Tag Archives: COVID-19

Good News Monday: Gettin’ The Boost

Another adventure in the ongoing saga,Tales of Covid. Despite all the perky reassurances that our initial Pfizer shots were still “highly” effective, whatever that means, Dear Husband and I were eager to get a third shot as soon as possible.

Breaking news Friday was that the Oregon Health Authority would follow the CDC’s Thursday booster recommendation for us 65+-ers as well as the immunocompromised and workers in potentially perilous industries.

Actually finding somewhere to do it was a bit more challenging. The first stop was a nearby RiteAid drugstore, where the apologetic youngster at the prescription drop-off told us they were waiting for the OR pharmacy board to also get on board so nothing was likely to happen any time soon.

Next stop: the Internet, to check availabilty through our local healthcare system. Although phone calls and attempting an online appointment proved futile, the walk-in urgent care clinic seemed poised to administer boosters, so off I went first thing Saturday morning while DH stayed behind to watch football and await my report. I expected long lines of eager seniors brandishing canes and face masks, but the clinic looked quite deserted.

I wasn’t optimistic, since the receptionist chirpily showed me a now-out-of-date notification that only mentioned the immunocomprised with an eight-month timeline for eligibility. But, to her credit, when I pointed out the smaller line reading “some people who received the Pfizer vaccine may get a booster six months after their second dose”, she allowed me to sign in. One of the few times that vagueness has been a benefit!

While waiting to be called back, I was happy to see two pairs of 20-somethings arriving for their second shots. The message is finally trickling down that the vaccine is a) effective and b) necessary if we’re ever going to beat this thing.

One quick jab, one sore arm, and several headaches later, I feel poised to rejoin the world with a bit less anxiety. DH, who received his booster Saturday afternoon, had more severe side effects — fatigue, soreness, headache, and feeling “flu-ish”– but is on the mend.

Photo by Bruno Scramgnon on Pexels.com

Do You Have PPSD*?

(*Post-Pandemic Survival Dysfunction)

Even as daily life seems headed towards recovery, it’s hard to relax. This insightful analysis explains why “burnout” only begins to describe what so many of us have been feeling.

[by Soo Youn, The Washington Post]

Why burnout won’t go away, even as life returns to ‘normal’

For Marcia Howard, the Cheez-Its were a breaking point.

At her son’s first in-person school event this year, she realized she forgot to bring the class snack.

“I just broke down in the car and I started crying,” she said. As a class parent, she was torn up about forgetting the crackers. “It turns out everything has been overwhelming. And there’s no shaking it.”

Howard started a new job at the beginning of the coronavirus pandemic working as a creative operations director at a Fortune 500 company.

“I’m a Black woman. Between the pandemic and everything that happened to George Floyd and the summer of protests. . . . I had that first wave of, ‘Oh, gosh, I’m tired. I don’t feel like I can do anything. I stay up all night, looking at my phone and just really can’t focus,’ ” she said.

Then the fall came around, and it became clear many schools wouldn’t fully reopen for in-person learning.

“I’ve never thought about quitting more,” said Howard, who lives in New York City.

She’s been told by her company that she can take time off as she needs, but it’s just not that simple for her, she said. “It is all really wonderful to hear. But trying to prove myself in a corporate environment as the only Black leader, can I?” Howard said.

In February, she says she was told by her therapist that she was on the verge of depression.

“I feel like everyone is starting to think the world is getting back to normal, and I just can’t even bring myself to be hopeful about it,” Howard said.

With vaccinations initiated for half of Americans over 12, and guidance on masking and social distancing easing, the triage stage of the pandemic is lessening for some in the United States. Yet external progress markers can disguise – or even induce – a flurry of conflicting emotional, physical or cognitive states. Like getting sick right after turning in your last final, for some women who bore the brunt of domestic burdens while juggling work pressures for over a year, the breaking point may come with the breathing room.

As the country races toward a “normal” summer, for women like Howard, the picture doesn’t match up with her reality. She’s still struggling through a burnout unlike any other.

“Traditionally, we think of burnout being a state where someone is increasingly overwhelmed with the tasks in their lives, feeling a markedly decreased sense of accomplishment and effectiveness in what they are doing, and feeling like the things they loved to do now feel like just additional tasks. After a time, there can be mental health consequences,” said Maureen Sayres Van Niel, a Boston-based psychiatrist.

