Neurological and psychiatric complications of severe SARS infections: review and meta-analysis
EM of sars-cov-2 budding from apoptotic (dying) cells–NIAID
A review of psychiatric and neurological complications from SARS and MERS compared with COVID-19, published in Lancet Psychiatry May 18 (full text) assessed common symptoms associated with acute illness and after recovery by meta-analysis of multiple articles (65 articles and seven pre-prints were selected for quality and comprehensiveness) :
Neuropsychiatric symptoms associated with COVID-19
Acute neuropsychiatric symptoms of SARS and MERS (both diseases with much higher mortality rates but caused by closely related coronaviruses): confusion, impaired memory, insomnia, anxiety, and depressed mood. Post-illness (assuming the patient recovered from the acute illness): insomnia, anxiety, irritability, memory impairment, fatigue, depressed mood, and “traumatic memories” (similar to post-traumatic stress disorder.) Three-quarters of recovered patients had returned to work after three years of followup.
Neuropsychiatric symptoms associated with COVID-19: delirium (and confusion with agitation) occurred in two-thirds of patients admitted to intensive care. Altered consciousness on admission was seen in about 20% of patients who subsequently died. At discharge, a third of patients assessed had “dysexecutive syndrome” (difficulty in making decisions, apparently.)
Exact figures from the text:
Acute illness; “common symptoms among patients admitted to hospital for SARS or MERS included confusion (36 [27·9%; 95% CI 20·5–36·0] of 129 patients), depressed mood (42 [32·6%; 24·7–40·9] of 129), anxiety (46 [35·7%; 27·6–44·2] of 129), impaired memory (44 [34·1%; 26·2–42·5] of 129), and insomnia (54 [41·9%; 22·5–50·5] of 129). ”
Post-illness: “depressed mood (35 [10·5%; 95% CI 7·5–14·1] of 332 patients), insomnia (34 [12·1%; 8·6–16·3] of 280), anxiety (21 [12·3%; 7·7–17·7] of 171), irritability (28 [12·8%; 8·7–17·6] of 218), memory impairment (44 [18·9%; 14·1–24·2] of 233), fatigue (61 [19·3%; 15·1–23·9] of 316), and in one study traumatic memories (55 [30·4%; 23·9–37·3] of 181) and sleep disorder (14 [100·0%; 88·0–100·0] of 14)”
Meta-analysis: “point prevalence of post-traumatic stress disorder was 32·2% (95% CI 23·7–42·0; 121 of 402 cases from four studies), that of depression was 14·9% (12·1–18·2; 77 of 517 cases from five studies), and that of anxiety disorders was 14·8% (11·1–19·4; 42 of 284 cases from three studies). 446 (76·9%; 95% CI 68·1–84·6) of 580 patients from six studies had returned to work at a mean follow-up time of 35·3 months (SD 40·1)”
COVID-19: ” delirium (confusion in 26 [65%] of 40 intensive care unit patients and agitation in 40 [69%] of 58 intensive care unit patients in one study, and altered consciousness in 17 [21%] of 82 patients who subsequently died in another study). At discharge, 15 (33%) of 45 patients with COVID-19 who were assessed had a dysexecutive syndrome in one study. At the time of writing, there were two reports of hypoxic encephalopathy and one report of encephalitis.”
So these diseases shared similar mental symptoms during the acute illness and we would expect chronic symptoms after recovery to be similar as well. This is important, because about a third of patients demonstrated post-traumatic stress disorder after discharge. About 15% of these patients had anxiety or depression as well. Three quarters of them returned to work, but the study followed them for three years after discharge, so we would expect prolonged disability with COVID-19 as well.
Underlying Neurobiological Pathology in COVID-19
Another study published June 30 in the Journal of Alzheimer’s Disease described itself as reviewing the neurobiology of COVID-19 and postulated three distinct phases of infection. The article summarizes a number of published reports relating to neurological symptoms in acute infection. It says that there are a number of common symptoms that could represent direct invasion of nerve cells or a sign of the body’s reaction to the virus: “Anosmia, stroke, paralysis, cranial nerve deficits, encephalopathy, delirium, meningitis, and seizures are some of the neurological complications in patients with coronavirus disease-19” but it is not obvious what is the underlying cause (or causes) of these symptoms.
The three phases of infection hypothesized in the article are: first, direct invasion of cells lining the upper respiratory tract which express ACE-2 on their surfaces (ACE-2 is the protein to which the virus binds before it enters the cell.) Anosmia (loss of smell sensation) and dysgeusia or ageusia (perversion or loss of taste sensation) are, the article says, separate symptoms– and dysgeusia is actually more common than anosmia. Both symptoms, it says, are caused by direct virus invasion and damage to the epithelial cells of the nose, mouth, and throat.
By the same token, airway epithelial cells of the trachea and lungs are hosts to direct viral invasion and result in cough, dyspnea, and chest pain.
It is not known whether the virus can directly invade the brain through the cranial nerves and infect central structures responsible for processing of smell and taste signals, but it is presently considered unlikely.
The second source of neuropsychiatric symptoms is through blot clots in the arteries leading to the brain and in the veins draining blood therefrom. This is due to a hypercoagulable state (excessive blood clotting) which is brought on by pathologies associated with higher mortality: obesity, high blood pressure, and diabetes. In these conditions, levels of inflammation-related blood proteins like interleukins are already higher than normal and rapidly become even more elevated. These mechanisms are responsible for strokes, known as cerebrovascular accidents (CVAs.)
