Monica Almendras and Erik Peper
For almost a year, we have managed to survive this pandemic. As we work in front of screen many people experience screen fatigue (Bailenson, 2021). The tiredness, achiness and depressive feelings have many causes such as sitting disease, reduced social contact, constantly looking at the screen for work, education, socializing, and entertaining, and the increased stress from family illness and economic insecurity. The result is that many people experience low energy, depression, loneliness, anxiety, neck, shoulder, back pain at the end of the day (Son, Hegde, Smith, Wang, & Sasangohar, 2020; Peper & Harvey, 2018).
Yet there is hope to reduce discomfort and increase by implementing simple tips.
Take breaks and take more breaks by getting up from your chair and moving. Taking breaks helps us to clear our minds and it interrupts any ongoing rumination we may have going on. Doing this helps a person be more productive at work or when studying, and at the same time it helps retain more information (Peper, Harvey, & Faass, 2020; Kim, Park, & Headrick, 2018). How many of you reading this actually take a short break at least once during work? We stay in the same sitting position for long periods of time, even holding off to go to the restroom. We tell ourselves ‘one more minute’ or ‘I’ll just finish this and then I’ll go”. Sounds familiar? We know it is not healthy and yet, we continue doing it.
Solution: Set a reminder every twenty minutes to take a short break. Download a program on your computer that will remind you to take a break such as Stretch Break (www.stretchbreak.com). Every twenty minutes a window will pop up on your computer reminding you to stretch. It gives you simple exercises for you to move around and wiggle as shown in figure 1. You can say it breaks the spell from staying frozen in one position in front of your screen. The best part is that yet is free to download on your computer. What more can you ask for?
Figure 1. Stretch break window that pops up on your computer to remind you to stretch.
Stop slouching in front of the screen. We tend to gaze downwards to our device and slouch, which creates tension on our neck and shoulders ((Peper, Lin, Harvey, & Perez, 2017). And yet, we still wonder why people suffer from neck-shoulder pain and headaches. It is time to make a transformation from slouching and feeling aches and pains, to an upright posture to be free of pain.
Solution: Use an UpRight Go 2 device on your upper back or neck is a great way to remind you that you are slouching (Harvey, Peper, Mason, & Joy, 2020). The UpRight is linked via Bluetooth to the App on the mobile phone, and once you calibrate it to an upright posture, you will see and feel a vibrate when you slouch. For people who are on the computer for long hours, this will help you to be aware of your posture.
If wearing a small device on your back is not your cup of tea, or perhaps it is not in your budget at the moment. There is a solution for this, and that means you can download the UpRight Desktop App on your computer or laptop (Chetwynd, Mason, Almendras, Peper, & Harvey, 2020). The desktop version uses the camera from your computer or laptop to monitor your posture; however, at the camera cannot simultaneous be in use with another program such as ZOOM. This version provides immediate feedback through the graphic on the screen as well as, an adjustable auditory signal when you slouch as shown in Figure 2. It is also free to download, and it is available for PC and Mac (https://www.uprightpose.com/desktop-app/).
Figure 2. Posture feedback app. When slouching, the app provides immediate feedback through the graphic on the screen (the posture of figure turns red) and/or an adjustable auditory sound (from: Chetwynd, Mason, Almendras, Peper, & Harvey, 2020)
Relax your eyes and look away from the screen. Many people struggle with dry eyes and eyestrain from looking at the screen for extended time periods. We log out from work, meetings, and class; to staring at the television, tablets, and mobile phones on our free time. It is a nonstop cycle of looking at the screen, while our poor eyes never have a single break. To look at the screen, we tightened our extraocular muscles and ciliary muscles; and the result is near-vision stress (Peper, 2021).
SOLUTION: The solution to relax the eyes and reduce eyestrain will not be to buy new eyeballs online. Instead, here are three easy and free things to reestablish good eyeball health. These were adapted from the superb book, Vision for life: Ten steps for natural eyesight improvement, by Meir Schneider, PhD.
