I believe that medicine’s potential is much more than the version we see in the world today. A doctor should be an educator with the goal of bringing patients to a place of deeper understanding of who they are in the world. To me, medicine is ultimately about self-empowerment through self-knowledge and growth.
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 homeby 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.
A 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.
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
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.
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!
I have a few things to tell you about masks. They are an important tool, but if used without discrimination one can experience harm! This is a fact that is under-represented out there but is my main message for today.
Read on and I will tell you FIVE essential facts about masks that will make you more in the know that anyone confined to what the Mainstream Media seems to be able to convey. It’s crucial to get it right because the MASK MANDATE is definitely here.
Eat your Porridge
Today we are seeking something we could call the “just right.” Goldilocks was one of our first teachers of this. No extremes for that little girl:
not too hot, not too cold-
not too hard, not too soft,
not too big, not too small- – but just right.
Whatchu looking at, Bear?The Middle Path
Harmony and health are born out of the middle. It is more difficult to avoid living with an extreme position or a reactionary one, but there is a richness when one learns to move about freely in the middle zone.
The two extremes create a vacuum between them where something entirely new can come in to being. This is a noble task for each of us- to occupy this middle place. There is a whole schooling in Mindfulness which points in this direction. Attention and precision certainly are key.
The clinician knows about the middle path. Medication dosages need to be just enough to be effective but not too high as to have untoward effects. The dosing has to be right on the point. Someone else’s way is not necessarily yours. Yesterday’s answer is not necessarily today’s.
In diagnostics, the same principle holds true. There are errors at either extreme. There is the error of inaction on one side and of over-instrumentation, needless intervention on the other side. A path in the middle which is neither too conservative nor too aggressive comes into view and invites the patient and clinician to explore it. Trust between a doctor and patient is indispensable for proper navigation. Trust comes from relationship! Icarus
My favorite Greek myth is the tale of how Daedalus and his son Icarus set out to escape from the labyrinth that Daedalus had been forced to build and that then became his prison.
The maze was alive and would shift, so there was no simple formula to escape. The walls were high and Daedalus knew his only chance for freedom was to go over them. He built wings which were held together with wax. His famous instructions to his son were to seek safe passage through the middle zone.
If they flew too high the sun would melt the wax in the wings and the wings would fail. Flying too low and too close to the water the wings could get wet and heavy and their weight would carry them into the ocean. The tragedy of Icarus was not being able to hold the middle. We all have Daedalus’ wings. We all access freedom and our highest goals through finding the delicate balance of the middle.
When errors happen, learn to examine them thoroughly and kindly. They are our greatest teachers.
Bringing it home
With the PANDEMIC we have a rock and a hard place. It’s easy to have the middle squeezed out!
Horrible outcome from isolation and shutdown on one side.
Terrible losses from massive amounts of illness on the other.
The middle is there. You can see it, right? Persevering and going forward with the right amount of sensible planning and preparation and just enough caution.
I’m writing to tell you that masks need a middle ground as well.
New Englanders generally don’t underuse masks. We seem to know that indoors and in crowds where physical distancing isn’t possible that masks make sense. We have more of a tendency to make the mistake of not recognizing the risks of masks.
What I am saying is there are two tiers to protective interventions. The first tier of interventions to greatly limit the risks of contact with others is:
inhabiting well ventilated spaces or staying outdoors
hand-washing with soap and water
These are low risk. Ok, zero risk. Use these indiscriminantly, early and often.
Masks provide additional protection when these first tier aren’t possible. They are an important part of our COVID response but because of their risks I put them in a second tier category (along with alcohol based hand sanitizers, as discussed in a previous bulletin).
When distance can be maintained outdoors please consider breathing freely. It’s important.
Masks are PPE which DO interfere with normal air exchange. They traditionally required training to understand proper use, risks and limitations. Why? Because they can cause illness in the workplace when used! Not in everyone, but in some for sure. This is getting no air time in our national discussion.
Here are my 5 points to consider:
First, realize the correct time for a mask is when you are in a poorly ventilated area, where physical distance cannot be maintained. If possible don’t spend a lot of time in these types of settings, no matter who you are.
Second, realize that when in well-ventilated areas and not around other people you shouldn’t wear a mask. Don’t exercise with a mask on. I’ve heard that occupational safety and health consultants limit mask use to 5 hours in a day and take extra precautions when the temperature is hot. Implement these ideas.
Third, certain medical conditions would raise a flag in the workplace and require extra fit testing to determine safe and healthy mask usage (anxiety disorders, pregnancy, PTSD, cardiopulmonary disorders, kidney disorders, cancer history, stroke history). If you are one of these people, limit your time in settings where you will need a mask. Don’t wear them in settings where you don’t need them. Mask exemption requests will make sense in some scenarios. Rely on your top tier interventions!
Fourth,know the symptoms that an come from mask use, the possible side effects. Headaches, lightheadedness, nausea and fatigue are possibly from wearing your masks and should be watched for with vigilance. Take mask breaks by going to sparsely populated, well ventilated areas and removing your mask!
Fifth, surgical masks optimally shouldn’t be used over and over. They filter the particles in the environment and hold on to them. Cloth masks should be boiled in hot water to clean them. Avoid the perfumes in fabric softeners, for example. It’s not good to breath that in.
If you see someone in an aisle not wearing a mask, maybe they have a medical indication to not wear one. Stay cool. No judgment. Give them some distance. All will be ok.
And if you’re outside and it’s not crowded and people are around without masks: join them. They are seeking the middle, like we all should!
As if you weren’t buckled down enough already, Isaias blew through town this week. Quite a storm! Downed trees, power outages, road closures!
It must have been confusing for some to have the impulse to stockpile toilet paper and then realize their closet was already fully loaded.
But, seriously, it feels like we have been at this at least a year, and we are only just starting our 6th month! We need something to keep us strong as we navigate the rest of this year and the first part of the next. My answer: Develop your skills and knowledge! & Use what you learn to be of service. Lake Bacteria
Here’s a lesson I learned with this storm: bacteria levels in lakes (and the ocean) are higher after heavy rainfall due to the human waste and pollution in runoff.
Bacterial levels can climb to 5 times above the safe upper limits. It is recommended to stay out of the water for 2 to 3 days after a heavy rain! Skin issues or GI upset are the risk. It’s good to know where the dangers are. Maybe a paddle after the rain is better.
New illness, New treatments
The advice not to swim is surely more relevant as the development in an area increases. It’s one of many examples of the illnesses that come with urbanization. As civilization changes so do the illnesses- and so must the treatments.
My wish for humanity is to have the spirit to access treatments and methods that are not only relevant to the precise moment but are actually born for it.
Innovators and Dreamers, all hands on deck!
Chaos and Pausing
I have to admit this storm took me by surprise. I actually missed the whole news story about its approach. I must be hyper-focussed on the Pandemic. Can you blame me? There is still so much to learn, and there are so many incredible life lessons embedded in this experience.