Some patients experience cerebral hemorrhages, which seems counterintuitive but appears to be related to vasoconstriction (closing of blood vessels by contraction of their intrinsic muscles.)
The third stage of brain injury in COVID-19 is also caused by excessive inflammation. In more severe cases, there is a “cytokine storm”, which involves the small blood vessels in the brain and results in leakage of blood proteins into the brain matter. Normally, the brain is protected by a membrane called the blood-brain barrier (BBB) which prevents all but a select few blood components from entering the brain. This barrier is tight enough to prevent many drugs that normally diffuse into tissues elsewhere in the body from entering brain tissue. When the endothelium (cells lining blood vessels) becomes inflamed, the BBB is breached and inflammatory molecules enter, damaging brain tissue.
The BBB breach causes symptoms of confusion, delirium, reduced level of consciousness (encephalopathy), seizures, coma, and death in extremis (at the end.) If a patient recovers from a partial BBB breach, he or she may be permanently disabled by memory loss and poor “executive function” (decision-making ability.) Depression, anxiety, and agitation are particularly common after recovery in these cases.
Some evidence suggests that SARS-COV-2 viral particles may, in some cases, directly enter the brain and infect neurons (some do have ACE-2 on their surfaces.) This may cause symptoms of meningitis and encephalitis: stiff neck, headache, and seizures. However, the virus has not been detected in cerebrovascular fluid as would be expected if there were direct viral invasion.
Cranial and peripheral nerves may be involved in COVID-19, similar to what was seen in SARS and MERS. There have been reported cases of Guillain-Barre syndrome (GBS) (flaccid paralysis with loss of reflexes and sensory loss or cranial neuropathy), caused by immune cross-reaction between nerves and the virus. These cases have responded to intravenous administration of immune globulin, typical of GBS. Therefore, these cases are not thought to be due to virus invasion of nerves but to immune reactions.
Heart and Skeletal Muscle Involvement in COVID-19
There is some evidence that invasion of cells with the virus leads to downregulation of ACE2 expression in the affected cells. This could lead to systemic effects of local invasion, by reducing the ACE-2 function, leading to hypertension, inflammation, and prothrombosis (increased blood clotting.)
Myocardial infarction in COVID-19 is thought to be due to the hypercoagulable state induced by severe inflammation. In addition, there is a suggestion that the nerves responsible for controlling the heart’s intrinsic rhythm may be involved by direct viral invasion. Early reports from Wuhan, China (also here) found frequent instances of arrhythmia and heart muscle weakness even in patients without myocardial infarction.
Viral invasion of heart cells would be described as myocarditis (heart muscle inflammation) as opposed to cardiomyopathy (weakness of the heart muscle caused by ischemia or other pathologies.) ACE-2 is expressed on the cell surface of many heart cells at high levels, including the heart’s smooth muscle (heart muscle, like other unconsciously controlled muscles, is smooth but skeletal muscle is striated.)
Skeletal muscles often show signs of involvement in COVID-19: the enzyme responsible for much of muscle’s activity, creatine phosphokinase (CPK), leaks out of damaged muscle cells and is found in elevated levels in the blood. However, direct injury of striated (skeletal) muscle appears unlikely because these muscle cells do not express high levels of ACE-2. High CPK appears to result from skeletal muscle injury by vasculitis (blood vessel inflammation) and other insults common to the intensive care unit (ICU.)
Skeletal muscles are weakened by the immobilization of serious illness and more so by the induced paralysis necessary to intubation and mechanical ventilation. This results in severe weakness after recovery; rehabilitation to regain strength is often prolonged.
Other Organs Likely to be Severely Affected by COVID-19
The cells that express the most ACE-2 on their surfaces are endothelium (the lining of blood vessels big and small), respiratory epithelium from the nose to the trachea, bronchi, and smaller tubes leading to the alveoli (tiny sacs in the lung where oxygen is absorbed into the blood), the lining of the digestive tract (mouth, throat, esophagus, small and large intestine– skipping the stomach itself which has a specialized lining that resists high levels of acid), the lining of the urinary tract (genitourinary endothelium– bladder, kidneys, and tubes in between), and smooth muscle cells (the heart and blood vessels, among others.) Damage from severe COVID-19 appears in all these organs, although it is most critical in the lungs (that fill with fluid, impairing oxygenation) and heart (where pump weakness and irregular beats lead to circulatory failure.) The brain clearly is involved in this cascade of disasters, whether directly or indirectly.
Patients Who Recover From COVID-19 Are Still Suffering Afterwards
I hope that this gives you a better idea of the spectrum of neurological and psychiatric symptoms associated with COVID-19. There is clearly a neurological basis for post-traumatic stress disorder, impaired memory, depression, and anxiety following the virus.
There are medical reasons why a previously highly organized and optimistic ER doctor would take her own life at 49 after appearing to recover from COVID-19 and returning to work. This case was reported on April 27. I won’t get into it in too much detail (here— NY Times, here–CNN, here–NBC, and here–NPR, are some news accounts), but there are reasons why someone with no predisposing psychological problems would kill herself– it’s the pernicious effects of the virus combined with the unreasonable and unrealistic demands that were placed upon her as an emergency room physician and director.
credit squeeze– photo by steve buissinne courtesy of pixabay.com
The Washington Post has an article on July 14 reporting that big banks have seen significant drops in their profits and are increasing their credit reserves in anticipation of multiple defaults on their loans. They apparently expect a prolonged recession as a result of the pandemic. Prolonged recession will turn into a depression.
