Health in a CyberSecurity Emergency

Disclaimer: This content is the result of my having survived several emergencies of varying effect sizes. Most of these ideas are rules of thumb, and not canned answers. As in any emergency your best outcome will be if you keep calm, consider many options, and flow from plan to backup plan as required.

Hospitals

Modern hospitals rely on computers for everything from taking vital signs and obtaining test results, to dispensing medication. Any of these systems could have cybersecurity intrusions that cause errors in reporting. Machine errors could cost lives, and catching those errors could be very difficult.

Methods for catching errors in machines at hospitals invariably involves double checking by doctors and nurses. Suppose that a machine gives vital signs. A nurse could make the rounds and double check blood pressure using a blood pressure cuff that does not rely on computers. Another way to double check is for multiple machines or doctors to vote on a result.

Additionally, since patients are really the best source of information, patients should alert doctors to any seemingly suspicious test results. In particular patients that have recently moved or who travel for medical care would be able to quote test results from other locations and compare them with local test results.

Health Emergencies

As usual, patients and by-standers are the first ones on the scene of any health emergency. In most cybersecurity emergencies, one should contact the first responders: EMTs, fire-people, and police-people. In some emergencies, the community would need to rely on basic first aid.

During a protracted emergency, health can decline in a population, due to anxiety and sleep disruption, and routine health emergencies can sky-rocket. If you are young, you might consider attending your community's first-aid training course. (Note: this is another instance where epidemiological data might be used to predict the presence of an emergency situation.)

Routine Physical Health

Constant stress takes a toll on the body. Under those conditions, common ailments might become worse, last longer, or occur more frequently. It is important to keep up with routine medical and dental appointments. Additionally, sleep hygiene, exercise, and keeping to a schedule can be critical to well-being. And, taking a break from your schedule can constitute rest and relaxation.

Take special care with any rare disease that needs constant attention, such as diabetes or auto-immune disorders. People with such diseases may be more prone to stress and anxiety. Also, these people likely have a more complicated disease course and treatment.

Indeed, doctors who practice traditional medicine in addition to western medicine may be particularly effective in such emergencies. These doctors would be trained to consult many sources of information in addition to results from machines.

Routine Mental Health

Mental health becomes somewhat more of a challenge in cybersecurity situations. In particular in instances where users travel to or from areas of cybersecurity emergencies, health professionals in other areas may not be aware of the existence of the emergency. Indeed, the users themselves may not be aware that they were exposed to unusual technologies or even know that they were in a region striving for peace.

Mental health professionals should be aware that unusual technologies can result in users telling unusual stories. Such stories would be rare occurrences in a non-emergency situation but would increase in prevalence in an cybersecurity emergency setting. For example, cyber-stalking may be unusually common. Cyber-fraud and cyber-identity-theft are two ways this can happen. Other infringements on personal privacy or security may occur, and it is important to remember that culture strongly influences whether these are actually 'infringements' or not. It is always important to respect local cultures and for health professionals to respect people who travel.

As another example, users may report new and unusual experiences with novel technologies of which they do not have control. Indeed, they may make these reports with a great deal of anxiety. Take a moment to imagine being a user that is exposed to a new and scary technology without their consent. Such an experience may well incite panic and result in true stories that sound delusional due to their novelty. In such cases, mental health professionals should avoid assuming that there is a biological mental illness and be extremely careful to consult the patients over-all health when making recommendations.

Indeed, it seems quite conceivable with modern technology that a person's speech center might be conditioned such that some form of EM radiation will result in a their speech center forming words. A technology like this would produce a user experience that is similar to organically heard voices, but would in essence be a technology problem. In many cases, relaxation and de-stressing can remove many of the effects of conditioning, although technologies that influence the brain may be ill-understood.

For example, if cell phone signals are conditioning the speech centers of users, it is natural to roll-back the phone network to an earlier version of wireless. In order for this to happen, the doctors who observe the health impact need to clearly communicate with their patients and the phone companies in order to prevent un-necessary harm. This clear communication only happens if the doctors suspend judgment about mental illness and really listen to their patient's user experiences carefully. If problems started with the roll-out of the 4G network, the medical establishment and the telecom companies are ethically obligated to communicate clearly on this issue and resolve it as quickly as possible.

Unfortunately, resolving such conditioning probably requires freedom from emergency stress and anxiety, which may not be possible while a person continues to live in an emergency environment. In these cases, it is crucial to consider time-scales of communication and prioritize believability. At the emergency location, your senses provide the best information, audible gossip from the community is second best, communication with the outside world may be unreliable and reliability can be promoted with older technologies. Ultra-fast time scale communications, particularly those which are difficult to say 'no' to are probably the least reliable for specific information content. However, the adept user can still learn to 'read the gossip network' and get a sense of the over-all situation. Ignoring the 'noise' of the ultra-fast communications is an extremely helpful strategy, and I have found that meditation and mindfulness can help far more than medications.

In many cases, the techniques of stress management that help people manage any emergency are helpful in cybersecurity emergencies. Anxiety is managed by relaxation and meditation. Keeping a schedule can help life feel predictable, and having routine metabolic events (eating, sleeping, exercising) will help a person keep to their schedule.