The pandemic magnified that condition exponentially.

“We had women with and without children managing situations that had life and death consequences in their daily lives: how to provide food for their families when the deadly virus was omnipresent or they were suddenly without an income, how to care for an elderly mother without physical contact,” she said. “Burnout in the traditional sense doesn’t capture the sense of the past year’s events.”

By March 2021, 1 in 4 Americans adults suffered the loss of a close friend or relative to the coronavirus, according to the KFF coronavirus vaccine Monitor; about 1 in 3 knew someone who died. And for those with family and friends in countries where death tolls are mounting daily, there is little relief.

“By mid-summer many will likely be feeling conflicting emotions such as relief that they are protected against the virus and happiness to see friends and family again. But having these new freedoms allows us to reflect on what we just lived through, what we endured, and what we lost. We will then be able to really feel our burnout, to let it surface,” said Stanford University sociologist Marianne Cooper. “People will need time to process what they have lived through.”

People are also mourning the loss of jobs – as well as routines, health, opportunities and time.

Baltimore-based psychiatrist Kimberly Gordon says burnout isn’t an adequate term. She treats patients from underserved communities and has lived and worked through traumatic events like Hurricane Katrina. She frames the current conversation as one of moral injury, a term referring to “the strong cognitive and emotional response that can occur following events that violate a person’s moral or ethical code.”

“Burnout suggests that the problem resides within the individual, who is in some way deficient. It implies that the individual lacks the resources or resilience to withstand the work environment,” according to a 2019 study published in the journal Federal Practitioner.

That’s impossible, the authors say: “While there is nothing inherently wrong with any of those practices, it is absurd to believe that yoga will solve the problems.”

The problem with using the term burnout, Gordon said, is that people equate it with a failure of their own, compounding the issue.

“You take these people who are really passionate and energetic, who want to do a good job, and they lose their motivation,” Gordon said. “Moral injury addresses the systems issues that lead to burnout, and calls for systems to address those issues.”

For some, the moral injury felt like betrayal by employers, the government and neighbors.

Jennifer Casaletto, an emergency physician in North Carolina, remembers one of the lowest points in the middle of the pandemic, a period she refers to as “backstabbing.”

“That was one of the hardest humps to get over, realizing we’re still going to work risking our lives and the lives of our family, and our friends telling us ‘This is completely overhyped.'” She recalled an incident during which a neighbor brought their child to Casaletto’s house to get stitches, then told her they were going on vacation to Mexico and were hoping to get around having to mask on the plane.

While the pandemic has been hard on everyone, women are bearing the physical and mental load of burnout unequally, emerging data shows.

In March, the Axios/Ipsos Coronavirus Index found 30% of women said they felt “overwhelmed or burned out” over the past year, compared with 21% of men.

“The pandemic has also laid bare the ways in which the society and its institutions were not created with the biology of women workers in mind,” Sayres Van Niel said.

Mental health professionals suggest telling employers about what you need to be more productive at work.

“We think of ourselves as passive participants in our workplace but we can actually have an active role in the culture,” Gordon said.

For example, say you can work until 7 p.m. but you need child care. One of Gordon’s patients recently told their manager they were manic depressive, and they were able to come up with a more flexible schedule.

“It’s really important to find workplaces or create workspaces, where people can have courageous conversations,” she said.

She also recommended making small changes in everyday life, like exercise or watching a comedy special. Little daily tweaks can be more effective than a week-long vacation over time, she said.

Howard, the Fortune 500 director, says she tries to work in a daily bath and is focusing on a renewed exercise routine. There’s still plenty for her to be stressed out about: an upcoming minor surgery for her son, family reunions with mixed vaccination statuses and a recent emergency room visit for the family cat.

It can feel like the rush to reopen is happening too fast, she said, putting her at odds with others who are thrilled to take off their masks and return to “normal.”

“I’ve just realized that I don’t have to be there. . . . I don’t emotionally have to get there. I can take my time recovering from the past year and a half. I’m sitting with my feelings and it’s still normal to be unable to focus.”

– – –

This story first appeared in The Washington Post’s The Lily publication.

Good News Monday: COVID Immunity

Reprinted from today’s New York Times

Is herd immunity ahead of schedule?

