Ending the year

Holly Doyne Posted on by

2020 has been a challenge for all of us.

It really doesn’t matter if you live in one of those rare areas which has either been not much affected by the spread of SARS-COV2 or had a sensible government which managed to pretty much keep things under control.

There has been much discussion especially in the US about “personal freedom.”

It seems strange to me. I served in the military for 33+ years. The key word there is served. I find it very hard to understand why anyone would choose to risk the health of others just to make a point. I find it on the same level as walking around with a loaded weapon and pointing it at random people….

What each of us does affects those around us. 

I know too many who have buried a family member, dead from COVID-19, this year to take anything lightly. 

Please stay safe and let us get through the next several months with the least loss of life possible so that all may have a future.

 

I took down the calendar

Holly Doyne Posted on by  

You can be so accustomed to having something in a particular place that you just don’t see it anymore. Or, if you “see” it, the significance doesn’t register.

So it was with the 19 month calendar hanging on the wall in our kitchen.

check the date …

 

Traditionally, I have liked having a physical calendar hanging on the wall. This particular location is  in among the car/house/shed/whatever keys for this location and several others. Thus it is in front of everyone’s eyes multiple times a week, if not every day. With this many people living in a household, it forms a “obligation at a glance” for anything that might affect others in the household.

What? Oh, let us say medical appointments, travel, baseball games, or invitations.

And now we come to 2020. The medical appointments have slacken off to the point where just using our phone calendars work for George and I. There aren’t any baseball games or soccer matches. Travel? What is that? A trip down the hill for take-a-away? Invitations are a thing of the past, conferences are on-line. 

All of which explains why this lovely, cheerful calendar is claiming that we are in August. Certainly there is nothing of import noted on the calendar. I took it down. I haven’t purchased a new one for this coming year. By the time I might need one, they all should be on sale…..

All dressed up

Holly Doyne Posted on by 2
and unable to go anywhere.

garage on Spruce St

In keeping with long standing tradition – the monkey frieze is decorated for the holiday. Otherwise, there isn’t much house decoration, lights, or action along the route from our house to the Package Sending station that is across the street from my local Peet’s. I had two packages to toss in the mail and had no interest in standing inside the official post office in line with rude people for however long it took. Instead, I could grab a coffee and wait outside in pleasant, cooperative, and socially respectful company. When my turn came, it was all of three minutes to handover, verify, and pay for the packages.

Which just left me the trudge back up the hill….

The well dressed dentist

Holly Doyne Posted on by  

Since I had to be at the SFVA anyway – I thought I would check to see if the dental clinic might just have an opening. Dental, like the Infusion Center and all the other procedure driven clinics requires a negative COVID test within 3 days. (Not that I enjoy getting a swab jammed up my nose, but it makes sense to maximize the amount of goodness I can get out of that particular bit of uncomfortableness.   My dentist’s afternoon patient hadn’t show up, so she was willing to haul me in for a short exam. 

Which will lead to me returning tomorrow – the only patient for the morning. I scored both a cleaning and a repair to a broken filling. 

The VA is taking good care of its dental staff – they have full protective equipment including PAPR’s (portable air purifying respirators). If you are not familiar with this particular bit of fun, it is a pump worn on the back of the belt. Sucking in room air, it filters it prior to blowing it into the hood. No matter how much aerosol is generated during a dental procedure, it doesn’t wind up in the dentist’s or dental assistant’s breathing zone.

protection +

Not quite space aliens……

or empty heads

Holly Doyne Posted on by 2

Since most of them are not exactly sweet (the politicians, that is)…

And, as Pat reminds me (oh, it is sooo nice to have friends who are medical librarians…) ..

Except … that original marshmallow study? Was later shown to be flawed, badly. It turns out what it was actually testing was not executive function or self-indulgence, but social determinants/influencers of health. Kids who were raised in scarcity, poverty, with a lack of resources had learned to not trust adults who said they could have more later, and figured a bird in the hand is worth two in the bush. 
 
 
Of course, that doesn’t mean that it still doesn’t apply to the situation. I wonder what would have happened if the study had continued on for a year, and the poor kids gradually learned they could trust the researchers, and the rich kids decided they were bored with waiting, their parents will buy all the marshmallows they want at home. 

