Health & Fitness

During the COVID-19 pandemic, legitimate concerns have been raised that the social distancing, financial upheaval, quarantines and virus fears could lead to an upcoming mental health crisis. While this is still a potential reality, challenging times bring out both the best and the worst in people, and there’s some evidence that there could be a silver lining to the pandemic, in the form of increased resiliency and fortitude.

Rather than leading to an increase in feelings of loneliness, at least one study has found that the unique circumstances surrounding the pandemic, including stay-at-home orders, led to increased feelings of social support among survey respondents.¹

Increased Resilience, Social Support During Pandemic

Florida State University (FSU) College of Medicine researchers surveyed 2,230 people to assess the trajectory of loneliness in response to COVID-19. While it was expected that loneliness levels would increase, this wasn’t what the study revealed.

Loneliness was assessed before the outbreak, in January and early February 2020, in late March when the U.S. was just starting its “Slow the Spread” campaign, and again in late April, when most states had enacted stay-at-home orders.²

“Contrary to expectations, there were no significant mean-level changes in loneliness across the three assessments,” the researchers wrote, and the study suggests people may be finding creative ways to stay connected, and perhaps are calling their friends and family more often than they would have otherwise, during the pandemic.

Rather than finding survey respondents to be increasingly lonely as the pandemic wore on, they reported a perception of increased support from others. There were some differences by age, with older adults reporting less loneliness overall, but an increase in loneliness during the outbreak’s acute phase.

This leveled off after stay-at-home-orders were issued. Other potentially vulnerable populations, including those living alone or with at least one chronic health condition, did have higher levels of loneliness at the start of the study, but the levels did not increase along with social distancing measures.

“Despite some detrimental impact on vulnerable individuals, in the present sample, there was no large increase in loneliness but remarkable resilience in response to COVID-19,” the researchers explained.³

“There has been a lot of worry that loneliness would increase dramatically because of the social distancing guidelines and restrictions,” lead study author Martina Luchetti, an assistant professor at the College of Medicine, said in a news release.

“Contrary to this fear, we found that overall loneliness did not increase. Instead, people felt more supported by others than before the pandemic. Even while physically isolated, the feeling of increased social support and of being in this together may help limit increases in loneliness.”⁴

Other Research Has Hinted at Soaring Stress Levels

While it’s possible that challenging times may bring out newfound resilience in many people, other research reveals Americans are struggling with soaring stress levels amid the pandemic.

For instance, the American Psychological Association’s Stress in America 2020 survey, released in May 2020 and conducted in partnership with The Harris Poll, found high stress levels related to coronavirus are “the new normal” for parents, while people of color were also more likely than white adults to report that the pandemic was causing significant stressors in their life, particularly related to fears of getting COVID-19 and having access to basic needs and health care services.⁵

A poll conducted by the American Psychiatric Association in March 2020 revealed that 36% of Americans felt coronavirus was having a serious impact on their mental health, while 59% felt it was seriously impacting their day-to-day lives.⁶

Even Small Increases in Loneliness Matter

In regard to loneliness, even small, population-wide increases in feeling lonely could have a significant effect on public health, considering loneliness’ toll on your health is equivalent to smoking 15 cigarettes a day⁷ and increases your risk of premature death.⁸ Loneliness was even associated with a 40% increased risk of dementia over a 10-year study period.⁹ Pre-pandemic, in a survey of 20,000 U.S. adults, 46% said they sometimes or always feel alone.¹⁰

“In the context of the coronavirus pandemic, it may be particularly difficult to reconnect with others given the restrictions on in-person social gatherings,” Luchetti says. “Even these transient feelings of loneliness can have a negative effect on health, meaning there could be dangerous unintended consequences if loneliness increases in response to the restrictive measures taken as a result of the pandemic.”¹¹

While it seems counterintuitive that the pandemic may have led to increases in perceived social support, it’s possible that the global experience has been unifying.

