4. #CopeWithCovid: learn, innovate, lead and thrive in addressing the injustices of inequities

Blog series (07/11/2020). My open peer-reviewed, sense-making learning journal is updated regularly based after discussions with others. Happy to chat with you if curious. This iterative work-in-progress invites you to join a learning journey about addressing the Covid crisis and the 21st century mega-problems from a long term perspective. If inspired, make a comment and share.

Blog warning: Allow time for slow thinking and deep self-reflective learning. Book mark blog to read and re-read the sections. This blog series will stretch your imagination in what you can learn, explore and discover together in communion with others in addressing complex problems. Click on hyperlinks to learn more about key concepts. Make notes in response to any questions that you feel called to discuss.

Read the covid revelations, netinar, network power, leadership failures, journey journal, macro-level perspectives and blogs 1-2-3.  Sense-making netinars prepare and enable learners to understand the vulnerabilities, volatilities, uncertainties, complexities and ambiguities (V2UCA) of addressing mega-problems.

____________________________

This blog will address how to intervene at micro, meso and macro levels.

• Expand beyond individualistic and self-sufficient ways of coping
• Scale up dynamic agile learning networks
• Set up peer support, coaching and learning platforms
• Implement micro, meso and macro-level interventions

1. Expand beyond individualistic and self-sufficient ways of coping

How did this #CopeWithCovid idea virus emerge? On March 16th, I read the WHO report mental health considerations of the Covid crisis. I wrote a brief reaction to this document with one question. What is the number 1 tip to keep covid stress and anxiety under control? This individual-focused and reductionist question struck a chord with 468 views within 24 hours.

This question tapped into the emotional pulse at that time. The rapid response rate to this short post made me realize how the hook of this quick-fix question defeated the wider purpose of how we #CopeWithCovid more effectively together.

Of course, there is no number 1 tip, but the question does focus the mind on setting priorities. So, what are the right combinations of #CopeWithCovid tips, depending on circumstances, that work synergistically to help you survive and thrive psychologically (during and well after the Covid death rate has resolved) as an individual but also within your family, organization and community?

This calls on us to learn about how our mindsets toward our mental health challenges can enhance or diminish their perceived levels of distress, stress and strain. Here are a few suggestions to manage these psychological issues.

• Develop realistic optimism and self-efficacy about positive outcomes (self-protection, social connections/intimacy with physical distancing and survival)
• Enhance social connections and intimacy despite physical distancing
• Minimize the negatives (the risks of severe illness and death) without denial
• Recognize when minimizing the positive perceptions and maximizing the negative perceptions and then make conscious attempts to reversing these perceptions

This latter challenge is easier said than done, for example: focus attention on the survival rate, not the death rate: "I will survive, not die." Up to 80% of people infected have mild or no symptoms and 99% of people recover from the infection. Taking additional precautions and using #CopeWithCovid tips on (described later) enhance immunity against theCovid-19 virus. And anticipate how sensational new stories, like 3 deaths in one New Jersey family, will evoke fear reactions that reverse the perceptions of risk.

The aim of this #CopeWithCovid #IdeaVirus is to exponentially spread evidence-based information, practical advice/support and ongoing learning opportunities about how to address the psychosocial aspects of Covid and its aftermath in more systemic ways to amplify positive impacts.

Self-reflective learning question.

• What is your take on how we can do better in terms of expanding beyond individualistic and self-sufficient ways of coping to a collaborative peer health learning, coaching and support process?

Pause, reflect and make notes about your reactions.

2. Scale up dynamic agile learning networks

Much of the current attention is focused on acute crisis: containing Covid, mitigating its spread, reducing demands on the hospitals systems and planning for the releases from shelters-in-place and the lock-downs. The secondary psychosocial pandemic will peak and linger much longer after the death rates peak and fade away. We also need to start preparing for is the psychosocial aftermath. This secondary chronic pandemic will far exceed the impact of the acute pandemic crisis.

The Covid crisis has greatly increased the mental health challenges of managing fear, stress, anxiety and depression, and other psychosocial problems. This calls for innovating how we can learn to transform bad stress into good stress, enhance our coping, emotional self-regulation and problem-solving skills, boost our resilience to lower our strain levels, and thrive despite adversity. Regrettably, these challenges are now compounded by the stresses of Covid misinformation and disinformation, as described in blog 3.

The overall demands for increased mental health care call for scaling up how we can create complex adaptive learning networks of peer learning, coaching and support care services, using collaborative online platforms.

