Friday/ cover your face (in enclosed public spaces)

The CDC and the White House Coronavirus Task Force today said to cover one’s face with a cloth mask when going into a store or an enclosed public space.

As someone on Twitter noted: how come masks are required for healthcare workers, but wearing nothing at all was recommended for the public, when they can come into close contact with other people .. even as they try to avoid them, and given that persons might be asymptomatic but still contagious? It never made sense.

A doctor on TV pointed out that wearing any kind of mask sends an important signal to others: something is seriously amiss (aka: a P-A-N-D-E-M-I-C). So everyone in public should avoid close contact, and not spread germs (and viruses). It also reminds the wearer not to touch his or her face.

Monday/ the ‘wabbits’ are under quarantine

I ran out to the grocery store again on Saturday.
Hopefully, the time will come again in the foreseeable future, when I would not have to dodge the other shoppers, nor be in a rush, so as to minimize my time in the ‘dangerous’ public space of the store.

My two Easter bunnies from Lindt still have a day or so to go before they are done with their 72 hour quarantine .. but I will probably wash the foil wrappers with soap anyway, before I tear it open.

Thursday/ tracking the pandemic’s toll

The Financial Times publish these graphs of Covid-19 fatalities every day, here.

This graph shows that deaths in Italy, Spain and the United States are still increasing at a more rapid pace than they had in China, at a similar time (number of days after the 10th death in the country).

 

This graph shows that the New York State, the Catalonia region and the Madrid metro, could eventually pass Lombardia, Italy, as the worst affected subregion. Washington State and California seems to be doing relatively better than New York State. The higher rate in New York State could be related to the very dense population in NYC, and the heavy use of crowded public transportation there.

Wednesday/ what’s in, and what’s out?

You don’t make the timeline. The virus makes the timeline.
So you’ve got to respond in what you see happen.
And if you keep seeing this acceleration, it doesn’t matter what you say.
1 week, 2 weeks, 3 weeks – you’ve got to go with what the situation on the ground is.
– Dr. Anthony Fauci, member of the White House Coronavirus Task Force


Below is a handy infographic from the Seattle Times, that shows what is allowed, and what is not, under the governor’s Stay-At-Home directive.

For the extra-careful (paranoid*?), there are YouTube videos that advise to wash or sterilize the outsides of packaged groceries, or to carefully dump out food from take-out containers onto clean dinner plates.  Packages from Amazon or elsewhere, should be quarantined for 24 or 48 hours. Wear gloves when going into a store, to minimize direct touch with shopping carts & screens, and so on.

*The late Andy Grove from PC processor manufacturer Intel Corp., wrote a business book titled ‘Only The Paranoid Survive’.

Friday/ sheltering in place

It has been beautiful outside this week, so I went for a few walks around the block a few times — but definitely avoiding people on the sidewalk. Yes, I’m steering clear of you. Don’t care if you are offended .. it’s good for both of us.

I find going to the grocery store harrowing*, and maybe I will get supplies for a whole month with my next trip.
Of course: I can always order from Amazon or even online, from the grocery store, as well.

*The last time I went, there was a woman with a persistent, bad cough in the store. So you absolutely had to come into the store? I thought.

It’s early days, but the number of positive tests on this dashboard from the University of Washington, looks promising. (The number of positive cases is stable and not increasing rapidly).

Friday/ the United States is in a National Emergency

Gov. Jay Inslee expanded school closures and prohibited large gatherings across all of Washington State on Friday, in an effort to slow the spread of the new coronavirus. Health officials reported at least five new deaths, and more than 560 people have now tested positive.
– Associated Press


Where coronavirus cases have been reported (official count: 2,100 with sparse testing). More than a handful of experts put the number of infected Americans already, as an estimated number, in the hundreds of thousands. [Graphic by the New York Times].
This is a scary graph. There is no sign whatsoever, that the ‘curve is flattening’ (the number of new cases reported every day, still increases at an exponential rate).

Trump finally announced today — some 30 minutes before Wall Street closed for the week— that he declares a National Emergency* over the coronavirus.  He shook hands with at least three Fortune 500 executives (a bad example in the time of coronavirus), and proceeded to exchange barbs with the press. ‘Such a nasty question’ he said, without answering, when asked why he disbanded the pandemic response team when he took office.

Panic buying erupted on Wall Street, pushing the Dow Jones Industrial Average and other indexes up almost 10%.

Okaayy .. but there is going to be a recession. How can there not be? The world is grinding to a halt. The three largest cruise ship lines have announced a suspension in cruising for 30 days. Delta Airlines says the drop-off in business is worse than after 9/11. If any number of states is like Washington State or the State of New York, the national economic impact will be significant.

