Tag Archives: COVID-19

The Shadow Pandemic: Women Work Longer, Sleep Less Due To COVID-19

Women around the world are facing a shadow crisis amid the COVID 19 pandemic, as their workloads for both paid and unpaid labor increase dramatically.

“The COVID 19 pandemic has aggravated the existing conditions for women, who are discriminated against in all sectors,” said Dr. Beatrice Duncan, Policy Advisor, Rule of Law, UN Women, at a May 22 briefing organized by Ethnic Media Services.

Panelists at the briefing noted that the COVID crisis has both highlighted and exacerbated gender inequality around the world. They also discussed the dramatic rise of domestic violence, including abuse by adolescent children. Duncan stated that domestic violence has seen a three-fold spike in the U.S. over the past two months.

Dr. Kirsten Swinth, Professor of History at Fordham University, compared the current pandemic to the 1918 pandemic and the Great Depression, suggesting that there were lessons from both that inspired women to push forward.

“The 1918-19 flu pandemic was a huge blow to male-led modern medicine, and its faith in science to cure infectious diseases,” said Swinth. Nurses however, were valorized, because of their professionalism in providing essential care services.

Similarly, in the current pandemic, essential workers, including those on the bottom of the economic ladder are lauded as heroes for providing essential services in a time of crisis, she said.

Recognition of women’s critical role in the 1918 epidemic occurred simultaneously with suffragettes going door to door to garner support for women’s right to vote: the 19th Amendment was ratified in 1920.

Swinth also pointed to how increased social and economic burdens on women during the Great Depression helped birth a generation of women leaders who fought for cost of living issues and increased participation in labor unions.

Dr. Nicole Mason, President and Chief Executive Officer of the Institute for Women’s Policy Research said women disproportionately account for the nearly 39 million people who have filed for unemployment in the last nine weeks because of their over-representation in service sector jobs which require employees to be on site, rather than working remotely. The service sector has been hit the hardest by the economic lockdown.

The U.S. Labor Department released data earlier in May, which examined unemployment claims by gender for the month of April. Unemployment rose overall from 4.4 percent to 14.7 percent. For women, unemployment rates rose to 16.2 percent versus 13.5 percent for men. In February, prior to the pandemic’s full throttle on the U.S. economy, unemployment rates for both sectors were roughly equal at 3.5 percent.

As day care centers and schools close down, women face the double burden of full-time care for their families — including home-schooling them — while also trying to hold down a full-time job. Conversely, women who have retained their service sector jobs are having to make very tough choices between working and taking care of their families, said Mason.

Women will also have a harder time economically recovering from the pandemic. “Many lost jobs will not be returning,” she said, advocating for long-term policy solutions which would help women re-enter and remain in the workforce; flexibility in schedules to address child care needs, along with work-site child care centers; paid sick leave mandated for all employers; and a universal basic income.

Dr. Estela Rivero, Research Associate with Notre Dame’s Pulte Institute for Global Development, stated that the COVID 19 pandemic has exacerbated the already limited opportunities for women to gain financial independence. “Time is one of our most precious resources,” she said, and women are now forced to spend more hours doing unpaid labor compared to men.

In the U.S., her studies show that amid the pandemic women ages 30-40 spend an average of 60 hours per week in paid and unpaid labor. Men spend 57 hours, primarily in paid labor.

In Mexico, women spend 80 hours a week in paid and unpaid labor, while men spend 70 hours primarily in paid labor. If a member of the household becomes ill, women spend an additional 10 hours per week caring for sick people. Overall, women’s sleep is decreased by 5 hours.

“One positive note is this: as family members spend more time at home, they get to see what women do to keep the household running,” said Rivero, expressing hope that this will lead to a shift in attitude about the value of women’s work.

Mimi Lind, Venice Family Clinic’s Director of Behavioral Health and Domestic Violence Services, said that the rise in domestic violence during the pandemic coincides with the loss of traditional lifelines such as shelters, the court system, and health care.

Lind defined the many types of abuse, which include physical and sexual violence; forcing a victim to be financially dependent; name-calling, shaming and using social media to hold power and control over a partner or ex-partner.

Women isolated at home with an abusive partner cannot call a hotline for help because of fears that the violent domestic partner or adolescent child might overhear, resulting in increased violence. As more health care services are conducted via tele-medicine, women also lose personal access to doctors and nurses who often ask about partner abuse when a woman comes into a hospital.

Some protections do remain for women living in Los Angeles County, said Lind. Courts within the county can still provide restraining orders against the abusive partner. Additionally, some domestic violence hot-lines can provide women with vouchers which would allow her to leave an abusive situation and go to a hotel or motel temporarily.

Duncan closed the briefing by likening the pandemic to a global war. “This could be the Third World War that we are facing.” Like her fellow panelists, she looked for signs of hope in what her agency describes as “the shadow pandemic.”

“In all the wars we have faced across the years, the fatalities have mainly been men, but the consequences are born by women because women then have to manage the households.”

“Whenever we experience this kind of social change, it also comes with changes in gender relationships,” said Duncan adding: “In some cases, it allows women to advance more because they become the household heads.”


image credit: Photo by Almos Bechtold on Unsplash

Battery Dance Company Energizes Healthcare Workers

Vivake Khamsingsavath, a dancer and choreographer at the Battery Dance Company is helping frontline healthcare workers take a break from Covid-19 by adding a ‘small dose of tranquility’ into their lives.

“Imagine a wave rising and gently settling back into the calm water,” Vivake tells his Zoom class, as his arms float upward and slowly fall to a soundtrack of lapping water.

On the virtual call, healthcare workers follow his delicate, graceful movements, stretching and swaying to release tension and find a quiet moment before their next stressful shift.

Jonathan Hollander, founder of Battery Dance.

“Vivake is the child of Laotian refugees who came to America during those terrible times,” says Jonathan Hollander, the founder of Battery Dance. “He has this calm voice and soothing way which has a kind of Buddhist mentality and experience behind it.”

As he takes his class through a brief set to relax and release tension, Vivake focuses on mindful movement related to breathing, inhaling, and exhaling.

“It’s something about a yogic kind of opening up and feeling the extremities, that helps take the mind off all of the horror people are seeing and experiencing all day long,” explains Hollander.

The series ‘Giving Back to Healthcare Workers’, was inspired by Giving Tuesday Now, a national day of giving to support those responding to the pandemic.

“Instead of asking for money on Giving Tuesday Now,” says Hollander, “we thought of this as an opportunity for us to turn it around and give back to the community that supports us.”

Battery Dance created a series of free, 15 minute, virtual classes for any frontline health care worker during May and June.

But participants don’t need prior dance experience, adds Hollander.

“When people see dance and they’re not dancers, they think they have two left feet – that’s not for me. But it is!”

He reminded his trainers not to include anything complicated. “We don’t need to put any more complication into any one’s lives.”

Vivake Khamsingsavath leading a virtual session on Zoom.

Vivake and Mira who lead the classes, designed the courses with movements that reflect simplicity and clarity.

“It’s for anybody. It has nothing to do with dance per se,” explains Hollander. “It’s just a wonderful way to release tension!”

The classes are proving popular with healthcare workers not just in New York, but also on the west coast and abroad.

