😷 Three Days In

It gets to me in the evening. The fear. The sadness. The discomfort.

In the evening, I start to worry whether I, someone I love, some I care about, a dear friend, a colleague, and yes, even someone I know only through social media — might get sick of this illness. That they might die. I’m selfish. I don’t want anyone I care about to be sick or ill.

As I wrote the other day on Facebook, the fears give into a malaise about the world — make that my carefully constructed world — around me crashing down. I crave order in my life. Things working. My iPod. My DVR. My weekends. Knowing I have the ability to get what I want at the market. Knowing I have the ability to see my friends. This little strand of RNA reproducing has disrupted all of that. I don’t like it.

Yet I know that I still have many blessings. I don’t have to worry about my job or income. Our customer wants us to do more work. We’re all reasonably healthy. To our knowledge, we haven’t been near carriers, and have been self-isolating. I’m generally an introvert — I should like this, right?

Right?

But I’m still unsettled. And we’re only three days in. This is likely to be a long haul — conceivably stretching into May or June. This is going to be a very long year — not what any of us had planned.

I’m hoping that by writing these thoughts down, I’m getting them out of my brain. I’m sure you’re having thoughts like these as well. Feel free to share. Perhaps by sharing, we can help each other.

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😷 Why The Panic? It’s No Worse Than The Flu … Uh, No

I have a number of Conservative friends are who are making fun of the whole COVID-19/Coronavirus response. I’m sure you’ve got friends like that. The ones who insist that the name-your-flu-pandemic was worse. The ones who insist that events shouldn’t be cancelled; the high-risk population should just avoid going to them. The ones who believe this is just a conspiracy theory.

These folks are wrong. I’m taking a break from working at home to share why.

The charts in this post from Vox give a great summary of why the response you are seeing is warranted. In short:

  1. The virus is spreading rapidly. There are charts that explain this in the Vox post, but the updated SciVs podcast on the subject gives more detail, and it was an update of their first episode on the subject. Basically, there are standard equations that those who deal with epidemics use to predict the spread of an epidemic. These are governed by the R0 value of the disease. R0 a mathematical term that indicates how contagious an infectious disease is. It’s also referred to as the reproduction number. R0 tells you the average number of people who will catch a disease from one contagious person. It specifically applies to a population of people who were previously free of infection and haven’t been vaccinated. If a disease has an R0 of 18, a person who has the disease will transmit it to an average of 18 other people, as long as no one has been vaccinated against it or is already immune to it in their community.  The estimates of the R0 value for the Novel Coronavirus was 2.2: If one person gets it, they will infect on average 2.2 other people. Working from that number, 20 to 70% of the population of the world will be infected. That doesn’t mean they will get sick: people can have a mild or no response to this. But they can go around infecting others. Even if we’re a bit off on that number, we’re looking at 20-60%. The risk is manyfold: not just person to person contact. We now know the virus can remain in the air for 3 hours, and on some surfaces for 3 days. So being out and about where an infected person has been can be very risky — and even if you don’t get sick, you can bring it back with you.
  2. This disease is deadly for certain populations. If you are young and healthy, you’re just going to get something mild and spread it. If you are older, have underlying health problems: this could kill you or land you in an ICU. So how does this compare with the Flu? According to Vox:The Spanish flu of 1918-’19, the most horrific pandemic in modern times, focused mainly on the young. It had biological similarities to a flu pandemic in the 1830s that gave some older people in the 1910s limited immunity. Covid-19 is not like that. So far, deaths in China have been concentrated among older adults, who have weaker immune systems on average than younger people and have a higher rate of chronic illness. People of all ages with chronic medical conditions are also at higher risk. The risk of death is real for younger people as well, but older people have the most reason to take care. Vox also notes: “It is tempting to compare Covid-19 to a more familiar disease: the seasonal flu. After all, the flu also has mild symptoms for most people, and can be dangerous and lethal among vulnerable populations like the elderly. But as the case fatality data shows, there’s no real comparison. About 6 percent of people 60 or older infected with Covid-19 die, according to data we have so far; that’s over six times the fatality rate for elderly people infected with the flu. The overall case fatality rate is at least 23 times greater (the fatality rate has risen since this chart was made). The LA Times also has a good article explaining why this is a greater risk than the seasonal flu. A later Vox article notes the real risk for the elderly: “In Italy, a country with one of the world’s oldest populations, a March 4 analysis by the national health institute found that of the 105 patients who died from the virus, the average age was 81. This put a 20-year gap between the average age of people who tested positive for the virus and the deceased, the institute said. On Friday, an ICU physician in Lombardy — the epicenter of Italy’s outbreak — told JAMA there have been only two deaths of people under the age of 50.”
  3. Our hospitals could be overwhelmed. When COVID-19 is lethal, it is often due to secondary lung infections that require ventilation in a hospital. If the hospitals are full, that treatment isn’t possible. So our goal must be to keep the hospitals below full. How do you do that? Delay the infection rate, and #FlattenTheCurve. If you can reduce the rate at which people get the disease, we can respond and it will be less deadly. Thus, the orders for social distancing and the cancellation of all the events.
  4. But couldn’t those vulnerable just not go to those events?. Sure. But that’s not the real risk. Remember that R0 number. Remember also that people can have this disease, be contagious, but have mild or no symptoms. So those not vulnerable go to the event and either spread the disease and/or get infected and bring it back home. We want to curb the spread rate. This disease is more contagious that the normal flu, which has an R0 of 1.3.  The “Stomach Flu” (Norovirus) is 1.3 to 3.1; measles is 11-18; ebola is 2, zika is 3-6.6. This is 2.2-3.1. That’s bad. Remember also this is a new disease: there are no vaccines, there is no immunity from it.
  5. But Only A Small Number Have This. Actually, we have no idea how many people have this. You only know if someone has it if you test for it, and our testing has been woefully lacking. When China started testing everyone, their numbers jumped. So it is quite likely that a lot more have this than we know. That’s why President Trump’s delayed response was so bad: he delayed getting the testing done, which would have allowed us to contain the first few cases before they spread into the general population. It’s too late for that now.
  6. How Do We Fight This? The answers for most folks is easy: social distancing, to stay away from others who might have the disease and #FlattenTheCurveWashing your hands and using hand sanitizer. If you look at the science of the Coronavirus, it is surrounded by an oily protective layer. Soap destroys this layer and destroys the virus. I’m going so far as to wash not only my hands, but my face as well to get rid of anything that got there through accidental touching. The right hand sanitizers do something similar.
  7. We Can’t Do It Alone As this Atlantic article notes: “Right now, one of the most important things Americans can do is deploy measures like social distancing and self-quarantining, even if they do not feel sick and are not at risk of the worst effects of the disease, in order to “flatten the curve” (epidemiologists’ term for slowing down the natural progression of an outbreak). This requires a radical shift in Americans’ thinking from an individual-first to a communitarian ethos—and it is not a shift that is coming easily to most, especially in the absence of clear federal guidelines.” It goes on to note: “If you are privileged enough to skip an event or work from home, you may save a life—even though the life you save may not be your own. It might be the life of your cousin with cancer, or your colleague’s brother, who has diabetes.”

In closing, I’d like to leave you with this, which is in tribute to Spongebob Squarepants at the Dolby, which had its run shortened due to social distancing:

Spongebob Squarepants Wash Chart

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📰 Ouch! I Got a Paper Cut! Time for Urgent Care!

So many boxes under the news chum tree! Which one should I open next? How about this one, with a lovely blue cross and a blue shield? I just hope I don’t get a paper cut opening the package — you know how insurance can be.