Or, those with reasonable knowledge in science are able to figure out that ignoring the rules for five days is not going to improve their lives in the long run.

As one of the members of Island Knitters commented last night – “Is getting the family together this year important enough that you are willing to take the risk that some of them will be dead next year?”

It is not rich or poor in the case pretending the virus is also going to go on holiday … wait! The virus is going on holiday, but not as taking a break but happily going along to enjoy new locations, new groups of people, and overwhelming even more city, town, and rural health care systems.

There will be an excellent discussion today from UCSF Medical Grand Rounds at 1200 (PDT) on schools, vaccines distribution – link here. If you read this later, you can find the recording on YouTube under UCSF Grand Rounds.

Yes, we all need to make decisions on our own health and sanity. But also be aware that those decisions have far reaching ramifications on our families, our community, and our society affecting both those we know and individuals that we have never met.

Marshmallows

Holly Doyne Posted on by 1
Ron reminds me of the following:

A classic experiment showed that kids who can resist immediately eating one marshmallow in order to later get two of them have better life outcomes.  Our fight against Covid-19 is being derailed by a surfeit of one-marshmallow adults.

That is certainly the case in the US White House. What? Stop holiday parties and keep people safe? Oh, wait, we should be fine since we have already risked all the employees here (hundreds of whom have contracted COVID-19). Guests? Being invited gives you immunity….

Or on the arrogant island collective where marshmallow-headed politicians, assuming that all who live in the 4-country semi-cooperative called the UK, have decided to give everyone a 5 day pardon from serious social distancing. Pods of up to three families with traveling allowed to join yours.

Then there is the German State with a current covid-19 infection rate of over 400 new cases per week per 100K, is allowing hotels to open from Christmas to New Years day to facilitate family get togethers with up to 10 adults and an unlimited number of children.

It all leads to a certain amount of fatalism, doesn’t it? Like – “here I have been obeying all the rules since March and now …..”

There have been plenty of wiser heads out there stating clearly that this lifting in restrictions is going to set us all back months. There will be millions more cases and thousands of unnecessary deaths. I will leave out, for the moment my rant about irresponsible religious leaders and faith groups (yes, Catholic Church, Hassidic Jews, Evangelicals – I am talking about you).

But seriously, I will review the bidding on Immunization priorities and realities tomorrow and why, just because there are vaccines on the horizon, it is not safe to drop sensible precautions now.

Of course, ignoring all safety means that there will be a lot fewer individuals to immunize come next year….

Can’t they add?

Holly Doyne Posted on by  

Ok. Let us do some simple arithmetic.

According to Wiki (why not?) the current US population is 326.7 M. That actually seems reasonable to me. Or, I can use WorldoMeter which says 331M. Ok, that many people is not reasonable. it is way too many people for me to deal with. Admittedly, it is not China or India. But still – it is a lot of people.

Now let us move on to an agency which has really lost reputation in the last four year – the Centers for Disease Control (CDC) home base in Atlanta Georgia. They are looking at vaccine distribution. COVID-19 in case you had any question. I found the following which I am not going to paraphrase – just quote for you –

The overlap is significant in the four priority groups put forward by CDC. The CDC staff estimated that about 21 million people would fall into the healthcare personnel category, which includes hospital staff, pharmacists, and those working in long-term care facilities. There are about 87 million people in the essential workers groups. More than 100 million adults in the United States, such as those with diabetes and cancers, fall into the high-risk medical conditions group. Another 53 million people are aged 65 and older.

Now, think about it. I can do those numbers in my head, but still. If you agree with those numbers, you are saying that 261M of the 326M are in the priority groups (only adults are in the priority groups). If you look at the population pyramid of the US, you will note that there are at least 80M who are aged 19 or below. Kind of scary that – less than 1/4 of the US are children/adolescents. The percentages for children in Australia and Germany are about the same,  the UK slightly higher.

Which means that children (unless you are one, or have some close to you) are not particularly relevant to discussions being held. 