The Pandemic is stopping us in our tracks in many ways. Confusion and chaos abound.
Chaos opens up possibilities. It is uncomfortable, but it is a needed condition for restructuring, for learning. Letting go of an old system always has a transitional chaotic period.
The pauses bring about the opportunity the to re-set your direction. We act, then we stop and analyze to decide how to restart. We need the pauses to stay on track. Being forced to stop sometimes is helpful.
Brain power, Heart Power
You know this concept that we use only a small part of our potential mental and physical resources? That we use only 10% of our brain? Some people dismiss it, but I have always been intrigued by it.
By now you know that development is central to my worldview. As human beings our starting point is incomplete. It’s not just in our thinking alone that we have amazing expansive potential, it’s in every organ and every aspect of our lives.
Accessing brain power gets the air time, but what about the untapped potential of the human heart?
The chaos of the pandemic and the quiet of the forced simplification of our lives invites us:
to wonder about the unknown
to accept and love ourselves and each other unconditionally
to trust that each of us matter and are not alone
to have compassion for our friends and enemies alike
We know so many things on one hand but so very little in relation to the expanse of the universe. And we plug along with the piece that we know, without the assurance that we are on the right path. Only when we believe in the vast capacity of the human being can we begin to tap our potential.
I’ve come to understand that a Pandemic means we are stuck between a rock and a hard place. There is danger on both sides. You have to find a delicate balance. On one hand more social mixing leads to more exposure and more risk. On the other too aggressive restrictions affect the psychological and physical welfare of children and families. The bottom line is that the distance learning failed a lot of people.
No matter how you proceed it’s going to be difficult.
The good news is that kids less than 19year of age:
don’t get COVID as often
have milder symptoms and shorter duration when they do get it (although the presence of chronic illnesses raises the risk for more severe symptoms)
seem to pass it on less.
These facts are the foundations to building a plan forward. As I study it, the path needs:
A) to be individualized and flexible
Weigh the dynamic of the outbreak in the region. You simply can’t proceed with a surge of cases.
Consider the ventilation of the building. Better yet, consider the ability to be outside. Temporary outdoor meeting places are the ideal.
Take into account the characteristics of the school’s population. Pay special attention to the at-risk members of the school
Ask whether the teachers are on board? Do they feel supported? They are becoming front line workers here.
B) to proceed slowly and with all safeguards in place; it should not be full time, at least at first, in my opinion. It’s too exhausting for everyone involved.
Remember that the potential risk of COVID-19 spread is highest when individuals are
within 6 feet of each other, for more than 15 minutes,
in a small space with limited ventilation, sharing equipment or food, and/or taking deep breaths (e.g. while singing, shouting or exercising).
Students and teachers will
stay home with any symptoms
be greater than 6 feet apart
work in well ventilated areas with modified schedules and movement patterns- and if so, it can work.
These are good parameters for all of us to remember.
Best Wishes on your day and all you have on your plate. Keep up the good work.
Here we are at the end of July! It was a hot one, wasn’t it?!
Things continue in their normal, abnormal way. We perhaps are in the middle of the pandemic now. It IS going to end, you know. Be sure of that. Let’s help keep each other intact for when we realize the coast is clear and we are through it!
The pandemic is being described as one big wave. That’s in opposition to what happened with the 1918 pandemic which had a first wave, disappeared, then came back in what is considered a second wave. Regardless, wave-like it is.
I’m struck by the profound beauty in thinking about the human race in its entirety and seeing various phenomena crest over it.
Yes, a disease can spread like a wave, but it is fascinating to see how ideas do the same. Take for instance the technological wave which is a strong signature of our age, starting with the creation of the printing press in 1440 all the way to the launching of Twitter and Facebook in 2006.
Ever heard of AI? This wave doesn’t let up!
Many Ideas vie for humanity’s attention, and some work against our basic human nature. Tyranny (abuse of authority) is a worldwide force to be reckoned with. It snatches people to propagate its cause and hinders civilization’s truest blossoming.
There are other waves, forces for Good. Going back to the Magna Carta in 1215 and the Declaration of Independence in 1776 we see efforts to limit the rights of the State and protect the individual, laying the groundwork for advancing the well-being of the human being as an individual, complete and whole.
I believe the forces for Good are unmatched and with precise and compassionate cooperation from us can be a Tsunami for the whole earth RIGHT NOW.
Let’s get going! Surf’s up!
Here were some of the questions I addressed this week that I thought would be helpful for everyone.
COVID BERKSHIRE FAQ 7/31:
Are Fairview and BMC still testing?
Yes. The nasal swab test is still what is being used. It is by appointment and is for all comers, regardless of symptoms. The BMC Nurse Triage line 855-262-5465 is what you call to set up the testing. They generally send the samples out to Quest Diagnostic lab.
What is the average turnaround for test results?
It depends on how busy the labs are. At best
24-48 hours, on average 72hours, and at worst, 6-7 days when the system is overloaded. With the travel advisories, testing is busier. Quest is on the slower side at this moment.
What about more rapid tests?
We have used Baystate who is turning tests around in 24-48 hours, they say. The doctor needs to make the appointment.
And even faster?
If you need it, there is a group in Connecticut called the Docs Medical Group who is doing rapid same day testing. They have several sites including Waterbury and New Milford CT. They don’t take appointments. After you get swabbed you have about a 15 minute wait to see the Doctor with the results.
Do they charge for tests?
Yes. All of the above do. Cost in medicine is tough to nail down. The price starts somewhere around $100. They take your insurance information and bill the insurance. Generally, all insurances cover testing when there is a symptom. There is some uncertainty what insurances will do when the testing is for travel. They recommend to check with your carrier.
Is there weekend testing?
Hours for Pittsfield
8am- noon, 7 days a week
Fairview has less hours.
What is the average number of people tested daily for Covid at the testing sites in the Berkshires?
Up to 100 daily at BMC at their busiest.
Fairview is less busy.
What is the average # of positive tests daily?
We have been at 1 positive per day in the County until recently when it jumped up to 2.5 – 3 per day average. A public health nurse tells me that the majority of positives are still related to travel. Mass is still in the top ten for states with lowest daily new infection per populace. Harvard has a great site to document the changing numbers county by county, state by state. Bookmark it if you want. Example of their map:
Is there a test shortage at Fairview?
No. There are sufficient tests, just slow results. We have testing at the office and have continued to test there at times as well.
What is the chief symptom of those who tested positive in Berkshire County?
Headache and heavy fatigue, just like the tick Bourne illnesses. Ticks usually cause a fever. COVID has most commonly presented without fever. Also cough. 1/2 of people who contract ithaven’t had a suspected positive case in their recent exposure profile.
What is the average duration of illness?
It has a range and it depends on whether or not there is significant pulmonary involvement, which extends the course.
In general, cases are not getting as sick as during the winter and spring. Patients followed by the public health nurses have a milder course right now.
Were positives retested to see if they are now negative and have antibodies? How many follow up tests are people usually given?
