We welcome back ESA-sponsored Dr Stijn Thoolen, as he continues his tales of life at the Concordia research station in Antarctica, in the harsh environment of the world's southernmost continent. If you have missed them, do check out his earlier blogs, complete with wonderful photos - Part 1, Part 2, Part 3, Part 4, Part 5  

Dr Stijn Thoolen​
​Medical Research Doctor, Concordia Research Station, Antarctica
​Concordia, July 10, 2020
Sunlight: none
Windchill temperature: -84°C
Mood: still OK

The Antarctic winter solstice is special. As the Earth’s south pole is maximally tilted away from the Sun and the longest night falls over the southern hemisphere, people everywhere and since prehistoric times gather in tradition to celebrate the change of season and welcome the return of sunlight. But for a bunch of lost scientists and technicians on the Antarctic continent, that longest night lasts much longer. They won’t see any Sun for another one-and-a-half months. For them, mid-winter marks not just the gradual return of daylight, but much more so the midpoint of an extraordinary nine-month winterover adventure.
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So it is an important moment. A time for celebration and for reflection (or perhaps just celebration…). To me it looks a little like Christmas, or New Year’s Eve, but with a twist perhaps (we are winteroverers, after all). Presents, dinners, parties, and (digital) mid-winter greetings from all the other Antarctic stations, kindly inviting us to come over to celebrate together. ‘The door is always open’, ‘generous parking space for motor vehicles and sledges’, ‘plenty of accommodation with ice sea vistas’, ‘bring your sleeping bag’, ‘COVID-19 free’. Anyway, you get the much-needed humour.

At first I wondered: being here only for about half a year now, how can such a completely new thing already hold such importance to people? No ritual, no guidelines, no one really knowing how to celebrate it, and yet the expectations are high in our crew, and the ideas plentiful. But looking back I have to admit: mid-winter is a beautiful tradition, even though never celebrated before…

While hints of daylight can be spotted on the horizon around noon, there won’t be any sun for another one-and-a-half months.
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Winter can be harsh, without sunlight, far away from home, and with the same twelve people, for such a long time. And even in such an interesting and beautiful place, also I have recognized a few moments of disappointment. I guess, with all those different backgrounds and being the only Dutch around, it is not always easy to feel understood. Or perhaps it is just me who is getting a little less tolerant, in higher need for emotional support. And while that doesn’t make life always easy here, I recently read a beautiful sentence:

‘Do not worry that others don’t understand you. Rather worry that you don’t understand others.’

Can we still bring up that flexibility to try to understand each other, in a world where we are tempted to blame our problems on all but ourselves? On the ethical playground of Concordia, where walking away is out of the question and a lack of group cohesion can have direct consequences to our own wellbeing, I like to believe it is essential. And wasn’t this exactly what I was here for? To learn to become a better person?

With such thoughts in the back of my mind and realizing we still have another half to go, mid-winter then becomes the perfect excuse to work a little on ourselves. To do an extra effort for each other, give rather than ask, and just share some fun. To collaborate in a positive way to get closer as a group, building that tolerance for each other again, and making us all a little more willing to see the best in each other. And as such, music went back on loud again, and we went to work…

Brazilian night complete with exotic travel stories (you can imagine how popular these become here) and table soccer tournament, quiz night, cheesy fatty Alpine dinner, ‘kermesse’ games event including prizes to win, a spa (our hospital doctor decided that we could give the hospital a better use for the winter months), the first Antarctic championship of the traditional Italian game ‘Ruzzolone’ (Google it, and let your imagination do the rest), and, for once this year, an opportunity to actually go out for dinner (we eat in the same room all year long) in our ‘McDome’ fast-food restaurant (you may know it better as the astronomy shelter…). Ordered by radio and served upon arrival. Burgers, chips, milkshakes, and amazing reactions from the rest of the crew: everything a deprived winteroverer needs!

Mid-winter was great! Each of us participated to organize some of the festivities, and it kept us busy for sure. We celebrated five days full of the most ridiculous activities, and we were all exhausted afterwards. I guess that all these efforts may seem trivial back home, and the details may not look like much from the outside, but here I feel it is pretty important to us. These ridiculous activities bring variety, make us smile, and get us fueled up for another four-and-a-half month together. These will become the memories that we take home after a year on ice, and I think that makes mid-winter worth all the effort!
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It makes me wonder how I will feel after a yearlong of practicing the much-needed tolerance and social consciousness here in Concordia: do we put the same amount of effort in each other at home?