The pandemic prompted people to stop going to public events and going out to eat or for entertainment. State governments ordered shutdowns for restaurants, bars, concerts, movie theaters, barber shops, hair stylists, tattoo parlors, bookstores, and many other establishments– anything nonessential. Only supermarkets, pharmacies, gas stations, and other “essential” businesses (like gun stores) were allowed to remain open.
Economic activity dropped dramatically in March. Advertising revenue for newspapers plummeted as businesses stopped placing ads for public events. Millions of people were laid off. In the United States, Statista showed a drop in employment from 128 million in March to 114 million in April. So many people tried to file for unemployment that state agencies charged with registering them were unable to keep up. As a result of the backlog, millions of people were unable to file. According to Statista, “As of June 2020, there were 120.17 million full-time employees in the United States. This is a significant decrease from June 2019, when there were 131.54 million…”
These numbers (a drop of more than 10 million employees) are almost certainly an underestimate. Unemployed people were unable to pay their rent or keep up the payments on their cars or credit cards. As a result, the banks are experiencing a sudden loss of revenue from people defaulting on their loans. Now the banks are anticipating that this drop will continue to affect their revenues for some time to come.
A sudden, severe recession, with people unable to feed themselves or pay rent, is going on right now. A slight improvement in employment for June will soon be followed by further job losses and a prolonged recession. Starvation and homelessness are on the rise. Congress responded to this crisis with legislation in March and April but nothing since then. Another Congressional stimulus is expected towards the end of July, but it will not be enough to relieve the suffering of millions in this country.
Here is a comment to the Washington Post article:
Finally getting through to business executives and Fed officials that no matter how high the stock market gets boosted by liquidity among the wealthy, people who are afraid they will die if they leave their home will not be spending much money even if they kept their jobs. And millions of unemployed will be spending MUCH less once the extra $600 / week federal unemployment top-up stops in a couple of weeks. So 70% of the economy is going down the toilet. Yet the stock market is flying high. Don’t you love trickle up economics!
This comment points out that the stock market, after dropping almost a third at the start of the crisis, has recovered most of its value despite the worsening infection numbers and death count. Even people who still have their jobs are afraid to go out. They are not spending online either because they are afraid that their jobs are at risk even though they are still employed. Lower consumer spending will perpetuate the recession and the job losses.
The stock market represents the fortunes of the upper half of society, which will do well despite the pandemic and will become increasingly divorced from the fortunes of the lower half, which will sink into depression.
This pandemic is even worse than the one a hundred years ago. During the 1918-1920 influenza pandemic, 675,000 Americans were killed and an estimated 50 million people worldwide died (cdc historical page.) We hope that not that many people will die this time, but it is still early. What makes this pandemic worse than that one already is the severe economic impact. Back then, the economy was mostly made up of manufacturing enterprises; now, the economy is mostly consumer-oriented. Manufacturing continued then, but now, consumer spending has cratered.
What makes things worse this time is that concerted action by the federal government could prevent the spread of the virus. If the feds organized testing, contact tracing, and isolation, there would not be so much confusion, shortages, and political infighting. Instead, the federal government’s executive branch leadership has consistently denied or downplayed the virus’ impact and refused to get behind public health measures. Lower level attempts by the CDC and others to offer guidelines and provide information has been undermined by ignorant behavior at the highest levels.
Nothing has been done at the federal level to organize supplies needed for testing or personal protective equipment. Shortages of everything are as bad as they were at the beginning. The leadership has denied that these shortages even exist.
On top of the pandemic, police brutality and murder has been captured on cell phone videos starting on May 25, stimulating an outraged response by minority people, their representatives, and the persuadable public at large. Police brutality (especially towards minorities) has existed since time immemorial, but it has never been seen so widely as now. Public protests about police brutality have been met with more brutality instead of understanding. The problem has reached a tipping point. Broad social change is resulting. Again, the federal government executive branch leadership has not responded in a constructive fashion.
The result of the presidential failure to respond to the pandemic and public realization that police brutality is ongoing is extreme social polarization. A majority of the public is aware that the pandemic is spreading out of control and that the police are as brutal as ever, but a large minority is in denial and is violently resisting calls for change. Society has long been deeply polarized, but matters are worse now than they have ever been.
The nation will soon come forth to vote in presidential elections which will probably see the present administration fall. That will not be the end of the battle. Just as before the Civil War of 1861, the election will result in crystallizing society into two opposing groups. Violent conflict will follow.
photo by nastya_gepp courtesy of pixabya.com– chosen because it’s not her.
The administration’s pressure to open all primary and secondary schools this fall and cut off international students from colleges that don’t re-open has two purposes. First, to score political points by making it look as if the Democrats are trying to keep schools closed for nefarious purposes. Second, to cause chaos and disruptions in public schools that will make charter schools and home schools more attractive by comparison. Part of the underlying motivation is to advance the administration’s goal from its opening days of spending billions of dollars to subsidize charter schools and vouchers for home-schooling parents. Betsy DeVos is part of the plan.
