A roundup of articles on the status of the Coronavirus and ways we can help….
Coronavirus: Why healthcare workers are at risk of moral injury
BBC.com, April 6, 2020
It is widely known that veterans can return from war with Post-Traumatic Stress Disorder (PTSD). Far less appreciated is moral injury – a trauma wrapped up in guilt that we are now learning more about thanks to US-based research, writes James Jeffrey.
Moral injury most often occurs when a person commits, fails to prevent or witnesses an act that is anathema to their moral beliefs.
The Department of Veterans Affairs website likens it to psychological trauma involving “extreme and unprecedented life experience”, that can lead to “haunting states of inner conflict and turmoil”.
US-based research into moral injury is now illuminating how such injuries can impact people in all walks of life, but especially first responders and healthcare workers facing the Covid-19 coronavirus outbreak.
Amid reports of New York City’s emergency services getting overwhelmed and states struggling to provide enough ventilators, first responders and healthcare workers potentially face having to decide who gets a ventilator and who gets saved – something one nurse has described as “her biggest fear”.
Already thousands are dying in their care – and medical workers say they are facing scenarios they had never anticipated.
One doctor told the BBC the stress was intense. “Seeing people die is not the issue. We’re trained to deal with death… The issue is giving up on people we wouldn’t normally give up on.”
Arthur Markman, a professor in the department of psychology at the University of Texas at Austin, says: “Few people in healthcare have had real-life experience with triage in which a significant number of life-and-death decisions had to be made because of equipment shortages. That increases the chances that they may experience moral injury as a result of their jobs.”
The risk is compounded, he says, by workers at the front-lines of the epidemic – in places like New York, Italy and Spain – working long shifts with little break and sleep before they get back on the job. This leaves little if any time to process an incident that, if left unattended, may prove a moral injury in the making.
“A person doesn’t just take the gloves off afterwards without that loss affecting their moral fibre, their soul,” says Nöel Lipana, who was left with a moral injury from his 2008 Afghanistan tour. He now works as a social worker while promoting better understanding of moral injuries both in the military and beyond.
“They came into this profession to help people, so what do you do when there is that sense of helplessness: you are a great physician, a great surgeon, you have some of the best medical equipment in the world, but you still can’t save someone.”
Mr Lipana notes how veterans are often the focal point of a trauma discussion that needs be much wider. Veterans Affairs treats about 500,000 veterans a year with PTSD symptoms while the National Institute of Mental Health estimates about 7.9 million civilians suffer from some form of PTSD.
“The range of human experiences that are potentially damaging, socially, psychologically, biologically and spiritually because they cause a crisis of conscience are in no way limited to the military serving in warzones,” says Brett Litz from the Massachusetts Veterans Epidemiological Research and Information Center, who is also a professor of psychological and brain sciences at Boston University.
A recent paper co-authored by moral injury experts Rita Brock and HC Palmer states that “the fight against the coronavirus is strikingly similar to battlefield medicine: desperate and unrelenting encounters with patients, an environment of high personal risk, an unseen lethal enemy, extreme physical and mental fatigue, inadequate resources and unending accumulations of the dead.”
Mr Lipana deployed to Afghanistan as an Air Force major acting as his unit’s counter improvised explosive device (IED) officer. He oversaw and trained US troops in how to detect and disable IEDs planted by insurgents. Two army soldiers he worked alongside died in separate explosions during his deployment.
“They were killed by the thing I was meant to protect them from,” says Mr Lipana, who was also involved in an operation during which four Afghan children were killed in a blast. “You play over what you could have done, should have done differently.”
Guilt has been identified as the crucial factor that distinguishes a moral injury, even as other symptoms – anxiety and despair, flashbacks, social isolation and suicidal thoughts – overlap with PTSD.
“Traditional trauma treatment is about what’s going on between your ears – it says you are just thinking about the incident wrong,” Mr Lipana says. “That has zero to do with the connection I have with my battle buddies, those kids, with our fundamental spiritual soul connection in this universe.”
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The breach of a person’s personal ethical code at the heart of a moral injury can inflict lasting behavioural, emotional and psychological damage, distorting a person’s self-identity and provoking reflexive distrust of others.