Mumbai may be among the cities that have already achieved herd immunity, scientists say.Indranil Mukherjee/Agence France-Presse — Getty Images

Today, we’re turning this section over to our colleague Apoorva Mandavilli, who has been covering the pandemic for The Times’s Science desk.

The pandemic will end only when enough people are protected against the coronavirus, whether by a vaccine or by already having been infected. Reaching this threshold, known as herd immunity, doesn’t mean the virus will disappear. But with fewer hosts to infect, it will make its way through a community much more slowly.

In the early days of the crisis, scientists estimated that perhaps 70 percent of the population would need to be immune in this way to be free from large outbreaks. But over the past few weeks, more than a dozen scientists told me they now felt comfortable saying that herd immunity probably lies from 45 percent to 50 percent.

If they’re right, then we may be a lot closer to turning back this virus than we initially thought.

It may also mean that pockets of New York City, London, Mumbai and other cities may already have reached the threshold, and may be spared a devastating second wave.

The initial calculations into herd immunity assumed that everyone in a community was equally susceptible to the virus and mixed randomly with everyone else.

The new estimates are the product of more sophisticated statistical modeling. When scientists factor in variations in density, demographics and socialization patterns, the estimated threshold for herd immunity falls.

In some clinics in hard-hit Brooklyn neighborhoods, up to 80 percent of people who were tested at the beginning of the summer had antibodies for the virus. Over the past eight weeks, fewer than 1 percent of people tested at those same neighborhood clinics have had the virus.

Likewise in Mumbai, a randomized household survey found that about 57 percent of people who live in the poorest areas and share toilets had antibodies, compared with just 11 percent elsewhere in the city.

It’s too early to say with certainty that those communities have reached herd immunity. We don’t know, for example, how long someone who was infected stays protected from the coronavirus. But the data suggests that the virus may move more slowly in those areas the next time around.

Good News Monday: Why Masks Work

Yes, it’s Tuesday. But, honestly, who can tell the difference between one day and the next?

This, from the Los Angeles Times, is interesting.  On the off chance that the link doesn’t work — because, mostly, they don’t since they want you to subscribe instead of reading for free — I’m pasting it here.

You’ll get the gist even if you don’t read the whole thing. (What’s a “gist”? Glad you asked. Extensive research indicates “early 18th century: from Old French, third person singular present tense of gesir ‘to lie’, from Latin jacere . The Anglo-French legal phrase c’est action gist [‘this action lies’ , e.g. occurs] denoted that there were sufficient grounds to proceed; gist was adopted into English denoting the grounds themselves.”  Now you know.

Masks offer much more protection against coronavirus than many think

RONG-GONG LIN II, MAURA DOLAN

There’s a common refrain that masks don’t protect you; they protect other people from your own germs, which is especially important to keep unknowingly infected people from spreading the coronavirus.

But now, there’s mounting evidence that masks also protect you.

If you’re unlucky enough to encounter an infectious person, wearing any kind of face covering will reduce the amount of virus that your body will take in.

As it turns out, that’s pretty important. Breathing in a small amount of virus may lead to no disease or far more mild infection. But inhaling a huge volume of virus particles can result in serious disease or death.

That’s the argument Dr. Monica Gandhi, UC San Francisco professor of medicine and medical director of the HIV Clinic at Zuckerberg San Francisco General Hospital, is making about why — if you are unlucky to get infected with the virus — masking can still protect you from more severe disease.

“There is this theory that facial masking reduces the [amount of virus you get exposed to] and disease severity,” said Gandhi, who is also director for the Center for AIDS Research at UC San Francisco.

The idea of requiring mask-wearing in public has become an increasingly pressing and politicized issue as California and the rest of the nation see a surge in new cases as the economy reopens.

California this week ordered a reclosure of many businesses, include a statewide halting of all indoor dining and a closure of bars. The state also ordered a closing down — in dozens of hard-hit counties, including L.A. County — of indoor gyms, houses of worship, hair salons, nail salons and offices for nonessential industries.

But experts say masks are essential for people to wear when they still go out in public, such as to shop or go to medical appointments, and to get exercise like heading to the beach or park.

California has mandated face coverings in public settings since June 18, and a growing number of communities said they will ticket people who disobey the rules. But there remains some resistance to the government mandating wearing masks in some corners of the state, including Orange County.

