Are We Peeing Our Pants to Stay Warm?

Updated: February 13, 2021

We are facing a global pandemic.

It should not surprise any of us if we look at the history of previous pandemics:

Visualization of Mortality from Historical Pandemics

Source: Visual Capitalist

Virus outbreaks have been part of human reality from time to time since the beginning of our era.

If there’s one thing that's certain, it’s that this pandemic will pass, just like all others have, mutations or not. This gives reason for optimism.

What keeps me awake at night is not the pandemic itself, but the possible consequences of the measures we resort to in order to meet this challenge.

One thing is the immediate consequences of the measures, which appear to be frightening enough.

Something quite different are the long-term consequences.

We can be incredibly grateful for the work the Norwegian Institute of Public Health (FHI) has done for us in investigating the immediate consequences. Here, we can rely on empirical research results.

Unfortunately, it is not possible to conduct empirical research on the future.

But we can at least try a bit of logical reasoning.

Let’s first summarize the (frightening) immediate consequences that have been observed so far.

All findings listed below are drawn from a meta-analysis that included 93 studies from OECD countries, of which 11 were from Norway and Denmark. You can find the report here.

Warning: It’s not uplifting reading.

Family Relationships

• Over 50% fewer child abuse cases and a 42% decrease in children and young people in emergency care.

It’s possible that children are being subjected to abuse without receiving help due to less reporting during the lockdown. If so, this is a group that is already vulnerable and is suffering even more during covid-19.

• Nearly doubling of infants needing emergency medical assistance.

• 1493%(!) increase in occurrences of head injuries suspected from abuse among toddlers aged 0-1.5 years. All affected families were from deprived areas, which additionally had other challenges, such as a criminal history, mental health issues, and poor finances.

• Higher risk of abusing children if parents lost their jobs or suffered from depression.

• 25% reported more arguments in the family.

• Correlation between covid-19-related stress factors and poor parental behavior (e.g., aggression, inconsistency), which in turn was a risk factor for distress in both parents and children.

• Parents with poor parenting practices had higher depression rates, more children, lack of childcare, and concerns about their relationships.

Social Conditions

• Decline in empathetic concern (worry for and warm thoughts about others) and prosocial behavior.

• Significant increase in social media usage.

• Significant increase in the proportion of girls/women following appearance-focused Instagram accounts. Researchers believed this indicated an increase in those following such accounts.

• 70% of boys spent more time gaming online.

• Lack of physical contact with friends predicted loneliness, anxiety, and depression.

• Nearly all social media and technology usage, aside from video calls, was highest among parents and children perceived (by parents) to have higher levels of anxiety.

• About 1/5 felt lonely, and just under half indicated in their responses that they did not feel happy.

• 78% of children and young people aged 6-14 showed symptoms of anxiety.

• A Norwegian study showed the following results: To the question "How often have you felt lonely in the past week?", 12.9% responded that they always felt lonely, while 45.5% felt lonely occasionally.

• 51% of adolescents scored above the clinical threshold for depression. 40% for anxiety and 45% for PTSD.

Substance Abuse

• Compared to 2019, the percentage of serious alcohol poisonings from total emergency admissions increased from 2.96% in 2019 to 11.31% after reopening.

• 49% used substances alone.

• Youth with greater fears of covid-19 or more symptoms of depression had an increased likelihood of using substances alone.

Is it not significantly more concerning that people use substances alone rather than in a joyful gathering with friends?

Quality of Life

Isn’t quality of life the ultimate goal of everything we do?

Quality of life is about what gives life value and meaning. For some, it is as much freedom as possible, for others joy, or the development of skills and interests. Because the concept of quality of life raises the question of what is valuable in itself, it touches the core of politics: to provide citizens the opportunity to live good lives. Good Lives in Norway (2016), Directorate of Health

Among boys, the proportion with high life satisfaction clearly decreased, from 88% in 2018 and 92% in 2020 before the covid-19 restrictions to 71% during the lockdown. Corresponding figures for girls were 78%, 81%, and 62%.

Vulnerable Groups

Middle-class families managed to maintain a higher standard of learning opportunities, both in terms of time and activities (e.g., homework, maintaining after-school activities) for children. Children from low socio-economic backgrounds had fewer learning opportunities.

In this way, it appears that the pandemic amplifies existing inequalities, and that particularly children from poor socio-economic backgrounds are more severely affected by the pandemic than others.

Physical Activity and Diet

Here we are fortunate that FHI already published preliminary results from the National Public Health Survey 2020 on February 8, 2021. You can read the preliminary findings here:

Here are some of the findings:

• 34% of those aged between 18 and 24 report that they have gained weight in the past year.

• A total of 23% in the age group 18-24 think they eat less healthily now than before corona.

• 44% of those between 18 and 24 indicate they are less physically active now than before the corona pandemic.

• 40% of those aged 25-49 report being less physically active now than before the corona pandemic.

• A larger proportion of those who were overweight and obese have gained weight during the corona pandemic than those of normal weight.