“In the military, we have it better in a way, as we get this break between deployments,” Mr Lipana says. “Firefighters and cops have to reset themselves every 12 hours and go back out on their next shift.”
Research in America has identified how for many veterans the pride in once wearing their uniform collides with a feeling of futility about what their service achieved and a belief that military leaders failed or deceived them and their fallen comrades. The resulting sense of violation from this can further fuel a lingering crisis of the conscience and spirit – deepening the moral injury.
While healthcare workers know they are doing the right thing by helping people with Covid-19, they may still be affected by responses of leaders, from the hospital hierarchy up to the national level.
Media captionUS death rates v UK, Italy and South Korea
“One of the most toxic forms of moral injury is betrayal,” says Ms Brock, who is also co-author of Soul Repair: Recovering from Moral Injury After War. “Our healthcare workers are working to save people, but they have been betrayed by the government’s inadequate response.”
So stay safe!
Coronavirus: Pastor who decried ‘hysteria’ dies after attending Mardi Gras
Aleem Maqbool BBC News, Washington, 6 April 2020
Pastor Landon Spradlin wasn’t worried about coronavirus when he went to New Orleans to preach during Mardi Gras. A month later he was dead.
“He loved to laugh. He loved to play guitar. He played guitar even when he wasn’t supposed to,” says Jesse Spradlin of her father, Landon.
“He was just the best man in the world.”
One day when this is all over, the wife and five children of Pastor Landon Spradlin hope to hold a large celebratory memorial for him.
For now they have had to make do with a funeral at which there were just a handful in attendance, including the blues guitarist who played at the graveside.
Covid-19 gives peace a chance in South Thailand
Thai Muslim insurgents commit for first time in 17-year conflict to de facto ceasefire to facilitate humanitarian response to Covid-19
by Anthony Davis, Asia Times, April 6, 2020
BANGKOK – What an unrelenting military crackdown has failed to deliver in 17 years of fighting, the insidious advance of the Covid-19 virus across Thailand’s restive southern border provinces may have achieved in just two weeks: a rare opportunity for peace in what had seemed like an endless conflict.
On April 3, the Patani Malay National Revolutionary Front, or BRN, the insurgent organization that has spearheaded the separatist revolt in the mainly Malay Muslim border region, announced it was willing, at least temporarily, to put down its arms on humanitarian grounds and facilitate the response to a threat it described as the “principal enemy of the human race.”
The watershed one-page statement, dated April 3 and bearing the stamp of the group’s Central Secretariat, represents the first time the rebel group has publicly committed to what amounts to a de facto ceasefire.
Against the backdrop of direct peace talks between BRN and the Thai government which opened in Malaysia in January, the sudden onset of Covid-19 in south Thailand may just sound an echo of the Indian Ocean tsunami of December 2004.
Within less than a year, that natural catastrophe had ended the long-running separatist conflict in the Indonesian province of Aceh with a peace deal that has held to present.
But a slow-spreading virus is not a wall of water; Patani is not Aceh; and crucially the response of the Thai state and security forces still remains to be seen.
It was notable that the BRN statement was couched in clearly guarded terms that hardly amounted to an enthusiastic endorsement of peace.
Nor did BRN, with a typically provincial perspective, make any reference to the March 23 appeal from United Nations chief Antonio Gutierres to “put armed conflict on lockdown” globally amid the pandemic.
Pointedly avoiding the term “ceasefire” or “cessation of hostilities”, the group undertook rather to “cease all activities.”
That stand-down, it said, would come into effect from April 3 and remain in force only for as long as the BRN was not attacked by government forces.
The statement also appeared to take days to formulate, finally appearing well over a week after the mid-March onset of the pandemic in the southern border provinces of Pattani, Narathiwat, Yala and Songkhla where BRN operates.
Reportedly imported by Thai Muslim pilgrims returning from the now infamous mass congregation of the Tablighi Jamaat sect early in the month in Selangor, Malaysia, the virus threatens to hit the border region especially hard.
By April 5, there were 156 confirmed cases and four Covid-19 related deaths in the four provinces, with Yala hardest hit with 52 cases followed by Pattani with 45. Several hundred others remain untested but under observation.
