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.
Just because there’s been a break down doesn’t mean anything’s broken
Excuse me, I’d like to have a word with you.
I’d like to speak with the part of you that feels overwhelmed with the difficulty of these times, that says — “I want to give up.”
I’d like to speak with the part of you that says, “Take a look around. Don’t you recognize the downward spiral here? What I see is decay. Suffering, ignorance, division. A veritable collective decline.”
I see what you mean. I notice it too. I’ll concede that the human race is confused and mired in chaos. We are clearly losing ground in many areas and many ways. The very ground we walk on is breaking down.
But we really should not stop there. Let’s move lightly and swiftly to discovering a way forward, through a deeper understanding.
Just because there’s been a break down doesn’t mean anything’s broken.
In the rhythm of life there are advances and declines, growth and decay. The year reveals it: Spring then Fall. Repeat. All living beings cycle through growth and decay.
Only in isolation are the declines overwhelming. Seen within a cycle, everything changes. Broaden your view and the outlook softens.
Both sides belong equally. Both are important. Both have their advantages too.
The decline serves to make way for the next growth cycle. You may prefer Spring over Autumn, but both growth and decay are essential.
“There is no rose without a thorn.” Joy and pain simply can’t exist without each other. Decay makes growth possible.
Consciousness is catabolic. It wears us down. Hmmmm. Decay is associated with wakefulness.
This time of complexity and decline on earth and in America is a time of decay, but it fits. We are awakening to what will come. Stay at it, and let it shape you.
You matter. It matters. Trust me.
Part of you might be saying,“I still feel there is nothing more for me in this life.”
You’d have the wrong orientation. Don’t ask what you can get from life…
Ask rather what you can do to leave this day better because of your smile and kind heartand good intention.
Group Hug and move on?
Berkshire County seven day rolling average remains low. (1 case per day per 100,000; ten cases in the last week).
Springfield area has seen an outbreak; making Hampshire County only one of two counties in the state with more than 10 cases per day per 100,000.
Rockland County NY is New England’s biggest hotspot with 37.2 cases per day per 100,000.
North Dakota is the country’s hottest hot spot hot pocket with some counties reporting more than 100 cases per day per 100,000!
Did you hear about the airborne nature of Virus?
The CDC came out with an update. Now their site says the virus is known to spread “through respiratory droplets or small particles, such as those in aerosols, produced when an infected person coughs, sneezes, sings, talks or breathes.”
These particles can cause infection when “inhaled into the nose, mouth, airways, and lungs,” it says. “This is thought to be the main way the virus spreads.”
“There is growing evidence that droplets and airborne particles can remain suspended in the air and be breathed in by others, and travel distances beyond 6 feet (for example, during choir practice, in restaurants, or in fitness classes),” the page now says. “In general, indoor environments without good ventilation increase this risk.”
6 feet isn’t enough if the ventilation is poor.
Indoor maskless dining needs to be reviewed.
So let’s talk strategy for really getting it and thriving with the airborne topic.
Here are the tips for the changing weather and considering anything indoors.
A) Only be comfortable with a limited amount of people in a space. My advice: Be ready to bolt if it’s crowded. I don’t like tables anywhere near 6 feet apart.
B) Check the ventilation. Indoor spaces need good airflow. Ideally the inside air is replaced by outside air several times per hour. The air exchange rate target is six per hour. My advice: stuffy rooms are to be avoided. Ask building managers about ventilation anywhere you will be a guest. You don’t want system that is simply recycling air.
C) Air filters are a factor, but DO NOT make up for poor air exchange or crowds, of course. The ideal suggestion is a filter with MERV-13 designation or higher. Or use a portable HEPA filter. Check to see if the building in question has these.
MERV filters fill up with more stuff more quickly and need to be changed. Another potential concern is with improper seals so that some unfiltered air sneaks past it and recirculates in the building; this downgrades its filtering ability. They need to be the right size to provide meaningful help.
Food for Thought
Life goes on. Pandemics come and go. Vaccines may help, but if they don’t, it’ll pass anyway. Keep the lens wide, says a trio of scientists from prestigious Universities. They say it’s a basic Public Health principle to not focus on one disease in isolation. And when they look with a wider lens they say economic fallout from restrictions can be measured in lives-lost too. And they are going to mount.
Therefore, keep the towns and schools open, so says their statement released this week out of Great Barrington’s own AIER (American Institute for Economic Research). This is being backed by tens of thousands of signers and is getting international press. Restrictions and shutdowns will have more impact than COVID’s worst case scenarios, they postulate. They are proponents of arriving at herd immunity through a smart strategy where the vulnerable are protected but almost all typical activities continue.
World Famous Locale
They aren’t the first ones to put this view forward, but they are well-respected and want to influence the discussion, with their social science knowledge. And put the hometown on the world map…once again. This is laid out in the Great Barrington Declaration with which I conclude this weeks’s bulletin.
As infectious disease epidemiologists and public health scientists we have grave concerns about the damaging physical and mental health impacts of the prevailing COVID-19 policies, and recommend an approach we call Focused Protection.
Coming from both the left and right, and around the world, we have devoted our careers to protecting people. Current lockdown policies are producing devastating effects on short and long-term public health. The results (to name a few) include lower childhood vaccination rates, worsening cardiovascular disease outcomes, fewer cancer screenings and deteriorating mental health — leading to greater excess mortality in years to come, with the working class and younger members of society carrying the heaviest burden. Keeping students out of school is a grave injustice.
Keeping these measures in place until a vaccine is available will cause irreparable damage, with the underprivileged disproportionately harmed.
Fortunately, our understanding of the virus is growing. We know that vulnerability to death from COVID-19 is more than a thousand-fold higher in the old and infirm than the young. Indeed, for children, COVID-19 is less dangerous than many other harms, including influenza.
As immunity builds in the population, the risk of infection to all — including the vulnerable — falls. We know that all populations will eventually reach herd immunity — i.e. the point at which the rate of new infections is stable — and that this can be assisted by (but is not dependent upon) a vaccine. Our goal should therefore be to minimize mortality and social harm until we reach herd immunity.
The most compassionate approach that balances the risks and benefits of reaching herd immunity, is to allow those who are at minimal risk of death to live their lives normally to build up immunity to the virus through natural infection, while better protecting those who are at highest risk. We call this Focused Protection.
Adopting measures to protect the vulnerable should be the central aim of public health responses to COVID-19. By way of example, nursing homes should use staff with acquired immunity and perform frequent PCR testing of other staff and all visitors. Staff rotation should be minimized. Retired people living at home should have groceries and other essentials delivered to their home. When possible, they should meet family members outside rather than inside. A comprehensive and detailed list of measures, including approaches to multi-generational households, can be implemented, and is well within the scope and capability of public health professionals.
Those who are not vulnerable should immediately be allowed to resume life as normal. Simple hygiene measures, such as hand washing and staying home when sick should be practiced by everyone to reduce the herd immunity threshold. Schools and universities should be open for in-person teaching. Extracurricular activities, such as sports, should be resumed. Young low-risk adults should work normally, rather than from home. Restaurants and other businesses should open. Arts, music, sport and other cultural activities should resume. People who are more at risk may participate if they wish, while society as a whole enjoys the protection conferred upon the vulnerable by those who have built up herd immunity.
Be brave. Ask the tough questions. Search hard for answers. And most importantly, stay at it! Your journey is astonishing and admirable.