Dr. Sean Mullen Profile picture
Dec 22 2 tweets 3 min read Read on X
The government's response to the pandemic, particularly in its evasion of the lab leak theory and inconsistent messaging about the virus's transmission and severity, is a textbook example of Mischel's Uncertainty Theory in action. This theory, which examines how uncertainty affects human behavior, offers a compelling framework for understanding the public's varied reactions to the pandemic.

By initially denying COVID-19’s airborne transmission and then flip-flopping on this stance, the authorities have created an environment of confusion. The emphasis on handwashing, despite clear evidence of the virus’s airborne nature, and the inconsistent recommendations regarding masks further contribute to this uncertainty. In this scenario, Mischel's theory suggests that people are more likely to rely on pre-existing beliefs or biases, leading to a range of responses, from heightened anxiety to a disregard for changing guidelines.

The use of the term 'mild' to describe COVID-19 symptoms is another striking example. Originally referring to the extent of syncytial formation in the upper respiratory tract, this term was co-opted to describe the Omicron variant's effects, misleadingly suggesting a lack of severity. This oversimplification, obscuring the virus's significant impacts on the brain, metabolism, and digestion, aligns with Mischel's ideas on uncertainty. In the absence of clear information, the public may downplay the seriousness of the disease, based on the misguided belief that 'mild' equates to 'harmless'.

This strategic ambiguity in communication may serve various purposes for the government, from shifting public focus away from systemic inadequacies to maintaining control over the narrative. However, it also exacerbates the public health challenges, leaving individuals unsure of how to best protect themselves and others.

Understanding the government's approach through the lens of Mischel's Uncertainty Theory highlights the urgent need for clear, consistent, and evidence-based communication. It's only through combating the uncertainty that breeds paralysis and misinformation that we can make informed decisions for our health and safety. 🧵 1/2
The way people interpret and react to the mixed messages around COVID-19 can be better understood through the concepts of self-efficacy and identity formation.

Many intelligent individuals, including those with advanced degrees, have downplayed the virus's seriousness. This seemingly paradoxical behavior can be explained by examining the sources of self-efficacy:

Mastery Experiences: Individuals who believed they adhered to masking guidelines early on but still contracted COVID-19 might interpret this as a personal failure, leading to a diminished belief in the effectiveness of masks.

Verbal Persuasion: Conflicting or misleading messages from influential figures regarding mask effectiveness can erode confidence in this preventive measure.

Vicarious Experiences: Witnessing others disregard masking without apparent consequences can weaken the perceived necessity of this behavior.

Emotional/Physiological Arousal: The anxiety and stress caused by inconsistent COVID-19 information can impact individuals’ confidence in their ability to protect themselves through measures like masking.

These factors also play a critical role in the formation and reinforcement of identities, such as those of anti-vaxxers or anti-maskers. These identities are often deeply rooted and resistant to change, as they are bolstered by social circles and information sources that reinforce pre-existing beliefs. Challenging and changing these entrenched identities requires a multifaceted approach, involving the counteraction of misinformation and an understanding of the deep-seated commitments that sustain these beliefs.

By applying this individual-level framework, we can gain a deeper understanding of why some people may resist public health measures despite the overwhelming evidence supporting their efficacy. This insight is crucial for developing more effective communication strategies that resonate on both a public and personal level. 2/2

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More from @drseanmullen

Dec 2
I asked ChatGPT to predict the future based on a novel virus that parallels the outcomes associated with SARS-CoV-2 (but I omitted the name to avoid misinformation). Remember, GPT aced medical exams and there are only a handful of people who’ve been screaming from the rooftops about these possibilities…

Here’s DrHouseGPT’s 🔮 thoughts:

