Eric Tian

A poem I’ve read several times this past week.

Lockdown

Yes there is fear.
Yes there is isolation.
Yes there is panic buying.
Yes there is sickness.
Yes there is even death.
But,
They say that in Wuhan after so many years of noise
You can hear the birds again.
They say that after just a few weeks of quiet
The sky is no longer thick with fumes
But blue and grey and clear.
They say that in the streets of Assisi
People are singing to each other
across the empty squares,
keeping their windows open
so that those who are alone
may hear the sounds of family around them.
They say that a hotel in the West of Ireland
Is offering free meals and delivery to the housebound.
Today a young woman I know
is busy spreading fliers with her number
through the neighbourhood
So that the elders may have someone to call on.
Today Churches, Synagogues, Mosques and Temples
are preparing to welcome
and shelter the homeless, the sick, the weary
All over the world people are slowing down and reflecting
All over the world people are looking at their neighbours in a new way
All over the world people are waking up to a new reality
To how big we really are.
To how little control we really have.
To what really matters.
To Love.
So we pray and we remember that
Yes there is fear.
But there does not have to be hate.
Yes there is isolation.
But there does not have to be loneliness.
Yes there is panic buying.
But there does not have to be meanness.
Yes there is sickness.
But there does not have to be disease of the soul
Yes there is even death.
But there can always be a rebirth of love.
Wake to the choices you make as to how to live now.
Today, breathe.
Listen, behind the factory noises of your panic
The birds are singing again
The sky is clearing,
Spring is coming,
And we are always encompassed by Love.
Open the windows of your soul
And though you may not be able
to touch across the empty square,
Sing.

Courtesy of Richard Hendrick, a friar in the Roman Catholic order.

These days, it seems like every conversation involves the recent coronavirus outbreak and its ramifications on society. Whether it’s the toilet paper shortages, job losses or the shutting down of schools and sporting events, a single word comes to mind when reflecting on the last few weeks: chaos. In light of this, I’ve decided to do some research on what’s been happening and reflect on some of the thoughts COVID-19 has brought on over the last few weeks.

Background

• Coronaviruses are a family of viruses causing diseases with variable virulence, ranging from the common cold to more severe diseases such as Middle East Respiratory Syndrome (MERS) and Severe Acute Respiratory Syndrome (SARS). SERS and MERS outbreaks have occurred in the past.
• December 2019: Reports of a new coronavirus outbreak emerge in Wuhan, China. This virus has been named SARS-CoV-2, with the disease it causes called Coronavirus disease 19 (COVID-19). Compared to SARS or MERS, COVID-19 spreads more efficiently between people to people but has a lower mortality rate.
• March 11: The World Health Organisation (WHO) declares COVID-19 a pandemic.
• March 12: The Australian Federal Government unveils its $17.6 billion stimulus package, targeting mostly businesses and welfare recipients. Italy goes into lockdown.
• March 16: The Australian Federal Government places a ban on non-essential gatherings of more than 500 people to prevent the spread of COVID-19. Events such as the Australian Grand Prix and spectators for cricket games are cancelled.

Present (as of March 22)

• In Australia, there are currently 1,072 cases reported, though this number is thought to be underreported and will almost certainly rise.
• Worldwide, 307,652 cases have been reported across 188 countries and territories. Of these, 95,797 have recovered and 13,051 have died – a mortality rate of around 4.2%. The top 3 affected countries are China, Italy and Spain.
  • Live statistics can be found here.
• While most people recover from the disease naturally, the mortality rate increases for the elderly, the immunocompromised and those with underlying illnesses such as diabetes, heart disease or cancer.
• Many countries across the world have put restrictions on social gatherings in order to ‘flatten the curve’, preventing an overwhelm of the healthcare system and to provide time for research to develop treatments. The mathematical models assessing the impact of non-pharmaceutical interventions on COVID-19 mortality can be found here.
• The Victorian State Government has announced shutdown of all non-essential activity across Victoria, commencing this coming Tuesday (March 24).

Future

• There is currently no well-established estimate as to when COVID-19 will peak or end, though concerns that the outbreak will coincide with flu season in August have led to the push of the influenza vaccine.
• The International Labour Organization (ILO) estimates that COVID-19 could claim up to 24.7 million jobs worldwide.
• Trials for a COVID-19 treatment are currently underway in labs globally, though a vaccine will take at least an year to develop, given the time required for pre-clinical development, phase 1 clinical trials and upscaling.  
• With SARS-CoV-2 accumulating 1 to 2 mutations per month, researchers are drawing up phylogenic trees to put together distinct lineages and gauge its spread. It’s currently unclear how exactly these mutations affect the behaviour of the virus.