#CopewithCovid tips provide practical information about what to do, ideally with a reference source or a citation of evidence that others can dispute. This reciprocal dynamic two-communication is just one characteristic of complex adaptive learning networks, ideally conducted on an open structured online interactive platform (like Reddit) to share, confirm and dispute emerging understandings and evidence about how to manage #CovidStress. What we need to do is to design learning platforms for crowdsourcing best educational innovation, curating the best learning resources, and create complex adaptive learning networks in order to scale up how we #CopeWithCovid?

The innovation challenge for servant leadership is: how can we continuously enhance our capabilities and capacities in helping each other cope more effectively and efficiently with the stresses and psychosocial impacts of Covid, both during and after this unprecedented challenge?

How can leadership institutions, consulting enterprises and executive coaches:

• Build social networks of transformational servant leadership to collaborate in developing an innovation platform to test idea viruses and scale up prototypes, such as Share #CopeWithCovid tips to create complex adaptive learning systems?
• Enable leaders to create complex adaptive learning systems and networks within and across organizations and communities about how to manage Covid stress and anxiety more effectively on a day-to-day basis?
• Help corporations and organizations evolve from fragile to anti-fragile (agile) organizations during and after the Covid crisis?
• Work with leaders, systems and organizations to minimize the rates of burnout and PTSD and also build our individual, family and collective resilience to enhance the prospects of post-traumatic growth and thriving?

The top-down and sage-on-the-stage approaches to #CopeWithCovid can get in the way or even worsen the bottom-up approaches of people learning how to manage #CovidStress and #CovidAnxiety on a day-to-day basis, as described in blog 2.

For example, the succinct UNICEF video provides with 5 tips about what to do in helping their children learn at home. The "how to" is the real challenge for parents. How can parents learn from each other peer-to-peer about the "how to's"?

Top-down advice with tips are prerequisite but insufficient to cope with #covidstress more effectively. We need WHO and UNICEF 2.0 to design complex adaptive learning networks with two-way peer-to-peer communications for dynamic learning and support.

To mobilize the creative wisdom of the crowd, servant leaders also use guide-on-the-side approaches to spread the #IdeaVirus (Share #CopeWithCovid tips and dialogue) faster peer-to-peer than the Covid-19 virus with an R0 of 1:2-3. In other words, each infected person infects 2-3 people.

The impact of bottom-up, peer-to-peer approaches far excel the capabilities and capacities of top-down and organizational approaches (such as the CDC and APA) to #CopeWithCovid. This calls for synergistically using top-down approaches with bottom-up approaches to build collective resilience and resolve to survive and minimize the pandemic disruptions.

To counteract the impact of sensational stories that distort perceptions of risk, we also need mainstream media to help in creating a #CopeWithCovid Infodemic that contain #CovidHysteria and counteract misinformation and disinformation.

Self-reflective learning questions.

• What is your take about developing complex adaptive learning networks, organizations and communities?
• What will make a difference in making them work well over time?

Pause, reflect and make notes about your reactions.

3. Set up peer support, coaching and learning platforms

• What are your top #CopeWithCovid learning tips to manage #CovidStress and reduce #CovidAnxiety and to improve your individual resilience and thrive?
• How will you help create social network power to build our collective resilience against this pandemic?

Use the APA, CDC and WHO resources (see resource list) to share what you have learned. Share your #CopeWithCovid story and learning tips on social media to create resources for others.

The psychosocial impacts of the Covid Crisis will far surpass the capabilities and capacities of healthcare systems. We need to develop bottom-up and peer-to-peer approaches to spread the #CopeWithCovid tips. This will help to manage #CovidStress (psychological, work, economic, family, etc) more creatively, effectively and efficiently.

Self-reflective learning questions.

• What is your take on how you can expand your role in leading how to do reciprocal peer support, coaching and learning?

Pause, reflect and make notes about your reactions.

The #CopeWithCovid #IdeaVirus calls on leaders to create agile systems and learning platforms in order to develop complex adaptive networks, organizations and communities that operate synergistically at macro, meso and micro-levels. The macro-levels are far more complex to implement than the micro-level tips. Start with the micro-level tips.

4. Implement micro-level interventions

These strategies focus on intrapersonal and interpersonal issues.