*The Stafford Disaster Relief and Emergency Assistance Act of 1987 is activated. When the Stafford Act is activated to deal with a pandemic, the federal government can begin providing direct emergency medical care to citizens throughout the country. This could include the establishment of temporary hospitals, for example, to ease the nation’s projected shortage of intensive care beds. The government could also use the act to provide food, water, medicine and other supplies to Americans. [Source: USA Today].

Tuesday/ numbers that grow exponentially

‘If you do the math, it gets very disturbing’, said Inslee. ‘In 7 to 8 weeks, there could be 64,000 people infected in the State of Washington if we don’t somehow slow down this epidemic. And the next week, it’s 120,000 — and the next week, it’d be a quarter of a million’.
– Washington State Governor Jay Inslee, Tue. Mar 10, 2020.


Washington State Governor Jay Inslee will announce tomorrow that all gatherings of more than 250 people, are banned in the Seattle metro area. The current coronavirus numbers may seem small: a total of 267 infections in Washington State (24 deaths).

The trouble is —
1. the real number might be a lot bigger, and
2. if left unchecked, infected persons can each infect between 2 and 3 others, making for exponential growth in the number of infections.

Check out the graph below: my own rough calculation starting with the 267, and repeatedly multiplying by 2.5 each week.  We know know that an infected person will typically start to show symptoms some 5-6 days after exposure.

For this graph I assumed a starting number of 267, and that the number grows by 2.5x every week. It shows that 267 becomes 670 after a week, then 1,700. It takes a shockingly short time to get to 10,000 from there, and then only 3 weeks to 100,000+.

Thursday/ empty places, around the world

Here’s a remarkable set of ‘Before’ & ‘After’ satellite photos, published by the New York Times.
It shows how public places around the world have emptied out because of the arrival of the coronavirus.

Monday/ fist bump – no handshake, nor high-five

In doubles tennis, it has become standard practice for the partners to high-five and low-five between points, all done to promote team spirit.

Well, with the coronavirus going around here in Washington State*, we decided at our regular social tennis on Sunday, that we will go with fist bumps instead.

*The count is 14 cases so far, of which 6 had turned fatal. The local Costco store was swamped this weekend with shoppers, stocking up on basic food supplies and other necessities. (People! Keep calm and carry on).

June 3, 2008, after the Montana and South Dakota primaries: candidate Barack Obama had secured enough delegates to clinch the nomination of the Democratic Party for President of the United States. This playful fist bump with wife Michelle, was right before he delivered his victory speech in St Paul, Minnesota that night. (Photo: Dunand/AP)
P.S. Super Tuesday is here. Pete Buttigieg, Amy Klobuchar and Tom Steyer had all suspended their campaigns by Monday night. Joe Biden emerged out of the South Carolina primary on Saturday as the main challenger to Bernie Sanders. Mike Bloomberg is the ‘X’ factor, and is looking to draw enough votes on Tuesday to prove him a viable candidate in the race.

Tuesday/ on coronavirus watch

‘Have you visited China in the last three months?‘ inquired the check-in person at the doctor’s office of me, yesterday.  ‘No, I have not’, said I, not sure what they would have done if I answered that I had been.

They need to add many more countries to that question, soon. Even the 2020 Summer Olympics is now said to hang in the balance, and it may be canceled altogether if the spread of the COVID-19 virus is not under control by May.

China still has the vast, vast majority of confirmed corona cases (77, 658), but the list of countries with confirmed cases is growing: USA 53, Canada 10, UK 13, Spain 2, France 12, Belgium 1, Austria 2, Croatia 1, Italy 229, Sweden 1, Finland 1, Russia 2, Egypt 1, Iraq 5, Iran 95, Afghanistan 1, Oman 2, Egypt 1, United Arab Emirates 13, India 3, Sri Lanka 1, Thailand 35, Vietnam 16, Malaysia 22, Australia 23, South Korea 977, Japan 159. [Source: www.aljazeera.com].
Here’s Fake President Trump, upset only because the coronavirus makes him look bad (nevermind that people are suffering and dying). His administration dismantled protocols and federal agencies for coordinated responses to outbreaks (that Obama put together for the ebola virus), and so now they are foundering in their response to the virus, and lying about it.  

Friday/ wash your hands, frequently

Wow .. the 2019 Novel Coronavirus (2019-nCoV) is making a lot of trouble in mainland China, and especially in Hubei province. The whistleblower doctor that sounded the alarm originally, Li Wenliang, has passed away in Wuhan. He was only 34.