ESA-sponsored Dr Stijn Thoolen, currently spending 12 months at the Concordia research station in Antarctica, presents the next blog in his series recounting tales from his time spent in the harsh environment of the world's southernmost continent. What an amazing experience - do take a look at his previous blogs (Part 1, Part 2, Part 3, Part 4) to follow his great adventure! 

Concordia, April 7, 2020
Sunlight: about 10 hours
Windchill temperature: -72°C
Mood: just fine

It is quite strange to be here, on the only continent not affected by the corona virus. To me, with everything that is currently going on in the rest of the world, it makes feel even more distant than we already are. Here, life just goes on, and although it has not been easy for some of us either, not being able to share in these experiences or provide support at home to those who could use it, messages are now suggesting that we are suddenly the ones better off!
And I have to admit indeed. Even though we are stuck here for nine months without any possibility for evacuation, with limited resources, a disrupted work/leisure balance, a threatening environment outside, both environmental and social monotony, and a group of relative strangers that come from all sorts of backgrounds (reading this I guess the situation for you may perhaps not be so different), at least we came here by choice…

So let me start with saying that I really hope you are doing well. Being isolated and confined comes with all kinds of stressors, deviations from the normal situation you could say, that ask our body and mind to adapt. Given the sudden disruption that the Corona outbreak has caused to all of you, I imagine that is certainly not easy.
And while our experiences are so different, and even though I feel probably as ignorant as you about how to deal with all those stressors (we have just been left to ourselves two months ago), perhaps this is a good time to share with you some of my own thoughts about isolation at Concordia.

A while ago I came across a story about the 1897-1899 Belgian Antarctic Expedition, which I found quite illustrative for what I have considered to make my winterover a happy one this year. At the time the Antarctic was still mostly unknown territory. The south pole was not yet reached, and the unforgiving environment made many expeditions end in disappointment. Aimed for exploration and for science, this one was no exception. When their ship the Belgica got stuck in the pack ice of the Bellingshausen Sea, the 19-member crew became the first in human history to winterover below the Antarctic circle, and as such you can imagine they were badly prepared to do so. It must have been pretty difficult, I imagine. Expedition doctor Frederick Cook described depression, irritability, headaches and sleeplessness among the crew, and basically provided a first recorded description of the so-called ‘winterover syndrome’.

The strange and extreme Antarctic environment, just like in space, indeed has a strong capability to upset our system. Symptoms like fatigue, headaches, sleep disturbances, impaired cognition, negative emotions such as depression, anxiety and anger, and interpersonal conflicts have all been observed in polar dwellers. Such symptoms are usually more prevalent during the harsh winter months, when stressors are highest. Hence the ‘winterover syndrome’. For the winterover crew of 1898, Dr. Cook reasoned that what they needed that was the opposite of that harsh winter environment. Apparently with good effect, he prescribed them a diet of milk, fresh meat (poor penguins) and cranberry juice, as well as exercise, warmth and light. Interesting I think, not necessarily his particular ‘baking treatment’ of having the crew sit naked around an open fire, but the way it shows how dependent we are on our environment, and our limitations to adapt. In other words, to facilitate adaptation, we may want to create an environment that is more familiar to us.

For here in Concordia, or perhaps for something as different and unexpected as a Covid-19 lockdown, I like to think the idea is quite similar. I therefore try to maintain a daily rhythm full of activities that mimic a little bit the world we come from. I try to wake up and go to bed at regular times to promote sleep and maintain a functioning biological clock (without sunlight it relies even more on social clues), and while I restrict myself as much as possible from bright computer screens in the evening hours, an artificial daylight is standing by in my office for the darkest months. Elisa, our cook, is making us pretty balanced meals twice a day, and even though I have to admit I eat a lot here (altitude plus cold equals many burned calories), I take vitamin D in addition to make up for the lack of sunlight. About three times a week I visit the gym (it got a little too cold outside) to stimulate myself physically, and if not working, sleeping, eating, or exercising, I try to stimulate my senses by an impact from the magnificent world outside, playing games together, or reading a book. Socially, I try to stay connected with my friends and family at home, and with the crew we regularly have video connections with schools for outreach purposes, and even with each other’s families. We are social beings after all, and we may easily become lonely if we don’t feel part of the group (whichever group that may be…). Finally, to relieve some of the excess amount of stress here, I try to practice meditation each morning, and for the same reasons we have our sauna (yes, sauna) open on Sunday’s. Perhaps it really is a paradise…

We welcome another blog by ESA-sponsored Dr Stijn Thoolen, currently spending 12 months at the Concordia research station in Antarctica conducting experiments. What an amazing experience - do take a look at his previous blogs (Part 1, Part 2, Part 3) to follow his great adventure to the world's southernmost continent. 

