August 28th 2020

8/28

Greetings All!

The Beat Goes on

Massachusetts has dropped out of the top ten states with the least amount of Coronavirus activity.  We are not even in the top twenty! Our ranking is 21st with just under 10 new cases per 100,000 population per day. Boston is experiencing a lot of those cases, but we are seeing an uptick in the Berkshires as well. We are averaging just under 3 new cases per day average, the highest in a while. This is after having a stretch with no cases.

This Band is seemingly going to play all night and into the morning. The music is a bunch of tunes we’ve heard before and will hear again. Friends, what if I told you there is no end in sight? Yes, I believe the Pandemic will come and go, but we will have natural disasters and other plagues perhaps even before we are through this one.

There is no finish line. The election will come and go as well. However, I believe we will still be faced with huge challenges, no matter the outcome, that will require our intense study and engagement.

Trials and tribulations are the signature of our time, it seems.  If so, our task is nothing other than to live through them, and support each other as we do, and to seek the strength, courage and proper standpoint it takes to get through them.

My point is we have no choice but to study this moment carefully and not hold our breath for a time when things are different. This is our moment, as full as any other. Let’s seek how make peace with these challenges, to find a home in the uncertainty. Let’s find a way to work with exactly what’s on our plate.

My message today is that there are two keys to navigating this.  One is to bring order to the tasks at hand in the world before us, and the other is to bring order to our inner world, our world of thoughts and emotions.

The first Key:
The first key is to have a clear goal for our outer actions, and for how to proceed through the next year with our towns open for modified business and a careful plan to mitigate risks. Let’s be clear what we are striving for in our approach:

Picture this, everyone can test every few days at home by spitting on a piece of paper. Results are ready in a few minutes. This way schools, nursing homes, workplaces are so much safer, and the asymptomatic cases don’t become spreaders.

That’s the missing ingredient. What exactly do we need?

  • Rapid tests, processed outside the lab
  • Goal 3 or 4 million per day. (The U.S. is now testing about 690,000 people per day, down from a peak of 850,000 daily tests late last month.)

We aren’t there yet but this week are taking a step. The Government is apparently jumping on the train, purchasing 50 million tests per month of a new rapid antigen test from Abbott, beginning in September. This is good news!

How about a short detour about molecular testing vs antigen testing vs antibody testing?

What’s the difference? What’s the breakdown? What should I know?

To begin with, there are two different types of tests – diagnostic tests and antibody tests.

  1. diagnostic test can show if you have an active coronavirus infection and should take steps to quarantine or isolate yourself from others. Currently there are two types of diagnostic tests which detect the virus – molecular tests, such as RT-PCR tests, that detect the virus’s genetic material, and antigen tests that detect specific proteins on the surface of the virus.
  2. An antibody test looks for antibodies that are made by your immune system in response to a threat, such as a specific virus. Antibodies can help fight infections. Antibodies can take several days or weeks to develop after you have an infection and may stay in your blood for several weeks or more after recovery. Because of this, antibody tests should not be used to diagnose an active coronavirus infection. At this time researchers do not know if the presence of antibodies means that you are immune to the coronavirus in the future.

Different Types of Coronavirus Tests
————————————————————————————————————————

Molecular Test Antigen Test Antibody Test
Also known as…

Diagnostic test, viral test, molecular test, nucleic acid amplification test (NAAT), RT-PCR test, LAMP test

Rapid diagnostic test
(Some molecular tests are also rapid tests.)
Serological test, serology, blood test, serology test

How the sample is taken…

Nasal or throat swab (most tests)
Saliva (a few tests)

Nasal or throat swab Finger stick or blood draw

How long it takes to get results…

Same day (some locations)
or up to a week
One hour or less

Same day (many locations)
or 1-3 days

Is another test needed… This test is typically highly accurate and usually does not need to be repeated.

Positive results are usually highly accurate but negative results may need to be confirmed with a molecular test.

Sometimes a second antibody test is needed for accurate results.

