More the reporting around it:
"Small Number of Covid Patients Develop Severe Psychotic Symptoms" by Pam Belluck, New York Times Dec. 28, 2020
Almost immediately, Dr. Hisam Goueli could tell that the patient who came to his psychiatric hospital on Long Island this summer was unusual.
The patient, a 42-year-old physical therapist and mother of four young children, had never had psychiatric symptoms or any family history of mental illness, yet there she was, sitting at a table in a beige-walled room at South Oaks Hospital in Amityville, N.Y., sobbing and saying that she kept seeing her children, ages 2 to 10, being gruesomely murdered and that she herself had crafted plans to kill them.
“It was like she was experiencing a movie, like ‘Kill Bill,’” Dr. Goueli, a psychiatrist, said.
I'm starting to think it is ALL a SCRIPT!
The patient described one of her children being run over by a truck and another decapitated. “It’s a horrifying thing that here’s this well-accomplished woman and she’s like ‘I love my kids, and I don’t know why I feel this way that I want to decapitate them,’” he said.
The only notable thing about her medical history was that the woman, who declined to be interviewed but allowed Dr. Goueli to describe her case, had become infected with the coronavirus in the spring. She had experienced only mild physical symptoms from the virus, but, months later, she heard a voice that first told her to kill herself and then told her to kill her children.
At South Oaks, which has an inpatient psychiatric treatment program for Covid-19 patients, Dr. Goueli was unsure whether the coronavirus was connected to the woman’s psychological symptoms. “Maybe this is Covid-related, maybe it’s not,” he recalled thinking, “but then,” he said, “we saw a second case, a third case and a fourth case, and we’re like, ‘There’s something happening.’”
Indeed, doctors are reporting similar cases across the country and around the world. A small number of Covid patients who had never experienced mental health problems are developing severe psychotic symptoms weeks after contracting the coronavirus.
Beyond individual reports, a British study of neurological or psychiatric complications in 153 patients hospitalized with Covid-19 found that 10 people had “new-onset psychosis.” Another study identified 10 such patients in one hospital in Spain, and in Covid-related social media groups, medical professionals discuss seeing patients with similar symptoms in the Midwest, Great Plains and elsewhere.
“My guess is any place that is seeing Covid is probably seeing this,” said Dr. Colin Smith at Duke University Medical Center in Durham, who helped treat the North Carolina woman. He and other doctors said their patients were too fragile to be asked whether they wanted to be interviewed for this article, but some, including the North Carolina woman, agreed to have their cases described in scientific papers.
Now they have a psychiatric excuse if you refuse the vaccine.
Medical experts say they expect that such extreme psychiatric dysfunction will affect only a small proportion of patients, but the cases are considered examples of another way the Covid-19 disease process can affect mental health and brain function.
Yet I get a major evaluation, 'er, article.
Although the coronavirus was initially thought primarily to cause respiratory distress, there is now ample evidence of many other symptoms, including neurological, cognitive and psychological effects, that could emerge even in patients who didn’t develop serious lung, heart or circulatory problems. Such symptoms can be just as debilitating to a person’s ability to function and work, and it’s often unclear how long they will last or how to treat them.
Experts increasingly believe brain-related effects may be linked to the body’s immune system response to the coronavirus and possibly to vascular problems or surges of inflammation caused by the disease process.
May be?
Possibly?
“Some of the neurotoxins that are reactions to immune activation can go to the brain, through the blood-brain barrier, and can induce this damage,” said Dr. Vilma Gabbay, a co-director of the Psychiatry Research Institute at Montefiore Einstein in the Bronx.
Brain scans, spinal fluid analyses and other tests didn’t find any brain infection, said Dr. Gabbay, whose hospital has treated two patients with post-Covid psychosis: a 49-year-old man who heard voices and believed he was the devil and a 34-year-old woman who began carrying a knife, disrobing in front of strangers and putting hand sanitizer in her food.
Physically, most of these patients didn’t get very sick from Covid-19, reports indicate. The patients that Dr. Goueli treated experienced no respiratory problems, but they did have subtle neurological symptoms like hand tingling, vertigo, headaches or diminished smell. Then, two weeks to several months later, he said, they “develop this profound psychosis, which is really dangerous and scary to all of the people around them.”