“Just knowing that you are not alone and that everyone is going through the same restrictions and difficulties may be enough in the short term to keep feelings of loneliness down,” Angelina Sutin, FSU associate professor of behavioral sciences and social medicine and senior author of the featured study, said in a news release.¹²

Becoming ‘Antifragile’ During the Pandemic

It’s important to note that there are multiple ways to harness a challenging time like a pandemic to make yourself increasingly resilient or, as Siim Land, whom I recently interviewed, puts it, “antifragile.” His latest book, “Stronger by Stress: Adapt to Beneficial Stressors to Improve Your Health and Strengthen the Body,” reviews the important concepts of hormesis and antifragility.

“Part of the reason I wrote the book was to help people become more resilient and more robust, because the world we live in is full of unpredictable challenges,” Land says.

“Pandemics and viruses are part of them, but there's also other potential dangers like global warming or fluctuations in temperature, different kinds of physical challenges that have been a part of the human condition for eons.

The modern human has become somewhat more fragile towards those things, and this kind of goes to show why most people just overreacted to the coronavirus and were really scared.

The book itself was meant to create more resilient people in the face of these unavoidable challenges of life, because you can't really avoid them. You can't create this bubble society where everything is perfect. We all come across different kinds of stressors all the time.”

Time-restricted eating is one of Land’s favorite tools because it allows you to become metabolically flexible and insulin sensitive, which builds your antifragility. However, there are other methods for staying resilient during the pandemic as well.

Resilience Sends You on an ‘Upward Spiral’

Resilience is the ability to quickly recover from difficulties. It’s an innate toughness that allows you to persevere through challenging times, and it’s something often found among centenarians.

Even as times changed, those in the 100-plus crowd kept on living, adapting to and welcoming the new phases of their lives. It’s this fortitude and emotional resilience that has likely played a major role in their longevity — and it’s something you can harness as well, including during the pandemic.

Researchers with the University of North Carolina at Chapel Hill’s Positive Emotions and Psychophysiology (PEP) Lab have been looking into what’s making people happy and resilient, despite the pandemic. They note:¹³

“Research has found that resilient people — people who handle life’s challenges especially well and who quickly bounce back from setbacks — do not somehow avoid negative states, delusionally thinking everything is fine.

Rather, even while feeling stress, anxiety, loneliness and depression, the resilient among us also feel love, gratitude, joy and hope. Our team’s research has also shown that resilience is not a fixed trait. It can be cultivated. Like an upward spiral, resilience increases as people experience more frequent positive emotional states.”

Keys to Staying Resilient

After surveying more than 600 U.S. adults about their experiences and behaviors of the past day, some clear trends were revealed. Positive emotions were associated with self-care, such as engaging in a hobby or relaxing, exercising or engaging in spiritual activities, such as prayer or meditation.¹⁴

This isn’t entirely surprising, but an important finding was that people who were feeling the most stressed, lonely or anxious benefited the most from these positive, self-care activities. This reiterates how important it is to take time to unwind, especially if you feel you’re nearing burnout.

Spending time actively engaging with others also led to more positive emotions, and this was true for both introverts and extroverts and was especially beneficial for people who live alone. However, the most positive emotions were gleaned from face-to-face, voice or video interactions — texts didn’t seem to do the trick, with the researchers explaining:¹⁵

“Interacting with others doesn’t seem to help much when you can’t actually see or hear the people you are communicating with. This was a useful wake-up call for us. We thought we were doing ourselves good by keeping up via text. But the evidence suggests that this isn’t as valuable as we thought. It’s much harder to establish a meaningful connection with someone via text.”

Passively browsing social media, such as scrolling through feeds, did not lead to positive emotions and instead was strongly tied to negative feelings and anxiety. On the other hand, doing good for others was associated with positive feelings — a finding that’s been proven in the past.¹⁶

To sum up their data, the PEP Lab researchers suggested the media stop touting the need for “social distancing,” when what’s really needed is physical distancing combined with social solidarity. In order to retain and find your resilience during the pandemic, increased connections are key, and they suggested the following five steps to help society “MARCH” together:

• Minimize passive scrolling through social media
• Accept negative emotion
• Really connect with people
• Care for yourself
• Help others

To help you accept and release negative emotions, the Emotional Freedom Techniques (EFT) is another recommended tool for coping with COVID.

