Wednesday, December 27, 2023
Hau'oli Makahiki Hou! Happy New Year!
Hau’oli Makahiki Hou! Happy New Year! I hope this letter finds you in good health, spirits, and living a life you love.
Retirement year-2 has been full of travel and fun. Here is how my year went:
A NY Times article enticed. I texted sister Gina in the waning days of January, “Would you be interested in an Amsterdam rendezvous?” That led to a 10-day, spring excursion to Amsterdam and London. Amsterdam RIJKS Museum held a Vermeer (one Dutch Master) exhibit: 28 of the known 36 paintings. 450,000 tickets sold out worldwide, in 4 days. We also toured the Van Gogh museum, discovered creamy eggs (YUM), visited the Hague to see The Girl with the Pearl Earring (who had already returned home from the RIJKS), admired the works of numerous Dutch Masters, hunted down a Dutch Baby (which is, as we discovered, not Dutch but German), ate Dutch pancakes (like a humongous crêpe - served sweet or savory), and walked, and walked, and walked.
We arrived in London nearly 2-weeks prior to the King’s coronation and stayed near the Paddington station and Kensington Palace. Eating fish and chips at a local pub on our first night, we then vowed to eat international cuisine for all subsequent meals. What an adventure - and such ono grinds (good food)! BIL Michael and I were London neophytes so we played tourist: British Museum (I got totally waylaid in the Polynesian halls by Hoa Hakananai-a Moai stone figure from Rapa Nui and by Capt. Cook artifacts from Hawaii), London Tower and Bridge, the Shard, etc. We also visited the Royal Observatory in Greenwich, which is ground zero for Greenwich Mean Time (GMT).
I made two trips to Oahu. My first trip coincided with the visit of niece Lael and her family. They are all active and beautiful. The triplets will turn six and Alanna, eight, in 2024.
I camped in Yosemite five different weeks. Two were volunteer weeks, one doing trail maintenance on an obscure trail between Tioga Pass Rd and the Hetch Hetchty reservoir. I climbed to Sierra Point, an old trail closed by rockfall in the 70’s. It’s a steep 1/2 mile and the real task is in sniffing out the old trail after crossing a boulder field. But the view… 5 waterfalls from a single perch: Vernal, Nevada, Illilouette, Yosemite, and Little Yosemite falls. It was worth all the effort and every scrape. I was also in the park twice with the Chinese Pilgrimage, a program that honors the work of the Chinese in literally building Yosemite NP.
I began hiking with two new groups. The German Hiking Club was started over 40-years ago in Grass Valley, about 90-minutes north of me. They hike in areas completely unfamiliar to me and that is attractive. I am also learning to guide hikes in the Sutter Buttes (Histum Yani or Middle Mountain to the native peoples). That has me hiking in the mountains twice a week or more - and that makes me happy.
To that end, I walk 5-6 miles on most days. When I’m training for something, I add ankle weights and a weighted backpack (a not-so-new activity newly named “rucking”).
My ukulele band, renamed Ka Pili (the Connection), is refocusing our sound after our friend and bandmate Malia moved to Fremont, CA. (Lotta tears shed by all ovah dat one).
I also continue to perfect my gluten-free baking - just for the heck of it.
Los Gatos (the cats): Cali quietly passed at 21 years on Dec 14th. The boys: Koa
Manoa and KeaMoku (6yo) - are delightful as ever and grow more affectionate with age.
Favorite binges of 2023? Netflix docu-series on The Blue Zones, those 5 global areas that contain an unusual concentration of centenarians. The series looks for commonalities. Best Book: Outlive by Dr. Peter Attia. This book distills the commonalities of the Blue Zone denizens into increasing “healthspan” vs lifespan in suburbia. How do we get there? Can we reap the benefits of a long, healthy life outside of the Blue Zones? How do we replicate their lifestyle in the burbs? This book is fascinating despite being dense with medical jargon.
What’s on tap for 2024?
Grand Canyon Rim-to-Rim-to-Rim in late February. I will definitely kick up my weight training, stair running, maybe even hiking in the Sierra w/ankle weights as Day-3 will be 17-miles with vertical elevation gain and loss.
Honolulu in March for a family reunion and to commit Aunt Sandra’s ashes to the ocean.
Joshua Tree NP with friends in early April for the spring bloom.
Mt Fuji in September. It’s a staircase = more stair training.
Lots of ukulele rehearsals as Kimi and I get deep into duet-mode.
I am thankful for good friends, a wonderful cat-sitter, and good health. Eh - how you? I would love to hear.
May you live fully and prosper in 2024. Love and Aloha ~Lorin
Friday, January 6, 2023
Hau'oli Makakhiki Hou! Happy New Year!
Hau’oli Makahiki Hou! = Happy New Year! I hope this holiday season finds you and yours happy, healthy, and creating a life you love aka “Vitality at every age and stage.”
In 2022, I did get some bucket list travel done by visiting Nepal and hiking into the famed Khumbu Valley, home of Sagarmatha (Mt Everest). In April we followed in the footsteps of famous climbers and trekked part of that trail. John (NP classmate and a favorite traveling companion) and I joined a group of ten for this trek. Our guide was Gary - with whom we previously hiked in the Dolomites. Three Sherpas guided and guarded us. Our bags were carried by jōkpë: a cow/yak cross, that is larger than a cow but more docile than a yak. So we hiked with lighter day packs and enjoyed the views. Our lodges were part of a new franchise on the route, Yeti Mountain Homes. Our rooms were private with hot showers but only when the sun shone sufficiently for solar hot water. At some point around 15,000 feet elevation, the trail curves around the spine of a mountain and the upper valley is visible all the way to Sagarmatha (Mt Ev). The famed Temboche Gumpa (monastery) was ahead on the right and Ama Dablam hung over that side of the valley. The Lhotse ridge hid Nuptse to the left. Sagarmatha took center stage, cloud plume blowing off her summit. Lohtse on the right. It was breathtaking - the best moment of my trip.
All my training seemed to payoff. I walked 6-8 miles daily with light backpack and ankle weights. Additionally, I hiked in the Sierra, at altitude weekly. That translated into a very pleasant trip.
In late June I did a horse packing trip into the Emigrant Wilderness, just north of the Yosemite border. It was peak mosquito season and the only thing I will say about the trip is that I would rather walk 15 miles than ride them.
Early August, I joined with a group of 22 Chinese people on a 3-day pilgrimage to climb Sing Peak, on the southern Yosemite National Park (NP) border. Tai Sing was a famous hi-country chef who cooked for the historic Mather Mountain Party of 1915 (google it) at the inception of the National Parks system. There were many Chinese people that worked in the areas now known as Yosemite, Sequoia, and King’s Canyon NPs; their story is now being told in Yosemite NP. It was a fun trip and all the youngins usually spoke several dialects of Chinese! I’m sooo jealous!
