By Dr. Anthony Policastro

My election week article was on the steps in the grief reaction. I pointed out that all individuals whose candidate lost the election would go through a predictable pattern of steps to deal with the results in a healthy manner.

We have now had about two months for that to happen. In many cases it has occurred. Those individuals have emerged with a healthy state of mind.

However, there is still evidence that some individuals have not proceeded through the necessary steps. Their mental health will be negatively affected until they do.

Some are still stuck in denial. They feel that the election was not really lost. They feel that their candidate actually won. Whether they are correct in that feeling or not is not relevant.

The results do not support that. Denial is a necessary part of dealing with loss. It is, therefore, a health step psychologically. Getting stuck in denial is not healthy. They need to move on for their own psychiatric welfare.

Some are stuck in anger. That was manifested in action by those who stormed the Capitol building last week. They are clearly angry.

They are not the only angry individuals who acted out. We saw violence with the Black Lives Matter movement as well. However, while some members of both groups were angry, there was a difference in their actions.

For example, if someone kills another in self defense, one individual dies. If a drunk driver kills somebody, an individual dies. In pre-meditated murder an individual dies. However, the circumstances are completely different.

During the inner city riots the anger was aimed at local businesses. The anger last week was not really aimed at the Capitol building. The Cambridge English Dictionary defines sedition as “language or behaviour that is intended to persuade other people to oppose their government.” The circumstances are completely different.

Anger is a necessary part of dealing with loss. It is, therefore, a healthy step psychologically. Getting stuck in anger is not healthy. They need to move on for their own psychiatric welfare.

Some are stuck in bargaining. The post election lawsuits are a form of bargaining. The phone call to the Georgia Attorney General to find more votes was a form of bargaining. The expectation that the vice president would change the results of the election was a form of bargaining.

Bargaining is a necessary part of dealing with loss. It is, therefore, a healthy step psychologically. Getting stuck in bargaining is not healthy. People need to move on for their own psychiatric welfare.

Mourning is the fourth step. Examples of this are not quite as obvious. Everyone mourns in their own fashion. However, like the other four steps, it is one to deal with and move onward.

Mourning is a necessary part of dealing with loss. It is, therefore, a healthy step psychologically. Getting stuck in mourning is not healthy. People need to move on for their own psychiatric welfare.

The bottom line is that good psychiatric health comes after dealing with loss in a healthy manner.

There are clearly still individuals who are suffering psychologically because they have not completed the process.

COVID-19 UPDATE

Overall figures for the US continue at between 200,000 and 300,000 new cases per day. There was a single day last week when the numbers topped 300,000.

Locally, numbers also remain high. We just doubled the number of cases in the state in 47 days. That compares to the previous two doublings of 87 days and then 103 days. So we are clearly seeing significantly more cases.

The same thing is true in Sussex County. We just doubled the number of cases in 61 days. The previous doubling was 128 days. So we are seeing cases rise about twice as fast as they had been.

The last time I reported on the death rate by state, Delaware was 21st highest. Since that time there have been some surges in other states. Delaware has now dropped to the 28th highest death rate. We were just above the average then. We are just below the average now.

With the vaccine so close, it makes little sense to be careless now. Catching the virus a few weeks before the vaccine does not make a lot of logical sense. Wear your mask. Social distance. Wash your hands. Now is not the time to be foolish about precautions.

Of course, we continue to see people making poor decisions about things like that. I found an interesting image while watching the videos of the mass gathering in Washington D.C. on January 6th. There was group of about 8 individuals. None of them were wearing masks.

One of the members of the group was coughing her head off while everyone else was breathing in the droplets. Perhaps she didn’t have COVID-19. But, perhaps she did.

As I mentioned a few weeks ago the state of Delaware had broken vaccine availability into three categories.

The first was early on when demand exceeded supply. The second was where demand equaled supply. The third would be where supply exceeded demand.

Therefore, in the early stages of the rollout, patience is the key. We have been waiting 10 months for this. A few more weeks should be something we can handle.

Early studies suggest that the vaccines are indeed effective against the new strain of COVID-19. Research continues to be done to confirm that.

Brazil has released results of its Coronavac study. It had a 78 percent effectiveness in preventing COVID-19 infection entirely. However, it also prevented moderate and severe infection in the 22 percent who did get COVID-19. None required hospitalization.

Thus, even when they got it, their infection was milder. These remain preliminary results.

Israel has vaccinated about 20 percent of its population already. It can be done when there is a well-organized effort. It helps that Israel has less than 10 million total people.

A few months ago I wrote about two arthritis drugs. They are called tocilizumab and sarilumab. A new study in England shows a further reduction in mortality rate for hospitalized patients treated with the combination.

Patients without the medication had a 36 percent mortality. Those who received the drugs had a 27 percent mortality. This is not the culminating solution. However, we keep chipping away at reducing the mortality from the infection.