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‘COVID Fatigue’ and ‘COVID-19 Caution Fatigue’

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By Dr B. J. C. Perera

Specialist Consultant Paediatrician

Physical fatigue, marked muscle aches, weakness of the body and bodily exhaustion are well-recognised clinical features of COVID-19 disease. Some patients feel really ill, lifeless and have severe muscular and joint pains during the acute illness. In some of them, these effects last a long time, even after recovery. By now, all these things have become well-known and sort of ‘old hat’ type of details of the actual disease.

However, the terminology of the title of this article, COVID Fatigue and COVID-19 Caution Fatigue, DO NOT, I repeat, DO NOT, refer to the physical effects of the illness. These really denote some of the mental effects and their repercussions in those who have not contracted the disease, but are being constantly bombarded and reminded, especially over mass media, of the implications of the disease itself. These may also result in certain undesirable behaviour patterns on the part of those who exhibit these phenomena. The medical circles are just beginning to see the significance and the importance of these manifestations with regard to the current scenario.

COVID Fatigue is a new phrase that refers to the general thoughts and psychological feelings that many people get of being mentally tired, discouraged, and even disgusted by everything that is going on with their lives that are being dictated to by this tiny coronavirus. This includes being isolated and preached on for so long that they have become totally sick of hearing these mantras, over and over, again and again. In some cases, the reaction on the part of some people have been one of irritation, intolerance, resistance, leading to even non-compliance. Some have given up on masking, regular washing of hands, physical distancing, and generally in all forms of self-protection. This type of risky behaviour and disregard for the health rules is an unwholesome way through which people try to cope with the stress that is piling up. Though this kind of behaviour may provide one with short-term relief, it is not truly beneficial and may even lead to disastrous results.

The COVID-19 Caution Fatigue is a related phenomenon that has slightly different connotations. When the pandemic began and lockdowns were ordered, many people were tremendously energized to do their very best and help to reduce the spread of the disease. They were an absolute model lot. However, months of isolation, all kinds of restrictions and the ever-present anxiety have drained people of their motivation. It has caused many to become less strict and less concerned about following the guidelines issued by the health authorities. They have become sort of immune to being constantly reminded of all kinds of cautions and restraints. They have become quite a bit nonchalant about the statements advising caution. It has led to a kind of ‘fatigue of caution’ after being cautious about the disease for far too long. Many people can only remain vigilant for so long before they start to become exhausted and throw caution to the winds. These could become the straws that finally break the camel’s back.

Ultimately both these components end up in a single common final pathway which may induce the public to assume a blasé attitude and take things for granted. It may appear to be the case that these affected people could not care less. In another perspective, they may sometimes even be tempted to behave like COVIDIOTS; yet another newly introduced terminology which is a kind of a slang-word, combining ‘covid’ and ‘idiots’. It describes some people who cause many a problem by going against the very grain that is designed to ensure their safety and freedom from the virus.

The problem with those who suffer from COVID Fatigue and COVID-19 Caution Fatigue is that they start to lose interest in life, stop enjoying the joys of living, give up general happiness with things around them and get into a state where they do not get any satisfaction from life. They may also become so disgruntled as to exhibit some irrational behaviour patterns. This could affect even highly educated and intelligent professionals but for clear socio-political and economic reasons, they are a lot commoner in the lower social strata. People who have all these problems may respond in one of two ways. Some may take the path of resolute resistance and fight back against society and the restrictions imposed. Others may become rather indifferent and get inevitably committed in their mindsets to any and every unfortunate eventuality that may come their way.

The coronavirus itself may be novel, but the outbreak is stirring up some very fundamental instincts in people. A keen sense of warning and coping mechanisms that have been with humankind since the dawn of time are also programmed to induce fear and anxiety. According to mental health experts, feeling worried in such a situation is absolutely normal and even healthy. This evolutionary trait has stuck around for millions of years because it alerts us in times of danger and prompts us to come up even with newer survival skills.

The catch is when anxiety becomes somewhat disproportionate to the situation. It can turn into intense fear or a feeling of hopelessness and it starts to interfere with our day-to-day lives and wellbeing. Following official instructions, things such as staying at home, social distancing, washing of hands, etc., become important to people because it engages problem-solving behaviour. But the uncertainty of how long this situation will last, the constant stream of new information and the social isolation, all create a fertile ground for escalating anxiety. It is important to realise that panic, could also be contagious. The biggest problem at the present time is that there does not seem to be any decent light at the end of the tunnel.

