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SocietyApril 4, 2020

You aren’t the only one having buzzy Covid dreams

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Alex Casey speaks to a dream expert about why so many people are suddenly remembering their vivid and often horrible dreams.

As the days begin to blur together and the only thing we get between sleeps is unimaginably horrible news and an embarrassing tootle around the block, it’s no surprise that our dreams are getting weird. Tiny Elton Johns buying burgers at the food court. Being covered in spiders having sex with each other. Michael Bay-style scenes of disaster. I asked the people of the internet how they had been dreaming, and the answers were chaotic and mostly quite scary and sad. 

Margaret Bowater, 83, is the national secretary for the Dream Network and has been researching and writing about dreams for over 30 years. In her work she has seen the way that global events and collective trauma can increase the rate of nightmares and anxiety dreaming, from soldiers returning from Vietnam to the people who witnessed the collapse of the Twin Towers. Living through this current moment, she says, is no different. 

“Dreams tend to reflect our major emotional concerns, so at the moment a lot of people are anxious about their physical survival, whether they will have a job or not, feeding their families, being isolated from their usual social network, worried about family members they can’t get to,” Bowater says. “There is real reason for fear, so it’s not surprising that people’s dreams are activating feelings of anxiety from other points in their lives.”

Because after you eventually fall asleep listening to a soothing podcast about the killer virus, you lose control over what happens next. “The part of our brain that makes decisions gets switched off as soon as we enter REM, which is when we have the most dreams,” Bowater explains. “We are then operating on the emotions present in our mind, which connects us with previous examples of emotions we have felt from stories, films, experiences – anything.” 

After crowdsourcing a bunch of dreams, trends started to emerge. The first, and most obvious, was people dreaming about having Covid-19, with many waking up gasping, coughing or short of breath. “That’s clearly a direct fear of contracting the virus,” says Bowater. “In our dreams we can’t determine between what is real and what is not, so if you were feeling in the dream that you had caught an illness, you might well experience some of the bodily symptoms of it.”

“It’s not an abnormal response, but it’s not a prediction that you are going to get it either.”

Let sleeping dogs lie (Photo: Getty Images)

People who dreamed of being stuck on the toilet, pissing on the carpet or pooing in a food court in front of Will Smith all share another emotional concern. “The theme there is exposure and feeling embarrassed,” says Bowater. “That would be consistent with the feeling that if you leave your house right now, you are under surveillance but you are also at greater risk of literal exposure to the virus.” She was unable to shed any light on the specifics of the Will Smith appearance.  

If you are seeing family members or pets who have passed away in your dreams right now, that’s normal too. “That’s consistent with the general fear that some of us are going to die; the news is forcing us to face our own mortality,” says Bowater. “For those who haven’t done any serious thinking about death, this is an expression of the apprehension that death could be coming our way or for the people we love.” 

She explains that when you feel emotions of mourning and loss in the present, your brain will often pull up an old memory associated with those feelings. “If you lost a family member or a pet and felt very upset about it at the time, that feeling will stick in your memory and will come back up when you are facing the issue of death at present times. It shakes us out of our complacency, especially among young people in their 20s who think that they are immortal.” 

Nightmares about sleeping through a phone call, being late for a flight or missing a meeting are all rooted in genuine fears from our “new normal”. “A lot of people are dealing with new schedules and missing things at the moment. These dreams could be a reflection of your anxieties around that, or you could be putting yourself in the shoes of someone else in the population and living their experience.” 

Another vivid theme in people’s responses was the feeling of trying to shake something off your body, whether you are suddenly a big wet dog trying to get dry or a person inexplicably on a beach covered in frisky spiders. “That’s fair enough too,” says Bowater. “That’s just a metaphor to symbolise the avoiding of contamination, literally trying to shake off the thing you don’t want – the bug, the little particles that might be on you from someone who is infected.” 

But why does it feel like everyone is suddenly remembering all their dreams? That’s simple, says Bowater – it’s because most of us are slowing down in the morning. “A lot of people now don’t have to leap out of bed and run for a bus. If you’ve got more time when you wake up and you become aware of dreaming, you can remember more.” Beware, though, if you drink more than a couple of bevvies in a night, you’ll find you probably won’t dream at all. 

If you want to try and get a little more control over your dreams, try limiting your social media and practising better sleep hygiene. “I think the amount of news on social media tends to heighten the anxiety because everyone is worried all the time, particularly younger people who tend to wind each other up,” says Bowater. Her advice is to switch off your phone an hour before bed, and keep it in another room if you can. 

“It’s a matter of being sensible and trying to not let terrifying imagery swamp your mind,” she says. “You have to try and keep control of your own mind. There’s no need to be terrified, but there is room for rational fear. Go outside. Go for a walk, observe the cycles of nature. Appreciate the seasons, we have seasons of decline and seasons where things rise up again. This is like a tidal wave, it will eventually pass.” 

Test tubes with samples of blood being tested for COVID-19 (Photo: Robin Utrecht/SOPA Images/LightRocket via Getty Images)
Test tubes with samples of blood being tested for COVID-19 (Photo: Robin Utrecht/SOPA Images/LightRocket via Getty Images)

SocietyApril 4, 2020

The squeeze on healthcare in locked-down New Zealand

Test tubes with samples of blood being tested for COVID-19 (Photo: Robin Utrecht/SOPA Images/LightRocket via Getty Images)
Test tubes with samples of blood being tested for COVID-19 (Photo: Robin Utrecht/SOPA Images/LightRocket via Getty Images)

Medical centres across the country are condensing services, moving online and ushering in pandemic plans. Josie Adams assesses what it’s like to access and provide essential medical care under alert level four.