No follow ups tests are used. Generally, people are isolated after a positive test and are infectious for ten days from after they started symptoms. After ten days the public health folks advise them to loosen their isolation efforts.
What are the different types of vaccines in clinical trials and which do you prefer?
I prefer none. I was taught by a very strong pharmacology department at Georgetown Med School to not be the first one on the new drug train. This rushed situation does not sit well with me. Since their will be a shortage, the willing will step forward and test the roll out. I would advise caution, depending on what the landscape looks like.
Is neurological Covid a given if you have a history of brain injuries?
Nothing is a given. With no symptoms could be how it presents, no matter who we are talking about. One very interesting statistic is that 2 local patients have presented with a serious neurologic syndrome called Giuliani Barre- which is sometimes seen as a sequela to influenza infections. It is a neurological condition that cases paralysis, needing hospitalization.
Does Covid trigger shingles?
There are three rashes that occasionally accompany COVID infections. Toe blisters, hives, and an itchy prickly rash with red spots. Shingles is not a common presentation at all. Emotional stressors can trigger shingles. Stay regular with your balancing practices.
Does Covid morph into pneumonia? If so, should we have the pneumonia vaccine?
The Pneumonia vaccine protects against Streptococcus Pneumonia, a common cause of pneumonia. The vaccine might be part of your approach depending on your age and co-morbidity profile. The idea behind the national push for flu vaccines and pneumonia vaccines this fall is to try to limit who is going to the clinics and ERs with fevers and coughs. The basic physical distancing and smart hand hygiene and masks are your mainstays.
What about hydroxychloroquine? Do you ever prescribe it?
My observation is that HQ has become involved in a game of political tug-of-war. It showed promise against previous SARS infections as a way to help zinc enter the cells. Zinc is a strong antiviral actor intracellularly, but needs help getting through the cell wall. It needs HQ or quercitin to get into the cells. All the studies with HQ that I have seen did not include zinc administration! By every standard the data out there on HQ is weak and of low quality. It would be premature to draw conclusions on the efficacy. The jury is still out, but this med is safe and has promise. In my opinion HQ is not a cure, but it might be a help. It is cheap and low risk and should be given a fair shake.
What is on your wish list, doc?
The biggest thing we need is a rapid test that we can all do once or twice weekly and get accurate results immediately. The PCR test (nasal swab) is clunky and quirky and not going to carry us well any more, if it ever did.
A group of Australians have developed a test for the tendency to clot, which is a common COVID symptom. The team was in the news this month (for the clotting test, also called agglutination test). There is some promise there. There is a group at MIT working hard on solving the testing riddle as their top issue. And probably every prominent lab in the world is addressing it, I hope. Testing progress could be a game changer.
Most of all we need to paddle straight and steady and take it one swell at a time because when the storm lets up, the entire ocean calms at once.
Friday is Venus‘ Day, in the tradition of attributing one day of the week to each of the 7 planets visible to the unaided eye.Think Sunday (Sun), Saturday (Saturn). (Those are the obvious ones.) Venus lights up the night sky as the brightest planet.
It’s striking how electricity and modern life pull us away from the night sky. How calming must it have been to get hours and hours of “evening sky time” every night?!
You have to admit that the modern era exposes us to an amazing amount of stressors that hit us on every level of our existence.
We are more and more challenged to set good boundaries for ourselves, both in body and soul.
“Good fences make good neighbors”, as Frost references in Mending Wall.
A Healthy Boundary region is neither stagnant nor inflexible. There is influx and outflow and remodeling. The body can shows us examples. Just study the cell wall’s permeability. To have a healthy boundary in our soul life we need to stay present to the subtle changes that are constantly weaving around and through us.
Your Epidermis is Showing!
All of us are quite familiar with the boundary region in the body made up by the skin. We learn a lot about each other through what the skin has to say.
It has a sensory role, of course, and it also breathes. Not only does it let off fluid and toxins, but it is active in absorption too. The skin assimilates atmospheric gases and is actually a very efficient surface for absorbing medicines…. or toxins.
What’s in that lotion or perfume or sunscreen you’ve been using? I want to tell you, it matters.
That brings me to the point of the letter.
This is a question I asked myself this week:
With all we know about the skin as an efficient absorber, is it ok to use liberal amounts of antibacterial gel?
We might be at this for awhile, how should we adjust?
Are you using a ton of alcohol gel? It was hard to keep stocked at first. Now suppliers have popped up from who-knows-where to get their product on the market.
1st point. Reminder that washing with soap and water is best… and safest. Period. Wash for 20 seconds. Let the gels be your back-up when you can’t wash but have had an exposure. When you need to use an alcohol gel, it’s recommended to use at least 60% ethyl alcohol to be effective. The least amount of gel you need is best. Why? Keep reading.
2nd point.Be educated and check the contents. Definitely make sure your gel doesn’t have triclosan. DON’T USE TRICLOSAN. This is a chemical that was used in antibacterial products over the last several decades. It does not offer any benefit to your health and it has lots of toxicities:
It can lead to antibiotic resistant bacteria.
it interferes with the body’s regulation of thyroid hormone.
it leads to a higher chance of developing allergies, including peanut allergies and hayfever.
and it is toxic for the environment.
3rd point. Ethanol gels can be contaminated with methanol, which is quite toxic. Methanol on the skin readily absorbs and can make you dizzy, can lead to blindness, and even death, especially in young children.
FDA has issued a recall on 75 different sanitation gel products that were improperly manufactured and tested positive for methanol.
The FDA highlighted nine products from the Mexican manufacturer Eskbiochem SA de CV, though the agency did not say where in the U.S. the products were sold. The products are:
· All-Clean Hand Sanitizer
· Esk Biochem Hand Sanitizer
· CleanCare NoGerm Advanced Hand Sanitizer 75% Alcohol
· Lavar 70 Gel Hand Sanitizer
· The Good Gel Antibacterial Gel Hand Sanitizer
· CleanCare NoGerm Advanced Hand Sanitizer 80% Alcohol
· CleanCare NoGerm Advanced Hand Sanitizer 75% Alcohol
· CleanCare NoGerm Advanced Hand Sanitizer 80% Alcohol
· Saniderm Advanced Hand Sanitizer
The full FDA list is growing and is here.
You might want to clear your product with FDA list, and avoid products left out by stores.
4th point. Even if the ethanol gel is not contaminated, it is only safe when used in moderation. Its use can lead to dry skin and irritation and even infection. Alcohol poisoning is rare but can be a real problem, especially in children who are more inclined to ingest gels when they are colored.
The most troublesome thing in my view that ethanol has been found to act as a penetration enhancer for many chemicals. Basically, it makes us more open to the environment. The barrier function is weakened. The barrier is opened and not with our blessing. More of the environment is able to pass in. The concern is the passage of Toxins.
So if we are going to be wise in our use of sanitizer, we should be mindful of our boundary function and careful of whatever we put on our skin and what we have in our environment.