Some leaders in Orange County have pushed back against requiring students to wear masks should they return to classrooms in the fall.

In policy recommendations approved by the Orange County Board of Education on Monday, a document stated that “requiring children to wear masks during school is not only difficult — if not impossible to implement — but [is] not based on science. It may even be harmful.” Individual districts will have the final say on how schools open.

Some health experts were appalled by that language.

“This anti-mask rhetoric is mind-blowing, dangerous, deadly and polarizing,” said Dr. Peter Chin-Hong, professor of medicine and an infectious diseases specialist at UC San Francisco. “There is no evidence that it is dangerous.”

In fact, wearing masks can help prevent children from being infected and suffering serious consequences of infection, such as multisystem inflammatory syndrome, a rare condition that has been seen in children who have been infected with the coronavirus. “Kids not only transmit, but they can get sick as well,” Chin-Hong said.

While children are less likely to develop severe illness from the coronavirus than adults, they can still be infected, be contagious and transmit the virus to other people, Gandhi said.

Wearing a mask at school would not only reduce their ability to transmit the virus to other classmates, teachers and administrators, but also protect the students from getting infected with a large dose of virus from infected people.

Transmission rates for coronavirus have been rising across the state. Nearly 1,000 of San Francisco’s nearly 4,600 cases have been diagnosed in just the last two weeks, said Dr. Grant Colfax, the city’s director of public health.

In San Francisco, nearly half of all those who have tested positive in the city are Latinos, he said, even though Latino residents make up just 15% of the city’s population. Overall, the city has seen 7.8 new infections per 100,000 residents over the last seven days, far above its goal of no more than 1.8 new infections per 100,000 people.

“This, again, indicates that the virus is spreading throughout the city, particularly … in the southeast part of the city,” Colfax said.

For every one person who contracts the virus, another 1.25 people on average are now infected, he said. “We really need to drive that down to 1 or below as quickly and as soon as possible.”

The transmission rate also rose above 1 in L.A. County in June, but has fallen back to 1. “The virus currently rages on in our community,” Public Health Director Barbara Ferrer said.

The reason why masks are so important in controlling the spread of the coronavirus is that it can be widely spread by people who are not visibly sick — either because they haven’t yet shown signs of illness, or they will spend the entire course of their infections with little or no symptoms at all.

A key piece of evidence for this emerged earlier this year, on the Diamond Princess cruise ship that carried infected crew and passengers in Asia. A study published by the U.S. Centers for Disease Control and Prevention found that of 712 people testing positive for the virus, nearly half were asymptomatic at the time of testing.

“We also know that viral load is highest early during disease,” said Dr. Chaz Langelier, an assistant professor at UC San Francisco, during the panel discussion. In fact, 44% of transmissions are believed to occur when the infected person has no symptoms, according to a study published in Nature Medicine.

That’s different from the seasonal flu, where peak infectiousness occurs about one day after the onset of symptoms, Langelier said.

Masks don’t filter out all viral particles, Gandhi said. But even cloth face masks filter out a majority of viral particles.

And even if a person wearing a mask gets infected, the mask — by filtering out most of the viral particles exhaled by the infected person — probably leads to less severe disease, Gandhi said.

The idea that a lower dose of virus when being infected brings less illness is a well-worn idea in medicine.

Even going back to 1938, there was a study showing that by giving mice a higher dose of a deadly virus, the mice are more likely to get severe disease and die, Gandhi said.

The same principle applies to humans. A study published in 2015 gave healthy volunteers varying doses of a flu virus; those who got higher doses got sicker, with more coughing and shortness of breath, Gandhi said.

And another study suggested that the reason why the second wave of the 1918-19 flu pandemic was the deadliest in the U.S. was because of the overcrowded conditions faced in army camps as World War I wound down.

Finally, a study published in May found that surgical mask partitions significantly reduced the transmission of the coronavirus among hamsters. And even if the hamsters protected by the mask partitions acquired the coronavirus, “they were more likely to get very mild disease,” Gandhi said.

So what happens if a city dramatically masks up while in public?

If Gandhi is right, it may mean that even if there’s a rise in coronavirus infections in a city, the masks may limit the dose people are getting of the virus and result in them more likely to show less severe symptoms of illness.

That’s what Gandhi said she suspects is happening in San Francisco, where mask wearing is relatively robust. Further observations are needed, Gandhi said.