Of course I volunteered in Yosemite for a week and we camped in my new, favorite campground = White Wolf. It was a historic summer home for the indigenous Miwok and Awahneechee tribes - and trust me, they occupied all the best places. Lots of ground rock grindstones near the river and bat caves nearby. For the 3rd year I worked on Tuolumne Meadows restoration and learned to use a 100-year-old cross cut saw - mannn it almost cut on its own; through downed tree trunks like butdah.
Lastly, in December John and I met friends in Joshua Tree NP - a designated “dark sky” area in the USA. We happened to be there during the Geminids Meteor Shower. Yowza! Shooting stars every 10-15 seconds! And man it was cold. I slept with my 20-degree sleeping bag inside another bag.
I tore out my front lawn this year and put in a drought-tolerant, low-water-use, Asian garden. Still planting - but the gist is in.
I continue to play ukulele and my band combined with my ukulele teachers band for summer and Christmas gigs. So fun!
Best books Bacon read in 2022:
Kareem Abdul Jabar is a devout Holmesian and is co-writing prequels to the Sherlock Holmes novels penned by Sir Conan Doyle. They are very true to Holmes history and are delightful in every way. I’ve become a KAJ fan.
American Scandal is my fave 2022 podcast. I have lived through many of these “scandals” but lacked details and did not follow them to conclusion. It covers subjects like Iran/Contra, Theranos, Edward Snowden, Hare Krishna, Waco, Exon Valdez, etc. Super, super interesting.
What’s on tap for 2023?
The Jane and Bill descendants are descending into Kaneohe this spring. It will be good to see ev’body. Plus I NEED some humidity!
Hope to volunteer in Yosemite again this summer. The application process begins in mid-January.
The price of gas kept me from driving/camping to the East Coast for fall colors. I may attempt that in fall 2023.
Dems da highlights!
E Hookaulana (celebrate) 2023 by creating a life you love.
With love and much Aloha ~Lorin
Thursday, December 30, 2021
Mele Kalikimaka e Hau’oli Makahiki Hou!
Mele Kalikimaka e Hau’oli Makahiki Hou!
Wishing you and yours a Merry Christmas and Happy New Year!
I pray thee well and hope this annual letter finds you in good health and spirits. Even better - with vitality at every age and stage.
What an interesting year I’ve had. After 42 years of nursing and one year on the COVID frontline, I retired April 1st - no joke! Eight months out, I’m still trying to find my rhythm. The pandemic has surely spared me the common malady of instant over-commitment. The one thing I have dedicated myself to is daily exercise: a 4-6 mile walk, sometimes 8, and/or yoga via Zoom. With another new COVID variant on the rise, I’ve not returned to the yoga studio. Additionally, my cats have learned that when my yoga mat is rolled out, I’ll be on the floor - just where they want me. I get a good core workout and intend to add some light weightlifting in the new year.
My trek on the Everest Trail in Nepal was postponed until April 2022 (fingers crossed). That opened my calendar for national travel. Though I currently loathe flying, I did fly home to Hawaii for nearly the entire month of May. There, we stood on a shallow sandbar in Kaneohe Bay to scatter the ashes of my parents, Aunt Cornelia, and Uncle Sammy. The day was beautiful and it felt “glorious” as my mother often proclaimed.
Kaneohe Bay: photo taken from sandbar.
In early June I attended the 3-day, Indian wedding of Mona and John in Long Beach. What a thrill! I attended with my dear friends, the Singh’s, whose large family has been so welcoming to me. I loved every minute!
In late August, Bill (a faithful backpacking buddy on loan from his wife) and I packed into BAM (Bacon’s Adventurosa Mobile) to head north along the coastal route, then east, paralleling the Canadian border. Mostly, we camped in national and state parks. We visited seven National Parks (NP): Redwoods, Olympic, North Cascades, Glacier, Theodore Roosevelt, Wind Caves, and Badlands. We also visited Devil’s Tower, Mt Rushmore, and Crazy Horse. Our terminus was Ann Arbor, MI to rendezvous with niece Lael and her family, sister Gina, and her husband Mike. I made the westward, return trip solo, never driving more than 300 miles/day. Again, I visited national parks: Cuyahoga, Rocky Mountain, Black Canyon of the Gunnison, Canyonlands, Arches, Capitol Reef, and Great Basin. I met innumerable, wonderful Americans and fielded many questions about my van. 
While I am thinking of it, here are some peak-season NP tips. You’ve undoubtedly heard that NPs are over-loved and overcrowded these last years. Some of them require timed-entrance passes, purchased online. So my biggest tip is to get into the park before the rangers manage the gates each morning. The park gates are typically open 24/7. Rangers begin controlling the entrances between 7-9am. Passing through the gates early will spare you the long, exhaust-fumed queues into the park. Many rangers now close their gates when park capacity reaches a specified limit. (When I arrived at Glacier and departed Arches, the gates were closed = no entry.) In Glacier NP, we awoke at 5am to be on the road by 5:30. So do some research before you go. Pack a cooler with food and hit the road. Also, be aware that all caves tours are now booked online several weeks in advance. Lastly, a senior “Golden Park Pass” is available at 62 years for a one-time fee of $80. (Free to Wounded Warriors and war-time vets with required paperwork). Not only does this provide free park access for one vehicle and four people but it also halves the camping fee. Wowee! Who knew?
In November, best buddy John and I retraced my earlier trip up Californian and Oregonian coasts into Washington state. As we approached the mountains, the roads were slushy, forcing a hasty retreat to the Columbia River Gorge - where we were pelted by another atmospheric river. We were duly impressed with the plethora of state parks along the Oregon coast - seemingly every few miles… and sooo beautiful! I might migrate that way as drought is an increasing problem for California.
I continue to play music with my ukulele band KaBang! (Kaneko, Bacon, and Yang). With bass player Wade, we typically hold weekly, outdoor rehearsals. I continue to take ukulele lessons though I am not sure my performance actually reflects that tutelage. Nonetheless, my teacher Carla (from Waipahu, Oahu) is skilled and patient. We collaborate on all the musical arranging I do for KaBang! and I’ve learned a bit about music theory, jazz, and how to modulate pitch to escalate musical movement in the distinctive style of the Brothers Cazimero (for you with Hawaiian musical roots). Good fun!
Best Books Bacon read in 2021:
The Only Plane in the Sky by Garrett Graff is an oral history of 9/11.
With time zone disparities between the coasts, I saw the Twin Towers fall on TV before I went to work. I worked in an Emergency Dept. so I was not glued to a TV that or the following days. Time and distance buffered me from the granular events of 9/11. This book is an account from survivors and their personal experiences on 9/11. It is not necessarily factual, as few survivors had the facts. I found it moving and enlightening. Remember how we rallied for one another after 9/11? This book left me feeling hopeful for the American spirit and our capacity to care deeply for one another.
You can also listen to an abridged version of the book in a podcast called Long Shadow - which you can find for free on your favorite pod-catcher.
