Tag Archives: self isolation

Vaccines Bring Hope As COVID’s Third Wave Hits

In welcome news and within a week of each other, pharmaceutical giants Pfizer and Moderna announced breakthrough vaccines to combat the deadly coronavirus.

Pfizer and its German collaborator BioNTech, say their vaccine may be 90% effective in preventing COVID19 in participants, while Massachusetts-based Moderna expects a vaccine efficacy of 94.5%.

It’s a promising sign in the yearlong battle against an out-of-control pandemic. But though the trends in clinical trials seem positive, don’t throw out your face masks just yet. Experts warn of a long wait before the general public gets access to these newly minted vaccines.

It may be spring 2021 before the vaccine is widely available, which means the coronavirus will continue unabated for a few months more. COVID19 positivity rates reported by the Kaiser Family Foundation indicate that every state is now a blood-red ‘hotspot.’

As epidemiologists predicted, the third wave of coronavirus ‘forest fires’ are raging across the country with devastating effect. Currently the US leads the worldwide COVID death toll at over 250K and counting; we also have surpassed the 11 million mark in total COVID cases.

Despite warnings from experts, the federal coronavirus task force failed to deliver a comprehensive plan to counter the coronavirus threat. In fact, their strategy has been to “just let the infection run…which is not based on science,” remarked Dr. Ashish Jha, Dean, School of Public Health at Brown University, at a November 13th EMS briefing on the pandemic.

Without adequate federal funding or guidelines, each state has devised its own COVID19 response, but many did not heed the science on containing the spread.

That haphazard approach has had catastrophic consequences. Coronavirus cases are surging across the country. Since November 1, more than 1000 Americans have died of the coronavirus everyday and that number is steadily rising.

“This is not a surprise,” said Dr. Nirav Shah of Stanford University’s Clinical Excellence Research Center. “We predicted that in the fall, with people staying indoors and without broad protections ..such as masking, and not gathering in large groups, the numbers would continue to rise.”

Desperate to jumpstart their economies and reopen businesses and schools for a populace weary of quarantines, lockdowns and job losses, states made some bad choices by ignoring the science, said Dr.Jha. Several states (the Dakotas for example), raced to get back to normal by rolling back restrictions on large gatherings, travel and mask mandates.  According to the AARP only 35 states mandated face coverings in public. In Boston for example, schools closed but casinos stayed open. “Those are the wrong tradeoffs,” added Dr. Jha.

Inevitably, the subsequent spike in COVID19 rates has left the country scrambling to reimpose certain restrictions; even so, cases are mounting. The Kaiser Family Foundation reports hotspots in every state. In fact, ‘super spreader’ events are happening even at the White House.

The COVID Tracking Project currently (as of Nov. 15) has recorded a staggering 76,000 hospitalizations and over 155,000 confirmed cases a day. Experts at the briefing say that figure is much higher.

“Hospitals are being overwhelmed,” warned Dr. Tung Ngyuen (Professor of Medicine, UCSF), as they face bed shortages and burnout from healthcare workers who have “been doing this close to seven or eight months now.”

“We are in the worst moment in the pandemic” said Dr. Jha. He admitted he is baffled by the disconnect between how bad things are and how little attention the country is paying to it. “Right now we have about 150 thousand new cases being identified every day. But the truth is that the true number of infections occurring in the US right now, is between 300 and 400 thousand a day, maybe even closer to 500 thousand. We’re missing them because our testing is inadequate. All those people who are not being identified are of course out there spreading it to others. We are in a moment of exponential growth. We will get to two thousand deaths a day by mid-December.”

Calling it ‘unconscionable,’ Dr. Jha estimates that a 100 thousand more people will die between now and Inauguration Day (January 20th).

However, the advent of two promising vaccines may be a start in the right direction, even though the world has a long wait before it’s rescued from the virus.

“The reality is that it’s just 10 to 20 million doses maximum by the end of the year,” said Dr. Shah. “But it’s going to be some time before we get the kind of widespread availability of multiple vaccines, with secure supply chains to get everyone the two doses they need to actually start to achieve even partial herd immunity.”

It’s unlikely the ‘mRNA vaccines’, created from brand new technology and currently awaiting FDA approval, will arrive before the year end warn experts. Initially, limited supplies of the vaccine will likely be rationed and given to frontline healthcare workers, the vulnerable and the elderly. It could be spring before most of America gets the vaccine.