“Right now, we have 8 sessions a week,” says Hollander, “but we will expand that because people in hospitals in Dallas and in San Diego are interested in joining this, and we’ve actually had people in India and Sri Lanka getting online.”

Located on the border of Chinatown in New York, Battery Dance is a multicultural dance company that Hollander describes as “a snapshot of New York…which is why people relate to us.”

March 13 was the last time his team met before Covid-19 sent them home.

“But,” Hollander smiles, “we’ve been together everyday building this presence online since March 27. We created Battery Dance TV and have  broadcast over 300 programs which include a fitness class in the morning, a ballet fusion, a jazz fusion class, and different ballroom classes every single night at 6 o clock.”

“The silver lining in a catastrophe like this is that it’s bringing us together with a community of healthcare and service workers we really didn’t have a connection with before,” says Hollander.

And, from his Brooklyn home, Vivake takes his online class through the graceful movements he’s created, telling them to send positive, golden energy out into the universe.

All healthcare workers and service providers can join the virtual mindful movement sessions for FREE!

Meera Kymal is a contributing editor at India Currents.


Image Credit: Battery Dance Company

Free, Easy COVID-19 Testing in Santa Clara County!

Residents in Santa Clara County can now get free and easy COVID-19 testing in their neighborhoods.  The county just launched six new and expanded drive-through and pop-up locations at community centers, parking lots, and county health system in Milpitas, Morgan Hill, Mountain View and San Jose.

People get who get tested at these sites pay nothing for the test.

“It’s fast, free and you don’t need insurance,” said Cindy Chavez, President of the Board of Supervisors, urging residents to advantage of the opportunity to get tested in their neighborhood.

“The County is bringing testing capacity to where it’s needed.”

The locations were chosen based on data showing a higher rate of recent cases in these areas compared to nearby areas. By adding six new locations, the county now has at least 46 sites offering COVID-19 viral detection testing.

Frontline Workers  Need Monthly Testing
The county recommends that essential workers (grocery store clerks, food delivery workers, retail associates, first responders, and other frontline workers), who regularly interact with the public to get tested at least once a month going forward, even if they have no symptoms at all. Testing can identify the infection before a person feels unwell or before they spread it to another person with potentially deadly consequences.

“I encourage everyone to protect themselves and their family by scheduling a test at one of our test sites throughout Santa Clara County,” said County Supervisor Joe Simitian. The tests offered are viral detection tests, which diagnose a person who currently has the infection.

Mobile testing services will be available at Rengstorff Park in the City of Mountain View. “We need everyone – including cities, the County, and private healthcare providers and labs,’ noted Mayor Margaret Abe-Koga, “to do their part to help us get through this crisis.”

WALK-UP TESTING SCHEDULE
Walk-up testing at outdoor “pop-up” sites will be available available without an appointment, insurance or doctor’s note, at Mountain View (May 25 & May 27 and in San Jose (May 29).

Monday, May 25, 10 a.m. – 2 p.m.
Rengstorff Park Pool Area, 201 S Rengstorff Ave., Mountain View, CA 94040

Wednesday, May 27, 9 a.m. – 1 p.m.
Rengstorff Park Pool Area, 201 S Rengstorff Ave., Mountain View, CA 94040

Friday, May 29, 10 a.m. – 2 p.m.
La Placita Tropicana Shopping Center parking lot, 1630 Story Rd, San Jose, CA 95122

DRIVE THRU TESTING SITES 
Drive-thru testing will be available 7 days a week at four county health system locations in Milpitas, Morgan Hill and San Jose. These require appointments which can be made online at sccfreetest.org or by calling 888-334-1000.

  • 1325 East Calaveras Blvd., Milpitas, CA 95035 (location subject to change)
  • 18550 De Paul Dr., Morgan Hill, CA 95037
  • 777 E Santa Clara Street, San Jose, CA 95112
  • 1993 McKee Road, San Jose, CA 95116

For more information on testing go to www.sccgov.org/sites/covid19/Pages/covid19-testing-learn-more.aspx#types.

For information on test sites call 211 or go to sccfreetest.org. The site is available in English, Spanish, Vietnamese, Chinese and Tagalog.

 

 

South Asians Hit Hard by COVID Need Help

As the death rate from COVID 19 in the US spirals toward 100,000, one fact is alarmingly clear. While the virus severely affects seniors and people of all ages with serious underlying medical conditions, it has hit communities of color the hardest.

“South Asians are suffering across the country on a level we haven’t ever seen,” says Lakshmi Sridaran, Executive Director of SAALT, in a recent call to action to the community.

Minority communities are more at risk because long standing disparities in health, social, and economic status make them more vulnerable. Many South Asians work high risk jobs as healthcare workers, domestic workers and grocery store workers. South Asian workers are employed in meat processing plants, and as Uber and taxi drivers. As a result of the pandemic many face economic hardships and limited access to healthcare services or even proper protection while performing their jobs.

“So many have fallen sick. Too many have died,” adds Sridaran.

SAALT is responding to the crisis by facilitating the National Coalition of South Asian Organizations-direct service organizations that are doing critical work to support those most impacted by the pandemic:  They offer services to provide food, health and financial assistance to victims of the pandemic that include undocumented immigrants as well as domestic violence survivors.

Sridaran is urging all South Asians to support and uplift the hardest hit people in our communities at this challenging time.  Links are provided below.

 New York, the epicenter of the pandemic

New York, the US epicenter of the COVID-19 pandemic, has among the largest South Asian populations in the country. Community leaders are reporting that the official data on infection and fatality rates are inaccurate and don’t reflect their experiences.

Many South Asians in Queens and the Bronx work as domestic workers, as drivers, in grocery stores, or delivering packages – without PPE or adequate healthcare. Those who are undocumented don’t even have access to government aid.

What’s more, so many community members are out of work, leading to a level of food insecurity not seen before. In response, community organizations and volunteers have shifted their work to set up mutual aid networks to deliver food and medicines and provide cash assistance and childcare.

Support them at Desis Rising Up and MovingAdhikaarSapna NYC

South Asian Domestic Violence Survivors

Community leaders from domestic violence organizations are especially worried about survivors. There’s been a drop in crisis calls – because survivors are trapped at home with their abusers and don’t have the space to make calls. And, many domestic violence shelters aren’t accepting people right now out of fear of COVID-19. Domestic violence organizations are delivering groceries, helping survivors apply for public benefits, and finding alternative shelter arrangements.

Support them at Daya Houston (TX)Raksha (GA), Maitri (CA),  Narika (CA)Asha Kiran (AL)Sahara (CA)South Asian Network (CA)Apna Ghar (IL)

South Asian Immigrants

People who are undocumented have no access to government aid or relief. South Asians in immigrant detention are stuck in crowded facilities where there have been reports of COVID-19 outbreaks and over 100 migrants could be deported back to India any day now. Even if released from detention many cannot afford the unduly high bonds. South Asians on H-1B and H-4 visas fear losing their jobs and falling out of status with dim prospects of finding another job in this uncertain economy. Immigrant rights groups are fighting these injustices at every level.