Betsy DeVos sat for a TV interview the other day. She chose this moment (Sunday, July 12) to make herself available because she has a message for the public: “open schools this fall, with in-person attendance for everyone, or we will cut off your funding.” (That’s a paraphrase, because what she actually said was obviously a talking point that had been drilled into her by an aide.) What she really said:
American investment in education is a promise to students and their families. If schools aren’t going to reopen and not fulfill that promise, they shouldn’t get the funds, and give it to the families to decide to go to a school that is going to meet that promise.
She said this repeatedly, in response to multiple questions, without any variations or any attempt to provide substantive answers to the big questions: 1) how can you insist on sending children back to school in the middle of a pandemic without a clear plan for preventing the spread of infection? 2) what makes you think you can unilaterally cut off funding to schools that don’t comply with your demands?
She had no answers for these vexing questions. There is no federal plan to guide schools in preventing spread of infections, from child to child and from child to teacher (or to janitors, for that matter.) There is no funding for the extra expenses that an infection-prevention plan would entail. There is no legal way the executive branch can cut off funding to the schools; most of the money for schools comes from local and state sources and is inaccessible to federal executive action. What money does come from federal sources is mostly earmarked for special programs for disabled and disadvantaged children, and could not be cut off simply by executive decrees.
This is a mischaracterization of why we are taxed to support public education. We don’t “invest” in education; we pay taxes to support teachers and schools, who in turn teach classes and provide activities that help children and teenagers learn things that we think are important to their careers and civic responsibilities. An investment implies a contract with an expected rate of return, in money. The returns we expect from spending money on schooling are not monetary– they are primarily an intangible benefit to society.
We could monetize the returns by calculating how much money people would make if they didn’t go to school versus how much they will make after graduating– and then divide out how much more they will pay in taxes for their better-paying jobs– but that would miss out on the intangible benefits. How do we calculate the monetary value of an educated populace to our society when they use their knowledge to elect good leaders, to comply with just laws, to live longer, more satisfying, and healthier lives because they understand the benefits of good diet, good hygiene, a balanced life, exercise?
In fact, the public educational system serves multiple purposes. First, for modern families, it is a place to put children while their parents are working– to prevent them from being left alone during the day (in the past, children not in school were employed on the family farm.) Second, it is a way to teach children things (so many different things.) Third, it is a place for children to play and socialize, and learn how to get along with others
Betsy DeVos was appointed to her post because she is rich, conservative, an evangelical Christian, and good-looking. She has no relevant experience in the field of education. Her education ended with a baccalaureate degree majoring in business economics (she might as well have majored in art or literature if she cared about education.) She is the daughter of a billionaire who made his money in the auto parts supply business in Detroit. Her husband is a former CEO of Amway (a “multilevel marketing organization”, or more bluntly, a successful pyramid scheme.)
She is politically active, starting with her work for the presidential campaign of Gerald Ford while she was in college. She was chair of the Michigan Republican Party. Her brother is Erik Prince, who founded Blackwater, a supplier of mercenaries to the US military (which became notorious after some of its men massacred 17 civilians at a highway intersection in Baghdad in 2007.)
She came to the attention of the current president because of her family’s monetary support for the Republican Party. She openly admitted in a Roll Call op-ed in 1997 that her family was the largest single contributor to the Republican Party in Michigan, and that she was essentially buying influence. She did not publicly support the president until after the election; the only public statement I could find was a comment from March 2016 in which she described him as an “interloper” who “does not represent the Republican Party.” Her family did, however, spend $2.7 million on Republican candidates and PACs in the 2016 election cycle.
Just how much influence became immediately apparent when the incumbent president announced a couple of weeks after the election that she would be nominated to the Secretary of Education post. This is despite the fact that she did not publicly support him before the election– afterwards, she did make some positive statements. She was one of the first Cabinet members for the new administration to pass through the Senate. She was confirmed by the Senate on a vote of 51-50 in which the Vice President had to come in to cast a tie-breaking vote; she did not even receive all the Republican Senators’ floor votes for confirmation.
Two Republican Senators, Susan Collins and Lisa Murkowski, voted against her confirmation, despite having voted in committee to move her nomination to the floor. Clearly their voting positions were intended to send a message that they were providing the minimum of support required of them. Their weak support may have been influenced by the Democrats’ vociferous opposition. This was the first time a nominee to a Cabinet position was confirmed by a tie-breaking vote from the Vice President in a very, very long time.
Despite scraping through the Senate, Ms. DeVos has remained on the Cabinet ever since– quite an accomplishment for the present administration and making her one of the longest-serving Cabinet members, along with Ben Carson and Mrs. Mitch McConnell. They have all retained their positions by keeping their heads down, avoiding scandalous spending, and not granting interviews.
Ms. DeVos has a very clear agenda: she wants to defund public education in the United States and substitute charter schools and home schools. What money she would support spending would be in the form of payments to families with children so they could be being home-schooled, preferably in a religious curriculum. She has been consistent in pushing this agenda throughout her career, including… her early leadership of the “Great Lakes Education Project.” This “project” pushed the establishment of “charter schools”, which are publicly supported but privately run educational institutions.
Michigan, and Detroit in particular, became the center of the US charter school movement partly as a result of her backing. The movement has led to hollowing out of public schools, especially in underserved areas like central cities. Detroit is a particularly egregious example of the effects of this movement. As its population dropped and became more minority-dominated, funding became ever weaker. The charter school movement allowed private companies to run schools with support from public funds, further draining the public schools of public support. This New York Times article from 2016 describes the disastrous results.