• Use your creativity to cope in new ways and use it in new tasks/activities in everyday life to #CopeWithCovid. Let constraints and disruptions liberate innovation. Be agile and test new ideas. Keep an open mind to adapt and learn from experience.
• See the upside of the downside. Reframe the lockdown as precious time for deep reflection. Embrace solitude for personal and professional development. "One of the greatest necessities in America is to discover creative solitude." Carl Sandberg. Re-examine your meaning and purpose in life. Make a journal and/or reach out to others for discussions-dialogues.
• Learn how to work from home with your partner without going crazy. Subscribe to Working Together newsletter.
• Act like you are a carrier of the #Covid19 virus but without the disease. Talk to people about doing the same. Protect yourself and others to #FlattenTheCurve. 
• Use your physical distancing time to socially connect remotely with family, rekindle past connections, and make new online connections.
• Use the Covid learning tips to develop resilience, prevent or minimize cabin fever, burnout and post-traumatic stress disorder, and prepare yourself for post-traumatic growth.
• Share your favorite Covid podcasts and say why. Listen to Zeev Neuwirth's interviews with cutting-edge innovators. Share your favorite Covid podcasts. Learn where cutting-edge organizations are heading and beyond. Who is leading the pack? Look at www.Zoomcare.com and Providence Health (listen to podcast)
• Think of the Covid shut-down as an emotional loss or grief reaction (denial, isolation, bargaining, depression and acceptance) to understand yourself and people’s reactions. Draw on your past experiences of addressing loss reactions in order to cope and adapt with covid in real time more effectively. Engage in conversations with others about how to cope with loss reactions.
• Find inspirational quotes to address uncertainty and fear. Viktor E. Frankl "When we are no longer able to change a situation, we are challenged to change ourselves.”  And of course, remember the serenity prayer.
• Do not take your health and well-being for granted during this crisis. Enhance your healthy well-being to manage #CovidStress and thrive through and beyond the crisis.
• Get good sleep, exercise and healthy nutrition to boost your immune system. Lack of sleep reduces the count of your killer white blood cells needed to destroy Covid-infected cells.
• Use evidence-based questioning to challenge current recommendations about how to reduce the spread of Covid-19 virus. The six foot rule of thumb only applies to people being static. Walking into an area where a Covid-infected person has just coughed, even if they are wearing a mask, may still spread the virus. A mask on an infected person greatly reduces the viral load of spread, but it is not 100 percentage. And conversely, non-infected people can be asymptomatic carriers and should wear masks in enclosed spaces and in the public, as a risk and harm reduction approach.
• Be wary of Covid hoaxes. The claim of 100% success rate in treating Covid-19 with hydroxychloroquine, zinc and azithromycin deserves further scrutiny, additional peer review and verification of what success means. How was success defined? How severe were the cases? What differences does hydroxychloroquine, zinc and azithromycin really make? If 100% effective, it will end the lockdown.

Self-reflective learning questions.

• What is your take on what will help you and others in using micro-level strategies
• What are your ideas and suggestions about developing and using microlevel strategies?

5. Implement meso-level interventions

These strategies operate at organizational and community levels.

• Ask innovation leadership, human resource and employee health teams to create #CopeWithCovid learning networks within and across systems and organizations to reduce the psychological impacts of covid uncertainties, fear, stress and anxiety. Share best practices.
• Care for caretakers before they need to ask. Build a coalition of systems and organizations to create and implement a proactive “CopeWithCovid” resource and support services specifically designed to help frontline healthcare workers build and sustain their resilience as a way to manage stress and anxiety, minimize burnout, reduce the risk of PTSD and enhance the prospects of post-traumatic growth. In addition to asking experts, we need to develop such support systems based on asking the first cohort of healthcare workers who are living with the Covid onslaught three questions. What would you have liked to have known in advance about how to cope with Covid-19 better? Are you willing to share your best tips about how to CopeWithCovid on the job and at home? What kinds of resources and services do you need to help you cope better?
• Sustain frontline responders during the Covid-19 Crisis. Join March 31st virtual Town Hall for first responders. hosted by Thrive Global & Harvard T.H. Chan School of Public Health. Learn how to take actionable micro-steps to sustain a healthy mindset. 
• Develop a Covid leadership communication team within your organization that provides coordinated daily updates (with emergency communications only as needed), ideally with provision of CE/CME credits. Tailor communications to different groups. Track readership use and send reminders to non-responders. Get user feedback for improvement. Avoid duplications of communications from different people. Otherwise, communications can feel like a fire hydrant. Information overload adds to stress and reduces readership.
• Develop a curating process to identify and spotlight the best #CopeWithCovid tips provided by frontline responders and health care workers and share them more widely.
• Provide an online platform for all healthcare personal (including those working from home) to create learning networks by creating peer-to-peer communications for discussing #CopeWithCovid tips, for all healthcare personal (including those working from home).
• Provide telehealth and counseling services for healthcare personnel about how to #CopeWithCovid.
• Create trust-based cultures and work systems that enable people to share their vulnerability and develop the courage needed to manage complexity, reduce fear and tolerate uncertainty.
• Use the Covid-19 crisis to deeply understand the system flaws arising from hierarchical structures that fragment organizations into silos. This crisis will challenge the systems with the least well developed person-centered, convenient, value-based and integrated primary care the most.   The upside of this pandemic crisis is that it provides innovation opportunities for these systems to develop new advanced direct primary care models.
• Mobilize organizations and communities to encourage people to use self-directed learning modules as a way to manage the Covid concerns and reduce the demands for Telehealth and the healthcare system.