Support them at Bond Funds: Fronterizo Fianza Fund, SAALT’s local partners on the border: Detained Migrant Solidarity Committee and Avid in the Chihuahua Desert, Mutual Aid Funds: South Dako­ta DREAM Coali­tion & South Dako­ta Voic­es for Peace and Jus­tice for Mus­lims Col­lec­tive Com­mu­ni­ty Relief Fund

These organizations are doing “lifesaving work right now” says Sridaran.

Click on the link for a full list of the National Coalition of South Asian Organizations.


Image Credit: Pixabay 

30-Somethings Go Home To Mom & Dad

It took three weeks, but Lawrence and Arlene Maze finally persuaded their younger son, Gregory, of Los Angeles, to get on a flight home to Austin.“He basically shut his business down to come here and has to restart his business when it’s safe,” his father said. “It was a very difficult decision.”

Alex Rose, a 33-year-old event producer and recording artist, didn’t need much persuasion. She spent a couple of weeks alone in her 500-square-foot Hollywood apartment, taking long walks to break up the days. In mid-March, her event bookings and performances began to disappear. Then a neighbor showed her video of an arsonist setting trash can fires on their street and she saw the melted cans next to her building.

“All of a sudden I didn’t feel safe anymore,” she said. “I didn’t feel safe, and frankly, I felt totally alone.”

The next morning, she and her cat, Eloise, flew home to Austin to her mother and stepdad.

As COVID-19 has ripped through densely populated communities, millennials have fled their own cramped quarters for less congested cities with more room in their parents’ homes. They are near family should someone get sick. The familiarity is comforting in an uncertain time. Overwhelmingly, parents and their adult children view the arrangement as temporary. Of course, no one knows how long “temporary” might last.

Lawrence Maze said the thinking was that Gregory could help him or his wife if they got sick, and they could help him if he did. Also, they believed Austin’s health care system would be less stressed than L.A.’s.“He’s lived on his own now for a very long time,” Lawrence said. “It’s not like he moved back into his old house. He knows he’s living in a guest bedroom.”

It’s a major disruption for young adults who have established their lives thousands of miles from home: They keep paying rent on empty places. They have left behind their routines and social lives. Some have lost their work. Others can work remotely alongside parents who are doing the same.

The magnitude of the outbreak has, for a time, reordered American lives. It’s fostering unexpected togetherness.

Rose’s mother, Elizabeth Christian, said her daughter hasn’t visited Austin this long since she was in college, and now “nobody is rushing off to do anything.”

“We’re having meals together. And we’re watching movies at night,” she said.

Christian and her husband, Bruce Todd, a former Austin mayor, wanted to make sure Rose got back before California wouldn’t allow her to leave or Texas wouldn’t let her in.

Sarah and Ken Frankenfeld had barely moved into their downsized townhome when the coronavirus pandemic brought their 31-year-old son and his girlfriend from New York City to quarantine with them.

“I was nervous about how this was going to work,” Sarah Frankenfeld said of their lack of furniture and readiness for houseguests. They’d met his girlfriend for one evening a few months earlier. “He hasn’t lived here in a while. But it’s worked and it’s been lovely.”

Kevin Frankenfeld, who works in digital, social strategy and marketing, has lived in New York almost nine years. He and his girlfriend, Maddie Haller, wanted to quarantine together.

“In Manhattan or Brooklyn, people are just on top of one another,” he said. “So we wanted to get out of town.”

This shared feeling of lockdown with so much unknown can cause stress and make us feel lonely and anxious, even with others around, said Dr. Vivek Murthy, U.S. surgeon general from 2014 to 2017.

“In this moment, we have no idea when the pandemic will end,” he said. “We don’t know when our lives will go back to normal.”

Well before the stay-at-home orders, Murthy recognized Americans’ increased loneliness, prompting his new book, “Together: The Healing Power of Human Connection in a Sometimes Lonely World.” Now that many are isolated by themselves, he urges us to “step back and take stock of our lives.”

“The silver lining of COVID-19 is that it’s given us the opportunity to reset our social lives and remember how essential relationships are to our well-being,” he said.

Rose is doing her own reset. She’s among California’s estimated 2 million self-employed. But because of the pandemic, she’s applying for full-time jobs around the country in digital media and project management.

“When I left L.A., I never expected that I would not go back to that apartment,” she said. With her lease up in June, she asked a friend to pack up her place and move everything into storage.

Rose and her mother returned late Sunday from a quick turnaround to California to retrieve Rose’s tiny 2016 Fiat 500 that was stranded six weeks in long-term airport parking.

Gregory Maze, 33, is a private chef, event caterer and part-owner of a coffee truck business. He moved to L.A. five years ago.

“I’m fortunate to have a situation like this, but leaving L.A. was not on my terms,” he said. “It’s out of my hands. I really don’t know what the landscape is going to look like at the end of this.”

While some younger adults mock baby boomers with the “OK boomer” meme, the pandemic seems to have shifted the tone — at least where parents are concerned.

Suzanne and Stuart Newberg’s older son, Jared, 27, and his girlfriend, Melissa Asensio, both of Manhattan, arrived March 21 to quarantine together.

“They bought one-way plane tickets and we said, ‘You’re welcome as long as you need to be here,’” Suzanne Newberg said.

Jared and Melissa, who both worked full time in their New York City offices, now work remotely from Austin. His three roommates left for their hometowns about a week before Jared and Melissa. Her two roommates left New York around the same time.

“It was a lot safer and more comfortable to come here,” Jared said. “We’re super-lucky and super-fortunate.”

Back in New York, one of Kevin Frankenfeld’s roommates remains in their three-bedroom apartment. The other went home to Boston. Maddie lives in the same neighborhood. Her apartment is empty now. Both Kevin and Maddie work full time remotely and are glad they’re not in the city.

“We didn’t want to be stuck in a small apartment to isolate in a hotbed,” Kevin said. “Here we’ve got a green area, dishwasher and laundry.”

This story was produced by Kaiser Health News, an editorially independent program of the Kaiser Family Foundation.

Developing World Reels From Pandemic Fallout

More than 265 million around the world currently face food insecurity in the wake of the global COVID-19 pandemic, and several million have lost their life-line of remittances, according to experts speaking at an ethnic media conference May 8 on the pandemic’s impact on the developing world.  

“COVID-19 is expected to double the number of people facing food insecurity. The world has never seen a pandemic like this,” said Dulce Gamboa, associate for Latino relations at Bread for the World.

Remittances — money sent from people working abroad to their families back home — have taken a huge hit, said Demetrios Papademetriou, who co-founded the Migration Policy Institute and is currently a Distinguished Transatlantic Fellow at the Washington DC-based think tank. The World Bank has estimated that $142 billion has been lost in remittances, as foreign workers lose their jobs to the coronavirus crisis.

“Remittances are an essential lifeline for people who receive that money. They will be thinner and more precarious,” said Papademetriou.

He equated the COVID-19 crisis to the decade-long Great Depression in the U.S. in the 1930s, and characterized it as an “economic abyss.” 

Daniel Nepstad, President and Founder of Earth Innovation Institute, discussed the impact of the pandemic on the Amazon rainforest, the largest tropical rainforest in the world. The summer months are typically burning season in the forest, as villagers burn patches to use for agricultural purposes.

In a normal year, thousands of people would get respiratory illnesses as forests burn. This year, however, Nepstad predicted an increased number of deaths as the COVID-19 virus attacks people whose immune systems are already compromised.