- Look out through a window at a distance tree for a moment after reading an email or clicking a link
- Look up at a distant tree and focus at the details of the branches and leaves each time you have finished a page from a book or eBook.
- Rest and regenerate your eyes with palming (Peper, 2021). To do palming, all you need to do is sit upright, place an object under your elbows (pillow or books) to avoid tensing the neck and shoulders, and cover the eyes with your hands (see figure 3). Cup your hands to avoid pressure on your eyes and with your eyes closed, imagine seeing blackness while breathing slowing from your diaphragm. For five minutes, feel how your shoulders, head, and eyes are relaxing, while doing six breaths per minutes through your nose. Once your five minutes are up, stretch or wiggle around before returning to your work. For detailed instructions, see the YouTube video, Free Webinar by Meir Schneider: May 6, 2019.
Figure 3. Position for palming.
Implement these tips as an experiment for a week and note how it affects you. Many people report that after three weeks, they experience less pain and more energy. By taking charge of your own computer work patterns, you have taken a first e first step into transforming your health.
Bailenson, J. N. (2021). Nonverbal Overload: A Theoretical Argument for the Causes of Zoom Fatigue. Technology, Mind, and Behavior, 2(1). https://doi.org/10.1037/tmb0000030
Chetwynd, J., Mason, L., Almendras, M., Peper, E., & Harvey, R. (2020). “Posture awareness training.” Poster presented at the 51st Annual meeting of the Association for Applied Psychophysiology and Biofeedback. https://doi.org/10.13140/RG.2.2.20194.76485
Harvey, R., Peper, E., Mason, L., & Joy, M. (2020). “Effect of posture feedback training on health”. Applied Psychophysiology and Biofeedback. 45(3). https://DOI.org/10.1007/s10484-020-09457-0
Kim, S., Park, Y., & Headrick, L. (2018). Daily micro-breaks and job performance: General work engagement as a cross-level moderator. Journal of Applied Psychology, 103(7), 772–786. https://doi.org/10.1037/apl0000308
Peper, E. & Harvey, R. (2018). Digital addiction: increased loneliness, depression, and anxiety. NeuroRegulation. 5(1),3–8. doi:10.15540/nr.5.1.3 https://www.neuroregulation.org/article/view/18189/11842
Peper, E., Lin, I-M., Harvey, R., & Perez, J. (2017). How posture affects memory recall and mood. Biofeedback.45 (2), 36-41. https://doi.org/10.5298/1081-5937-45.2.01
Peper, E. (2021). “Resolve eyestrain and screen fatigue.” Well Being Journal,.30, Winter 2021 https://www.researchgate.net/publication/345123096_Resolve_Eyestrain_and_Screen_Fatigue
Schneider, M. (2019. YouTube video Free Webinar by Meir Schneidere: May 6, 2019.
Son. C., Hegde, S., Smith, A., Wang, X., & Sasangohar, F. (2020). Effects of COVID-19 on College Students’ Mental Health in the United States: Interview Survey Study. J Med Internet Res, 22(9):e21279 https://doi.org/10.2196/21279
At the moment the United States and the rest of the world are participating in an unprecedented experiment of being vaccinated for COVID-19 to end the pandemic without completely knowing long-term risks. The Federal Drug Administration (FDA) has authorized the emergency use for the vaccine based upon clinical trials that showing that the vaccine is highly effective in reducing or preventing COVID-19 disease and morbidity (FDA, 2021). Because it is an experimental procedure, it is necessary to monitor and follow-up everyone who is vaccinated in order to identify possible rare complications that could occur in the future. What has been reported is a very rare complication of anaphylaxis that may occur immediately after administration of the vaccine by Pfizer-BioNTech (4.7 cases per million) and Moderna (2.4 cases per million) (Shimabukuro, Cole, & Su, 2021); however, this data may under report the actual negative side effects. In the recently published prospectively study by Blumenthal et al. (2021) of 64,000 employees associated with Mass General Brigham (MGB) were actively followed through a multipronged approach including email, text message, phone, and smartphone application links. The complication rate of acute allergic reaction rate was 2.1% and the severe anaphylaxis reaction was 247 cases per million. This is 50 times higher than the previously reported results which depended on voluntary reporting instate of active all participants follow-up. Nevertheless, the benefits of vaccination far outweigh the risk of anaphylaxis, which was experienced within the first 15-30 minutes after the vaccination and treatable. What is disturbing is that at this moment, the USA does not have a systematic long-term follow up strategy for all the people who vaccinated to identify possible delayed long-term side effects since it depends upon voluntary reporting, however, rare. Thus, we are all part of an uncontrolled experiment in which I am also participating.