Self-reflective learning questions.

• What is your take on what will help your organizations and community in using meso-level strategies?
• What are your ideas and suggestions about developing and using meso-level strategies?

6. Implement macro-level interventions

These strategies operate at the political, policy and system levels.

Conscious capitalist corporations, the social media giants (Google, Facebook, Twitter and Linkedin) and business leadership institutions (such as the Center for Creative Leadership) have traditionally kept business separate from politics and civic society, other than to protect their own business models and interests. This leadership omission of social and political responsibility has allowed for the rise of fake patriotism, the alt-right propaganda machines and demagoguery to run amok over our political and legal institutions, downgrade our democracy and corrupt our constitutional republic to its core.

How will we use our experiences of responding to the Covid Crisis to address these ethical and political challenges? Imagine building social networks of servant leadership development to redesign our political systems and transform our public policies to support intrapersonal and interpersonal transformations, and vice versa.

• Use #Copewithcovid as a social innovation #ideavirus without a personal, professional or corporate branding. #Copewithcovid is a transcendent global brand for uniting stakeholders and unifying humanity to act together for the greater good of all. #CopewithCovid is a wake-up metaphor for learning how we can address the other mega-problems, challenges and emergencies, such as IP3H - Improve Personal, Population and Planetary Health. These mega-issues includes toxic food policies that promote the Standard American Diet, the epidemics of unhealthy lifestyles and chronic diseases, the climate emergency, planetary demise, environmental degradation and the sixth extinction. Covid is the enemy now, but will we learn that the enemy is us. The covid crisis is giving us golden opportunities to birth a new human consciousness and civilization. This calls for cultivating servant leadership to open, transform and align our mindsets to IP3H. We need to develop meta-strategies to re-design our corrupt political systems and develop public policies to serve we, the people, in unprecedented ways. This calls for designing political systems based on the true patriotism of servant leadership (empowerment, transparent accountability and altruism) to deconstruct the deep state of fake patriotism (megalomania, sociopathy and narcissism), neoliberalism and the colonization of wealth.
• Learn about how modern anti-terrorist strategies and tactics can defeat the Covid pandemic, counteract societal atomization and minimize political tribalism. Use central coordination to support distributive leadership to address Covid challenges locally. Listen to Sam Harris converse with Stanley McChrystal and Chris Fussell
• Let #Covid19 uncertainties cultivate leadership humility, open-mindedness and willingness to learn and adapt. Learning agility is essential for leadership development in order to effectively and efficiently navigate the stormy weather of V2UCA: Vulnerability, Volatility, Uncertainty, Complexity, and Ambiguity. Learning enablers of agility include innovating, performing, reflecting, risking and being open-minded to minimize defensiveness. Use "After Action Reviews” (AAR) by creating tight feedback cycles between thinking and action, individually and collectively, to improve effectiveness and efficiency and thereby enhance personal and organizational agility. Take up to 15 minutes per day to do AARs. Review and reflect on them weekly to prepare for the next week. Convert AARs into learning tips and share them widely in order to create complex adaptive learning networks.
• Use the Covid-19 crisis to amplify social resonance to burst the bubbles of political fundamentalism. Unite together to unrig the system, address the pandemic and improve personal, population and planetary health concurrently (see #IP3H blog series) effectively and efficiently. This is not a dream but a viable vision if we can cooperate in overcoming the limitations of self-centered rugged individualism and neo-liberalism needed to address complex interconnected meta-challenges and problems. This calls for opening our minds to develop new socioeconomic enterprises capable of achieving the Millennium Development Goals (MDGs). This involves co-opting traditional corporations to embrace the MDG goals, so that they become part of the solutions. We must rid ourselves of the destructive biases and minimize the dysfunctional polarizations that prevent this vision from becoming a reality. Or Mother Nature will teach us all the cost of our planetary abuse. Unless we adopt effective meta-strategies, we will not learn quickly enough to avert and manage further catastrophes.
• Use the pandemic to educate people about how virus mutations and the development of the Covid-19 virus are enabled by human activities and factory farms. Preventing the development of new viruses will reduce the need for creating new vaccines. This calls for developing public policies to fix our unhealthy food systems.
• Further develop the Covid-19 primary care telehealth policies and practices in the future in order to manage viral infections at home and thereby reduce the spread and death rates of seasonal influenza.
• Spotlight philanthropic efforts that address the pandemic crisis and expose the ethical injustices and socioeconomic inequities of neoliberalism's failures to decolonize wealth and address healthcare injustices. Read about funds to support Native American families impacted by COVID-19.
• Advocate for federal consensus to coordinate State lockdowns in accordance with the WHO Guidelines.