A healthy house has non-toxic environmentally safe cleaning products: best for the environment and best for you. Buy clean, high quality, natural products for personal grooming and hygiene.
There is a family-oriented documentary called “Stink!” which shines a light on the unregulated use of toxic chemicals in U.S. consumer products, from baby wipes and shampoo to floor cleaners and laundry detergents.
The movie details how manufacturers, with the aggressive backing of the chemical industry, routinely conceal thousands of potentially toxic ingredients in the baby care, household and personal care products you and your family use every day.
Don’t overuse sanitation gels in an effort to be healthy
Take the option to wash with soap and water to sanitize when available.
Minimize your chemical exposure. You make an investment in your health when you buy natural cleaning and hygiene products.
HOCL (hypochlorous acid) spray is something I have mentioned before, and in my opinion can be used to supplement your approach and minimize your alcohol gel use.
Hypochlorous Acid (HOCL)
It has been around for a long time and is a food grade product. It is not proven or listed by the CDC to be active against the novel coronavirus, but it is viricidal and many people familiar with it are comfortable with its place in the pandemic. I have a spray bottle that lives in my car, one at home, and one at work. I carry it into stores and use it often while I’m shopping. HOCl exists in the body and is an important part of the innate immune system. HOCl is produced by white blood cells and is involved in boundary building against foreign substances.
Hypochlorous acid (HOCl) has many characteristics of an ideal disinfectant as it has broad-spectrum efficacy, is odorless, non-flammable, non-toxic, fast drying, environmentally friendly and is easy to use.
Consider it as an option.
I personally believe our task is to face the stressors of the modern era and our individual challenges and to receive the lessons they bring. Let the struggle with them shape you. Don’t waste any time or energy wishing they weren’t here.
Find a way to thrive in the face of them. Not only in spite of them, but because of them!
And in doing so be part of the legions working to transform them and the world we live in.
I’m getting out there! My dogs chased a porcupine up a tree last evening on a walk. I think it was a porcupine, unless it was a wolverine. I’m not sure. I grew up in the city. It was something. I don’t have a lot of experience with big animals in trees.
The summer has (1) wind to help disperse what is not wanted, (2) greenery to lower air pollution, and (3) UV light to sterilize the atmosphere. It’s the perfect trifecta.
(Keep an eye out for 3’s today!)
Deaths per day are dropping in the state and yesterday were down to just 5, a new low since the peak. Berkshire County remains to get, on average, one positive test daily…in the whole county… not bad. That’s including a little cluster of 4 positives in Monterey this week.
Since July 1, 2020, BHS has tested 1924 patients with only 16 positives (as of yesterday). BHS testing continues to be available for all test requests. Any patient who needs asymptomatic clearance for work, camp, schools, etc. can receive it. Turnover is not guaranteed to be less that 3 days.
Baystate can turn around testing in 48 hours, they tell us. Consider them, if needed. We set that up with an order.
Berkshire Center for Whole Health
The office continues to provide an option for testing as well; we seem to get slightly slower turnaround because Quest is overloaded and is giving priority to the hospitals.
We are also seeing patients in the office when we needed and continue telehealth and tent visits when able.
PHASE THREE !!!!
We are now in phase three of the reopening, and with expanded loosening of restrictions of service-oriented businesses like restaurants, gyms, hair salons, it is likely we will see more positive tests. Wear your mask! Limit useless exposure!
Most insiders consider us to be in the middle of the nation’s big surge. We keep setting records for daily case incidence, and there are several hot spot states. So far death rates are not matching the surge’s intensity. That’s what we hoped for. Pray with me that it remains that way.
(FYI. There is interesting discussion out there about prayer in medicine.)
BTW, we spent March and April saying we wanted to flatten the curve, not eliminate it. Despite confusion and chaos we appear to be on a reasonable pathway to keeping the curve flattened in some but not all states. An emphasis on smart, careful measures like we do here in Berkshire County will move this thing through. We can be really smart and wear the virus down. (More to come on immunity below.)
Containment and waiting for a vaccine is not our best strategy but seems to be on a lot of people’s minds. A rushed vaccine is what science-fiction horror stories are made of. There is no guarantee that we will be able to come up with anything worthwhile. Attempts at coronavirus vaccines have been made over the last couple decades, to no avail.
Did you know researchers will have to watch for artificially produced antibodies through the vaccine process that can make the viruses effects more powerful? This is an actual phenomenon called Enhancement. It happens sometimes in vaccine attempts. I’m constantly reminded of what my physician Uncle said to me at my medical school graduation. He told me, “despite all the technology, modern medicine is still a shot in the dark.” That wasn’t yesterday but I would tell the same thing to my nephew were he graduating today from medical school.
I’m not a pessimist, I’m just in support of a revolutionary make-over of how we view the human being and subsequently what we see as smart interventions. (More to come.)
People are still not sure what to make of the whole immunity question, ie, whether or not immunity will persist. There are very small datasets triggering big speculation. Maybe immunity will last 6 months at best, they say. Maybe it only lasts as long as the antibodies are detectable, they say.
If I may, I’d like to make a suggestion. RELAX ALREADY. It’s going to play itself out. Our news coverage is like an anxious back seat driver. There’s lots of different scenarios with this, just like there are risks when you decide to get out of bed in the morning, even when there is no dang Pandemic going on.
Most likely we will have immunity. If it’s not perfect immunity then most likely if we get it again it will be muted and cause a milder infection. Why worry about the worst case scenario? If you did that in life I would tell you to settle into the present and don’t get out in front of yourself. Even if we must face the unlikely worst case scenario (we can get an infection over and over), we will adapt. The human spirit will prevail.
Holistic Philosophy 101
As growers and learners, we have a starting point that is incomplete. We feel an inborn need to change our state. Learning is the purest way to do that.
I want to change gears and give you a very simple 101 class on a holistic view of your body.
(OK, maybe it’s not soooo simple, but you’re super smart.)I can see why most people think of thebody as a machine. I can’t really blame them. We doctors are trained that way. And we educate our patients.
Replace this body part, cut that one out- you don’t need it; tinker with the wiring over here and the plumbing over there.
Carpenters, mechanics and doctors could almost share office space. It could save money and advance expertise. (I’m not being serious).
Bottom line: the body is not a machine! It has an intelligence that we really should behold in complete awe.
At some point after med school I was presented with a poetic viewpoint on the human body. I can’t express strongly enough just how nourishing it was to me. More and more it occurs to me that only with the right starting point can we make meaningful progress.
We want meaningful progress, right?
Well, the body-as-machine approach divides the body into 12 or 13 or 14 different coexisting but isolated systems, for example endocrine, immune, digestive systems. This leaves us with no greater understanding. The poetic view of the body taps into a finer organization that is interactive and integrative. And I’m not just talking about, for example, how the digestive system informs the immune system, etc- although that type of thinking is helpful.