And I think we need to really stop, and think about these decisions in terms of society and the future. Given the priorities above – 3/4 of the US population is essentially in a Cat 1 -risk. Seriously? Perhaps (and yes, I would have to wait) we should first eliminate everyone in the first round of immunizations who can shelter in place. No, it isn’t fun. But I can do it, I can afford to do it. And someone else might not be able to. We need to include high risk children (and their parents) if we want to reduce risk, suffering, and burden on the health care system. We need to not include those who are not in direct contact with others (admin staff isn’t, cleaning staff is). 

I agree with Canada – children in school are critical. They are our future. Better that I, and those like me, be bored for another six months in favor of getting children and teachers back into the classroom.

But flinging around large numbers like those put out by the CDC, even with a caveat of “there is overlap” is irresponsible. It doesn’t educate, it doesn’t give anyone a sense that there are adults in charge. All it does is set up for “more excuses…”

off soap box.

rather than fish

Holly Doyne Posted on by

let us take a break and look at fowl.

Please follow this link to New Zealand Birds – Vote. 

Yes, even if you are not in New Zealand you can vote. While you are at it, learn a little about their native bird species.

It is much more interesting than watching paint dry, vacuuming up cat hair, or watching vote counting….

waiting patiently

Holly Doyne Posted on by  
Is all that any of us can – or should – do.

The US is still a democracy – it is time to let the process run its course.

That means obeying all the laws, all the court order, and letting people do their jobs.

The post office is required by law to deliver ballots to be counted. This is not an choice on the part of left leaning, right leaning, or bored/tired/ill personnel. Legally, letters, once they getting a box must get picked up, sorted, delivered. There are standards, time limits. Managers are normally held accountable. This week should be no different.

Those ballots are equally important, and probably even more so, in local, regional, and state elections. Neither of the main parties should be able to interfere with the Post Office – perhaps all the ballots could be for third party candidates? Or my daughter’s cat? None of that matters.

Counting in each state is determined by that state’s laws and overseen by the election officials. I don’t gs inet an opinion. I don’t get to chose if my or my neighbor’s ballot is accepted – except by whether or not an individual ballot meets my particular state’s requirements.

Unlike when I have voted in past elections (Florida if anyone cares between the early 1980-2016), my vote gets counted. Florida, in the past, sometimes counted absentee ballots and sometimes didn’t. Let me explain: if you were voting by absentee and were out of country, you could vote at the state level, but not in local elections. As a result, the mail-in ballots were held till the physical count was in. If the number of absentee ballots (usually 32K give or take) was greater than the difference between the candidates, those ballots were counted. If not, why bother since those votes were not going to change the election. Or so the thinking went.

Now, with the number of mail in ballots exceeding in person voting – obviously all the ballots need to be counted. And each state has it’s own laws. There are those states which count as received (results are not released until the polls close). There are those who don’t count until after the polls close. There are states that go by the post mark date. Others by the received date. It is not uniform. It doesn’t matter if you, I, or someone who lives in DC likes it, agrees with it, or throws a temper tantrum. It is time to respect the law. The political parties don’t decide, the news outlets don’t decide, and most certainly the candidates themselves don’t decide. We, as voters, decide and that decision doesn’t occur until all our votes are counted.

Perhaps the time is now right to have a national standard. We are no longer in the 1700s when it could take weeks for ballots to arrive. At the same time, we have grown as a country and grown up. You don’t have to be a white male landowner to be entitled to vote. You didn’t use to have to prove citizenship if you were one of those white males. (In many places you still don’t as long as you “sound right.”)

So what we all need to do is sit back, relax, take a swallow of our favorite beverage, be it coffee, tea, hot chocolate, water, or something with a significant kick and demonstrate to the rest of the world that we are adults and can execute calmly, safely, and objectively the election process. The process that we have been standing first in line and pointing fingers in other countries when we don’t think that they have been fair.

Perhaps cleaning up our own house is in order.

 

Vote

Holly Doyne Posted on by  
If you are not a US voter – skip the next little bit. And, for your information – the US, unlike several countries, does not have mandatory voting.

Vote. Exercise your rights. Retain your ability to honestly be able to complain about the results, the laws, the politicians, the results. If you don’t play, you are still going to pay. It doesn’t matter if you vote by mail, by dropping off your ballot, by going into a poling location early, by showing up today. Vote. Be part of the solution. It does make a difference. Not voting negates the blood, sweat, and tears of women and men for decades who have fought for the right to have their voices heard, their votes counted.