There’s more evidence that masks can be protective — even when wearers do become infected. She cited an outbreak at a seafood plant in Oregon where employees were given masks, and 95% of those who were infected were asymptomatic.

Gandhi also cited the experience of a cruise ship that was traveling from Argentina to Antartica in March when the coronavirus infected people on board, as documented in a recent study. Passengers got surgical masks; the crew got N95 masks.

But instead of about 40% of those infected being asymptomatic — which is what would normally be expected — 81% of those testing positive were asymptomatic, and the masking may have helped reduce the severity of disease in people on board, Gandhi said.

The protective effects are also seen in countries where masks are universally accepted for years, such as Taiwan, Thailand, South Korea and Singapore. “They have all seen cases as they opened … but not deaths,” Gandhi said.

The Czech Republic moved early to require masks, issuing an order in mid-March, Gandhi said; that’s about three months before Gov. Gavin Newsom did so statewide in California. But in the Czech Republic, “every time their cases would go up …their death rate was totally flat. So they didn’t get the severe illness with these cases going on.”

By May, the Czech Republic lifted its face mask rule. “And they’re doing great,” Gandhi said.

End of article, back to me.  If it’s good enough for hamsters, I’m definitely wearing a mask.

hamster

Photo by Juris Freidenfelds on Pexels.com

COVID-19 Spending and Saving

Perhaps the only upside to what I call the “pandammit” is that I’m not shopping like a drunken socialite, to quote my friend S. Which doesn’t mean I’ve stopped shopping altogether; it’s more that I’m buying different things.

Big-ticket items flew out the window as life got simpler and our activities remain close to home. Meanwhile, entire categories (hello, hand sanitizer) became essentials. What a topsy-turvy world! (Google reports that the expression “may be an adaptation of the medieval verb ‘tirve’, meaning ‘to turn or to topple over’. It has also been suggested that ‘turvy’ is an allusion to ‘turf’ and that ‘topsy-turvy’ means ‘with one’s head on the turf’.”) 

Spending more

  • Amazon – miscellaneous household items, esp. hard to get stuff
  • Whole Foods delivery in the early months
  • Fresh fruits and veggies from farmers’ market and small specialty grocers
  • Cooking gadgets
  • Wine and booze – do you even have to ask why?
  • TV streaming services
  • Zoom membership
  • Books
  • Vitamins, supplements, acetaminophen PM
  • Face masks — whoever predicted one would need a wardrobe of these?!
  • Cute socks
  • Cleaning supplies
  • Fresh flowers to maintain sanity and illusion of elegant normalcy

Saving more

  • Makeup, especially lipstick – kind of pointless when wearing a mask, no?
  • Hair salon – spreading out appointments and doing trimming/touch-ups myself until desperate
  • Pedicures – My toes are not worth dying for
  • Restaurants
  • New clothes – to go where, exactly?
  • Travel
  • Cultural events/theatre/opera tix
  • Massages and facials (see pedicure)

Yep, things are definitely tirving these days.

photo of inverted woman on wooden chair

Photo by Wendy Wei on Pexels.com

 

 

 

Good News Monday: Tales from the Dark Side

They say laughter is the best medicine. (And possibly our only one until we get a reliable vaccine.) Luckily, this pandemic has some upsides. Let’s call them “coronadvantages”:

  1. Crime deterrent:  Only a fool would break into a house without knowing if its inhabitants were infected. Plus, they’re probably home
  2. Ivanka’s shoes (made in China) might finally go out of business
  3. You now have the perfect excuse to avoid just about anything
  4. West Coasters have something to take our minds off worrying about The Big One
  5. There’s no shame in being a hypochodriac
  6. Terrorists may think twice:  No large gatherings = no large targets
  7. Your neighbors will stop hosting loud parties
  8. Working in pajamas
  9. Alcohol kills germs; ergo, vodka surely has medicinal properties
  10. A new appreciation for canned goods
  11. It’s far less likely your significant other will cheat on you

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Today’s COVID-19 Practical Tip: Hands

Have your local stores run out of hand sanitizer? Make your own.

Mix one-third cup aloe vera gel with two-thirds cup rubbing alcohol in a bowl until it’s well blended.  Add a few drops of an essential oil such as lavender to help calm the nerves and make it smell more luxurious.

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