I can start you off with a small understanding with vast implications about the human organism. The lead in recalls the idea that man is created in the image of God, so this is no small exploration. Central to this glimpse of the body is the number 3.
There is a threefold nature of the body. Three is a huge operative number. It needs to be kept centrally in mind when you explore the human body. First I want to point out that there are two opposite poles. Let’s start with those two, then we will add the third.
The first pole is the head,which houses the brain and is the sensory headquarters of the body. The main sensory organs (eyes, ears, taste buds, balance centers, smell and taste organs) are located on the head.
This is where the world enters us (through the senses) unchanged.
Stillness is important for accurate processing.
Coolness is best for a brain to take in percepts properly. No hotheads please!
Vitality and reproduction are low (blood flow is limited)
This pole is open to the outside environment
The other pole is our digestion and our limbs. Food as nourishment enters here. We incorporate this through our digestive tract. We greatly alter the substances as they comes in. We need to destroy these substances that we allow to enter our body.
Here the world is changed completely as it enters
Movement is key at this pole of the body.
And warmthis paramount. A cold, immobile gut is problematic! The limbs need to keep mobile and are best warmed up.
Vitality and cell reproduction are high…reproductive organs are here!
This pole is closed to the outside and doesn’t have a direct connection with the surroundings like the head pole does.
They are crystal clear opposites, hidden in plain sight!
The cool, still head pole has a contracting nature. The warm, mobile pole of the metabolism and limbs has an expansive nature. Both poles are nourishing to us. Both poles aren’t inherently good or bad. Health is their balance.The third area lies in between the two poles and makes a distinct region that is neither soley contraction or expansion but rather a region that rhythmically alternates between one pole then the other, contracting and expanding, time after time, balancing the two poles. This region lies between the head and the metabolism and has two components: the rhythmic expansion and contraction in the lungs, and the rhythmic expansion and contraction of the heart. The rhythmic systems “listen” to what needs to be balanced and adjust and heal any abnormalities, as they are able to.Can you believe that is not taught in medical school? If that takes your breath away, then we come from the same tribe.
The right starting point is crucial. It opens up new insights about health and illness and the possibility for deeper healing.
That’s all the time we have for today. Thank you so much for tuning in!
It’s a good day to be alive! So speaks the indefatigable optimist in me (I like it when he is present and well).
One highlight of my week, I’m excited to share with you, was paddling on Lake Garfield with my brother-in-law and our sons and seeing a bald eagle fly by! It just may be the first time I have ever seen one!
In any event, these truly are historic times. It’s horrific on many levels, but I would offer that it also is providing the exact conditions we need for the changes we desire as a collective group.
History will ask itself- Which came first?
Which was first? The pandemic or the major societal change that is upon us? My belief is that even before the Pandemic arrived, we were living in a massive turning point. You definitely are living that change if you
think we should not settle for the status quo
believe in the power of Goodness and inclusion
think we should be awake to all the implications of our actions
Much of how we live our daily lives effects the earth in ways that we would outright reject if we made the connection with the available knowledge. For example, our oceans have massive amounts of plastic pollution in them.
Did you know ten million tons of plastic enter the oceans every year?
Did you know there are several massive patches of plastic garbage like the Great Pacific Garbage Patch which is the size of Texas?
Did you know that these patches account for only 1% of the plastic garbage in the oceans? 99% is in the depths.
Our recycling programs are not keeping up with what we set aside for recycling, so why do we buy plastic?
We can connect our actions with our values more and more, just by setting out to do so…..with knowledge as our guide. And the actual doing is everything.
At the end of last week we started to hear of a few cases among our patients and their contacts and in the greater community here in the Berkshires. This was the first time in a while we heard that. Three out of four of the cases involved airline travel from hot spots.This got my attention. Could we start to see community spread again? Reassuringly, over the ensuing several days the daily case count stayed on it’s average of only one new case per day in the county. So far no spike. Although yesterday we had 5 new cases. So please be aware that even though the national spike is elsewhere and MA is doing very well, we should still be on our toes.
Trending COVID Topics
There is lots of talk about opening schools and how to do it. Also there was big news about sports seasons at the college level being cancelled. But the biggest recent news is the discussion about airborne spread!
It became a big topic this week after the NY Times reported on an opinion letter authored by over 200 scientists across 30 different countries declaring that the evidence points strongly to this possibility.
Why do they say that?
In part it’s because of what the contract tracers are seeing. This bug spreads like a wild fire. Half the people who have tested positive for it, don’t know where they got it. There are no suspicious contacts in their lives. We know that the majority of cases are undetected, probably the vast majority. The airborne spread idea has lots of implications. More on this below.
First, explain airborne.
Compare it to droplet spread, please.
It’s all about particle size, not of the virus but of the molecules that carry the virus. Aiborne spread means the infectious agent can stay intact and infectious in smaller particles that linger in the air. Droplets, on the other hand, are larger and fall to surfaces faster. Surfaces then become important in that situation.With airborne infections point of entry into the body can be mucus membranes and our breathing or even our ocular membranes: the eyes! In hospitals eye protection is important with airborne infections. Airborne spread in general is more contagious and requires more precautions and further distances.
But hold on! It’s not all bad. This has positive implications as I will share below.
More basic facts, please:
Common airborne diseases include:
Varicella (chicken pox)
Examples of droplet spread:
Pertussis or whooping cough
Influenza or the flu
Meningitis (bacterial or viral)
It’s important to note that there is crossover. Flu can be airborne a minority of the time, for example. There is a lot of ambiguity as to exactly where the different agents fall on the airborne vs droplet scale. For example, I’ve seen Ebola as well as strep on both lists. Ladies and gentlemen, it’s not exactly guess work, but it certainly isn’t black and white!
What do we do with airborne infections?
FIRST, the approach to an airborne pandemic virus involves improvingventilation. This to help exchange air between the inside and outside of a building. This will be a big task for many businesses. In the short run, until we hear more, I would advise to consider avoiding indoor public facilities when you can, especially if our local case numbers spike. The best ventilation is outdoors in the open expansive air.
I can’t say enough about getting outdoors. The dispersing nature of open areas and also the UV light is so vital in getting through this. Look at this crew of hikers practicing excellent physical distancing on their walk through Bartholomew’s Cobble! (OK, you got me. That’s actually New Zealand)
SECOND, We might find ourselves with stronger recommendations on how to protect ourselves. Masks and hand washing are still the biggest protections, we may want to add in eye protection. We might see larger distance considerations or at least firmer policies on masks. More to come.
And the THIRD important consideration is give consideration to cleaning the air in your space. The basic filtering methods include mechanical air filters, UV purification, HEPA filters, and ion generators. Stores will consider having UV lights to treat their store after everyone leaves. Again, more to come. Stay tuned to this topic.
In other news, contact tracers are hard at work and are collecting data. Activities which have an inherently high risk of spreading the coronavirus, per their observations, include:
drinking in a bar,
attending music concerts,
eating at buffets
playing physical sports with significant contact like basketball.
