Learning to live with Covid-19, mindfully….

As Universities re-open for the new academic year this autumn students and staff are facing a whole new world, a very different experience to one we may be used to or have come to expect.

• Big lectures with hundreds of students are no more.

• Online video recorded lecture material and online live meetings are the new order of the day.

• And maybe some small group teaching or lab working, where possible, in 'bubbles' of various sizes.

• But social events on campus are hugely curtailed.

Covid-19 has created it's own existential anxieties for many while for some the risks seem overblown. But as I've discussed in my previous Coronavirus blogs (1-4), this spectrum of perception is normal, depending on your own personal circumstances.

Government guidance in the UK, most would agree, has been somewhat erratic and inconsistent, but we are now beginning to get a slightly more coherent set of messages with hands, face, space, even if Government ministers aren't always as clear as they could be in communicating it.

Hands, face, space….

If you:

• Wash or sanitize your hands regularly, and

• Wear a face covering in public settings, and

• Maintain 1-2metres distance where possible...

….it is pretty difficult to transmit or acquire the virus (and much else probably!). Each measure adds further mitigation, reducing the risk for all. Pretty simple actually.

And other constraints (e.g. the so-called ‘rule of six’ or restrictions on large groups/household mixing) further minimise the extent of any further transmission to reduce overall transmission rates.

Is this really so difficult or such a hardship? It’s unlikely to be for ever.

Adapting to a new norm.….

For those of us who lived through HIV/AIDS during the 1980s and 90s to the present day, safe sex became the norm - an effective coping strategy for suppressing transmission whether you were HIV+ or negative, whether you knew it or not. Testing was way more complicated than for Covid-19 and for many years no one really knew very much about it. But amongst the tragedy and the grief grew the bright light of community resilience; arguably the root of the strong identity today of much of the LGBTQI+ community. Rather than safe sex being a problem it became the driver of openness about sex and sexuality that had not been seen before, and a source of great creativity!

So the lesson is - whatever the strategy of governments - we as individuals will have to live with Covid-19 for some years; we will have to accept that. Even if there is one or more vaccines the chances of them being 100% effective in preventing infection is remote; few vaccines are. And that’s before you even get to uptake of vaccines by the public.

So we have a choice:

• we worry about Covid-19 (how helpful is that?); or

• we don't care and to hell with it (how helpful is that, when your older friends, relatives and loved ones suffer or die from it, even if you are asymptomatic?); or

• we live with some necessary, simple precautions that allow us to get on with a more ordinary existence, that protects ourselves and others.

A bit of a ‘no-brainer’ really?

Hands…

Hand washing or sanitizing is about as simple a technique as you can get. Just make it a routine habit - use the sanitizer at train or tube stations, on the way in and on the way out. Make it as much of a habit as swiping/scanning in/out at the turnstile. Use the hand sanitizer when you enter a building and when you leave. After a few days it will become automatic, like brushing your teeth.

Face…

If you find a face covering uncomfortable, problem solve it; try finding one that's more comfortable. Get creative, make the face covering a fashion accessory; have a number of different ones for different occasions; be humourous with them! And if still a little uncomfortable, try accepting it for what it is - it's just a sensation against the face, neither good nor bad, just a sensation. And if you shift your focus away from that sensation you may be surprised that you forget it is even there. Of course there are times when it is inconvenient, but if you struggle with it, it becomes even more of an issue for you.  And if you feel anxious or frightened about wearing a face covering, try practicing with one at home (trying different types, snoods, scarves), acknowledging that you feel anxious and sitting with it to allow it to pass (as it will) - ‘…..OK, I’m feeling anxious - it’s OK, it will pass’. It is the struggle with the anxiety (the negative thoughts that accompany the feeling) that maintains it. Avoidance may reduce the anxiety temporarily, but means you never discover that the anxiety will pass if just observed.

Space…

It takes little effort to be aware of space around you, if you are mindful, i.e. have present moment awareness. If you are lost in your thoughts - or staring at/scrolling through your phone, you won’t notice what is going on around you. And there are lots of activities you can still do at distance - you can still have coffee or lunch or a drink with a friend or friends, just not lots of them at once. So, engage in the present - use hands, face, space as a simple mindfulness mantra, to bring yourself into the present and be aware of what you touch, how close you are to other people etc. Worry (or rumination) takes you out of present moment awareness and into negative thoughts about the future (or about the past). It won’t help in maintaining your new-found positive habits of these simple mitigation measures - hands, face, space.