Though the clinical trials have produced strong results, enough data is not yet available to determine the longevity of the vaccine’s effects, or even its side effects. No one knows what level of protection it will offer younger vs older people, or whether we will need regular vaccinations like the flu shot.

The logistics of storing and distributing the vaccine are equally difficult. The vaccine has to be stored at extremely low temperatures which will make its distribution to remote and rural areas challenging and especially so among communities of color, where “skepticism is high and strong.”

Realistically, to reap the benefits of having a vaccine, states global health expert Tom Bollyky, at least 75% of the population will need to be vaccinated and that will take time.

“We are entering the hardest days of the pandemic,”  said Dr. Jha on Twitter. “The next two months will see a lot of infections and deaths. But he added, “There is a light at the end of the tunnel. Today, that light got a bit brighter.”

The disregard for advice from health experts and a lack of trust in science have precipitated some of the worst outbreaks so far, so it’s time say experts, for leaders and the general public to “rebuild the trust” and to stop politicizing the science.

Getting back to normal in the short term will mean that people have to take precautions to avoid transmissions until they can roll up their sleeves to be immunized.

Testing has to ramp up. But in the meanwhile, said Dr. Jha, “Wearing masks are a good thing to do for yourself, you family and community.”

Meera Kymal is the contributing editor at India Currents

Photo by CDC on Unsplash

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.

Red Dawn Breaking Bad – A Warning Ignored!

A high-ranking federal official in late February warned that the United States needed to plan for not having enough personal protective equipment for medical workers as they began to battle the novel coronavirus, according to internal emails obtained by Kaiser Health News.

The messages provide a sharp contrast to President Donald Trump’s statements at the time that the threat the coronavirus posed to the American public remained “very low.” In fact, concerns were already mounting, the emails show, that medical workers and first responders would not have enough masks, gloves, face shields and other supplies, known as PPE, to protect themselves against infection when treating COVID-19 patients.

The emails, part of a lengthy chain titled “Red Dawn Breaking Bad,” includes senior officials across the Department of Veterans Affairs, the State Department, the Department of Homeland Security and the Department of Health and Human Services, as well as outside academics and some state health officials. KHN obtained the correspondence through a public records request in King County, Washington, where officials struggled as the virus set upon a nursing home in the Seattle area, eventually killing 37 people. It was the scene of the first major outbreak in the nation.

“We should plan assuming we won’t have enough PPE — so need to change the battlefield and how we envision or even define the front lines,” Dr. Carter Mecher, a physician and senior medical adviser at the Department of Veterans Affairs, wrote on Feb. 25. It would be weeks before front-line health workers would take to social media with the hashtag #GetMePPE and before health systems would appeal to the public to donate protective gear.

In the email, Mecher said confirmed-positive patients should be categorized under two groups with different care models for each: those with mild symptoms should be encouraged to stay home under self-isolation, while more serious patients should go to hospital emergency rooms.

“The demand is rising and there is no guarantee that we can continue with the supply since the supply-chain has been disrupted,” Eva Lee, director of the Center for Operations Research in Medicine and HealthCare at Georgia Tech and a former health scientist at the Atlanta VA Medical Center, wrote that same day citing shortages of personal protective equipment and medical supplies. “I do not know if we have enough resources to protect all frontline providers.”

Reached on Saturday, Lee said she isn’t sure who saw the message trail but “what I want is that we take action because at the end of the day we need to save patients and health care workers.”

Mecher, also reached Saturday, said the emails were an “an informal group of us who have known each other for years exchanging information.” He said concerns aired at the time on medical protective gear were top of mind for most people in health care. More than 35 people were on the email chain, many of them high-ranking government officials.

The same day Mecher and others raised the concern in the messages, Trump made remarks to a business roundtable group in New Delhi, India.

“We think we’re in very good shape in the United States,” he said, noting that the U.S. closed the borders to some areas. “Let’s just say we’re fortunate so far. And we think it’s going to remain that way.”

The White House declined to comment. In a statement, VA press secretary Christina Mandreucci said, “All VA facilities are equipped with essential items and supplies to handle additional coronavirus cases, and the department is continually monitoring the status of those items to ensure a robust supply chain.”

Doctors and other front-line medical workers in the weeks since have escalated concerns about shortages of medical gear, voicing alarm about the need to protect themselves, their families and patients against COVID-19, which as of Saturday evening had sickened more than 121,000 in the United States and killed at least 2,000.