Working at food processing plants
Drinking in a bar tops the list. It turns out bars aren’t healthy after all?! Hmm!
C’mon, you knew that!
This one stands out to me for a few reasons. I like to talk about alcohol. Can I lead you on a short tangent. Bear with me.
Alcohol proponents have us believing that regular drinking is good. Alcohol lobbyists with billions to gain are lurking around every corner reinforcing that idea. A large meta- analysis recently determined the safest alcohol level to be none. Zero. Nada. You don’t have to be a tea totaler, just know that alcohol isn’t medicinal.
Actually, drugs including alcohol cause you to loosen your grip on your consciousness. That’s sounds ok, right? Not if you understand the highest and healthiest goal as becoming the master of your domain, the president of the board of your inner company. If you’re not working to create and cultivating an approach towards a commanding presence in your doings then you’re missing an opportunity to thrive, in my opinion.
It doesn’t matter what your circumstances are. Finding access to the nuance of the moment and turning off autopilot is an option for everyone at every moment. Emily Dickinson called it removing the film of familiarity.
And substances are a distraction to this whole event. It’s like checking email on your phone for the eveningwhen you finally get a good night for viewing the Aurora Borealis.
Conclusion: What does it mean that we may have airborne spread?
Ok so here goes. Evidence supporting airborne transmission of Coronavirus might actually be good news. My opinion is that because of the ease of spread discussed here and the fact that we had our main exposure long before we could test, I think it is possible that we in the Berkshires are close to achieving mass immunity.
Let me take you back to Feb/March. We had a bare-bone access to testing if at all, and it was only for the sickest. Cases were rampant. The ERs were dealing with cases in large numbers. All the radiologists were reporting large numbers of CT scans of the lungs that had classic COVID findings. People weren’t coming in unless they had to. I can’t prove it, but in my estimation it is likely there was massive exposure at that time, the vast majority being asymptomatic. The proof comes if we don’t surge with positive cases when and if infections come in from out of town. Watch for that.
We have 600 plus documented cases in the county as of right now. It’s an insanely bad underestimation, as is every county’s, even if you just factor in the fact that testing misses many cases. We also have to account for the fact that the majority of the cases are asymptomatic and wouldn’t even qualify to receive testing by state officials. I may be being aggressive with these numbers, but I want to emphasize the possibility that we may have had 10’s of thousands of cases in the County!
And we have no capacity to determine that or to disprove that. The test that looks for antibody evidence of a COVID infection turns negative in 90% of people after 8 weeks, so when we went to evaluate those feb symptoms in April with the antibody test, the massive exposure easily would remain hidden in plain sight because the false negative rate was so high- over 90%!.
Yes, the optimist is on a roll today. It’s true we can’t prove it, but neither can we deny the possibility that the majority of our community has been through the COVID tunnel. Airborne transmission would make it more likely that we had a massive exposure. That’s my point today. I present to you not a fear for the future but a possible reassurance from the past.
And, like I have said previously the absence of a single report in the last two months of a second infection speaks volumes to me. 13 million cases worldwide and no one with a credible story about a repeated infection. Very good immunologists with coronavirus expertise have said it is very likely we will be immune for life after infection.
Want more evidence?
The three states with the highest death rates (from their early outbreaks): NY, NJ and MA are the three states that are closest to achieving containment, per recent reports. Yes they have good testing programs and tracing capacity. That’s a part of it. In my opinion the most interesting reason is because the majority of people in these states may have been exposed and are immune! Remember the most common symptom of COVID infection is an absence of symptoms.
Places in America that saw barely any cases before the shut down have a different path through. New York and MA and NJ were hit hard and have likely a high instance of immunity, certain to be higher than even the most optimistic estimation that the mainstream can give (in my opinion).
So we will watch closely and continue to act just as carefully as ever. And hold in our heart the possibility of the best possible scenarios for ourselves and the entire world.
With all the uncertainty out there, the medical community has no choice but to lead with humility. It’s the path to better answers. I heard a term this week called medical democracy. I understood it to be the opposite of medical dictatorship. One size does not fit all in life or in medicine. Individualized care and soft universal mandates are smartest. It’s the best and only safe way forward.
This week we saw the virus’ spread accelerate. It seems to be never ending, but it will pass. One medical official postulated that by January we will be mostly through it. It’s tough to know, but in the meantime, we need strategies to remain sane…and healthy.
A greater understanding connects us to solutions. The more understanding we can weave around the problem the more likely we will find meaningful actions. School is in session!
Today’s lesson, class, is on cutting edge viral theory that will remind you of your capacity to remain whole at every moment during any situation.
Who wants a little lesson to help you through the Pandemic?
Very well! So, you probably have been given the idea that viruses are tiny, beastly, foreign invaders that highjack our cells to make more virus then release their progeny by killing the cell in some sort of self-serving (psychopathic) manner.
Suspend that narrative for a minute, take in these three facts about viruses, and let’s see where we arrive.
#1 All living cells have viruses, even down to the one-celled organisms. No cell is free of viruses. We should wonder as to why we consider their presence abnormal. It is better to see viruses as part of the normal machinery of the cell. That’s different!
Viruses are ubiquitous in the environment. Millions of airborne viruses are wafting around you each day, and billions more microbial travelers are descending everywhere on Earth, after riding air currents around the world.
The soil, our oceans and our bodies also contain massive amounts of viruses.
Viruses are little non-living packets of genetic (DNA & RNA) information. They enter and leave cells in a highly regulated fashion. Sometimes they cause disease, but many times they don’t. Viruses leave behind a piece of their genetic sequence. After recovering from an infection there will always be a piece of that virus encoded within your DNA.
A large percentage of the human genome is actually viral in origin. 50% of the human genome is said to have a viral etiology! The genome insertion can cause disease or can bring important benefits.
Professor Luis P. Villarreal, the Founding Director of the Center for Virus Research at UC Irvine, says it like this: “So powerful and ancient are viruses, that I would summarize their role in life as ‘Ex Virus Omnia’ (from virus everything).”
We have barely begun to understand viruses. They are invisible to microscopes and weren’t discovered until 1940 when the electron micrograph was invented. 99.999% have not been described in detail. The origin of viruses is unclear.
Much to ponder
Putting this together raises the possibility that there’s more going on than meets the eye. Who’s getting what I’m saying?
Excellent! Let’s tie this in to 2020 goings on.
On to SARS CoV-2
On a couple of occasions, before the Pandemic, a doctor named Zach Bush MD lectured that the Hubei Province in Central China (where Wuhan is) was rife for the next pandemic. Why? Because they use more pesticide and other unnatural farming techniques than anywhere else in the entire world. Amazing, right?
Stress to the environment stimulates nature’s adaptive responses. Bush postulates genomic information is being passed in this novel virus to the host which learns an important advantage. This virus is a nano-communication, just like any other virus. The majority of people don’t even know they are incorporating it, but a minority get quite ill in the process.