Self-reflective learning questions.

• What is your take on what will help your organizations and community in using macro-level strategies?
• What are your ideas and suggestions about developing and using macro-level strategies?

______________________

Read part 1, part 3 and part 4 of #CopeWithCovid blog series

Calls-to-action: If inspired, make a comment below. If so inclined, share this #ideavirus blog series with your connections on social media. Invite them to share this series. Help build a #CopewithCovid infodemic to #FlattenTheCurve and the #DisinformationCurve until we develop new viral covid-19 treatments and vaccines.

Candor and feedback appreciated about #CopewithCovid interactive webinars. Any ideas about leads, connections or organizations to host webinars appreciated. Happy to chat too with kindred spirits. Contact via Linked-in. Pro-bono offer.

_______________________

Resource lists: using top-down approaches

Work-in-progress: search for #CopewithCovid to read more tips.

1. Provider

• Taking Care of Patients During the Coronavirus Outbreak: A Guide for Psychiatrists (Center for the Study of Traumatic Stress, CSTS)
• Helping Patients Manage the Psychological Effects of Quarantine and Isolation(CSTS) 
• How Healthcare Personnel Can Take Care of Themselves (CSTS)
• Supporting the Mental Health of Patients During COVID-19: A Guide for Healthcare Personnel (CSTS)
• Supporting Patients During Quarantine or Confinement (CSTS)
•  Care for Critically Ill Patients With COVID-19, (JAMA Insights: Clinical Update, March 11, 2020)
• Telepsychiatry and COVID-19 (APA) New guidance from CMS, updated 3/17/20
• Best Practices in Videoconferencing-Based Telemental Health guide (APA and American Telemedicine Association)

2. Families

• Harvard Public Health Resources for Families
• Taking Care of Family Well-Being (National Child Traumatic Stress Network, NCTSN)
• Supporting Homebound Children During COVID-19 (CSTS)
• Supporting Your Family During Quarantine or Isolation: Tips for Social Distancing, Quarantine, and Isolation during an Infectious Disease Outbreak (Substance Abuse and Mental Health Services Administration, SAMHSA)

3. Resources for Healthcare & Community Leaders

• Helping People Manage Stress Associated with the COVID-19 Virus Outbreak(National Center for PTSD)
• How Public Health Leaders Can Support Communities Dealing with Quarantine (CSTS)
• Health Risk and Crisis Communication to Enhance Community Wellness (CSTS)
• Addressing Stigma Associated with COVID-19 (World Health Organization) 

4. Centers for Disease Control and Prevention (CDC) for general resources and guidance

• What you need to know
• Guidance on prevention and control
• Guidance for travelers
• Coronavirus Stigma and Resilience
• Mental Health and Coping During COVID-19

?Additional mental health resources

• Mental Health America: 31 tips to boost mental health
• The Lancet: Rapid Review,  The psychological impact of quarantine and how to reduce it: rapid review of the evidence
• United Nations Inter-Agency Standing Committee, Briefing: “Addressing Mental Health and Psychosocial Aspects of COVID-19 Outbreak” 
• Doing what matters in times of stress (WHO)
• COVID-19 Mental Health Impacts: Resources for Psychiatrists, Families and Leaders

Additional biomedical resources

• The Lancet Covid-19 resource
• Up-to-date
• Dynamed
• JAMA network
• Cochrane database
• Evidence based management guideline for the COVID-19 pandemic