Anger Displacement as a coping mechanism in the Pandemic

The following text is an excerpt of our upcoming book Emotional Frustration- the hushed plague.

—”Doctor…when I get home, I can’t help lashing out at the kids—so bad.”

Verschiebung. This German term can be translated as “shift” or “move.” It was used by Sigmund Freud to describe a psychological defense mechanism; it entails the shifting or displacement of an aggressive emotion from an important person or object into other ones that are less relevant and often lame. [i] Our patient had many situations of Emotional Frustration in her blue-collar job with her despotic boss and his unreasonable demands but, being a single Mom, she hid her anger towards him and the system, fearful of losing her job in tough  times. Often, she scolded her children a little bit too much for just some obnoxious but inconsequential pranks.

This unconscious defense mechanism is an expression of what Freud dubbed as the mortido—our basic aggressive drive. There are three main mechanisms:

  1. Displacement of object
  2. Displacement of attribution
  3. Bodily displacements.

Unfortunately, as we slowly come out of our forced Social Distancing and we interact much more with other human beings, we are loaded up with stress and, as a natural consequence, we will have a shorter fuse, easily snapping away. We will have a hard time containing ourselves, even with an act of mea culpa [ii], if we allow our emotions to get the best of ourselves in the mad frenzy for survival.

Note. This reproduction of Un episodio de la Fiebre amarilla en Buenos Aires, the great painting from our fellow Uruguayan artist Juan Manuel Blanes, was taken from Wikimedia Commons. Even though it is shockingly gory to watch, it does convey the message that there are many dangerous things that we can bring home and affect our families’ well-being – the virus is just the most lethal.

One of the most disregarded aspects of the Social Isolation that we have all been enduring for almost one year already is its serious emotional toll on us. Like the young women and men that went into isolation in a Florentine villa in the Decameron, those coming out of seclusion will not be the same ones that went in. There will be multiple changes in our societies, especially for labor opportunities. The economic analysts are already predicting that, besides the contraction of consumer spending due to loss of jobs, there will be a two-speed labor market.

On one hand there will be persons that can work at a distance, with little physical contact. But on the other hand, there will be those that will be dangerously exposed to contagion. This will bring a generalized angry mood in the street like we have never witnessed before. No longer will we be able to take for granted the barista’s familiarity when we arrive at our Starbucks; she might be too worried about being infected while mulling about her son’s day care. After her shift is over, she might be too stressed out to hang out with her girlfriends. A self-sustaining vicious circle.

Stay distant. Stay safe. Stay beautiful.


[i] Sigmund Freud, New Introductory letters on Psychoanalysis, George Allen and Unwin, London, January 1940,

[ii] This term in the Latin language refers to the ancient act of contrition of Christians in front of the Holy Cross when they beat up their chests while they publicly assumed responsibility for their sins or faults.

What do you think? Please tell us.

Don’t leave me alone.



Sexual Pleasure as a coping mechanism in the Pandemic

During the incredibly lengthy and tragic Pnndemic that we have been suffering from the worldwide Covid-19 infection, we have oftentimes discussed, in public and personal spheres, whether our sex life has improved or not due to the close proximity. The results are mixed, as many long-term happy couples have enjoyed it, while others with “less than friendly attitudes” toward each other have definitely hated it.

The fact that both members of a couple had to spend more time together at home has certainly frayed the nerves of all genders, as it always good to have “a little respite.” Now that the economy is slowly picking up in the USA, after the quasi-massive vaccination of almost 50% of the population and the corresponding lifting of the restrictive measures in public, many employees and professionals are reluctant to go back to the offices with the 9 to 5 presence. But others are only too happy to do it.

Of course the natural reaction is to ascribe this “enthusiasm to go back to the office” to Men, who were always looking for any kind of excuses to play “two-timing.” Even though there are not yet any reliable social and psychological studies about the changing dynamics of our (true) sexual lifestyles, there are some good indicators. One of them is that Women seem to be almost as enthusiastic to “hit the road again” to re-connect with friends, work buddies, etc., and pourquoi pas, a hidden flame.

One of the most radical aspects of the Pandemic’s aftermath is that Women, who have been bearing the brunt of keeping their homes functional under extreme duress, may no longer accept the same sex they used to. We discussed this in our new book Emotional Frustration-the hushed plague. We hereby present two excerpts from different sections of that upcoming book.

—”Doctor…Never had so many fab orgasms—not going back to same old.”