Like heading out for coffee and a Globe each morning.
Also striking is that most patients have been in their 30s, 40s and 50s. “It’s very rare for you to develop this type of psychosis in this age range,” Dr. Goueli said, since such symptoms more typically accompany schizophrenia in young people or dementia in older patients, and some patients — like the physical therapist who took herself to the hospital — understood something was wrong, while usually “people with psychosis don’t have an insight that they’ve lost touch with reality.”
That's a bit complicated.
Some post-Covid patients who developed psychosis needed weeks of hospitalization in which doctors tried different medications before finding one that helped.
Dr. Robert Yolken, a neurovirology expert at Johns Hopkins University School of Medicine in Baltimore, said that although people might recover physically from Covid-19, in some cases their immune systems, might be unable to shut down or might remain engaged because of “delayed clearance of a small amount of virus.”
Persistent immune activation is also a leading explanation for brain fog and memory problems bedeviling many Covid survivors, and Emily Severance, a schizophrenia expert at Johns Hopkins, said post-Covid cognitive and psychiatric effects might result from “something similar happening in the brain.”
It may hinge on which brain region the immune response affects, Dr. Yolken said, adding, “some people have neurological symptoms, some people psychiatric and many people have a combination.”
ImageFrom left, Drs. Jonathan Komisar, Brian Kincaid and Colin Smith of Duke University Medical Center, who treated a woman whose sudden psychosis made her paranoid that her children were about to be kidnapped and that cellphones were tracking her.
Just because they are paranoid doesn't mean they are not out to get them.
Experts don’t know whether genetic makeup or perhaps an undetected predisposition for psychiatric illness put some people at greater risk. Dr. Brian Kincaid, medical director of psychiatric emergency department services at Duke, said the North Carolina woman once had a skin reaction to another virus, which might suggest her immune system responds zealously to viral infections.
Sporadic cases of post-infectious psychosis and mania have occurred with other viruses, including the 1918 flu and the coronaviruses SARS and MERS.
“We think that it’s not unique to Covid,” said Dr. Jonathan Alpert, chairman of psychiatry and behavioral sciences at Albert Einstein College of Medicine, who co-wrote the report on the Montefiore patients. He said studying these cases might help to increase doctors’ understanding of psychosis.
The symptoms have ranged widely, some surprisingly severe for a first psychotic episode, experts said. Dr. Goueli said a 46-year-old pharmacy technician, whose family brought her in after she became fearful that evil spirits had invaded her home, “cried literally for four days” in the hospital.
He said the 30-year-old construction worker, brought to the hospital by the police, became “extremely violent,” dismantling a hospital radiator and using its parts and his shoes to try to break out of a window. He also swung a chair at hospital staff.
How long the psychosis lasted and patients’ response to treatment has varied. The woman in Britain — whose symptoms included paranoia about the color red and terror that nurses were devils who would harm her and a family member — took about 40 days to recover, according to a case report.
She must have seen the opening of the 2012 Olympics.
The 49-year-old man treated at Montefiore was discharged after several weeks’ hospitalization, but “he was still struggling two months out” and required readmission, Dr. Gabbay said.
The North Carolina woman, who was convinced that cellphones were tracking her and that her partner would steal her pandemic stimulus money, didn’t improve with the first medication, said Dr. Jonathan Komisar at Duke, who said doctors initially thought her symptoms reflected bipolar disorder. “When we began to realize that maybe this isn’t going to resolve immediately,” he said, she was given an antipsychotic, risperidone and discharged in a week.
The physical therapist who planned to murder her children had more difficulty. “Every day, she was getting worse,” Dr. Goueli said. “We tried probably eight different medicines,” including antidepressants, antipsychotics and lithium. “She was so ill that we were considering electroconvulsive therapy for her because nothing was working.”
About two weeks into her hospitalization, she couldn’t remember what her 2-year-old looked like. Calls with family were heartbreaking because “‘You could hear one in the background saying ‘When is Mom coming home?’” Dr. Goueli said. “That brought her a lot of shame because she was like, ‘I can’t be around my kids and here they are loving me.’”