Why do some people get sick?
So why do some people get sick and even die from these things we used to think of as invaders, but now think of as communicators?
One major factor is pollution.
Remember the link between COVID case mortality and air pollution? A Harvard study from the end of April showed us that each incremental increase in measured air pollution in a city effects the death rate in a big way!
A recent study showed that heart related deaths, the leading cause of death in older people, are also connected to poor air quality. Are we dying for our industrial enterprises?
The implicated particles are produced by combustion sources such as car engines, fireplaces and coal-fired power plants. They’re small enough to be breathed deep into the lungs where they can cause chronic inflammation.
Got me, class?
Good. Here is a refresher on helpful measures:
Eliminate tobacco smoke
Reduce your use of wood stoves and fireplaces
Don’t burn leaves, garbage, plastic or rubber
Use HEPA air filters and air cleaners designed to reduce particles
Drive less: carpool, use public transportation, bike or walk
Keep car, boat and other engines tuned
Inflate tires to the recommended pressure
When refueling: stop when the pump shuts off, avoid spilling fuel, and tighten your gas cap
Use low-VOC paint and cleaning products, and seal and store them so they can’t evaporate
Choose energy saving appliances
Set thermostats higher in summer and lower in winter
Turn off lights you are not using
We can have hope that the fall in pollution from the shutdown, when our cars and airplanes were in the garages and hangers, will weaken the death rate. Pollution levels are certainly lower. It is uncertain as to whether previous exposure will count too heavily.
It is Interesting to know that winter is a time of poorest air quality. Bush postulates that this is why we get flu season when we do. Interesting to think in those terms.
What remains clear is improper care of our environment stimulates disease, death and suffering. And, disconnection with nature stimulates novel viruses.
Remembering our connection with the world is the Healing Step!
Steps to mitigate it: Easy as 1,2,3
Consider the earth as a part of our larger human body and treat it with utmost respect. We win when every part of us is well.
TWO! Consider societal structures and the environment to be the most fitting arena for intervention. Clean our air, water and soil and our understanding of the world and our role in it. Our deepest research shows that advances in sanitation and hygiene account for far more of the improvement in life expectancy over the last 120 years than does the creation of vaccines and antibiotics.
Let’s avoid the trap of tinkering with the world and when it makes us sick tinker with the body because it cries out in protest. Respect the vast intelligence in the body. Support natural cures that keep the body whole.
Viruses are communicators. Supporting careful, considerate, loving communication in your life supports careful, considerate, loving communication everywhere. Let’s model peaceful communication. Ghandi said to be the change you want to see in the world.
One must first create peace in himself if he desires to see peace in the world; for lacking peace within, no effort of his can bring any result. Bowl of Saki, July 2, by Hazrat Inayat Khan
Everyday we cast a vote for how we want the world to be. We cast it in the way we talk to others, in the way we talk to ourselves, and also in the way we choose to spend our money and the type of industry we support when we do so. Let’s line it up.
Struggle isn’t the problem, not learning from it is.
Committing to expanding our understanding, lovingly, is the first step to being blessed by illness.
What a year so far! We have been through so much, and as we reach the halfway point, there appears to be a lot of work remaining.
I’d like to share with you a couple of thoughts on what can be done to confront the uncertainty of this year fearlessly-and to be part of the critical mass that is ready to do today’s important work. It’s all here, read on. I invite you to fully take on the adventure of what lies ahead.
First, we have an important announcement. We have some exciting news! After a thorough, inter-galactic search we are excited to announce the addition of a new member to our administrative team.
She is a recent transplant from Austin, Texas and starting Monday will take reins of the command center next to Nicole in the front office, completing tasks for you and us with care, timeliness and precision. We are all excited! Be sure to watch for her.
Today’s theme: No Fear
Now on to the theme. FEARLESSNESS! This just has
to be an active goal, a priority in our lives.
It becomes clearer and clearer that fear is a nasty driver of our 21st century ailments, whatever they may be. It is the main cause of our self-interest pandemic which fuels disconnection and disease, both individually and socially.
Healthy community is a part of our makeup, and we respond when we see it:
Studies show that volunteering can lower your risk of early death by roughly 22 percent.
In one experiment participants who were assigned to conduct random acts of kindness had their leukocyte genes less tuned toward inflammation — which is a good thing, since chronic inflammation has been linked to such conditions as cancer, heart disease, and diabetes.
Bottom line: Volunteering, charity donations and kindness all contribute to better health.
Fear is an illness. An amazing starting point to healthy community is working daily in an active way at confronting fear.
Healthy fear-fighting habit # 1 Work to acquire serenity when you think about the future. No matter what theoretical concerns you wrestle with. No matter the degree of uncertainty. Practice it.
We have our new tent set up (fresh air is the wild card against COVID). We see people inside when we need to. We continue to do lots of phone check-ins.
BMC has a well-vetted antibody test. We have had several conversations with the pathology team there and have decided to use their lab for COVID antibody testing. Let us know if you want to have the test done.
Numbers are good locally and have continued to decline in Massachusetts and the Berkshires as well.
Big numbers coming in from around the world, especially where the virus hasn’t been seen before, especially in areas where air pollution levels are high. It took more than three months for the world to see 1 million confirmed infections but just eight days to see the most recent 1 million cases.
Many areas around the world are overwhelmed with the front end of the pandemic. States with surges are turning back their roll-outs. The basics tools remain:
wearing masks and keeping hands away from the face
physical distancing and open air meetings
smart policy for air pollution reduction
We only do well when we all do well. That’s the “WORLD FIRST” philosophy. We as a world community have to go through this; there is no way around it. We are stronger for doing it. We can lessen the impact by sticking with our healthy habits and thinking in terms of helping out whenever and wherever we can.
Fearlessness Tip #2: Look forward with absolute equanimity to what may come out of the future. Good things come in surprising packages. Don’t be quick to judge.
Update on Antibodies
A study out of China this week reported the tendency for COVID antibody levels to decline in subjects recovering from COVID infections. A small number of symptomatic and asymptomatic patients were serially tested to follow the levels of antibodies (75 patients total). 90% showed sharp declines by 2-3 months.
Does declining antibodies mean we can get COVID twice? Short answer: NO. In February, March and April there was a lot of attention given to the question of a second COVID infection. Now that July is almost hear and the months tick by, there are not mounting stories of second infections. It looks like, in the great majority of cases, reinfection doesn’t happen, that people get infected only once. Testing quirks accounted for some of the early speculations of second infection.
Detectable antibody levels are not synonymous with immunity. Immunity can be stored in T cells, another arm of the immune system.
Experts are cautious, however, and say there isn’t evidence that an infection prevents a second one. I say there also isn’t evidence that you don’t become a better dancer after a COVID infection. So we have lots to consider.
The fact of the matter is with other coronavirus strains, the antibodies that patients produce during infection give them immunity to the specific virus for months or even years. I think we can expect immunity after an infection. Evidence supports this. Be careful and don’t test it, but practice serenity and equanimity around this.