Wanda X. is a lovely middle-aged entrepreneur that had the misfortune of being surprised by the “staying at home” order in a business trip to a distant state. Fortunately, she had an old friend from college that gladly welcomed her to bunk. Unlike her, she was single and childless, which gave her a lot more sexual leeway.

One of the little perks of her friend’s lifestyle is to unabashedly recur to the use of a vibrator when she felt the irrepressible urge to satisfy her sexual desire. Reluctant at first, Wanda X. eventually relented, after a month of seclusion. Slowly she learnt how to handle it and at the same time learn more about her sexuality. When she would be finally able to return to her home, she is planning to sit down for a serious discussion with her partner. She will tell him that she is tired  of her culturally assigned role of a passive giver of love and that she wants the urgent addition of the role of active demander of love. Clear as a spring brook can be.

Note. This reproduction of Toulouse Lautrec’s Dans le lit- Le Baiser was taken from Wikimedia Commons.

The same chronic anxieties pervading the workplaces may foster a creeping loss of libido and eroticism in many blue collars’ bedrooms. On the other hand, women with a “hot” privileged spot in the upcoming New World Order will be less amenable to passivity, demanding equal rights inside and outside the bedroom. Moreover, after months of this pandemic and its Social Isolation, our nerves are so frayed that we are seeing in our offices a rising number of patients sick with a depression associated with high anxiety—the Post Covid 19 Anxiety Syndrome.

Note. This reproduction of Gustave Courbet’s Les amants was taken form Wikimedia Commons.

Has my world become dangerous? Will I keep my job? Will I find a partner? 

 Can I safely touch this person? Did I clean my groceries carefully enough?

We are just beginning to see (and experience) a radical re-engineering of erotic relationships.

Stay distant. Stay safe. Stay beautiful.

What do you think? Please tell us.

Don’t leave me alone.

Alcohol Abuse as a coping mechanism in the Pandemic

Did the Social Isolation during the Pandemic increase the use and abuse of Alcohol in the USA?

In a recent article of the Journal of the American Medical Association (JAMA) Rita Rubin stated that the generalized decision to keep the liquor stores open in the USA during the worst period of the pandemic (wrongly considered as “essential businesses”) had the unintended but grave effect of increasing its use and abuse by many segments of our society. She said: “…the immediate effects of alcohol abuse patterns have been increases in alcohol-related emergencies such as alcohol withdrawal, withdrawal-related suicides, methanol toxicity, and alcohol-related motor vehicle crashes.”

Moreover, the abuse of Alcohol might have worsened the clinical symptoms of the patients infected with Covid-19 because the virus impairs the normal immune defenses of the Respiratory System. an effect that the medical personnel treating the 1918 Influenza pandemic had already observed.

Note. This reproduction of Edouard Manet’s Un bar Aux Folies Bergères was taken from Wikimedia Commons.  

By Édouard Manet – Un bar aux Folies-Bergère d'E. Manet (Fondation Vuitton, Paris), CC BY 2.0,

If women often have borne the greatest brunt of the social and economic consequences of the dire Social Isolation and changes in the work/study parameters of their homes, did they abuse it too? We do not have yet a much needed segmentation of the data in a published paper, but we guess they did. As the dynamics of Alcohol Abuse in Women is different, we would like to present an excerpt of our upcoming book Emotional frustration- the hushed plague, to start the discussion. Here it is:

—”Doctor…Got to have a shot before I go to bed…Can’t sleep if I don’t!”

Carol X. is a divorced middle-aged mother of three that looks much older than her chronological age due to her chronic abuse of alcohol and smoking. Paradoxically she kicked her husband out of their house due to heavy drinking but his bottle—a callous counsellor of sorts—stayed behind in a cupboard’s top shelf. Like for many women, it started as a self-medication for her resilient depression and insomnia, furtively used at home, without nosy witnesses; slowly she became hooked on that habit, even after having Detox and joining Alcoholic Anonymous.[i]

A study [ii] by the National Institute of Alcohol and Drug Abuse shows that 60% of US women have at least one drink a year; 13% of the latter group have more than seven drinks per week. This level is above the “Dietary Guidelines for Americans” [iii], issued by the Health and Health Services Department.  Women’s bodies have less water than men’s ones, which makes it harder for them to disperse the toxic by-products in brain, liver, digestive tract, and kidneys. Even with small intakes, they are at a higher risk for car accidents and abuse.[iv]  Even though it is illegal in all states, underage women engage in it, especially in American colleges.[v] Alcohol temporarily blunts all the sensory input to the brain, which brings an illusory sense of relief; it enables the onset of the first superficial phase of the sleep process, but it decreases the duration of the REM phase. [vi]





[iv] National Institute on Alcohol Abuse and Alcoholism, Video presentation “Alcohol and the Female Brain”, presented by NIAAA Director Dr. George F. Koob, January 9, 2018.