On Monday, Sandra Russell woke up before dawn and drove to Milford to get her blood tested. She has an incurable blood cancer, myeloma, and needs weekly tests to see if the injections she gives herself are working to build her immune system. If she contracts Covid-19 now, it could kill her.

She has a poor immune system, so is used to self-isolating. “I’ve had two stem cell transplants, and you have to isolate yourself for six months afterwards,” she said. “I’m not going anywhere, but the one place I have to go is Labtests.”

Her usual centre is Devonport, but under alert level four she must go to Milford. She drove in the dark to join a line that was already growing. Inside the clinic, paper towels marked with Xs dotted every odd seat, so patients would maintain physical distance. When it was Russell’s turn, she was ecstatic to see her usually Devonport-based phlebotomist, who told her she’d had to buy her own face mask.                                     

PPE not necessary

A release from Labtests last week stated that in order to protect the health of its phlebotomists, it would turn away patients with respiratory or feverish symptoms. When Russell attended the clinic on Monday, a young woman stood at the door screening patients with two questions: had they left the country in the past fortnight, and did they have any symptoms of Covid-19? She was employed by a security company, and was not medical staff. Russell saw her handed a jacket and t-shirt to wear during her shift, not a mask or gloves.

When approached, Labtests did not comment on specifics about its alert level four practices, but stated it had activated a pandemic plan that included limitations on the number of collection centres remaining open. In the statement, it said:

“There are a number of considerations with collection centre closures, including our ability to maintain safe staffing levels with the available personnel, our ability to operate in compliance with the requirements applicable during alert level four (such as physical distancing) and distribution of collection centres across the three Auckland DHB regions,” said a spokesperson. “The situation is developing rapidly and service levels are continually monitored.”

Labtests’ policies regarding personal protective equipment (PPE) are in line with current government guidelines.

PPE is not compulsory when taking blood (Photo: Getty Images)

According to the Labtests website, only 18 of its 60 Auckland clinics remain open. This is expected; many medical services are condensing or closing their services throughout lockdown, as only essential medical care will be provided face-to-face. For those with ongoing needs, blood testing will be available throughout alert level four. Home visits are only available to those with “urgent need“.

STIs going unchecked

Family Planning is one business that has turned off the lights in its premises nationwide. 

Rose Stewart, national nurse advisor at Family Planning, said that although clinics are physically closed, staff are still working. Phone consults are available, and patients can book in for one via the website.

Stewart said many services were still accessible. “We can fax through prescriptions, and we can offer doctor’s consults,” she said. “You can still access abortions, too.” This was a major fear for many, but Stewart confirmed hospitals are still performing terminations where required and Family Planning is still providing information to patients.

One thing Family Planning is unable to do during alert level four is offer shots. “If you have gonorrhoea, we can’t treat you,” said Stewart. (In most cases, gonorrhoea is treated with a single injection of an antibiotic and a dose of tablets.)  “But people probably aren’t spreading that right now.” 

You might not know you have an STI; Labtests is focusing on Covid-19 samples, so if you’ve had a routine check for an STI recently it likely hasn’t been processed. However, if you have obvious symptoms you can still receive treatment. “We can treat chlamydia right now,” said Stewart. The symptoms are easily recognised and the treatment is antibiotics by prescription.

Those with IUDs, implants, and depo provera shots about to expire will also have to wait until the alert level decreases to get these updated by Family Planning. “If you are due for your depo provera jab or for your implant to be changed, we will give you a prescription for the pill until we’re able to do face-to-face appointments again,” said Stewart.

Jane Morgan of the Waikato Hospital Sexual Health Service said New Zealand was facing a syphilis epidemic when alert level four occurred, and medical services were still committed to treating STIs during this period. Syphilis is a destructive, eventually lethal infection, and its symptoms can take up to three months to show up. “Not everyone gets symptoms,” said Morgan. “We are still able to do syphilis blood tests for anyone with symptoms that suggest syphilis or who were at high risk of getting syphilis in the last few months.”

Morgan said sexual health clinics and GPs would continue to offer services requiring face-to-face consults during this time, including gonorrhoea treatment and depo provera injections.

Not-so-general practice

The government has, more broadly, been directing healthcare providers to narrow their focus onto Covid-19. Three of Tāmaki Healthcare’s clinics — Airport Oaks, Henderson Specialist Centre, and St Lukes White Cross — are all now dedicated to testing for Covid-19. 

FlexiHubs, discussed briefly in Friday’s press conference with director-general of health Dr Ashley Bloomfield, are being rolled out in greater numbers. These are clinics that will triage patients and test for Covid-19 away from the main medical centre, so patients with non-Covid-19 essential needs can be seen in relative safety.

The minister of health David Clark and the director-general of health Dr Ashley Bloomfield give an update on the response to COVID-19

Dr Alistair Sullivan, the director of Urgent Care Tāmaki Health, said that although they were redirecting resources to combating Covid-19, keeping things essential-only was affecting operation. “Attendance numbers are down by 50-60%,” he said. “We have consolidated our clinic operations by closing a small number of sites.”

The government has just announced $30 million in funding for GPs and pharmacies, to support management of the Covid-19 workload and community-based assessment centres. This came just as the Royal New Zealand College of General Practitioners announced GPs are a workforce in crisis.

“Financial assistance for general practice and urgent care clinics is necessary in order to protect the availability of primary health services now, and for the future,” said Sullivan. “Together we ensure that patients get the medical care they need close to their homes, and that our hospital system is free to deal with more serious medical presentations.”