It is quite possible that mental health epidemiology data would be useful for identifying cybersecurity emergencies retrospectively. Perhaps the most sensitive users and the first to notice unusual user experiences and the first to report these anxiety-provoking experiences to mental health professionals. It is possible that these sensitive users might be 'canneries in the coal mine'.

Sleep

In an emergency, the issue of sleep is one of the most important. In order to reduce anxiety and keep a clear head, sleep is essential. However, in the presence of anxiety, sleep is often disrupted first, before other health issues appear.

How to promote sleep (i.e. sleep hygiene):

  1. Keep a schedule, going to sleep the same time every day, and waking at the same time. Try to schedule the most metabolically impactful events: eating, exercise, and sleep. When your body naturally rests at night and reminds you to eat, you have a strong circadian rhythm going. Even if you cannot sleep at night, please rest in the dark.
  2. Avoid drugs at all costs. A very old study shows a strong correlation between poor sleep and more prescription medications.
  3. Consider taking drugs for sleep on your worst nights of sleep. Most drugs promote sleep, particularly when taken rarely. Over the counter options include anti-histamines and cold medicines. Prescription options range from typical sleep drugs to anti-anxiety and anti-depressants. But take care with long-term use, as drug dependence is shown to worsen sleep over the long-term (see above).
  4. Coffee is avoided in the most stringent application of sleep hygiene, and over-dosing will likely impact the following night's sleep.
  5. Alcohol is avoided in the most stringent application of sleep hygiene.
  6. Preserve the bedroom for rest. Do not talk, watch TV, or argue in the bedroom. If a insomnia makes you angry at night, then leave the bedroom while calming down. Any association of strong emotion with your bed will disturb your rest.
  7. Good associations with the bedroom can be created by meditating, light reading, and music. All of these promote rest, even if sleep is difficult to achieve.
As you pursue sleep, please remember that a sleep-deprived body will revert to an ancient mechanism for sleep in emergencies: micro-sleeps. If you are very sleep deprived and find yourself forgetting things or loosing your train of thought, your body might be using micro-sleeps. Soldiers, in particular, will probably have become adapted to functioning in the presence of mirco-sleeps, but the rest of the population may not recognize this when it happens. Micro-sleeps produce strange effects that might be mis-interpreted as distraction, forgetfulness, or cognitive impairment. When this happens, the principle strategy is to slow down, don't commit to specific deadlines, and use a schedule to slow down and help yourself make progress towards your goals. The slower you proceed through a task, the more time you have to remember, to push away distractions, to push away anxiety, and to focus on the most critical goals.

It is important to remember that all these health issues are a natural part of an on-going cybersecurity emergency. Coping with health effects is critical for successful resolution of the emergency.


Homework

  1. Any time you feel fear or anger, take 5 minutes out to breath deeply. If you notice a friend having a fear reaction, encourage them to breath deeply. The panic reaction is an endocrine fight-or-flight reaction. It takes several minutes to biophysically calm the reaction. If you know meditation, this is the time to use it. If you can distract your fearful friend, do it. Ask them to name 5 green objects in the environment and then ask them to breath. Ask them to name their loved ones, etc. Some people find singing to be a helpful way to manage endocrine disruptions. Some people favor calming routines: making a cup of tea, pacing, talking out-loud, chewing gum, etc.
  2. Ask your neighbors, particularly the experienced ones, how they have promoted sleep during a difficult time in their life. Some of the old remedies for sleep work extremely well. Also, you will be promoting community, checking on your neighbor, and improving security all at the same time. (A watchful and respectful neighbor is critical for physical security.)
  3. Ask your neighbors and friends which doctors they like and which medical options have helped them with anxiety and sleep.
  4. Try to document the effect that micro-sleeps have on you, as they effect everyone differently. Communicate with your family and friends about how they can know that you are sleeping and when to be patient with you.
  5. Find an elderly neighbor, and help them complete a task in daily hbor, and improving security all at the same time. (A watchful and respectful neighbor is critical for physical security.)
  6. Ask your neighbors and friends which doctors they like and which medical options have helped them with anxiety and sleep.
  7. Try to document the effect that micro-sleeps have on you, as they effect everyone differently. Communicate with your family and friends about how they can know that you are sleeping and when to be patient with you.
  8. Find an elderly neighbor, and help them complete a task in daily life, such as grocery shopping. This will help your community, while also being a lesson in patience and slowing down for you.
  9. Schedule your routine medical appointments and show up: annual physical, biannual dental cleaning.
  10. Carefully consider your place of living and the devices that you routinely use. Smart-homes and smart apartment buildings, all of which are still in beta testing, would not be good places to live during a cybersecurity emergency. Also, in an apartment building, the sheer number of overlapping wireless router signals can produce strange health consequences for sensitive users. In particular, these signals could cause strange forms of conditioning, regardless of whether conditioning is an unintended consequence of the design or an actual attack. For example, cell phones held close to the head might accidentally condition the user's speech center. A particularly malicious attacker might purposefully change the technology to make such an effect stronger.

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