HinesSight

I get Paxlovid "rebound," but I'm OK with being Covid positive again

Six days ago I completed my 5-day course of Covid treatment with Paxlovid, which basically puts a brake on replication of the virus, giving your body a chance to deal with it before it gets up a big head of Covid steam.

I commemorated that event with a blog post, "My somewhat contrarian take on Paxlovid 'rebound.'" I said:

My symptoms (nasal congestion and a cough) have been gone for a few days. The rapid test I took this afternoon was negative. So things are looking good. 

And I'm not all that worried about Paxlovid rebound, which doesn't seem like a big deal to me.

I still feel it isn't a big deal, even though last Wednesday, four days after I finished the Paxlovid treatment, I was dismayed to find that a rapid test I took showed I was positive for Covid again. So far (this is Friday) I'm still testing positive.

That's irritating, since I enjoyed my few days of post-Covid normalcy -- having coffee with a friend, going back to exercising at my athletic club, attending my Tai Chi class. 

On the plus side, my symptoms are milder than before, and they were pretty mild the first Covid time around. I haven't had to take a decongestant at bedtime, which I did during the first bout of Covid. And I came across a recent Scientific American story about Paxlovid rebound which indicates that my "contrarian take" on this actually is scientifically mainstream. 

A tweet clued me in to the story.

If you have doubts about Paxlovid because you've heard about the rebound effect, or if you know people who qualify to get Paxlovid because they're in a higher-risk Covid category (elderly, for example) and might be reluctant to take the drug, check out the February 8, 2023 Scientific American story by Lauren Gravitz, COVID Rebound Can Happen Even without Paxlovid.

Here's a PDF file if you have difficulty accessing that web page.
Download COVID Rebound Can Happen Even without Paxlovid - Scientific American

Some excerpts from the story:

Paxlovid gets a bad rap over concerns about COVID “rebound.” That’s the primary takeaway from a series of papers showing that whether or not people take the antiviral medication, many have symptoms that wax and wane before going away completely.    

Over the past few months a number of peer-reviewed and preprint studies have looked at patients with COVID in the placebo groups of clinical trials for Paxlovid and other treatments. As part of the trials, the patients in these groups were required to fill out daily symptom trackers. Researchers consistently found that as many as 30 percent of those who did not take an antiviral experienced a rebound in coughing, fatigue, headache or other symptoms after initially feeling better. 

...Despite Paxlovid’s proved efficacy at preventing severe disease and death in people considered high-risk, Smith found increasing resistance to it. “When Paxlovid rebound started to gain traction—I’m going to be blunt—I kind of got annoyed,” he says. Perhaps more worrisome, however, is the fact that some physicians have become hesitant to prescribe it. “The drug kept people out of the hospital and kept them from dying,” Smith says. “My patients started saying they didn’t want to take it,” he adds, and “I felt guilty because I’d started it all.”

Because he knew that respiratory viral symptoms have a tendency to come and go no matter the virus or treatment, Smith set out to better characterize the course of COVID itself. As chair of the U.S.-government-sponsored ACTIV-2 trial—a series of placebo-controlled studies that aims to assess new COVID treatments—he had troves of data at his fingertips, so he dove into the trials and gave the placebo groups extra scrutiny.    

...Smith wasn’t surprised by the results. “As an infectious disease doc, [I] know that respiratory disease viruses often have this waxing and waning,” he says, adding that it also happens with colds, influenza and respiratory syncytial virus (RSV). “It’s just their nature.” This is likely because most symptoms are related to the body’s inflammatory response to the virus, not the virus itself, he says. The inflammation—which is different for everyone—generally lasts longer than the virus, and it ebbs and flows as viral remnants are cleared from the body.

Other infectious disease specialists agree. “In my view, the story of rebound was overblown,” says Ziyad Al-Aly, a clinical epidemiologist and chief of the research and education service at the Department of Veterans Affairs St. Louis Health Care System. He notes that he frequently hears of physicians who resist prescribing Paxlovid to high-risk patients for fear of rebound or the much-lamented side effect of a bitter, metallic taste. And yet, he says, “rebound never killed anyone. But COVID can put you in the hospital or, even worse, could lead to death.”    

Robert Wachter, chair of the department of medicine at the University of California, San Francisco, has heard similar reactions to Paxlovid. “I’ve heard many times from patients and from a fair number of physicians that ‘I don’t like to use it because of rebound,’” he says. “I kind of understand it viscerally, but it doesn’t make sense when looking at a dispassionate ledger sheet of the medication’s benefits and downsides.... It’s not that close a call.”    

...Until more data emerge, physicians must rely on their intuition and whatever solid information they can find. Existing data consistently point to the upside of Paxlovid. “In my world, people have looked at the data and believe the benefits of medication are quite probable,” Wachter says. “I’m certainly going to give it to high-risk people. Most of my colleagues who have gotten COVID have taken it.” And Wachter, who is 65 years old, adds that if he tests positive for COVID, he will absolutely take the drug himself.    

Physicians agree that COVID rebound after antivirals may be a nuisance, but it is far better than hospitalization or death. “Paxlovid is the best weapon we have right now for people who have COVID,” says Smith, who knows the treatment landscape better than most. “It keeps people out of the hospital, keeps them from dying and probably decreases the risk of long COVID. In short, I think it’s worth the bitter taste.” 

My somewhat contrarian take on Paxlovid "rebound"

After getting some Covid symptoms and testing positive on a rapid test last Monday, this morning I completed the 5-day Paxlovid treatment regimen. 

My symptoms (nasal congestion and a cough) have been gone for a few days. The rapid test I took this afternoon was negative. So things are looking good. 

And I'm not all that worried about Paxlovid rebound, which doesn't seem like a big deal to me.

Nobody really knows how many people who take Paxlovid either get Covid symptoms after the 5-day treatment is over, or test positive after testing first positive, then negative, then positive again. A Scientific American story says:

The Pfizer clinical trial reported between 1 and 2 percent of those who received the drug tested positive for COVID after finishing the Paxlovid course; their illness rebounded. Those rebounds were not statistically different from rebounds experienced by people with COVID who received the placebo, however.

And a Los Angeles Times story strikes a cautionary tone.

This is a story about a COVID-19 medication, a nasty trick the coronavirus sometimes plays on its victims, and how the two became a pandemic couple called “Paxlovid rebound.”

It’s also a story about how looks can be deceiving.

Americans have been quick to embrace the idea that the antiviral drug is to blame for COVID-19 relapses in people just days after they’ve seemingly recovered. President Biden was said to have experienced Paxlovid rebound this summer, after White House doctors declared him coronavirus-free. The same thing happened to Dr. Anthony Fauci and Stephen Colbert, among others.

It’s tempting to presume a cause-and-effect relationship between two things that occur in quick succession. And even when events are completely random, we tend to see the patterns we expect to find.

But researchers are not so sure Paxlovid rebound is real. Relapses have occurred in COVID-19 patients who didn’t take the drug — they just didn’t get as much attention when there wasn’t a new medicine to blame.

Doctors fear some patients who could benefit from Paxlovid are skipping it in an effort to avoid a boomerang bout of COVID-19. That’s troubling because the medication has been found to powerfully reduce the risk of hospitalization or death in the unvaccinated, older people and those with compromised immunity. Preliminary research hints it may even reduce the risk of long COVID.

Today I shared some thoughts with a friend about the subject of Paxlovid rebound. She also took Paxlovid, but is still testing positive about a week after the treatment ended. She shared an email from her doctor, which I cited in my own message. 

The way I see it, your doctor and my pharmacist are saying the same thing. Paxlovid doesn’t cause any virus lingering in the body after the 5-day treatment regimen to somehow pop back up and reinfect the person. It’s the Covid virus that caused the initial infection and it’s the Covid virus that causes any negative test result at the end of treatment to turn into a positive test result later on.

As your doctor correctly noted, Paxlovid puts a brake on replication of the virus during the 5-day treatment period. If a person’s body/immune system wasn’t able to clear all of the virus during that period, or if the person for one reason or another didn’t respond properly to the Paxlovid treatment, then any residual virus can emerge after the Paxlovid brake is turned off after the 5-days.

So if a positive test result occurs after Paxlovid, as has happened with you, this doesn’t mean Paxlovid is responsible. Paxlovid did what it should. And the Covid virus is doing what it does so well, replicate if given the chance. 

I look at the situation this way. Without Paxlovid, you or I might well have spent several weeks suffering from moderate symptoms. That was the case with a woman I know, somewhat younger than me, who got Covid and emailed me, “I hope you get over it more quickly than I did.” I recall she was sick for a couple of weeks.

So we take Paxlovid. It puts a brake on the virus replicating in our bodies. We have mild symptoms. If after the brake is released, some residual virus causes a positive test result some days after the end of Paxlovid treatment, we’re still considerably better off than if we hadn’t taken Paxlovid at all, because of the 5-day brake period, which enabled our bodies to better fight the comparatively small amount of virus that the Paxlovid brake couldn’t stop.

Like you said, it seems to come down to word choices. The word “rebound” conjures up an image of something happening that shouldn’t, whereas actually a positive test result after the 5-day course of treatment isn’t surprising, if some residual virus remained in the body after the five days. Some people seem to view “rebound” as meaning that Paxlovid caused two Covid infections rather than just one, which makes them reluctant to take Paxlovid. Of course, there was just one Covid infection.

They don’t realize that if they qualify to get Paxlovid, they should take it, since whatever happens with the course of treatment, they’ll be better off than if they just let Covid run its course in their body without Paxlovid. I took another rapid test about an hour ago: negative. So that’s good news. Of course, I’ll re-test myself every few days to see if a positive test result emerges.

I couldn’t tell from your message whether you took a rapid test after the 5-day course of treatment. If so, I’m curious if it was negative. 

I test positive for Covid. And feel positive about Paxlovid.

Well, it was a good run without ever getting Covid -- about three years since the nasty virus came to the United States in early 2020. 

After I had trouble sleeping last Saturday night, feeling on edge for no discernible reason, I took a rapid Covid test Sunday morning, which came back negative, even though my voice was a bit hoarse.

But Monday morning I had some nasal congestion and increased hoarseness, so I tested again. Yikes! A positive result. 

That kicked off a flurry of phone calls. First, I called my Salem Health family physician's office. I talked with someone who described my treatment options after I told her that I'd like to get Paxlovid given my age (74) and understandable desire to avoid a serious case of Covid.

She explained that a complication was that Paxlovid interacted with several prescription medications that I was taking. OK, I told her, no problem. I just won't take the medications while on the five-day Paxlovid course of treatment.

I then was told that they use the Salem Health pharmacy and that I'd be getting a call from a pharmacist. Probably the same day. Around 2:30 in the afternoon I got that call.

The Salem Health pharmacist was wonderfully clear.

He had me repeat what the person in my doctor's office had told me (which probably was in my chart): stop taking all of my other prescription medications for the five-day Paxlovid treatment, plus three days afterward, waiting another two days to restart the most problematic medication, Lovastatin (10 mg).

Again I said, no problem. I told the pharmacist I wasn't going to suffer much, if at all, from not taking the other medications. I'd much rather shorter the course of my Covid infection and lower the risk of getting Long Covid, which a VA study indicates is about a 25% risk reduction. 

Laurel, my wife, picked up the no-cost Paxlovid prescription for me. I took my first dose of three pills late Monday afternoon on the same day I tested positive for Covid. So I felt good that it was possible to get going with Paxlovid so soon (Paxlovid needs to be started within five days of having Covid symptoms). 

Here's how Paxlovid works.

Paxlovid is an antiviral therapy that consists of two separate medications packaged together. When you take your three-pill dose, two of those pills will be nirmatrelvir, which inhibits a key enzyme that the COVID virus requires in order to make functional virus particles. After nirmatrelvir treatment, the COVID virus that is released from the cells is no longer able to enter uninfected cells in the body, which, in turn, stops the infection. The other is ritonavir, a drug that was once used to treat HIV/AIDS but is now used to boost levels of antiviral medicines. 

As a COVID-19 treatment, ritonavir essentially shuts down nirmatrelvir’s metabolism in the liver, so that it doesn’t move out of your body as quickly, which means it can work longer—giving it a boost to help fight the infection.

At the moment I'm 3 1/2 days into the 5-day treatment. Starting today, Thursday, I'm almost symptom free.

My nasal congestion is just about gone. I cough occasionally, but way less than before. The only annoying side effect is some diarrhea, along with a bit of a metallic taste in my mouth for several hours after taking a dose.

Regarding the oft-heard Paxlovid "rebound effect," where Covid symptoms recur after going away, the Salem Health Pharmacist told me that this isn't due to Paxlovid, but to Covid. I believe he's right, after some Googling of this subject. For example, see here and here.

Not everyone with Covid is eligible to get Paxlovid. Based on my experience, I recommend that if you have Covid, ask if you can be prescribed Paxlovid.

Covid cases rising in Oregon and Marion County with fewer people wearing masks

I've never stopped wearing a mask in indoor public spaces, even though masks are no longer required. When I see most people maskless, sometimes I wonder if I should join them.

But since wearing a mask is no big deal, and I'd much rather do that instead of getting Covid and running a significant risk, about 30% I believe, of having nasty Long Covid symptoms persist for months or even years, I always end up putting my mask on.

That decision is looking even wiser given the recent rise in Covid cases both statewide in Oregon and here in Marion County.

The real number of cases is at least ten times greater than shown, since most people with symptoms are getting tested for Covid at home now, so the vast majority of cases aren't getting reported to the Oregon Health Authority.

Why are cases rising? The Albany Democrat-Herald has a good story by Tim Gruver, "OHA: Fewer face masks likely leading to more COVID cases in Oregon." 

COVID-19 cases are climbing back up in Oregon, and fewer people wearing face masks is likely the cause, according to state public health officials.

While the state is faring much better than other states, it is far from out of the woods, Deputy State Health Officer Tom Jeanne said at a virtual press briefing on Wednesday, April 20.

...Hospitalization figures, however, lag behind case counts, and right now, daily case counts are seeing steady rises since their lows of 300 per day at the start of the month.

The seven-day rolling average, Jeanne said, is now 600 cases per day as of Tuesday, April 19.

Those numbers are higher than what Oregon saw when COVID-19 restrictions were last relaxed in July while also far short of January's case surge brought on by omicron variant of the disease.

Why? Fewer people than ever are wearing face masks, according to Jeanne.

...The Oregon Health Authority has no threshold for when it would reinstitute a statewide mask mandate, according to Jeanne, regardless of what COVID-19 case trends are signaling.

"We hope that that kind of intervention will not be required," Jeanne said.Nevertheless, Jeanne described wearing a face mask as one of the simplest and least burdensome measures people can take to protect themselves and others.

I think of it this way.

If I stop wearing a mask in a store or other public indoor space, after more than two years of doing this and not getting Covid, then I get infected and suffer from COVID-19, not just for a few weeks but for many months, I'd berate myself for failing to heed the masking advice of public health experts for people like me -- over 60 or otherwise at greater risk.

But if I keep on wearing a mask until Covid truly becomes endemic, rather than an epidemic/pandemic, I'd feel bad if I got Covid but I wouldn't feel like an idiot for failing to wear a mask when this is such an easy thing to do.

Why I'm still wearing a mask in public indoor spaces

I readily admit that if you look at photos of me with and without a mask, there's good reason to feel that the reason I'm still wearing a mask out in public, even though it isn't required now in most places, is that I look better with my face covered up.

(For sure, I look younger.)

But actually I have some pretty good reasons to buck the clear maskless trend, now that Governor Brown has lifted the indoor masking order (which still remains for health care facilities and pharmacies).

These reasons are based on public health advice/information I've been getting from my Twitter feed and usual news sources: New York Times, Washington Post, The Atlantic -- you know, the mainstream media that reality-based liberals like me enjoy reading.

(1) I'm old. Being over 60 puts me in a high-risk Covid group. Being over 70, even more so. People at higher risk from Covid for whatever reason should still wear a high quality mask in public indoor spaces where unvaccinated people and infected people will be encountered.

(2) I don't want to get long Covid. Or short Covid, for that matter. When I hear people say, "a mild case of Covid is just like the flu," I think, OK, but I don't want to spend a week or two sick with the flu. Plus, many people with Covid have serious lingering symptoms like fatigue that can last for months or years. This can happen even with mild cases. So no Covid is way better than any form of Covid.

(3) An Omicron subvariant could be coming soon. Omicron is a variant. BA.2 is an Omicron subvariant. It's causing a rapid rise in cases in many parts of the world. Bad news is that BA.2 is even more infectious than original Omicron. Good news is that it appears to be no more severe. 

New infections jumped by eight per cent globally compared to the previous week, with 11 million new cases and just over 43,000 new deaths reported from March 7-13. It is the first rise since the end of January.

The biggest jump was in WHO's Western Pacific region, which includes South Korea and China, where cases rose by 25 per cent and deaths by 27 per cent. 

...The picture in Europe is also not universal. Denmark, for example, saw a brief peak in cases in the first half of February, driven by BA.2, which quickly subsided.

But experts have begun to warn that the United States could soon experience a similar wave to that seen in Europe, potentially driven by BA.2, the lifting of restrictions and possible waning of immunity from vaccines given several months ago.

"I agree with the easing of restrictions, because you can't think of it as an emergency after two years," said Antonella Viola, professor of immunology at Italy's University of Padua.

"We just have to avoid thinking that COVID is no longer there. And therefore maintain the strictly necessary measures, which are essentially the continuous monitoring and tracking of cases, and the maintenance of the obligation to wear a mask in closed or very crowded places."

Scheduling group meetings is tough in the Age of Covid

For many years I've done the scheduling for a monthly Salon discussion group my wife and I are members of. 

Pre-Covid, that used to be easy. 

We'd meet in the homes belonging to the dozen or so people in the group. I kept track of where we met each month, doing my best to keep to a regular rotation among the various homes. 

I'd ask the people who were next up in the rotation if they could host a meeting on a certain date. If they could, then I'd email everybody in the group to see if that date was OK for them.

Pretty damn simple. 

Post-Covid scheduling also was easy for quite a while. From March 2020 until November 2021 we met either via Zoom, or, if the weather was warm and dry enough, outside in the back yard of one of our members.

In December 2021, when Covid cases were pretty minimal, we had a maskless in-person meeting at our house. Everyone survived. A few people chose not to attend the meeting, feeling they weren't ready yet to meet in person.

Now our discussion group is in an awkward period, along with the rest of the country, really. 

Covid cases are rapidly declining, along with hospitalizations and deaths. But we're not quite in the endemic stage, when Covid simply becomes an ongoing problem to live with, like the flu.