Ultimately, risperidone proved effective and after four weeks, she returned home to her family, “95 percent perfect,” he said.
“We don’t know what the natural course of this is,” Dr. Goueli said. “Does this eventually go away? Do people get better? How long does that normally take? And are you then more prone to have other psychiatric issues as a result? There are just so many unanswered questions.”
I sure hope the kids don't turn up dead (?????)?
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Related:
"There is compelling evidence that COVID-19 will have long-term effects on the brains and nervous systems of survivors as they age, and researchers on Tuesday announced a large international study to investigate the correlation between the coronavirus and cognitive decline, Alzheimer’s disease, and other dementia in later life. Decades of evidence from other respiratory viruses, along with observations of patients in recent months, suggest such infections may increase a person’s risk for Alzheimer’s disease, Parkinson’s disease, and other brain disorders, according to a paper announcing the study, published Tuesday in Alzheimer’s & Dementia: The Journal of the Alzheimer’s Association. The paper called the coronavirus pandemic ’'a unique — if unwelcome — opportunity’' to study the effects of respiratory virus infection on the brains of COVID-19 survivors. The study, which will follow survivors over age 50 or at some sites over age 60, will be funded initially by the Alzheimer’s Association, which will also help coordinate it internationally, with technical guidance from the World Health Organization. Researchers also will seek funding in their own countries. Scientists from nearly 40 countries have signed on, and researchers hope to enroll about 40,000 participants. In the year since the coronavirus began spreading across the globe, doctors have noted lingering post-recovery conditions ranging from brain fog and forgetfulness to anxiety, depression, and psychosis. ’'Abnormal brain imaging has emerged as a major feature of COVID-19 from all parts of the world,’' the paper said, adding that brain abnormalities have been observed even in a person whose only symptom was anosmia, or loss of smell. The flu of 1918, severe acute respiratory syndrome (SARS), and Middle East respiratory syndrome (MERS) have been connected to memory impairment, sleep disruption, anxiety, and psychosis. In some people, the novel coronavirus, also known as SARS-CoV-2, triggers a huge release of inflammation signals leading to blood-brain barrier dysfunction, which can promote neuroinflammation and brain cell death."
Get a good night's sleep and you should be fine.
Also see:
"During the global pandemic, with entire cities locked down, travel heavily restricted and isolation fatigue setting in, thousands of people have been caught, fined or jailed for breaching coronavirus restrictions that have made once normal activities taboo. Some have intentionally broken the rules to make a political statement. Others have claimed they are immune to the disease and from the consequences of breaking those restrictions. Others have simply blundered into breaches because they apparently didn’t understand the rules or were acting in a moment of desperation. “Everyone is operating in a crazy world where our normal, rational decision-making goes out the window,” said Robert Hoffmann, a professor of economics at RMIT University in Melbourne, Australia. “A pandemic is a perfect storm.” Here are a few unusual cases....."
That's as crazy as taking the shot.
"The curse of the incidental illness: Seen as side effects to Covid vaccinations, ailments may have little to do with them" by Helen Branswell, STAT December 28, 2020
As Covid-19 vaccines go into broad use, some rare side effects of vaccination will almost certainly emerge, like the reports of small numbers of people developing anaphylaxis, but so will medical events whose timing just comes down to random chance — and the potential ripple effects of those reports already have experts concerned.
Every single day, people die unexpectedly. They have strokes and heart attacks and seizures. On an average day, 110 people in this country may develop Bell’s palsy, a temporary facial paralysis, and another 274 will develop Guillain-Barré syndrome, a form of paralysis that usually resolves over time. The trigger for these medical events often isn’t known, but when they happen shortly after someone gets a vaccine — especially a new one — well, conclusions will be drawn.
It's called cause and effect.
“It is logical for people to say: That person had something done to them and something bad happened in the hours or days after that,” said Art Reingold, chair of the division of epidemiology and biostatistics at UC Berkeley’s School of Public Health, “and if it was you or your family member, you would be inconvincible that that wasn’t true.”
He's the guy who said the flu virus could be taking a year off -- in theory, of course.
