Author: Marina Frid, a postdoctoral researcher in Communication and Culture at UFRJ, Brazil. You can contact her at firstname.lastname@example.org.
Fieldsite: I am staying in touch with a group of 16 informants who live and work in Rio de Janeiro, Brazil, and are quarantining in different parts of the city. From my home in Rio, I am interviewing them over the phone, Skype and WhatsApp video calls.
At home, but moving
Social isolation rules forced all sorts of activities to adapt to online environments, including those related to health. State and municipal guidelines led physicians to cancel elective surgeries and limit face to face appointments to urgent and serious cases. To encourage patients with minor or chronic conditions to stay home, the Federal Council of Medicine (CFM) determined that “telemedicine” – patient orientation, treatment supervision and exchange of information between physicians through distance communication channels – would be considered possible and ethical, exceptionally, while the country fights to contain COVID-19. Besides medical doctors, psychologists, physical therapists and physical trainers were also removed from their ordinary spaces and routines.
My informants talked about their various experiences as providers and users of these new forms of health assistance. Gabriela had just started doing psychotherapy when the crisis began in Rio.[i] Already in her second session, she had to connect with her therapist over a video call. Adjusting to online therapy was not difficult for Gabriela, because she already uses digital platforms for most of her work meetings. Though virtual, therapy sessions are helping her cope with changes brought on by the pandemic, especially, work overload and staying at her parents’ house. “My life is very digital in almost everything I do. (…) it’s not hard for me to have a hybrid life. It’s not an issue.”. The therapist did ask Gabriela if she had any objections to online appointments, but she thinks it makes no difference to her.
Pedro and his wife, Joyce, closed their physical therapy clinic as soon as social isolation measures were imposed in mid-March. They started using apps like WhatsApp to treat patients over video calls and decided to do in-person sessions only if a very severe case came up. Also, they were filming themselves doing the exercises and sending the file via WhatsApp to elders that do not know how to use the video chat function. Their older patients usually need the assistance of a family member or caregiver to do video calls but feel comfortable with the asynchronous exchange of messages. That is, they do not have trouble opening video files nor texting their questions regarding exercise instructions.
As a temporary response to the pandemic, Pedro said this system of distance physical therapy was about 70 to 80% satisfactory, but not enough for the appropriate treatment of patients. As we entered the sixth week of social isolation, he was beginning to think up strategies to reopen the clinic in May. Distance physical therapy “lacks touch, some manipulation procedures that are typical in our profession, almost mandatory in 90% of treatments.”. Though patients can provisionally do certain exercises by themselves, the physical therapist’s handling of their bodies is important in most cases. The professional is trained to observe bodies in the flesh, not their pixelated images. Pedro, Joyce and their patients adjusted to the online sessions to some extent. The couple’s dog, however, was having a bit of difficulty in conforming to their work from home situation, making special appearances in the middle of sessions.
Workout routines were also affected by social isolation. Every fitness centre in the city had to close, outdoor group classes were suspended, and personal trainers were discouraged from visiting clients at home. Gabriela stopped attending her CrossFit classes one week prior to social isolation decrees due to news about first cases of coronavirus in Brazil. Since commercial establishments were officially shut down, her instructor has been offering distance classes and sharing daily workout routines for those unable to connect or reluctant to use video conferencing apps for that purpose. Gabi is joining online classes Monday through Friday at 7am. She says it is not exactly the same thing as doing classes in person. Problems like poor internet connection affect the experience, but one has to be flexible. “The alternative that’s been given to me is much better than nothing. I’d be going crazy if I wasn’t throwing away that energy”.
Memes on social media reveal a sense that people forced to stay home during the COVID-19 crisis are gaining weight. They would be eating more and exercising less. Most memes on that subject reached me around the third and fourth weeks of social isolation. Mila used to workout in her lunch hours. With social isolation, she subscribed to the online fitness program of a popular instructor based in Rio. She had been following him for some time on Instagram at the recommendation of friends. The instructor runs a gym centre and had a distance training system in place before the COVID-19 crisis.