The Differences Are Amplified

Several reports provide quotes suggesting that the differences between people are being exacerbated:

A small segment of the population seems to have had the time and resources to be more physically active and to eat healthier during the pandemic. Nine percent say they eat healthier and 14 percent are more physically active than before.

— These results may indicate that changes in diet and physical activity due to the pandemic could contribute to explaining some of the weight gain. This is concerning, particularly because negative lifestyle changes and weight gain seem to hit younger adults the hardest. It may be challenging to lose these pounds, and it may also increase the long-term risk of obesity and lifestyle diseases.

A Step Back

Okay. We have now seen some of the effects the corona pandemic has had in the short term. There’s no doubt that it has had negative consequences for both mental and physical health, family relationships, social conditions, economy, experienced stress, substance use, physical activity, diet, and obesity.

There are also clear indications that children and young people are more significantly impacted by the negative consequences, and that those who were already in vulnerable groups are even more adversely affected.

Then we add the indisputable fact that all these negative consequences are factors that affect our mental state and that influence and reinforce each other.

Do we see the connections here?

We humans are one being.

Everything we do, see, and experience affects us, our brains, and our choices. Both in the short and long term.

The relationship between physical activity and mental health is unequivocal.

Exercise balances neurotransmitters — along with the rest of the chemicals in our brain. And as you will see, keeping your brain in balance can change your life. - Dr. John Ratey, "Spark"

In a report from the World Bank, overweight is described as "a ticking bomb ready to explode."

Another recent report on overweight and obesity in Norway states:

Overweight and obesity are associated with a number of health challenges. These challenges include both somatic and mental disorders, such as diabetes and depression. Furthermore, people with overweight and obesity face challenges related to discrimination and stigmatization in society. This encompasses everything from stigmatizing references in newspaper articles to difficult encounters with healthcare professionals. The sum of this reduces health-related quality of life for the individual and increases the risk of death. Weight loss has been shown to improve health-related quality of life for the individual by, among other things, reducing the number of obesity-related symptoms and the discomfort associated with them.

This is due to these correlations.

Our need for social relationships is something I won’t delve deeper into. This need is apparent to most.

These are mechanisms deeply ingrained in our cerebral cortex.

We become mentally ill when these needs and opportunities are taken away from us.

And when we humans become mentally ill, it becomes harder for us to make good choices.

Then we might do things we wouldn’t do in our healthy state.

I believe these connections provide us with enough information to propose a hypothesis.

Let’s call it the Mental Spiral Hypothesis;

Mental Spiral Hypothesis

Those in a good mental state become stronger during crisis situations. They handle stress, adversity, and challenges better. They find new ways to create social relationships, bond with family, spend time in nature, do meaningful work, maintain or increase physical activity, and eat healthier. They have used the pandemic as a catalyst for their positive momentum.

They are "antifragile."

They turn adversity into fuel.

They become stronger through challenges.

They are like a strong flame that grows stronger with a gust of wind.

The corresponding hypothesis for those with a poorer mental state would then be:

Those in a poor mental state cope with a crisis situation worse. They can't handle rising stress as well, they become increasingly isolated, they argue with family, they spend more time on screens and (unproductive) social media, they are more likely to lose their jobs and suffer economic consequences, they have reduced their daily activity level, and they eat less healthily than before.

They are crushed by adversity.

They can't handle the challenges.

They are like a thin candle that gets blown out by the wind.

Long-Term Effects

When we view the Mental Spiral Hypothesis in conjunction with the self-reinforcing effect of small choices and habits and fast forward a bit, the picture becomes alarming.

Some of the questions that arise:

• Are we pushing those who had negative momentum off a cliff?

• Is the cliff too steep for them to begin climbing again?

• Are we amplifying the transfer effect from parents with negative momentum to children?

• How will this affect the vulnerable in the long run?

Are we peeing our pants to stay warm?

Are we reducing the long-term quality of life for a large segment of the population?

Isn’t the population's quality of life the most important issue our elected representatives should work toward?

Are the long-term effects of measures that affect our mental state being thoroughly evaluated and weighted?

Some quotes from friends on Facebook should further stimulate thoughts:

"Would you rather live safely in captivity or freely in danger? I want to climb trees, fight in cages, thank friends for the fight, find love, be hurt by love, party with friends, be sick, but mostly healthy. I want the painful with the good, and the good with the painful. I want to choose myself!"

Can we just adapt?

It’s easy to think that everyone is adaptive enough to make the changes required in daily life to meet the challenges we face.

"We can always go skiing instead of going to the gym."

"We can just spend more time with family."

"We can be socially active digitally."

But it’s not that easy. It’s like saying to an overweight person, "You can just stop eating sweets."

Our lizard brain shuns change.

And when we are in a poor mental state, the lizard brain is incredibly strong.

So what can we do?

Just as a soldier sent to war should follow orders, we must contribute to the effort. If we do not, society will break down.

However, we should also be able to ask critical questions like this for...