Ms. DeVos wants to substitute home schooling and a few charter schools for our public school system. She wants to reduce funding for schools overall and substitute a tax break for families that home school their children. This is primarily an excuse for families to religiously educate their children at home rather than pay for them to be educated in public schools alongside minority children. Public schools, in the view of her supporters, are godless communist indoctrination systems. Charter schools, as private institutions from their point of view, would have more leeway and motivation for religious instruction.
All of her claims that poor children are left behind by public schools are so much gaslighting. Poor families can’t afford to home school their children. They need the public schools to keep watch on and feed their children during the day so that both parents (when there are two parents) can work, and make enough money to support them. Grandparents in poor families are not strong enough to care for children at home during the day, if they have not already died from the novel coronavirus.
Betsy DeVos has been a very effective advocate for quietly defunding public schools under the banner of charter schools. She has been destroying them from the inside, just as most of the current president’s Cabinet members have tried to destroy the Environmental Protection Agency, the Consumer Financial Protection Bureau, the Centers for Disease Control, and other executive branch agencies. The damage that this president has done to our federal government is immense and will take years to undo. All the more reason for us to vote in eight years of Democratic administrations, with a House and Senate to match.
Coronavirus studies by Engin Akyurt via pixabay.com
This report on Vox.com was published on July 12: “My patient caught Covid-19 twice. So long to herd immunity hopes.” In the report, a doctor in Washington DC describes one of his patients a 50 year old man, who had COVID-19 twice, the first time as a mild illness, the second time more severe. He had a mild cough and sore throat the first time, three months ago. The second time, a couple of weeks ago, he had high fever, dyspnea (shortness of breath), and hypoxia (low oxygen levels in the blood.)
In between, he felt well for at least six weeks, and had two negative PCR (polymerase chain reaction, an antigen test for acute infection) tests. He was exposed to another member of his family (“a young adult”) with the virus. He was not able to get an antibody test after the first infection, so we don’t know if he had developed antibodies– which makes a big difference.
Other reports of similar cases have occurred, including this one from central New Jersey. Two patients were reported by a doctor there, including one who had developed antibodies and donated plasma to treat other patients infected by SARS-COV-2. Apparently both patients were from the same family. The doctor who made this report also posted a video to Facebook, which I did not consult as I am averse to that particular medium.
We don’t know what these cases of reinfection mean or how common they are. We don’t know how many people are susceptible to getting sick again. We do know that laboratory tests of rhesus monkeys showed immunity after repeat challenge with known dosages of the same virus. The likelihood is that most people will be immune but some will not. It is also possible that there is more than one strain circulating, although the known mutation that caused increased efficiency of infection (without showing worse infections) apparently had the exact same antigenic characteristics.
After all that has been done to research this virus, there is still much that we don’t know. The number of cases is rapidly increasing, so rarer complications and more unusual cases are surfacing. What these things mean will not be revealed for some time.
As to Facebook: it may be a useful tool for making connections with people and exchanging information, but it is also a dangerous time-sucker. I am averse to being used as a commodity. I have avoided that platform for the last year. Other media are available for communicating information and I don’t think I am missing anything by not going there.
photo by Manfred Antranias Zimmer courtesy of pixabay.com
(The following descriptions should be seen as a simplification based on the Wikipedia texts that describe the concepts of the two religions, the Vedas, and other specific pages. I tried to make sense out of them but only succeeded partially. Some of what I’ve written is correct, some is oversimplified; I’ve tried to avoid obvious errors but if Wikipedia is mistaken, then I’ve just repeated the mistakes. If you know differently, please tell me.)
Buddhism and Hinduism share their origins in the Vedic literature of northern India (circa 1500-500 BCE.) Brahmanism can be thought of as the precursor to Hinduism; its rituals were recorded in the Vedas. Hinduism asserts the authority of the Vedic scriptures but Buddhism criticizes them. Brahmanism was preceded by Vedism– the religion described in the earliest Vedas.
Vedism was the religion of the Indo-Aryans who migrated into the Indus River basin circa 1500 BCE. It is described in the Vedic literature, including the early Upanishads. In Vedism, there was an afterlife but no reincarnation. Ancestor worship was prominent, with rites like offerings of food; this declined but did not completely disappear in Hinduism. Vedism is described in Wikipedia as a complex animistic religion, with pantheism. Vedic rituals that survived into Brahmanism and Hinduism include (among many others): fire rituals, horse sacrifice, cow sacrifice, royal consecration, and cremation. Human sacrifice is alluded to in the Vedas, but whether it existed in pre-Vedic times is highly controversial.
Vedism included the gods Indra, Agni, and Soma among many others. Hinduism began with the change in emphasis from these gods to others: Vishnu and Shiva especially. The hymns of Vedism described in the Vedas were given a different interpretation by Brahmanism and Hinduism.
In this period, the concept of rebirth developed and the afterlife was changed; ancestor worship was de-emphasized. Jainism, Hinduism, and Buddhism all adopted the idea of rebirth. The concept of rebirth includes the doctrine of samsara, an eternal cycle. In this cycle, a person is reborn after death, but not necessarily into another human body. As a result of karma, you can be elevated or degraded. A particularly bad person may be reborn as a cockroach. A good person will be reborn into a higher caste and eventually into a Bodhisattva or enlightened being.