What it shows…

Diagnoses active coronavirus infection

Diagnoses active coronavirus infection

Shows if you’ve been infected by coronavirus in the past

What it can’t do… Show if you ever had COVID-19 or were infected with the coronavirus in the past

Definitively rule out active coronavirus infection. Antigen tests are more likely to miss an active coronavirus infection compared to molecular tests. Your health care provider may order a molecular test if your antigen test shows a negative result but you have symptoms of COVID-19.

Diagnose active coronavirus infection at the time of the test or show that you do not have COVID-19
————————————————————————————————————————

Abbott’s new, rapid antigen test was just authorized on Wednesday by the FDA and is the first, rapid coronavirus test that doesn’t need any special computer equipment to get results. It can be done cheaply with the help of you doctor’s office, like a strep test.

Here are the specifics:

It will sell for $5, and:

  • Takes 15 minutes to get results
  • Is based on the same technology used to test for the flu, strep throat and other infections.
  • Cannot be done at home, only at the doctor’s office, like a strep test
  • Requires a Nasal swab
  • Less accurate than the molecular test, but useful and relevant.

Several companies are developing rapid, at-home tests, but none have yet won FDA approval. These will take us further down the road through this!!

FDA also recently greenlighted a saliva test from Yale University that you might have heard about. This is used by the NBA. It:

  • Also is rapid, but it needs a high level lab (also not at home).
  • Bypasses some of the supplies that have led to testing bottlenecks.
  • Is a spit test

The two approved tests mentioned above (Abbott and Yale) should help greatly expand the country’s testing capacity, an important step in getting our outer situation lined up:  our first key. And now the other?

So, how can we be fully effective against an invisible contagion that is out of control? Or systemic injustice deeply entrenched in our culture? We have to take outer steps, AND we have to pay close attention to our inner game. It brings everything together.

The second key- the inner game

With your thoughts you don’t do the deeds of changing the world, but do you believe that your thinking is just as real and important for your health as well as society’s health as are your deeds?

I do. And I want to share with you a couple things about it.

Introspection and the self-criticism that inevitably follows are normal, but listen also for the voice that consoles and wants to deepen a connection to your Life, through all the challenges.
I think if everyone were able to connect to more deeply and truthfully and deliberately to their Lives through kindness, there would start to be subtle shifts. Subtle inexplainable shifts. Maybe in your household, at first. But it doesn’t stay there.

Confucious laid it out neatly:

“If there is righteousness in the heart, there will be beauty in the character.
If there is beauty in the character, there will be harmony in the home.
If there is harmony in the home, there will be order in the nations.
When there is order in the nations, there will peace in the world.”

It can be broken down rather easily. We have a lot of self-chatter. You are either helping or hurting. The whole field of positive psychology revolves around learning healthy ways to speak to yourself, even when you’re challenged. Yes, be kind, and also align with the Good. Let it shine into you.

Should we try it? Just pay attention to how you speak to yourself. Be Kind.

In Summary, the inner game

First, you must be aware. It’s not possible without practicing meditation, without learning how to listen and without learning how to see. Spend a minute in receptive prayer or meditation for every hour you are in front of a screen. 4-7 minutes per day is a good starting point.

Second, practice healthy thoughts. This is why the gratitude journal is so helpful. Wake up with a recurring verse or prayer. Here is an example:

Third, participate less in relationships that are toxic. You don’t owe anything to anyone. You owe yourself a deep connection to your Life. Emphasize the relationships that build you up.

Finally, challenge what you accept as your identity.  We all wear many hats. But we have one unwavering and true identity. No fact, no circumstance no twist of fate can alter that. Seek to connect and get better acquainted.

Parting thought

At the beginning of the pandemic people would ask me what are your trusted news sources? Who does a good job? My answer is to trust nobody on the networks or social media. Learn to test everything and to think for yourself!

Best wishes on your day!

As Always, let us know if you need anything!

Dr Cooney and staff