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According to the American Academy of Pediatrics (AAP), the academic, physical and mental benefits of returning children to school for in-person learning outweigh the potential health risks of COVID-19.

To that end, the AAP has issued guidelines for the “safe reopening” of schools. However, many parents wonder whether the guidelines themselves may do far more harm than good in the long term. One parent outlines her concerns in the video above.

The U.S. Centers for Disease Control and Prevention has also issued school reopening guidelines¹ in anticipation of nationwide reopenings. Unicef² also supports students’ re-entry into schools, noting that reopenings should “be consistent with each country’s overall COVID-19 health response to protect students, staff, teachers and their families.”

American Academy of Pediatrics Calls for School Reopenings

As noted in the AAP’s guidance for school re-entry:^3,4

"The importance of in-person learning is well-documented, and there is already evidence of the negative impacts on children because of school closures in the spring of 2020.

Lengthy time away from school and associated interruption of supportive services often results in social isolation, making it difficult for schools to identify and address important learning deficits as well as child and adolescent physical or sexual abuse, substance use, depression, and suicidal ideation.

This, in turn, places children and adolescents at considerable risk of morbidity and, in some cases, mortality. Beyond the educational impact and social impact of school closures, there has been substantial impact on food security and physical activity for children and families."

Children Rarely Transmit COVID-19

AAP points out that, unlike the influenza virus, SARS-CoV-2 does not appear to spread easily among children and teens. Indeed, studies from the U.S.,⁵ Israel⁶ and the Netherlands⁷ have demonstrated that children are far less likely to become infected than adults, and far less likely than adults to transmit the virus to others. 

In one such study,⁸ children accounted for just 13% of transmissions within households. Another found⁹ children under the age of 4 were 47% less likely to test positive for SARS-CoV-2 infection compared to adults in the same household.

A July 2020 study¹⁰ looking at COVID-19 in children and the dynamics of infection within families found only 0.9% of COVID-19-positive patients were under the age of 16, and in just 8% of cases did a child within the household develop symptoms before an adult. Science Daily¹¹ also cites a number of other studies confirming the theory that children are rare disease vectors when it comes to COVID-19:

“In a French study, a boy with Covid-19 exposed over 80 classmates at three schools to the disease. None contracted it. Transmission of other respiratory diseases, including influenza transmission, was common at the schools.

In a study in New South Wales, nine infected students and nine staff across 15 schools exposed a total of 735 students and 128 staff to Covid-19. Only two secondary infections resulted, one transmitted by an adult to a child.

‘The data are striking,’ said Dr. [William V.] Raszka. ‘The key takeaway is that children are not driving the pandemic. After six months, we have a wealth of accumulating data showing that children are less likely to become infected and seem less infectious; it is congregating adults who aren't following safety protocols who are responsible for driving the upward curve.’"

Originally, school closings were based on the premise that the virus responsible for COVID-19 would behave like other respiratory viruses, but since it doesn’t, returning children to school is unlikely to pose a significant risk to health.

“ … the preponderance of evidence indicates that children and adolescents are less likely to be symptomatic and less likely to have severe disease resulting from SARS-CoV-2 infection. In addition, children may be less likely to become infected and to spread infection,” AAP notes,¹² adding that:

“Policies to mitigate the spread of COVID-19 within schools must be balanced with the known harms to children, adolescents, families, and the community by keeping children at home.”

Guidelines Promote ‘Institutionalized Isolation’

As mentioned, the CDC has also issued guidelines¹³ for the re-opening of schools. While the CDC and AAP guidelines are very similar, the AAP’s restrictions tend to be a bit more flexible.

For example, while both call for social distancing with 6 feet between each student at all times, the AAP concedes that this may not always be feasible, and if not, spacing can be 3 feet if students wear face masks and are asymptomatic. Still, as noted in the featured video, students are likely to be just as scarred having to follow COVID-19 prevention guidelines as they are staying at home.