Caste by Isabel Wilkerson, a Pulitzer Prize-winning author. In Caste, she argues that the racial tensions in the United States are better explained through the lens of caste, not race… [She examines] the eight tenets of a caste system, how the caste system affects the lives of people in the upper and lower castes, and how we can move away from caste and create a more equitable society. I love books that enlighten and move me, this was one.
I am currently reading Grant, the definitive biography of Ulysses S Grant by historian Ron Chernow. I dunno… it seemed fitting to understand the events of the Civil War more fully.
What’s on tap in 2022?
First and foremost, I am making a commitment to switch to automated, randomly-generated, long, and complex passwords for my devices (iPhone, iMac, iPad). Like a dinosaur, I have resisted - and you know the rest of their story.
If COVID allows, best-buddy John and I will trek on the Everest Trail to 15,500 feet. Then on to Egypt, for I have friends in Cairo. We hope to see The Great Pyramids of Giza, Alexandria, Luxor, and Petra.
I also hope to volunteer for 1-2 weeks in Yosemite this season. Dat’s real soul food. Perhaps a cross-country trip to New England to see the fall colors?
What is going on in your world? What inspires you and keeps you moving? How is your family? I would love to hear.
Keep an open mind to changing science. Walk with caution. Use kind words and a gentle tone. Love self and one another.
E Hookaulana (celebrate) 2022!
With love and much Aloha ~Lorin
Friday, January 1, 2021
Hau’oli Makahiki Hou (Happy New Year)
Hau’oli Makahiki Hou (Happy New Year) to you and yours. I hope this letter finds you in good health and spirits.
My annual letter a-l-w-a-y-s opens thusly, wishing that you and yours enjoy good health and spirits. Never has this been more salient as we are assaulted with job loss, income stress, social and physical isolation, while being stalked by a deadly virus. I hope even in this, you can find moments of joy, happiness, and hope.
 |
| Koa, Kea, & me |
For only the second time in my life, I spent Christmas alone. The lights on my tree blazed all day while a constant stream of carols suffused every nook and cranny. Nonetheless, it lacked luster without the gathering of friends and family. The footer on my emails reads:
This year, to lovingly observe z Holidays means giving up “but we always…” for the sake of everyone - so that next year we might once again have it all.
Only you can make it so. So do so.
… I could hardly ignore my own advice.
Well COVID sure put a monkey wrench into our year; didn’t it? So much for traveling home for Mom’s 95th or a subsequent memorial. Cancelled our 3-week hiking trip in the UK and a 2-week Home-for-the-Holidays including both Christmas and New Year. Do you know that in my 41 years of nursing I have never had a vacation that included both Christmas and New Years? This, my final year of nursing, was gonna be it. Auwe (alas) no mattah no moah; I going retire in 100 days anyways.
Yes, we lost my Mom and her sister Cornelia this year. This social isolation is very, very hard on our super seniors. Weeks before Mom died, just when Honolulu ended its lockdown, my cousins whisked “the sibs” (Aunties Jane (my Mom), Corn, San, and Ellen, and Uncle Dave) to an outside, physically-distanced luncheon. They invited us all to FaceTime into the gathering. Mom was mostly non-verbal and it was the last time I saw her and Aunt Corn. Good thinking cousins! Dey so akamai (smart)!
Working in an outpatient clinic is all kinds of new stress. Because my asthma has become a real problem, particularly during winter, I work in an N95 from the first day of fall, through the winter. (See how much you’ve learned this year? I don’t even need to explain PPE and N95.) So even before COVID hit, I was already in protect-my-lungs mode.
Kaiser was very fast to respond, canceling all in-person appointments and non-emergent surgeries prior to the California lockdown. Because we already make telephone and video visits, we pivoted to virtual work over one weekend. It wasn’t pretty but it was better than anyone else in the region - by far.
While I am fortunate to be working, still, it is anxiety producing to be locked in a small exam room with anyone for 20-minutes. What if they are asymptomatic or pre-symptomatic? I think I pretty much speak for most healthcare workers (HCW) when I say: wear a mask, practice physical distancing, do it outside, and during this surge - stay home and do not gather.
Remember that during the 1918 flu pandemic, most of the 1.5 million deaths occurred during the winter. Just like, “Only you can prevent forest fires”; Only YOU can keep you/yours/us safe.
I am flummoxed by the lack of COVID response in the US - as is, BTW, the rest of the world. I’ve presented the science in my blog and will not repeat it here. But you are welcome to visit and read at:
https://lorinzmuze.blogspot.com.
One last thing regarding COVID. We saw early reporting in January from Wuhan that implied coronavirus was airborne. Unfortunately, it took the CDC the better part of a year to make that known. This new reporting shows confirmation data out of S Korea. “Coronavirus can travel farther and faster inside restaurants than previously thought, South Korean study suggests. Two diners at a South Korean restaurant were infected with novel coronavirus in a matter of minutes from a third patron who sat at least 15 feet away. The third patron was asymptomatic at the time.” WATCH z video!
https://www.washingtonpost.com/food/2020/12/11/korean-restaurant-coronavirus-airflow-study/
But I don’t go to restaurants, you say. Yes, but when you invite even a few people over to eat, your home becomes like a restaurant. If attendees have not quarantined before and after a negative test or for 10-days, your gathering poses an unnecessary risk. With the virus mutation becoming increasingly transmissible, nothing but an N95 will keep viral particles out. The surge we are experiencing now is from small, familial gatherings over Thanksgiving. Officials fear the Christmas bump will force us to triage people away from healthcare from tents in the parking lot.
We are living through, what is on track to be, what history books will call, the greatest catastrophe in American history. With 350,000 Americans dead and a disease continuing to spread like wildfire, keep your masks on - we will likely need them for most of 2021 if not longer. Remember, the COVID vaccine does not prevent infection nor the spread of infection. Hopefully, like the flu vacc, it boosts your immunity to prevent a lethal infection. Make sure your lifestyle choices are consistent with survival.
The number of HCW COVID fatalities now number in the several thousands, though this data is not officially tracked. It stands to reason that if no one is tracking, the numbers are assuredly higher.
As we discuss surging outpatient personnel (like me) into staffing the hospital, I will make my exit if needed. Nurses and doctors came out of retirement to work the pandemic - some of them died. This is not the battle for older, frontline workers. This is a young persons war - and that’s not me.
My ukulele band KaBang! had continued to hold outdoors, physically-distanced rehearsals all year. But we have stopped for the winter, taking no chances to get through this surge.
 |
| Cora, Ayla, Leia, Alanna |
I did get to Newport Beach, CA in October to visit with Lael and her family before their move to Michigan. Because I could not isolate ahead of time, I wore a mask, kept my distance, and slept in BAM (Baconz Adventurosa Mobile). With some reluctance, I took my Humpty Dumpty (made by Aunt San) and bequeathed him to the next generation. He’s like 58 years old so I was a little sad to let him go.