[v] “Are women more vulnerable to alcohol effects?” National Institute on Alcohol Abuse and Alcoholism, No. 46, December 1999.

[vi] Soon-Yeob Park, Mi-Kyyeong Oh, Bum-Soon Lee, “The effects of Alcohol on Quality of Sleep”, Korean Journal of Family Medicine 2015 Nov; 36(6): 294-299

Stay distant. Stay safe. Stay beautiful.

What do you think? Please tell us.

Don’t leave me alone.




Longer lasting Immunity against Covid-19 from mRNA vaccines

A successful humoral response to any modern vaccination entails the creation of a high affinity and durable antibody response that will protect individuals for many years. For all those of us who have received the mRNA-platform vaccines—the Pfizer BioNtech or the Moderna brands—the question is: “How long will our protection really last?”

In an accelerated article preview—mechanism through which a paper of high public interest gets prioritized —of the prestigious journal Nature, Jackson S. Turner et al., from the Washington University School of Medicine, addressed this issue. They studied the induction of Antibody Secreting Plasmablasts (PBs) and Germinal Centre (GC) B cells by the two available messenger RNA-based vaccines at present.

They said: “we conducted an observational study of 41 healthy adults (8 with history of confirmed SARS-CoV-2 infection) who received the Pfizer-BioNtech vaccine…Blood samples were collected at baseline and at weeks 3 (pre-boost), 4,5,7 and 15 after the first immunization. FNAs of the draining axillary lymph nodes were collected form 14 participants (none with history of SARS-CoV-9 infection) at weeks 3 (pre-boost), 4, 5, 7 and 15 after the first immunization.” Do the mRNA-based vaccines induce significant antigen-specific PB and GC B cell responses?

They found that one week after the booster immunization, this vaccine induced a strong IgG-dominated antibody response in blood and that there were strong binding GC-B cell responses and PB responses in the lymph nodes’ aspirates from the 14 participants. These responses were initially detected after the first immunization, and they rose significantly after the second dosage. Compared to the humoral response to the seasonal flu-virus vaccination, these responses were higher in magnitude.

The authors said: “the persistence of S-binding Gc B cells and PBs in draining lymph nodes is a positive indicator of induction of long-lived plasma cell responses. Future studies will be needed to examine whether mRNA-vaccination induces a robust-S-specific long-lived plasma cell compartment in the bone marrow.” The authors admit that these are just preliminary studies that need much stronger scientific follow-ups. If the mRNA-based vaccines induce strong GC reactions, they will become critical tools in the fight against a pandemic that is still producing dangerous virus variants. Moreover, the rise of vaccine hesitancy in the USA and other nations, has to be remedied by increased delivery of good information to the public by the often “isolated, haughty scientists.”

Stay distant. Stay safe. Stay beautiful.

What do you think? Please tell us.

Don’t leave me alone.

Just a good vaccine will not magically fix the pandemic

Today, December 10th, an experts’ commission on vaccines from the Food and Drug administration (FDA) is reviewing the scientific data of the Pfizer-BioNtech vaccine candidate to eventually determine whether it is safe and effective against the COV-Sars 2 virus that has been producing this terrible pandemic we have been suffering for almost a year. As expected, we are all very hopeful that they will approve it.

In a recent paper in Health Affairs, A. David Paltiel—nominated by President-elect Joe Biden to join a group of experts to advise him on the pandemic’ cure—et al. warn us that there are other factors that will determine the vaccines’ effectiveness. They said that: “Using a mathematical simulation of vaccination, we find that factors related to implementation will contribute more to the success of vaccination programs than a vaccine’s efficacy as determined in clinical trials. The benefits of a vaccine will decline substantially in the event of manufacturing or deployment delays, significant vaccine hesitancy, or greater epidemic severity.”

In a June 2020 paper, the FDA stated that there are two pillars of vaccine efficacy:

  1. Ability to cut the viral transmission. The capacity of the virus to jump from an infected person to a healthy one and provoke the disease.
  2. Disease-modifying effects. The capacity to slow the progression of the clinical symptoms and to hasten the recovery process to save scant resources.