Relative risk….again

In Coronavirus 2: Emerging from lock-down (back in May 2020) I referred to the need to gain some perspective on relative risks and, slowly, debate is now beginning to focus more on relative risk and the trade-offs we make when we become overly and disproportionately focused on one thing, at the expense of other aspects of life - livelihoods, cancer treatments etc (see for example Professors Sikora, Henegan, Gupta etc al in their open letter to the UK Government on 21 September 2020).

Having spent many years myself also working in evaluating environmental policy interventions, a lack of a clearly articulated goal for a government policy or strategy is not uncommon. That is one of the problems we are seeing with current approaches by governments to Covid-19 - a poorly or unarticulated goal. What are we trying to achieve when governments talk about suppressing the virus - to what end? What’s the overall aim or purpose? For how long? Suppression is not an aim in itself; it should be a means to an end.

Is it ‘Zero-Covid’ - (i.e. eradication of the disease)? No, it seems not, since eradication is hardly feasible when the virus is now globally distributed and endemic in most countries/communities, and global travel will always allow it to re-enter a country.

Is suppression actually a means to ‘live with Covid’? It could be, but as a goal ‘Living with Covid-19’ needs to be articulated as such, since it then sets in train a range of options to achieve that goal. We can use mitigation measures to help suppress transmission of the virus with the intention (aim/goal/purpose) of ensuring we are better able to live with the virus. Even with effective vaccines we will not eradicate the disease rapidly, if at all. Without an honest and open debate about the aim behind the strategy the public can’t know why they are being asked to adopt the mitigation measures, and so adopt their own practices that make sense to them in their own personal circumstances. And a consequence of a poorly articulated goal, and confusion among the public, is also increased anxiety, stress and anger among the public. Using fear and blame to persuade people to adopt mitigation measures seems unhelpful (especially in the absence of trust in government actions) and has wider consequences for physical and mental health and well-being of the whole population.

Students and Covid-19 anxiety

For students starting or returning to university there will be lots of things that seem abnormal; not what you might expect when going to university. But Covid restrictions don’t mean you can’t meet other people, or have fun - it will seem strange and maybe difficult, and partying is unlikely to be consistent with mitigation measures! Learning remotely or in mixed-mode through technology can be tiring, isolating, lonely, exhausting, frustrating, stressful and more. The same is true for staff.

But it may also provide you with more ready and easy access to materials, clearer guidance on what you need to do to help you develop your own learning strategy; to work independently as well as with others in groups. Never before will students have had so much at their finger tips through a laptop, tablet, phone - everything to hand. Wow! Without Covid-19 this level of technological innovation in universities might have taken another 5-10 years to achieve.

So as you enter universities now, you are at the forefront of this way of learning. You will be well-placed to take this knowledge and skills into your future careers. And it will give you more time to organise your life as you want to; less time spent travelling into and back from uni gives you more time to do the study you want to do and other things you want to do. Be creative, manage your time effectively and make the most of the situation you find yourself in, despite the downsides. Many of your predecessors would have loved to have had lecture content provided so readily to hand as you will have from this year onwards. And these Covid-19 restrictions will pass, things will change and if you are starting uni on a 3-4 year undergraduate degree there will be lots of time when things will seem more normal again. And if you end up being stuck in uni over Christmas because travel home gets banned, make you own Christmas with new-found friends - would it really be so bad?

If you do experience stress, anxiety, low mood as a result of Covid-19 and its consequences here are a few dos and don’ts to remind you of how to deal with it:

Do - stick to hands, face, space - make it a habit, part of your normal routine.

Do - talk to each other, friends, family, colleagues, staff.

Do - create a routine that includes time for exercise/sport, recreation/fun, relaxation and interests other than studying - a sensible work/life balance is essential

Do - give yourself time and space to yourself; if you find you are spending all your time with a few people with no time/space to yourself, tempers can fray and frustration steps in.

Do - switch off screens for downtime, especially at night before bed, to switch off your thoughts and allow your brain to process and relax.

Do - seek help; universities are now very alive to mental health concerns and have support processes in place. They recognise the challenge of remote learning and potential for isolation.

Do - practice mindfulness.

Don’t - assume you should be able to cope with everything on your own; support is there to support you - use it.

Don’t - suffer alone, in silence.

Don’t - rely on unreliable sources of information - you are at university so have ready access to high quality information and advice.

Don’t - lose perspective; risk is relative - we take risks and make instant risk assessments all the time as a matter of course, and we adjust our actions accordingly. Covid-19 is a new risk, but for most it is not a great risk, but one to be aware of in order to make simple adjustments to the way we do things, to minimise the risk to ourselves and to others.

Time passes, and so will Covid-19. With care, compassion for ourselves and others, and mindful awareness, we will learn to live with it, because we have to. What choice do we have?

Bill Sheate, 25 September 2020