In Manaus, Brazil, deep in the Amazon rainforest, Nepstad reported that mass graves have been erected for those succumbing to the virus. In Loreto, Peru, a lack of oxygen bottles has contributed to a high mortality rate from COVID. 

The biggest threat to the rain forest comes from people fleeing there as a last resort, Nepstad said. Farmers can no longer bring their products to markets, which have shuttered in the wake of the pandemic. More than 200,000 migrants have left Lima, Peru by foot, walking through deserts and up into the highlands and from there to the rainforest for some measure of food security.

Nepstad urged the global community to support farmers in the Amazon — providing them with seed capital to grow tree crops which have a longer life-span — and also advocated for the formalizing of supply chains and for fair price support. 

“Now is the time for solidarity, listening to local leaders and understanding what they need,” said Nepstad. “We tend to demonize the people that are clearing forests, but I think it’s important to have more nuance there.”

“Lots of people are extracting food by clearing the rain forests. We eat that food around the world.”

Even if there is no surge in food prices, the global hunger pandemic will continue, said Gamboa, noting that the situation will deteriorate most rapidly in countries where a large percentage of the labor force works in the informal economy.

Yemen currently faces the worst food insecurity crisis, said Gamboa, with 53 percent of its population — almost 16 million people — facing starvation. 

Sudan and Nigeria are likely to be hit by famines, she said. Zimbabwe, South Africa, the Congo, and the Horn of Africa are also facing massive food insecurity issues due to high inflation, poor harvests and drought. 

“Malnourished people have less effective immune systems,” said Gamboa, adding that a child who is malnourished during his first 1,000 days of life will face a lifetime of stunted growth, both physically and intellectually.

“People are saying ‘we’re going to die of hunger before we die of coronavirus.’”

“The U.S. needs to have strong leadership to help millions of people around the world, including women and children,” stated Gamboa. 

Global migration has ground to a halt as countries close their borders and restrict incoming travel, said Papademetriou. However, there has been a significant amount of labor migration as people in developing countries return home, he said.

“There has been an elite consensus that has allowed migration to continue to be large and to thrive because of the demography of many of the rich countries,” said Papademetriou. “We will have to see if that elite consensus continues to hold as this pandemic continues,” he said, adding that countries will have to reassess afresh the number of immigrant workers they need, especially in the agricultural sector.

Papademetriou said it was too early to assess whether the U.S. would grant legal status to undocumented immigrants, many of whom are now considered essential workers.

“I have spent 14 years of attempting to come up with compromises that legislators on both sides were able to support. We have failed every single time.”

“The last time we failed big was in 2013 under President Obama. So it’s difficult for me to be optimistic,” said Papademetriou.

 

This article was published with permission from the author.

When You Can’t Send Money Home

Parents of migrants live alone denied the presence of their children in times of need.

Their children, immigrants in another country, send money home to ensure their parents are not wanting for food and help. Often migrants leave their own children behind with grandparents or family members as they seek a living in a foreign land, promising to return with treasures for both parents and children.

As a result of the COVID-19 pandemic, one out of five workers are unemployed and many have their wages reduced, threatening to cut that lifeline of support between child and parent.

The inability to remit money home because of job loss or a decline in wages endangers the reliability of that support. A drop in remittance means that a migrant’s family back in their home country won’t be able to afford food, healthcare, and basic needs. As the money dries up, the pandemic will unleash unrelenting poverty and an unexpected pandemic of hunger for some families.

The number of people dying every day due to starvation will overtake the number of dead as a result of COVID-19 and the “hunger pandemic” will bring “the worst humanitarian crisis since World War II, warned UN World Food Programme (WFP).130 million people could be on the brink of starvation by the end of 2020 as a result of the coronavirus outbreak and its economic ramifications.

At a webinar on May 8th organized by Ethnic Media Services and sponsored by the Blue Shield of California Foundation, to examine Covid-19’s Impact on the Developing World, experts reviewed trends as the pandemic spreads. Demetrios Papademetriou, of the non-partisan, Washington-based think tank The Migration Policy Institute, stated that the true effects of this pandemic would be visible in the next 3 months. Unparalleled economic devastation, the kind we have never ever experienced, not even during World War II, will reveal its true form.

Dulce Gamboa, a Policy Specialist at Bread for the World, discussed the impact of Covid-19 on malnutrition and famine in the developing world and the need for a global response to a new pandemic of hunger. COVID-19 could cause extreme hunger to double, she said. Malnutrition weakens peoples’ immune systems and children who are malnourished face long-term health and cognitive consequences. Bread for the World is urging Congress to expand health and humanitarian programs, strengthen the global food supply chain and social protection programs, and allow U.S. funded school feeding programs around the world to serve children while schools are closed.

The United Nations food agency reports that at least 300,000 people will die every day over a three-month period as a result of the outbreak and its economic ramifications as the catastrophic coronavirus chokes off cash lifelines for hard-pressed households in poorer countries.

Globally in 2017, an estimated $625 billion (USD) was sent by migrants to individuals in their home countries, according to economists at the World Bank. These remittances are important economic resources in developing countries. According to a 2016 World Bank report, remittance flows into these nations are more than three times that of official development aid. For instance, Nepal received an estimated $6.6 billion in remittances, equivalent to 31.3% of its GDP, according to a Pew Research Center analysis of World Bank data for 2016. In Sri Lanka, where seven percent of the households have a migrant abroad, remittances form 8% of the GDP.

Remittances, once considered more stable than other kinds of external capital flows, are now in danger of drying up as all countries have been hit at the same time with the same pandemic.

The economic fallout of COVID-19 will be catastrophic for families and nations. COVID-19 has shown us how globalization spreads contagion of all kinds.

We have little visibility into how bad, bad is going to be, but for now, the song that once played at the Sri Lankan airport is silent.

“After much hardship, such difficult times
How lucky I am to work in a foreign land.
I promise to return home with treasures for everyone”

Ritu Marwah wrote this article as a fellow of Ethnic Media Services.

 

What Does Recovery From Covid19 Look Like?

Reports of recovery from serious illness caused by the coronavirus have been trickling in from around the world.

Physicians are swapping anecdotes on social media: a 38-year-old man who went home after three weeks at the Cleveland Clinic, including 10 days in intensive care. A 93-year-old woman in New Orleans whose breathing tube was removed, successfully, after three days. A patient at Massachusetts General Hospital who was taken off a ventilator after five days and was doing well.

“Patients are definitely recovering from Covid-19 ARDS [acute respiratory distress syndrome] and coming off vents,” Dr. Theodore “Jack” Iwashyna, a professor of pulmonary and critical care medicine at the University of Michigan, wrote on Twitter recently.

But the outlook for older adults, who account for a disproportionate share of critically ill COVID-19 patients, is not encouraging. Advanced age is associated with significantly worse outcomes for older patients, and even those who survive are unlikely to return to their previous level of functioning.

According to a new study in The Lancet based on data from China, the overall death rate for people diagnosed with coronavirus is 1.4%. But that rises to 4% for those in their 60s, 8.6% for people in their 70s and 13.4% for those age 80 and older.