There are too many people in the US who seem to feel that the presidential election is the only thing that matters. Not so – in reality, your state, county and local officials will have a major impact on your lives. They control local public services, oversee the police and fire departments, regulate the schools. All of those issues along with a myriad of others impact you, taxes, and your wallet.

California, this year, joined several other states in providing physical drop off/mail in ballots to all registered voters, Everyone in this household received their ballot, filled it out, All ballots were dropped off prior to today. Alameda County, California has a population of 1.7 million people, There are 66 drop off points (plus the Oakland Coliseum which was set up for massive in person voting as well as a drop off site). Harris County, Texas, population 4 Million + apparently believes that one (1) drop off location is enough. Hello?

Misinformation has been higher this year than any other. As one of those military members who voted by absentee ballot for decades, I thoroughly resent the implication of wide spread voter fraud. Stationed in Germany in the early 1980s along with 300,000+ other service members + families, it was just assumed that it was our right to vote. That our home states respected our right to vote. That our votes could be mailed in, that they would be counted. As the traditionally largest population of out of country voters, the states of Texas, North Carolina, Kentucky, Washington, Tennessee, Florida, California where the largest military bases were located welcomed our votes.

What is different now? One of my former lieutenants, who voted by absentee for years faced the challenge of being questioned when he retired and returned home. It took his birth certificate, his passport, his military ID to be allowed to register. Why? His skin is not white, he speaks with an accent. Apparently NY state doesn’t recognize Louisiana/Cajun as part of the US.

So, for those of you who are US – vote. Make your voice heard. No matter who you support remember that dignity and respect are the basis off all major faiths. Let us be civilized, not savages. We don’t eat our young, we don’t abandon our elderly.

And for the non-US reading this, thank you. Educate yourself on your own countries issues and exercise your voice when the next opportunity arrises.

Portland

Holly Doyne Posted on by  
After staying in Ashland this past night, I drove the rest of the way to Portland. Discovering that the people for whom I was hauling toys from my garage lived in the SW area which turned out to be the easiest to reach. Lovely, I avoided downtown Portland completely.

I don’t think that Keith was expecting the number of boxes and toys which I off loaded. He was thinking small, circular sock knitting machine. I have one of those but it is still buried somewhere in the garage. Instead, I happily gifted the two larger knitting machines complete with stand, a spool rack, a warping mill, several rigid heddle looks, and a bag of weaving toys.

Unfortunately, looking at my garage, the absence of these items hardly makes a dent….

Otherwise, I had a lovely afternoon. There is a lovely coffee shop with in walking distance followed by stitching, listening to an audiobook and and sipping my latte.

Ashland Oregon

Holly Doyne Posted on by 1
A friend assures me is a lovely town, well worth a visit in non-Covid times. There is a Shakespeare Festival, historic inns. It might be lovely, it might be industrial, I have no clue. When arriving off I-5 around 1900 in the evening it was impossible to tell. Most certainly it is not a town that is spending significant resources on street lighting. Located 16 miles north of the California border, the sign for Ashland was a welcome sight.

The sun is setting earlier and I do not enjoy driving in the dark. Not in the dark, not up and down hills (mountains?), nor around curves. We will not speak of the fact that more than 50% of the vehicles sharing the road with me had twelve wheels or more. They sail down hills before gradually slowing as they grind their way up the next. Their head lights provide an unwanted glare in my rear view mirrors. The few other cars dart past, between the trucks sometimes managing a speed only marginally faster than required for overtaking.

This kind of excitement and stress do not bring me joy. I really, really no longer enjoy driving at night and have decided that I will not blow this particular popsicle stand prior to decent light in the morning.

In case you are wondering, I am currently headed to Portland. There is a knitting friend there who is also a weaver. He is a brother to a much longer known friend, indie.dyer and yarn shop owner in the San Juans. I have “toys” that have been occupying space in my life, our garage prior to our most recent move to Germany if that gives you an idea on the age. I am never going to use them again. Selling them is just too much of a pain. So why not give them to an engineer? Neither he nor his son have a clue as to what fills the back of our  VW Golf. But I was reassured that there was plenty of space in his great room.

We shall see….

