Wednesday/ Shanghai’s lockdown has ended

As of midnight Tuesday, Shanghai’s 25 million residents were allowed to leave their apartments and residential compounds to go to work.  Businesses are  cleared to resume normal operations with restrictions (such as no inside dining in restaurants).

Officials are eager to get China’s most economically important city running again.

Peter Jolicoeur enjoying an Oktoberfest-sized beer in Shanghai. His Twitter profile says he is a ‘Shanghai-based aviation consultant, pilot, musician, runner & Chinese student’. Cheers!


P.S. —for your vocabulary

shanghai
shang·​hai | \ ˈshaŋ-ˌhī , shaŋ-ˈhī \
shanghaied; shanghaiing

transitive verb
1a: to put aboard a ship by force often with the help of liquor or a drug
b: to put by force or threat of force into or as if into a place of detention
2: to put by trickery into an undesirable position

Example sentence: “To shanghai your friend into a mental health intervention might be a mistake”.

Thursday/ one million

Here are two questions that Bill Gates had answered on Reddit today:
Why do you think the world was utterly unprepared for Covid?
Infectious disease in rich countries isn’t the big problem it used to be. For things like fire and earthquakes we have small ones to remind us of the problem. A pandemic that gets into Europe or the US only comes along rarely so it is easy to not practice and not have dedicated resources. A few countries like Australia did a better job and have 10% of the deaths of most rich countries.

Why is the COVID-19 model behaving very differently in America as compared to other countries? With state-of-the-art vaccines and close to 70% of people fully vaccinated, the cases are always rising after dipping for a few days. Looking at the statistics of the number of people catching COVID and the number of people dying due to it, seemed like this was to end by January / February. The model is quite weird.
The new variants come along and evade immunity from vaccination and infection. Also immunity wanes fairly quickly in the elderly. When the cases are high people do change their behavior and when they are low they go back to normal behavior. So you get huge ups and downs in the case rate driven by seasons, variants and people’s behavior. Fortunately Omicron is less fatal than previous variants.

Monday/ the dinosaur with the mask

So a Trump-appointed judge in Florida overrules the national mask mandate for airplane travel and throws the CDC’s recommendation out the window .. and then the Biden administration promptly announces that the Transportation Security Administration (TSA) will no longer enforce it.

Nice try, United. I will be the dinosaur with the mask, but this cutesy tweet does not work for me, because it should not be about comfort. You would have done so much better reiterating that airline cabin air is completely changed every three minutes through HEPA filters, and all that. 
What was also completely unacceptable on Monday: for pilots from several airlines to announce midair that the mask mandate is gone, and that it’s OK for everyone on board to take their masks off. 

Sunday/ to sleep, perchance to dream 🌃

To sleep: perchance to dream: ay, there’s the rub;
For in that sleep of death what dreams may come
– from Shakespeare’s Hamlet, Act III, Scene I


The results from last night is promising, and more in line of what I experienced as far as my sleep: in bed for almost 8 hrs, and asleep for a little less than 7.

 

The Apple Health app that tracks my sleep every night, has been reporting only 4 to 5 hours of sleep for me, even after I had been in bed ‘sleeping’ for the most part of 8 hrs.

I generally feel OK in the daytime, so I believe I get more than 4 or 5 hours of official ‘sleep’.

For comparison with the Apple Health app, I’m trying an app called Sleep Cycle (screen shot on the right). The results from last night look encouraging (more accurate).

Friday/ let’s hear it for lidocaine

The original packaging for lidocaine, labeled LL30 for its Swedish inventors Löfgren and Lundqvist. Clinical trials started in 1944 and a few years later it was used around the world. The compound was overwhelmingly superior to local anesthetics in use at the time.

The hard cast came off my wrist and forearm today. In addition, two stainless steel pins were extricated. The surgeon pulled them out with sterile pliers, basically.

The pins had held the lunate and scaphoid bones against each other so that the new scapholunate ligament could establish itself.

The second pin had a slight bend in (by design), and was not easy to pull out. I was very thankful for the fat syringe of lidocaine that was deployed on my wrist. Lidocaine blocks the pain signals that nerve cells send to the brain, by interfering with the so-called sodium channel that is the pathway for the signals.

Tuesday/ 12 years of Obamacare

Former President Obama was in the White House today for the first time after leaving office (more than 5 years ago, Jan. 2017).

Obama was there to celebrate 12 years of the Affordable Care Act (also known as Obamacare) with President Biden. They also announced that they are pursuing expanded coverage for families, and how to make it easier to enroll.

Also mentioned in the reporting today, was Biden’s famous hot-mike comment ‘This is a big f**king deal’, which he made in 2010 as the ACA was signed into law.
I couldn’t agree more.
The Affordable Care Act has saved me a lot of anguish⁠— and tens of thousands of dollars in health insurance costs, just over the last five years.

The East Room in the White House today. As former President Obama took the podium, he started with ‘Vice-President Biden, Vice President (Kamala Harris) .. ‘ then stopped. ‘That is a joke!’ he said, and walked over to shake President Biden’s hand.