How often do people who are critically ill recover? According to a report from Britain out last week, of 775 patients with COVID-19 admitted to critical care, 79 died, 86 survived and were discharged to another location, and 609 were still being treated in critical care, with uncertain futures. Experts note this is preliminary data, before a surge of patients expected over the next several weeks.

According to a just-published small study of 24 critically ill COVID-19 patients treated in Seattle hospitals, 50% died within 18 days. (Four of the 12 who died had a do-not-resuscitate order in place.) Of those who survived, three remained on ventilators in intensive care units, four left the ICU but stayed in the hospital, and five were discharged home. The study appeared in the New England Journal of Medicine.

What does recovery from COVID-19 look like? I asked Dr. Kenneth Lyn-Kew, an associate professor of pulmonology and critical care medicine at National Jewish Health in Denver, named the No.1 respiratory hospital in the nation last year by U.S. News & World Report. Our conversation has been edited for length and clarity.

Q: What’s known about recovery?

It’s helpful to think about mild, moderate and severe disease. Most people, upwards of 80%, will have mild symptoms. Their recovery typically takes a couple of weeks. They might feel horrible, profoundly fatigued, with muscle aches, a bad cough, a fever and chest discomfort. Then, that goes away. Also, there are some people who never have symptoms, who never even know they had it.

Q: What about people with moderate illness?

Because we’re so early into this, we have less information about these patients. Often, they spend a few days in the hospital. People feel more short of breath: Sometimes, an underlying condition like asthma is exacerbated. Typically, they need a bit of oxygen for a few days.

Also, there are patients who have high fevers or severe diarrheal illness with COVID-19. Those patients can get dehydrated and need IV fluids.

There also appears to be a small population of people who can develop myocarditis ― inflammation of the heart. They come in with symptoms that mimic heart attacks.

Q: How long do these patients stay hospitalized?

It can vary. Some people get a little oxygen and IV fluid and leave the hospital after two to three days. Some of these moderate patients start to look a little better, then all of a sudden get a lot worse and decompensate.

Q: What about patients with serious illness?

Many of the sickest patients have acute respiratory distress syndrome [ARDS, a disease that floods the lungs with fluid and deprives people of oxygen]. These are the patients who end up on mechanical ventilators.

Those least likely to recover seem to be frail older patients with other preexisting illnesses such as COPD [chronic obstructive pulmonary disease] or heart disease. But there’s no guarantee that a young person who gets ARDS will recover.

ARDS mortality is usually between 30% and 40%. But if you break that down, people who have ARDS due to trauma — for instance, car accidents ― tend to have lower death rates than people who have ARDS due to infection. For older people, who tend to have more infections, mortality rates are much higher — up to 60%. But this isn’t COVID-specific data. We still have a lot to learn about that.

Q: If someone is sick enough to need ventilation, what’s involved?

People usually need a couple of weeks of mechanical ventilation.

Ventilation is very uncomfortable for many people and they end up on medication to make them more comfortable. For some people, just a bit of medication is enough.

Other people require heavier doses of medications such as narcotics, propofol, benzodiazepines or Precedex [a sedative]. Because they act on your brain, these medications can induce delirium [a sudden, serious alteration in thinking and awareness]. We really try to minimize that because delirium has a significant impact on a person’s recovery.

Being on more medication affects other things also: a patient’s sleep-wake cycle. Their mobility, which can make them weaker. It can slow down their gastrointestinal tract so they don’t tolerate nutrition as well and get suboptimal nutrition. Many of these patients end up having PTSD [post-traumatic stress disorder] and impaired concentration afterwards.

Q: When can someone go off a respirator?

There are three criteria. They have to be awake enough to protect their swallowing mechanism and their airway. They have to have a low enough need for oxygen that I can support that with something else, such as nasal prongs. And they have to be able to clear enough carbon dioxide.

Q: What will a patient look like at the end of those two weeks?

That depends. If we’re able to do everything right, these people are up and walking around with the ventilator. Those patients come out on the other end looking pretty good. Maybe they’ll have some weakness, some weight loss, a little PTSD.

The patients who are sicker and more intolerant of the technology, they tend to come out weak, forgetful, confused, deconditioned, maybe not even able to get out of bed. Sometimes, in spite of our best efforts, they’ll have skin wounds.

Some of these patients have significant lung fibrosis ― scarring of the lungs and reduced lung function. This might be a short-term part of their recovery or it could be long-term.

Q: Are there special considerations for older adults?

Older adults tend to have more preexisting illnesses that put them at more risk for complications. Their immune system is less robust. They’re more prone to secondary infections such as pneumonia in spite of everything we do to prevent that.

Frailty is an important factor as well. If you come in frail and weak, you have less reserve to fight this through.

Q: When are people ready to be discharged?

You can go home on supplemental oxygen if you still need that kind of assistance. But you need to be able to feed yourself and move around or, if you have more disability, have someone to provide that for you.

Some people spend a couple of weeks in the ICU, then two to three days on a medical/surgical ward. Other people take another week or two to regain some strength. Some will go to an acute rehabilitation facility to get rehab three times a day. Others can go to a skilled nursing facility, where they’ll get rehab over a couple of months and then go home.

Q: Who’s unlikely to recover?

That we just don’t know yet. When we sit down after all this and look at everything afterwards, we can pull up those patterns.

In the ideal world, I wish I could predict who would do well and who wouldn’t, so I could talk to them and their family and have an honest conversation.

Q: Are other factors complicating recovery?

With such a high number of sick people, it’s harder to do things to maximize recovery, such as bringing in physical therapy and occupational therapy. People aren’t able to get as much therapy because there are only so many therapists and some hospitals are limiting who can come in.

COVID-19 is really a nasty disease because of its infectiousness. It isolates people from a lot of things they need to get better — perhaps, most importantly, their family, whose support is really critical along with all the other things I’ve talked about here.

This story was produced by Kaiser Health News, an editorially independent program of the Kaiser Family Foundation.

image credit:(iStock/Getty Images)

CA Drivers Should Get 50% Refund During Lockdown

Drivers should get a 50% to 70% refund on their auto insurance premium for the duration of California’s shelter-in-place mandate, said state Insurance Commissioner Ricardo Lara April 22.

“We feel 50% to 70% percent is fair,” Lara told reporters at a briefing organized by Ethnic Media Services. “You should be getting more of a refund because, frankly, you’re not driving.”

On April 13 Lara ordered the state’s auto insurance companies to refund premiums to drivers at least for April, and possibly May, if California continues its stay-at-home order. His order, according to a statement released by his office, extended to six types of insurance: private passenger automobile, commercial automobile, workers’ compensation, commercial multiperil, commercial liability, medical malpractice, and any other insurance in which the risk of loss has fallen substantially because of the COVID-19 pandemic.

“With Californians driving fewer miles and many businesses closed due to the COVID-19 emergency, consumers need relief from premiums that no longer reflect their present-day risk of accident or loss,” Lara said as he introduced the order. “Today’s mandatory action will put money back in people’s pockets when they need it most.”

Some companies subsequently issued refunds or credits of 15% to 20%, but the insurance commissioner believes companies must go further: Risks have been dramatically reduced as the state’s roads remain far more untraveled.

California Insurance Commissioner Ricardo Lara speaks during the Ethnic Media Services briefing.