Given the scenario where the novel virus has significantly compromised immune systems, similar to severe immunodeficiency disorders, several specific infections might emerge or re-emerge. Here's a list of potential infections to watch out for:
Respiratory Infections:
•Bacterial Pneumonias: Streptococcus pneumoniae, Haemophilus influenzae, and Staphylococcus aureus could cause more severe infections.
•Viral Respiratory Infections: Influenza, parainfluenza, and other common respiratory viruses could lead to more complications.
Opportunistic Infections:
•Fungal Infections: Candidiasis and Pneumocystis jirovecii pneumonia (PCP), particularly in severely immunocompromised individuals.
•Mycobacterial Infections: Tuberculosis and non-tuberculous mycobacterial infections could see a significant rise.
Gastrointestinal Infections:
•Bacterial infections like Salmonella, Shigella, and Campylobacter, which can cause severe gastroenteritis.
•Viral infections like Norovirus, which might lead to more severe and prolonged symptoms.
Neurological Infections:
•Viruses such as West Nile Virus or enteroviruses could cause more severe encephalitis or meningitis.
•Progressive multifocal leukoencephalopathy (PML), a rare brain infection caused by the JC virus, could occur in severely immunosuppressed individuals.
Skin and Soft Tissue Infections:
•Increased incidence of severe skin infections caused by common bacteria like Staphylococcus aureus (including MRSA) or Streptococcus pyogenes.
Reactivation of Latent Viruses:
•Herpesviruses, including cytomegalovirus (CMV), Epstein-Barr virus (EBV), and Varicella-zoster virus (VZV), could reactivate and cause severe disease.
Sexually Transmitted Infections (STIs):
•Higher susceptibility and severity of STIs, including HIV, syphilis, and herpes simplex virus.
Parasitic Infections:
•Toxoplasmosis and other parasitic infections might become more common, especially in regions where they are endemic.
In addition to these infections, there could be a general increase in the severity and duration of typically self-limiting or minor infections. It's crucial in this scenario to enhance surveillance, infection control, and public health measures to mitigate the impact of these infections.
Then I asked it:

This is an incredibly horrible scenario DrHouseGPT. Can you tell me what the best mitigations should be in this scenario if we know this novel virus is principally transmitted through aerosolized particulates? Is seems to infect people in the air within as little as 2 minutes of exposure. What could we possibly do to stop this thing and prevent what feels like an extinction level event?

Response:

In a scenario with a highly contagious virus transmitted through aerosolized particles with such a rapid rate of infection, aggressive and multi-faceted mitigation strategies are essential to prevent what could indeed be a catastrophic public health crisis. Here are the key strategies:

Universal Masking: Mandate high-quality masks (N95, KN95, or FFP2/3 standards) in all public spaces, especially indoors and in crowded areas. This would significantly reduce the transmission of aerosolized particles.
Enhanced Ventilation and Air Filtration: Upgrade ventilation systems in buildings to include HEPA filters. Encourage outdoor activities over indoor gatherings. Portable air purifiers can also be used in settings where ventilation upgrades are not feasible.
Rapid and Widespread Testing: Implement widespread testing with rapid turnaround times to quickly identify and isolate infected individuals. Regular testing in schools, workplaces, and other high-density areas can help in early detection.
Contact Tracing and Quarantine Protocols: Efficient contact tracing and strict quarantine measures for those exposed to the virus are critical to contain outbreaks.
Vaccine Development and Distribution: Fast-track the development and distribution of an effective vaccine against the virus. Ensure global access to vaccination, particularly in high-risk areas.
Public Education Campaigns: Educate the public on the seriousness of the virus, modes of transmission, and the importance of following public health guidelines.
Travel Restrictions and Screening: Implement travel restrictions or mandatory quarantine for travelers from high-risk areas. Increase screening procedures at entry points like airports and train stations.
Personal Hygiene Measures: Promote rigorous personal hygiene practices, including frequent handwashing and use of hand sanitizers, especially in public places.
Social Distancing Measures: Implement social distancing in public spaces, workplaces, and schools to reduce close contact and potential transmission.
Research and Development: Invest in research to understand the virus better, including its mutations, and develop effective treatments.
Healthcare System Strengthening: Increase the capacity of healthcare systems to handle a surge in patients, including more hospital beds, ventilators, and trained healthcare workers.
Global Cooperation: Foster global cooperation for sharing resources, information, and best practices to combat the virus effectively.
This approach combines public health measures, scientific research, and community engagement. Swift and decisive action, along with international collaboration, would be key to preventing an extinction-level event.
Upon request by a few folks in this thread, I prompted it to tell me how much time we might have left…