With lots of alone time I have devoured books, podcasts, and MasterClasses. Here are some of my recommendations:
Favorite podcast: Presidential by the Washington Post. This was originally a weekly broadcast prior to the 2016 elections. Highlighting each President in order of ascension, it begins with Washington and ended with Obama. They have since added two more episodes. I discovered Presidents I knew nothing about. It was a fascinating recall of American history as everything of import is touched by the hand of the President. Really, it was fascinating.
Favorite books: Lincoln-Team of Rivals. At times, reading this was a slog, an almost daily accounting of Lincoln’s presidency. Nonetheless, there are striking similarities to our times and division. Famous for his generous opinions of others, one cannot fail to admire the thoughtfulness and grace that ruled Lincoln’s decisions. Angry letters never sent, snippets from his journal, and headlines from the NY Times all combine into a stimulating, nourishing stew that renewed my hope for our male-dominated, federal leadership. This tome is worth the time.
Kareem Abdul-Jabbar has co-written a few excellent prequels to Sir Conan Doyle’s Sherlock Holmes series. Apparently KAJ is a real Holmesian; these books are true-to-form, in-the-vein, and riveting respite.
I have more recently been thinking and reading about citizenship, civic duty, and living in a way that is responsible to and for others in my community. America is known for its rugged individualism but that, it turns out, is a myth. Nor does that mentality serve us well in a time that requires us to consider others, to love them as ourselves, and to speak the truth. The new year is always a good time to reflect on who I’ve been, how I behaved, were my words kind and did I honor others?
What’s on tap for 2021?
Believe it or not, my 65th birthday quickly approaches and I am eligible to retire on April 1st. I had planned on another big party for both birthday and retirement. Auwe! Maybe 2022? When safe, I do plan to pack my van and drive east to see friends and family. Maybe even drive parts of Route 66. Maybe end up in the NE for a never-done-before: see the fall colors before returning home.
I would love to hear how you have fared and the direction of your life.
Be well. Find joy. Laugh, sing, dance, play, and love.
A hui hou kakou (until we meet again) ~Lorin
Sunday, October 25, 2020
WWFD? What Would Fauci Do?
WWFD? What Would Fauci Do?
From the Trenches - # next
To enlarge, tap picture. Click X in upper right corner to return to blog.
Sadly, little has changed since my last blog in July but the rising death count and case load. Perhaps the disease is more real now, perhaps you know or know of someone succumbed to COVID-19.
America leads the world in COVID-19 deaths by many tens of thousands. If you think for one-minute that many of these deaths were not preventable - change your news channel - your information source is inaccurate. More Than 1,000 Current and Former CDC Officers Criticize U.S. Covid-19 Response. An open letter calls for the federal agency to play a more central role in addressing the pandemic. [1]
As we head into winter, flu season will be complicated by COVID-19. As the weather cools and people gather indoors, the risk of viral spread increases. We are already in, what has been named, “the fall surge.” Hospitalizations and cases are rising across the nation. We have not “turned the corner” by any stretch. The virus is surging - it is not disappearing.
Trump is right when he says people are sick of COVID-19. This is called COVID fatigue, we are tired of being apart, we want to hug our grandkids and gather at Thanksgiving - and we may give-in to our wants. The problem is, with 220,000+ dead Americans, COVID-19 is not sick of us. In fact, COVID-19 might just be warming up.
The intention of this blog is to give you the latest data on how to keep you and yours safe until we have the political will to come up with a national plan. Why a national plan? Because the nations who have successfully navigated COVID spread have done so with a unified, national strategy. With the resources of the nation being brought to bear on supply chains for PPE and testing materials, with case tracing and a plan for dealing with those infected and those exposed. 220,000+ American deaths clearly demonstrate that whatever plan this country is working is an ineffective one.
What have we learned since July?
- We’ve learned that the CDC (Center for Disease Control) has been compromised by pressure from the White House. [2] The first obvious example occurred July 8th when Trump tweeted that CDC’s guideline for reopening schools were “too tough.” CDC capitulated and revised them. [3] July 8th was the first (though not the last) time that I logged onto CDC’s website to print their COVID-19 Guideline so I could track changes made in subservience to Trump and against the advice of career epidemiologists and public health experts.
Other examples of CDC compromise:
September 1st CDC announced: “If you have been in close contact (within 6 feet) of a person with a COVID-19 infection for at least 15 minutes but do not have symptoms, you do not necessarily need a test unless you are a vulnerable individual or your health care provider or State or local public health officials recommend you take one.” This was a head-scratcher and completely at odds with contact tracing (the bedrock of epidemic management) but consistent with a misguided theory that less testing equals less cases. California’s Gov. Newsom immediately announced that the state would not be downgrading its testing. CDC reversed this guideline on September 24th. [4]
2) We’ve learned that the this virus is aerosolized - like measles - this is a big deal. Aerosolization greatly contributes to ease of infection. Remember the Disneyland measles outbreak during the Christmas Holiday of 2014?
CDC: Measles Outbreak - California, December 2014 - February 2015
As of February 11, a total of 125 measles cases with rash occurring during December 28, 2014–February 8, 2015, had been confirmed in U.S. residents connected with this outbreak. Of these, 110 patients were California residents. Thirty-nine (35%) of the California patients visited one or both of the two Disney theme parks during December 17–20, where they are thought to have been exposed to measles, 37 have an unknown exposure source (34%), and 34 (31%) are secondary cases. Among the 34 secondary cases, 26 were household or close contacts, and eight were exposed in a community setting. Five (5%) of the California patients reported being in one or both of the two Disney theme parks during their exposure period outside of December 17–20, but their source of infection is unknown. In addition, 15 cases linked to the two Disney theme parks have been reported in seven other states: Arizona (7), Colorado (1), Nebraska (1), Oregon (1), Utah (3), and Washington (2), as well as linked cases reported in two neighboring countries, Mexico (1) and Canada (10). [5]
We’ve heard similar COVID-19 stories: In June, a surprise birthday party in Texas resulted in 18 coronavirus cases. In July, a house party in Michigan led to 43 cases, and a family gathering in North Carolina led to 40 cases because the attendees "went about their daily lives" before they started showing symptoms. In some places, in-home gatherings are now responsible for the majority of new coronavirus cases. A recent Centers for Disease Control and Prevention report showed how a chain of family gatherings in Chicago let to three deaths. [6] I think we’ve all heard about the wedding in Maine that resulted in multiple COVID cases and deaths of people not even in attendance.
Aerosolization is a big deal, micro viral particles can hang in the air and be inhaled by another. In another example of CDC flip-flops, CDC finally declared what has been evident (to the medical community) for months: COVID-19 is aerosolized to enable airborne transmission. They quickly reversed that declaration with a backflip, only to reverse the reverse with a running Round-off- Back Handspring-Back Tuck. It would be entertaining and laughable if it weren’t so tragic. We have never seen such a schizophrenic CDC and it is more than disheartening for health care workers (HCW) across the globe who have depended upon the guidance of CDC for decades.