3 Thoughts

1. Variable Responses

How does one respond when a safe and predictable week suddenly gets turned on its head due to a virus outbreak that’s taking over the world? The spectrum of responses is amazing, from people simply enjoying the show to others fighting over toilet paper. While it’s understandable that there would be a dramatic response to the pandemic, it’s unfortunate to see unhelpful attitudes such as xenophobia rearing their heads, only adding fire to the chaos.

Perhaps this period can illustrate where one’s priorities lie. For those who are concerned about their own wellbeing, xenophobia isn’t a surprising reaction – this is the perhaps one of the most unstabilising events of the last century and being weary of others is normal. But for those whose concern involves the wellbeing of others, a rare and selfless nature can emerge in a time where looking out for one’s self is the norm.

I’ve noticed it’s difficult to find posts regarding the few benefits COVID-19 has brought about. The media seems to focus exceedingly on new policies, new restrictions and new death toll updates. Very few seem to report that greenhouse gases are at an all-time low. That skies in Wuhan are blue and clear. That the sound of birds, previously deafened by the noise of city noise, now sing out through the silence. That while this time can seem incredibly isolating, it has the possibility to be wholly uniting, as people become increasingly aware of their actions on others. If this translates to more empathy and understanding of others in the future, I think that’s something we can all rejoice about.

2. Default Habits

Crisis doesn’t change people; it reveals them.

Eric Walters

If there’s one thing that COVID-19 helps reveal, it’s our default habits. When the structures and expectations that set up a week collapse, do we still maintain our usual habits and routines or do we turn to other activities, ones which seem more enjoyable and meaningful than our usual work?

Personally, I noticed that my motivations for studying drop immensely when lectures and tutorials aren’t in person. There’s something about being physically present in a class or lecture hall that creates a sense of accountability – something that makes me think, ‘hmm, maybe I should be as studious as the rest of my cohort…’ And that gets me over the line to study. Perhaps this disinterest in studying is a warning sign that my motivations for medicine aren’t as strong as I once imagined, but that’s a thought for another time.

3. Physical vs Social Isolation

I sometimes fear that maintaining physical health through social isolation neglects another piece of wellbeing: mental health. I identify as fairly introverted, but the notion of socially isolating myself for a few weeks doesn’t sound too appealing. Without social interaction, dangerous states such as loneliness can seep in and easily lead to other, more destructive thoughts.

For the majority of people who are more extraverted than myself, I pray people will still interact with and support others during these isolating times. Honestly, ‘social isolation’ should be renamed ‘physical isolation’, since it’s the only the physical aspect of meeting which is dangerous, not the social. Indeed, to fully socially isolate from others would be dangerous, perhaps more so than the virus itself.

As the pandemic situation progresses, only God knows what will happen to us all. But if we remember to add some empathy, some awareness and some kindness each day, I trust we can all get through this together in one piece.

As I’m writing this, there’s a bit of a problem. The problem is as follows:

1. I need to post something here once a week by Sunday,
2. This week, I’ve started writing 3 reflections but am nowhere near close to finishing any of them,
3. It’s 11:44pm on Sunday and I’m tired.

A part of me grumbles:

Look Eric, you’ve had a long day, you need to get up early tomorrow and no one will care if you post on a Monday instead of a Sunday. Forget this – just go to bed.

However, here I am writing this short thought anyway. Over the last few years, I’ve learnt that just showing up can put big steps forward in achieving particular goals. It doesn’t really matter how the actual ‘session’ goes, but the act of showing up does something incredible: it builds a sense of consistency, which in turn gives evidence for becoming a particular type of person to do a particular action again: a positive feedback loop, in a sense. To put it in clearer terms, here’s James Clear on the topic:

Every action you take is a vote for the type of person you wish to become. If you finish a book, then perhaps you are the type of person who likes reading. If you go to the gym, then perhaps you are the type of person who likes exercise. If you practice playing the guitar, perhaps you are the type of person who likes music. Each habit is like a suggestion: “Hey, maybe this is who I am.”