Concordia, February 7, 2020
Sunlight: 24 hours (but not for long)
Windchill temperature: -45°C
Mood: a little roller coaster
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At this moment I am just plain excited. Next to me the rest of the DC16 crew are having their own emotions. Our freshly inaugurated station leader Alberto, draped in the colours of our three national flags, came up with the idea to have our national anthems playing while the last Basler plane of the summer campaign leaves Dome C. So here I stand, hearing my own voice on maximum volume pronouncing a Dutch translation of too patriotic sentences from the station’s speakers, and with the Dutch ‘Wilhelmus’ screaming over the Antarctic plateau as an official start of our winter over. Haha, such an unrealistic scenario! And while those sounds are quickly overruled by the roaring engines of the plane, and with snow blowing in our faces, I can only smile. There goes our last connection to the rest of the earth, disappearing into the distant sky. Unbelievable!

I guess I have already spilled all of my emotions at this point. In the past few days, more and more planes have been taking away more and more of the beautiful people we enjoyed our summertime with, and the station has become more and more empty. Funny: they were already leaving, and I have the idea we just started… It has been an exciting idea on the one hand, but the closer we came to being left alone, the more and more confronting that got on the other. When two days earlier another plane left with sixteen more people, the goodbyes were harsh, with everyone in tears again. You know, those healthy ones. And when it was gone, those left on the ice slowly returned back to the station, all silent, all caught in their own thoughts. It had been an intense few summer months, and this was the weird moment of realization that it had come to an end, with a big unknown lying ahead. I guess the blend of feelings has been a repetition of those during the days before my departure to the Antarctic. Perhaps a little lighter this time.

The Antarctic continent is considered to be one of the most realistic analogues found on Earth of the situations of extreme isolation and confinement experienced in space. Since 2014, we have been conducting at the Belgrano II Argentine Antarctic Station the project "Chronobiology of Antarctic Isolation: the use of the Belgrano II Station as a model of biological desynchronization and spatial analogue", also known as “Belgrano to Mars”. The project aims to explore the impact of a year of isolation on different physiological, psychological and social variables. In particular, we are interested in studying how biological rhythms are affected by the lack of natural light during the four months of polar night typical of that latitude. The study of the chronobiological responses to extreme isolation increases our understanding of the physiological mechanisms underlying human biological rhythms, with applications in space exploration or other highly demanding professional settings, as well as in human health.

The Belgrano II Antarctic station consists of a series of scientific research facilities located approximately 1,300 km away from the South Pole at 34°S, 77°W. It is the most southerly Argentinian station and one of the three southernmost permanent stations on the planet. The temperature ranges from 5°C to 48°C below zero. One feature of this station is that, due to its latitude, it has four months of continuous sunlight, four months of twilight and four months of polar night. The station crew is composed of around 20 men. To generate a light-dark cycle during the summer, windows with blinds closed are used, in accordance with a normal sleep routine, while using eye covers during the night if necessary. Exposure to ultraviolet light is also stronger and sunglasses for external work are mandatory. Conversely, in the wintertime, the light-dark cycle depends entirely on artificial light. Schedules with well-defined times for meals (breakfast, lunch and dinner) work and rest are paramount in Antarctic stations.
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“Belgrano to Mars” is a collaborative project in which researchers Camila Tortello and Santiago Plano (UCA-CONICET and UNQ) participate in the analysis and interpretation of the information and Juan Manuel Cuiuli (Joint Antarctic Command) in the scientific coordination between Buenos Aires and Antarctica. Other members of the project are Marta Barbarito (Argentine Antarctic Institute), Diego Golombek and Patricia Agostino (UNQ and CONICET), Agustín Folgueira and Juan Manuel López (Central Military Hospital), and Guido Simonelli (University of Montreal). Field work during isolation is carried out by physicians from the wintering crews at the station and staff members that volunteer for the study. Antarctic scientific activity is coordinated by the National Antarctic Directorate (DNA), which together with the Joint Antarctic Command, provides the logistics of the bases.