As Mecher and others sent emails about growing PPE concerns, HHS Secretary Alex Azar testified to lawmakers that the U.S. had 30 million N95 respirator masks stockpiled but needed 300 million to combat the outbreak. Some senior U.S. government officials were also warning the public to not buy masks for themselves to conserve the supply for health care providers.

U.S. Surgeon General Jerome Adams tweeted on Feb. 29: “Seriously people – STOP BUYING MASKS! They are NOT effective in preventing general public from catching #Coronavirus, but if healthcare providers can’t get them to care for sick patients, it puts them and our communities at risk!”

Still, on Feb. 27, the FDA in a statement said that officials were not aware of widespread shortages of equipment.

“We are aware of reports from CDC and other U.S. partners of increased ordering of a range of human medical products through distributors as some healthcare facilities in the U.S. are preparing for potential needs if the outbreak becomes severe,” the agency said.

Simultaneously, Trump downplayed the risk of the novel coronavirus to the American public even though the Centers for Disease Control and Prevention was warning it was only a matter of time before it would spread across the country. On Feb. 29, the CDC also updated its strategies for health workers to optimize supplies of N95 masks.

An HHS spokesperson said Saturday the department has been in “an all-out effort to mobilize America’s capacity” for personal protective equipment and other supplies, including allowing the use of industrial N95 respirators in health care settings and awarding contracts to several private manufacturers to buy roughly 600 million masks over the next 18 months.

“Health care supply chains are private-sector-driven,” the spokesperson said. “The federal role is to support that work, coordinate information across the industry and with state or local agencies if needed during emergencies, and drive manufacturing demand as best we can.”

The emails from King County officials and others in Washington state also show growing concern about the exposure of health care workers to the virus, as well as a view into local officials’ attempts to get help from the CDC.

In one instance, local medical leaders were alarmed that paramedics and other emergency personnel were possibly exposed after encountering confirmed-positive patients at the Life Care Center of Kirkland, the Seattle-area nursing home where roughly three dozen people have died because of the virus.

“We are having a very serious challenge related to hospital exposures and impact on the health care system,” Dr. Jeff Duchin, the public health officer for Seattle and King County, wrote in a different email to CDC officials March 1. Duchin pleaded for a field team to test exposed health care workers and additional support.

Duchin’s email came hours after a physician at UW Medicine wrote about being “very concerned” about exposed workers at multiple hospitals and their attempts to isolate infected workers.

“I suspect that we will not be able to follow current CDC [recommendations] for exposed HCWs [health care workers] either,” wrote Dr. John Lynch, medical director of employee health for Harborview Medical Center and associate professor of Medicine and Allergy and Infectious Diseases at the University of Washington. “As you migh [sic] imagine, I am very concerned about the hospitals at this point.”

Those concerns have been underscored with an unusual weekend statement from Dr. Patrice Harris, president of the American Medical Association, which represents doctors, calling on Saturday for more coordination of needed medical supplies.

“At this critical moment, a unified effort is urgently needed to identify gaps in the supply of and lack of access to PPE necessary to fight COVID-19,” the statement says. “Physicians stand ready to provide urgent medical care on the front lines in a pandemic crisis. But their need for protective gear is equally urgent and necessary.”

By Rachana Pradhan and Christina Jewett
This story was produced by Kaiser Health News, which publishes California Healthline, an editorially independent service of the California Health Care Foundation.

(KHN Illustration; Getty Images)

Survive COVID-19 with a Cabin Fever Playbook

What seemed improbable a month ago is today a shared global reality. The steady unravelling of COVID-19 has forced us all – across generations and geographies, to stay home. Morale is low and stress levels are high as we work from home, grieve for and worry about those afflicted, homeschool our children, and struggle to make ends meet in a crumbling economy.

While challenges of confinement and the lack of routine have pushed me out of my comfort zone, strangely, this period has also been a deeply introspective one. I have had teaching moments that have helped me prioritize and gain perspective to effectively navigate these difficult and fluid times.

