My practice in my company offices includes very strict protocols, including daily housekeeping services, using Covid￼ approved cleaning products. I use two full office suites, so that cleaning can be happening in between every single patient. I have created a large garden with seating areas and beautiful flowers so that anyone who accompanies a patient can be seated outdoors, if they choose. I own copious amounts of hand sanitizer. ￼￼We have been blessed with beautiful weather here in the Washington DC area, and often I meet outdoors with my patients￼. I have masks, bottled water service, and I wear PPE while working.￼￼￼￼￼
On COVID-19 infection and mental and cognitive health: In addition to mood disorders, common symptoms include fatigue, headaches, memory loss and problems with attention. There may be a number of reasons for these brain changes, including inflammation and cerebrovascular events (describes a syndrome caused by disruption of blood supply to the brain).
Research suggests that the virus may gain access to the brain via the forebrain’s olfactory bulb, which is important for the processing of smell. Loss of smell, as well known, is a symptom in many patients with COVID-19.
As part of the system responsible for your sense of smell, the olfactory bulb sends information about smell to be further processed in other brain regions including the amygdala, orbitofrontal cortex and the hippocampus, all which play a major role in emotion, learning and memory.
As well as having extensive connections to other brain regions, the olfactory bulb is rich in the chemical dopamine, which is important for pleasure, taste, intimacy, motivation and action. It may be that COVID-19 alters the levels of dopamine and other chemicals, such as serotonin and acetylcholine, in the brain, but we can’t say for sure yet. All these chemicals are known to be involved in attention, learning, memory and mood. It doesn’t matter if people get sick and supposedly recover. We know empirically that both HIV and Lyme disease have a strong effect on the brain and functioning. ￼The effects of COVID may also be very long lasting, based on emerging neuropsychological research.￼
Photo, Washington, DC Arboretum, 2019.
(statistics, courtesy of the Lancet medical journal and Embolden Psychology). ￼