Some fitness centres in Rio are already firing employees due to financial constraints. Four of my informants are fitness instructors and have had their work significantly disturbed by the pandemic. Jacqueline has been dismissed from one of her jobs, so has Alex. Fortunately, both of them have other jobs and private clients which are giving them some financial safety, at least for a while.
Diana works mostly with elders, many of which have some form of dementia. Part of them are private patients, but she also works with a group undergoing treatment in a public health centre as part of her specialization in an extension program called LAB (pseudonym). One of her concerns related to social isolation is that these elders may suffer significant functional losses if they stop exercising for weeks in a row. Since confinement measures were determined, she continues to give private training sessions to her 91-year-old patient, in person, at the request of the family. She has persuaded two younger private clients to train over Zoom or other video conferencing apps, but not her other older clients that depend on caregivers to handle the technology.
To continue assisting patients of the public health centre, Diana contributed to LAB’s initiative of making short videos with exercise orientation. Videos are sent to caregivers via WhatsApp, posted on Instagram and uploaded in the program’s website on a weekly basis. In fact, this material is available not only to their patients, but any elder stuck at home in need of moving their bodies and distracting themselves. “My mother’s neighbour is receiving my videos and is able to do the exercises.”.
On the fifth week of social isolation, Diana started offering live online classes twice a week under the supervision of LAB’s coordinator, Ana. The last time we spoke, she had done three sessions and was very pleased with the level of participation. Patients and their caregivers/relatives (spouses, daughters, grandchildren, even great-grandchildren) exercised with Diana via Jitsi Meet.
According to Ana, some of the patients were becoming very inactive at home. Though carers showed them the exercise videos, they were having trouble focusing on the instructions and, therefore, losing interest. Hence, she decided to try the live sessions with Diana, hoping the interaction would stimulate them.
Caregivers of the public service patients are very collaborative because they were already used to participating in workout sessions at the health centre. But the caregivers of private patients used to take advantage of Diana’s presence to have time for themselves or other activities. “It’s a moment when the wife goes to the supermarket, takes a nap, or the caregiver takes a shower.”. Because online classes require their participation, they perceive them as another responsibility to take on, not as something helpful. In this time of social isolation, Diana feels that engaging patients who have smartphones and use WhatsApp in an exercise routine is easier than accessing those that rely fully on the mediation of carers. She said:
“My perception is that I depend on the caregiver a lot. I depend on someone willing to stimulate that elder. (…) I receive videos from certain patients every day – from their caregivers, themselves or their grandkids, and everyone is doing the exercises at home. On the other hand, there are caregivers that tell me ‘I can’t do it, no way, it’s too complicated”.
Ana said that accessing the video conferencing platform for the first time was not easy for some older carers. She and her team had to help them over the phone and with video tutorials sent via WhatsApp. It is all new to health professionals, patients and caregivers. But motivation and patience on both sides help them overcome barriers.
Live and comfy concerts
The arts and entertainment segments are suffering a great deal with the social isolation regime. Singers and musicians are prevented from touring and performing on stage to crowded audiences. As a response to these restrictions, a new form of presentation has emerged and become quite popular: live concerts streamed from home on social media.
The popular artist Gusttavo Lima was one of the first to attract a huge audience with his live-streamed performance. In his first concert, up to 750 thousand users watched him at the same time. His second live show, on the 11th of April, lasted more than seven hours and reached a peak of 5.5 million concurrent viewers. During the concert, Gusttavo Lima got drunk and cursed in an unrestrained manner.
Joana has been gathering with friends over Zoom to watch live-streamed concerts of famous artists – usually in the “sertanejo universitário” genre – “together”. She says Gusttavo Lima’s seven-hour concert was pretty fun to watch:
For instance, in some cases, like Bruno & Marrone, Gusttavo Lima, their ‘lives’ are becoming very popular because the guys drink during the show. Well, you can imagine how things get after seven songs or so. You end up laughing… Gusttavo Lima, his last ‘live’ went on for seven hours. The guy even cooked during the show. So, it’s a distraction.