Except, of course, it often isn’t. Heart attacks occur most commonly in the morning, yet we don’t blame breakfast for causing them. A heart attack on the morning after a Covid-19 vaccine, though? That might be another matter, but the public doesn’t have a great grasp of the concept that many problems that occur after vaccination probably aren’t tied to immunization itself. In part, that’s because that context has been missing from public health messaging about Covid-19 vaccinations.
“I think the lay public is fully, fully unprepared for understanding this,” said Kate O’Brien, director of the WHO’s immunization, vaccines, and biologics program.
Yeah, we just a bunch of stoopideoes.
Quickly distinguishing a true side effect signal from an abundance of noise will be critical to ease the alarm of a public already skittish about vaccines developed at “warp speed,” experts warned.
The risk of the public misinterpreting such anecdotal reports may be especially acute early on in the rollout, when elderly adults and people with health conditions have been prioritized to get the vaccine. Nursing home residents are in Phase 1a — currently ongoing — and seniors 75 and older are in Phase 1b. People aged 65 to 74 and those with medical conditions that increase the risk of severe Covid disease are in Phase 1c. These are people to whom medical events occur most commonly.
“Things are going to happen to them,” said O’Brien, though she noted that more medical misfortune would befall people in these groups if they were not vaccinated.
Still counted as a COVID death.
Helen Keipp Talbot, who is on the expert panel that devised the vaccine distribution priority lists for the Centers for Disease Control and Prevention, actually voted against putting nursing home residents at the front of the line, in part because vaccinating people who are in frail health first could inadvertently undermine confidence in the vaccine, given how common heart attacks, strokes and even deaths are in this population.
“All of the events are going to be temporally associated, but how do you explain that to the nurse’s aide who’s been taking care of that patient and loves her like her own grandmother? Who then decides that she’s not going to get vaccinated and tells everyone else not to get vaccinated?” Talbot told STAT.
“I fear a loss of confidence in the vaccine. That the vaccine will actually truly be safe, but there will be temporally associated events and people will be scared to use the vaccine,” said Talbot, an associate professor of infectious diseases at Vanderbilt University.
OMFG!
In some cases, there’s reason to believe reports of adverse events are likely due to the vaccine. Anaphylaxis — a potentially life-threatening allergic reaction — has been linked to multiple types of vaccines in the past.
But you are a crazy conspiracy theorist to think so!
Britain has reported several cases of anaphylaxis among people who have received the Pfizer vaccine. In the U.S., about 11 cases have been reported since the vaccine rollout began earlier this month, according to the CDC. Most followed receipt of the Pfizer vaccine, but a Boston doctor with a shellfish allergy developed a severe allergic reaction after receiving the Moderna vaccine. If and when other Covid vaccines are authorized for use, health authorities will be watching closely to see whether anaphylaxis is linked to all Covid vaccines, or merely those like the Pfizer and Moderna vaccines which are made using messenger RNA.
He says it was the worst he ever felt, but the Globe says the dangers of COVID-19 still outweigh risks and thank God he had an Epipen.
Btw, they are up to 929 dead now, of all ages.
A three-year review of adverse reports logged into a U.S. national vaccine database found that anaphylaxis after vaccination is rare, occurring at a rate of about 1.31 per million doses of vaccine administered. Of those cases, 85% were in people with a history of allergies. None of the 33 cases — out of 25 million vaccinations — died. Some needed epinephrine, the drug in EpiPens, but others recovered after treatment with antihistamines.
Bell’s palsy, too, has been linked in at least one circumstance to a vaccine, an intranasally administered flu vaccine that was briefly brought to market in Switzerland. Eight people in the Pfizer and Moderna trials, which enrolled nearly 74,000 participants in total, were diagnosed with the condition — seven in the vaccine arms and one in the placebo arm of the Moderna trial. The jury is still out on whether Bell’s palsy, which afflicts about 40,000 people a year in the U.S., is an occasional side effect of taking a Covid-19 vaccine.
Can you imagine half your face and body being paralyzed?
As vaccinations begin on a larger scale, reports of other potential side effects will likely pop up. A few cases of something are anecdotes, not data, and definitely not proof of a causal relationship. While they must and will be studied, investigations of this sort take time. The CDC and the Food and Drug Administration have a number of surveillance systems set up to monitor for potential side effects, as do some other countries, but it’s going to be important to look for, and be ready to react to, vaccine safety rumors anywhere they start to swirl, said Steven Black, a professor emeritus at the University of Cincinnati Children’s Hospital whose career has focused on vaccine safety.