So the twelve members of our group are representative of the range of attitudes toward Covid at this stage of the pandemic, which probably soon will become an endemic (using that word as a noun rather than an adjective).

Eight of us, including my wife and I, are fine with meeting in-person indoors.

Everybody in our group has been fully vaccinated and boosted. We're all Covid-careful. So getting together in someone's house seems low-risk. After all, we've been in public stores, gyms, and such with strangers who don't always wear a mask.

Having a small private meeting with people you know and trust is considerably less risky. And naturally anyone who wants to, can wear a mask during the meeting, which reduces the Covid risk even more (likely to almost nothing).

However, four members of our group aren't ready yet to meet indoors. They're OK with meeting outdoors, but currently the weather is too unpredictable for that to be a good option. 

This has made scheduling our March meeting difficult. I've always gone by the adage, "greatest good for the greatest number." If nine people can make a meeting on one date, and eleven on another date, I'll go with the day that works for the most people.

Problem is, a Zoom meeting would have the largest number of our members taking part. Yet eight of our twelve members prefer an in-person meeting. 

That's the way we're going to go this month, with hopes better weather will enable us to meet outside soon -- a desirable option until the four people reluctant to meet indoors feel comfortable doing that.

Complicating things is the difficulty in gauging how strongly people feel about meeting indoors versus via Zoom. How is it possible to compare those who really hate Zoom meetings with those who really hate the idea of meeting indoors when Covid is still circulating in our community?

Is one form of hate more worthy? Maybe. Maybe not. But I don't know how to assess that, so I'm simply assuming that the opinion of someone who wants to meet indoors is equal to the opinion of someone who wants to meet via Zoom.

Anyway, these are interesting times we live in.

Everyone wants to get back to complete normal, but Covid isn't going to allow that for the foreseeable future. So we all have to navigate a course that leads as close to normal as possible, without veering off into the shoals of either excessive risk-taking or excessive caution.  

Covid is declining, but these tweets show the danger of relaxing too soon

For about a week I've been collecting Twitter tweets from people knowledgeable about the current state of the Covid crisis. Most of them deal with the danger of relaxing public health measures too soon. Denmark did away with all restrictions, and now is paying the price in deaths and cases.

Below you'll find screenshots of my carefully curated tweet collection. Most recent are shown first. The top tweet from yesterday has some possible good news for those of us in Oregon.

Schmidt is referring to the fact that Governor Brown has announced that the indoor mask requirement in public spaces will expire on March 31, unless the number of Oregonians hospitalized with Covid drops before that date to 400 or fewer.

Today's Oregon Health Authority Coronavirus Update said that 776 people are hospitalized with Covid, so we've got a ways to go before 400 is reached.

 

Protests against vaccines and masks are super selfish

Tonight we had a meeting of the monthly Salon discussion group my wife and I are a part of.

We met via Zoom because even though some in the group, including Laurel and me, are fine with meeting in-person, others aren't.

So we do our best to accommodate those who are most wary of coming down with Covid, even though everybody in the group is fully vaccinated and boosted. 

This is called being reasonable. Also, unselfish. Doing what you want only is justified if that action isn't going to harm other people. 

I'd like to believe that most people feel the same way.

Freedom has limits. Someone might really enjoy driving while drunk, but this is illegal because of the danger to others. That handicapped parking space is conveniently located, but it needs to be reserved for those who really need it.

This also is the rationale for public health measures.

Each person has a responsibility to look out for the welfare of everybody else. Getting vaccinated and wearing a mask in indoor public spaces both protects the person doing these things, plus other people.

This evening we talked some, as we usually do, about the phenomenon of Trump. I noted how his superpower is shamelessness. We're used to leaders who try to hide their wrongdoing. Trump revels in his misdeeds.

While members of our group had some different ideas about why Trump still is so popular with Republicans (though his approval seems to be dropping), we agreed on some basic points.

Even though it's tempting to view Trump as the cause of the increase in overt racism, disdain for LGBTQ people, anti-vaccine/masking hysteria, and such, this is too simplistic.

It takes two to tango.

Trump is a master manipulator of the dark side in his followers, but he wouldn't be so successful unless there was a dark side to manipulate in a disturbingly large percentage of the Republican Party.

The protests currently happening in Canada show that Trumpist views are gaining traction in our neighbor to the north, as well as in some European countries.

I started attending protests while in college, 1966-71. Back then, as now, until Trumpism reared its ugly head, protests almost always called for a change that would benefit the common good.

End the Vietnam War. Stop unjustified police killings. Act to reduce greenhouse gases. Those were progressive causes. Conservatives had their own causes, such as the Tea Party movement that sought to reduce government taxation and wasteful spending.

I disagreed with those conservative causes, but I could understand that those espousing them sought their own vision of the common good.

In the Canadian protests, though, which are largely funded and supported by right-wingers in the United States, the main battle cry is "Freedom!" Not freedom for someone else. Not freedom for an oppressed group.

Freedom for the protesters to not have to be vaccinated, wear masks, or engage in other public health measures. They are demonstrating zero comprehension of why those measures are needed to prevent deaths, disease, and disability from exposure to Covid.

It's all about Me. Just as Trump is all about Him. Trump's shameless openness about his own selfishness gives an impetus to others to follow in his selfish footsteps.

Which don't lead to any sort of conception of the common good. No, those footsteps make a circular pattern, always facing inward to the desires of Me, Me, Me, with the welfare of other people completely irrelevant.

This is something that hasn't been seen before in American politics, nor in Canadian politics, I'm pretty sure.

A large share of a major political party being captivated by the notion that freedom isn't something to be fought for to benefit others, but solely to allow those protesting to be able to do whatever the hell they want, even if this harms their fellow humans.

I got some CBDA. Covid can't touch me now!

Like I said in a recent post about an Oregon State University study that found CBDA and CBGA prevented Covid infection in a laboratory study of cells, regular CBD has very little of these acids that are  precursors to CBD, so mostly disappear when CBD is created from hemp.

But I found several online sources of CBDA. Fewer seem to exist for CBGA. This story describes the key differences between CBD, CBDA, and CBGA, with this takeaway quote.

A study published this week by researchers at Oregon State University found some hemp compounds have the ability to prevent the virus that causes COVID-19 from entering human cells.

Findings of the study led by Richard van Breemen, a researcher with Oregon State’s Global Hemp Innovation Center, College of Pharmacy and Linus Pauling Institute, were published this week in the Journal of Natural Products.

...“We identified several cannabinoid ligands and ranked them by affinity to the spike protein,” van Breemen said. “The two cannabinoids with the highest affinities for the spike protein were CBDA and CBGA, and they were confirmed to block infection.”

So I was thrilled to find this bottle in our mail today, which arrived quickly from FluxxLab, a Colorado company.

The label on the back says that half a dropper contains about 10 mg of CBDA and 6.6 mg of CBD. I've had two doses today, so it's pretty clear...

Covid can't touch me now!

Leaving aside the minor detail that there's no evidence CBDA actually prevents Covid in humans, as opposed to cells in a lab dish. But if the placebo effect is at play here, I'm even more protected, since I believe in CBD and CBDA.

I don't claim to fully understand what makes Fluxxlab products different from regular CBD, but this excerpt from the product page for their CBDA oil say those products are considerably more potent -- five times as much. 

FluxxLab™ CBDA Tinctures

Expect results that will outperform any CBD you have ever experienced. Completely natural, this pure CBDA oil tincture delivers potency many times greater than standard CBD. Carefully crafted in our own Colorado lab, we have added exactly the right natural terpenes to precisely balance the performance of what our customers tell us is “The World’s most perfect Tincture.”One ounce will provide you with a full month’s supply of the Best CBDA Rich Oil tincture you will ever find anywhere. Satisfaction always guaranteed.

Beyond all other tinctures

FluxxLab™ tinctures are precisely formulated to fit your needs and usage levels. Experience tells us that 90% of people who use CBD don’t take enough and don’t get the full benefits that they need or expect. At Fluxxlab™, we have addressed that problem with an economical and effective solution. We offer you three carefully selected CBDA tinctures. Our 500mg tincture is exactly right for those serious users who would otherwise be taking 2,500mg of regular CBD per month. We refer to this as the normal CBD dosage level. Our 1000mg CBDA oil is correct for users who would otherwise be taking 5,000mg of CBD per month, on average.

OK. I've been taking about 50 mg of CBD a day, so that comes out to 1,500 mg a month. Thus supposedly I've been well under the normal CBD dosage level of 2,500 mg.

Regardless, I'm enthused about trying out CBGA, a new thing for me. There hasn't been as much research on it as on CBD, but there's some intriguing potential benefits aside from preventing Covid.

CBDA shows promise as an effective medicine in the treatment of a variety of conditions. CBDA’s affinity for serotonin receptors helps it affect everything from mood to nausea to inflammation.

CBDA has shown to have a more intense activation of 5-HT1A serotonin receptors compared to CBD. Serotonin can affect a variety of physiological functions including mood regulation, nausea, vomiting, and intestinal motility. 

Based on the current research, CBDA’s potential as a medicine is still up in the air. 

Up until now, clinical trials have largely focused on animal models. Until trials focus on human health and how CBDA works, we will not know the full extent of CBDA’s power.

Pain relief also is a possibility (scroll down and click on benefits). 

There can be dramatic results when using CBD products. At FluxxLab™ we have first-hand experience with many hundreds of cases where our customers have experienced dramatic and amazing results using CBDA as compared to plain CBD.

The overall Endocannabinoid response to CBDA appears to be far more powerful than it is with CBD. CBDA binds with some of the same Endocannabinoid receptors in the human body as CBD, but it is also known to bind with different receptors.

Expect to find many cases where CBDA acts in similar but more powerful and effective ways than plain CBD. For example: Research indicates that CBDA acts on the human body by inhibiting COX-1, an enzyme linked to inflammation. When the human body feels there is a problem in a particular organ, it sends this enzyme to cause inflammation and stop the problem from spreading throughout the body. Inflammation is a natural body response. However, our body often creates inflammation even when there is no real problem. People suffering from such inflammation usually complain about chronic pain. CBDA appears to be as much as 100 times more effective in targeting this receptor, compared to CBD.

Not much Covid-fighting CBDA and CBGA in regular CBD

I've been using CBD oil and capsules for quite a while. So I got excited yesterday when I saw reports of an Oregon State University study that found precursors to CBD, CBDA and CBGA, prevented Covid infection in a laboratory study of cells.

Hemp

CORVALLIS, Ore. – Hemp compounds identified by Oregon State University research via a chemical screening technique invented at OSU show the ability to prevent the virus that causes COVID-19 from entering human cells.

Findings of the study led by Richard van Breemen, a researcher with Oregon State’s Global Hemp Innovation Center, College of Pharmacy and Linus Pauling Institute, were published today in the Journal of Natural Products.

Hemp, known scientifically as Cannabis sativa, is a source of fiber, food and animal feed, and multiple hemp extracts and compounds are added to cosmetics, body lotions, dietary supplements and food, van Breemen said.

Van Breemen and collaborators, including scientists at Oregon Health & Science University, found that a pair of cannabinoid acids bind to the SARS-CoV-2 spike protein, blocking a critical step in the process the virus uses to infect people.

The compounds are cannabigerolic acid, or CBGA, and cannabidiolic acid, CBDA, and the spike protein is the same drug target used in COVID-19 vaccines and antibody therapy. A drug target is any molecule critical to the process a disease follows, meaning its disruption can thwart infection or disease progression.

“These cannabinoid acids are abundant in hemp and in many hemp extracts,” van Breemen said. “They are not controlled substances like THC, the psychoactive ingredient in marijuana, and have a good safety profile in humans. And our research showed the hemp compounds were equally effective against variants of SARS-CoV-2, including variant B.1.1.7, which was first detected in the United Kingdom, and variant B.1.351, first detected in South Africa.”

Those two variants are also known the alpha and beta variant, respectively.

But since the news release spoke of CBGA and CBDA being precursors to CBD, this paragraph caused me to wonder whether the CBD drops and capsules I'd been taking were Covid fighters.

“These compounds can be taken orally and have a long history of safe use in humans,” van Breemen said. “They have the potential to prevent as well as treat infection by SARS-CoV-2. CBDA and CBGA are produced by the hemp plant as precursors to CBD and CBG, which are familiar to many consumers. However, they are different from the acids and are not contained in hemp products.”

So last night I emailed the folks at Sunsoil, a Vermont company where I've been buying CBD, asking if their products contained CBDA and CBGA. They replied promptly today, referencing a news story I'd sent them about the OSU study.

Hi Brian,

 

Thanks for sending this article along! We've had a few customers forward it to us today as well 😀 We post all of our lab reports on our website and you can find them here: https://www.sunsoil.com/pages/lab-results-1. You can match your specific bottles and batch/lot # to the reports on our website.

 

As you will see, our products do contain the full range of cannabinoids present in the hemp plant, but we definitely focus on and propagate our seeds and plants to product more CBD than other cannabinoids. Our oil does contain CBGA and CBDA but in very small quantities so that on the reports you may see either "ND" (none detected) or <LOQ (below the limit of quantification). Both of these mean that there is trace amounts of these cannabinoids in our oil, but lower amounts than the lab equipment used for results can detect.

 

Let me know if you have any other questions or need clarification! The reports can be tricky to read so I always recommend scrolling down to the Sunsoil header report as it's a bit more reader friendly. Hope this helps!

 

Have a great day,

Tia

Following the link in the email message, I checked out the lab results for the Sunsoil CBD drops I've been taking with 20 mg of CBD in a serving. Here's a table of what they contained.

The easiest way to look at this, assuming I'm reading the table correctly, which I think I am, is that the sample totaled 27.55 mg of Cannabinoids, with 22.43 mg being CBD. There was 1.83 mg of CBDA in the sample, and just a trace amount of CBGA, not enough to measure.

So, hey, almost 2 mg of CBDA is better than nothing, Covid-fighting-wise, but pretty minimal. That led me to a Google search for real CBDA or CBGA.

I focused on CBDA, since there seemed to be more sellers of this. Montkush has a detailed description of CBDA, which educated me about this CBD precursor. Excerpt:

What Is CBDA?

All cannabinoids in cannabis and hemp come from cannabigerolic acid (CBGa), the mother of all cannabinoids.

Plant enzymes then convert the CBGa into a combination of the three major cannabinoid precursor compounds: tetrahydrocannabinolic acid (THCA), cannabichromenic acid (CBCA), and cannabidiolic acid (CBDA). The combination will depend on the unique cannabis strain they are derived from.

CBDA is a non-psychoactive compound that serves as a precursor to CBD. More specifically, CBDA is decarboxylated to create CBD, meaning it is heated. This can happen instantly if smoked or vaped, or slowly if the plant material is left to dry in the sun or even at room temperature.

Cannabidiolic acid can, therefore, be thought of as raw CBD. CBDA is most often found in the live or raw hemp plants bred for high CBD levels.

Cannabidiolic acid is often consumed as CBD, but it can also be beneficial in its raw form. CBDA oil can be consumed or absorbed via tinctures, raw cannabis juice, topical creams, and raw CBDA oil.

To date, CBDA has attracted much less public attention and is seen less on the market. However, the raw juicing cannabis trend is bringing CBDA into the spotlight. People are wondering about the differences between CBD and CBDA and if CBDA is better than CBD.

So is it?

Let’s take a look.

The Differences Between CBDA & CBD

The major difference between CBDA and CBD is actually the amount of heat applied to the substance.

As we mentioned, the main difference is that CBDA is a precursor to CBD. You create CBD by heating CBDA or raw CBD.

While research in CBDA is in much earlier stages than even CBD, we know that they share some similarities.

Unfortunately, Monkush was sold out of CBDA. I signed up for an email alert for when it is expected to be available at the end of January.

I had better luck with Myriam's Hemp, which offered CBDA oil. I also got some from FluxxLab, even though their ordering process was frustrating. The box I had to check to agree to the terms of service didn't work with Safari or Chrome, but using Firefox enabled me to make an order. 

Of course, the OSU study was just laboratory research. There's no evidence, so far as I know, that CBDA prevents Covid in humans. But I figure that taking some CBDA won't hurt me, and it may have a placebo effect.

I also read that CBDA has a much stronger antidepressant effect that CBD, so if I do get Covid, hopefully I won't feel as sad about that.

Salem, be Covid-safe on New Year's Eve

After almost two years, we're all tired of dealing with Covid. A lot of people in Salem are going to want to party-on tomorrow night. 

I urge you to do that responsibly. 

Just as the admonition, "if you drink, don't drive," is intended to both protect the person who's drinking and others who could be harmed if they drive, the same applies to Covid.

You might think that it would be no big deal if you were infected, which probably would be with the Omicron variant. But keep in mind the risk to your friends, family members, co-workers, and such.

Omicron is super-contagious. That's why Covid cases in Oregon have been rising rapidly.

So seriously consider wearing a mask when you're not eating or drinking if you're out and about, even if you're vaccinated. 

Reportedly most Omicron cases are like the flu if someone is fully vaccinated with a booster shot, and like a bad case of the flu if they haven't had a booster. 

But having the flu isn't fun. And Covid can be much worse than the flu, especially if you're in a high risk group. Wearing a proper mask will help protect you and other people.

Here's some good news. South Africa, where the Omicron variant was first reported, says that the country has passed the peak of cases without a major spike in deaths. 

“The speed with which the Omicron-driven fourth wave rose, peaked and then declined has been staggering,” said Fareed Abdullah of the South African Medical Research Council. “Peak in four weeks and precipitous decline in another two. This Omicron wave is over in the city of Tshwane. It was a flash flood more than a wave.” The rise in deaths over the period was small, and in the last week, officials said, “marginal.”

So the United States could see the same rapid fall in Omicron cases sometime in early 2022 -- all the more reason to be extra careful now.

“We’ll be in for a tough January, as cases will keep going up and peak, and then fall fast,” said Ali Mokdad, a University of Washington epidemiologist who is a former Centers for Disease Control and Prevention scientist. While cases will still overwhelm hospitals, he said, he expects that the proportion of hospitalized cases will be lower than in earlier waves.

Yelling at a grocery store clerk isn't cool. They're Covid heroes.

When I was ready to checkout after grocery shopping at the South Salem Fred Meyer store today, there were long lines at every register.

I picked the most promising line. There were just a few people ahead of me.

But one of them was an older woman who not only wasn't wearing a mask, she had a humungous amount of groceries and other items piled high in her cart.

That worried me. However, I figured that it wouldn't take very long for the clerk to handle her purchases, and those of the woman just ahead of me.