  • Why People Avoid The Doctor. The results of an interesting Medicare Advantage survey shows why people avoid the doctor: alas, their presentation is a slideshow, but reasons range from the cost, to not having the time, to thinking there is nothing wrong with them, to preferring natural remedies. Me? I figure that if I make my schedule so busy, my body won’t have time to fail. Alas, that’s not working.
  • Insurers Don’t Make It Easy. Dealing with Insurance is probably one reason people don’t go to the doctor. Take CPAP machines. Sleep apnea is a fast-growing health complaint among Americans, and that has triggered a set of deceptive and unethical measures by US health insurers to shift the cost of using CPAP machines (the forced air machines that sleep apnea patients rely on to stay healthy) to the people who use them, with the effect that it’s often much cheaper to pay cash for your machine and its consumables than it is to get them through insurance. NPR also had an exploration of the problem.
  • Doctors and Computers. Modern medicine. Computers were supposed to make it easier. But doctors hate their computer systems. A 2016 study found that physicians spent about two hours doing computer work for every hour spent face to face with a patient—whatever the brand of medical software. In the examination room, physicians devoted half of their patient time facing the screen to do electronic tasks. And these tasks were spilling over after hours. The University of Wisconsin found that the average workday for its family physicians had grown to eleven and a half hours. The result has been epidemic levels of burnout among clinicians. Forty per cent screen positive for depression, and seven per cent report suicidal thinking—almost double the rate of the general working population. Doctors are among the most technology-avid people in society; computerization has simplified tasks in many industries. Yet somehow we’ve reached a point where people in the medical profession actively, viscerally, volubly hate their computers.
  • Standing Desks Don’t Help. If you are like me, you’ve (reluctantly) been moved to a standing desk, because the old sitting computer desks with ergometric key trays are harder to find than unsalted fries at a McDonalds.  Research, however, suggests that warnings about sitting at work are overblown, and that standing desks are overrated as a way to improve health. Standing is not exercise, and it isn’t necessarily better for you.
  • And Sex is Overrated. Well, at least in the eyes of young people, who according to one article are having a lot less sex. The stock markets aren’t the only thing that is tanking, the Atlantic says we are in a sex recession. From 1991 to 2017, the Centers for Disease Control and Prevention’s Youth Risk Behavior Survey finds, the percentage of high-school students who’d had intercourse dropped from 54 to 40 percent. In other words, in the space of a generation, sex has gone from something most high-school students have experienced to something most haven’t. And that’s just the tip of the iceberg.
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🗯️ Pressure Relief Valves

Recently, we had to replace the fill valve in our toilet. We went to our local plumbing supply store and got the replacement part, but called a plumber to install it as neither of us have the mobility to get in the tight area required to install it. That plumber, after going outside to “examine” the pressure regulator, later proclaimed that the pressure regulator had failed and our water pressure was too high. That could result in all sorts of damage if we didn’t repair it. He, of course, could do so for around $500.

We suspected he had played with the regulator and broken it. But our pressure was too high. So we called the plumber we should have called in the first place. He examined it, and noted that once installed, if you adjust it you break it. It was broken, and he replaced it and the pressure relief valve as well. Out the door, just over $300. The pressure in our house is lower, damage averted (hopefully).

***

Recently, I went to the doctor because my legs were swelling. He took my blood pressure: 159/119. Although I had been fighting high blood pressure for years, this scared him. We adjusted meds, added walking, and I’m the winner of compression stockings. But the meds are working. For the last three weeks, my lower number hasn’t gone above 80; my higher number tops at around 140. This morning at work, I was 98/58. I’m now getting to deal with the impacts of lower blood pressure: a bit more fatigue, a bit less energy. I’m told my body will get used to it. More importantly, however, the lower blood pressure will reduce the stress on my systems. I’ve already seen a significant reduction in my migraine frequency.

***

Lowering the pressure in your house, and in you, is a good thing. Society these days, however, is also showing signs of being under too much pressure. Systems are failing from the pressure, and the mechanisms we have in place to serve as pressure regulators also appear to be failing. And so the pressure keeps building and building, to what appears to be an inevitable explosion that won’t be pretty. In fact, just like your plumbing, it could leave shit everywhere.

Luckily, however, you have the power to fix that regulator, and it doesn’t cost all that much. All that it needs is: your vote. By mailing in your ballot, or going to your polling place and voting, you can fix the pressure regulator. You can ensure that our regulation mechanisms that are in the system can start working again. You can hold our leaders responsible, in the same way (and with the same scrutiny) that the previous administrations had been held accountable.