Definitely no proof -- before an investigation has even begun!
How shameful!
“The reason I think you need to think globally is that vaccine scares are global,” said Black, who is also co-director of the Global Vaccine Data Network, a 17-country collaboration that studies vaccine safety and effectiveness. “We know very well that misinformation spreads much more quickly than information, so that a couple deaths in Brazil or a death in Indonesia or whatever, the public outcry could cause lack of confidence and undermine the whole vaccine program.’’
And we wouldn't want that, would we?
That’s why it’s so crucial to set expectations before and during a vaccination campaign, but public literacy about vaccination — the benefits, the risks, and how to balance the two — is poor, said O’Brien, who points to how often people insist they contracted flu from a flu shot, even though that is biologically impossible.
Then she is a liar, and we ain't so dumb as you thinketh we is!
One of the ways vaccine experts try to combat the rise of rumors and unfounded claims is by knowing background rates of medical events, so that when things arise, one can get a sense of whether the number of cases is abnormal, or what might be expected to occur, whether or not a vaccination program was underway.
“If we know that Guillain Barré occurs in 1 in 100,000 people and a million people have been vaccinated, you would expect 10 cases, maybe,” Black explained, “but if you have 30, you begin to wonder: Maybe there’s an issue here? So, knowing background rates as a frame of reference is something that’s being promoted.”
Differentiating between what’s relevant from what isn’t is going to be tough, especially with multiple new vaccines (hopefully) starting to be used within a short period of time. When suspect medical events occur, it will be important to know which vaccine the individual in question received — though that may be a bigger challenge than you would expect. Record keeping for immunizations — especially adult immunizations — isn’t close to where it ought to be, O’Brien said.
Should it become clear that one, some, or all of the vaccines pose rare risks of some side effect, how will the public take the news?
“At some point, if events are occurring one in 100 million [vaccinations], people may be willing to accept that risk if it allows the world to get rid of Covid and go back to normal life,” Black said, “because you have to remember, hundreds of thousands of people are dying of the disease.”
There isn't going to be a return to "normal."
How that risk is communicated, though, will be critical, because many people can’t easily understand how to assess the significance of a rare risk. “They’re wary about very rare events and then they text while they’re crossing the street where they’re much more likely to get killed. Yeah, people do that very poorly,” Black said.
The sickening condescension is driving me crazy.
Giving people a comparison that makes sense to them can help, said Alison Buttenheim, an associate professor of nursing and health policy at the University of Pennsylvania, who works on vaccine acceptance.
The idea that 1 in 500,000 people who are inoculated with a Covid vaccine might have a serious side effect — this is a hypothetical example — might seem too risky to some people. Explaining to them that they run the same risk of being hit by lightning in a given year can put a different spin on that piece of information.
Then I will take my chances without the jab!
Likewise, pointing out that 1 in 500 New Jersey residents have already died from Covid-19 can remind people that the risk of not being vaccinated far exceeds the rare risks the vaccines may possibly pose, Buttenheim said.
At the end of the day, helping the public understand these issues requires communication — and that isn’t happening on a national level, said Bruce Gellin, president of global immunization at the Sabin Vaccine Institute, which promotes access to vaccinations.
The Department of Health and Human Services, not the CDC, has taken the lead on Covid vaccine communications efforts, but its output to date has been limited.
“It would have been nice if they could come up with a communications strategy at the same warp speed as they came up with vaccines,” said Gellin, a former director of HHS’s National Vaccine Program Office.
“My mantra is there’s a vaccine world and there’s a vaccination world, and they’re not necessarily connected by an arrow. [Operation] Warp Speed was largely about the vaccine world and about logistics,” Gellin said. “Warp Speed, unfortunately, was not about a vaccination program, and now what we’re seeing is that we’re now facing the vaccination program and are under-prepared.”
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What's crazy is a woman falsely accusing Black hotel guests of stealing her phone after the Amy Cooper incident.
What's really crazy is the substitution of race for cla$$ when it comes to the potentially deadly virus.