While the exact measures vary depending on the age of the students, some of the basic recommendations found in the CDC and AAP guidelines include:^14,15,16,17

• Physical distancing — Students must sit apart on the school bus; desks must be spaced 6 feet apart and face in the same direction; floor markings will indicate “safe distancing” from the teacher’s desk and other areas where lines are formed; plexiglass barriers will be used in work spaces where physical distancing cannot be achieved; congregation in shared spaces, including playgrounds and cafeterias, is to be discouraged for students and teachers alike; hallways are to be trafficked in one way only to minimize face to face interaction; students may not share school supplies; nonessential visitors, including parents, are discouraged from entering the school, and field trips are to be replaced with virtual events.
• Face covering — Teachers and students are to wear face coverings at all times.
• Symptom screening — Symptom screening such as temperature checks should ideally be made by parents before dropping the child off at the bus stop or at school. Staff or students with a temperature above 100.4 degrees Fahrenheit will not be permitted in school.
• Disinfection — Hand hygiene, use of disinfectant and regular cleaning of surfaces must be adhered to.
• Signage and broadcasts — Signs are to be posted in various areas, such as entrances and bathrooms, promoting protective measures to minimize spread of pathogens, and announcements are to be broadcast over loudspeakers and/or video screens informing students of the same.

As noted in the featured video, these guidelines amount to “institutionalized isolation” and fear-mongering that can cause significant emotional and mental harm to children, especially if implemented for weeks or months on end.

Humans need physical contact and social face-to-face interactions, and this is particularly true for children. At best, these remedies will lead to the creation of a generation of fearful germophobes. At worst, it may stunt their ability to function normally in social situations altogether.

Choices Vary Depending on Where You Live

While the AAP and CDC are calling for the reopening of most schools nationwide, parents may face a variety of choices, depending on where they live. As reported by USA Today:¹⁸

“In just two examples, the Nashville, Tennessee public school system recently offered parents a choice between sending their children back to school full time or keeping them at home for online classes, while Fairfax County, Virginia public schools are making families choose between fully online schooling or a ‘hybrid’ that combines in-person and remote instruction.”

In a June 12, 2020, article^19,20 in The New York Times, epidemiologists weighed in on the decision to send children back to school. Of the 304 epidemiologists that replied to the New York Times’ survey, a majority — 70% — said they were ready to send their children back to school somewhere between now and this fall.

Costs May Have Catastrophic Consequences for School Systems

On top of everything else, there are financial dilemmas to address. As noted in a July 9, 2020, New York Times article,^21,22 school budgets that are already stretched thin are facing million-dollar expenditures if they are to comply with school opening guidelines:

“Bus monitors to screen students for symptoms in Marietta, Ga.: $640,000. Protective gear and classroom cleaning equipment for a small district in rural Michigan: $100,000. Disinfecting school buildings and hiring extra nurses and educators in San Diego: $90 million …

Exactly how much money the nation’s schools need to reopen is a matter of debate, complicated by the conflicting, sometimes shifting advice and guidelines that administrators have received from government agencies and medical authorities …

Regardless of which recommendations are followed, reopening schools will require changes. An average-size district of 3,700 students can expect $1.8 million in pandemic-related costs for 2020-21, representing 3 to 4 percent of a typical annual budget, according to an estimate from AASA, the School Superintendents Association …

But some experts have suggested that much of what schools are planning for the fall, such as checking students’ symptoms before they board buses or enter schools, is unnecessary, akin to the type of ‘security theater’ Americans became accustomed to after the terrorist attacks of Sept. 11, 2001 — reassuring, but often providing only superficial protection.”

As reported by U.S. News,²³ some school systems are already feeling the economic pain from the shutdown. Both state and local budget cuts are expected in many areas, some projected to be as high as 25%, due to lost revenue.

In Massachusetts, 2,000 teachers have already been laid off due to budget cuts, and the National Education Association estimates upward of 700,000 teachers may lose their jobs over the next two years.

Some states are also seeing skyrocketing homeschooling submissions, which further threatens schools’ funding. In North Carolina, the online system for filing a Notice of Intent to Establish a Home School temporarily crashed²⁴ due to the influx of NOIs being filed, according to a July 7, 2020, report by Life Site.²⁵

I personally find this very encouraging as most educational systems in the U.S. leave much to be desired. While it certainly is an additional challenge for parents, I am convinced most children will be far better off home schooled.