But accountability isn’t the only way voting brings pressure relief. Our government gains its authority by the acceptance of its authority by the people as a whole. When our leadership is elected by a mere 20% of those eligible to vote, can it really be called a government of the people? We need voting numbers in the 80% to 100% of legal, eligible voters. Show that this administration is accepted by the people, or demonstrate that it does not (and needs to be replaced). That alone is your power, and you gain it by understanding and studying everything on your ballot, and voting with your brain (and not doing what social media tells you).

You have the new pressure regulator and relief valve in your little hands. Tuesday, you can install it. Together, we can reduce the pressure in our nation, and make our systems healthy again.

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Health and Medical News of Note

As I continue to clear out the links, here is a collection of articles with some interesting health and medicine news:

  • Colds and Flus. A few articles related to the cold and flu season. First, here’s a useful chart of how to pick the right medicines for that cold or flu that you have. The key tip: Know your ingredients, what they do, and go for single-ingredient generics. Next: If you haven’t gotten that flu shot yet, GO GET IT. Anything you read about the dangers is only fear-mongering. Perhaps you think you shouldn’t get it because it isn’t fully effective. Even less effective, it is important to get it.  Think about it this way: seatbelts and air bags aren’t fully effective — people still get into accidents and die. But if you get into an accident, seatbelts and airbags reduce the amount of damage you will incur. Flu shots are like that:  you might still get sick, but it will likely be less severe. Better to be in bed for a few days than in the hospital or dead.
  • Tide Pods. They won’t go away, will they? Here’s an interesting infographic on the chemistry behind laundry pods, demonstrating succinctly why should should never never never put one in your mouth. You shouldn’t even eat real foods made to look like Tide Pods, so you don’t confuse the gullible and stupid out there.
  • Better Medical Testing. You might have heard about the recent Ikea advertising for women: they would pee on the ad, and it would reveal a discount on baby furniture if they were pregnant.  But it turns out that’s just the beginning, and the Ikea technology could save your life if you where having a heart attack. How? The cited article explores the technology behind the ad, and notes that the developer of the ad is now working on developing a type of synthetic paper that could combine all of those characteristics, and be used to develop diagnostic tools to detect certain types of heart diseases. Heart attacks, for instance, are very hard to diagnose from symptoms alone, like chest pain. But if, say, paramedics in an ambulance had a tool that can pick up certain biomarkers from plasma, just like the ad picks up the pregnancy hormone from the urine, they could quickly determine whether someone is having a heart attack. That would allow patients to receive immediate treatment, which is key to survive a heart attack. Oh, and someone else is working on a quick and easy blood test to detect cancerThe test, detailed in the journal Science, could be a major advance for “liquid biopsy” technology, which aims to detect cancer in the blood before a person feels sick or notices a lump. That’s useful because early-stage cancer that hasn’t spread can often be cured.
  • The Alien. I have an odd problem. When I essentially do a sit up (i.e., lie on my back and curl up), I get a belly bulge. My internist thinks it is a form of hernia (muscles separating), and although it can be fixed surgically, such fixes aren’t all that effective. Reading an article the other day, I found an interesting explanation of what I’ve got — which is oddly a post-pregnancy belly problem called diastasis recti.  Doctors diagnose diastasis recti when the distance between the two sides of the rectus abdominis muscle gets to be two centimeters or more. DR can affect anyone — women, men, and children. “Coughing, laughing, pooping, breathing, birthing, and moving (i.e., your posture and exercise habits) are all things that can change the amount of pressure in your abdomen” and can, over time, cause DR. As the article notes: “DR can give the belly a soft, protruding appearance. It can push the bellybutton out, or look like a visible gulch at the midsection when a [person] bends or does an abdominal curl.” For me, it seems to only be there when I move like a sit-up; for others, it is much more common post pregnancy due to the pressure of the baby. Alas, the cited article notes there are no good solutions to the problem yet, and exercise done wrong can make it worse.
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Food, Medicine, and Science

Today’s lunchtime news chum post brings you three interesting recent reports related to food and medicine:

  • Artificial Sweeteners. Obesity is a growing problem in the world — although the issue should really be not the size, but the health of the individual. For the longest time, people believed that “diet” products were (a) good for you, and (b) helped you either lose or not gain weight. Increasingly, we’re believing and discovering otherwise. Specifically, a recent analysis of data from 37 studies has shown that artificial sweeteners are associated with weight gain and heart problems. After looking at two types of scientific research, the authors conclude that there is no solid evidence that sweeteners like aspartame and sucralose help people manage their weight. And observational data suggest that the people who regularly consume these sweeteners are also more likely to develop future health problems, though those studies can’t say those problems are caused by the sweeteners.  In other words, if you are going to have something sweet, have the real sugar.
  • Carbohydrates. If you have tried to lose weight, you know how it is. Those carbs call to you. Here’s an explanation of why it is so hard to cut carbs. The answer is: Insulin. It directly links what we eat to the accumulation of excess fat and that, in turn, is tied to the foods we crave and the hunger we experience. It’s been known since the 1960s that insulin signals fat cells to accumulate fat, while telling the other cells in our body to burn carbohydrates for fuel. By this thinking these carbohydrates are uniquely fattening. As insulin levels after meals are determined largely by the carbohydrates we eat — particularly easily digestible grains and starches, known as high glycemic index carbohydrates, as well as sugars like sucrose and high-fructose corn syrup — diets based on this approach specifically target these carbohydrates. If we don’t want to stay fat or get fatter, we don’t eat them. This effect of insulin on fat and carbohydrate metabolism offers an explanation for why these same carbohydrates, are typically the foods we crave most; why a little “slip,” as addiction specialists would call it, could so easily lead to a binge.Elevate insulin levels even a little, and the body switches over from burning fat for fuel to burning carbohydrates, by necessity. In other words: The more insulin you release, the more you crave carbs.
  • Expiration Dates. We’ve all been taught to throw away stuff that is expired. Food, medicine, grandparents. If it is expired, throw it away. But it turns out, that’s really bad advice and a waste of money. Food dates rarely are true expiration dates: most are “best by” dates and the food remains perfectly fine and nutritional, and for some, the printed date can be overtaken by poor handling. A study recently released shows that medicine expiration dates are also meaningless. A cache of medicine was recently found in a hospital from the late 1960s, and it was tested for efficacy. Of the 14 drugs, 12 were as potent as when they were manufactured.  Both of these findings point to needed better rules on “expiration dates” to avoid waste and early unnecessary disposal; it also should teach you to use your common sense. Look and smell before using. You may discover it is still good.

 

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Needling (Anti)Vaxxers About Risk (or This Isn’t Your Father’s 11/780)

userpic=mad-scientistWhat’s this I hear about people being anti-Vax? Don’t they realize that without the Vax, and its older sibling, the PDP 11, there might not have been the Internet as we know it? I mean, Unix was developed for the Vaxxen. Oh, wait, I wanted to write about a different Vax. Nevermind.

Seriously, now that we’re past that bad but obligatory pun, I’d like to talk to you about a different sort of “vax” — vaccines, and their well-publicized opposition, the “anti-vaxxers”. These folks have been in the news lately because of a recently enacted California law that requires parents to vaccinate their children except when medically-contraindicated (no exemption for belief or parent choice), and a Federal Judge upholding that law. Do a search on the Internet related to that law, and you are overwhelmed by the anti-vax opposition sites, such as this one, masquerading as an information site. Closer to home, the subject is on my mind because of a recent discussion with a relative who is in the anti-vax camp, where she asked if she was anti-science because she was skeptical of many things such as the planethood of Pluto, the accuracy of meteorologists, and science’s disbelief (until recently) about the value of the microbiome. This particular post was prompted by a “Fuck You Anti-Vaxxer” rant a different friend posted, which made me realize that a more reasoned screen was necessary.

Let’s work through this and some of the arguments together. The BLUF (Bottom Line Up Front) is that being an anti-vaxxer is not necessarily being anti-science, but it is a clear demonstration of how humans want to blame something or someone when something goes wrong, how humans have difficulty separating correlation and causality, and how bad we are at judging and assessing risk. When properly assessed, the best way that a parent can reduce risk for their child is to ensure they are vaccinated.