Both the language of the statements and the delay served to point up two central aspects of the conflict, neither of which bodes well for long-lasting Covid-19 inspired peace.
The first is the deep distrust of the Thai state in the ranks of BRN and the wider Muslim community after 15 years of insurgency and decades of top-down policies from Bangkok aimed at assimilating the region into the Thai Buddhist national mainstream.
The January opening of direct talks, a milestone of sorts, has only begun to scratch at the surface of long-ingrained suspicions.
Mystery Mom Has Been Leaving Out Free Bagged Lunches ‘Made With Love’ for Anyone Who May Need Them
McKinley Corbley, Good Ndews Network, Aoril 2, 2020
An anonymous Maryland mother is being hailed for leaving out hundreds of bagged lunches for her community during the novel coronavirus shutdowns.
The unidentified do-gooder has been leaving the healthy meals on a tent-sheltered table at a busy intersection in Severna Park. Hanging from the table is a sign that reads: “For anyone who needs it … I will be leaving some healthy sack lunches on this table for you if you are hungry and need to eat. Made with love by a neighborhood mom in a clean and sanitized kitchen.”
The table has reportedly been stocked with free lunches between 11AM and 1:30PM every day for a number of weeks.
For Kimberly Gussow, a mother-of-two who has been scrimping and saving to make ends meet as she works from home, the lunches have been a much-appreciated gesture of kindness for her kids during the quarantine.
“This makes me embrace my community even more. I’m proud to live here,” Gussow told ABC News. “It’s great to show our kids that there is good in our world. It’s not just about ourselves, it needs to be about others too.”
The table even caught the eye of state Delegate Nic Kipke, who praised the labor of love on his Facebook page, saying: “Things like this really lifts my spirits! It’s great to see so many in our community doing so much to care for others during this stressful time.”
The coronavirus pandemic, and the massive gut punch it’s dealt to businesses and workers, makes the case for radical reforms that need to be adopted, including a wealth tax and universal base income, according to a Financial Times editorial.
The rapid spread of the virus throughout the world, and the subsequent collective shuttering of businesses, has left governments scrambling to stave off bankruptcies and cope with mass unemployment. In the last two weeks of March alone, a record-shattering 10 million Americans filed for unemployment benefits — a stunning sign of the breadth of the economic downturn.
But the economic lockdown, according to the Financial Times editorial board, has disproportionately impacted individuals who are “already worst off.” Workers hurt by the crisis include those in hospitality, leisure and related sectors who were laid off.
According to the Labor Department’s March jobs report, which revealed that employers shed 701,000 jobs last month, leisure and hospitality accounted for the bulk of the job losses, with 459,000 vanishing from the sector. Food services and drinking places — one of the hardest-hit areas of the economy, as cities and states enforce strict stay-at-home policies — lost 417,400 positions in March.
And while many “better paid knowledge workers” have the luxury to work from home without risking exposure to COVID-19, the respiratory illness caused by the novel coronavirus, workers in low-wage jobs like grocery store employees, health care support workers, delivery drivers, cleaners and shelf stackers must continue to show up, “often risking their lives” in the process, the editorial said.
“Despite inspirational calls for national mobilisation,” the editorial said, “we are not really all in this together.”
To address the economic inequalities exposed by the virus, the editorial board of the London-based newspaper proposed major reforms like basic income, taxes on the ultra-wealthy and redistribution.
“Radical reforms — reversing the prevailing policy direction of the last four decades — will need to be put on the table. Governments will have to accept a more active role in the economy,” the Financial Times editorial said. “They must see public services as investments rather than liabilities, and look for ways to make labour markets less insecure. Redistribution will again be on the agenda; the privileges of the elderly and wealthy in question. Policies until recently considered eccentric, such as basic income and wealth taxes, will have to be in the mix.”
Democratic presidential candidate Bernie Sanders, a self-avowed democratic socialist, has similarly used the pandemic to make the case for his progressive agenda, in particular universal health care.
“At a time when millions are losing their jobs AND their health care, the American people are now seeing the gross deficiencies in our employer-based private health care system,” Sanders tweeted last week. “Health care is a human right, not an employee benefit. Medicare for All!”