Gusttavo Lima’s audience probably did not remain focused on his performance for seven hours straight. Joana did other things while she listened to the concert. As she put it, people that have a smart TV can leave it on the show all day instead of leaving it on Globo (the leading Brazilian TV network). In a similar way, Gabriela found that leaving her parents’ television on live stream concerts of “pagode” and “sertanejo” bands is a good strategy to keep household harmonious: “They love it.”. The artists’ performances give them something to talk about other than politics.
Both Joana and Gabriela highlighted Marília Mendonça’s concert as one of the live streams they most enjoyed watching over the past weeks, in social isolation. Among YouTube’s ten most-watched concerts in real time in April, seven were by Brazilian artists. Marília Mendonça appeared at the top of that list, ahead of Andrea Bocelli’s Easter concert livestreamed from the Duomo cathedral in Milan (Reuters, 2020).
Diana and her husband are enjoying live concerts on social media almost on a daily basis. “We are living on ‘lives’ here in our home.”. They experience the shows as if they were hanging out in a bar, with cold beer and nibbles. There are so many bands and singers doing live stream concerts that Diana’s husband even wrote down a list with those they were planning to watch over the week. In the first couple of weeks of social isolation, Diana watched the primetime news on Globo to keep herself informed. But, since getting caught on this live concert spree, she basically let go of that habit. “The Chromecast is plugged on our TV, ready for ‘lives’ and nothing else”.
These “lives”, as Brazilians call the live webcasts, are not just entertaining informants, but have become opportunities they take to socialize with friends and relatives over video chat and with the people in their homes – husbands, wives, parents, siblings. For instance, Carol told me that one of the most pleasant moments she has had during social isolation was watching the concert of musician Nando Reis with her mother.
Live streams of musical shows require an audience used to social media. But, television networks are also broadcasting some of the online concerts by popular artists. My grandmother was able to watch Andrea Bocelli’s Easter concert live on CNN Brazil, a cable news channel. Globo also broadcasted concerts by famous Brazilian artists like Roberto Carlos and Ivete Sangalo, who performed from their homes to audiences on television and social media.
On my first interview with Mario, I was forced to interrupt our conversation for a moment and move to the living room, because a musical performance began in the patio of the apartment building behind mine. My husband then told me the singer, Dan Levy, enjoys some popularity in Rio de Janeiro’s nightlife, especially, in bars and clubs in the city’s West Zone. His concert was livestreamed on Instagram and YouTube for two hours straight with residents in the surrounding buildings singing along from their windows.
Mario is a musician and played in the carioca nightlife until recently. Today, he gives private guitar lessons and performs in events, besides occasionally producing his own shows for music halls. In fact, he had to cancel a concert that was scheduled to happen in April because of COVID-19. In our first chat over Skype, Mario did not mention any interest in doing a live stream show. But, just a couple of weeks later, he performed live, from his home, on Facebook. He did the show at the request of a colleague who manages a community music centre. Mario rehearsed for the concert in two “pre-live” sessions for friends that helped him decide whether to use his computer or smartphone, the best way to position the camera and how to better light his room. For his setlist, he chose to play famous old songs by Roberto Carlos and Erasmo Carlos. Another decision he made was to not interact with viewer comments during the show because that could be too confusing to him. It was a “challenging” experience, but he was very happy with the result.
Regarding the experience of the pandemic as a whole, Mario thinks we are all witnessing something entirely new. The technology was available prior to COVID-19, but telemedicine, workout sessions over Zoom and live-streamed shows were not a part of my informants’ everyday lives seven weeks ago. In ordinary circumstances, people had to wait for months or years to enjoy a brand-new performance by their favourite Brazilian artists. Now, they are having a chance to see most of them in a different light, for free, from the comfort of their homes. In Mario’s words, “who would have thought it”?
F5 (2020). “Gusttavo Lima acorda de ressaca após mais de sete horas de live: ‘Atropelado por caminhão’”, Folha de S. Paulo, 12 April. Available at: https://folha.com/406sf2kn.
Reuters (2020). “How Housebound Brazil Popstars and CEOs Caught Streaming Mania and Dominated YouTube”, The New York Times, 29 April.
[i] I have changed the names of all informants to protect their privacy.