Herd Immunity

Holly Doyne Posted on by 3
This is a rant – delete at will.

Before I even go down the trail of why this new plan of the US White House is immoral, obscene, and not even remotely ethical – let us talk about herds.

Herds are groups of bovine or related species.  There is absolutely no question in the herd that all are not equal, not all members have equal chance at survival, that there is limited ability to protect the most vulnerable members of the herd. It is Darwin at the finest. The weakest members can and are left behind. They are brought down by predators while the rest of the herd escapes. A balance of nature – so to speak. If a member of a wild herd gets a serious infection – it dies. A newly born member of the herd, if physically “defective” dies. The elderly members, especially those past reproductive age, who can’t keep up with the herd – die.

As humans – we like to pretend that we are not herd animals. We care for our young, long past the point in most societies where children born with defects are left outside for the elements. We have antibiotics and treat all those infections that we can. We don’t routinely discard members of society who are past childbearing age so that there is enough food for those who are perpetuating the species (not going down this rabbit hole at the present – as there are way too may locations in the world where grandparents are raising their grandchildren). We pride ourselves on care and respect for our elderly, elders, and aged.

Or, I thought we did. That we were not a herd.

So why would we pretend that it is perfectly all right for us to say that “let the disease spread while those who are vulnerable are protected”?

Is this idea finding root now because one person has survived his episode of COVID-19 with a level of medical support that is not available to the vast majority of the US -especially those of us who live in areas where the hospital infrastructure is old, crumbling, inadequate, and lacks even remotely current ventilation standards?

Is it because the vast majority of deaths thus far have been in aged care facilities, nursing homes, residential homes, poor neighborhoods, essential workers of color? Do those in certain places assume that their whiteness, their economic status, their privilege will protect them? Their families.

Is it because it is easy to assume that SARS-COV2 is a one and done? How easy is it to ignore the reality of long-haul COVID and the thousands upon thousands who will be living with the consequences for years.

Does someone, somewhere think that we can identify who is vulnerable? That we have enough trained personnel to staff our hospitals and care facilities to take care of that 60% of the population getting infected that it will take?

Are we willing to accept that – with our current best medical care available to all – that the death rate is about 4%? That, my friends, translates to 12 MILLION people dying in the US. Our current US death count is just past 220,000.  Look around you – that means that 1/25 of those you know would be sacrificed to herd immunity. Does your family – including partners, parents, off-spring, siblings – number 25?  Who are you willing to let die for the cause? How about your friends, colleagues? How about you? Are you willing to die to promote herd immunity?

This disease is real. It is deadly.   All those scientist who signed the Barrington? All I can think of is that they don’t view themselves at risk. That they are sure they can protect themselves. I can play with numbers. But as a physician – those numbers have human faces; dreams, families, futures. Do I, sitting behind a computer and playing with numbers have a right to say – you get to die so that others can have a “normal” life?

The long term consequences of this disease are ugly in human life, in disability, in economic cost. No one who survives an intensive care unit stay ever returns to full normalcy. The idea that political leaders could advocate sacrificing a portion of the US population to death so that they don’t have to wear a mask is ludicrous.

Excuse me – but I think we have been here before in history. When a particular movement decided that cleaning house would be advantageous to themselves, their beliefs, and their economy. The result?

We call it the Holocaust.

And now? Will we go down the same path using a disease rather than ovens?

Think about it.

 

 

 

 

And the saga continues

Holly Doyne Posted on by  

Yes, I know that I am whining. And that the inconvenience of dealing with a new phone is a first world problem. I get all that. What I also get is that I have the financial and intellectual ability to deal with the royal PTIA involved.

The last time I made a phone switch, the backup worked flawlessly. This time? Not so much. All the new improvements in the software mean that every last flipping location wants me to sign in. Again. I don’t know about you – but passwords are not me. Yes, I have most of them buried in m browser software, but spending the time is driving me nuts. 

 I will survive – even if someone very unkindly mentioned that old Badger meme yesterday which means I now have an ear worm singing badger, badger, badger … mushroom, snake. Yes, that was 2003 with multiple updates since them. Go google. Or listen to Tom Smith’s version…. to be found on Bandcamp…

Me? I think I am going to spend the rest of the evening blowing up things on computer games….