A good vaccine will have direct effects—preventing the spread of the virus—and indirect effects—reducing the infectivity of affected individuals. The FDA determined that there should be a transmission endpoint and a disease-modification endpoint. “Regardless of how a manufacturer defined their efficacy endpoint, the FDA also established a minimum efficacy threshold, specifying a primary efficacy endpoint point estimate of at least 50% to ensure—in FDA’s view—that a widely deployed COVID-19 vaccine is effective.” The determination of that relatively low efficacy—common in vaccines against influenza, a much less contagious and deadly disease—baffled many scientists, used to much higher FDA demands for vaccines. However, the terrible human, social and economic consequences of this pandemic might have exerted a deciding influence on the experts, desperate for a good cure.

In order to rigorously evaluate the efficacy of a vaccine, the experts must not only determine their usefulness to cut the transmission of the virus but also its beneficial effects to stop the progression of the disease in already infected individuals. Moreover the vaccine efficacy against the virus is just one of many factors at play.

These authors used mathematical models because they “asked how vaccine-related changes in susceptibility to infection, progression of disease, and severity of illness might translate into population outcomes of interest such as cumulative infections, hospitalizations and deaths. We explored how those downstream outcomes might vary in the face of alternative operational assumptions (e.g. the pace of scale-up and the degree of public acceptance) and changes in the epidemiological context.” The researchers used three different scenarios, based on the Rt reproduction number:

  1. Rt of 1.5, which represents the strict adherence to preventive measures.
  2. Rt of 2.1, which represents greater risk due to the winter weather and greater indoor activity.
  3. Rt of 1.8, which represents a baseline.

The Rt is the ratio of the infected and the potential victim of transmission; an Rt of 2.I means that for each infected individual, he/she will infect two other individuals.

The researchers utilized the Susceptibility-Exposed-Infectious-Recovered (SEIR) model, which considers the disease progression as “a sequence of transitions among a finite number of health states (or compartments)” First they divided the “infected” compartment into four well defined sub-compartments like this:

  1. Asymptomatic
  2. Mild (outpatient)
  3. Severe (hospitalized)
  4. Critical (hospitalized in an ICU)

Second, they account for the vaccination by creating a parallel set of compartments:

  1. Susceptible unvaccinated
  2. Susceptible vaccinated
  3. Exposure
  4. Infection
  5. Recovery
  6. Death

They studied three types of vaccines:

  1. Preventive vaccine. It decreases the likelihood of infection in a healthy person
  2. Disease modifying vaccine. It improves the health outcomes in infected persons.
  3. Composite vaccine. It combines the attributes of both types of vaccines.

For both types of vaccines they set the efficacy rate at 50% for both components; they examined ranges of 25 to 75% in sensitivity analyses. The time needed to reach effectiveness were considered to be:

  1. Fourteen days for fast acting, single dose
  2. Thirty days in the base case in two-dose vaccines with partial immunity after the first dose.
  3. Forty-two days for a two dose-vaccine with no efficacy after the first dose.

The effectiveness of a vaccine deployment drive does not only depend on the quality of the product per se but also on two implementation variables: pace and coverage. The researchers said: “In a population of 100,000 and at a baseline Rt of 1.8, the model projects 61,112 infections and 2755 cumulative deaths over the course of 6 months without a vaccine. Introducing preventive, disease-modifying and composite vaccines at baseline efficacy levels would result in 42,583, 39,767 and 1,199 cumulative infections and 1,896, 1318 and 1199 cumulative deaths, respectively.”

They found that a 50% effective disease modifying vaccine would have a greater impact on hospital admissions, clinical morbidity, and mortality than a 50% effective preventive vaccine. The impact of both vaccines would be similar in the worst epidemics but the disease modifying vaccine would have a bigger benefit in less grave epidemics. The 50% effective composite vaccine would have the best impact.

The researchers found that the potential benefit of any vaccine is highly dependent on the number of circulating virus at the time of its introduction in a community. When the viral spread, measured by the Rt factor, is relatively low, a vaccine with relatively low efficacy—for example 25%—has greater benefits on the morbidity and mortality rates that a much effective vaccine—for example 75%—introduced when the viral spread is relatively high. Where a vaccine lands, has consequences.

This study buttresses the opinions of many health care experts who are warning the public at large that only an effective vaccination drive with a good product will not magically erase the human, social and economic consequences of the pandemic. We must still continue to use the Social Distancing guidelines for many months to come.