I was wrong.

For one thing, it turned out that the maskless woman was buying even more items that I originally thought. She must have had a hidden compartment in her cart, because she kept piling stuff on the conveyor belt beyond what I thought was possible.

Plus, I was too far back to hear the details of the problem that arose when it was about time for the woman to pay, but I could see the clerk reach for her phone -- which usually means a manager is needed.

It was. I'm not sure why. Maybe a dispute about the cost of an item.

Regardless, the manager's involvement took more time. All told, I guess it took at least ten minutes for the clerk to checkout the maskless woman. She ended up paying well over $400, I recall.

The woman ahead of me didn't have nearly as much stuff, so I thought it wouldn't be long before I got to the head of the checkout line.

Wrong again.

This time the reason for calling a manager had something to do with the price of a big package of Brawny paper towels. I got the impression that the woman wanted a sale price for an individual roll to be applied to each of the dozen or so rolls in the package, or something like that.

At first the clerk tried to calculate what the cost should be by using her touch screen. Then, confused, she asked a manager who was standing nearby for his help. He told her she should cancel the original paper towel purchase and enter a new price.

That didn't work either. 

The clerk picked up the phone, asked for the manager, and tried once more after getting some additional instructions about what to do. Still no luck. So she had to call the manager again.

By this point I was getting irritated. Not at the clerk. At the woman who was adamant about getting a lower price for the Brawny paper towels. The line had gotten longer behind me. Clearly the clerk was getting stressed at not being able to figure out how to put in a different price for the paper towels.

I toyed with the idea of telling the woman that I'd be glad to give her a few dollars if she'd give up on trying to get the reduced price.

Upon further reflection, though, it seemed like this wasn't wise, so I just kept adjusting my posture to look as irked at possible at the woman who was holding up the long line of shoppers behind me just so she could save a small amount of money that maybe she wasn't really entitled to anyway.

Then I heard one of those shoppers yell at the clerk. I couldn't tell what was said, just that it was a complaint about how slow her line was moving. The clerk politely said, "I'm doing the best I can." Which, she was.

The manager had to come back one more time to help the clerk adjust the paper towels price. She told him, "I don't know how to do this very well. I've got to learn how to do it." The manager was supportive. "Hey," he said, "we're not on strike, which is good. Don't worry, you're doing great." 

(Fred Meyer stores in the Portland area went on strike recently, but it only lasted a day until an agreement was reached.)

My checkout went smoothly. I told the clerk, "You deserve an easy customer after your previous two." When she handed the receipt to me I patted her shoulder and said, "Thanks for what you're doing. Much appreciated." I heard the man behind me say something similar as I left the checkout line.

We've got to remember what a tough job grocery store clerks have had in the almost two years since the Covid pandemic hit. They've got to stand there, facing irritated customers, some of whom refuse to wear a mask, not knowing if they're going to become infected during their shift. 

Yes, most of us feel stressed around the holidays, especially this year, with the highly contagious Omicron variant lurking around. But this isn't an excuse for yelling at a grocery store clerk. They're Covid heroes.

Take Omicron seriously, Salem. Very seriously.

Omicron, the newest Covid variant to impact our country, is more attractive than original Covid and the Delta variant. But even though it looks like a Christmas ornament, don't be fooled. 

It appears Omicron could devastate Oregon in the coming weeks. So says an excellent Oregon Capital Chronicle story, "Governor, health experts brace Oregonians for a serious impact from Omicron by February."

In the past week, the Covid-19 outlook for Oregon shifted dramatically, with the state now facing the prospect of having the highest surge yet of infections and hospitalizations.

A new forecast by Oregon Health & Science University indicates that more than 3,000 people would need to be hospitalized in Oregon by early February, surpassing the 1,200 hospitalized during Delta’s peak. 

If that develops Oregon will not have enough hospital beds for everyone who needs one and hospitals will have to decide who to treat.

“We’re seeing all the pieces we need to say that it could be bad,” Peter Graven, director of OHSU’s Office of Advanced Analytics, told the Capital Chronicle after a news conference Friday with Gov. Kate Brown and Oregon Health Authority officials.

The dire forecast stands in contrast to general expectations that Omicron would be little worse than a bad cold while the Delta variant continued to fade.

Earlier projections expected infections in the state to continue declining, but Graven said he noticed an uptick in Covid-19 cases. He said he received new information in recent days from Kentucky, Washington state and Denmark that led him to calculate that Omicron could become the dominant strain in Oregon in two to three weeks. 

Governor Brown isn't planning any new Covid restrictions at the moment, but she leaves open that this may be necessary. Getting a booster shot into the arms of as many Oregonians as possible is the main public health approach that needs to happen now.

Hopefully people in Salem, and elsewhere, will realize that Omicron shouldn't be taken lightly.

Omicron spreads much more rapidly than original Covid and the Delta variant. So even if cases are milder on the whole, with so many people slated to come down with Omicron, serious cases are going to rise markedly.

Today I went to exercise at the River Road branch of Courthouse Club Fitness. I always wear my mask the whole time I'm at the gym. However, most of those at the club don't. Before, this bothered me. With the rise of the Omicron variant, I'm more irritated by the maskless people.

Because most of the elliptical trainers were being used in the aerobics room, I had to use a machine in-between two maskless guys exercising away. As soon as one of them finished, I moved to a machine further away from the other maskless guy. 

I understand why people are getting complacent about wearing a mask in indoor public spaces where you don't know the vaccination status of others in the area. But this isn't the time to get more lax. The rise of Omicron (which sounds like a super-villain movie) demands increased vigilance. 

Here's a series of tweets by physician Bob Wachter today that do a good job of explaining what's currently known about Omicron and how we should react to it.

I dove into the deep end of life with Covid today

Since March 2020 -- almost two years -- I haven't sat inside a home with friends to eat, drink, and talk. My wife and I, being in our seventies, have been Covid-cautious. 

Even though we're fully vaccinated with booster shots, we've been reluctant to take the risk of getting together with other people indoors for an extended period. Laurel has eaten occasionally at restaurants with friends. I haven't. 

But today I dove into the deep end of life with Covid. And it felt great!

This afternoon we hosted a three hour meeting of our monthly Salon discussion group at our house. Eight of us enjoyed a potluck totally maskless. It felt wonderfully normal to sit in our living room enjoying the company of good friends not through a Zoom computer screen, in 3-D vibrant reality.

Then in the evening we went to a holiday gathering at a neighbor's house. Again, everybody was maskless (and vaccinated).

I talked for well over an hour with a man I'd just met. He was British, though living in this country now. Our conversation ranged widely, including discussing Donald Trump, Boris Johnson, parliamentary system versus our election approach, World War II, electric bikes, and numerous other topics.

It was delightful to stand close to a stranger for that length of time, not worrying that he was going to breathe Covid on me.

Understand: I'm not advocating a reckless approach to the pandemic. It isn't wise to socialize indoors with people who may not be vaccinated if you aren't wearing a mask. However, Covid is going to be with us for a long time, probably forever, just as the flu is.

Outbreaks will come and go. We might have to get an annual Covid shot to protect against new strains, as we do with the flu vaccine.

Life has to go on. Not totally normal. Just close to normal.

Today it was rejuvenating to finally feel normal in those two indoor gatherings. So if you're old and very Covid-cautious as I have been, consider lightening up a bit and start meeting indoors with vaccinated friends.. 

You won't regret it.

Be Covid safe at Thanksgiving, then don't worry much

Yesterday via Zoom, my wife, Laurel, and I discussed the holidays from a Covid perspective with a dozen friends about our age -- some older, in their 80s, some younger, in their 50s and 60s, and some like us, in their 70s.

So, yeah, it was a decidedly senior group. Keep that in mind as I describe both the anxiety and hope shared last night. 

Since this was a meeting of our monthly Salon discussion group, we took the opportunity to talk about what to do in December: have an in-person gathering, or keep on Zoom'ing. 

Two-thirds (8) were fine with meeting in-person at our house. We're all fully vaccinated. I'm pretty sure everybody has gotten a booster shot. We all wear masks when out and about in indoor spaces, like grocery stores, where some people may be unvaccinated.

This portion of our group, which included me and Laurel, felt that the benefit of getting together for a December potluck definitely was worth the minor Covid risk of meeting in-person.  

We don't find a Zoom meeting nearly as satisfying as a real meeting. Zoom is better than nothing, but way less satisfying than sitting in a living room and conversing face-to-face. Naturally we're concerned about our physical health. Our mental health is equally important to us, though.

The other third of our group, four people, were less enthused about meeting in-person. Two friends were adamant that they didn't want to do this maskless, since eating and drinking requires taking a mask off.

They correctly noted that asymptomatic spread of Covid can happen via vaccinated people, which potentially increases the chance that more dangerous variants other than Delta will pop up. And two friends were undecided, leaning for the moment against meeting in-person.

Which is fine. 

As with most issues, different people can be equally familiar with the same facts, yet come to varying conclusions about the meaning of those facts. My Tai Chi instructor likes to say about alternative ways of doing Tai Chi, "Not good/bad or right/wrong. Just different."

So if your family or group of friends isn't in agreement about how to handle a Thanksgiving get-together, don't make this into a battle. Likely there's a way to please most people, though maybe not everyone completely. 

The New York Times has a useful story, "We're Having a Holiday Gathering. Are We Nuts?" 

The story asks a series of questions about your gathering, beginning with Will everyone at the gathering be vaccinated? In the case of our discussion group the answer was yes. Which produced this response.

Happy Vaxgiving! Enjoy your celebration knowing that by being vaccinated, you’ve already made the party safer for everyone.

To further lower risk, encourage every adult to seek out a booster shot. It only takes a few days for the extra protection to kick in. While you’re at it, get your flu shot! Flu remains a serious health risk during the winter.

You’re well protected with vaccines and boosters, but since no vaccine provides 100 percent protection, keep going for more advice to help make sure the coronavirus doesn’t crash your holiday party.

The next question was Is there anyone who will be at your gathering who's at high risk from Covid-19? I said yes. Which elicited: 

A lot of people will share their holidays with an older parent, grandparent or others at high risk. The key to a safer celebration is this: Plan the event around the most vulnerable person in the room.

Consider bringing the party to them, so someone at high risk doesn’t have to spend time in airports or on trains. People at high risk should get booster shots and talk to their doctors about the risks of traveling.

Getting tested a few days before the party and using on-the-spot home tests on the day of the event will allow you to enjoy each other’s company without worrying. Adding a portable air cleaner, opening windows or turning on exhaust fans can also lower risk for Covid and any other viruses that might be lurking. Anyone with the sniffles should stay home.

Nobody likes wearing masks — and if everyone is vaccinated and tested, they aren’t really needed. But some high-risk people may be more comfortable using a mask and having others wear them, too.

Since we all live in the Salem area, traveling by public transport didn't apply to our group. The other advice did, though.

It makes sense to use home tests to reassure people that no one at a gathering has Covid. I'll suggest this to our group, though I'm not sure how easy it is to get home tests or how much they cost.

Regarding masks, I'm going to tell our discussion group that anyone who wants to wear a mask throughout our December gathering should do so. No need to partake of food and drink if they don't want to.

And we could use part of our house as a place where anyone who's concerned about being around maskless eaters and drinkers could do their own eating and drinking, then rejoin us when they're done.

There's ways to make almost everyone comfortable with attending a holiday gathering. This just takes a bit of common sense, collaboration, and flexibility. The New York Times story correctly points out that the most Covid-vulnerable people should get special consideration, since they run the greatest risk.

A look at how Covid was handled in Marion and Polk counties

Today the Salem City Club meeting featured a Zoom program, "Lessons Learned Combatting COVID in the Mid-Willamette Valley."

The Salem Reporter has a good story about the program.  So I'm going to focus on how I viewed what the speakers said.

Here's a screenshot of two of the speakers, Jacqui Umstead, RN, Public Health Administrator for Polk County Health Services (top) and Katrina Rothenberger, MPH, Public Health Director for Marion County Health & Human Services (bottom).

They came across as caring and competent. Almost always that's the case with public health workers. We're fortunate to have them as key leaders in the 18-month battle against the pandemic.

I haven't been impressed with how the Marion County Board of Commissioners -- three Republicans -- have handled Covid-related affairs. They've resisted the governor's public health orders and have expressed skepticism about vaccine mandates.

So Rothenberger deserves a public health medal for doing her best to get Covid under control in Marion County, since she has had to balance the politics of keeping the Board of Commissioners happy while doing what was needed based on evolving scientific understanding of the pandemic and orders from Governor Brown.

At the end of this blog post you'll find screenshots of the slides that Rothenberger and Umstead shared. Some of the content of the slides will seem cryptic without their narration, but you'll get a feel for the lessons they learned during the Year and a Half of Covid Hell.

One clear lesson I want to emphasize is how public health and prevention needs to be a much higher health care priority. It's crazy that our country has spent trillions of dollars dealing with Covid, yet an investment of mere billions would have gone a long way toward making the United States much better prepared for dealing with the pandemic when it hit our shores.

I'm reminded of a recent New Yorker article about how Costa Rica vastly improved the health of people there by taking a public health community-based approach toward health care rather than a treatment approach centered on individual problems.

Sure, treatment is necessary when prevention fails.

However, the United States is way over-balanced toward expensive medical care rather than disease prevention. The speakers noted that the first few months of the pandemic were really tough for their understaffed/underfunded public health departments until money started arriving from the federal government.

The third speaker was Cheryl Nester Wolfe, RN, MSN, NEA-BC, President and Chief Executive Officer, Salem Health. 

In a way Salem Health is the flip side of the public health departments. Lots of money. Lots of staff. High visibility. Focused on treatment rather than prevention. However, the vaccination clinics Salem Health organized at the fairgrounds were absolutely key to getting Covid under control this year -- before the Delta variant got things out of control again.

Wolfe shared this slide that shows Salem Hospital's Covid patient census since the start of the pandemic. The yellow line is breakthrough cases that had to be hospitalized, which I gather are a subset of the blue line showing all Covid patients.

She said that 91% of Covid patients are unvaccinated. 

Wolfe said the hospital was extremely busy prior to the pandemic, which had led them to plan for additional beds. When Covid hit, hospital capacity was stretched even thinner, at times surpassing 100% of traditional capacity, as shown in the figure below.

She correctly noted that Oregon has one of the lowest (maybe the lowest) ratio of hospital beds per 1,000 population in the country. So just as the pandemic showed the downside of "just in time" supply chain/inventory management, which leaves little margin for error when unexpected events happen, the same is evident with hospital beds in Oregon.

(I bear some responsibility for this, since many years ago I worked for the State Health Planning and Development Agency, which handled requests from hospitals to expand capacity and services, something we planners were very cautious about in order to keep costs down. That was good, but sometimes there can be too much of a good thing.)

During the question and answer period I submitted a written question about why Marion and Polk counties have vaccination rates quite a bit below the state average of 68% with 1+ dose. Marion County is at 62% and Polk County is at 61%. But the moderator wasn't able to ask my question before the City Club meeting ended.

As noted above, I suspect that a lack of strong support for vaccines by conservative county commissioners is part of the reason for Marion and Polk lagging the state average. There's surely quite a few other reasons also, though.

CovidActNow.org has a nice compilation of Covid-related data for the entire United States. Here's how that web site discusses the vulnerabilities of Marion County. As you can see, they cite "Minorities & non-English speakers," "Population density," and "Housing and transport challenges" as the three Very High sources of Covid vulnerability that lead to an overall High rating.

Having three clueless county commissioners isn't one of the criteria, though I think it should be.

Here's the slides that the county public health directors shared.

 

Maskless Oregonians, here's what I'm thinking when I see you

Public health experts say we shouldn't shame people who choose not to be vaccinated or ignore mandates to wear a mask in indoor public spaces. 

OK. I get that. Shaming isn't a good way to change behavior.

Anyway, I'm too polite and well-mannered to go around telling maskless Oregonians what I think when I see them scoffing at Governor Brown's order to wear a mask because of the highly contagious Delta variant that has filled up almost every general hospital and ICU bed in this state. 

This is causing non-Covid patients to die unnecessarily, because the mostly unvaccinated Covid patients are sucking up hospital beds that otherwise could be used by people who need one because of a traffic accident, heart attack, or whatever.

So, yeah, I have good reason to be irked at those who refuse to wear a mask -- the second best way to prevent Covid other than by getting vaccinated. 

Here's what I'd tell the maskless if I felt like walking up to them and sharing my honest feelings about their foolishness.

You're either ignorant, uncaring, or infected with the Fox News-Republican Party disinformation virus. Doesn't matter which of these explains your decision to walk around maskless in this store, gym, or other place we're sharing.

Probably you believe it's your decision whether to wear a mask. Actually, it isn't. You can make your own decision about whether to be treated for cancer. But you can't make that decision for anyone else. 

Likewise, with Covid, your freedom ends when you exhale. 

By not wearing a mask, you're markedly increasing the chance that I or someone else will get Covid should you be infected. Even if you don't have symptoms, you can still put someone in the hospital, or even die, because of your failure to wear a mask.

You maskless fools walk around in your own self-absorbed bubble. You must enjoy the feeling of ignoring public health advice. You must relish the idea that you're marching to the beat of your own uncaring drummer.

Problem is, your selfishness increases the risk that someone else isn't going to be able to march to any beat at all, because they're lacking a heartbeat after losing a battle against COVID-19.

And don't get me started about how stupid it is to "wear" a mask with your nose exposed, or dangling under your chin. 

You do realize that breath comes out of your nose and mouth, right? And goes in that way, also. Even if you're anti-science, you must have grasped by now that air goes in and out of your nose and mouth, not your neck. 

I don't respect people who fail to wear a mask when one is mandated. 

However, if you're going to act like a maskless jerk, own your jerkiness! Walk around proudly uncaring, ignorant, and clueless. Wordlessly scream out to your fellow shoppers or gym-goers "Look at me! I'm a selfish dude/dudette. My maskless face proclaims how little I care about other people."

Maybe wearing a mask under your nose or chin allows you to feel that you're able to have your Covid cake and eat it too. Hey, I'm wearing a mask! Take that, store owner whose sign on the front door says "masks required."

But actually this just brands you as a wishy-washy fool. When I see someone with a mask that doesn't cover their nose and mouth, I'm more irritated than I would be if they weren't wearing a mask at all.

Not wearing a mask could mean that the person forgot to put it on. Or they have a rare medical condition that prevents them from wearing a mask. Letting a mask dangle under your chin, or slightly better, under your nose, explicitly tells the world that you're a jerk who has a mask, but doesn't want to protect yourself or others from Covid.