To get through this time as efficiently, serenely and healthily as possible, it is important to be familiar with some ways to calm ourselves. It is quite essential, to try and ward off such mental complications brought on by utter despair and try to get on with this ‘NEW NORMAL LIFE’. In that context, there are some possible coping mechanisms to try and mitigate the effects of COVID Fatigue and COVID-19 Caution Fatigue.

For a start, staying informed does not mean that one has to be perpetually connected and follow live news 24/7. It can really become exhausting. Turning the push notifications off on news apps can help relieve some of that pressure. It is necessary to choose just one or two reliable sources, and keep track of their updates at allocated times once or twice a day. It is also recommended to set a specific length of time for social media to avoid getting caught up in it, which is often, very likely to increase anxiety. Of course, it is not possible or recommended to completely bury your head in the sand and be totally oblivious to what is happening. One is bound to see some unnerving headlines on social media and in news reports. It is essential to remind yourself that a lot of it is speculation and not fact. A concerted effort must be made to follow the clear instructions of the health organizations and try to avoid news headlines that do not contribute to your wellbeing.

One should not be deterred if the exercise or dancing class that one is enrolled in is not taking place at the moment or your regular walking sessions in the designated exercise sites are impossible because of locked-in situations or curfews. Aerobic exercise is known to allay anxiety, especially if it was already a part of your usual routine. Practicing a dance routine, exercise sequence, or yoga are all healthy ways to keep your mind distracted and channel your adrenaline elsewhere. You can turn your garden into a workout area, or move around some furniture in your living room for the purpose.

For some people, it is not just the prospect of catching the virus itself that is causing stress, but the feeling of emptiness and the disruption of daily routines. You need to connect with others. Staying indoors means being by yourselves, or with your family or housemates for a much longer period of time than you are used to. Some might be asked to self-quarantine, but that does not mean completely isolating yourself from your social contacts, apart of course from physical isolation. Maintaining human interaction at such times is very important. Being able to express your thoughts concerning the virus, exchanging opinions and even making jokes will make you feel supported and make it easier to overcome the anxiety. Humans are social beings, wired to be loved, to love, to belong and of course, to meet in-person. It is no wonder that people are finding physical distancing so difficult. In such a case, technology is quite a blessing: call people via a telephone, have a video chat and check on your friends and acquaintances as frequently as possible.

One also needs to guard against certain things that may accompany these changes in the mental status. Spiralling into undesirable and even destructive behaviour is easy when confined to your home. Sleeping in and walking around in your night-clothes might feel nice for a couple of days. However, if it is to be done for days on end and perhaps even for weeks, it will only increase anxiety in the long run. Try to keep the sleeping routine as consistent as possible and get at least eight hours of good-quality sleep. Wake up at a reasonable time in the morning, change out of your night clothes and set a structure for yourself. Work or study from home if possible, cook for yourself and the family, and eat three proper meals a day.

Many experts advocate focusing on the immediate future so that uncertainty about the longer-term outlook does not make one feel hopeless and helpless. However, it is also important to work against the ‘current-moment’ type of biases during the pandemic. Avoid the temptation to do something that brings you pleasure in the moment without acknowledging the risk it may pose in the future. In the case of the pandemic, this could mean going to a large group gathering in your lane without thinking about how this may affect the spread of COVID-19 down the lane. It is hard to assess the perils and risk, especially when the risk is invisible, like the coronavirus and most of the infected people are symptom-free. One needs to find a balance; an equilibrium which may mean less pleasure in the current moment, but more risk mitigation in the future and put risks into their proper perspectives. It may be hard to stay committed to goals like improving public health by staying home, because they are so abstract and can often seem to have no effect on one personally. However, it is necessary to reframe this thought to acknowledge how your behaviour could increase the chance of you or your loved ones getting sick.

In the current scenario, when anxiety takes over a person in a sort of big-time way, it can feel like as if this catastrophe will never end. But it always does end. Remember the Spanish Flu of 1918 which killed over 50 million people? There were no effective anti-viral drugs and there was no vaccine. However, although the scientists are not quite sure as to how it happened, the epidemic died out within about two years. The current pandemic is a worrying time for almost everyone, but this situation is temporary. Be kind to yourself and your loved ones. It may sound rather optimistic, but we will overcome this together.

Finally, people need to be warned against falling into “thinking traps” such as the assumption that since you have not been sick, you will not get sick in the future, or convincing yourself that an outing is necessary when your motivation behind it may just be boredom. Now is not the time to let our guard down. For the good of everyone’s health and the well-being of the country, we need to do our part to maintain an appropriate level of caution and try our very best to re-flatten the curve. Indeed, sanity must prevail, through sheer necessity of course. Come rain or sunshine or this miserable corona, life must surely go on.