Lara encouraged people who have lost their jobs to ask their auto insurance carriers to delay payments of premiums for up to two months. To get help with such calls, people can call his office — 1-800-927-4357 — where his staff speak multiple languages. His office also has asked insurance carriers to allow a 60-day grace period for paying premiums during California’s shelter-in-place mandate and even beyond, as the state re-opens its economy in stages.

Lara also has asked insurance companies to extend coverage to drivers making deliveries with their personal cars. Typically, personal auto insurance doesn’t cover those who use their cars for commercial purposes.

At the briefing, the state insurance commissioner — the son of undocumented parents — spoke about how immigrant workers benefit nation’s economy.

“The broader community is finally realizing how essential they are,” said Lara, noting undocumented workers’ contributions to food production, processing, delivery, warehouse work and similar services. “Leaders across the country are recognizing the value of immigrant workers. We have demonstrated in our state that the sky doesn’t fall when you incorporate everyone into our economy.”

Lara added that the United States must “get (undocumented workers) out of the shadows, incorporate them into our economy as quickly as possible, and get their kids into school. Our economy will grow by embracing our immigrant community, rather than scapegoating them.”

In California, one out of every 10 workers is undocumented, according to the Public Policy Institute of California. The Pew Research Center reports that the state’s labor force includes about 1.75 million undocumented immigrants, the largest number of whom live in Los Angeles and Santa Clara counties.

Although undocumented workers were denied the $1,200 federal stimulus check mandated by Congress’ first COVID-19 relief package, here in California Governor Gavin Newsom announced a $125 million relief package for undocumented workers April 16, the first of its kind in the nation.

Lara encouraged immigrant workers to apply for workers compensation if they become infected with COVID-19 on the job. He noted that the Trump administration’s public charge enforcement has scared away many immigrants from applying for benefits to which they are entitled. Workers also should advocate for personal protective equipment at their job sites, he said, and they should call his office if adequate protections aren’t provided.

Sunita Sohrabji is a contributor to Ethnic Media Services

image: EMS
Photo by Barna Bartis on Unsplash

We Need an Army of Public Health Workers

Last month, facing the prospect of overwhelmed hospitals and unchecked spread of the novel coronavirus, seven Bay Area county and city health departments joined forces to become the first region in the nation to pass sweeping regulations ordering millions of people indoors and shuttering the local economy.

It shocked people, but health experts around the country applauded the bold step, which since has been broadly replicated.

They also say it can’t go on forever. And so Bay Area leaders, along with others around the nation, are trying to figure out how we can resume something akin to normal life without triggering a catastrophic wave of illness and death.

The shelter-in-place orders were a sledgehammer response to two colliding realities: a little-understood virus that is proving ferociously deadly in vulnerable populations and a withered public health infrastructure that has made it impossible to track and contain the spread of the virus that causes COVID-19.

For all the light the new virus has shone on vulnerabilities of the U.S. hospital system — shortfalls in hospital capacity, ventilators, and protective gear — what many officials see are the cracks in the foundations of public health.

“Nothing should come as a surprise,” said Laura Biesiadecki, senior director for preparedness, recovery, and response with the National Association of County and City Health Officials, which represents more than 3,000 local health departments. “What you’re seeing in COVID-19 is an exacerbation of existing fault lines that everyone in the public health community has recognized over the years.”

Still, there’s broad agreement that core public health work — the ability to find people with the virus and prevent them from passing it to others — will be essential to reopening schools and businesses. That strategy is endorsed by the director of the Centers for Disease Control and Prevention, who recently told NPR the agency was working on a plan to deploy more disease investigators.

We spoke with more than two dozen health experts to get their thoughts on what public health resources will be needed to reopen the economy.

1. What works?

It may be rare that the World Health Organization and experts on the right and left in the U.S. see the same solutions to a problem, but that’s the case when it comes to reopening the economy in the face of COVID-19. The principles are simple: Stabilize the number of people who have the virus (through the strict social distancing already in place), and ensure hospitals can handle the cases they have. Then, put tools in place to stop new infections in their tracks so there isn’t a renewed outbreak.

It all starts with testing, and several countries that revamped their public health programs in the wake of the deadly 2003 SARS epidemic seem to be reaping the benefits now. That includes Singapore, which quickly ramped up testing for both active infections of COVID-19 and an antibody test to show previous infection, and South Korea, which tested tens of thousands of people in the weeks after it detected its first cases.

South Korea, like many other Asian countries, is also relying on hundreds of workers armed with phone location data, credit card information and security footage to try to reach everyone who has come into contact with an infected person.

Authorities release detailed information to the public whenever someone infected has been in their area. Though South Korea and Singapore report a recent surge in cases imported from abroad, both countries have seen far more moderate economic and health fallouts than has the U.S.

Politically and culturally, European nations make for an easier comparison with the U.S. Germany not only deployed widespread testing early on, but it also has sent health teams to people’s homes to check for symptoms and initiate aggressive interventions if symptoms arise.

Italy, which has had more than double the deaths of China despite having less than 5% of its population, has lessons for the U.S. as well — and not all grim.

The scenes from Lombardy, where doctors have rationed care for weeks, making decisions about who lives and who dies, are bleak. But neighboring Veneto, which found its first case of the virus on the same day as Lombardy, is faring much better, said Dr. Nancy Binkin, a professor at the University of California-San Diego who spent 12 of her 20 years at the CDC embedded in Italy’s public health system.

Binkin and colleagues suspect the difference lies in the extensive use of public health tools to contain the initial outbreak in Veneto. That included testing nearly everyone in the town of Vò where the first cases were found, quarantining that city, and making heavy use of assistenti sanitari, or health assistants, to track down people with the virus and make sure they stay isolated.

There have been far fewer infected health workers in Veneto, and deaths overall, than in Lombardy, which is renowned for the quality of its hospitals and health care.

What the places with fewer cases have in common is not just social distancing, said Binkin, but also aggressive tactics to identify and isolate people with the virus.

2. How does the U.S. compare?

U.S. public health budgets and staff have hemorrhaged over the years, accompanied by a steady stream of warning calls that the U.S. was not ready to face a pandemic.

When COVID-19 arrived, identifying and tracking everyone with the virus was all but impossible for local health departments because of flawed tests and narrow guidelines for who should get tested. Compounding the problem was a beleaguered public health infrastructure.

The stay-at-home orders are largely about slowing the spread of the virus — to keep hospitals from being overwhelmed — not necessarily about preventing cases, said Adia Benton, an anthropologist at Northwestern University who studies inequalities in global health. Mobilizing a massive workforce to isolate everyone with the virus could prevent infections, Benton said. “The interventions we see reflect what we value,” she said.

Public health is run locally, and health departments have different resources and organizations. They are also confronting different degrees of outbreak.

In Tennessee, front-line health workers are contact-tracing everyone who gets the virus. To do so, many employees are working seven days a week, 12 hours a day, said Dr. Mary-Margaret Fill, a physician and epidemiologist with the state who is helping coordinate its emergency response. “They are the internal cog in this response; without them, we fall apart,” she said.

In California, public health is the responsibility of counties, and resources vary wildly. Many, including Sacramento and Orange counties, moved away from contact tracing weeks ago, citing minimal access to testing and a surge in cases. (A lack of testing is one thing nearly all health departments have in common.)