Read More …

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It’s What’s For Dinner: Mixed-Up News Chum Stew

Observation StewFinally, it is time for the main dish: A hearty news chum stew made up of items that I just couldn’t form up into a coherent (or even incoherent) post. I’ll note the first three are roughly science related:

  • Things That Go Bump in the … Ouch. The title is worrisome enough on its own: “How A Simple Bump Can Cause An Insidious Brain Injury“. The concern here is a kind of brain injury that’s very insidious — a subdural hematoma. These don’t occur with falling off a ladder, slipping and bash your head on the ice, or playing football. Basically — and this can be a problem as you get older — you bump your head. You get a small brain bleed, but below the dura that lines the brain. The bleed creates a very low-pressure ribbon of blood that’s layering on top of the surface of the brain. As that blood starts to pool over days or weeks, it irritates the brain cells. And if the pool’s big enough, it presses on the brain and damages it, much like a tumor. Ouch.
  • It’s better than Progenitorivox. Asprin is indeed a miracle drug, when taken daily. Not only can it help your heart, but it can lower your risk of prostate disease. Men with prostate cancer had almost a 40% lower risk of dying of the disease if they were taking aspirin for cardiovascular protection, a large cohort study showed.
  • At Last My Row Is Complete Again. Those of you with real periodic tables of wood, time to get out your engraving router. The last row of the periodic table has been filled: the final four elements are confirmed. Needless to say, you won’t be able to keep the samples for long. That’s how it goes.
  • Clearing Out the Stash. Lots of useful info here for knitters and crocheters. Here is a list of 10 charities looking for yarn projects, and in that list are links to about 15 more. There’s also Operation Gratitude, which is looking for knitted scarfs for soldiers. Now, go forth and clean out that sewing room. Your non-crafting partners will thank you.
  • High Fashion Religious Scarfs. A couple of related items here. First, Dolce & Gabbana have launched a line of high-fashion hijabs and abaysas (Islamic head scarves). This is actually a big deal, as the purchasing power of this market is high, and this is an untapped area of fashion. In a different religious area, H&M has marketed a scarf that looks very much like a tallit.  This is a bit more in bad taste (although I must admit we once did find a fancy tallit in a thrift store — National Council of Jewish Women, in fact — that was labeled as a scarf). It is so problematic that they have pulled it from sale in Israel.  Just imagine the next conversation: Hey, boss: I’ve got this great idea for a new hat for women.
  • Tongue Tied. Moving from the Hebrew to the Yiddish: Here is a set of Yiddish Tongue Twisters. My favorite? “Schmoozing in the shtetl with a schmutzy sheitel is a shande.”
  • Ikea Games. Mental Floss had a neat article on secrets of Ikea. One is that there are multiple quick routes through the store, both for safety reasons and stocking reasons, and they’re open to the public. But they’re not advertised, so you’ll need a keen eye for secret passageways. Often they take the form of unmarked service doors. But they change them fairly frequently because customers get familiar with the shortcuts and know how to zip through. They change the shortcuts to force people to go around the long way again.
  • Getting a Lyft. I’ve been hearing more and more about Lyft and Uber. I’ve never used them. In LA, Lyft has just been authorized to pick up at LAX. Here’s a report on what it is like to use Lyft at LAX.
  • Ride the Red Cars. It is appropriate that I’m wearing an Orange Empire shirt as I type this. Here’s a retrospective on the decline of the Pacific Electric in Los Angeles. Alas, as usual, the comments go off the rail into conspiracy theories and partisan politics (yes, the removal of PE is Obama’s fault. Right.). Further, no one mentions they are still running at OERM.
  • There are Beans, and there are Beans. The inventor of Jelly Bellies is jonesing for a comeback. His next idea: caffeinated coffee jelly beans. Now that his non-compete has passed, the founder and his business partners have launched a Kickstarter campaign seeking $10,000 to launch their Original Coffee House Beans, which will come in flavors such as hot cocoa and peppermint, chai tea, coffee and doughnuts and caffe macchiato. Sounds interesting. Sugar and caffeine in one little pill. Who needs an energy drink.

 

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