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Islamophobia and the threat to democratic development

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There’s an ill more dangerous and pervasive than the Coronavirus that’s currently sweeping Sri Lanka. That is the fear to express one’s convictions. Across the public sector of the country in particular many persons holding high office are stringently regulating and controlling the voices of their consciences and this bodes ill for all and the country.

The corrupting impact of fear was discussed in this column a couple of weeks ago when dealing with the military coup in Myanmar. It stands to the enduring credit of ousted Myanmarese Head of Government Aung San Suu Kyi that she, perhaps for the first time in the history of modern political thought, singled out fear, and not power, as the principal cause of corruption within the individual; powerful or otherwise.

To be sure, power corrupts but the corrupting impact of fear is graver and more devastating. For instance, the fear in a person holding ministerial office or in a senior public sector official, that he would lose position and power as a result of speaking out his convictions and sincere beliefs on matters of the first importance, would lead to a country’s ills going unaddressed and uncorrected.

Besides, the individual concerned would be devaluing himself in the eyes of all irrevocably and revealing himself to be a person who would be willing to compromise his moral integrity for petty worldly gain or a ‘mess of pottage’. This happens all the while in Lankan public life. Some of those who have wielded and are wielding immense power in Sri Lanka leave very much to be desired from these standards.

It could be said that fear has prevented Sri Lanka from growing in every vital respect over the decades and has earned for itself the notoriety of being a directionless country.

All these ills and more are contained in the current controversy in Sri Lanka over the disposal of the bodies of Covid victims, for example. The Sri Lankan polity has no choice but to abide by scientific advice on this question. Since authorities of the standing of even the WHO have declared that the burial of the bodies of those dying of Covid could not prove to be injurious to the wider public, the Sri Lankan health authorities could go ahead and sanction the burying of the bodies concerned. What’s preventing the local authorities from taking this course since they claim to be on the side of science? Who or what are they fearing? This is the issue that’s crying out to be probed and answered.

Considering the need for absolute truthfulness and honesty on the part of all relevant persons and quarters in matters such as these, the latter have no choice but to resign from their positions if they are prevented from following the dictates of their consciences. If they are firmly convinced that burials could bring no harm, they are obliged to take up the position that burials should be allowed.

If any ‘higher authority’ is preventing them from allowing burials, our ministers and officials are conscience-bound to renounce their positions in protest, rather than behave compromisingly and engage in ‘double think’ and ‘double talk’. By adopting the latter course they are helping none but keeping the country in a state of chronic uncertainty, which is a handy recipe for social instabiliy and division.

In the Sri Lankan context, the failure on the part of the quarters that matter to follow scientific advice on the burials question could result in the aggravation of Islamophobia, or hatred of the practitioners of Islam, in the country. Sri Lanka could do without this latter phobia and hatred on account of its implications for national stability and development. The 30 year war against separatist forces was all about the prevention by military means of ‘nation-breaking’. The disastrous results for Sri Lanka from this war are continuing to weigh it down and are part of the international offensive against Sri Lanka in the UNHCR.

However, Islamophobia is an almost world wide phenomenon. It was greatly strengthened during Donald Trump’s presidential tenure in the US. While in office Trump resorted to the divisive ruling strategy of quite a few populist authoritarian rulers of the South. Essentially, the manoeuvre is to divide and rule by pandering to the racial prejudices of majority communities.

It has happened continually in Sri Lanka. In the initial post-independence years and for several decades after, it was a case of some populist politicians of the South whipping-up anti-Tamil sentiments. Some Tamil politicians did likewise in respect of the majority community. No doubt, both such quarters have done Sri Lanka immeasurable harm. By failing to follow scientific advice on the burial question and by not doing what is right, Sri Lanka’s current authorities are opening themselves to the charge that they are pandering to religious extremists among the majority community.

The murderous, destructive course of action adopted by some extremist sections among Muslim communities world wide, including of course Sri Lanka, has not earned the condemnation it deserves from moderate Muslims who make-up the preponderant majority in the Muslim community. It is up to moderate opinion in the latter collectivity to come out more strongly and persuasively against religious extremists in their midst. It will prove to have a cementing and unifying impact among communities.

It is not sufficiently appreciated by governments in the global South in particular that by voicing for religious and racial unity and by working consistently towards it, they would be strengthening democratic development, which is an essential condition for a country’s growth in all senses.

A ‘divided house’ is doomed to fall; this is the lesson of history. ‘National security’ cannot be had without human security and peaceful living among communities is central to the latter. There cannot be any ‘double talk’ or ‘politically correct’ opinions on this question. Truth and falsehood are the only valid categories of thought and speech.