Even San Francisco, with its abundant wealth and renowned expertise in HIV, was relying on a skeleton staff to track routine communicable diseases like measles, tuberculosis, and sexually transmitted diseases, according to the city’s health officer, Dr. Tomás Aragón.

Los Angeles County, with its 4,000 public health employees, is still doing some contact tracing for every person who tests positive, said Dr. Barbara Ferrer, director of the Los Angeles County Department of Public Health. Rural Tulare County is trying to do the same but has pinpointed the need for more people to trace cases as its greatest hurdle.

Those techniques matter everywhere. “Social distancing, contact tracing, identification, quarantine, and isolation. We need all of those tools,” said Ferrer.

3. How do we ramp up?

Experts say the situation necessitates, at least temporarily, adding thousands of people to the ranks of public health. Three former Obama administration officials called for a “public health firefighting force” via a program like AmeriCorps or the Peace Corps.

Others suggest we make use of programs already in place. The Medical Reserve Corps program, a national network of volunteer medical and public health professionals, has 175,000 volunteers, some of whom have already been deployed to state health departments, said Biesiadecki. That program could be expanded.

“We need a Marshall Plan. We need a New Deal. We need a WPA for public health,” said Gregg Gonsalves, a Yale epidemiologist who won a MacArthur Fellowship for his work on global health and justice.

And it doesn’t necessarily require M.D.s, Ph.D.s, or even public health degrees. In many countries, governments have trained community health workers in situations like these.

But in the absence of a federal program, some local departments in the U.S. are already taking up the cause. San Francisco, for example, is planning to recruit around 160 people to keep tabs on people diagnosed with the virus. Aragón said he hopes to repurpose staff from within the county where possible and hire where necessary.

“We started off with a scarcity mentality,” Aragón said. “We have to have an abundance mentality. The amount of money that’s being lost economically, if we put just a fraction of that into our public health workforce, we could get the economy back up and running.”

Massachusetts asked the global health nonprofit Partners in Health to help it, hire 1,000 people to carry out mass contact-tracing.

In Connecticut, Yale University faculty said they realized the state had the capacity to contact trace only in Fairfield County, a wealthy bedroom community of New York, leaving few resources for much poorer New Haven, where the university is located. So they recruited more than 100 public health, nursing, and medical students, said Dr. Sten Vermund, dean of Yale School of Public Health. The volunteers were trained online by the state and, working alongside university staff, have been doing contact-tracing for the local hospital.

But he doesn’t think these volunteer efforts are the solution. Vermund called it “the definition of insanity” if the U.S. didn’t take this moment to reinvest in public health. “There is no greater threat to the economic well-being of planet Earth,” he said, “than pandemic respiratory viral illness.”

This story was produced by Kaiser Health News, which publishes California Healthline, an editorially independent service of the California Health Care Foundation.


image credit: (Hannah Norman/KHN Photo Illustration; NIAID)

ICU Doctor Debunks 6 COVID-19 Myths

Dr. David Chong, an ICU doctor on NYC’s front line shares a few home truths about COVID-19.

It’s Easter Sunday, just after Passover, just after another exhausting 13 hour shift.

I can’t watch the news. I’m too busy and too frustrated by all the misinformation.

Forgive me, but I need to debunk a few viral myths.

Myth #1: COVID-19 is a disease of the old and sick

This cannot be further from the truth. As a critical care physician, I’m caring for the sickest of the sick. I know the data. What little good data there is, I see that 80% of ICU patients are under 65 (in a Wuhan study) or that 40% in ICU were under 60 (in an Italian study). The highest death age group was 60-69. The third highest was 50-59. The most common co-morbid conditions were high blood pressure, diabetes, and obesity.

These are not weird immune-related illnesses, they’re common, and this hits close to home. I’m 53, I have high blood pressure, diabetes and, like millions of Americans, I’m a little obese. Our stats? 60% of our intubated patients are under 65. Most of my ICU patients have never been sick enough to be hospitalized before this. Sure, many who die are old and have other illnesses, but the popular narrative almost says, if you’re not in a nursing home you’re safe. Nothing can be further from the truth. It’s a myth.

Myth number #2: The main concern is a lack of PPE and ventilators

Partially false. Sure, some NYC and UK caregivers have had to use cooking aprons, garbage bags, and other scraps to protect themselves, but many hospitals have all the PPE they need. Luckily, my hospital has been able to keep up with all our PPE needs. But many unanticipated shortages go unreported: COVID test swabs, dialysis machines, and dialysis fluid needed to keep people alive (COVID causes kidney failure), sedative medications, and we need more oxygen, we’re using so much.

But most of all, we need more amazing people. Especially nurses and respiratory therapists, because many are now sick and some have died. Over 100 doctors have died in Italy. Doctors, therapists, pharmacists, students, and others now have a new career as nursing assistants. No-one is a specialist anymore, we are all COVID care providers. Thank you to the many volunteer doctors and nurses from all across the US that have come to NYC to help. Recovery for patients can take weeks to months, so we’ll need your help and sacrifice for a while yet.

Myth #3: Hydroxychoriquine is a “game changer” and it’s safe

This potentially false idea was launched on the back of a very small trial from France. I’ve read the paper and it has major flaws. Three larger and more recent trials were negative but they don’t get press. These “game changer” drugs have dangerous side-effects. A recent trial in Brazil was stopped early for fear that high-dose chloroquine was killing people. Other drugs, however, show promise. Watch this space but no “game changers” yet.

Myth #4: Social distancing is our only option and it’s easy to do

This is also untrue. My home, NYC, is one of the most densely populated cities in the world. Many of my patients are poor and immigrated here. They live in small apartments with large families. Social distancing is impossible for many parts of NYC. And in the US more than 10% of the workforce is unemployed.

Sure, we’re finally flattening the curve, but as a Korean-American, I am proud to say that South Korea did it better and they didn’t shut down their economy. They tested, tested, tested, tracked, and isolated people and provided a mobile app, food, masks, and a thermometer to track their fever. This was done for visitors as well as citizens. The US hasn’t tested widely or efficiently enough. And we need to talk about the painful economic and human impacts of social distancing. Banning all hospital visitors means many terrified patients dying lonely deaths. The loss of human dignity is unimaginable.

Myth #5: We can blame China for the current US pandemic

This is false. Recent research shows that our outbreak in NYC came from Europe. And how helpful are country labels anyway? The 1918 Spanish Flu apparently didn’t originate in Spain, so should we rename it? When it comes to infectious diseases, borders mean nothing in our global economic village, but anti-Asian sentiment has spiked all over the world.

Just read the online hate speech about the “KungFlu” and the “WuhanVirus”. As an Asian American, who is doing as much as I can, this is very distressing.

Andrew Yang wrote, “We need to step up, help our neighbors, donate … and do everything in our power to accelerate the end of this crisis.” This is what my wife and I and so many others are doing. I work 12-15 hours days alongside residents, doctors, nurses, pharmacists, and others. (BTW, many of these heroes are Asian-American.) We’re active in our local church, and my wife has a Facebook group that donates tens of thousands of dollars to food and supplies for front-line workers. Daily, she buys food from struggling restaurants, delivers it to the hospital, and I distribute it in between seeing my patients. This has been our life for months and will be our future for a while.