What does aerosolization mean for our own safety? It means masks are helpful. They stop droplets and some aerosol. But if you spend 15 or more minutes in a confined space with an infected person (i.e. carpooling, flying, exam room, meal prep in the kitchen), a simple, cloth mask will not keep aerosolized virus out of your respiratory tract.
What about public transportation, flying or carpooling? Best practice would have everyone wearing an N95 mask (get them on Amazon, Home Depot) to contain your own droplets and aerosols. Keeping the windows open will disperse any escaped viral particles thereby reducing the build-up of virus to infectious levels. Avoid the instinct remove the mask to cough or sneeze. DO sneeze inside your mask, that is what its for. I’ve read of a plan to physically distance commuters and open the windows on commuter trains into NYC through the winter.
What if everyone has a negative COVID test? Technically that could work, however, the White House Rose Garden Super-Spreader event gives us a stellar example of when it did not. Twenty-eight people were infected at that event where every attendee had a negative test. If the people living in a biologic bubble can get infected… that ain’t you and that ain't us; don’t let your guard down.
Rule #1 for indoors and out - keep physically distanced from people not in your “quarantine pod”. No close contact (within 6 feet) to any person for greater than15 minutes., wash hands, wear a mask. Keep it outdoors if possible (the odds of contracting the virus are 20 times higher indoors). Keep indoor gatherings small and with people under 60 years.
If not the CDC?
WWFD? = What would Fauci do? I am a fan of Dr. Fauci. He is not beholding to Trump, he cannot be fired by Trump, and he shrugs off the bullying. Yes, Dr. Fauci made some missteps - who didn’t? This IS the novel Coronavirus - a never-been-seen-before virus to which humans have no immunity. Do not get attached to a treatment plan or way of interacting with the virus. Good scientists will change their recommendations as we learn more and the data change. A man who can say, “I thought this, the data suggests that, we were wrong, the new plan of action is…” THIS is not ego driven but science driven; isn’t that what you want?
"Let's see if we could put this to rest once and for all," Fauci said. "Cloth (face) coverings work. If you look at the scientific data, the masks clearly work. I mean, they are part of a multifaceted approach of—masks, keeping distance, avoiding crowds, washing hands, doing things outdoors, much more than indoors. All of that is a combination of prevention modalities that are easy to do relatively speaking.” [7]
Follow the advice of Dr. Fauci and the World Health Organization. Dr Sanjay Gupta of CNN seems to be pragmatic and sound. California’s state or local health department has good information. Beware information dispersed by any politician unless it closely follows that of the Health Department.
And one more thing: listen to epidemiologists and public health professionals. Shun the radiologist who plays a public health professional on TV. He might have slept at a Holiday Express but he’s still bogus.
Bill Gates: I’ve tackled every big new problem the same way, by starting off with two questions. Who has dealt with this problem well? And what can we learn from them?
Look for best practices from other countries.
Totally Under Control is a new 2-hour documentary (streaming on Hulu & Amazon Prime) tracks our COVID-19 response against that of South Korea. Both countries learned of their first case on the same day in January. Both national responses are chronicled at critical decision points, when S Korea went right and the US went awry.
Research and follow best practices of other countries. i.e. Australia (905 deaths), New Zealand (25 deaths), S. Korea (457 deaths), Taiwan (7, yep, no typo, just 7 deaths). To be fair, these countries have a national strategy to protect their citizenry and national healthcare and electronic medical records that provide data in real time. The US could have that, we have the infrastructure, so far we lack the will. But we could personally follow the practices imposed by those countries.
Follow their example: universal mask wearing in public spaces, physical distancing from others, keep rooms well ventilated, avoid crowds, closed spaces with close contact, sanitize hands, cough into elbow, avoid touching your face. WHO instructs those with underlying conditions or over 60 to wear a medical/surgical mask. These practices are simple and the bedrock of interrupting the spread of any contagion.
Australia and other southern hemisphere countries had record low flu seasons. The physical distancing and other public health precautions put in place to combat COVID-19 quashed the flu season. It makes sense, flu is also a viral illness. The US could hope for the same but then, we would have to behave the same.
COVID-19 vs. cold and flu symptoms — Because the symptoms of COVID-19, a seasonal cold, and the flu have a lot of similarities, mild cases of COVID-19 may go undetected. Watch our video to learn more about the different symptoms for COVID-19, the flu, and a cold. [8]
The symptoms which are unique to COVID-19: shortness of breath, new loss of smell and taste, rash on hands and feet. Fever (over 100.5), shaking chills, headaches, cough, sore throat, diarrhea, muscle aches, and fatigue, are common to both COVID-19 and influenza.
Colds come on gradually and the most common symptoms are a stuffy nose, sore throat, and sneezing. They sometimes also include a cough and fatigue. Fevers and headaches are rare.
All three infections are viral illnesses - we don’t use antibiotics for viral illnesses. We use Tylenol for fevers, Robitussin for cough, Cepacol and salt water gargles for sore throat, inhalers for wheezing, etc. Even for COVID-19; its a virus.
If you have symptoms, contact your doctor. Many doctor offices do not have PPE (personal protective equipment) so we do not necessarily want you in our office. We will try to treat you over the phone or by video visit. We will send you to the Emergency Department for shortness of breath - where staff are properly protected and chest X-rays and blood oxygen saturation can be assessed.
What about the Holidays?
WWFD? Dr. Fauci's Tips for Celebrating the Holidays in a Safe Way During the Coronavirus Pandemic
1. Go small-scale or go virtual.
"Be very careful and prudent about social gatherings, particularly when members of the family might be at a risk because of their age or underlying condition," Fauci told CBS Evening News. "You may have to bite the bullet and sacrifice the social gathering unless you're pretty certain that the people that you're dealing with are not infected ... either they've been very recently tested or they're living a lifestyle in which they don't have an interaction with anyone but you and your family." As he explained this, Dr. Fauci pointed to his relationship with his wife, Dr. Christine Grady. The duo only socializes with each other and no one else.
2. Don't assume that just because you feel OK you are OK.
While explaining this on CBS Evening News, Fauci referred to nationwide observation reports from his fellow coronavirus task force member, Dr. Deborah Birx. Those reports discovered that family members are spreading the coronavirus to each other more often than at the beginning of the pandemic.
"Household transmission is assuming a greater element of the transmissibility," Fauci said. And since researchers are learning that about 1 in 5 people who become infected with the coronavirus are asymptomatic, it can be a big challenge to know if you might be at risk for spreading the virus to someone who may experience more severe symptoms or complications. (Say, someone with any of these high-risk medical conditions pointed out by the Centers for Disease Control and Prevention.)
3. Travel early.
If you do decide to gather in person, follow the CDC's safer holiday travel tips: Drive and don't stop along the way (What about bathrooms? See below); then, after arriving, quarantine at a separate dwelling (such as a no-contact Airbnb) for at least five days (the median time it takes to test positive). Then get tested before gathering with your family.