Mask Test Reveals Hazardous Carbon Dioxide Levels

Last but certainly not least, many parents worry the wearing of face masks might jeopardize the health of their child by restricting oxygen flow and allowing for the buildup of carbon dioxide with each exhale. There may indeed be something to this concern, and it’s something that none of the health authorities have addressed.

The Occupational Safety and Health Administration (OSHA), which is part of the U.S. Department of Labor, requires the oxygen level in a working atmosphere to be above 19.5%. Anything below that is considered hazardous to health.

In the video above, which, of course, was banned and removed from YouTube, Del Bigtree shows a video of a man demonstrating how the oxygen concentration — when wearing a surgical mask — can easily drop below OSHA air quality standards.

Bigtree then conducts a simple carbon dioxide test with his 11-year-old son to check the air quality behind a variety of masks.²⁶ Using a testing device that measures carbon dioxide concentrations in ambient air, Bigtree checks the carbon dioxide concentration behind his son’s mask.

With an N95 mask on, the carbon dioxide level spikes above 8,480 parts per million (ppm) within seconds. Above 5,000 ppm, OSHA warns that “toxicity or oxygen deprivation could occur.”

Carbon dioxide levels between 2,000 ppm and 5,000 ppm are associated with headaches, sleepiness, poor concentration, loss of attention, increased heart rate and slight nausea. The maximum permissible daily exposure limit is 5,000 ppm.

Wearing a standard surgical mask, carbon dioxide levels again reached above 8,000 ppm, although it took longer. Shockingly, wearing a cloth bandana resulted in carbon dioxide buildup near the nose and mouth exceeding 8,000 ppm.

Even wearing a clear plastic face shield (without a mask) resulted in carbon dioxide levels in the 1,500-ppm range, which is associated with drowsiness and poor air quality.

There Is No Scientific Basis for Most of These Measures

Unfortunately, many have been swept up in the mainstream media fearmongering that has bombarded us daily for several months, and when government and health officials encourage shaming and reporting those who refuse to succumb to irrationality, it only worsens matters.

The scientific evidence is clear on several points, however. We now know children are not significant vectors of disease, even when they’re infected. Children are also at virtually zero risk of death when they develop symptoms.

Even among adults, the infection mortality rate is now down to a median of about 0.25%.²⁷ As Stanford University's disease prevention chairman Dr. John Ioannidis noted in a June 27, 2020, interview with Greek Reporter:^28,29,30

“For people younger than 45, the infection fatality rate is almost 0%. For 45 to 70, it is probably about 0.05-0.3%. For those above 70, it escalates substantially, to 1% or higher for those over 85.”

And, as testing continues, and more people are found to be asymptomatic yet positive, these mortality rates will be driven down even further. Science also conclusively shows that masks do not protect the wearer against viral infection and do not prevent its spread to others.

This evidence was clearly laid out in my interview with Denis Rancourt, Ph.D. He did a comprehensive review of the scientific literature on masks, concentrating on evidence showing masks can reduce infection risk, especially viral respiratory diseases:

“What I found when I looked at all the randomized controlled trials^31,32 with verified outcome, meaning you actually measure whether or not the person was infected … NONE of these well-designed studies that are intended to remove observational bias … found there was a statistically significant advantage of wearing a mask versus not wearing a mask.

Likewise, there was no detectable difference between respirators and surgical masks. That to me was a clear sign that the science was telling us they could not detect a positive utility of masks in this application.

We're talking many really [high-]quality trials. What this means — and this is very important — is that if there was any significant advantage to wearing a mask to reduce this [infection] risk, then you would have detected that in at least one of these trials, [yet] there's no sign of it.

That to me is a firm scientific conclusion: There is no evidence that masks are of any utility either preventing the aerosol particles from coming out or from going in. You're not helping the people around you by wearing a mask, and you're not helping yourself preventing the disease by wearing a mask.”