Whew. That was a lengthy message.

Now I guess I could print up some cards with this blog post URL and a statement, "Read this to see what I think about you," then hand them out to to the maskless or wrongly-masked who irritate me.

Covid craziness tweets to make you outraged (and laugh)

For the past few days I've been collecting tweets from my Twitter feed related to the current Covid state of affairs. Most have to do with the horror show of Republican governors in Florida and Texas doing their best to kill people in their states by trying to prevent mask mandates, including in schools -- where children younger than 12 can't get a vaccine yet.

Several tweets pertain to the worsening state of affairs here in Oregon.

And one humorous tweet, my favorite, is from a woman in Tennesee who sent a marvelous email to school authorities regarding their policy of allowing parents to opt out of their children wearing a mask. She says that this must mean an opt-out of the school dress code is possible. So her daughter will be wearing provocative clothing now, if she wants.

Here's the tweets.

Here's the full very clever email from the Chattanooga mother.

Covid reality: thoughts are not facts

Driving into Salem today, listening to a news channel on satellite radio, I heard a public health expert say something that made me grab a piece of paper and write it down as soon as I came to a stop:

Thoughts are not facts. 

She was referring to wearing masks in schools as they reopen after a summer break. Like when a student or parent says, "But I thought that wasn't going to be necessary since Covid cases were declining so much a few months ago."

OK. You thought that. But thoughts aren't facts, they're just thoughts. The only way a thought can be a fact is -- no big surprise -- if the thought is factual.

And the facts are that the Delta variant now accounts for almost all Covid cases in the United States; it is much more transmissible than original Covid; 19% of current Covid cases are occurring in children; hospitalizations among children are rising sharply; the Delta variant appears to cause more serious disease among the unvaccinated than original Covid.

These thoughts of mine are based on watching today's Meet the Press show, which featured an interview with Anthony Fauci, and on a bunch of reputable news stories that I've read recently. If you want to check my facts, watch the show yourself.

What's deeply irritating is how so many people are refusing to get vaccinated or wear a mask because they have unfactual thoughts in their head that they wrongly assume are true.

I don't need a shot because I've already had Covid and can't get it again. False. The Delta variant is called that because it varies from original Covid. Plus, immunity diminishes over time, whether from having Covid or getting the vaccine.

Masks help protect the wearer from getting Covid. I'm not afraid of Covid, so I don't need to wear a mask. False. Masks also protect other people from getting Covid. You may have no symptoms of Covid, but you could be spreading it to others. So wear a mask, unless you're so selfish, you don't care about infecting other people.

If someone is vaccinated, they shouldn't care if Covid spreads widely among the unvaccinated. False. Aside from making the pandemic last longer than it would if more people were vaccinated, the unvaccinated are markedly increasing the risk that the virus will mutate into an even more dangerous variant. Fauci talks about this in the video above.

Government has no business telling me what I should do. False. A government driver's license is needed to drive a car. A government screening has to be gone through before boarding an airplane. Everybody, including ardent conservatives, comply with government rules in many aspects of life. So listen to government public health experts.

The Biden administration can't be trusted when it comes to the vaccines. False. The vaccines were developed during the Trump administration. Trump loves to take credit for how rapidly this happened. Think of them as the Trump vaccines.

Here's some additional Covid information I came across today.

A New York Times story, 'This Is Really Scary': Kids Struggle With Long Covid. Every person with a school age child who rejects vaccines or mask-wearing should read the story. Excerpt:

As young people across the country prepare to return to school, many are struggling to recover from lingering post-Covid neurological, physical or psychiatric symptoms. Often called “long Covid,” the symptoms and their duration vary, as does the severity.

Studies estimate long Covid may affect between 10 percent and 30 percent of adults infected with the coronavirus. Estimates from the handful of studies of children so far range widely. At an April congressional hearing, Dr. Francis Collins, director of the National Institutes of Health, cited one study suggesting that between 11 percent and 15 percent of infected youths might “end up with this long-term consequence, which can be pretty devastating in terms of things like school performance.”

The challenges facing young patients come as pediatric Covid-19 cases rise sharply, driven by the highly contagious Delta variant and the fact that well under half of 12-to-17-year-olds are fully vaccinated and children under 12 are still ineligible for vaccines.

Doctors say even youths with mild or asymptomatic initial infections may experience long Covid: confounding, sometimes debilitating issues that disrupt their schooling, sleep, extracurricular activities and other aspects of life.

And here's a couple of Twitter tweets. Yes, it's that Peter Frampton. 

Maskless indoor Tai Chi class today after long Covid layoff

Last week Warren Allen, my Tai Chi instructor, said that today he was going to start having indoor classes again at his Pacific Martial Arts studio on Court Street in downtown Salem.

I was worried, happy, reluctant, and eager. Which is fitting I guess, since Tai Chi is all about blending yin and yang in a harmonious combination of seeming opposites. 

My feelings were natural given how long it had been since I'd been maskless indoors with people other than my wife. About fifteen months, I guess. 

A Voice of America story, "Many Americans Anxious About Returning to 'Normal' After Pandemic" talked about this.

According to a survey by the American Psychological Association, about half of adults are uncomfortable about returning to in-person interactions after the pandemic. Their concerns range from getting COVID-19 to communicating with friends, family and co-workers again.

"Some people will feel paralyzing anxiety about resuming their normal activities after being in a fear mode for more than a year," McBride said. Even when the threat is gone and they've been vaccinated, it is going to take time for them to be comfortable reentering society after the pandemic, she said.

For sure. 

But I figured that going to a Tai Chi class was a great way to begin transitioning into normal post-Covid life. Naturally I trusted that all of my maskless classmates had been vaccinated.

And Warren had said that we wouldn't be doing any "push hands" training for a while requiring person-to-person contact. 

So I felt pretty darn relaxed as I headed up the stairs to the Tai Chi studio above the Court Street Dairy Lunch restaurant, clutching a bag of treats that I'd gotten from Great Harvest to celebrate our return to indoor classes. 

There were just six of us at the kick-off class this afternoon -- which, cosmic coincidence, happened to be the exact number of scones, muffins, and such that I'd bought.

Maybe because we all knew each other so well, it seemed like hardly any time had passed since we'd last done Tai Chi together indoors. (There'd been a few outdoor Riverfront Park classes.)

I'd been doing some Tai Chi every day at home during the pandemic. But that's a lot different from practicing Tai Chi with others. We were a bit rusty, yet not hugely so. I've been Tai Chi'ing since 2004, seventeen years, so the forms are embedded in my mind quite well now.

Talking with my classmates felt wonderfully normal. Covid has isolated us. I'm ready to start being more social again, so long as I'm socializing with other vaccinated people. 

Being retired, and living in a rural area, I'd fallen into a basic habitual pattern of daily activities.

Wake up; eat breakfast; read and meditate; take shower; exercise (Tai Chi, resistance band "weight training"); lunch; chores; dog walk; more stretches and exercising while watching political program on TV; dinner; write blog post; bath; watch entertaining TV; sleep.

Most days weren't exactly this way, of course.

However, during the Covid times I'd become accustomed to a life rhythm that didn't involve many face-to-face interactions with other people. While it wasn't like solitary confinement, it also wasn't unlike it -- if my wife and dog are included in "solitary."

This helps explain why I had some anxiety about our indoor Tai Chi classes starting again. New rhythm, though with familiar people. Pleasingly, I enjoyed the first Tai Chi class so much, Covid anxiety has vanished from my mind.

I'll still be wearing a mask when I go grocery shopping tomorrow. But likely even that will seem like something that is coming to an end. Or at least, the beginning of the end.

(I wanted to include a Tai Chi photo in this post, yet forgot to take one of my classmates today. So here's a screenshot from a video of me doing the Tai Chi sword form on our deck back in 2008 when I was so much younger. And just as gray.)

To mask or not to mask is a big Salem question

We're in an awkward stage of the Covid pandemic. Things are getting better fast, yet Covid cases, deaths, and hospitalizations are still quite high in Oregon. 

This is part of the Oregon Health Authority report that was emailed to me today.

Oregon Health Authority’s  COVID-19 Weekly Report, released today, shows decreases in daily cases and increases in hospitalizations and deaths from the previous week. 

-- OHA reported 4,108 new daily cases of COVID-19 during the week of Monday, May 10, through Sunday, May 16. That represents a 16% decrease from the previous week. 

-- New COVID-19 related hospitalizations rose to 265, up from 245 last week. 

-- Reported COVID-19 related deaths rose to 57, up from 31 last week — the highest weekly death toll in 10 weeks. 

So it's difficult to know how seriously we still need to observe public health measures like wearing a mask indoors and physically distancing ourselves from other people.

At first the CDC and Governor Brown were vague about how, exactly, people should behave given the effectiveness of vaccines and the low probability that vaccinated people could transmit Covid if they got a breakthrough (of the vaccine) infection.

Brown now is saying that it's OK not to wear a mask indoors if everyone else has been vaccinated. Problem is, businesses don't want to ask their patrons if they're vaccinated, and many people would lie about this regardless.

Probably most businesses are going to stick with requiring masks of everybody who enters their premises. This was the case last Monday when I did my weekly grocery shopping at Trader Joe's, Fred Meyer, and LifeSource Natural Foods.

The only store where I noticed several maskless people was Fred Meyer. Also, disturbingly, one young guy at the south Salem Walgreens when I went in there on Sunday. Sure seems like a pharmacy should be strict about customers wearing masks.

Fred Meyer still had their usual "No Mask No Entry" sign by the front doors. But I was behind a customer in the checkout lane who wasn't wearing a mask and seemed to be talking with the clerk about this, though I was too far away to clearly hear their conversation.

At both Walgreens and Fred Meyer I was tempted to say something to the maskless people. However, I figured that if store employees don't want to ask them about why they aren't wearing a mask, I'm not going to do this.

The best advice I've seen comes from Bob Wachter, M.D., chair of the UCSF (University of California at San Francisco) Department of Medicine. He shared this tweet a few days ago.

Makes sense. 

Yet these conditions are easier to assess in a small gathering of friends or family rather than a business. Again, it's very unlikely that Salem businesses are going to check the vaccination status of their customers.

Legally they could do this, and I wish they would. But after the Enchanted Forest theme park attempted to make this their reopening policy, they got a bunch of nasty emails and threats, according to a Salem Reporter story.

The much-loved amusement park located south of Salem had posted on Facebook earlier this week that it would open for the season on Saturday, May 22.  The post (which has since been deleted) said guests would be required to either show proof of vaccination or wear a mask while in the park.

But on Tuesday Susan Vaslev, a member of the Tofte family who’s run the park for nearly 50 years, said in a statement that the park would not be opening because of mask requirements that have been in flux since last week.

“We had hoped to do so this weekend with safety protocols consistent with the most up-to-date guidance from the (Centers for Disease Control and Prevention), the Governor, and the state epidemiologist,” the statement, which was also posted to Facebook, said.

“Unfortunately, recent comments and threats have made clear that our community is not in agreement as to how we will interact in public places with regard to mask requirements for those who are vaccinated versus those who are not vaccinated.”

It's deeply disturbing that anti-vaccination/anti-mask people would threaten the staff of Enchanted Forest, one of the most enjoyable places to go in the Salem area with or without a child. 

Likely most of the threats came from conservatives who view asking for proof of vaccination or requiring a mask be worn as taking away their freedom.

Which isn't true, since businesses have a perfect right to limit what their patrons can do, as evidenced by the "No shirt, no shoes, no service" sign that popped up in the 1970s to keep long-haired hippies out.

(The shirtless shoeless ones, at least.)

Look, I'm not going to accost someone who isn't wearing a mask in a store I'm shopping at. Maybe they have a good reason not to wear a mask. Maybe they forgot to put one on, something I did at the Lowe's Garden Center a few months ago.

Likewise, I don't want anyone to give me, or someone else, a bad time because we choose to wear a mask in a place where masks aren't mandatory. 

When flu season hits, I'm leaning toward wearing a mask when I go shopping even if Covid cases have almost disappeared. I don't want to get Covid, and I don't want to get the flu. Putting a mask on is an easy thing to do. 

If it helps keep me and others healthy, I'm going to keep on doing it.

No mask, no problem -- only if you're vaccinated

Obviously there's a lot to like in today's CDC guidance that fully vaccinated people don't have to wear a mask or socially distance both indoors and outdoors, with some exceptions.

We're tired of Covid restrictions. We want life to get back to normal. We're weary of being afraid of coming down with COVID-19 just because of breathing some infected air.

Governor Kate Brown wasted no time in saying that Oregon will follow the CDC recommendations. 

Today the CDC issued new guidance for lifting mask and social distancing requirements for fully-vaccinated individuals. It is yet another sign that, if we all continue to do our part, the pandemic is coming closer to an end.

Starting today, Oregon will be following this guidance, which only applies to fully-vaccinated individuals. That means Oregonians who are fully-vaccinated no longer need to wear masks or social distance in most public spaces.

Sounds good. But a Willamette Week tweet contains a caveat.

Well, to adapt the (somewhat erroneous) "Houston, we have a problem," Salem, we're going to have a problem. 

Lots of people here don't want to be vaccinated, resist wearing a mask in indoor public places, and bristle at being told what to do Covid-wise.

So I sympathize with stores, restaurants, and other businesses who try to make sure that everyone who enters their establishment without a mask has been vaccinated. 

If they simply ask people at the door, "Are you fully vaccinated, with two weeks having passed since your last shot?," there's no way to tell whether someone is being truthful.

If they ask for a completed vaccination card, many people won't have it with them. Or they could brandish one of the fake cards that are available online.

If they decide it's too much trouble to check their patrons' vaccination status, this undermines the ability of fully vaccinated people to not wear a mask.

Why? Because no vaccine is 100% effective at stopping a Covid infection.

When vaccinated people are together, the risk of coming down with COVID-19 is minimal. But throw in a bunch of unvaccinated people, and the risk rises. (Though perhaps to less than 1%.)

Right now I'm going to be reluctant to go maskless in a store.

I'd rather go through the small discomfort of wearing a mask than increase my chance of getting sick. When most people in the Salem area are fully vaccinated, upwards of 70% ideally, I might change my mind.

I'd feel fine going maskless in a store if I could be sure that all the other customers also were vaccinated.

But unless Oregon mandates some sort of foolproof vaccination passport, a low probability, I'd rather wear a mask and be safe, than not wear one and be (hugely) sorry I got COVID-19.

The frustrating thing is how much easier it would be if everyone would just get a damn Covid shot. They're safe, effective, and widely available now. No waiting. No cost. 

Yet here in Salem we've got a thriving community of irresponsible people who ignore Covid public health measures and wrongly feel that they have a right to put others at risk by not wearing a mask or socially distancing.

The Peoples Church has the dubious distinction of having the largest workplace outbreak in Oregon, 87 cases so far. Yet the pastor vows to keep on with packed, maskless, in-person services. 

Yay, Salem! We're #1 in COVID-19 religious idiocy.

Marion County could go into Covid "extreme risk" soon

If you thought it was OK to relax with the mask wearing and social distancing, think again.

Oregon Covid cases are increasing at the highest rate in the nation, 58% in the past two weeks. The next closest state is Alabama with a 37% increase.

When Alabama is kicking our butt on public health, that's reason to be worried.

Here's a chart of how badly Oregon has been doing recently.

Remember how freaked out everybody was in the spring of 2020 when Covid was a new thing to worry about? The 7-day average of cases in Oregon back then was 50-70 a day. Yesterday it was 740.

So however much you freaked out a year ago, freak out ten times as much now.

Unfortunately, too many Oregonians wrongly believe it is time to go back to normal, with few if any Covid restrictions. The all-Republican Marion County commissioners are part of that group, sadly.

I hope the commissioners take a long hard look at how Marion County is doing compared to other large counties. 

These are the ten counties (out of 36) with the highest recent Covid infection rate per 100,000 population. Marion is doing the worst of any large county. Our 14 day change of +116% is double the state average of 58% -- which, again, is the worst in the nation.

So almost certainly Marion County is one of the dozen or so counties that Governor Brown warned could move back to an Extreme Covid risk category. Currently we're in the High risk group.

Here's excerpts from an Oregonian story about this, "Oregon governor to close indoor dining next Friday in some counties if COVID hospitalizations spike."

In her most serious and stark tone in weeks, Gov. Kate Brown said Friday that she will shut down indoor dining in bars and restaurants in Oregon’s hardest-hit counties as soon as the end of next week if COVID-19 cases and hospitalizations continue to surge.

Brown said despite her best efforts to keep the economy open while holding back on virus-control measures, she will cancel a “warning week” buffer and immediately move what looks like a dozen counties into an “extreme risk” category by next Friday if the number of statewide hospitalized patients reaches 300.

That could possibly include Clackamas County if not others in the metro area. The move would shut down indoor dining, as well as limit large gyms and movie theaters to no more than six patrons and prohibit indoor visits at nursing homes and other long-term care facilities.

...Based on the most recent infection rates, the counties most likely to move into extreme risk as soon as next Friday are: Baker, Clackamas, Columbia, Crook, Deschutes, Jackson, Josephine, Klamath, Linn, Marion and Polk. That’s 11 counties, and Brown had mentioned “at least” 12 counties.

If indoor dining is shut down and movie theaters/gyms are limited to six patrons, we here in Marion County will have no one to blame but ourselves.

The bizarre thing is that conservatives like to rant about government overreach when it comes to Covid restrictions, but most of them aren't willing to wear a mask, socially distance, and do the other stuff that would allow Governor Brown to lift those restrictions.

It isn't that hard, folks. 

Health care workers, including the staff in my dentist's office, wear a mask for most of their working day. Putting on a mask indoors for a shorter period, or outdoors if a crowd of people are close together, is no big deal.

Remember, the life you save could be your own. And even if you don't die from getting Covid, the risk of nasty long-term symptoms should be plenty of motivation for everybody, young and old alike.

Plus, it's the right thing to do. Wearing a mask and socially distancing protects us, and it also protects other people. Let's act as if we're all in this together.  

Trump's inept Covid response killed about 400,000 people

It's been clear for a long time that Donald Trump caused many thousands of Americans to die needlessly because of his astoundingly inept response to the COVID-19 pandemic.

What's been in question is how many. 

Thanks to Andrew Akteson, a UCLA professor, we now have an answer: nearly 400,000 deaths could have been avoided if the United States had done things differently and better.

That's an astoundingly tragic number. 

Not all of those unnecessary deaths are Trump's direct responsibility. But most are, since he oversaw our country's Covid response when strong public health actions could have markedly reduced the death toll.