Friday/ the (opposable) thumb is back

The monkey in my kitchen can now use his opposable thumb, to grasp light-weight things to put away.

 

I got my final cast today.
It allows my thumb to move a little more, and actually touch my index finger.

I also have exercise instructions for my digits— a set of ten that I do four times a day (hold fingers straight, make a hook, make a fist, and so on).

 

Wednesday/ vaccine status checks to be cancelled

Officials announced today that restaurants, bars, theaters and gyms here in the city of Seattle and surrounding King County will no longer be required to check the vaccination status of their patrons beginning March 1.

We are waiting for everyone’s beer to be brought to the table, at Thai restaurant Jamjuree here on 15th Ave tonight. They did check our vaccine cards at the entrance.
I get take-out food here sometimes, but the food always seems tastier and more enjoyable in the restaurant itself. So will delivery operators like UberEats and DoorDash hold on to any gains they made during the height of the pandemic? I doubt it.

Tuesday/ COVID-19 testing 101

I entered my address into the new Washington State COVID-19 test kit page on Friday.
Just yesterday, two 2-pack test kits landed on my porch.

The manufacturer’s website says these test kits correctly identify positive specimens in 94% of tests, and negative specimens in 98% of tests.

The test kits are for doing a so-called lateral flow test for COVID-19 antigens (proteins from the virus).

Doing the test seems pretty straight forward.
The test strip looks the same as the strip in a pregnancy test kit.
C stands for ‘Control’ and T for ‘Test’.

If both lines are colored (the T line may be very faint), the test is positive.
If only the C line is colored, the test is negative.
(If no line is colored, you did something wrong and the test is invalid.)

Here’s a table that I compiled of the types of COVID tests.

Polymerase Chain Reaction (PCR) ('Molecular')AntigenAntibody
Detects genetic material from the virus.Detects proteins from the virus. Detects immune system antibodies (a spike protein test or a nucleocapsid test).
The gold standard to test for an active COVID-19 infection.Not as sensitive as PCR tests.Not suitable to diagnose an active COVID-19 infection.
Nasal swab sample processed by a lab.Nasal swab sample processed by lab or with home test kit.Blood sample processed by lab.

 

Friday/ a new cast

The stitches on my wrist & arm came out today.
Next up was an X-ray to peek inside, and make sure the scaphoid and lunate bones are still in their proper places.
The surgeon said everything looks good.
Finally, I got a new cast.

I have a little more of my fingers and thumb exposed. (Good.)
First layer on the skin was an elongated fabric sock, then a little padding around the wrist and a bandage wrap on the wrist and arm.. Finally, on came a gauze wrap, soaked with cornstarch that made it harden into a shell.
Four weeks in this cast, and then another check-up.

Tuesday/ the Omicron wave’s spike

It looks like the Omicron wave of the Covid-19 pandemic has crested in the Northeast of the United States. Recent numbers for the other regions show it is (at least right now) no longer increasing there.

A look at the recent numbers of cases for regions in the US. That number for Rhode Island is SIXTY times what we had at one time long ago, here in Seattle’s King County (7 per 100,000).
[Graphic from the New York Times]
Here’s Washington State: not looking good, but hopefully near the peak of the Omicron wave. King County is at 220 cases per 100,000, a number I never thought we would reach.
[Graphic & statistics from the New York Times]

Wednesday/ upgrading to an N95: not so easy

I bought a box of N95 masks on Amazon to use (instead of my cotton cloth masks— that are apparently no longer cutting it against the Omicron variant).

The N95 masks are more difficult to put on than ones with ear loops .. and then there is the question of how many times they can be used before they should be discarded. (They cannot be washed in the washing machine).

The short answer: it depends. If the mask was used in a crowded place, or for a long time (say, 4 to 8 hours), it should probably be discarded.

There are a lot of fake N95 masks out there. I bought mine on Amazon; the brand is from US industrial giant Honeywell, but the box they came in confirms that the masks were made in China (by the Honeywell subsidiary there). Are they fake/ substandard? Who knows. Like a reviewer on Amazon says: ‘Everything’s made in China – get over it’. Sigh.
[Infographic by John Blanchard for The San Francisco Chronicle]

Wednesday/ doing a Bier’s block

Illustration from ‘Essential Clinical Anesthesia’ published by Cambridge University Press.

My wrist operation went without a hitch. My forearm now has a splint and a casing with a thick bandage on, with four fingers sticking out.  The recovery period is going to be three months, all told.
During the preparation for the surgery, the  anesthesiologist explained to me that they were going to do a Bier’s block. ‘Nothing to do with beer— it’s named after a German doctor August Bier’, said he.

The Bier’s block involves the injection of a local anesthetic solution (such as lidocaine) into the arteries of an upper or lower extremity, from which the blood had been squeezed out, or drained by gravity. The careful application and use of two tourniquets isolate the bloodless and numbed arm or leg from the central circulation system.

Monday/ my first Covid test

I injured my wrist on the tennis court some time ago.
An X-ray (done in November) had revealed that the two bones at the base of my thumb (the scaphoid and the lunate) are no longer snug against each other, but separated. This means that the ligament between them is torn.