Note. On December 10, the experts’ panel of the FDA recommended the Pfizer BioNtech vaccine for human use. On December 14, the first American citizen, an Intensive Care nurse in a Long Island hospital, was the first patient to get vaccinated. On December 17, the FDA panel will review the results of the Moderna vaccine. Let’s pray for the best!

Stay distant. Stay safe. Stay beautiful.

What do you think? Please tell us.

Don’t leave me alone.

Emergency Use authorizations for Covid-19 vaccine candidates

We are all extremely tired of the devastating health, economic and psychological consequences of the Covid-19 pandemic produced by the SARS-CoV2 virus. For the past few months, several scientific groups have been actively working in the design and preparation of vaccine candidates that will be both safe and efficacious. Recently we got very auspicious news from the Pfizer-BioNtech vaccine we had already discussed in a previous article.

On November 19, an article in The New York Times informed us that: “the drug maker Pfizer announced on Monday that an early analysis of its coronavirus vaccine trial suggested the vaccine was robustly effective in preventing Covid-19…The company said that the analysis found that the vaccine was more than 90 percent effective in preventing the disease among trial volunteers who had no evidence of prior coronavirus infection. If the results hold up, that level of protection would put it on par with highly effective childhood vaccines such as measles.”

Buoyed by these highly encouraging results, the companies are already talking about getting an emergency approval with the corresponding regulatory authorities. We have already discussed in another article how the deep public distrust of vaccination could undermine the generalized acceptance and eventual efficacy of a vaccine to cut the transmission chain of the virus in public and private spaces. A big challenge.

Do we have any recent scientific experience about provisional authorizations? Yes. In a comment published in The Lancet, Maxwell J. Smith et al.—after discussing the dubious validity of the Russian and Chinese vaccines that have not met the stringent regulatory controls of the Phase III clinical trials—said: “So why have the actions of Russia and China drawn such criticism? And how can other national regulatory authorities ensure that future emergency use authorizations for Covid-19 vaccines are issued in a way that is scientifically and ethically sound? Experience for emergency use authorizations for investigational Ebola virus vaccines in Guinea and Democratic of the Congo (DRC) can elucidate key lessons that can guide ethical emergency use authorizations for Covid-19 vaccines.”

In 2016, the regulatory authorities of Guinea granted a temporary authorization for an expanded access to the recombinant vesicular stomatitis virus (rVsV) vaccine that expresses the glycoprotein of Zaire Ebola Virus (ZEBOV) which induced and immunogenic response in the affected patients. Using a World Health Organization (WHO) protocol for scientific research ethics, the vaccine was approved for the individuals exposed to the Ebola-infected patients in a national vaccination drive. In the beginning of 2017, two other Ebola vaccines that were in Phase III of clinical  trials, but that were not yet licensed, were also approved for expanded access. In 2019 the Food and Drug Administration (FDA) approved these vaccines and in 2020 the European Commission followed suit, approving their medical use.

The authors state that there are two major differences in the regulatory requirements for the emergency approval of the Ebola and Covid-19 vaccines. First of all, the emergency authorization of the Ebola vaccines was done in an extremely transparent way. “The 2013-2016 outbreaks of Ebola virus disease in West Africa prompted WHO to develop an Emergency Use Assessment and Listing (EUAL) procedure to expedite the availability of vaccines.” This was meant as a guiding manual to engage the public discussion with representative institutions, media influencers and the general public about the unavoidable trade-offs in times of extreme social danger. Would the Guinean public be willing to accept “a little bit certainty” regarding the safety parameters for the concrete possibility of accessing a life-saving tool for millions of them, including children?  These authors stated that: “it is unclear whether these Covid-19 vaccines meet WHO manufacturing quality norms and standards, including whether the benefits outweigh the foreseeable risks.”

The second key difference is the disgusting chauvinism that “has infected” the larger public discussion of the many vaccine candidates, with most developed nations with the critical capacity to conduct clinical trials and to mass manufacture the product, fighting to be “the first one” to get the product to their citizenry and insisting of having early access to a vaccine before giving it to other less endowed countries. This resembles a “war with other means” and History has taught us that the first casualty in any kind of war is always the same: Truth. This geopolitical tug of war will compromise the access of poor citizens to the vaccines, with risks for us all. Moreover, can we really trust any product if we suspect that there are dark political interests behind its emergency use authorization? Talk of fear of The Deep State

Stay distant. Stay safe. Stay beautiful.

What do you think? Please tell us.

Don’t leave me alone.