Here's an excerpt from a Washington Post story, "A better pandemic response might have saved hundreds of thousands of lives -- and Trump's presidency."

One year after the coronavirus pandemic began, the United States has been reshaped in remarkable ways. One of every 600 people alive at the beginning of last year has died of covid-19, the disease caused by the virus. Millions more have been infected with it, with some part of that group enduring lingering symptoms. Millions of people remain out of work.

The ship is turning. Multiple massive economic support packages have passed — the most recent by the Democratic-controlled Congress and White House. Millions more people have been vaccinated against the virus than have contracted it over the past several months. But there’s still the nagging question: What could have been different?

Such questions are hard to answer in real time, depending on the slow gathering and analysis of information. But we're starting to find some answers, including ones that offer a pointed political lesson.

It’s likely that the government’s response to the pandemic led to hundreds of thousands of deaths that could have been prevented. And it’s likely that the pandemic response cost Donald Trump the presidency.

The first point is a particularly contentious one. In the past, there's been analysis comparing the U.S. response to other countries, finding it lacking. Last summer, for example, researchers compared the American response to other countries, showing how their more muscular approaches tamped down the relative death toll.

More recently, research from Andrew Atkeson of the University of California at Los Angeles determined that implementation of robust efforts to halt the spread of the virus last May — widespread testing, mask mandates — could have held the country’s death toll below 300,000 in total.

His model estimates that the country will reach 672,000 deaths overall as vaccines are rolled out, one of every 490 Americans alive at the beginning of last year. That’s a gap of nearly 400,000 deaths.

Trump didn't embrace such mechanisms.

The Centers for Disease Control and Prevention were recommending the wearing of masks as early as April of last year, but Trump declined to do so. That helped bolster a partisan response to the pandemic, with Trump advocating for states to stay hands off — largely, it seems, out of concern that reductions in economic activity would hurt his reelection bid.

Trump is the worst president the United States ever has had. Thankfully, many, if not most, of Trump's destructive actions will be undone by the Biden administration and a Democratic congress.

However, what can't be undone are the deaths of hundreds of thousands of people who are no longer with us because of Trump's horrible decision to downplay the seriousness of COVID-19 and failure to implement a competent national response to the pandemic.

Everyone who voted for Trump in the 2016 election also bears some responsibility for those deaths. After all, it was an open secret that Trump disdained science and had no interest in making government a better servant of the people.

So when the pandemic hit and we needed a president who embraced science and a robust government response, all we had was a man in the White House who acted like a clown.

Which would have been funnier if almost 400,000 people hadn't died for no good reason because of Trump's antics.

Should Oregon seniors get a Covid vaccine before teachers?

There's little debate about who should get the first doses of Covid vaccines allocated to Oregon: health care workers and long-term-care residents/staff.

These groups are at high risk of being infected by the virus. Plus, the older someone is, the more likely they will die after falling ill with COVID-19. Those 65 and older account for the vast majority of Covid deaths, with people 85+ accounting for about a third.

So it makes sense that both the CDC's Advisory Committee on Immunization Practices (ACIP) and Oregon health officials agree on who should be immunized initially with the Pfizer and Moderna vaccines.

After that, though, who should be next in line?

Oregon Governor Kate Brown has said that she wants teachers and school staff to be a priority. Reportedly ACIP has a somewhat different idea.

Regarding who will be next in line for the subsequent rollout phases, the ACIP has named as priority groups “workers in essential and critical industries, people at high risk for severe COVID-19 illness due to underlying medical conditions, [and] people 65 years and older.”

Those ACIP priorities obviously need to be refined, as the way they're stated above is much too general to be useful. So who exactly should come next? Essential workers such as teachers, people with underlying conditions, or seniors 65 and older?

Here's my thoughts, which I readily admit are biased by the fact that I'm 72 and my wife also is over 65 with an underlying condition, asthma. I'm well aware how anxious our friends are about getting COVID-19, most of whom are about our age or older. 

Our chances of having a severe case of Covid are high, much greater than, say, a 35 year old teacher. 

But it's reasonable to take other factors into consideration, such as the desirability of reopening schools to in-person learning as soon as possible. Governor Brown now is allowing local school districts to decide when to reopen -- a controversial move that is making many parents happy, but disturbing many teachers.

Especially if a school district reopens before teachers and staff have gotten vaccinated. 

Again, I'm biased because of my age. Even so, it's a plain fact that dying from Covid is something that can't be reversed, while falling behind in school because of distance learning likely is temporary. And you're still alive, regardless.

To me that argues for prioritizing those 65+ over teachers and other essential workers, most of whom are younger. This happens to be in line with an August Harris poll of Americans cited in a CDC presentation. (The poll defined seniors as 55+.)

Those with preexisting conditions apparently are "immunocompromised people." They deserve to be a vaccination priority, though here's a good reason to have seniors be an even higher priority.

Age is clear-cut. It is on Oregon drivers licenses.

Since pharmacies like Walgreens and Rite-Aid are going to play a large role in getting people immunized, it would be easy for health officials to announce that currently those 80 and older can go there and get the vaccine. Then lower the age to 70 and older. And so on.

This eliminates the complexity and confusion of people having to prove that they have an underlying condition. Perhaps those people are best served by getting vaccinated at their doctor's office, since the doctor knows what health problems they have. 

A key thing is to make the priorities for vaccination simple and fair. Oregonians shouldn't have to worry about people cutting ahead of the line, so to speak. A vaccine free-for-all has to be avoided at all costs. 

I'm reminded of the Vietnam draft lottery that took place on December 1, 1969, when I was a senior in college.

The lottery was intended to reduce the inequities of who got sent off to possibly die in the Vietnam War. I remember sitting around with friends in front of a TV, watching birth dates drawn one by one from a glass jar. My birthday was the 234th chosen. The first 195 were later drafted, so I escaped by virtue of chance.

This was a fair, though nerve-racking, way of choosing who was put at risk of dying in an unpopular war. I'm not suggesting that Covid vaccines be prioritized this way, but some form of a lottery could make sense in determining, say, when those aged 65 get to head off to a pharmacy to get their shot 

Rather than having everybody that age compete for vaccinations at the same time, birth dates could be chosen randomly and publicized by the media. Maybe this wouldn't be necessary, but it would help promote a sense of fairness among the public.

Wake up to Covid reality, fellow Oregonians

I'll be blunt.

If you're wearing a mask every time you're in a public place, are physically distancing, wash your hands regularly, and aren't socializing often with strangers or with large numbers of people you know -- good for you! 

But if you're not doing some or all of these things -- shame on you! 

You are either clueless about the skyrocketing Covid cases and hospitalizations both in Oregon and the United States as a whole, or you're so selfish, you don't care if you're helping prolong the suffering of this pandemic.

Here's a chart of the depressing reality here in Oregon, courtesy of the Washington Post. 

Oregon did really well following the March 23 stay-at-home order by Governor Brown. But the order only lasted for about six weeks. After that, there was a mid-summer spike in cases, then a moderate decline. 

Cases started rising again in mid-September. In late October they began to skyrocket far above anything seen since the beginning of the pandemic. Today Oregon had the all-time record of new cases, 1,122. Here's the Oregon Health Authority report.

It looks like a Covid vaccine will be widely available sometime in the first half of 2021. So this is a horrible time to be letting down our guard against the virus. 

I've read stories about how many American soldiers were killed in the last few days of World War I. It was painful to visualize people being so close to celebrating victory, only to die needlessly. 

Equally painful is reading about the Covid deaths in Oregon.

These are the most recent deaths. They include a 62-year-old man without underlying conditions. I'm 72. This man easily could have lived to my age, and likely beyond. Yet his life was cut short, as was the 35-year-old man who died from COVID-19. Think about this: almost everybody would do whatever they could to save the life of someone drowning. We value life. We fight premature death. Yet a disturbing number of Oregonians refuse to wear a mask and do the other things necessary to save lives from COVID-19.

Yes, deaths in Oregon haven't risen as rapidly as cases. But deaths lag cases and hospitalizations by several weeks. That's why Governor Brown said this today.

Here's the Washington Post Covid death chart for Oregon.

Note at the bottom of the chart that new daily reported cases rose 49% in the past week, while the number of tests reported rose only 16%. This shows that more testing isn't the reason for more cases being reported. Also note the high positive test rate of 13%. It should be below 5%.

Salem, mask up in the name of freedom

Fall is here. Leaves are falling. COVID-19 isn't. Infections are rising in Marion County, in Oregon, in the United States.

Not good. In fact, horrible. People have become complacent about wearing masks and physical distancing. It doesn't matter if you're inside a grocery store or the home of someone who is having a social gathering. 

Wear a damn mask! 

In the name of freedom. Yes, freedom. Too many people have the crazy idea that going maskless shows you're a freedom lover. Actually, it shows that you have no idea what freedom means. 

If you don't believe me, read this opinion piece: "There's a Word for Why We Wear Masks, and Liberals Should Say It." That word is freedom. 

One of the key authors of the Western concept of freedom is John Stuart Mill. In “On Liberty,” he wrote that liberty (or freedom) means “doing as we like, subject to such consequences as may follow, without impediment from our fellow creatures, as long as what we do does not harm them even though they should think our conduct foolish, perverse or wrong.”

Note the clause “as long as what we do does not harm them.” He tossed that in there almost as a given — indeed, it is a given. This is a standard definition of freedom, more colloquially expressed in the adage “Your freedom to do as you please with your fist ends where my jaw begins.”

Now, conservatives revere Mill. But today, in the age of the pandemic, Mill and other conservative heroes like John Locke would be aghast at the way the American right wing bandies about the word “freedom.”

Freedom emphatically does not include the freedom to get someone else sick. It does not include the freedom to refuse to wear a mask in the grocery store, sneeze on someone in the produce section and give him the virus. That’s not freedom for the person who is sneezed upon. For that person, the first person’s “freedom” means chains — potential illness and even perhaps a death sentence. No society can function on that definition of freedom.

...Freedom means the freedom not to get infected by the idiot who refuses to mask up. Even John Stuart Mill would have agreed.

Recently my wife and I wanted to get an estimate from a Salem company for some work our house needed. The guy who came out wasn't wearing a mask In fact, he didn't even have one. We gave him one to wear while he was inside our house. 

The estimate was too high. But even if it had been acceptable, we wouldn't have hired this company, because they obviously don't respect our freedom to not get COVID-19. We also won't buy food from restaurants that don't do their best to keep their customers safe.

So it's bad business to ignore public health measures like requiring mask wearing indoors.

It also is selfish for anyone to go maskless. For example, the Salem-Keizer School District can't have in-person learning for all grades until the local infection rate is much lower than it is now. Thus everyone who fails to wear a mask is helping doom children and teenagers to online learning.

Here's some charts that show how Oregon and Marion County are doing. Again, not good.

Statewide, we've surpassed the COVID-19 previous peak of mid-July. In Marion County, our cases per 100,000 residents for the past seven days are the fifth highest of the 36 counties in Oregon, even higher than Lane County, which has been put on a Watch List by the Oregon Health Authority.

Marion County has about 42% of the Multnomah County population, yet 64% as many COVID-19 cases as Multnomah County. If we don't get our act together, Salem, along with the rest of Marion County, could have our re-opening policies rolled back.

Three high-quality COVID protective masks I've ordered

A few months ago, when the COVID virus was really taking off in the United States, like a lot of people I spent quite a bit of time searching for N95-quality masks.

My wife, Laurel, and I are 71. Laurel has asthma. So we're in a high-risk category when it comes to COVID. The more we can lower our risk by physical distancing, hand washing, and wearing a mask, the better.

Back in 2011, when some Fukushima nuclear plant radiation was making its way across the Pacific, my wife and I had gotten a box of medical N95 masks. We dug them out to wear during the COVID crisis, but I knew they wouldn't last forever and I wanted some alternatives.

Which were difficult to find. Very difficult. Almost impossible, in fact. 

I turned to Kickstarter. In case you aren't familiar with it, this is a way for fledgling companies with innovative products to raise money from backers to get their venture off the ground. In exchange, you get the product once it becomes available. I like how frequent updates are sent to backers, making you feel like you're a company insider. 

in addition, I found a Canada company that offered a N95-quality mask, albeit with a lengthy shipping date. I've gotten that mask and one of the Kickstarter masks. Here's my take on them, along with a link to the web site of the other Kickstarter mask that hasn't arrived yet.

Me modeling the O2 Nano Mask

First, my favorite so far: O2 Nano Mask. I got this Kickstarter mask about a week ago. I've worn it grocery shopping and to a haircut. The O2 Nano Mask seems like a great product, designed in San Francisco and made in the United States. It costs $36. I got a large for me and a medium for my wife.

Both fit us fine. The mask is a stretchy blend of Poly Nylon and Spandex material. As you can see in the photo above, a filter is inserted through the slots on each side of the mask. The ends of the filter are held tight to velcro on the mask so the filter doesn't move around.

Here's a screenshot from the O2 Nano Mask web site that shows what the filter is made of and what it does. Pretty impressive. Each filter is good for up to 60 hours of wear time.

I got some extra filters. Three come with each mask, but I figured it would be good to have some additional filters since there is no way to know how long we're going to be dealing with the COVID crisis.

Second, I got a hard shell mask from a similarly-named Canadian company, O2 Canada. It seems like a quality product, but the mask isn't as comfortable as the O2 Nano. It fits more tightly, which likely means it protects better.

However, there's a certain Darth Vader look to the mask, so probably I'll be wearing the O2 Nano much more often. If I wanted the highest level of COVID protection, though, I'd wear this mask.

The Canadian mask would be excellent for do-it-yourself jobs where you don't want to inhale noxious substances. And also don't worry how you look while wearing the mask. It has a replaceable filter also. The cost is pretty high, $70. The shell comes in various colors in addition to the standard white. I got a black one, obviously.

Third, I haven't gotten the B2 mask yet. It's a Kickstarter project where delivery has been delayed due to a supplier of a component having to fulfill orders from the government that have a higher priority. I'm supposed to get the mask in August now. It has an interesting filter design. 

I paid $99 for two masks and 20 filters. Here's a description of the mask from the Kickstarter page.

The B2 is a reusable respirator that filters 99% of common contaminants and reduces filter cost and waste by half. Unlike existing consumer masks, the B2 features a flexible, patent-pending facepiece that provides superior protection and comfort. The B2 is the culmination of 4+ years of design and development, and is now ready to be mass produced.

Now, you might be wondering why I've spent several hundred dollars to get three different N95-quality masks. Well, one reason is that I had no idea how long it would take to get each mask. With the COVID virus spreading like crazy (it still is, in the United States at least), I was highly motivated to get masks to protect me and my wife from infection.

Another reason is the cost-benefit ratio.

Coming down with COVID isn't like getting the flu. Even if you don't die or end up in an ICU, nasty effects of the virus can stay with you for weeks, months, or a lifetime. Believe me, if someone asked a COVID sufferer, "Do you wish you'd paid $200 for masks that could have kept you from getting it?" they wouldn't hesitate to say, "YES!"

That said, any mask or face covering is better than none at all. So please wear one. A cloth mask will do just fine, though it won't be as protective as masks like the one's I've talked about that filter much smaller particles.

Trump wants schools to reopen physically. Is this wise?

When I was young, I was really eager to have school start in September. I wanted to see my classmates. I was bored with summer vacation. I looked forward to being in a class one year farther along.

Even though I'm far past my school days, I do have a granddaughter about to start eighth grade. Evelyn, like most students, had to do her learning online in the spring after the Covid crisis hit the United States. 

That must have been difficult.

So even though I disagree with Trump on almost everything, his call for elementary and high schools to open physically strikes me as halfway reasonable -- which is much closer to reasonableness than I usually judge his pronouncements.

Here's an excerpt from a New York Times story, "Trump Leans on Schools to Reopen as Virus Continues Its Spread."

President Trump demanded on Tuesday that schools reopen physically in the fall, pressing his drive to get the country moving again even as the coronavirus pandemic surged through much of the United States and threatened to overwhelm some health care facilities.

In a daylong series of conference calls and public events at the White House, the president, Education Secretary Betsy DeVos and other senior officials opened a concerted campaign to lean on governors, mayors and others to resume classes in person months after more than 50 million children were abruptly ejected from school buildings in March.

Mr. Trump and his administration argued that the social, psychological and educational costs of keeping children at home any longer would be worse than the virus itself. But they offered no concrete proposals or new financial assistance to states and localities struggling to restructure academic settings, staffs and programs that were never intended to keep children six feet apart or cope with the requirements of combating a virus that has killed more than 130,000 Americans.

“We’re very much going to put pressure on governors and everybody else to open the schools, to get them open,” Mr. Trump said at a forum at the White House. “It’s very important. It’s very important for our country. It’s very important for the well-being of the student and the parents. So we’re going to be putting a lot of pressure on: Open your schools in the fall.”

Well, Trump also put pressure on "governors and everybody else" to open restaurants, bars, and other businesses, and we've seen how badly that played out. Record numbers of Covid cases nationally due to the rushed reopening, with deaths appearing to begin to rise also.

I heartily agree with this quote from the New York Times story.

Critics said Mr. Trump was the one playing politics, willing to gamble the health of students and teachers to salvage a flagging bid for a second term.

“The reality is no one should listen to Donald Trump or Betsy DeVos when it comes to what is best for students,” said Lily Eskelsen García, the president of the National Education Association, the nation’s largest teachers’ union. She added: “Everything is about his re-election. Our No. 1 priority is that we keep our students safe.”

Another priority has to be keeping teachers and other school staff safe. Even if students are asymptomatic, they can easily pass the virus on to adults in the school. Also, to parents and grandparents.

I believe that the school my granddaughter goes to in southern California is going to use a mix of virtual and physical classes, several days of one and several days of the other each week. That makes sense, especially for older children. First graders need to be in a real classroom, I would think.

But what do I know about teaching? Not much, since I've never done it.

Hopefully the Trump administration will come up with guidance for schools that is based on solid research and expert professional advice. However, given Trump's dislike of facts and experts, I'm doubtful this will happen.

Since Trump has been big on letting states decide how quickly to reopen their economies (with decidedly mixed results), one would think that Trump would do the same with the reopening of schools. After all, elementary and high school education is largely a local affair, governed by school boards.

Seemingly the worst thing would be for Trump to demand that every school in the country reopen physically. This could make sense in areas where the Covid infection rate is low and getting lower, but not in other areas. 

Of course, typically when I visualize the worst thing Trump could do, he ends up doing just that.