This year, we have traveled to Antarctica to supervise the implementation of the Belgrano to Mars project in the field, to test measurement instruments and to train the crew in the use of the equipment and software. The trip demanded six weeks of navigation in the ARA Almirante Iríza icebreaker. In addition, we started working with the European Space Agency (ESA) in the operational test of the Telemedecine Tempus Pro equipment, under the framework of an ESA-CONAE-DNA agreement. The project, led by Dr. Víctor Demaría-Pesce, from ESA's European Astronaut Center, involves conducting operational simulations in a situation of extreme isolation and confinement, which will contribute to the design of a definitive prototype to be used by astronauts and medical teams during future space missions to the Moon and Mars. The equipment will be tested at Belgrano II (Dr. Bruno Cauda and Enf. Luis Almaraz) and Carlini (Dra. Melina D'Angelo and Enf. Gustavo Cruz) stations, through six simulations that will recreate medical scenarios similar to those encountered by astronauts in space.

We have recently published in the journal Scientific Reports (from the Nature Group) data regarding changes in the sleep-wake cycle during a winter campaign at Belgrano II. We observed that during the polar night the subjects tended to go to bed one hour later and sleep one hour less. A possible explanation is that this is due to the lack of exposure to natural light, since bright light acts as a synchronizer of our biological rhythms. This loss of sleep was somewhat compensated by naps, which were longer during that time of year.

These results show us how biological rhythms can be desynchronized in periods of prolonged confinement, such as the ones we have had to go through during the quarantine periods instituted in different countries. Moreover, it highlights the importance of exposure to natural light in the morning and darkness during the night and maintaining fixed activity and rest routines to avoid the desynchronization of our biological rhythms. Other sleep hygiene measures include the limiting of daytime naps to 30 minutes, regularly exercising (it may be necessary to avoid working out before bedtime), having a light dinner, avoiding stimulants like caffeine and nicotine close to bedtime, and making sure that the sleep environment is dark, silent and with a pleasant temperature. The beneficial effects of having good sleep relate to an increase in alertness during the day, the prevention of anxiety or depression, and the improvement of our general health, which in turn will reduce the chances of becoming ill.

For as long as I can remember, I have always been flying around. My mother was a flight attendant, my father was an Air Force mechanic and we spent most of our lives living in an Air Force base. To board, deplane and wake up with the noise of helicopters and jets was part of the routine, which did not make it less special to me.
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When I was 17 years-old, my family was transferred to Sweden and I had to decide what I wanted to do with my life. I was only sure about 2 things: I wanted to help and serve people, and I loved airplanes and the life in the air. How was I supposed to combine these two? I had no idea. Most people did not see a link between these two points, but I knew that I had to find a way, otherwise, I would never feel complete. If I would imagine myself permanently away from jets and airports or not in direct contact with people in need, a huge void would open in my chest; it just was not right, “either, or” was not an option to me.

In a Spring afternoon of 2018, I overheard some fighter pilots telling stories about accidents they had witnessed: a smashed jaw during the ejection after a period of temporal distortion, tunnelled vision, and a total blackout during the centrifuge training. Then, it hit me, those people were the link, they were the ones who connected those amazing machines to the human factor, they were the ones I wanted to help.

I started to research, and I still remember the first words that caught my eyes: “flight-surgeon”, “AsMA”, “Aerospace Medicine”. Upon reading the last mentioned, my heart dropped. I had found it. I had found an entire field and community of people as curious as me and that shared the same passions. And at the end of that year I was given the chance to get in touch with it more directly.

To graduate the International Baccalaureate (a different kind of high school), every student must carry out an independent research about a topic they would be interested in studying in university, our first research paper. I knew exactly what I wanted to do, I wanted to understand the symptoms and episodes I had heard about countless times, I wanted to understand what that so feared G. was. I read all the books about aerospace medicine fundamentals and flight physiology I could find, I started to talk to every single crew member and engineer I could reach, but the understanding of the symptoms through medical lenses was still missing. Another important thing that was missing was a supervisor, who would be willing to help me to start the research. Basically, the Science Department of my school did not understand what I was going for, how I was going to do it and no teacher was exactly thrilled with the idea of supervising a student they had no idea of how to help. It was even hard to decide whether to classify it as a Biology or Physics project!

To my heart-stopping surprise I got all of them, and they were all mostly glad to help me and to send me papers, videos, and pictures from their own centrifuge trainings (thank you so much Major Forneas and Colonel Leite). Nevertheless, to my despair the data collected contradicted my primary hypothesis! Great!