Third, we also now know that COVID-19 has not been the devastating pandemic killer it’s been made out to be. When looking at all-cause mortality from year to year, Rancourt found the pandemic has not led to a significant increase in deaths compared to the same time frame in previous years. To understand why all-cause mortality statistics are crucial for understanding the impact of this pandemic, please review my interview with Rancourt.

Clearly, I’m not going to tell you what to do with your children. The choice to send your children back to school will have to be a personal one. All I will suggest is to look at some of the statistics and scientific evidence brought forth in this article.

Look up the references, read the studies. Try to really understand the data. Chances are, armed with science rather than mainstream media reports, you’ll be better equipped to make your choice, and feel confident in doing so.

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As our society and culture become more connected through technology, the use of headphones has increased. Headphones allow people to enjoy music and have conversations from anywhere at any time. The ease of headphone use and the mobility that they afford cannot be overstated. This is particularly true currently, as our society spends more time with virtual meetings and headphones during the COVID-19 pandemic. Despite the convenience of headphones and the increased utility, questions about safety of use have been raised. There is such a thing as healthy headphone use; you just need to know about safe sound levels and when to take a break from headphones.

How does sound cause hearing loss?

Isn’t sound supposed to provide a tool for communication and awareness of our environment? Yes, sound is an essential mode of communication that also orients us to our environment; however, the inner ear is very sensitive to the balance of sound that it perceives. There are thousands of cells in the ears, some of which have little hairlike structures called hair cells that are responsible for transmitting sound from the ears back to the brain, where it is further processed. Excess sound can cause permanent damage to these cells, which interrupts the mechanism of sound transmission. Damage may also happen via the connection between the hair cells and nerve cells, which can be interrupted by excess sound, even if the hair cells remain normal. In short, one thing is clear: sound that is too loud is harmful.

How loud is too loud?

The CDC has detailed information on various daily experiences and the volume, or decibel (dB) level, associated with them. One of the important things to note when considering headphone use is that personal listening devices are tuned to a maximum volume of around 105 to 110 dB. For reference, exposure to sound levels above 85 dB (equal to a lawnmower or leaf blower) can cause possible ear damage with exposure of more than two hours, while exposure to sound of 105 to 110 dB can cause damage in five minutes. Sound less than 70 dB is unlikely to cause any significant damage to the ears. This is important to know, because the maximum volume of personal listening devices is above the threshold at which damage occurs (in both children and adults)! It is important that as a listener, you are aware that most devices can, in fact, be used in a way that is harmful. Ultimately, personal listening devices should be comfortable to the listener.

How long is too long?

In addition to volume, the duration of sound exposure is an important factor that contributes to possible ear damage. Simply stated, louder sounds have potential for more damage with less exposure. The Occupational Safety and Health Administration (OSHA) mandates that employers offer hearing protection for employees with averaged exposure of 85 dB for greater than eight hours. While this sounds like a long time, headphone use at only slightly higher sound levels can cause damage in less than one hour, and it is easy to imagine listening to music with headphones for an hour or longer. Importantly, listening at a comfortable level should be safe for an unlimited amount of time, though it is essential to balance duration of use with loudness of exposure.

Suggestions for safe listening

Our ears can be damaged by excess sound, and the combination of excess level of sound and duration of exposure contributes to potential hearing problems. Here are some suggestions for healthy listening habits.

• Be aware of how long you have been listening and how loud the sound is.
• Take breaks after prolonged listening sessions, and be sure to listen at a comfortable level.
• Be prepared. If you are going to attend an event where there is likely to be prolonged loud noise (such as a concert or sporting event), bring earplugs or headphones. There is a range of devices available that offer protection from a potentially damaging situation, from simple foam earbuds, to headphones with noise cancelling properties, to customizable ear molds made by an audiologist.
• Finally, don’t hesitate to talk with an audiologist or otolaryngologist about any questions you have around headphone use or safe sound levels. Hearing health is important and complex, and we can help you take steps to protect your ears while using headphones.

The post Healthy headphone use: How loud and how long? appeared first on Harvard Health Blog.

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