Those in authority everywhere claiming to be democratic need to adopt a scientific outlook on this issue as well. Studies conducted on plural societies in South Asia, for example, reveal that the promotion of friendly, cordial ties among communities invariably brings about healing among estranged groups and produces social peace. This is the truth that is waiting to be acted upon.

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Pakistan’s love of Sri Lanka

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By Sanjeewa Jayaweera

It was on 3rd January 1972 that our family arrived in Karachi from Moscow. Our departure from Moscow had been delayed for a few weeks due to the military confrontation between Pakistan and India. It ended on 16th December 1971. After that, international flights were not permitted for some time.

The contrast between Moscow and Karachi was unbelievable. First and foremost, Moscow’s temperature was near minus 40 degrees centigrade, while in Karachi, it was sunny and a warm 28 degrees centigrade. However, what struck us most was the extreme warmth with which the airport authorities greeted our family. As my father was a diplomat, we were quickly ushered to the airport’s VIP Lounge. We were in transit on our way to Rawalpindi, the airport serving the capital of Islamabad.

We quickly realized that the word “we are from Sri Lanka” opened all doors just as saying “open sesame” gained entry to Aladdin’s cave! The broad smile, extreme courtesy, and genuine warmth we received from the Pakistani people were unbelievable.

This was all to do with Mrs Sirima Bandaranaike’s decision to allow Pakistani aircraft to land in Colombo to refuel on the way to Dhaka in East Pakistan during the military confrontation between Pakistan and India. It was a brave decision by Mrs Bandaranaike (Mrs B), and the successive governments and Sri Lanka people are still enjoying the fruits of it. Pakistan has been a steadfast and loyal supporter of our country. They have come to our assistance time and again in times of great need when many have turned their back on us. They have indeed been an “all-weather” friend of our country.

Getting back to 1972, I was an early beneficiary of Pakistani people’s love for Sri Lankans. I failed the entrance exam to gain entry to the only English medium school in Islamabad! However, when I met the Principal, along with my father, he said, “Sanjeewa, although you failed the entrance exam, I will this time make an exception as Sri Lankans are our dear friends.” After that, the joke around the family dinner table was that I owed my education in Pakistan to Mrs B!

At school, my brother and I were extended a warm welcome and always greeted “our good friends from Sri Lanka.” I felt when playing cricket for our college; our runs were cheered more loudly than of others.

One particular incident that I remember well was when the Embassy received a telex from the Foreign inistry. It requested that our High Commissioner seek an immediate meeting with the Prime Minister of Pakistan, Mr Zulifikar Ali Bhutto (ZB), and convey a message from Mrs B. The message requested that an urgent shipment of rice be dispatched to Sri Lanka as there would be an imminent rice shortage. As the Ambassador was not in the station, the responsibility devolved on my father.

It usually takes about a week or more to get an audience with the Prime Minister (PM) of a foreign country due to their busy schedule. However, given the urgency, my father spoke to the Foreign Ministry’s Permanent Sectary, who fortunately was our neighbour and sought an urgent appointment. My father received a call from the PM’s secretary around 10 P.M asking him to come over to the PM’s residence. My father met ZB around midnight. ZB was about to retire to bed and, as such, was in his pyjamas and gown enjoying a cigar! He had greeted my father and had asked, “Mr Jayaweera, what can we do for great friend Madam Bandaranaike?. My father conveyed the message from Colombo and quietly mentioned that there would be riots in the country if there is no rice!

ZB had immediately got the Food Commissioner of Pakistan on the line and said, “I want a shipload of rice to be in Colombo within the next 72 hours!” The Food Commissioner reverted within a few minutes, saying that nothing was available and the last export shipment had left the port only a few hours ago to another country. ZB had instructed to turn the ship around and send it to Colombo. This despite protests from the Food Commissioner about terms and conditions of the Letter of Credit prohibiting non-delivery. Sri Lanka got its delivery of rice!

The next was the visit of Mrs B to Pakistan. On arrival in Rawalpindi airport, she was given a hero’s welcome, which Pakistan had previously only offered to President Gaddafi of Libya, who financially backed Pakistan with his oil money. That day, I missed school and accompanied my parents to the airport. On our way, we witnessed thousands of people had gathered by the roadside to welcome Mrs B.

When we walked to the airport’s tarmac, thousands of people were standing in temporary stands waving Sri Lanka and Pakistan flags and chanting “Sri Lanka Pakistan Zindabad.” The noise emanating from the crowd was as loud and passionate as the cheering that the Pakistani cricket team received during a test match. It was electric!

I believe she was only the second head of state given the privilege of addressing both assemblies of Parliament. The other being Gaddafi. There was genuine affection from Mrs B amongst the people of Pakistan.