At the age of 76, I choose to be vaccinated after having assessed the risk-benefits reported in the published clinical studies (the possible harm caused by Covid-19 would be significantly worse than the possible harm caused by the short and long term side effects from the vaccine). It was confusing and challenging to figure out where the vaccinations were being offered. Luckily, I searched online to find a location where I could sign up to make an appointment for the first vaccination. After having successfully navigated signing up and getting an appointment for Thursday, I contacted the older couple who live nearby and asked if they already had a vaccination appointment. When they told me that they were unable to find a location, I shared with them the information for signing up on the website.
After having received the vaccination, I installed the V-safe app in my cellphone and answered the questions on the App survey; however, to participate, I had to opt in instead of having to opt out. Later on Thursday, I received the first text message from V-safe to which I responded by answering the short symptom questions. I reported that the site of the vaccination felt sore and tight and whenever I lifted up my left arm, I felt a dull ache and stiffness. It was slightly more uncomfortable than I had experienced two years earlier from a tetanus and diphtheria (Td) vaccine injection. That night I could not sleep on my left side since the deltoid area continued to feel sore and painful to pressure. The next day, I worked and did not look at my text messages. On Saturday morning, I realized that I had not responded to Friday’s check-in text message from V-safe. When I tried to response, the survey link embedded in the text message no longer worked. Thus, my discomfort that continued through Thursday night and Friday was not reported to the CDC.
As I still felt some slight tenderness, I also wondered how the older couple were doing since they had received the vaccine on the same day as I did. I called them to check on how they were doing and see if they had signed up with V-safe. They responded that they were doing well except for some soreness in the upper arm; however, they had not signed up for V-safe.
This experience brought to mind studies finding that when follow-up information depends voluntarily opting in, most people do not opt in. Thus, the follow-up data and reporting of possible negative side effects will be less reliable since it would reflect only a small subset of all the people who received the vaccine and are tech savvy. The CDC needs to revise their tracking strategy so that it is able to survey accurately the occurrence of side effects from everyone who gets vaccinated by enrolling them, unless they choose to opt out.
- Enroll people automatically unless they personally decide to opt-out. The enrollment process should be organized so that when an individual receives the vaccine, they automatically are enrolled. Automatic enrollment leads to much higher participation than a voluntary opt-in approach. The difference in participation has been demonstrated in many settings ranging from organ donations to signing up for 401K retirement plans. For example, in Austria, organ donation is the default option at the time of death, and people must explicitly ‘opt out’of organ donation. “In these so-called opt-out countries, more than 90% of people register to donate their organs. Yet in countries such as U.S. and Germany, people must explicitly ‘opt in’ if they want to donate their organs when they die. In these opt-in countries, fewer than 15% of people register” (Davidai, Gilovich & Ross, 2012). Similar results have been observed in employees’ enrollment in 401K saving plans (Nash, 2007). For example, in analyses of recent hires by Fortune 500 firms, 85.9% of new hires will participate in a 401 K retirement plan when they are automatically enrolled versus 32.4% if they have to voluntarily enroll (opt –in).
- The V-safe app needs to allow symptom data to be reported after the deadline. There needs to be an option to allow a delayed response. In addition, if the person did not respond to the automatic survey, the person needs to be contacted to identify the cause of the non-response.