The religions share basic concepts that include dharma and karma. Briefly, dharma is the “law” or prescriptive doctrine which everyone is obligated to obey. Karma is a kind of causality, the effect of obeying or disobeying dharma. Karma is not necessarily an immediate result of one’s behavior. The consequences may not play out in someone’s present life, but be carried over into one’s next life.
Brahmanism probably began with the “monist” (unifying) doctrine of Brahman, or the universal soul. This universal soul was postulated to be at the center of all living things and also the unifying principle of the cosmos. Brahmanism also brought together people into a system of castes.
Basic caste (varna) theory holds that each person is born into a certain category, of which there are four: brahmin (scholars and priests), kshatriya (warriors, kings, and princes), vaishyas (farmers, merchants, and artisans), and shudras (workmen and service providers.) Not mentioned in the original caste theory are untouchables, who are outside the caste system. The theory of caste, although based on ancient Vedic scripture, was not practically applied in India.
Instead, a system called “jati” or birth groups was applied in practice. There were many categories of jati, each applying to a hereditary group of specific occupations. The varna categories were actually applied by the British when they took over control of India and Pakistan in the eighteenth century and thereafter. This made the caste system more rigid, which is ironic considering the criticism of its static nature applied by British sources.
What distinguishes Buddhism from Hinduism (and Brahmanism) is the Buddhist emphasis on fluidity of one’s merit, regardless of caste. To a Buddhist, what matters is one’s behavior, not one’s caste, in accumulation of merit. Ordination as a priest is available to people of all castes in Buddhism, whereas a Hindu priest had to be a brahmin. Buddhists did not deny castes, but felt that a person’s caste was a reflection of their behavior in a past life rather than an “accident of birth.”
This brings us to the concept of liberation, called “moksha” or “nirvana” depending on the religion. The ultimate goal of existence is liberation from the cycle of samsara or rebirth. To reach this stage, one must first live in harmony with dharma or the rules. Then one must become enlightened. This is achieved through jhana, which is usually done in meditation but can occur spontaneously. The Buddha reached jhana momentarily during his childhood in a particularly auspicious time of perfect calm.
To Buddhists, it is necessary to have the correct perceptions– the permanent transcendence of the belief in the separate existence of the self is integral to the enlightenment of an arhat or arahant (enlightened one.) The most important difference between the two religions is their disagreement over the existence of a permanent, separate self or atman– Buddhists say there is no cosmic self. Instead, there is a state of change or impermanence called anicca and a void called shunyata. There is no true self and no universal self– there is only non-self, anatman or anatta.
All sentient beings are capable of enlightenment, eventually. Sentience is a quality of being that can include plants as well as animals, although it is more remote for more vegetable beings (even non-organic items like rocks can sometimes be described as sentient.) During one’s experience of samsara (rebirth), one cycles through many sentient objects or bodies, possibly including rocks.
Wikipedia says that sentience is characterized by specific qualities: “Sentient beings are composed of the five aggregates, or skandhas: matter, sensation, perception, mental formations and consciousness.” Plants are capable of sensation (light and touch, for example), but perceptions may not be present. Whether perception, mental formations, and consciousness are characteristics that plants share is questionable.
This is important because both Buddhism and Hinduism share the dharma of ahimsa: nonviolence towards sentient beings. The concept of ahimsa starts in the Rig Veda and is extended throughout the Vedas. A hymn to Indra in the Rig Veda (the earliest Veda) mentions satya (truthfulness) and ahimsa. The concept gradually developed during the Vedic period, from a mention of meat consumption and animal sacrifice as being undesirable to, eventually, elimination of sacrifices and promotion of vegetarianism.
The Jain sect of Hinduism, already well-developed in the early Vedic period, emphasized ahimsa as its first principle and included vegetarianism from the beginning. Even in consuming vegetable foods, roots were frowned upon because pulling them up kills the plant and involves violence against soil organisms. Consuming yeast-made bread, fermented foods, beer, and wine are now forbidden to Jains because the micro-organisms in such foods are killed (before the invention of the microscope, no-one knew that yeasts were living organisms or that bacteria existed.) Previously, intoxicating beverages were proscribed for Jains only because they impaired thinking rationally about non-harm.
Ahimsa imposes restrictions on warfare and self-defense but allows violence to preserve the lives of potential victims. Cruelty to one’s opponents and harming noncombatants, however, is considered always wrong. Negotiation in an attempt to prevent war is strongly encouraged. The doctrine of ahimsa is most famous in the work and thought of the Mahatma, Mohandas Gandhi. Wikipedia says: “In Gandhi’s thought, Ahimsa precludes not only the act of inflicting a physical injury, but also mental states like evil thoughts and hatred, unkind behavior such as harsh words, dishonesty and lying, all of which he saw as manifestations of violence incompatible with Ahimsa.”
Both Buddhists and Hindus agree on ahimsa as an essential part of dharma. They both practice meditation, although in different ways. They also agree on the use of mantras, which are symbolic phrases or poems that help in attaining concentration when one meditates (and for other purposes.) The word “yoga” is shared between the two religions but seems to mean different things– in Hinduism, it means the binding of one’s soul to the universal soul through physical means. In Buddhism, it appears to mean any spiritual practice, including tantras.
