Less of this hysteria? With measles and malaria, there is indeed less reason to see the new virus as the most dreadful enemy. It’s ‘just’ one of several deadly infections. This might say more about the rest of the world than about Africa itself. Africa saw a relatively large death burden from the 2009 H1N1 Influenza (not Corona) pandemic. There was no specific invulnerability back then; quite the contrary. The difference may be one between a somatic and a psychological origin. The 2009 pandemic had an overall estimated global fatality of 152.000 – 575.000, mostly in low-income countries. We are still far from that, but the panic is much bigger, mainly in high-income countries.

In China, meanwhile, the epidemic power is already declining. This is scientifically noteworthy. Have many people become immune to the virus? Or to the hysteria?

Several strains of coronavirus exist. Some are dangerous; most are benign. SARS, MERS… many people have been psychologically sensitized by stories of viruses (including Ebola) with a much higher fatality rate. One should indeed be watchful for a pandemic of a kind of synthesis of Ebola and the common cold. In that case, the disaster is unimaginable. The possibility exists. We should be prepared! The unknown makes the case of Covid-19 scarier. It appears to be of the more dangerous kind, but not as dangerous as SARS or MERS in the percentage of fatality among the infected.

Yet panic is never a good advisor. Sowing panic for political gain is ethically wrong. We also see that not many influential people dare to row against the current. This is understandable, but it creates a hyperbole of additional panic. Nobody wants to be the guy who was less cautious than the other guy.

Streams of information about fatality rates may cause part of the hysteria. Well, people die. Strangely, we have become less used to living with death. Strangely, the media talk about fatality rates as if death is something uncommon. It is not. Not even your smartphone makes you invulnerable.

One might object that this pandemic comes after the Influenza season, in which normally seen, weaker persons may have already died. So, this pandemic seems worse. I agree with this only partly. People may be weakened by Influenza, now getting a second hit. I remember working in a Brazilian favela where uncomplicated measles had a high fatality rate among undernourished children. Moreover, in the case of hysteria, there is a vulnerability of a different kind.

Part of the present obvious hysteria shows in how people storm to shops to buy lots of stuff they may personally need without any thought of the common good. In any case, this doesn’t show the best side of the human being. Natural disasters unite people; pandemics may rather divide people. Why is this so? Are people egoistic in the first place, then also a bit altruistic ‘for the good feeling of it’? Perhaps. In my view, this is what makes us prone to global hysteria, be it this one or the next.

Yes, I am quite sure there will be a future global hysteria of the kind. The world is getting smaller. ‘Global’ seems next door. Billions of people provide billions of self-broadcast opinions and, thus, lots of energy for a hysterical global tsunami. Can we learn from this one? This one is about dying. What if the next one is about violent behavior?

Nothing should be taken for granted. As proof in the pudding, or at least a step in that direction, I propose the use of an Implicit Association Test (IAT), such as what is available online from Harvard: https://implicit.harvard.edu/implicit/takeatest.html. The Covid-IAT (to be developed) could gauge implicit assumptions about the personal risk to get severely ill or even die from the virus. We can differentiate groups and discern the impact of non-conscious convictions in this matter. This may give a good indication for further investigations.

At present, most people think in one direction, and this is not the direction towards inside. One can see this precisely as an essential part of things unfolding now. Inner dissociation (‘not being connected to inside’) makes one vulnerable: to manipulative politicians, to burnout, to chronic pain, to addictions; you name it. We have increasingly seen a fair share of this the last few years. Meanwhile, it is indeed very challenging to think out of this box. Everybody – globally! – thinks in one direction, so it is just weird to take another direction. Yet we may have to, not only concerning this crisis but much broader. As said, many problems have been mounting, and they will continue doing so. Maybe the present crisis can be a turning point in getting a grip on this other more existential crisis.

After the acute phase of this crisis, we will see an aftermath that may take many years, well into a generation. Of course, there will be economic aftermath. Also, there will be an aftermath of post-traumatic stress. This can have a huge effect culturally, which from now on, can best be seen as global-culturally. This stress is ‘energy:’ it leads to change. There will be a lot of it, with huge danger, and a huge possibility to use it constructively. What will it be?

Most of all, let us try to remain rational. We end as we started: concerning Covid, this is as yet a hypothesis; nothing more, nothing less. We should continue being at least as cautious as we are. At the same time, let’s research this possibility: In Covid-19 – the disease progression, not the infection – the mind may be more important than the virus in cause as well as proper management.

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Some practical to-dos:

Follow all hygienic advice from a trusted source.
Get a clear picture of the width of the ideas in this article. Your conscious insight by itself is more valuable than you might think. The non-conscious acts in non-conscious ways. For every person, making an effort towards the best possible insight is invaluable.
Appreciate the power of your mind as much as possible, even in ways that you are not fully aware of. Stop your activities once in a while and contemplate.
Contemplate about your mind and body being one. Don’t let there be any remaining doubt about this.
Make a clear distinction between ‘infection rate’ and ‘confirmed infection rate’ in your appreciation of morbidity and mortality rates.
Listen to the news with a critical mind, taking into account what you have just read. Analyze the news for its intent to sell by sowing panic, and talk about this with your family and friends.
If you are an anchorman, please don’t sow panic. There are many ways to bring the news objectively.
Promote research using IAT as denoted in the article. Play a while with the Harvard test. It’s fun and lets you know yourself a bit better. For millennia already, self-knowledge has been seen as the basis of all wisdom. Count inner strength to the latter.
Each time you wash your hands (many times), also imagine washing your mind. ‘The virus’ is metaphorically important as well as physically.
Appreciate your life. Appreciate every day. A trying period may help more than ever.
Help someone. Do it as if it’s the same as helping yourself. In that case, it is.
Read my book Your Mind as Cure, and take it to heart. Read and fully understand the more theoretical chapters.