Signs of Feminine Infidelity for dummies

Since the posting of our previous article about Clandestine liaisons in pandemic times, we have received a few discrete yet forceful email messages from our readers with varying kinds of commentaries. One of the most surprising has been the request of a manly reader (yes, men do read our page too) to share signs of wifely infidelity. Bowing to his request, we are sharing an excerpt from our new book Emotional Frustration – the hushed plague. Please remember that we are just re-transmitting “what others have said”, and it is not necessarily our opinion (sic)

Men brag about their affairs, but women—much better at histrionics as they internalize the script lines to give the illusion of veracity—are truly perfidious. For men, the feminine infidelity can be puzzlingly cryptic. What are its telltale signs?

  1. Suddenly having her cellular phone out of the reach of her partner.
  2. Excessively worry about her personal appearance.
  3. Make plans with “friends” that are unknown to her partner.
  4. Being unusually emotional and happy.
  5. Arrive home late from work and being hard to reach.
  6. The irrepressible impulse to hide her feelings.
  7. Being sarcastic and indifferent in her formal relationship.
  8. Lack of interest in her partner and common activities.
  9. Flirting with other men (or women) that might be old friends.
  10. Loss of libido and disdain for her partner. [i]

The last feature might be the easiest one to conceal, as supposedly women might be less keen on sex than men are, for which the latter often miss the mark. Antoni Bolinches said that some shrewd women before being unfaithful might fabricate a false couple crisis—based on real tenets or not—in order to buffer their guilt complex after their misdeed.[ii] Men are not the only ones having fun.  Esther Perel, a psychotherapist and author, said that since the 1990s, the number of women who have cheated in their couples increased by 40%.[iii]

A nugget of wisdom. Your wife stopped nagging you. Did the storm pass?  Beware. It is the eye of the hurricane before its outer ring comes crashing. Didn’t you notice that she cares more about her waistline and started a new diet? Didn’t you notice that she has some furtive chats in a phone unavailable to you? Didn’t you notice that she has new, exciting friends that are unbeknownst to you? Didn’t you notice that she works until late and comes back home with a smile?  Didn’t you notice that she seems absent-minded and hums ballads all the time? Didn’t you notice that she looks at you with a mischievous glint in her eyes? Didn’t you notice that even the family dog looks at you in a funny way lately?

Men try to callously conceal their transgressions by hook or crook.

Like a reverse-Sherlock Holmes, women blow clues to the four winds.

Usually women engage in adultery, not because they have “an irresistible urge for sex” like we men do, but rather because there are emotional frustrations that have been sapping her strength. If you want to find out how to remedy these situations, you might have to buy our new book…


[i] “Bajo Sospecha. 10 errores que cometen las mujeres infieles (y las delatan frente a sus maridos)” Entemujeres, Clarín, Buenos Aires, 23 Enero 2015.

[ii] “Vinculos” Ibidem as above.

[iii] Esther Perel “The State of Affairs: Rethinking Infidelity”, Harper Collins, New York, 2017.

Stay distant. Stay safe. Stay beautiful. 

What do you think? Please tell us.

Don’t leave me alone.

Clandestine liaisons in pandemic times

-“Doctor…Gave up all my social life, except my virtual dating – My daily dose of oxygen.”

Verónica X. is a successful lawyer with a stellar career in a competitive business realm who has a nice family that has backed her all along the expected ups and downs, including a supportive husband and two teenage daughters that admire her.  For all her personal and professional achievements, she still longs for the adrenaline shots she used to get in “her rather hectic days” as a college student in the 90s. She still keeps a roster of girlfriends from those times that meet with her once per year in order to remember their “wild times” and laugh all along a nice dinner outing.

However, what constituted an unexpected, and most welcome surprise, was the re-connection with an old flame that burned intensely for several months in her senior year. Due to the not-so-subtle pressure from the unwritten yet very influential rules of her starchy social milieu, she dumped him for “one of her own kind”, which she still resents in spite of her supposedly “perfect marriage.” Out of the blue, he found her in a Facebook page and send her an open invitation. Initially she considered dismissing him as a thing of the past, but she was curious. Extremely piqued.

In the beginning they were both skittish, talking inconsequentially about their old times and their present family structures, but slowly the talk became more erotic. After a several weeks-courtship in the web, they became de facto “spiritual lovers” again, openly dreaming about a future physical encounter. They are both professionals who, in spite of working largely at home during the pandemic, can still snatch some secluded time in their home offices for a chat almost anytime under the cloak of a pressing “business conference.” What used to be an escapade in the 9 to 5 regular working hours has shifted to the after-hours when the rest of the family is distracted with a Netflix series.