Timeline Estimation: Estimating a specific timeline like 5 years or a decade for human survival under these conditions is speculative. However, without effective mitigation and in the presence of a continuously spreading lethal virus, the situation could become critical within a few years. The impact would not only be in terms of direct mortality from the virus but also from the collapse of healthcare systems, disruption of supply chains, and breakdown of societal structures.
Read 4 tweets
Oct 15
I’ll keep saying it until data suggest otherwise, but there’s growing evidence that Covid causes brain damage. Reacting to traffic signals, accurately reading signs, switching lanes to anticipate obstacles, and staying calm under stress all rely on our executive functions like inhibition control & task-switching. When these are impaired, accidents can happen. Covid causes more vehicular accidents & likely contributes to plane and train accidents as well.
People want evidence, so I’ll be posting evidence all day.

1 study per hour that I’m awake.

Here’s the first linking mild, non-hospitalized Covid infection with unfavorable changes in the brain.

nature.com/articles/s4158…
Ok, here’s a bonus, since I already posted this review:
Read 6 tweets
Oct 4
Many use Zombie analogies🧟‍♂️ to explain aspects of viral infections from symptoms to transmission.

In the spirit of Halloween🎃, I will say that nature's eeriest "zombie-like" conditions are toxoplasma gondii (rids rodents of fear, making them easy cat prey!), CMV (can cause blindness, jaundice, purplish skin splotches, seizures, etc), & prions (Mad Cow).

While there's some truth in fiction, I believe there's another angle to consider.
The virus accelerates our aging, disrupting internal clocks. Telomeres, biological markers of aging, shorten with chronic illness and correspond with reduced lifespan.
Our collective trauma and societal pause due to the pandemic erased many temporal markers, disturbing our sense of time. Combine this with the direct (neural inflammation, cell death) and indirect (absence from life events) effects of the virus on memory.
Read 11 tweets
Aug 25
🧵 Pandemic Reflections

The past few years have been a crash course in health and safety for many of us. From understanding masks and respirators to the intricacies of viruses, the amount of information has been overwhelming. /1
In 2019, I couldn't differentiate between valveless and valved masks, or all the NIOSH ratings. Grilling outside was just about avoiding smoke, not understanding the nuances of respiratory protection. /2
The pandemic brought a deep dive into vaccine mechanisms, virus structures, and their relations to other diseases like SARS and HIV. It's been a whirlwind of learning. /3
Read 14 tweets
Aug 18
Something I learned from a well-read, highly intelligent Twitter/X contributor & science communicator:

SARS-CoV-2 is a syncytial virus - the ability to cause the fusion of neighboring infected cells, leading to the formation of multi-nucleated giant cells called syncytia. 🧵
@DonEford was the 1st to really connect the dots for me why this isn’t “just a cold.” A common cold can be caused by >200 different viruses.

Most of them are NOT syncytial (frequent culprits are rhinoviruses, which belong to the picornavirus family & do not form syncytia) /2
Other viruses like coronaviruses, adenoviruses, & parainfluenza viruses can also cause cold symptoms, & not all of these form syncytia either. /3
Read 13 tweets
Aug 2
@jljcolorado is providing an awesome talk right now on air cleaners - I am shocked to learn that anything but HEPA, CR-Box, MERV13 and Activated Carbon filters can cause severe harm that outweighs the benefits. Simulated deaths from cleaner-caused pollution negate effects! /🧵

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Also one should keep in mind that while most activated carbon filters have good underlying technology, the quality of most of these filters on the market are too weak or insufficient for a given space (check grams or may need kilograms in some cases).
Very cool to see these data on the cheap Corsi-Rosenthal 📦 @CorsIAQ !
Read 4 tweets

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