So I’m going in for an outpatient operation on Wednesday to have the ligament repaired, and I have to present a negative Covid-19 test. I will get the results of the test tomorrow. I should be good to go. Fingers crossed.

The scene at the make-shift Covid testing booth at 319 Terry Avenue, outside Harborview Hospital. They are taking scheduled appointments only, so the line was short. 
I appreciated that they checked us in outside, with the walk-up window where the nasal swab was done, just a few steps away. (On top of it all there was an icy wind about. Any cold, flu or Covid viruses were surely blown to oblivion).

Monday/ Omicron now rules

In three short weeks, the Omicron variant has displaced the Delta variant.
The first case of Omicron in the Unites States was reported on Dec. 1.
GET VACCINATED. GET A BOOSTER SHOT. WEAR YOUR MASK.

The purple piece of the pie in each of the ten regions in the United States shows the proportion of specimens that were Omicron: variant B.1.1.529. This is for specimens that had been collected during the week that had ended on Friday Dec. 18. 
It averages out at 73% for the whole of the country. 
[Infographic from the CDC’s Covid-19 web page]

Monday/ the end is not yet in sight

This pandemic will end some time. We just don’t know when, yet.
GET VACCINATED. GET A BOOSTER SHOT. WEAR YOUR MASK.

NBC Nightly News reported tonight that the count of COVID-19 deaths in the USA had crossed 800,000. The numbers compiled by the New York Times is close to that. Some 1,200 people perish every single day. 75% are older than 65. In this cohort, only heart disease and cancer kill more people than COVID-19. The unsettling thing is that the pace of deaths has increased by a lot since summer.

Wednesday/ no check for proof of vaccination

Bryan, Gary and I made our way down to The Chieftain for a beer and a bite tonight.

There’s no one at the door to check for masks & proof of vaccination, and it was not done at the table, either. At this point, all bars and restaurants in King County with inside seating— no matter how small — must check for proof of vaccination. We let it slide .. the waiter wore a mask, and the tables are very far apart. King County is 75% fully vaccinated per the New York Times.
Many other counties in Washington State lag far behind, with numbers like 65% (Snohomish), 59% (Pierce), 57% (Yakima), 51% (Kittitas).  

Caturday

These pictures are from the Twitter account of Pyonta the feline (ピョンタ・フロスキー@pyonta_F on Twitter).
From what I gleaned from translating the Japanese, his owner was a little boy when he picked up the bedraggled fur ball near the Arakawa river, north of Tokyo, Japan.
That was 10 years ago, and look at them now.

Friday/ here, there, everywhere

It has only been 8 days the announcement of the Omicron variant, but it’s clear that it has probably been spreading for several weeks (months?) around the world already.

No cases discovered yet in Washington State. The first case detected in the USA was a traveler from South Africa that had returned to San Francisco. There are several other cases in the USA through community transmission, though (persons that have not traveled outside of their state or even their county).
Update Sat 12/4: Public health officials have confirmed 3 cases of the Omicron variant of the COVID-19 virus in Washington state.
[Map from the New York Times online]
And here are the countries that have reported cases of the Omicron variant. Almost all (99%) of cases in the USA are still the Delta variant, but that is expected to change. Many, many communities in the States still sit at 60% vaccinated, which is not good enough. There is evidence that the Omicron variant can reinfect people that had a previous Covid-19 infection, and no vaccination.
[Map from the New York Times online]

Black Friday/ B.1.1.529

Hopefully it turns out that Black Friday meant the purveyors of products-at-a-discount ended up in the black, and not that the B.1.1.529 variant (Omicron) had started a really bad turn in the pandemic. (We will know in about two weeks if this ‘variant of concern’ can evade the antibodies produced by the current vaccines*).

Angelique Coetzee, chairperson of the South African Medical Association, says in The Guardian newspaper: ‘It’s all speculation at this stage. It may be it’s highly transmissible, but so far the cases we are seeing are extremely mild’.

*From the New York Times: The B.1.1.529 variant has a “very unusual constellation of mutations,” with more than 30 mutations in the spike protein alone, Mr. de Oliveira (director of the KwaZulu-Natal Research and Innovation Sequencing Platform, in South Africa) said. The spike protein is the chief target of antibodies that the immune system produces to fight a coronavirus infection. So many mutations raised concerns that Omicron’s spike might be able to evade antibodies produced by either a previous infection or a vaccine.

Passengers travelling from South Africa line up to be tested for Covid-19, tested after being held on the tarmac at Schiphol Airport, Netherlands for hours on November 26, 2021. About 600 passengers arrived on Friday on two KLM flights. After initial testing, Dutch authorities estimated that some 85 people may be infected. Those that test positive will have to quarantine in hotels near the airport, and their samples will be tested to see if it’s the omicron variant.
Update Sat 11/27: Per the BBC, 61 of these 600 travelers tested positive for Covid-19. (Not yet known if any is the Omicron variant). 61 sounds like a lot to me. Surely almost all of these travelers have been vaccinated. Was the testing (in South Africa) three days before traveling not very reliable? Did the travelers get infected on the airplane? 
[Picture obtained from social media by REUTERS]