I always remember the indefatigable efforts of Mr Abdul Haffez Kardar, a cabinet minister and the President of the Pakistan Cricket Board. From around 1973 onwards, he passionately championed Sri Lanka’s cause to be admitted as a full member of the International Cricket Council (ICC) and granted test status. Every year, he would propose at the ICC’s annual meeting, but England and Australia’s veto kept us out until 1981.

I always felt that our Cricket Board made a mistake by not inviting Pakistan to play our inaugural test match. We should have appreciated Mr Kardar and Pakistan’s efforts. In 1974 the Pakistan board invited our team for a tour involving three test matches and a few first-class games. Most of those who played in our first test match was part of that tour, and no doubt gained significant exposure playing against a highly talented Pakistani team.

Several Pakistani greats were part of the Pakistan and India team that played a match soon after the Central Bank bomb in Colombo to prove that it was safe to play cricket in Colombo. It was a magnificent gesture by both Pakistan and India. Our greatest cricket triumph was in Pakistan when we won the World Cup in 1996. I am sure the players and those who watched the match on TV will remember the passionate support our team received that night from the Pakistani crowd. It was like playing at home!

I also recall reading about how the Pakistani government air freighted several Multi Barrell artillery guns and ammunition to Sri Lanka when the A rmy camp in Jaffna was under severe threat from the LTTE. This was even more important than the shipload of rice that ZB sent. This was crucial as most other countries refused to sell arms to our country during the war.

Time and again, Pakistan has steadfastly supported our country’s cause at the UNHCR. No doubt this year, too, their diplomats will work tirelessly to assist our country.

We extend a warm welcome to Mr Imran Khan, the Prime Minister of Pakistan. He is a truly inspirational individual who was undoubtedly an excellent cricketer. Since retirement from cricket, he has decided to get involved in politics, and after several years of patiently building up his support base, he won the last parliamentary elections. I hope that just as much as he galvanized Sri Lankan cricketers, his political journey would act as a catalyst for people like Kumar Sangakkara and Mahela Jayawardene to get involved in politics. Cricket has been called a “gentleman’s game.” Whilst politics is far from it!.

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Covid-19 health rules disregarded at entertainment venues?

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Believe me, seeing certain videos, on social media, depicting action, on the dance floor, at some of these entertainment venues, got me wondering whether this Coronavirus pandemic is REAL!

To those having a good time, at these particular venues, and, I guess, the management, as well, what the world is experiencing now doesn’t seem to be their concerned.

Obviously, such irresponsible behaviour could create more problems for those who are battling to halt the spread of Covid-19, and the new viriant of Covid, in our part of the world.

The videos, on display, on social media, show certain venues, packed to capacity – with hardly anyone wearing a mask, and social distancing…only a dream..

How can one think of social distancing while gyrating, on a dance floor, that is over crowded!

If this trend continues, it wouldn’t be a surprise if Coronavirus makes its presence felt…at such venues.

And, then, what happens to the entertainment scene, and those involved in this field, especially the musicians? No work, whatsoever!

Lots of countries have closed nightclubs, and venues, where people gather, in order to curtail the spread of this deadly virus that has already claimed the lives of thousands.

Thailand did it and the country is still having lots of restrictions, where entertainment is concerned, and that is probably the reason why Thailand has been able to control the spread of the Coronavirus.

With a population of over 69 million, they have had (so far), a little over 25,000 cases, and 83 deaths, while we, with a population of around 21 million, have over 80,000 cases, and more than 450 deaths.

I’m not saying we should do away with entertainment – totally – but we need to follow a format, connected with the ‘new normal,’ where masks and social distancing are mandatory requirements at these venues. And, dancing, I believe, should be banned, at least temporarily, as one can’t maintain the required social distance, while on the dance floor, especially after drinks.

Police spokesman DIG Ajith Rohana keeps emphasising, on TV, radio, and in the newspapers, the need to adhere to the health regulations, now in force, and that those who fail to do so would be penalised.

He has also stated that plainclothes officers would move around to apprehend such offenders.

Perhaps, he should instruct his officers to pay surprise visits to some of these entertainment venues.

He would certainly have more than a bus load of offenders to be whisked off for PCR/Rapid Antigen tests!

I need to quote what Dr. H.T. Wickremasinghe said in his article, published in The Island of Tuesday, February 16th, 2021:

“…let me conclude, while emphasising the need to continue our general public health measures, such as wearing masks, social distancing, and avoiding crowded gatherings, to reduce the risk of contact with an infected person.

“There is no science to beat common sense.”

But…do some of our folks have this thing called COMMON SENSE!

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