4. Keep things small.
"When people do things in crowds without masks—particularly indoors—it's just asking for trouble. We know without a doubt that those are the events that have spreading among people. It isn't as if we haven't been there before. We know that's trouble. It just seems obvious you've got to avoid that," Fauci said in the interview with CBS Evening News.
(Check out one poignant example of this in our story about a coronavirus survivor who spoke out after hosting a gathering that infected 14 and killed 2 family members.) So only invite a small crew that can stay safely spaced at least 6 feet apart in the event of any congregating.
5. Speaking of masks, wear one with anyone outside of your household—even relatives.
At the beginning of the pandemic, Fauci wasn't a huge proponent of masks, fearing that there might be a shortage for health care workers. But just one month later, Fauci reversed his stance, once he learned that masks—even the cloth face masks you can buy or make—help prevent infection.
"When you find out you're wrong, it's a manifestation of your honesty to say, 'Hey, I was wrong. I did subsequent experiments and now it's this way,'" Fauci said during a 60 Minutes segment that aired on October 18. So in case you're looking for his final answer, it's wear a mask—even with your family—each and every time you're sharing space with anyone outside of your household and especially anytime you're inside. (That is, when you're not eating or drinking.)
While not seeing family might feel like a tough pill to swallow, those are some sage doctor's orders as turkey time inches closer and closer. [9]
What about bathrooms; both public and private?
Public bathrooms continue to pose a problem. [10] Ever heard of toilet plume? Aerosolized viral particles can hang in the air of an enclosed bathroom. Scroll to my previous blog dated July 12th to the paragraph: What about bathrooms; both public and private?
Lastly, remember the 3 W’s: Watch your distance, Wear a mask when you can’t watch your distance, and Wash your hands.
e malama he pa waiho ai = keep safe
Footnotes:
[1] https://www.wsj.com/articles/more-than-1-000-current-and-former-cdc-officers-condemn-u-s-covid-19-response-11602884265
[3] https://khn.org/morning-breakout/cdc-to-revise-school-reopening-guidelines-after-trump-blasted-initial-ones-as-too-tough-and-expensive/
[4] https://www.bmj.com/content/370/bmj.m3386
[5]https://www.cdc.gov/mmwr/preview/mmwrhtml/mm6406a5.htm
[6] https://www.theatlantic.com/politics/archive/2020/10/it-safe-have-dinner-together-inside/616568/
[7] On CNN’s Reliable Sources with Brian Stelter 9/27/2020
[8] Kaiser Permanente
[10]https://www.washingtonpost.com/lifestyle/2020/10/15/coronavirus-public-restroom/
Sunday, July 12, 2020
You ARE Your Brother’s Keeper - From the Trenches #5
To enlarge, tap picture. Click X in upper right corner to return to blog.
America’s First! First in COVID cases (3,000,000+); first in COVID fatalities (133,000+). Let’s just be with that for a moment.
The graph below is a comparison of new cases per million - which we OWN baby! If this does not horrify …I pray I am never indifferent to… never able to justify the damaged and lost lives represented by this graph.
Prof. Michael Osterholm Univ of Minnesota, Director of the Center of Infectious Disease says the US COVID-19 catastrophe “is a raging forest fire looking for human wood.” Kindling made in America.
Perhaps the bigger message, also clearly demonstrated, is that there IS a path to living better with COVID-19 - and we’re not on it.
How do we differ from other countries? They employed centralized leadership with a strategic plan guided by science: lockdown, physical distancing, masking, hand washing, reopening once case levels were low with robust testing and tracing. In the US, a strategic plan guided by science would have the CDC running the show with federal and state policies reflecting their guidelines. Want to see what a US national response could have looked like? Read them and weep:
First, How to Read Obama’s Pandemic Playbook
AND (Obama’s) PLAYBOOK FOR EARLY RESPONSE TO HIGH-CONSEQUENCE EMERGING INFECTIOUS DISEASE THREATS AND BIOLOGICAL INCIDENTS
https://www.documentcloud.org/documents/6819258-Playbook.html#document/p2
We’re STILL not following the Playbook (though it is never too late to start) and without centralized leadership, every state is on their own. And while states have capable people, one state medical director lamented, “The experts are at the CDC” - who seem to be muzzled.
In the absence of national leadership; remember the admonition in my last blog? Listen to experts like Dr. Fauci. Listen to experts in virology, epidemiology, and public health. Listen to your local politicians only if they are clearly guided by science. If your Governor is touting something at odds with Dr. Fauci, I’d pick Fauci over e-v-e-r-y-o-n-e just now.
“The reality is that the virus is not under control; it is IN control.”
So here we are - at starts and stops - as I predicted last month. We have added 1,000,000 new cases and 40,000 fatalities. What now?
Contract! Pull in! Slow down! Just because the gym is open does not mean you need to be there. Just because air fares are cheap does not mean you need a ticket.
What have we learned in the last month? We’ve learned that the US COVID-19 mortality rate is 4.2% versus 0.1% for the flu. This is no flu. We’ve learned that systemic inflammation called leukotriene storm causes multi-organ disruption and failure leading to death. We’ve learned that an old and cheap steroid called Dexamethasone is helpful. We learned Hydroxychloroquine, an anti-malarial drug touted like snake oil as a prophylactic and cure - is harmful. We’ve confirmed that COVID-19 is mostly spread through the respiratory tract and less so by touching infected surfaces. We’ve learned that peak infectiousness (highest quantity and virulence) occurs in the pre-symptomatic or asymptomatic period and accounts for 50% of viral transmissions. Which is why masks and physical distance are effective in crushing the curve, as demonstrated by the EU, Scandinavia, S. Korea, Singapore, Taiwan, Hong Kong, and New Zealand, just to name a few. We’ve confirmed that indoor gatherings, no matter how well intentioned, can be the spawn of death. We’ve learned that the PR number is important but that Joe Public does not know how to interpret the data. We’ve learned that safe re-opening cannot be done “my way”. Remembering that we are in this together; MAYBE we’ve learned that reopening must be done “our way” - with each of us being responsible for all of us - as again demonstrated so aptly by countries who have done so.
The CDC: - On June 25th, the CDC updated its list of specific conditions that increase a person’s risk of severe COVID-19 illness: advanced age (65 and over), COPD (chronic obstructive pulmonary disease, CKD (chronic kidney disease), obesity (BMI >30), immunocompromised state, serious cardiac diseases (i.e. coronary artery disease, cardiomyopathies, heart failure), sickle cell disease, and uncontrolled diabetes. Combine any of these with common diseases like high blood pressure, over weight (BMI 25-30) or asthma and the risk for severe illness with COVID-19 infection increases exponentially.