No single instance will transform your beliefs, but as the votes build up, so does the evidence of your new identity. This is one reason why meaningful change does not require radical change. Small habits can make a meaningful difference by providing evidence of a new identity. And if a change is meaningful, it actually is big. That’s the paradox of making small improvements.

Source: James Clear

Personally, I’ve found this to be true. I mean, I barely ever go to the gym so being a ‘buff guy’ is a title I would never consider claiming – I have no experience of lifting to show for it. However, showing up for the tasks I do perform gives a ‘vote’ for the type of person my actions embody. If I clean my room, I ‘vote’ for being a tidy person. If I get up early for a run, I ‘vote’ for being a runner. And when I stick to my self-allocated writing schedule, I ‘vote’ for being a person who sticks to their word. Even though these thought patterns can be unhelpful, I find them difficult to avoid and I suspect other people have similar tendencies as well.

But crucially, the converse is also true: when I don’t show up for such actions, or take unproductive actions, it gives a small ‘vote’ against the person I would like to become. For example, I’ve recently been rocking up to class late various times these last few weeks – one of the dangers of living close to Uni. Now when I leave to go to class, I almost habitually push how long I can wait until I’m too late, as I’ve ‘voted’ for myself as being a late person. Of course, this is an unproductive and rude characteristic to have, but due to my past votes for this identity, I’ve struggled to break out of this thought pattern. This means that any productive tasks done consistently have substantial carry-forward effects whilst unhealthy, habitual tasks have similarly powerful but destructive effects, reiterating the simple importance of just showing up.

11:59pm. Alright – time to sleep.

In the middle of Year 9, I failed my first exam. It was for chemistry and having never failed an exam before, this came as a huge shock and I remember staring down at the number on my paper, stunned. Then reality hit and a disturbing thought crept into my mind: maybe I’m not as smart as I thought.

This chemistry exam forced my perceptions of cognitive ability to be re-evaluated. Before the exam, I held a fairly steady academic record, being a straight A student and achieving Dux of my primary school. Scoring above the class average was expected of me, by both everyone around me and myself.

But perhaps this steady academic record was what got me into trouble. In the days leading up to this chemistry exam, I wrote in my journal,

I really haven’t studied that much for this chem exam… but I’ll be fine right? Chem isn’t that hard. Lol.

Look, I was in Year 9

Instead of reflecting on my study techniques and work ethic that got me to this place, perhaps I let my academic standing get to my head. You’re smart enough. I might’ve whispered. Look at your exam history – you don’t need to study for this.

The Dunning-Kruger effect: a cognitive bias in which people assess their cognitive ability as greater than it is. It largely stems from both an overestimation of their abilities and a failure to recognise any lack in ability.

In the moments before the chemistry exam, I’ll call the state I was in as ‘Dunning-Kruger positive’, whereby my cognitive abilities were heavily overstated, even delusional. Directly after the chemistry exam, I’ll call the state ‘Dunning-Kruger negative’, whereby my cognitive limits are reflected upon and re-evaluated.

This exam begun a series of Dunning-Kruger cycles, in which ‘Dunning-Kruger positive’ and ‘negative’ states came and went. After the chemistry exam came a series of successful assessments, which unfortunately lead to a replacement of solid study habits with arrogance, a ‘positive’ state. Soon after, I began my Biomedicine degree in University and began performing poorly there, transitioning back from a ‘positive’ to a ‘negative’ state. Right now, having started medicine and realising how little I know versus what I need to know, I’m well and truly in the ‘negative’. However, this time I wonder if I’ll ever feel like I’ll come back to a ‘positive’, given the complexity of medicine.

Sometimes it’s easy to forget how we got to the places we are now. We misconstrue our history, ignoring key moments and forging erroneous causes. Was I smart in Year 9? Maybe, but it was definitely by no inherent means. Rather, it was through the hard work of my parents to fund my secondary education, who gave me opportunities to pursue extra-curriculars and who supported me through every step. Rather, it was through the teachers who inspired me to learn and guided my academic adolescence. Rather, it was through God, the creator of heaven and Earth, who gave the greatest privilege of life. To ignore these factors would not just be arrogant, but pathologically delusional.

This serves as a reminder for me to continuously reflect on my limitations and earnestly pray to overcome them. While there will almost certainly be times where I drift back to an arrogant state, I hope I’ll be able to recognize this and reassess my limitations – before I fail another exam, or worse.