Which doesn't mean schools have to go along with whatever reopening scheme Trump ends up pushing for. There's got to be a wise balance between the needs of students, teachers, parents, and the community at large.

To gather or not to gather, that is the Covid question

I don't want to die. I do want to see friends in person, not just on a Zoom screen.

That's my basic dilemma, finding the right balance between safety and socializing. Being 71, rather than 17, makes the question of To gather or not to gather more consequential, since I'm in a high risk Covid group because of my age. 

And my wife is in the same situation, with the added complication of having asthma. Still, both of us have been edging into the To gather side of the question.

After honing our Covid prevention skills by going to grocery stores and pharmacies, armed with a mask and sometimes several pairs of plastic gloves that we only use once per store and then wash for reuse, we've started to get together with friends in person.

Always outdoors, though. (For example, see "Having coffee with an old friend on Father's Day is a great gift.")

This fits with an informative New York Times story I came across today, How Safe Are Outdoor Gatherings? Good news is, quite safe. At least as compared to indoor gatherings. Some excerpts:

Is it still safe to socialize outside?

As the coronavirus continues to rage throughout the country, public health officials are telling us to stay home this holiday weekend. Beaches in Texas, Florida and California are closed. And now some recent backyard gatherings are being blamed for new cases of Covid-19.

The new restrictions and outbreaks have led to new confusion about the safety of socializing outdoors. But experts say the science hasn’t changed: Your risk of catching the virus is much lower outdoors than indoors. If you want to spend time with friends, taking the party outside will reduce your risk of contracting Covid-19.

“Outside is definitely safer,” said Erin Bromage, a comparative immunologist and biology professor at the University of Massachusetts, Dartmouth. “But it’s the type of interactions you have when you’re outside that are important.”

A Japanese study of 100 cases found that the odds of catching the coronavirus are nearly 20 times higher indoors than outdoors. Outdoor gatherings lower risk because wind disperses viral droplets, and sunlight can kill some of the virus.

...“Outdoors is what will save us,” Dr. Marcus said. “Why can’t the message be: ‘We understand you want to get together with friends. There are ways to do this safely.’ We’re just telling them not to gather. That doesn’t recognize basic human behavior and basic human needs.”

...If you attend a social event and find yourself in close conversation with someone from outside your household, even outdoors, wear a mask. Keep music levels low so people don’t have to shout. (Loud speaking expels more droplets than a quiet voice.) Don’t share food or serving utensils.

My wife has been attending meetings in a park of a discussion group she organized. She's become adept at hosting Zoom meetings, but finds they are considerably less satisfying than talking in person.

I agree.

Zoom is better than nothing, for sure. It's just more tiresome to be continually focusing on who is talking, who wants to talk, and not talking over each other. So I think I'm ready to make the jump from meeting outside with a single friend to getting together with a larger group.

Still, I'm somewhat conflicted. I want to start getting back to normal social interactions. I also would feel terrible, to put it mildly, if in doing that I got infected with the Covid virus. And doubly terrible if I passed it on to my wife or someone else.

In addition to the New York Times story, today I also read a story in New Scientist that was decidedly disturbing, The enduring grip of covid-19.

Yikes! Scary! Not only is death a possibility, so are nasty health problems of many sorts that can last for months or even longer. Have a read.
Download New Scientist article re COVID

Here's how the story starts out.

WITHIN 24 hours of asking an online covid-19 support group if anyone had been experiencing prolonged or unusual symptoms, I had been messaged by 140 people. The list was mind-boggling and deeply upsetting. “I feel like I'm in the middle of a waking nightmare,” said Zoe Wall, who was previously fit and healthy. Two months after developing covid-19-like symptoms, she was still experiencing chest pains and “fatigue beyond description”.

Harry's symptoms started with a terrible headache and itchy body, followed by shortness of breath. He was still experiencing breathing difficulties, chest pain, numbness in his arm and bloating 10 weeks later. Jenn had had no sense of smell or taste since testing positive for covid-19 on 31 March. Abbi had minimal respiratory symptoms, but very bad gastric ones and lost 19 kilograms in two months. Others reported fatigue, headaches, tingling fingertips and brain fog.

As the months tick by since the start of the coronavirus pandemic and we learn more about covid-19, it is becoming increasingly evident that even mild cases can have distressing and long-lasting effects.

“There's clearly something going on here. It is not their imagination or hypochondria. It doesn't even seem to be linked to how severely they had the disease, as far as I can see,” says Danny Altmann, an immunologist at Imperial College London. All this means we need to rethink how we diagnose and treat covid-19. The long list of symptoms also seems to suggest there might even be several subtypes of the disease, which could help us predict which cases will become serious.

Dear young people, us old folks don't want to die from COVID

Dear young people of Oregon, and elsewhere also,

I'm writing to you even though I know you aren't big on reading blog posts, or Facebook, where I'll be sharing this message. I just feel the need to reach out across a generational divide (I'm 71) and talk to you about the coronavirus crisis.

Things aren't going very well at the moment. After states started re-opening, new cases have skyrocketed. Today they surpassed 40,000 nationally, a record since the crisis began.

This afternoon Vice-President Pence said it's good news that now young people are accounting for a larger share of cases, a change from earlier in the epidemic.

Well, I doubt that you guys and gals feel that way, since even if you don't die from COVID-19, the disease can be really unpleasant with a long recovery period. But likely you're less concerned about becoming ill than old folks like me are, since we're at much greater risk of dying from COVID-19.

Which gets me to the main thing I want to say to you, so much so I'm putting it in boldface and red to make it stand out.

Us old folks don't want to die from COVID.

If this already is obvious to you, great. We're on the same wavelength.

But since I've seen lots of stories about how young people are flocking to bars and other fun places as reopening has been happening, usually not wearing face coverings or practicing physical distancing, hopefully you can understand why I feel the need to state the obvious.

Look, I'm qualified to be speaking to you this way because I'm an old person who used to be young. By contrast, young people have never been old.

So I have more direct experience about how you look upon life than you do about how I look upon life -- since your direct experience of old age is precisely zero. When I was in the 60's, the decade, not the age, there was an oft-heard saying, "Don't trust anybody over 30."

That's how crazed we were back then about staying youthful forever. At the time it didn't dawn on me that soon I'd be over 30 and, seemingly, wouldn't be able to trust myself. 

I mention this tale from the Very Old Days to show that I realize how young people can look upon folks my age as if we were strange beings from another planet, with even those over 30 being difficult to grok. (Look it up; great word.)

Sure, you have parents and grandparents. I'm confident that you don't want them to die, but maybe you feel that after a certain age, 70 or 80 or 90, old folks are ready to cash in their life-chips and see what sort of game, if any, exists after this life.

I readily admit that some old people feel this way. Yet most don't.

I know this because I know a lot of old people, being one myself. Some haven't left their home since the epidemic hit, they're so afraid of getting COVID-19. Others are extremely wary of going to a grocery store or restaurant.

This is one reason COVID-19 deaths have declined while cases have been rising. Old people are continuing to shelter in place, or go out only while wearing a mask and otherwise doing what public health experts are recommending, while young people are party'ing on.

That'd be absolutely fine but for one not-so-minor detail. To repeat:

Us old folks don't want to die from COVID.

Yes, we're taking precautions.

But masks, physical distancing, and hand-washing only go so far. They aren't 100% effective. If someone is infected with the coronavirus -- and I'm talking about you, young people -- they won't know it for a while. Maybe not ever, if they remain without symptoms.

Yet they can unknowingly spread the disease to others. This is why it is really important that young people wear face coverings in public indoor places, and outdoors also when staying six feet apart from other people isn't possible.

Maybe you already know that. If so, I apologize for taking up your time. In that case, send this message on to some of your friends through whatever mysterious unknown-to-old-people medium you use to communicate with each other (TikTok?).

Lastly, I've got to say that there's a reason I said "Us old people don't want to die from COVID" rather than simply "Us old people don't want to die."

We know we're going to die.

It's a clear and present danger to everybody my age. The only question is, How will dying happen? Ideally, peacefully, at home, surrounded by loved ones. Which is precisely what doesn't happen with most COVID-19 deaths. It's a dreadful way to die, isolated and hugely distressing.

Keep that in mind when you're tempted to go out without a face covering. The life you could save might be mine. Or your grandmother's.

Marion County and Oregon still seeing lots of new COVID-19 cases

This wasn't a cheery sight to see in my email inbox today, the latest Oregon Health Authority update about new COVID-19 cases.

Those 178 cases statewide are the most in a single day since the pandemic began.

Which means Marion County isn't going to enter Phase 2 of reopening tomorrow.

Like everybody else, I want things to get back to normal as quickly as possible. But this isn't going to happen so long as new infections keep occurring at a rapid rate. So please, people, wear a mask and maintain social distancing. Many people in Salem aren't doing this. 

Here's a letter to the editor in a recent issue of New Scientist about wearing masks that I liked a lot.

From Lloyd Timberlake,
Ridge, Maryland, US

Jessica Hamzelou's excellent piece on the science of the protective effects of face masks against the coronavirus inevitably didn't touch on unscientific, but important, aspects of masks, which the US Centers for Disease Control and Prevention now recommends we wear in settings like grocery stores.

Masks are a form of theatre, saying, "I am playing the role of a responsible citizen." They are a uniform expressing serious solidarity in the war against the pandemic. 

They are also a polite way to say: "Stay away from me. You don't know whether I am wearing this mask to protect me from you or you from me."

Perhaps most importantly, President Trump won't wear one. So they must be an excellent idea.

Salem, we're all in this together. So please, wear a mask.

I feel better when I shop at Trader Joe's and LifeSource Natural Foods than at Fred Meyer. The reason doesn't have anything to do with the stores' prices, selection, ambience, or anything like that. 

It's because Trader Joe's and LifeSource require customers to wear masks. Fred Meyer doesn't. 

I have a feeling of We're all in this together when everyone around me -- grocery store staff and customers alike -- are wearing masks to protect ourselves and others from being infected with the coronavirus. 

This graphic from the East Alabama Medical Center shows why my feeling is justified.

Wearing a mask does a lot to protect someone who carries the virus from transmitting the COVID-19 virus to someone else. And wearing a mask also does a lot to protect a healthy person from having the virus transmitted to them from a carrier.

That's the clinical or public health reason for wearing a mask. But this graphic comes closer to expressing why I enjoy shopping at Trader Joe's and LifeSource more than at Fred Meyer.

I could quibble with Andrew Cuomo's choice of words, because I prefer "care about" to "respect." However, his sentiment is right on.

When I see someone walking into Fred Meyer without a mask, and many people are doing this, I can't help but think that either they are clueless about COVID-19, or they simply don't care about helping to protect others from getting the disease, along with themselves, of course.

This is an area where science and philosophy are saying the same thing. 

Often I hear public health experts say, "An infection anywhere is an infection everywhere." Why? Because the COVID-19 virus doesn't care much about borders. It can travel halfway around the world in a day by hitchhiking in the body of an infected person who may not show any symptoms.

Likewise, until every state in our country gets the coronavirus under control, each state will be at risk of a COVID-19 recurrence by infected people traveling around the United States.

Individualism has its merits.

However, the notion that each of us is an island unto ourselves doesn't match up with reality. Everything and everybody is highly interconnected. Causes here have effects there. None of us is capable of being self-sufficient. Even the most ardent survivalist requires supplies and equipment that come from sources other than themselves.

And in a pandemic like what we're going through now, individualism can be deadly. It leads people to wrongly believe that they can prosper by going their own way. No need to wear a mask. No need to socially distance. I'm going to do my own thing.

Well, do your own thing made more sense in the 1960s than right now. 

In the nineteen sixties, "do your own thing" became a common expression. It meant to do whatever you wanted, without feeling guilty.

I was a college student in the San Francisco Bay area from 1966 to 1971. I and my fellow hippies did our own thing, guilt-free. However, what we did was a minimal risk to others. When I ingested LSD, no one else was going to have a psychedelic experience. By contrast, not wearing a mask today does increase the chance of other people getting sick with COVID-19.

Look, I understand that we Americans tend to believe ours is the greatest country in the world and we don't need to adopt the practices of other nations. But I sure like this passage in a story from The Atlantic, "Face Masks Are In," which describes how masks are viewed in East Asian countries.

The president [Trump] seemed to be implying that a masked country couldn’t be our country — that such a sight would be alien and alarming, and thus hopefully a short-lived ordeal. It was an expression of the stigma long attached to mask-wearing in the Western world, unlike in many Asian countries, where those who don’t wear masks during public-health crises are the ones who are stigmatized.

While an American might walk into a grocery store these days and view the proliferating number of masked shoppers as crushing confirmation that the apocalypse is nigh, someone in Hong Kong or South Korea might see the same scene as an uplifting indication that the community is coalescing to fend off catastrophe.

Hong Kong mask wearers in 2003 at the height of the SARS epidemic

I'm part of the OHSU COVID-19 research study!

This evening I became part of an exclusive group of Oregonians, if "exclusive" is taken to mean 100,000 adults chosen at random for the Key to Oregon study. Here's how the study is described in a FAQ page.

The study will test, track and map the COVID-19 symptoms, and new infections, of up to 100,000 Oregonians in real time. OHSU is leading the study in partnership with the OHSU-PSU School of Public Health and in collaboration with the Oregon Health Authority.

Data from the study will guide state and local leaders in easing stay-home orders while protecting against new outbreaks. The study will enroll about 100,000 adults, chosen at random, from across Oregon. It will last up to one year.

Researchers want to develop an early-warning system that allows them to see:

• • How many people in Oregon have been infected with the coronavirus.
  • Where infections may be occurring.
  • How the virus may spread statewide.

Leaders expect the study to help them balance Oregon’s economic and social needs with keeping Oregonians healthy and safe.

Since I'm an admirer of science, and can't stand people like Trump who have politicized the COVID-19 crisis, I was thrilled to get a postcard about a week ago telling me to watch my mail for an invitation to join the Key to Oregon study. Which arrived today.

All members of a household who are over 18 can join, so Laurel, my wife, also will be part of the study if she chooses to do so.

Obviously the main motivation is to play a small part in helping Oregon, and the country, deal with the coronavirus crisis. Another FAQ answer says:

The study will:

• • Show the link between lifting physical-distancing restrictions and any rise in infections.
  • Find cases early so people who test positive for the coronavirus can stay home (isolate), and so  those they’ve been in contact with can be identified (contact tracing). These steps keep the disease from spreading.
  • Spot outbreaks early so officials can act to contain the spread before they need to bring back stay-home measures.
  • Find people who are infected but who don’t have symptoms, to control this otherwise invisible source of spread.

But there's a few other benefits to being a study participant. I can request a free Kinsa digital thermometer that will send daily readings directly to OHSU via a Bluetooth app. That's cool! (Hopefully my temperature will also remain cool, non-feverish.)

And...

The consent/authorization forms took a while to review this evening. Here's part of the initial one.

IRB#: 21408

RESEARCH CONSENT AND AUTHORIZATION
SUMMARY OF KEY INFORMATION ABOUT THIS STUDY  

 

TITLE: The Key Study-COVID-19 Symptom Tracking

PRINCIPAL INVESTIGATOR: Jackilen Shannon, PhD
CONTACT INFORMATION: [deleted]

You are being asked to join a research study. This consent form gives you important information to help you decide if you want to join the study or not.

PURPOSE:
We want to learn more about the COVID-19 virus and how it spreads across Oregon. We are measuring symptoms and the number of people who are infected with this virus. We will share this information with state and local decision makers about whether such things like stay-at-home orders and wearing masks are working to control spread of the infection. We also want to learn about people’s behaviors during this outbreak and how the crisis is affecting their lives.

STUDY ACTIONS:
If you choose to join, you will be asked to:

• • Consent to the study in the website
  • Answer daily questions about your symptoms that will take between 1-10 minutes a day
  • Take your temperature with your own thermometer or a no cost, study-provided, internet-connected thermometer
  • Answer questions (survey) once a week
  • Choose if you want to allow us to contact you for future research
  • Choose if you want to add your study information into a repository (a large database that has many people’s information in it)

If you meet a certain level of symptoms or you are chosen randomly, we may send a COVID-19 testing kit to you. We may offer to send testing kits to all adults in your household. The testing kit(s) will need to be returned for testing.

The study will last about one year but you can choose to leave the study at any time.

RISKS:
You may experience the following risks:

• • Mental distress or possible financial hardship if you are found to be positive for COVID-19.
  • Feeling uncomfortable about questions, but you may choose not to answer any question.
  • Possibility of a breach of confidentiality, but this is a small risk, as we follow all of OHSU’s privacy rules.

BENEFITS:
If you choose to join this study, you may benefit from being tested for COVID-19 and possibly getting earlier treatment for the infection. You may also help cut the risk of spreading the infection to others.  

Doing one errand can be a day's work in the COVID-19 Era

Being retired, I'm used to having a pretty relaxed schedule. But before the coronavirus arrived to mess up our lives, frequently I'd set off in my car with a bunch of to-do's and manage to get them all done.

Bank. Pharmacy. Grocery store. Hardware store. That sort of thing.

Now, I feel I should get a trophy if I just get one errand accomplished, because these days most things aren't nearly as easy to do. Here's today's example. 

Yesterday I decided to paw through a wicker storage basket that contained quite a few pairs of shoes that I wasn't regularly wearing anymore. Some were too small for me now.

Since I'm 71, not 7, the reason can't be that my feet are growing. I guess they're flattening out. Or fattening out. Regardless, those shoes went into the giveaway pile.

Along with shoes that seemed like a good idea to buy a few years ago, yet now made me wonder, What was I thinking when I got these?

My wife also had been doing some culling of clothes, shoes, and other items.

So she loaded our combined donation stuff into the back of my Subaru Crosstrek, as I was planning to take it to the south Salem Goodwill store on Monday, since my reading of the Goodwill web site indicated that store was reopening today.

However, Monday is my grocery shopping day.

And I figured there would be fewer people taking things to donate at the south Salem Goodwill store today as it would take a while for word to get out about the reopening.

Good idea. It just didn't mesh with reality.

Because when I drove into the parking lot of the Goodwill store on Commercial Street, my first reaction of Great, hardly anybody is here was quickly followed by... Because the store isn't open.

Nevertheless, I noted that a large stack of stuff had been left in the outside donations area.

Getting out of my car, I perused the signs that said it was illegal to take anything, and it would be considered littering (or a word to that effect) if donations were left outside of business hours.

I pondered these two edicts, tempted to join with those who had left their donations, but worried that someone might steal the shoes and other things that I'd leave there as, technically, litter.