Feeling a little bit sated with the precious personal and professional objectives she had fought so hard to reach, Verónica X., like the central character in our novel, feels the irrepressible urge to shake her torpor and boredom. Hedonic adaptation is a psychological phenomenon whereby the initial excitement of a new situation, a new relationship, a new purchase, etc. slowly starts to wear down and we go back to our previous emotional state. Veronica was in the beginning very happy to take possession of a privileged social status that she would have never reached if she had married her former penniless boyfriend. But over the years, the joy of having a nice mansion in the suburbs, three cars in the driveway, spare money to splurge on shopping, eating out, vacations overseas, etc., all that begun to lose its initial shining and looked aged compared to the possibility of feeling a romantic thrill again.

As related by an article published on October 24 in Clarín, an Argentine newspaper, “a survey done in the site for the unfaithful called Second Love (they actually used the English term), 80% of the 989 participants confessed that the quarantine increased their desire to meet other people outside their stable relationship. But, at the same time, only 10% has materialized a date from the time the pandemic was declared (from a total number of 1102 cases)” The majority of respondents claim that they have maintained the rules of Social Distancing during their clandestine encounters. Only 36% of the respondents admitted using the videoconferencing to have some intimate moments with their paramours; paradoxically 32% of the respondents admit that their partners do know about their use of the social media.

Walter Ghedin, a psychiatrist and sex therapist in Buenos Aires, said: “the fantasy of an affair has surely come up some long time ago and it has most likely stalled as a mental elucubration without ever translating into an act…The ever enduring cloistering due to the pandemic has affected the sexual desire, especially in the couples that share the same residence…In fact those that are daring to try a tryst in the context of a pandemic might consider it as an excitatory stimulus that they cannot find in other activities.”

The predictable, safe alternative might not excite us erotically. But the mysterious stranger will make us dream.

Stay distant. Stay safe. Stay beautiful.

Note – The featured reproduction of Gustave Courbet’s Amants was taken from Wikimedia Commons.

What do you think? Please tell us.

Don’t leave me alone.

Anxiously awaiting the arrival of Ms. Right

For all those anxiously waiting for the arrival of a good vaccine so we can get readily inoculated and start the process of methodically cutting the transmission of the SARS-CoV-2 virus (most likely almost all the billions of humans on Planet earth) the news that two of the six major clinical trials have ben paused was bad news indeed. However, we must analyze these facts with the proper scientific light to understand.

In an article dated September 8, 2020, Katherine J. Wu and Katie Thomas informed the NY Times readers (like yours truly) that: “pharmaceutical company AstraZeneca halted large, late-stage global trials of its coronavirus on Tuesday because of a serious suspected adverse reaction in a participant, the company said.” As we discussed in our previous article, that clinical event was a case of transverse myelitis in a British participant that the researchers eventually determined was a coincidence and not an adverse effect of the studied vaccine. The clinical trial was resumed. However, the scientists in charge of the review board in the USA have not yet authorized the re-start of the same.

On October 12, 2020, Virginia Hughes, Katie Thomas, Carl Zimmer and Katherine J. Wu (her, again?) wrote an article in the NY Times saying: “Johnson and Johnson has paused the large late-stage clinical trial of its coronavirus vaccine because of an ‘unexplained illness’ in one of the volunteers, the company said on Monday.” We still do not have any information about that incident as it is under review at present. In their website, the company said that: “following our guidelines, the participant’s illness is being reviewed and evaluated by the ENSEMBLE independent Data Safety Monitoring Board (DSMB) as well as our internal clinical and safety physicians.”

We understand the natural reaction of so many people, including us for a brief moment, of despairing about this temporary setback, as we are all scared of the tragic consequences of the pandemic in our societies and tired of the Social Isolation. After that initial deception, we must understand that those trials were stopped precisely because the system of safety safeguards of the clinical trials does work. Whenever there is a major adverse clinical event, the administrators say, “hands off” and everybody along the long process of scientific evaluation must stop it quickly. Patients are still monitored but there is no drug administration until further notice. The institutional review board (composed of entirely independent scientists and clinicians) will take all the needed time to check each nook and cranny of the trial.