Does it really matter if the virus is from China, Europe, or Mars? Our response would have been the same: to save as many lives as we can.

Myth number #6: This is all overblown, COVID is just like the Flu

I’m just shocked by this one. The infectivity of COVID 19 is three times that of the flu, and it is 40 times more deadly (Dr. Fauci says “10 times”). On Good Friday in NYC, 783 patients died; that’s one death every 2 minutes. In the US, it was one death every 42 seconds. Brace yourself. This is nothing like the flu. If you don’t believe me, just walk into any emergency room in New York, Detroit, Miami, LA, or New Orleans.

On a final and personal note, I’m blown away by the response of my residents, my colleagues, the people around me, and all NYC hospital staff. Never have I been more proud to be a health care worker and a residency director. I’m impressed by the sacrifice and commitment of all my residents. I’m in awe of their hard work. These are the finest people on earth. I am humbled by their sacrifice and courage to go above and beyond the call of duty. Oddly, it took a pandemic to bring us this level of mass cooperation.

But it’s also frightening.

I have practiced critical care medicine for more than 25 years and never have I been so challenged, saddened, and emotional. Almost every hour of every shift, someone needs intensive care. I’m very used to comforting patients and their families to prepare for death. I used to do this for someone weekly; now it’s hourly. Death has become very common: every shift, every ward, and in every emergency room.

It feels like a bomb went off somewhere and the whole of New York is slowly suffocating.

The 7 PM cheering for health care workers moves me. Previously, at parties, I’d say “I work in an ICU and I ventilate people”. That was a big conversation killer.

Now, I feel like a rock star or a military veteran. Who knows? Maybe one day I’ll get to priority board an airplane. But seriously; this experience will lead to future PTSD, pain, scars, and tears, for me and so many residents and health care workers.

For now, however, we really need your prayers and support.

I hope this demystifies a few things.
Thanks for reading. #columbiamedicine#columbiastrong

Dr. David H. Chong is the Medical Director for all Critical Care Services at NewYork-Presbyterian Hospital/Columbia University Medical Center.


image credit: Dr.Chong
Photo by Max Anderson on Unsplash

Tips On Working Effectively From Home

This is a difficult time for some – and merely a different time for others.

What makes the difference? Mostly attitude.

You can decide to be uncomfortable or you can use this as an opportunity to catch up on things you don’t ordinarily find time to do.

Of course, it’s so much easier for those who have experience working from home, and I don’t mean to minimize the difficulties facing people who are not accustomed to that. I suspect that Skype and Zoom and other platforms are on overload because so many people who don’t ordinarily need to use them – do so now.

BUT – we are sheltering at home – so here are some ideas as to how to make it work more successfully for you.

Hours worked – Holding Yourself Accountable

There are those who will tell you to shower and dress as though you were going to the office – and to keep regular business hours.

That may work for some – but may be totally unnecessary for others. Don’t get caught up in following someone else’s rules – but figure out what works best for you.

As I write this, I’m in an “at home” long dress with no makeup. My hair is pulled back. You probably don’t want to see me right now – it is certainly not my best look.

Some people need fixed structure. If you are one of those people – decide what hours you are going to work – and what you can wear that is comfortable but makes you feel as though you have dressed for work.

Have a special place from which you are working. This might not be the living room couch.

For those of you that are self-motivated and don’t require the external structure – be comfortable, no one is looking. Wear just enough to be safe if someone comes to the front door. Oh, if you are online visually wear a little more clothing!

Instead of setting “office hours” set deadlines – when do you have to have certain projects finished? Can you select “sprints” so that you know when you have accomplished a portion of what you need to accomplish?

Let me give you one example of what I mean: When conducting a one hour webinar, I keep a list besides me of how many power points I have to complete in 15 minute intervals. In that way, I stay on time and am not rushing to finish during the last ten minutes or so.

When writing, I think of concepts – or chapters if you will. I learned many years ago not to be looking at the whole project or I will frighten myself.

I’m also really wed to “to do” lists that are prioritized. I usually scribble notes from the living room where I am watching TV, or in the bedroom before I fall asleep. Those notes get transferred to a formal “to do” list when I sit down at my desk the next day.

I prioritize them – and get them done. Some don’t get done because sometimes it is a long list and unimportant items (like filing) fall to the wayside.

BUT – that’s me. What works for you?

  • Fixed time of day
  • Fixed location
  • Accountable to someone else
  • Dress for work
  • To do lists
  • Freedom to choose whatever time suits
  • Casual comfortable clothes
  • Laptop on the patio
  • Fixed amount of work per hour
  • Project by project.

 

Family Members at Home

Some of us are all alone. That makes it easier to work without interruption, but for some a sense of sensory deprivation – some people are afraid to be alone for any length of time.

For others, there are family members around and it is tempting to interact with them rather than get any work done….It’s a special treat to have our loved ones nearby during the day – but we have to get work done.

Also, if we have young kids, it’s hard for them to understand that you are home – but you are at work as well. So you have to find ways to make it clear to them so that you minimize the interruptions.

Let me tell you a story from many years ago. I was step-mother to two young children. At the time I am going to describe, I was working on a term paper that was due that Monday. The children were with us that weekend and they were 8 and 5 years old. I was working out of my second bedroom where I had a desk. I’d asked the kids to leave me alone because I was working on a deadline. They could interrupt me only if it was important.

Well, as you can imagine, important to me was quite different from important to 5 year old Laura. Every few minutes she came knocking on the door. Finally, I sat her down and asked: “Laura, do you have to write a book report for class?”

“Yes” she replied. I asked her how long it needed to be and she explained one page – in her big print – she was just learning to print. I explained that mine had to be 20 pages typed.

Oh, she said with big eyes – left the room and didn’t interrupt me for the rest of the day.

So, my message is: Find a way to explain to your kids with examples and in words that they can understand. Remember, this is a different experience for them as well.

Cabin Fever?

For those of you at home alone – here are some things you can do to make yourself feel better:

  • Open a window – or a patio door – and get some fresh air
  • Watch more TV than you usually do
  • Call a friend – telephones still work
  • Skype or Zoom or something
  • See what kind of special meal you can create from the items in your freezer and pantry
  • Give yourself that facial you’ve been meaning to do for months now
  • Read a good book – that always works for me
  • Write in your journal – or start a journal
  • Write an article
  • Start to write the memoir you have been dreaming about writing
  • Clean out the closet and your dresser drawers
    – Stuff to keep for the coming season
    – Stuff to bring to the garage for next year
    – Stuff to sell to a second hand store (there are many)
    – Stuff to give to someone in need
    – Stuff to give to Goodwill – Salvation Army, etc.
    – Stuff to just plain throw away
    – Catch up on your filing

I bet if you looked around you could find many things to do at home that are fun and useful. Intersperse those with the work you have to do.

This too shall pass. Don’t let it get you down – you have the resources to make it merely a different time – but not all that difficult.

ArLyne Diamond, Ph.D. is a consultant specializing in people and processes in the workplace and can be reached at ArLyne@DiamondAssociates.net

Photo by Emma Matthews Digital Content Production on Unsplash

Photo by Allie Smith on Unsplash