What does this mean? It means if people wish to avoid contracting and transmitting COVID-19, for which there is no natural immunity and no vaccine, they will have to diligently practice physical distancing, masking in public, meticulous hand washing, avoid gatherings of more than 10 people FOR THE NEXT YEAR OR SO. Until “All Clear” is proclaimed from the rooftops by Dr. Fauci or his emissary.
Review the CDC guideline links to recommendations regarding gatherings, public bathrooms, restaurants, schools, etc. See the latest recommendations on how to comport one’s self during a pandemic.
Speaking of schools, I’m heartened to see the CDC hold their ground on recommended guidelines for reopening schools. Were I a parent, I would make a copy of their current and recently released school guidelines (~ 17 pages), in case they buckle to Presidential pressure and tweet-storm and weaken their guidelines. I’d kinda want to know; wouldn’t you?
Lets talk about testing. We ARE testing more. Is that why we detect more cases? Of course, but that is only half the story. Epidemiologists watch the PR = positivity rate. That is the ratio of positive tests against total number of tests expressed as a percentage of positive tests. This graph from Propublica demonstrates the rolling positivity rate (PR) of Arizona vs New York. The number of actual tests are rising in both locales but so is the PR in AZ; meaning more tests are positive. Conversely, the number of tests are also rising in New York but the PR is falling. The PR is how we know that we are not seeing more positive COVID-19 cases just because we have more tests.
A PR of 30% is an unmitigated disaster. We see this kind of exponential PR increase in hotspots across the US. Experts say wide spread infection can only be stopped by reversing course and shutting down hotspots once again. Recall that China quarantined another major city in May.
We can’t test our way out of this mess. Testing works once the numbers of infected people are low and the contacts of each new case can be traced. Testing is a useful tool only if resulted in 1-2 days.
The current California PR = 6.8%. With the recent flare of cases in Sacramento, we are booking testing appointments a week out with another 3-4 days for results. (Quest has been taking 11 days to result tests. Making testing useless.) Part of this delay is secondary to a lack of testing and developing supplies. Additionally, the government could activate more labs, like veterinary labs, as was done in Europe.
Ask yourself, why are we 5 months into a pandemic and we still can’t get a q-tip?! Why can’t I get an N-95 mask for seeing patients? If you’re upset about that - write your Senator, Senate Leader McConnell, and your President. There is no jumpstarting an economy, no getting kids back to school and parents back to work when well people have to quarantine at home for 2-weeks waiting for a test and results.
Does anyone still think this is a hoax? Helluva hoax!
Obviously, testing is only part of the equation. Many Americans are behaving badly. What do we do? “There is no single method for protection,” Prof. Osterholm says, "Distancing is huge, distance, distance, and distance. That only occurs when people are not congregating altogether.”
WEAR A MASK
Yes, we’ve had conflicting messages from the start. Remember this is called the novel coronavirus. The key word here is NOVEL = NEW. We knew and know very little about this virus and we are still learning. Be open to changing instructions. Remember when we thought smoking improved ones health, cars did not have seat belts, and driving drunk was not unlawful? Refusing to wear a mask is like driving drunk. We will get to smoking later but the point is, new information does point to overwhelming respiratory spread. Protect your respiratory system.
But I thought a mask doesn’t protect me; it protects others? Evidence continues to point strongly to spread by respiratory droplet. A mask will slow droplet spread. It will slow inhalation of droplets and it will contain the spread of exhaled droplets.
There is a plethora of data including caged mice infected with corona virus adjacent to a cage of healthy mice separated only by the thin barrier of mask fabric. Look East to the very low infection rates in densely populated cities like Hong Kong, Taipei, and Singapore. Masks are a big part of their successful strategies.
“Researchers at Florida Atlantic University, in a study published (clic “published” here to jump to best DIY masks) in the journal Physics of Fluids on June 30th, found that bandanas reduced the average distance that coughs traveled from 8 feet to 3.6 feet. A folded handkerchief took that distance down to 1.25 feet. Commercial cone masks reduced the distance to 8 inches, and a two-layer, stitched mask to 2.5 inches.”
A picture is worth a thousand words - watch this CNN video clip with Dr. Sanjay Gupta and Jake Tapper. The graphics show all you need to know about “why mask”.
WE are in a pandemic. Wearing a mask is a tool to keep people safe, to slow the curve, to prevent deaths. Nothing more. A mask is not a political tool or statement. A mask can help slow the spread of a deadly virus for which there is no natural immunity, no vaccine, and no cure. In this, you truly are your brother’s keeper.
A mask is not a muzzle. A mask is not an impingement on personal freedoms. My snarky brain hisses, the dead have no freedoms. If you honor the sanctity of life - wear a mask. If you are pro-life and/or (because amazingly, these two do not automatically coincide) anti-death penalty, wearing a mask is consistent with this belief. If you believe Black Lives Matter or that All Lives Matter, wearing a mask is consistent with this belief. Every religion charges its followers with caring for others; wearing a mask is consistent with all religious beliefs. Ask yourself - WWJD? Darwin would wear a mask.
I’m healthy; I won’t get it and if I do - I’ll survive. …And you might - do not assume those you might unknowingly infect - will. Let me repeat: in this, you truly are your brother’s keeper.
Follow the advice of Dr. Anthony Fauci, America’s guiding voice during the pandemic. He seems to have been recently un-muzzled - and he has a lot to say. Follow him.
Want to know what Dr. Fauci and other experts view as permissible behavior in a pandemic? From airplanes to grocery stores and groceries to gyms to house guests to routine doctor visits, read the WaPo article below. How experts are dealing with Covid-19 risk in their own lives:
What about bathrooms; both public and private?
Ever heard of toilet plume? Like the vapor cloud around ones mouth when speaking (recently named mouth rain), it is the spray that occurs when a toilet is flushed. You might remember around 2000 when toilets got their wings and began flushing with great gusto like airplane toilets. (You would never flush an airplane toilet without closing the lid; would you?) It was found that great-gusto flushing aerosolized bacteria from the toilet into the air and it wasn’t long before great-gusto toilets were de-gusted. During the drought, we went to low-flow toilets and gustatory toilets became less prevalent. Nonetheless - toilet plume is a known problem though there are no known cases of COVID-19 from said contact.
Home toilets have lids. Close the lid before flushing.
What about public toilets? They typically do not have lids. Wear a mask - that’s the most important thing. If you can, do all your business, including hand washing, then flush just before exiting.
What about automatically flushing toilets? If possible, take a deep breath before standing, wash your hands and exit - pronto.
What about one-holers vs multi-holers (meaning single vs multi-toilet bathrooms)? Believe it or not, in this case, a multi-holer might be safer because they occupy a larger footprint with more airflow for improved viral dispersion into the air and the time allotted for droplets to go-to-ground. One-holer (private) bathrooms are smaller spaces with less air circulation and thereby decreased viral dispersion. Concentrations of viral particles can build in small, enclosed spaces (hence the new discussion of viral aerosolization, which will be mentioned briefly below). If possible, let the bathroom stand vacant for 1-minute before entering. In my own workplace, theoretically it is safer to use the public bathroom than the private ones for staff. Public restrooms and toilet plume:
Want more information on viral dispersion? Read the paragraph called Outside versus Inside in my previous blog.