I have to stop here. No more work today. I’ve been reading too much scientific stuff which makes it all too clear that our country has a major crisis that is not being addressed by the current government. The only clarity I’ve gotten is in the importance of ahimsa and the difference between brahman (universal soul) and anicca (impermanence). I’m going to go back to the beginning and start again tomorrow. Let me know if you can articulate where I’m mistaken– please.
S Hermann and F Richter photo via pixabay.com
Someone we know, who was a friend, died from COVID-19 today after being in the hospital for two weeks. We’re not surprised (but we still don’t think he should have died, and in a just world– not this planet– he wouldn’t have died…) We will miss him, but his wife will miss him more.
Excess Deaths not including COVID-19 in Florida, Texas, and other states increased in early April
photo by Jakub Orisek courtesy of pixabay.com
Examining this CDC “data dashboard” of weekly excess deaths shows that there were significant increases in early April even in states that did not report significant numbers of COVID-19 deaths.
Looking at Florida, for example, there was a 2.1-7.6% excess of deaths (of any cause) totalling 4,562 for the week ending April 11– when only an average of 36 deaths a day (252 a week) due to the virus were reported. This suggests that there may have been a dramatic undercount of deaths due to COVID-19 during that period– or else something unexplained was killing about 5% more Floridians than usual that week.
If we examine New Jersey for this period, we find that over 200% more people died than normal in the week ending April 11. If we exclude COVID-19, the graphs still show 57-68% more people than normal died. This suggests that people either died from the virus that were uncounted, or else people died from not going to the emergency room even when they didn’t have the virus. For example, people could have died of heart attacks because they didn’t go to the hospital with chest pains due to fear of the virus.
I can’t go into this in detail because of time limitations today, but you can examine the data yourself and you will see that states reporting few deaths from the virus had unexplained increases in total death rates starting in early April. States that reported a lot of virus deaths, like New Jersey, had large increases in death rates that were unexplained.
Your take-home assignment today is to look at the larger states, like California, Texas, Illinois, and so on, and ask yourself– did some states have higher death rates than expected since April? Why? Was it undiagnosed COVID-19 in places where there wasn’t testing for political reasons? After all, in blue states, people could be tested for political reasons, but the tests would have turned out negative anyway… and a death is only counted as being from the virus if someone suspects it, tests for it, and puts it on the death certificate.
photo courtesy of Gerd Altmann (geralt) via pixabay.com
From the New York Times on July 9:
At a clinic in Corona, a working-class neighborhood in Queens, more than 68 percent of people tested positive for antibodies to the new coronavirus. At another clinic in Jackson Heights, Queens, that number was 56 percent. But at a clinic in Cobble Hill, a mostly white and wealthy neighborhood in Brooklyn, only 13 percent of people tested positive for antibodies.
The novel coronavirus has hit poor people and people of color harder than anyone else during this pandemic. New York City experienced a wave of infections from March through May, mostly brought in by visitors from Europe. Overall, the city showed some 20% positive results on antibody testing. Upper-class neighborhoods were not affected as much as lower-class places. People who had to continue coming to work, travelling on the subway and on buses, and coming home to crowded households, were hit the hardest.
People who are of African-American and Caribbean-American ethnicity, Hispanic, and Native Americans and people from the Marshall Islands, were hit hardest of all. A third of the population of the Marshall Islands– 30,000 people– migrated to the United States over the last thirty to fifty years (partly because unemployment there was as high as 40%.) Most of them are permanent non-citizen residents of the US; many settled in Arkansas, Washington State, and Oregon.
Many people from the Marshall Islands were forced to relocate after their homelands (the Bikini Atoll in particular) were rendered uninhabitable by radioactive contamination from atomic testing. Many of these people, poor and uneducated, took jobs working in meatpacking plants. Now they are suffering from frequent infection with SARS-COV-2 and are often getting sick or dying as a result. In northwest Arkansas, Marshall Islanders represent 3% of the population and half of the deaths.
COVID-19 affects non-white people more than anyone else. Well-to-do, mostly white, people, can work from home or have moved to their second homes in rural areas. Poor people have lost their jobs or work in “essential” but poorly-paid industries; they also live in crowded households and are unable to isolate. The result is more infections. They also have more co-morbidities like high blood pressure and diabetes, so they get sicker. When they do get sick, they don’t have as much health insurance. They have to go to hospitals in poorer parts of the city that have a lower quality of care. So they die more often.
Nowhere is this disparity as great as with Native Americans and Marshall Islanders.
The bottom line is that, in the US, poor people of color are being hit the hardest by COVID-19. Poorer parts of the world are also more affected; South America and India are the worst off.
The system is failing, and it is failing the hardest for poor people. The federal government must take this into account when allocating resources to help with this pandemic– but it won’t. There is no better argument for not re-electing Republicans in November.
photo by Jakub Orisek courtesy of pixabay.com
Texas had only 20-23 deaths a day on average at the end of May. Now it is seeing a 7-day average of 60 deaths a day, and the last two days had 90 and 119. Florida, which averaged 32 a day at the end of May, now averages 48– and it had 63 on July 7 and 48 yesterday (Florida’s daily case average has increased more than ten-fold in the last 6 weeks.) Arizona, which averaged 12 deaths a day at the end of May, is averaging 32 now– and had 101 on July 7 and 40 yesterday. California had 83 deaths on July 6, 111 deaths on July 7 and 145 yesterday (pushing the 7-day average to 77)– after a low point of 56 average on June 8 and 60 average on June 28.