That is when my dear friend Jonas comes into scene. He worked at SAAB, the company which was developing the new Brazilian Grippen, state-of-the-art fighter jet, and offered to arrange me an interview with a test-pilot. It was by far, one of the greatest days of my life!

While we were waiting for Andreas to finish his debriefing, Jonas took me on a tour around the Flight Test Centre. I had always wanted to see the Grippen; only one was ready so far, it had flown only once and only authorised personal could see or get close to it, or at least I had been told. Jonas opened the hangar’s door and there it was! The mysterious Grippen and I was one of the few civils, who had nothing to do with the project whatsoever, who had been able not only to see it but to climb up to its cockpit! Right there, I knew I had made the right choice.
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Andreas, the test-pilot, still wearing his anti-G suit, spent a long time answering my endless questions, and by the time I finished the interview I understood where I had gone wrong and the kind of data that I needed to prove my new hypothesis right! And again, I was mesmerised by how the scientific community mobilised itself to help an enthusiast like me, who was still not even part of it.

The COVID-19 pandemic has generated the need to employ social distancing measures to reduce the spread of the new coronavirus. However, negative effects on the physical and mental health of individuals have been noted, as the sudden change in routine has resulted in a new lifestyle for people, who are now spending their lives in confinement. Increased worries, anxiety, prolonged sadness and inactivity are some of the consequences caused or aggravated by isolation.
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Physical exercise continues to be recognised as an effective non-medication strategy that is useful for mitigating these effects, as it helps in the prevention and treatment of physical, metabolic and/or psychological diseases. However, measures taken to suspend and limit the use of establishments, such as gyms and sports clubs, to avoid people gathering together, have led to many people undertaking regular physical activities within the home.

In this context, an interesting phenomenon has been seen on the internet, which is an increase in the search for information online. Google Trends, for example, is a resource reporting the most searched terms in different locations of the world and reveals the popularity of these terms on a scale of 0 to 100. It was possible from this to identify an increased search for information related to the consequences of the pandemic and the needs it has generated. It can be seen that in Brazil, prior to March 2020, searches for the term in Portuguese “exercício físico em casa” had low popularity (fluctuating between 0% and 25% on the scale of Google searches). The following month, after the beginning of social distancing within the country, the search for this term has varied between approximately 40% and 100% until the present day. When analysing the same term in English, it was seen that interest in this search varied between 0% and 25% in January 2020, whereas, from February until May of this year, searches rose to between 25% and 100%, before decreasing in June after several countries had relaxed their isolation rules. Analysis of this data evidenced a considerable increase in the popularity of the term during this period, demonstrating a greater interest in the subject by Internet users. These variations seem to be linked to the closing and opening of trade and other activities around the world.

It is also interesting to mention the need to adapt to performing exercise at home. Consequently, it was noticed that interest in the sports equipment needed to practice physical exercise at home also increased, being demonstrated by searches on Google. The search for the term in Portuguese "equipamentos para atividade física" in the first two months of 2020 was close to zero in interest levels; by March interest had increased a lot, reaching 100 in April. From a global perspective, the term “equipment for physical activity”, researched in the English language showed a peak of interest (100 on the scale) in February and less interest by the beginning of June (0 on the scale). As the pandemic is not yet under control, and indeed with the prediction of new waves of contagions and deaths, it is very likely that people's habits will really change as a way of adapting to the new reality.

While recognising that people are in general resilient, it cannot be denied that psychological damage is evident, and it is often even difficult to understand and deal with the magnitude of the feelings that may arise. With this in mind, we repeated the research process on Google Trends with the term in Portuguese “depressão na quarentena”, and found little interest from the Brazilian population between January and early March (0 on the scale), probably due to the fact that social confinement did not exist in Brazil at that time. However, from March onwards, the search for the term grew a lot, reaching a peak in searches (100 on the scale) by the beginning of May. Similarly, when researching the term “quarantine depression” in English, there was little interest in the world population between the months of January until early March, with a subsequent exponential increase in searches for the term, reaching a peak in April, followed by a decrease until the month of June.

From Space to COVID-19: what can we learn? Astronauts need to know how to deal with confinement and, despite being submitted to various forms of training to adequately meet the challenges of space missions, psychological effects caused by confinement have already been reported in the literature. In the case of COVID-19, there was no preparation for this new reality, leaving us all trying to develop mechanisms to become more resilient to and cope better with the pandemic and all the events related to it. The Internet has become an ally, a service that provides information and shopping possibilities for people. The challenge now is to deal well with this volume of information, dividing it up in terms of what is true and what is applicable.