- Longterm follow-up to monitor for possible adverse effects needs to be implemented. The minimum follow-up period needs to be two years to be able to monitor possible adverse effects that may be triggered by the vaccines. In theory, this could include “antibody-dependent enhancement” to another virus. This occurs when the immune response that has been previously activated makes the clinical symptoms worse when the person is infected a subsequent time with a different type of virus and that trigger an over-reaction, creating a cytokine storm. For example, when a person gets dengue fever and is infected a second time by a different strain of dengue, the person becomes much sicker the second time (Murphy & Whitehead, 2011). Some researchers are concerned that the vaccine in the future could cause an excessive immune reaction when exposed to another virus.
Without automatic enrollment and follow-up, the short and long-term general public safety data may be unreliable and will not accurately capture the actual frequency of side effects. The reported data may under report the actual risk. When independent researchers investigated medical procedures they often find find the complication rate three-fold higher than the medical staff reported. For example, for endoscopic procedures such as colonoscopies, doctors reported only 31 complications from 6,383 outpatient upper endoscopies and 11,632 outpatient colonoscopies. The actual rate was 134 trips to the emergency room and 76 hospitalizations. This discrepancy occurred because the only incidents reported involved patients who went back to their own doctors. The research did not capture those patients who sought help at other locations or hospitals (Leffler et al., 2010).
The data reported by the cellphone web-based app V-safe may represent possibly only 20% of the people vaccinate, biased to those who are healthier, more affluent, younger, and technologically adept. In order to be able to sign-up for V-safe and respond to the text messages, the person needs to be tech savvy, have a cellphone, and be able to respond to the text message during the same day the message is send.
Blumenthal, K.G., Robinson, L.B., Camargo, C.A., et al. (2021). Acute Allergic Reactions to mRNA COVID-19 Vaccines. JAMA. Published online March 08, 2021. https://doi.org/10.1001/jama.2021.3976
CDC (2021). V-safe After Vaccination Health Checker. Centers for Disease Control and Prevention (CDC). Accessed January 30, 2021. https://www.cdc.gov/coronavirus/2019-ncov/vaccines/safety/vsafe.html
Davidai, S., Gilovich, T., & Ross, L. (2012). The meaning of default options for potential organ donors. Proceedings of the National Academy of Sciences, 15201-15205. https://doi.org/10.1073/pnas.1211695109
FDA (2021). COVID-19 Vaccines. Accessed January 30, 2021. https://www.fda.gov/emergency-preparedness-and-response/coronavirus-disease-2019-covid-19/covid-19-vaccines
Leffler, D.A, Kheraj, R., Garud, S., Neeman, N., Nathanson, L.A., Kelly, C.P., Sawhney, M., Landon, B., Doyle, R., Rosenberg, S., & Aronson, M. (2010). The incidence and cost of unexpected hospital use after scheduled outpatient endoscopy. Arch Intern Medicine, 170(19), 1752-1757. http://archinte.jamanetwork.com/article.aspx?articleid=226125
Madrian, B. & Shea, D. (2001). The Power of Suggestion: Inertia in 401(k) Participation and Savings Behavior. ”Quarterly Journal of Economics, 116(4), 1149-87. http://www.jstor.org/stable/2696456
Murphy, B.R. & Whitehead, S.S. (2011). Immune response to dengue virus and prospects for a vaccine. Annu Rev Immunol., 29, 587-619. https://doi.org/10.1146/annurev-immunol-031210-101315
Nash, B. J. (2007). Opt in or opt out? Automatic enrollment increases 401(k) participation. Region focus, 28-31. https://core.ac.uk/download/pdf/6670505.pdf
Shimabukuro, T.T., Cole, M., & Su, J.R. (2021) Reports of Anaphylaxis after Receipt of mRNA COVID-19 Vaccines in the US—December 14, 2020-January 18, 2021. JAMA. Published online February 12, 2021. https://doi.org/10.1001/jama.2021.1967