These are the four biggest states with increasing outbreaks at the moment. All have posted record new case days during the last week. All are now pushing record new deaths and 7-day averages. Data comes from the New York Times interactive pages on coronavirus counts. Here is a piece in the Miami Herald on the same subject.
This comes with a Pro Publica report yesterday noting a dramatic increase in deaths at home in Houston. The Pro Publica piece begins with a description of a case that occurred on June 22, in which a 54 year-old woman with diabetes died suddenly at home after complaining of chest pain and fatigue to her daughter. She noticed that her mother was breathing rapidly and called 911. Then the mother stopped breathing altogether. The daughter tried to do CPR (without really knowing how) but when the ambulance arrived, the mother was already dead. She had not been suspected of having COVID-19 before she died; she had no headache, fever, or cough. An autopsy found that she had the virus.
In June, Houston ambulances responded to 300 cases in which the patient was already dead when they arrived– 75 more than in either of the previous two Junes. On July 3, they had 18 such calls in a single day. Something similar happened at the height of the outbreak in New York City, where 300 calls a day were for cardiac arrests; only 65 calls a day were recorded last year at the same time. The Pro Publica piece ends with a discussion of the risks for post-traumatic stress disorder in the survivors as well as the ambulance technicians.
The Houston woman whose mother died suddenly says she and her siblings are in a constant state of panic now. She wants to take CPR classes after trying and failing to revive her mother. Her father is grieving alone– and she can’t face being in the same house where her mother died.
The number of new cases per day for the country as a whole hit a nadir between May 26 and June 9. Since then, the rate of new cases has tripled. Deaths over the whole country peaked at an average just above 2,000 a day the third week of April, then dropped to around 600 by the end of June. New deaths hit a daily low of 292 on June 21 and 270 on June 27, then 209 on July 5 and 242 on July 6. On July 7, there were 922 deaths reported, on July 8, 897, and this morning, 867. Suddenly, rates are going back up again.
So, to the erstwhile leader of our country who claims that deaths have plummeted: just wait. They’ll start dying soon enough.
Post-script: the rate of new coronavirus cases in Tulsa, Oklahoma has been increasing since the ill-omened rally for the Republican presidential candidate. Since June 20, there have been 8.459 new cases reported in Oklahoma and the total of cases has almost doubled; the rate of new cases per day has doubled in the last three weeks. The number of people currently hospitalized has more than doubled (see COVID tracking project data for Oklahoma.)
photo by Manfred Antranias Zimmer courtesy of pixabay.com
The Vedic period (1500-500 BCE) was characterized by a transition from dominance of a post-animist religion in which specific gods began to play a larger part in the story of religion.
Animism is a form of religion, thought to be the most primitive, in which every object, both animate and inanimate, has an inner “god” or “spirit” that “animates” it and gives it specific characteristics. Thus, a stone has an inner spirit that causes it to behave like a stone. A place, such as a meadow or a mountain, also has an inner spirit. Even non-material objects, such as words and concepts, have their own spirits.
Dravidian religions were post-animist, but continued the worship of sacred trees and animals. They subscribed to belief in a Mother Goddess and had a complex metaphysical system. Shakti (or Parashakti) or Devi (or Mahadevi) is the Hindu version of the Dravidian Mother Goddess. Harappan (Indus Valley) civilizations included a female figure in many small sculptures that were found in Harappan ruins. There is a possibility that worship of the Mother Goddess involved human sacrifice with the blood of the victim offered to obtain fertility for the crops.
Wikipedia says that the scholar Lockard stated: “Hinduism can be seen historically as a synthesis of Aryan beliefs with Harappan and other Dravidian traditions that developed over many centuries.”
The Aryan religions probably included the gods Indra (supreme god), Agni (fire god), and Varuna (sky god.) They also probably included the ethical concepts of satya (truthfulness) and rta (the concept of the natural order.)
The Dravidian and Aryan religions were synthesized into the historical Vedic religion, which is memorialized in the Rig Veda. The language of the Rigveda is Sanskrit, which is separated from the Iranian language and evolved from the hypothetical proto-Indo-Iranian language. After separation, the Iranians evolved a religion called Zoroastrianism (from the prophet Zoroaster or Zarathustra.) In the early Iranian religion, Zoroaster preached a form of dualism in which Ahura Mazda was the supreme deity and was all good– opposed to Angra Mainyu, all evil. This religion was memorialized in the Avestas, the foundational Zoroastrian religious documents.
In the Rigveda, the gods are numerous, beginning with Indra. Agni is the second most important and is closely associated with Indra. Soma or Chandra is the Moon god and is also the name of a drink made from the juice of a plant, for which preparation instructions are given in the text (the exact source of this plant is uncertain as it is not described, but it may have been ephedra sinica– the source of ephedrine.) The Rigveda includes hymns to at least 33 major gods and goddesses, in addition to numerous minor deities. Many of these divine personages have indistinct or overlapping identities. Some are personifications of concepts or natural forces. Others are associated with heavenly bodies.
That’s as far as I’ve gotten in the last few days. To be continued. I was distracted by a Pro Publica article about sudden deaths in Houston– see next post.