Temptation gave way to Heck, i've got the time. I'll drive to the West Salem Goodwill store, since I knew it was open.

First, though, I needed to check out the status of the all-important Starbucks Drive Through Lane. Getting a grande decaf nonfat vanilla latte once or twice a week is a high point of my Stay Home, Save Lives existence these days. 

However, when I turned into the Starbucks on the north side of south Commercial (not to be confused with the Starbucks down the road on the south side of south Commercial), the long line of cars in the drive through was daunting. 

Then I noticed a woman standing at a window, being served by a Starbucks employee. Sweet! I parked, walked up to the window, all ready to order my latte, and was met with a question. 

"Did you make a mobile order?" "Um, no." "Sorry, this window is just for mobile orders." 

Semi-glumly walking back to my car, I had a bright idea: I'll get out my iPhone, fire up the Starbucks app, and make a mobile order for a grande decaf nonfat vanilla latte. After which, I'll walk back to the window and say, NOW, I have a mobile order.

Unfortunately, I'd never used the app for a mobile order.

It was more complicated than I expected to fashion a latte to my specifications. Meanwhile, as the minutes ticked by I couldn't help but notice that the line of cars in the drive through lane was moving along quite briskly.

Definitely more briskly than the slow progress I was making on a mobile order for this Starbucks location, especially since I was sitting less than 50 feet away from it.

So I started my car, got in line, and soon was in possession of a grande decaf nonfat vanilla latte that was handed to me from a window on the opposite side of the building from where my latte search had started.

Now I was ready to head to West Salem.

I'd never been to the Goodwill store there, but it's hard to miss, being new and large. Approaching the donation drop-off, I was thrilled to see that there was only one car there. 

That thrill dissipated when the Goodwill employee at the drop-off started waving his hands in a go-away fashion. Rolling down my window I heard, "You've got to go around and get in line." "Sorry," I said.

There were about eight cars ahead of me. I passed the time sipping my latte and listening to the latest depressing news on MSNBC and CNN. Eventually I reached the promised land of the West Salem Goodwill donation drop-off.

I was told which bins held certain donated items, and to not put in the  boxes and bags containing the stuff we were donating. I proudly said, "No problem. I tied together the shoelaces of my shoes." The employee said, "Good. Sometimes it's difficult to find a missing shoe."

Pleasingly, because my wife is almost always right, and I'm almost always wrong (normal state of affairs in a 30-year marriage), in one of the bags I came across a pair of shoes that Laurel had left loose.

I made a point of saying loudly enough for the Goodwill employee to hear, "Oh, look, my wife didn't tie the shoelaces together. Guess I'll have to do it."

Thus ended my sole errand for a Friday. I felt a lot like Leonardo DiCaprio in Titanic (before it sank). I'm the king of the world. I succeeded in making a Goodwill donation. Time to go home and relax for the rest of the day. 

Here's why the U.S. has to be cautious about relaxing stay-at-home orders

Yesterday Andy Slavitt, a high-ranking health official in the Obama administration, presented a brilliant thread on Twitter about the danger of relaxing social distancing rules in May. Below I've copied in screenshots of what Slavitt said.

It's a well-reasoned, and also disturbing, counterpoint to the small number of strident demonstrators against stay-at-home orders in Oregon and elsewhere who are getting way more attention from the media than they deserve.

l'll also take this opportunity to mention something that deserves more attention from public health authorities here in Oregon. Why the heck does the county where I live, Marion County, have such a high number of coronavirus cases? Click on the Demographics section of this web page to see the data. 

Lane County (pop. 382,000) and Marion County (pop. 348,000)  are Willamette Valley counties that are about the same size. But to date Lane County has 54 confirmed COVID-19 cases and Marion County has 544, ten times more. Wow. 

Anyway, check out Slavitt's series of tweets about May being 30 days of (ignorant) bliss nationally.

NOTE: The text in the chart below is difficult to read. It shows cumulative COVID-19 deaths from April 1 to April 30, 2020 for New York (blue at bottom), New Jersey (green in middle), and rest of the United States minus New York and New Jersey (yellow at top). 

My top 10 bright spots during Oregon's stay-at-home period

Like everybody else, I'm hugely looking forward to the relaxing of stay-at-home and physical distancing orders that are succeeding in slowing the spread of the coronavirus. 

But amid the distress of so much human misery caused by COVID-19 infections, I've been experiencing some bright spots during the month Oregon's Stay Home, Save Lives policy has been in effect. Here's my Top Ten.

(1) This afternoon I came home from a dog walk to find my wife taking part in a Zoom dance party celebrating her grand-niece's birthday. Naturally I had to grab my iPhone and upload a short video to You Tube.

(2) Before, I never knew that finding toilet paper on the shelf of a grocery store could be such a peak experience. Now I can relax about climbing Mt. Everest or visiting Machu Picchu. 

(3) I'm not a highly social person. But when I encounter neighbors on a daily two-mile dog walk out here in rural south Salem, my enforced soliitude leads me to get all chatty, as if I'd been shipwrecked on a deserted island and finally some fellow humans show up on the beach.

(4) With more available time, my wife has been busy getting rid of stuff that sits around the house with no discernible reason to keep it. So far I've avoided being taken to the dump. (Maybe because I empty the dishwasher once in a while.)

(5) Watching TV in the afternoon has never appealed to me. Now, though, every day I record MSNBC from 2 pm to 6 pm, so I can be sure I won't miss Trump's White House coronavirus briefing performances. Super entertaining! Especially his back and forth with reporters. And his B.S. gets my heart rate up without exercising.

(6) Rather strangely, I'm enjoying The Late Show With Stephen Colbert more than I did when it emanated from the Ed Sullivan Theatre. I like the informality of Colbert broadcasting from his home. Also, seeing his super adorable dog. 

(7) I've always enjoyed going grocery shopping. In these coronavirus times, that Monday afternoon experience is the highlight of my week. I see people! I drive my car! I stand in line at Trader Joe's! Life is good.

(8) Because we let packages get sterilized in the sun for a few hours after they're delivered by UPS, the mail person, or FedEx, getting something from Amazon is a bit like my childhood Christmas mornings. I have to wait to open my presents, and I'm not sure what exactly is in the box. I'm young again.

(9) Our crappy DSL out here in the far reaches of the broadband desert, albeit just five miles from the city limits of Oregon's capital, is even slower than usual. Streaming movies is problematic, so I'm happy that Netflix still sends DVDs through the mail. 

(10) Having medical appointments by phone isn't as bad as I thought it might be. I don't have to watch my doctor spending most of their time staring into a computer screen while they're talking to me -- though likely they're still doing that; I just can't tell that they are.

Nature soothes in COVID-19 pandemic

Working in our rural south Salem property yesterday, I realized that nature is a wonderfully soothing antidote to anxiety about the coronavirus crisis. So I took some photos of our spring-blooming yard and shared them in an Adobe Spark web page, along with some commentary.

Click on the second large image below to open the web page. (The first smaller image is for Facebook sharing purposes.)

 

Oh, the thoughts I have while grocery shopping during the COVID-19 pandemic

In case someone out there is interested in what goes through my mind during my weekly grocery shopping expedition here in Salem, Oregon during the coronavirus crisis, and why wouldn't there be, here's a pretty accurate glimpse of my thoughts last Monday.

[Note: my wife and I already had some N95 masks that we got during the Fukushima nuclear plant scare following the tsunami some years back when radiation was crossing the Pacific.]

Getting into my car: OK, check my protective gear. N95 mask. Three pairs of lightweight garden gloves. Hand sanitizer. Disinfecting wipes. Plastic bag to put used gloves in. Yup, all there. Time to fire up the Subaru and head out.

Approaching Trader Joes: Sure hope there isn't a huge line to get into the store. Leg has been hurting from damn sciatica. Don't want to stand for long time.

Entering Trader Joes parking lot: Oh, boy. Just six people in line. Sweet!... No, wait. Shit. Line goes around the side of the store. Just have to tough out the standing. Now, mask on. Gloves on. Ready to rumble. 

Trader Joe's social distancing line: Check time. 1:50. See how long it takes to get in the door. Geez, forgot my cap. Sun is warmer than I thought. Just April. Must be global warming. Not many people with masks. Oh, there's some. Old folks like me. Good to see Trader Joes employees in masks. Ah, made it in. Just took ten minutes. Not bad.

Returning to car after Trader Joes shopping: Damn, touched door unlock button with my gloves on! Where's a disinfectant wipe? Got to take gloves off without touching outside of them. Tricky. Ah, did it. Now put them in plastic bag. Clean door with wipe. Got to remember to take gloves off before touching door.

Fred Meyer parking lot: Need fresh pair of gloves. Pull mask up. Still got grocery list in pocket? Yes. Time for second grocery shopping trip.

Inside Fred Meyer: First, need salad mix and bananas... Wait, what's in that guy's shopping cart? Big package of toilet paper? OMG! OMG! Could it be?... Oh, no, it isn't. Brawny paper towels. Still, go for it. Paper towels hard to find also... Yes, wow, so many packages of Brawny. One to customer...fine with me. Maybe now we can stop tearing paper towels in small pieces whenever we need one.

Returning to car after Fred Meyer shopping: Focus, focus, remember -- gloves off before touching door handle. Dude, you remembered! Senility hasn't arrived just yet. Still, dab on some hand sanitizer just in case before pressing start button.

Entering Starbucks parking lot: Must reward myself. Went to three stores, Trader Joes, Fred Meyer, LifeSource. Hard day grocery shopping. Not really enjoyable anymore. But paper towels! Hope not long line in drive-up lane... OK, kind of long. Who cares. Craving grande decaf nonfat vanilla latte... Fire up iPhone Starbucks app. Hold up so barista can scan it. Ah, good to hear "hope you're having a good day." Actually, I am. Paper towels!

The poetry of field mowing in our coronavirus era

I'm no poet. Far from it. But I guess I have some poetic inclinations. Just look at the title of this blog post. It's got "poetry" right there in the damn title!

Anyway, what poetry really means to me is feeling something subtly indistinct, yet decidedly real, in an everyday activity. Today that activity was doing some mowing of open areas on our ten acres in rural south Salem, Oregon. 

l use a walk-behind DR Field Mower with the lawn mower attachment. I used to put on the field mower attachment once a year to cut grass after it had gotten really tall by early July. But that was a lot of work, and now that I'm 71, for several years I've been leaving the lawnmower attachment on, raising the blade height as far as possible, and cutting tall grass that way.

That works.

I just need to mow the fields, or open areas, two or three times a year rather than just once. With two blades, rather than the one on the field mower attachment, the mowing goes quicker. And the wheels on the front of the lawn mower attachment mean much less wrestling of the DR Field Mower.

Everybody else in our rural neighborhood uses lawn tractors, or actual tractors, to mow their fields. However, I like the increased intimacy of my walk-behind mower. When we moved here in 1990, for a few years I used a John Deere lawn tractor. It would get stuck in muddy areas, though. And I worried about it tipping over on steep slopes.

This is the just-cut Bamboo Field past the rear deck of our house. The clump of non-spreading bamboo on the right of the photo was planted by me from bamboo that i brought from the house in Salem that I lived in before Laurel and got married in our current house back in 1990.

When I maneuver the mower past it, walking by at a slow mowing speed, I enjoy how the bamboo got transplanted at about the same time as Laurel and I pulled up our connection with where we'd been living before and made the commitment to a fresh life together -- me after getting divorced, Laurel after being single until our marriage.

There'a a lot of fear and anxiety going around these days. Entirely justified. COVID-19 often kills. Or causes people great suffering. Watching the news on television is something I can't stop doing, because I want to know what's going on. Mowing helps keep me sane.

The grass is growing this year just as it does every year. Green and fast.

That's the way it is in April. Next month the grass will grow more slowly. In June, slower still. Then it stops growing at all in the fields during Oregon's dry and warm summer. There's something reassuring about the steady cycle of nature. It's dependable. The coronavirus makes me anxious. Mowing grass makes me feel like I'm doing something real, even precious.

Life comes with no guarantees. I don't know how long how I'll be alive, or how long I'll be healthy enough to keep on doing the field mowing. Sometimes Laurel asks, "Don't you want to pay somebody to do this?" I reply, "No. I enjoy the mowing." This is the next open area down from the Bamboo Field. 

When we moved here, it was completely covered with blackberries. Basically, impassable. We hired someone with a tractor to cut down the blackberries and till up the roots. Then we planted grass and trees. A lot of work, but we were much younger then. 


After mowing this area, which I think of as the Oak Arch Field (a large branch of a massive oak fell off in a windstorm; we left the arch of the branch where it was), I went back to the house to get my iPhone to take these photos. A deer seemed curious about the recent mowing. 

Around here, the deer are almost tame. They're used to people and don't run away. I felt like I'd encountered a friend. Who didn't have to worry about social distancing, pleasingly.

By the way, at the right end of the Oak Arch is where the ashes of Tasha, the German Shepherd Laurel had when we got married, were put. I think of Tasha when I mow around the fallen branch. It was nice of the branch to fall just in the right position -- not over Tasha's ashes, just close to that spot.


Actually there were several deer friends in the field. I believe this is a mother and her two deer children. They were browsing in the tall grass that's on my mowing to-do list for tomorrow. 


This is what awaits me. It's the most difficult field that I mow, because the ground is so uneven. The heavy rains in 1996 caused torrents to flow through this part of our property, leaving a gully that is impossible for me to forget, because the mower bucks like a bronco if I don't guide the mower at just the right angle.


These are two redwood trees that Laurel planted a few years after we moved here and had done away with the blackberries. It seemed a bit crazy to be planting itty-bitty trees some 28 years ago. Now look at them. They remind me that nature knows what it is doing, even if we humans often don't.

We probably watered the redwoods at first. I can't remember for sure. But we definitely have paid them little attention over the years. They simply do what trees do: grow on their own. 

Times are rough for people now in this Coronavirus Era. "Now" though soon will become "Then," leaving a fresh present moment that will be an outgrowth of what we're doing now. There's no guarantee that things will be better, but I believe they will be. 

Mowing today refreshed my spirit. That's the power of being out in nature, doing simple things. 

Oregon looking good on the COVID-19 front

Today there were some positive mentions of how Oregon is doing in the fight against the coronavirus pandemic.

This should encourage Oregonians to keep on with physical distancing (better term than social distancing), as hard as this is on both people and businesses.

In the White House coronavirus briefing, Dr. Birx, the White House coronavirus coordinator, praised Oregon, Washington, and California for the good job they're doing. 

I recall that she was referring to cases per 100,000 population, but that figure depends on the amount of testing each state is doing, which varies a lot.

Deaths per 100,000 population as of April 7 show that Oregon and California have a low rate of just 1 death per 100,000 population. Washington is at 5 deaths per 100,000 population, but much of that seems to be due to the deaths of 26 residents of a single long term care facility as of March 11.

Ari Melber interviewed Oregon Governor Kate Brown on his MSNBC show this afternoon. She had nice things to say about the Oregon spirit of working together that is making a difference through her Stay Home, Save Lives order.

And the projected total coronavirus deaths for Oregon has dropped significantly since I first wrote about the Institute for Health Metrics and Evaluation (IHME) model that has become the most widely cited approach to forecasting the impact of the pandemic.

Partly this is due to changes in the model's assumptions, as more data comes in from around the world on the outbreak. However, almost certainly another factor is how well Oregonians are practicing physical distancing.

This is the current April 7 total death forecast for Oregon through August 4: 171 COVID-19 deaths.

This was the forecast as of March 30: 469 COVID-19 deaths.

In the current forecast, the 171 deaths are reached on May 25, then level off with no additional deaths through August 4. Maybe this is unduly optimistic, but we all could use a healthy dose of optimism right now.

Perhaps this points to June 1 as being a date when Gov. Brown's Stay Home, Stay Safe order could begin to be relaxed.

Until new deaths drop to zero for a week or so, it's difficult to see this happening. Deaths lag new infections by about three weeks. Thus if Oregon stops having COVID-19 deaths, that's a sign physical distancing has been working well for almost a month.

NEXT DAY UPDATE: On the 11 pm news last night there was a mention that Gov. Brown wants to see no deaths for 10 days before she starts relaxing the stay at home order. 

Of course, until a vaccine is widely available, likely coronavirus outbreaks will continue to occur, so I suspect that we'll be seeing masks worn and the six feet rule followed by many Oregonians through at least the end of 2020.

But hopefully restaurants and bars can reopen considerably sooner, albeit with initial restrictions on how many people can be seated at one time.

In this COVID-19 era, let's worry less about online ads

My wife, Laurel, has become a quasi-expert in how to use Zoom for online meetings. She's paid for an account that allows for unlimited meeting time, rather than the 40 minute limitation on the basic free plan.

I've taken part in one of the three meetings Laurel has hosted. Zoom works well, though since people are new to it, typically the first part of the meeting is filled with "can you hear me?," "unmute yourself," and other sorts of how does this work talk.

And since we live in a rural'ish area with crappy DSL, our broadband connection is slow, which creates problems with Zoom. Connecting an ethernet cable directly to my wife's computer from the Century Link wi-fi device helped somewhat.

I've never been much concerned about online privacy. I use my laptop a lot. I enjoy being on Facebook and Twitter. I accept that when I buy something, or search for an item on Google, online ads will follow me around the internet like a puppy sniffing dog treats in my pocket.

Plus, I've stopped using an ad blocker. In part this was because an increasing number of web sites that I liked to visit would present me with a message along the lines of, "We notice you're using an ad blocker. Please turn this off. Online ads enable us to keep on doing what we're doing."

But Laurel has found that some of the people in the groups she's arranged Zoom meetings for are hyper-sensitive about not having any ads directed at them, or sharing personal information with Zoom.

My attitude is that this is the price we pay for a quality online experience. Yes, I was an early user of the internet and fondly remember when everything was free. Even now, many people still believe that they shouldn't have to pay anything to surf the web.

That didn't make sense to me before the COVID-19 era, and it makes even less sense to me now. We've all become much more dependent on the online world, since most states (like mine, Oregon) have stay-at-home orders and closures of schools, restaurants, bars, and other non-essential businesses.

So a main way we're staying connected to those who aren't our live-in family is the big wide world of the internet.

Sure, phoning is fine, but I really enjoyed it when my daughter and I did the FaceTime thing on our iPhones a few days ago. Being able to see how they've set up their Orange County home for my granddaughter's online learning, plus how cute their fairly new dog has become, was great.

Nothing online is free. It costs either time or money (usually both) to offer content or a service. I've been blogging for seventeen years, so I know how much work it takes to maintain my three blogs. 