Third fearlessness tip : Consider that whatever the future has in store for you is like a gift from a wise friend. Seek greater meaning in everything you experience.
If antibodies disappear, how can we tell who has had an infection? How can we tell the true incidence? The answer is, we can’t! Researchers at Penn State this week estimated that there were 80 times as many cases in the first months of the pandemic as reported based on analysis of testing and influenza like illness reports! That’s good news. Because the infection can only spread to people not exposed previously. And the case fatality rate would be lower than currently reported.
Underreported cases and undetectable antibodies combined with suspected enduring immunity means we are moving through this possibly a lot faster than anyone is predicting.
And then there’s this: Italian doctors were back in the news this week still saying that despite having their economy opened up, the intensity of the cases they are seeing continues to be much less. They are not sure why, but larger than predicted exposure likely plays a roll.
We are going to get through this!
The Pandemic has torn us from our everyday, often misdirected, routine. We face a pressing need now and we have to give it our full attention. It’s made our agenda simpler in many ways.
It’s a metaphor for what we all have wanted all along. We don’t want to get lost in the meaningless goals in our life. We want to be absorbed in the things that we should be doing. When it’s all said and done and we have the grand review of our life, we will be proud of the things that touched us or others. We will recognize fear as a useless exercise. We will be proud when we did good, when we found new answers, when we contributed to the healing of every being on the planet, when we gave more than we asked for.
COVID is a practice-run for connecting to deeper meaning in our lives, to hidden elements that have been present all along but were ignored. Here’s to doing more of the real work of our lives.
Final tip for the Fearless Practicioner: Know that you have help and you are not alone. The whole universe in all its mystery is backing you up. Trust that!
(Tips paraphrased from a verse from Rudolf Steiner‘s work)
“The greatest threat we face now is not the virus itself. It’s the lack of global solidarity,” WHO Director-General Tedros Adhanom Ghebreyesus.
That is something we can fearlessly start working on right now.
The days are long and so n! (despite the challenging circumstances).
There is a lesser-known holiday celebrated in several countries this week called Midsummer’s Eve. It falls on June 24th and is also called St. John’s Day or St. John’s Tide Day. This day is said to be the day of birth of John the Baptist. It entails outdoor parties, singing, dancing and bonfires.
It’s a national holiday in Sweden and Finland. There is a lot of richness to be had in living deeply in the cycle of the year.
Meanwhile, back in COVID country…
The News is making us Crazy
Whether its scrolling social media posts or plopping in front of the old TV set, we are imbibing a seriously strong substance when we take in all the news stories that we do. For everyone who has been ravenously following breaking reports on the progress against the pandemic, I’d say two things. First, be careful. The news can make you ill. If we only took in a fraction of what we do, we’d still be quite informed but have a clearer head. Secondly, from all the confusing, inconclusive medical content in the news we are getting a reminder emerges about how opinions and best practice change depending on what new data is collected.
This week is a good example. Some big news arrived about dexamethasone. Its administration lessened the death rate in critically ill (intubated) patients by 1/3! It was less helpful in patients only requiring oxygen, but still lowered deaths by 20%! That by far is the biggest therapeutic news this year! If this data proves to be true, a lot of people will be saved. And, steroids are quite inexpensive!
It’s curious because our Intensive Care Units avoided steroids at the beginning of the Pandemic due to experts taking into account steroids’ lack-luster performance with SARS and MERS.
When we don’t know we make speculation. It is highly susceptible to getting reversed. Truth is fickle in medical science, unfortunately.
Being a doctor is not just sitting around measuring people’s smiles, you know.
It’s a difficult business, often not having clear answers. The toughest part about my training years was asking “why?” and hearing too often “we don’t know.”
And that unwelcome chorus continues:
We don’t know why COVID raises the risk for diabetes.
We don’t know why A blood type fares worse.
We don’t know why some people have a symptom set very consistent with COVID but test negative.
We don’t know why some people are asymptomatic and others are severely effected.
And the list goes on and on.
Why is a particular person sick in a certain way? “We don’t exactly know.”
With scientific study we can slowly pick up knowledge bit by bit, and it’s amazing what we can amass with time. Science is so great! It’s a source of great hope. And we can always rely on the results of our studies, right?
Why? There are two problems:
Data is often Not Reproducible– what happens when the studies can’t be replicated?
The psychology literature is notorious for this. A few years ago a large group of researchers in Virginia repeated the original work in 98 papers from three psychology journals to see if the results were reproducible.
Less than 40% of the studies could be replicated. That’s a big puzzler. Maybe we can’t rely on yesterday’s conclusions!
Corruption- fabrication of data. This is worse. Way worse.
In the news this week:
NIH firing of 54 scientists, for lying about their connection with foreign countries.
Florida scientist fired for pushing back against orders to lie to the public- she was told to make the COVID numbers look favorable to reopening efforts. She refused and now has her own site. Good for her.
Lancet and NEJM retracted a recently published influential paper when the data was found to be questionable. The study raised safety concerns about Hydroxychloroquine. We know how politicized that medicine is! The WHO reportedly was influenced by the paper’s results and paused enrollment in a clinical trial testing the drug. The authors denied an independent reviewer access to their data, heightening falsification accusations.
We need clean and rigorous scientific data. It’s tough know what we can believe when certain people have deep investment ($, etc) in making other people think in a certain way. Manipulation is everywhere nowadays.
Really look at this quote by Harvard Medical School’s Dr. Marcia Angell:
“It is simply no longer possible to believe much of the clinical research that is published, or to rely on the judgment of trusted physicians or authoritative medical guidelines.
“I take no pleasure in this conclusion, which I reached slowly and reluctantly over my two decades as an editor of The New England Journal of Medicine.”
This is the world we live in. We might as well know it. We might as well face it. We clearly can’t passively depend on someone else for guidance.
Is there a way through this?
Ever heard of a scientist going to prison for lies? In Europe you would. Fabricating data can land you in prison in other countries!
But forget it, because we would probably somehow just end up with a bunch of good guys in jail. It would get flipped. I think there is a better mandate anyway.
“We are living in a time of hard tests for humanity,
and these tests will become harder still.
Many old forms of civilization, to which people still mistakenly cling,
will sink into the abyss,
and there will be an incessant demand that man must find his way to something new. ”
We won’t find it on TV and we won’t find it on social media. Apparently we need to be cautious in the science magazines. I would argue we won’t find it even in nature. There is a different way to face an illness, to run an economy, to protect our communities, to live our lives.
Remember Midsummer’s Eve? St John’s Day on June 24th?
In her book Karen Rivers writes, “John the Baptist represents man at the center of history, devoted to what is beyond himself, to the revelation of the spirit brought by Christ. His summons was to turn inward, to search within toward a confrontation with oneself.”St. John’s Day is a fitting time to re-assess and re-balance ourselves in this spirit. And to ponder our inner fount of truth, to confront ourselves.