The local authorities in Wuhan have bumped up the number of new makeshift hospital beds from 26,000 to 36,000. More people have also tested positive in that cruise ship under quarantine in Yokohama, Japan. There is a severe shortage of facemasks in China (the cheap ones are not very effective, but I guess it gives the wearer a psychological boost).

So far – outside of China – the spread of the virus seems to be contained, though. Even so, courtesy of the Port of Seattle website .. 

  • Wash your hands frequently, cover your mouth and nose with a tissue when you cough or sneeze, then throw the tissue in the trash and wash your hands.
  • Avoid contact with people who are sick, and stay home when sick.
  • Avoid touching your eyes, nose or mouth with unwashed hands.
  • Avoid non-essential travel to China.
  • Check-in with your airline if you have questions about your travel itinerary.
  • While not protective against the coronavirus, it’s not too late to get an influenza vaccine, since flu season can last into spring.
Guidelines from the CDC from Americans coming home from China (14 days of self quarantine). Non-citizens will be quarantined for 14 days. Seattle-Tacoma airport has identified a site (a firefighter training center in North Bend, far from any neighborhoods) for asymptomatic foreigners that might still arrive from China. The travel industry and hospitality industry along with all economic activity in China is taking a serious hit from the virus.

Monday/ got my flu shot!

I was at the pharmacy today, and the pharmacist said ‘just so you know’, that they already have a shipment of the 2019/ 20 flu shots. ‘Let’s do it!’ I said, and got my flu shot right there and then.

It was a quadrivalent shot: a vaccine for four strains of the flu virus — for what it’s worth. I read online that the 2018/ 19 season’s flu shot was only about 30% effective. There was a late-surging strain, against which it was no help at all.

Missing the mark: cartoon by Dave Granlund, published during the 2014/ 15 season when the vaccine was even less than 30% effective.  P.S. I would say it’s not really the lab that misses the mark — it’s the panel of experts that try to predict which strains of the flu virus will circulate around the regions of the world for the upcoming flu season.

Wednesday/ ditching the whitening

I read once that Americans have somewhat of an obsession with super white teeth – so that must be why so many toothpastes are ‘whitening’ or ‘extra whitening’.

Well, says my dentist:
1. if you are using toothpaste for sensitive teeth, whitening ingredients detract from the effect of the potassium nitrate (which helps with tooth sensitivity); and
2. the amount of whitening actually achieved with toothpaste is minimal.
So I’m ditching my Sensodyne Extra Whitening toothpaste, and will go with one that only has the potassium nitrate.

I got this toothpaste sample from my dentist, and I like it, but I have not been able to find it in a store yet. I guess I could order it online from You-Know-Who, but I will try another store or two first. The dentist says to smear a little toothpaste over the tooth and gums where the heat & cold sensitivity is, before brushing, to amplify the effect of the potassium nitrate.

Thursday/ my new mattress

The iSeries® Hybrid 500 Cushion Firm mattress with one of Serta’s googly-eyed sheep, used in the marketing of their mattresses. I suppose one would do well to fall asleep by counting only to sheep No 29! .. but even though counting sheep to doze off is popular in cartoons and folklore, it is not really used in real life as an aid to fall asleep.

I bought a new mattress on Wednesday, and it was delivered today.
It was high time to get a new one, even factoring in all the nights I did not sleep in my own bed over the years (but in a hotel while traveling for work).

My new sleeping pad is a fancy Serta hybrid mattress: layers of memory foam on a base of coiled springs.  It is a little firmer than medium*, and I did try it out in the store before I bought it.

*My hotel room in Rotterdam during my recent stay there, had a soft mattress, and it felt as if I was trapped in quicksand.

Monday/ how to beat FOBO and FODA

Yoda from Star Wars was a legendary Jedi Master and stronger than most in his connection with the Force. (I needed a picture for my post, and Yoda rhymes with FODA. Be Yoda when fighting your FODA?).

FOBO is Fear of Better Options. FODA is Fear of Doing Anything. Both are quandaries a decision-maker may find himself or herself in, when faced with lots of options. These states of mind definitely apply to me sometimes!

Here is advice from Patrick McGinnis in a New York Times article :

1. For everyday things, I do what I call “Ask the Watch.” I whittle something down to two options and then assign each item to a side of my watch. Then I look down and see where the second hand is at that moment. Decision made. It sounds silly, but if you try it — asking the universe — you will thank me.

2. For the big things, I try to think like a venture capitalist. I write everything down on the topic — pros, cons, and so on — and I read it out loud. That process is basically like writing an investment memo for a V.C. investment, but in this case the investment is of your time, your money, your energy.