On October 16, 2020, Albert Bourla, Chairman and CEO of Pfizer, said in an open letter that: “we are operating at the speed of science. This means that we may know whether our vaccine is effective by the end of October. to do so, we must a certain number of COVID-19 cases in our trial to compare the effectiveness of the vaccine in vaccinated individuals to those who received a placebo. since we must wait for a certain number of cases to occur, this data may come earlier or later based on changes in the infection rates.”

Last Monday we were watching CNN at early dawn when Rosemary Church, its lovely presenter with a plum accent, announced that British scientists of the Imperial College were about to start a clinical trial that might provide the definitive answer as to whether a vaccine candidate has immunogenicity or not: a Human Challenge COVID study.  They chose19 previously immunized young participants that would be expressly exposed to the SARS-CoV-2 virus to determine whether their acquired immunity is sustainable for a certain period of time or not. Bravo for these heroes!

There is widespread skepticism about the safety of a future vaccine(s) in the USA, especially among various Minority communities that discreetly feel they are being used as “guinea pigs” to advance research. This cautious attitude might start to allay their reasonable fears, one step at a time. Congratulations for these corporate “johnny-come-lately” but nonetheless “never-too-late” opportune exercises in a long-in-coming Cultural Sensitivity prurience.

Like the lovely lady of this tableau, we are all anxiously peeking through the window for the arrival of Ms. Right. We intentionally used the Ms. article as “la vacuna” (vaccine) has a feminine gender in the Castilian language.

Note – The feature image, Déjà from Alfred Stevens 1862-1864, was taken from Wikimedia Commons..

Stay distant. Stay safe. Stay beautiful.

What do you think? Please tell us.

Don’t leave me alone.

Inborn errors of Immunity determine lethality of COVID-19

The COVID-19 pandemic has already claimed the life of more than a million human beings worldwide and the terrible human, social, labor, and economic consequences have not abated at all, changing our daily lives forever. The clinical manifestations range from an innocuous “cold syndrome” to the grave respiratory cases; the infection fatality rate ranges from 0.1% to 0.9% and the risk factors seem to be old  age, being male and co-morbid conditions like hypertension and diabetes.

However some patients, including younger people that do not carry the risk factors, seem to be especially susceptible to the infection, which has baffled the clinicians. Considering that some other grave respiratory diseases like Influenza pneumonia were shown to prey on some clearly defined genetic abnormalities of humans, several scientists and clinicians from many countries have established a virtual space called the COVID Human Genetic Effort to test the hypothesis that the lethality of the SARS-CoV-2 virus might be enabled by monogenic inborn errors of immunity.

In an article recently published in Science, Quian Zang, from Rockefeller University in New York City, Paul Bastard, from the Necker Hospital for Sick Children in Paris, and a long list of collaborators, genetically tested 659 patients with life-threatening COVID-19 pneumonia to find out if they showed the “rare variants of loss-of-function (LOF) at the 13 human loci known to govern TLR-3 and IRF7-dependent type I interferon (IFN) immunity to influenza virus.” First the investigators tested the hypothesis that the same genetic abnormalities that determine the increased lethality of Influenza Pneumonia might have a similar effect in grave COVID-19. They recruited 659 patients—74.55men and 25,5% women, 13.9% of whom died—from various ethnic and socio-economic backgrounds, aged between one month and 99 years; they had all been hospitalized due to life-threatening pneumonia.

They initially studied three loci—TLR3(6), IRF7 (7), and IRF9 (8)—that had been already shown to be mutated in patients with symptoms of Influenza pneumonia. They also studied 10 loci that had shown mutations in other grave viral infections. “We showed that PHA-driven T-cell blasts (PHA=-T cells) from patients with AR or AD IRF7 deficiency had low levels of IRF7 expression. We then isolated circulating plasmacytoid dendritic cells (pDCs) from a patient with IRF7 deficiency. These cells were present in normal proportions, but they did produce any detectable type I or III IFNs in response to SARS-CoV-2…” They found a relatively higher importance of the deficiency in the type I IFN production compared to type III IFN. They found the presence of neutralizing auto-antibodies against type I, but not type III IFNs in other patients with life-threatening COVID-19 pneumonia. Their studies suggest that “there might be type I IFN-related genes in other patients with life-threatening COVID-19 pneumonia. They also suggest that the administration of type I IFN may be of therapeutic benefit in selected patients, at least early in the course of SARS-CoV-2 infection.”

The tragic pandemic has spurred the creative imagination of thousands of scientists and clinicians across the world, which will bring innovative therapies to cure it. The addition of genetic based – therapies looks promising enough to foster their study.

What do you think? Please tell us.

Don’t leave me alone.