What about using another’s home toilet? Here are the rules we have established for our outdoor, 4-person, ukulele rehearsals. Wear a mask, sanitize hands before entering the home, use bathroom, wash hands, close lid and flush, return to the outside lanai without touching anything inside the home. Easy-peasy.
We are going to be doing this for a while. Get schooled and get good.
MODIFIABLE RISK FACTORS: we call them modifiable because you can actually modify your lifestyle and impact your risk factors.
Recently, doctors caring for hospitalized COVID-19 patients are successfully treating them with steroids = powerful anit-inflammatory medications. In retrospective, observational studies, looking back on fatalities in New York City and the UK, people with pro-inflammatory (inflammatory causing) diseases like diabetes and being overweight had worse outcomes of critical illness or death. Smoking and vaping also causes inflammation in the lungs.
What can you do to lower inflammation? Stop smoking or vaping. Lose weight. Get diabetes under control (A1c<7.0). While your working on that consider an anti-inflammatory diet - start with reducing meat intake. Meat = anything that had a mother, a father, and face. Meat includes: fish, pork, beef, poultry, wild game, reptiles, amphibians, in short, any animal. I encourage patients to start with meatless Mondays and grow that to 3-4 days/week. A vegan diet is highly anti-inflammatory.
Finding ways to improve health:
Stop smoking and/or vaping: Get help, get patches, pills, gum, support, and get smoke-free. I tell my patients - to stop smoking is the single, fastest change you can make to improve your health. There is no better time - and your life may depend on it.
Lose weight: with over 66% of American adults deemed medically overweight or obese, contracting COVID-19 could lead to dire consequence.
Being overweight is the second biggest risk factor for serious illness, behind age. Overweight causes systemic inflammation and hypoventilation (decreased oxygenation of body tissues). The connection between weight and increased risk of severe or fatal infection with flu-like viruses, was first identified during the 2009 swine flu pandemic, which killed 284,000 worldwide.
Weight is rated according to body mass index (BMI) — a BMI under 25 is considered ‘healthy’ while 25-29 is classed as ‘overweight’ and 30 plus is ‘obese’. (Find your BMI on Google. Of note: the Asian BMI scale is significantly lower than the common, Caucasian BMI scale. Anyone of Asian continent descent should be aware and beware.) U.S. research published last year also found vaccines are less effective in overweight people.
Intensive Care National Audit & Research Centre (ICNARC) data has shown three-quarters (75%) of critically ill UK COVID-19 patients were overweight or obese.
Similarly, a study of 4,103 seriously ill COVID-19 patients by New York University, showed while age is the biggest, single risk factor for serious illness, obesity is a close second.
If it were easy - you woulda done it. Losing weigh is obviously easier said than done. Get help and find support. Choose among a myriad of online tools. Your healthcare system assuredly offers a selection.
Get diabetes and hypertension under control. Weight loss can drive both diseases into remission but in the meantime - work with your doctor. This is not a time to cut yourself slack and give in to stress eating or reason du-jour. If ever there was a time; this is it. This is the time to take on the challenge and possibility of a healthy body - like your life depends on it - because it may.
Do I need to stay indoors? No - going outside good. My ex-mother-in-law thought she was trapped indoors and missed a month of walking. Walking is good; just give passing people a wide berth. Ride your bike. My yoga studio is offering online classes. Yoga on my lanai no ka oi (da bes)! Keeping yourself healthy, both mentally and physically, keeps your immune system strong. Get some exercise!
Want to support your favorite restaurant and see your friends? I meet my bestie for lunch in a park, where we sit at opposite corners of an 8-foot picnic table, eating take-out from our favorite haunt. A beer with the neighbors? Outside, in appropriately spaced lawn chairs works.
Any activity that you might want to engage in will be infinitely safer if you move it outside. A Japanese study says 20 times safer.
WHO (World Health Org) just announced the possibility of aerosol spread. What is that? Aerosols are tiny bits of virus that hang in the air. Do you remember the measles outbreak a few years ago? Every case was traced back to a particular weekend at Disneyland. (That was testing and tracing at its best.) Measles can hang in the air …making it highly contagious in those long, snaking, indoor queues (think Pirates of the Caribbean). Aerosol infection is why researchers think choral singing (inside) has resulted in many infections while protesting outside has not.
There is no economic recovery if our workforce cycles in and out of illness and workplaces become incubators for disease. There is no paying my mortgage if I get sick. There is no retirement in 9-months if I die. Lets get serious people!
This will take mental toughness, emotional intelligence, and emotional discipline. This will require physical discipline. Many economists are predicting global recession if not depression - so this may require economic discipline as well.
This just might be a defining moment, a sentinel moment for the USA. Look again at my opening graphic. The US is number 1, but this time it is nothing to crow about. We are not recovering, we have not even turned the corner. And no other nation is following our lead - which means, if we want their results, we must follow their lead. If as a nation, we continue to behave like wild-west cowboys, then we who lack the yahoo-gene will be required to be even more vigilant and more careful.
One last thing, here’s one for the team because most of my colleagues are far too polite to say anything like this. Dr. Daniel Summers, MD tweeted this and he speaks for many, “No amount of clapping or cheering or calling healthcare workers heroes meant a damn thing if you undo all our work with your shi__y, irresponsible behavior now.” Touché!
Additionally, we can’t take care of you if too many of us get sick.
To a large degree, my health & life depends on my savvy and the health of my coworkers, my friends, and my family. Our actions reflect our commitments. I have a commitment to myself and my community - to keep us well. What’s yours?
Footnotes:
1 https://www.motherjones.com/kevin-drum/2020/07/trump-orders-the-cdc-to-change-its-school-guidance/
2 Washington Post, 7/3/2020
3 Johns Hopkins Univ https://coronavirus.jhu.edu/data/mortality
4 Yale Alison Galvani, PhD https://whdh.com/news/silent-spreaders-may-be-responsible-for-half-of-coronavirus-cases-study-finds/
5 Face mask construction, materials matter
6 https://search.yahoo.com/yhs/search;_ylt=AwrTLfophQRfU44Afwo2nIlQ?p=propublica+az+positivity+rate+chart&hsimp=yhs-fullyhosted_011&hspart=iry&fr=yhs-iry-fullyhosted_011&fr2=p%3As%2Cv%3Ai%2Cm%3Apivot&stype=web
PUBLISHED: 17:08 EDT, 20 April 2020 | UPDATED: 03:08 EDT, 21 April 2020
How to Read Obama’s Pandemic Playbook
(Obama’s) PLAYBOOK FOR EARLY RESPONSE TO HIGH-CONSEQUENCE EMERGING INFECTIOUS DISEASE THREATS AND BIOLOGICAL INCIDENTS
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