I've never had ads on them, but that's because my online writing is a labor of love, not of money. Most web sites, including Zoom, have to bring in money one way or another. That's a fact of life. If we want to enjoy the benefits a web site offers, we have to be willing to pay one way or another -- either directly, or by having ads presented to us.

This is no different than the two newspapers delivered to our box every morning. My wife and I pay for a print subscription to the Salem Statesman Journal and the Portland Oregonian. There also are ads in the newspapers, which I mostly ignore. I understand, though, that without those ads, there wouldn't be a newspaper. 

So it makes no sense when people are adamant about not having ads shown to them online. That's akin to getting upset because their daily newspaper or weekly magazine contains ads even though they've paid for a subscription. 

Yes, I get why having online ads track you around the internet can be annoying. I used to think this was an invasion of my privacy. With additional thought, though, I realized it is no big deal. Where's the harm in having Facebook present me with ads for shoes after I just bought a pair of Allbirds online? (great wool shoes, by the way; I just got another pair).

I'm grateful to companies like Zoom for the services they're providing during the coronavirus crisis.

It costs money to do that. If they want to present ads to me while I'm using their service, great. Thus my advice is, let's turn off our ad blockers and accept that seeing some advertisements is the price we need to pay for keeping those companies in business.

Oregon forecasted to have 469 COVID-19 deaths by August

Tomorrow it appears that the Trump administration will discuss the models they've been using to predict the course of the COVID-19 pandemic in the United States.

But a Washington Post story about the coronavirus modeling says that a University of Washington researcher, Chris Murray, independently has been preparing forecasts for both the United States as a whole and each state that came up with similar results as the Trump administration model.

Debbie Birx, the coordinator of the White House coronavirus task force, said that federal scientists reviewed a dozen different models for how this pandemic might play out before constructing their own. Using techniques learned from tracking HIV, tuberculosis and malaria, she explained, “we went back to the drawing board over the last week or two and worked from the ground up.”

Simultaneously, the Institute for Health Metrics and Evaluation at the University of Washington, led by professor Chris Murray, was doing something similar. “When we finished, the other group that was working in parallel, which we didn't know about, IHME and Chris Murray ended up at the same numbers,” Birx said in the Rose Garden on Sunday evening.

...The government is keeping its own projections private, but Birx twice said that people can study Murray’s work to better understand White House considerations. “If you go on his website, you can see the concern that we had with the growing number of potential fatalities,” she told reporters.

Naturally I was eager to check out the website maintained by Murray and his team at the Institute for Health Metrics and Evaluation (IHME). While COVID-19 is ugly, the website is a thing of beauty. Clean, clear, easy to understand. (With one exception that I'll talk about below.) And it's going to be updated daily. 

Here's the forecast for Oregon deaths. The solid line is actual deaths; the dotted line is the projection. You can see that the death projection becomes almost flat by mid-June, which is good news. 

However, the forecast has a large 95% UI (Uncertainty Interval, which is the same as a Confidence Interval). That's the light brown shading on either side of the dotted line. This is what I didn't understand at first, until I clicked on some of the dates and saw that, for June 15 as an example, the projection of 466 deaths by then had a range of 112 to 868.

I'm assuming this range reflects how strongly Oregon engages in efforts to mitigate the spread of the coronavirus. A web page describing the methodology seems to indicate this, though it isn't crystal clear from my admittedly brief reading of the IHME site.

The estimated excess demand on hospital systems is predicated on the enactment of social distancing measures in all states that have not done so already within the next week and maintenance of these measures throughout the epidemic, emphasizing the importance of implementing, enforcing, and maintaining these measures to mitigate hospital system overload and prevent deaths.

Here's more good news for Oregon from the IHME model.

The forecast shows that our state will have enough ICU beds to meet the COVID-19 demand on the peak resource use of May 3, along with enough hospital beds under even the worst projection. But the caveat is, obviously, that ICU and other hospital beds also are needed for patients with different problems. So it's good that our hospitals are planning ways to handle non-COVID 19 patients in various ways.

By contrast, here's the scary forecast for the state of New York. Yikes! Peak hospital resource use is soon, April 9, when 11,070 ICU beds would be needed, with just 718 beds available, producing a shortage of 10,352 beds. I don't know if this takes into account the hospital ship that has been sent to New York, or the hospital bed capacity being constructed as rapidly as possible.

Lastly, here's the total deaths forecast for the nation as a whole. The peak number of deaths is on April 15, after which the curve begins to flatten out. The 95% UI for August 1 is between 39,174 and 141,995 deaths, with 82,141 deaths being the projected number. All of those numbers are super-scary.

That said, I was strangely reassured by poking around the COVID-19 projections on the IHME web site. There's something about solid scientific analysis that is grounding in a time of dangerous uncertainty. The human misery is absolutely real and can't be ignored.

However, I felt better knowing that researchers like Chris Murray are working hard to provide policy makers at the local, state, and federal levels with the best possible information needed to get us through the coronavirus crisis. 

I just wish there was a toilet paper availability forecast so I'd know whether I could modify my "two squares per poop" rationing sometime soon. 

How to strengthen your immune system -- advice from New Scientist

When I got the mail today and plopped the current issue of New Scientist, a British magazine, on a table, almost right away my wife started reading the cover story, "You're only as young as your immune system."

(Online version has different title, "How to fight infection by turning back your immune system's clock.")

That's the effect of the coronavirus pandemic. Suddenly almost everybody is concerned about their ability to fight off the virus, especially people over 70 like my wife and me, along with those with compromised immune systems and/or underlying health conditions. 

It's a good cover story. So good, and so timely, I'm sharing a PDF file so those without a New Scientist subscription can read it in full.
Download How to fight infection by turning back your immune system's clock | New Scientist

Below are some excerpts from the piece. I've focused on advice (in bold, for emphasis) on boosting our immune system that almost everybody can follow.

Sure, it may not be possible for someone to strengthen their resistance to infection in time for that to make a difference in how their body would respond to the coronavirus, but now is always an excellent time to start improving our immune health. Here's the excerpts:

WASH your hands religiously for 20 seconds, sneeze into your elbow, avoid touching your face, stay 1 metre away from all other people and, as a last resort, self-quarantine for a week with only your emergency rations for company. If you want to avoid getting the new coronavirus, all of these are a good idea. But ultimately, one of the most important things standing between you and a deadly bout of covid-19 is your immune system.

We know that the immune system gets weaker as we age – which is a key reason why those over the age of 70 are most at risk from the disease. But what is becoming clear is that when it comes to immune health, age is just a number. Some people have an immune system that is effectively significantly older or younger than they are.

“Some 60-year-olds have the immune system of a 40-year-old, some are more like an 80-year-old,” says Shai Shen-Orr, an immunologist at the Technion-Israel Institute of Technology. The good news is that there are some simple ways to turn back the immunological clock. Because even after the threat of this virus has passed – sooner or later another one is going to come along, and none of us is getting any younger.

...If you are younger than 60, in good health and don’t have too many bad habits, then your immune system is probably functioning well enough to keep you safe from almost any infectious disease, including coronavirus.

The bad news is that as we age, our immune systems gradually deteriorate too. This “immunosenescence” starts to affect people’s health at about 60, says Janet Lord at the University of Birmingham, UK. The older you get, the weaker your immune system becomes, and the more likely you are to get seriously ill or die because of it.

...Beyond genetics, the team found that smokers have a much older immune profile than non-smokers of the same age. It’s unknown if this is reversible. But if you don’t want to prematurely age your immune system, it would be best not to smoke.

...One key approach to keeping our immune age down relates to the fact that as we get older, some of our immune cells start to misbehave. This is especially problematic for a class of immune cells called neutrophils, the most common type of white blood cell. These form part of the innate immune system, the body’s first line of defence against infection, and are the border force of the immune system, patrolling tirelessly through the bloodstream on the lookout for harmful bacteria.

...What are these miracle drugs [that boost neutrophils]? Statins, the ordinary cholesterol-lowering drugs already taken by millions of people. Turning to real patient data from the University of Birmingham’s Queen Elizabeth hospital, Lord found that people admitted to hospital with pneumonia were much less likely to die if they were already taking statins to lower their cholesterol.

Another class of immune cells that begin to misfire as we age are T-cells. These are pivotal in the adaptive immune response – the more targeted part of the system – but are blunted in two ways by immunosenescence. As with neutrophils, their internal signalling pathways go awry, and they are also inhibited by inflammaging.

But there may be a simple way to undo this damage. According to Dayong Wu, a nutritional immunologist at Tufts University in Boston, the answer is vitamin E. ...Wu recommends people over 65 routinely take 200 international units (IUs) of vitamin E. “It may help immune function. It doesn’t hurt,” he says.

...There is also a drug-free way to rejuvenate your neutrophils: exercise. In 2016, Lord and her colleagues measured exercise levels and neutrophil migration in 211 older adults.

“Those doing 10,000 steps on average had neutrophils as good as young adults,” she says. She emphasises that neutrophils aren’t antiviral so won’t prevent you catching coronavirus or help you beat it, but they will protect you from the real danger, which is pneumonia. “Usually what carries people away with these [viral] infections is secondary infections,” she says.

...Exercise has other immune-boosting effects too. “Active skeletal muscle is anti- inflammatory and stimulates macrophages,” says Lord, who goes running every day. “Skeletal muscle is a profound immunoregulatory tissue in the body and keeping it going by physical activity really will have a lot of benefits for health. Exercise benefits all ages.”

Asked what one thing she would recommend to strengthen your immune system, she says: “Increase your step count to 10,000 per day.” In the face of the new coronavirus, it is more important than ever to find ways to stay active – even in lockdown or isolation, which isn’t going to be easy.

...Vitamin D, meanwhile, appears to do the same for the innate arm of the immune system, especially among people living at latitudes where there isn’t enough winter sunlight for their skin to synthesise the molecule. A 2017 review of the evidence for taking vitamin D supplementation concluded that it prevents upper respiratory tract infections. About 1000 to 2000 IUs should be safe and beneficial, says Wu, but people shouldn’t go higher than that because big doses actually suppress T-cell function.

...A third supplement with good evidence for immune-boosting powers is zinc. “It is very effective for viral infections,” says Wu. Though he adds, “be cautious, the effective window is narrow and an overdose will suppress your immune system”.

...What you eat will also matter to your immune system – now is the time to look after your gut flora. There is good evidence that probiotics can enhance the immune system, that poor gut health is a cause of premature ageing and even that a healthy microbiome can reduce your immune age.

...Even if a fasting diet isn’t for you, simply keeping your weight down can have immune-boosting effects. According to Bonnie Blomberg at the University of Miami in Florida, being obese suppresses the immune system to a similar extent as being immunosenesced. 

...None of these interventions is without sacrifice. But if you want to stay alive and well for as long as possible, looking after your immune system is a no-brainer – especially now the new coronavirus is being called the biggest threat to public health since the 1918 flu. “The age of your immune system is a critical component of your lifespan,” says Shen-Orr. “Think about what the system is supposed to do!”

Why we can feel good about living in Salem during the COVID-19 pandemic

It's difficult to maintain a positive attitude these days, given the constant reminders of the COVID-19 outbreak here in Oregon and just about everywhere else in the world.

(Except Antarctica. So far.)

So I thought I'd dredge the corners of my mind for reasons we're fortunate to be living in Salem right now, rather than somewhere else.

Of course, I readily admit that some of what follows is by no means unique to Salem. But since I'm not in those other places, but here, I'm including those bits of positivity anyway.

(1) Just the right size. I'd hate to be living in a super-dense city, like New York. Practicing social distancing and avoiding surfaces that could have the coronavirus must be much more difficult when millions of people surround you. It'd also be worrisome to live in a rural area that is a long ways from hospitals and doctors. Thus Salem seems to be in a sweet spot, size-wise. Large enough, but not too large or too small.

(2) Marion County ranks #4 out of  36 in ability to hospitalize the elderly. Since I'm 71, and my wife is about the same age, we're in a high risk COVID-19 group. The Portland Business Journal ranked Oregon's 36 counties on how equipped they are to hospitalize their elderly population, using criteria such as the number of ICU beds per 1,000 people 65+. Pleasingly, Marion County ranked #4. Multnomah County is #1.

(3) Volunteerism is strong here. As elsewhere, admittedly. But people in Salem seem eager to make lives better for others by volunteering their time, money, and energy. Since my wife is a long-time Willamette Humane Society volunteer, along with many others, I know that "others" definitely includes dogs and cats. Today the Statesman Journal is reporting that Salem Health is looking for volunteers to sew 10,000 masks for health care providers. I bet they'll find those volunteers. 

Salem Health is asking for volunteers to sew nearly 10,000 mask kits for nurses and other care providers. 

Salem Health staff have created and bagged mask-making kits — enough for nearly 10,000 masks — that include surgical paper fabric, instructions and a bag for the finished product.

Those interested in helping need a sewing machine; white thread; scissors or a rotary cutter; and a yardstick, straight edge or cutting mat.

(4) Grocery stores are doing their part in difficult times. Whenever I go into a grocery store in Salem, I'm impressed with how energetic, positive, and helpful the employees are. They're working long hours under tough circumstances. I wish there was a tip jar at each check-out line so I could do more than just say "thank you for what you're doing." And many, if not most, stores are offering seniors and those with compromised immune systems a chance to shop during the first hour after opening. Much appreciated. 

(5) We aren't in India. A few days ago Prime Minister Modi announced that all 1.3 billion Indians are supposed to stay in their homes during a 3-week total lockdown. (I wrote about this on one of my other blogs.) Wow. And that lockdown happened with just four hours notice, leaving very little time to look for essential supplies.

Gov. Kate Brown's "Stay Home, Save Lives" executive order is mild by comparison. And Salem has plenty of pleasant places for walkers and runners to exercise. I'd go crazy, or crazier than I am already, if I had to stay in my home for three weeks. 

Governor Brown issues Stay Home, Save Lives order

Good news. Governor Brown has issued an executive order in response to Oregon's coronavirus crisis. It lists businesses that must be closed and contains excellent advice for social distancing. 

Have a read.

Grocery shopping in Salem in the Coronavirus Era

Here's a report from the front lines of people venturing out to do some grocery shopping in what I've come to think of as the Coronavirus Era. 

By "people," I basically mean me. But I'll start with a second-hand report from my wife, Laurel, who headed out in the morning in a (futile) search for toilet paper and facial tissue.

Laurel was staring at the completely empty shelves where toilet paper used to be at the south Salem Fred Meyer store. A man walked up and said, "Wow, what happened to the toilet paper?" Naturally she said that it was a result of the coronavirus outbreak.

"Oh, that's a scam," he remarked. Which left my wife speechless, because she missed an opportunity for a snappy comeback. Like, "Dude, you've been watching too much Fox News."

So it's disturbing that there's even one person in Salem who doesn't understand how important it is to take the outbreak seriously, which means social distancing and taking other precautions to avoid being infected with COVID-19, for the good of both yourself and other people. 

I headed out to do our main weekly grocery shopping in the afternoon, following Laurel's return. Though she struck out on paper products, Laurel was successful in getting bread and some other must-have's.

Since my wife has asthma, she wore a mask and gloves when she goes into stores. And since I both fear and love my wife, which happens after thirty years of marriage, I was pleased to obey her command that I also wear a mask and gloves.

I found an N-95 mask that we'd gotten during the Fukushima nuclear reactor disaster in 2011, when some low levels of radiation were projected to reach the United States. Since I'd never tried it on before, my first reaction was, Wow, this isn't very comfortable. Yet many health care workers have to wear a mask for a lengthy time every day.

Pulling into the Trader Joe's parking lot, I also found myself thinking that I was going to look kind of strange with my mask and gloves. But that thought didn't last long, being replaced with the realization that whatever helps keep me and Laurel free of the coronavirus is a good thing, strange or not.

And I then noticed that there was a line of people waiting to enter Trader Joe's.

To reduce the risk of social contagion, friendly employees were letting a shopper into the store only when someone left the store. It only took about ten minutes for me to reach the head of the line, where I asked a question spurred by a sign that said it was only possible to buy two of any item.

"Um, I like to have your small container of yogurt every day, so I need seven to get me through the next week. Would it be OK to buy that many, or do I need to get one or two large containers of yogurt?" The reply was, "Don't worry about it. You should be fine."

Which I was.

Trader Joe's also had put green tape to show where people were supposed to stand when waiting in line for a cashier. And once my groceries began to be rang up, there was another piece of green tape where I was to stand during that process. So only when I had to put my credit card in the reader was i close to the cashier, which makes a lot of sense.

When I got back to my car, I could hardly wait to lower my mask to chin level, in part because I quickly realized that wearing dark glasses with the mask on made my glasses fog up. Some health care workers must wear glasses, so there's got to be a trick to combining a mask with glasses that I'm not aware of.

Fred Meyer was my next stop.

All went smoothly there. I ended up getting more than was on my list, because as I wandered the aisles I'd see something that we use regularly, like coffee filters, and think that I should get some in case there's a shortage in the future, even though we don't need that thing right now.

Not a great idea, since this is how shortages happen -- people fearing that a shortage is going to happen. But understandable, especially given the desolate look of the aisle where paper towels, facial tissue, and toilet tissue usually grace the shelves. Zero. Nada. Zilch. 

But hey, I've got plenty of coffee filters! And, yogurt. Sadly, neither of which are suitable for wiping my butt.

My final stop was Lifesource Natural Foods.

All seemed pretty normal there, aside from the change to the bulk foods department. Now you can't put bulk stuff in a plastic bag yourself. Instead, two Lifesource employees were doing that in an efficient manner. I only needed salted mixed nuts, so getting them was quick and easy.

Yesterday my wife and I had less positive results with our first attempt to order groceries online, then pick them up outside the store. Laurel ordered quite a few things that were shown at being available at the Sunnyside Roth's. But by the appointed time to pick them up, every item but paper towels wasn't available. 

(At least paper towels are closer to being toilet paper than coffee filters and yogurt.)

Same thing happened with some hand sanitizer that i'd optimistically ordered from Lifesource after seeing it available on their web site. I got an email saying that the order had been cancelled, since that item was out of stock. Some friends of ours have had success with local online ordering, though. So I guess it depends on what you want and how much in demand it is.

We're appreciative that so many stores are earmarking an early time for at-risk people to come in, like at 7 am. Being over 70, we might take advantage of that at some point. Especially if toilet paper continues to be in such short supply. It was good to see that Fred Meyer is only allowing people to buy one item of paper products like toilet paper. 

But when there is zero available on the shelves, one is a very lonely number.