Tuesday/ the perils of turning 62

From Monday’s Wall Street Journal, in a short article titled ‘Why So Many Men Die at 62’

A study out just this past December, of US mortality data for the period 1979 to 2012, revealed that there is a curious jump in the death rate at age 62, especially for men (not so much for women). Why is that? Researchers think the eligibility for social security payments at age 62, and retirement at that age, is the combined culprit.

Retirement from a desk job could very well have long-term benefits (more exercise, less stress, being better able to take care of oneself).  But it could also mean the person becomes more sedentary after doing physical labor as part of his job, smokes more, or even drives around a lot more, and end up in a traffic accident.

Says one of the authors of the study: ‘We aren’t necessarily saying people shouldn’t retire. But if you are thinking about retirement, particularly if you are 62 and your health is poor to start with, think of preventive health measures. Stay healthy, see a physician, don’t just sit on the couch, but don’t overdo it, either. Be careful about driving. Just be careful. It’s a tricky time’. 

Tuesday/ prescription drug prices: buyer beware

I have a new health insurance plan for 2018.  It turned out my new plan does not cover a prescription drug that I use, and was looking to refill.

Now I know why prescription drug prices, is a top health care issue in the United States. Insurers and pharmacies can basically charge any price they want for prescription drugs. The drug I was looking to refill today, has been around a long, long time (more than 10 years).  Its manufacturer sells billions of dollars of it every year.  A generic version came out in 2016.

To illustrate:
Walgreens 90 day out-of-pocket, no insurance: $575. What?! 
Walgreens w. GoodRx coupon 90 days, out-of-pocket $168. Better. 
Costco w. GoodRx coupon 90 days, out-of-pocket $26. <Yes! I pick this one. 

What is going on here? The vaunted free market at work? I say it is capitalism and healthcare-for-profit, both gone haywire.  Bernie Sanders for President!

On-line commercial for prescription drug discount coupon website GoodRx. What the picture shows is absolutely true. Pharmacy B just miles away from Pharmacy A can sell the same drug for 3 or 4 times the price.

Thursday/ ‘excellent health’?

President Trump is in ‘excellent health*’, and mentally fit for office reported Dr. Ronny Jackson, presidential physician, on Tuesday.  Trump aced the Montreal Cognitive Assessment test, a brief, basic test used to detect mild cognitive impairment and Alzheimer’s disease. (Critics point out that Jackson is not a  psychiatrist nor a psychologist, and mention other tests that could have been done).

*Trump is in fact borderline obese and has elevated cholesterol. He maintains a poor diet, has a stressful job, and gets very little exercise. Dr. Jackson did admit that Trump has to work on his diet.

Here is Forbes magazine, weighing in:  We are invited accordingly to ask: ‘excellent’, compared to what? Even that tends to vary, but the customary answer would be: the prevailing norms of a given population or culture. The typical American, with a typical American diet and lifestyle, is at massively elevated risk for debilitating chronic disease relative to, say, the typical Blue Zone resident, or the atypical Americans who manage to take good care of themselves here in spite of it all. America overall is famous for spending more on disease care than peer nations around the world, while having far less health to show for it by the measures that matter most: years in life, life in years, and the bounty of both. Americans lag behind much of the developed world in longevity, and lag even further behind in vitality.

Here is the ‘Naming (the animals)’ panel from the Montreal Cognitive Assessment test. Hey! I have all three in my animal collection, I thought. (Mine are African Lion, Black Rhinoceros and Bactrian Camel).

Thursday/ only a ‘public health emergency’

About 90 Americans die every day due to opioid drug overdoses. Opioids are powerful painkiller drugs that attach to receptors in the brain. Once attached, they send signals to the brain which blocks pain, slows breathing, and has a general calming and anti-depressing effect.

President Trump finally declared it as a ‘public health emergency’ on Thursday (but not the national health emergency that it really is).  A ‘public health emergency’ does not appropriate federal funds the way a ‘national emergency’ does.

Congress is not helping.  Politicians are addicted to money from big pharma lobbyists, as comedian Trevor Noah noted on his Daily Show.  (Leave it to comedians to tell us the truth).  In 2015, the American Medical Association petitioned Congress to outlaw the running of commercials for prescription drugs on TV, to no avail.  In one case that came to light, pharmacies in a West Virginia town with 400 residents, received 9 million opioid drug pills in one year.  Did Congress pass a law that made it easier for the Drug Enforcement Agency to prosecute shady distributors of prescription drugs? Of course not: they made it harder.

Stills from Trevor Noah’s Daily Show. Washington DC is Pharmaville, with lobbying by the pharma industry just out of control.