LEARNING TO ROLL WITH AMBIGUITY
The steepest learning curve for me has been accepting unpredictability and rolling with it. I find myself:

  • Improvising. For example, when I couldn’t find any sanitizers anywhere, I was forced to make my own. My favorite recipe is mixing ¼ tsp of bleach with 4 cups of water.
    When getting my daily yoga stretches seemed impossible, I resorted to CosmicKids Yoga. Now, I get a yoga workout with my preschooler in tow since it engages kids through story and movement.
  • Getting creative. I buy whatever fresh produce is readily and easily available and turn to the internet for inspiration. I’ve dug out my formally forgotten cookbooks and am trying my hand at new recipes.
  • Relaxing standards. With everyone homebound, there’s more mess, less tidiness and meals are often prepared on the fly. But that’s to be expected. Once this realization struck, I recalibrated and lowered standards. This helped me stay calm and centered. Beds don’t always get made, but the sheets are clean. Meals may be prepared on the fly, but they’re healthy. I learned not to sweat it. There’s enough to worry about as is.


STAYING ORGANIZED
I am by no means a planner. But, when I saw the panic around me at our local grocery store, I was jolted into action:

  • To create a weekly meal roster to plan grocery runs.
  • I stocked up on non-perishables. Fortunately, being accustomed to eating and cooking Indian food, between atta (whole wheat), rice, Sabudana (tapioca), pasta, flour, sooji (semolina), besan (chickpea flour), poha (flattened rice), bread, and a few packs of frozen rotis and naans, I had an array of grain options. My new favorite comfort food now is a simple and wholesome Sabudana khichri.
  • To bolster our supply of vitamins, ginger tea, and citrus fruits to keep up our immunity.


COMMUNICATING
At a time when schedules are unpredictable with no school and everyone working from home, things don’t always fall in place as seamlessly as they used to. As a result, I found it vital to effectively communicate household rules and expectations.

  • We have a written daily routine and each person is assigned household chores and responsibilities. That way everyone’s on the same page and knows when and how to chip in. This has provided the much-needed predictability in times of uncertainty and has also fostered teamwork.
  • I am also making the most of this opportunity to double down on conversing in my native language (Hindi) with my preschooler and second grader. I can already see some promising results.

MAKING TIME FOR LITTLE THINGS
I find myself making more time for family. A relatively slower pace of life is allowing more time to connect with each other as well as with extended family and community members. More than before, I see us using FT, Skype and Zoom to connect with each other. Most importantly, I’m enjoying simple activities like:

  • Walking. It is Spring after all! If parks are out of bounds, we take family walks. These aren’t long. Sometimes squeezing in a short walk between meetings or a break is good enough. It’s refreshing to marvel at blooming flowers and seek joy in the many signs of new life and activity around us.
  • Playing. We make up silly games, play board games, word games, card games, Simon says, red light-green light, do messy art projects; all of which fuel our creativity and bring us closer as a family.
  • Baking. Instead of composting that overripe banana, we make banana bread. We roll dough and cut out shapes when we make atta ladoos and atta cookies respectively.


LAUGHING
For some time, I had replaced humor with fear, anxiety and stress. One day, my eight-year-old asked me, “Why do graveyards have a fence around them?” Looking at my confused expression, he promptly replied, “Because people are dying to get in!” With all the dread unfolding, it felt like a scene from a dark comedy movie. It lightened the mood and we all had a good laugh.

I realized that it’s ok to laugh even in the face of adversity. Given our current reality, it’s easy to forget to let some humor into our lives. Besides, doesn’t laughter reduce stress-generated cortisol that kills our immune system? So, why not laugh, boost our immunity and flatten the curve!

To get in some laughs every day:

  • I have intentionally added joke books to our children’s daily reading stack. Kids love jokes and rarely miss an opportunity to share something that tickles them.
  • In the evening, my husband and I carve out some time to watch something funny. It’s a wonderful way to relax, connect and laugh together as adults.

The COVID-19 pandemic continues to be a trying time, stretching our mental and physical capacity to endure fear and uncertainty. Yet, it’s heartening to see folks reach out to provide services like grocery runs or offer free in-home entertainment materials like family games, books and DVDs. We’re connecting with family, friends and our extended community, to make sure we’re all okay. Our children are virtually interacting with cousins, grandparents and friends. I’m reminded of Gilda Radner, who once wisely said – “Life is about…taking the moment and making the best of it, without knowing what’s going to happen next.”

We’re certainly trying our best!

Nidhi Kirpal Jayadevan’s pre-kids’ life was dedicated to the complex field of Communication Sciences. After choosing to be a fulltime mother, reading and playing with her high energy boys has been a fascinating journey. It has (re)kindled in her a sense of wonder in all things small. She constantly sees the world through little eyes, applying simple learnings to deepen life’s meaning for herself and her family.

Edited by Meera Kymal, contributing editor at India Currents

Photo by Jyotirmoy Gupta on Unsplash