On Herd Immunity: or Not

Path of least resistance AND looking at new ways of getting information (mostly for me) out of my “second brain” of Roam Research (“networked tool for thought) and into a place that has at least a weak possibility of finding its way into other minds and unlikely conversation:

So I will, from time to time, post stuff in this fashion. In this instance, all “highlights” are pulled directly from the long article to help me better understand the content. In future, at times, I will add my own commentary. FWIW.

►Most important info here: learn about Rt versus R0 (R Nought) and what they mean with regard to COVID rise and fall.

In Roam, I will further digest such a piece via “progressive summarization” so that I have some level of mastery of the details. But enough, already.

Article:: Dangerous misunderstandings by [[Dr. Felicia Keesing]]

Dangerous misunderstandings | Cary Institute of Ecosystem Studies

  • Tags:: #roam_highlighter #pandemic #prevention
  • See also graphs by state of Rt Rt: Effective Reproduction Number
    • 📌FBF: this is really worth a look!
  • See also Herd immunity | Cary Institute of Ecosystem Studies
  • Highlights::
    • def: Rt, the effective reproduction number
    • What does it mean to say that Rt is less than one?
      • It means that if 10 people were infected, they’d infect only 9 others (in the case of Rt = 0.9) or 8 others (in the case of Rt = 0.8). Whenever Rt is less than one, there will be fewer and fewer infected people over time. The further Rt is below one, the faster this decline will happen.
      • Right now in the United States, most states have an estimated Rt of between 0.75 and 0.98. A handful of states have Rt above 1, but even the highest – Minnesota this week – is only at 1.05.
    • In most places, if we kept doing what we’ve been doing for long enough, the disease would slowly, slowly decline, potentially to zero
      • The three important points about this are these:
        1. The decline to zero would take a long time. Months and months. And months.
        1. Along the way, more and more people would be getting infected, and some of them would die. The total number of people infected at any one moment would be declining, but the actual people suffering would keep changing.
        1. As soon as we change what we’re doing about social distancing, hygiene, and quarantining, Rt will change as well, almost certainly by going up.
      • A problem for many of the reopening scenarios is that they assume that there is a threshold density below which students (or workers) returning to campuses (or offices) will be “safe” and above which they won’t be. But at least for now, there isn’t. For now, the less contact infected people have with others, the safer it will be[3]. It’s not a threshold. It’s a continuum.
    • If we want to reach the thresholds of *safe* or *normal*, we will need better solutions
      • For example, we could reopen higher-density settings, including campuses, (fairly) safely if we could test everyone daily, trace their contacts, and quarantine anyone who tests positive. But we can’t [4]. We could reach a threshold of something like normal if we had a safe, effective, and widely available vaccine. But we don’t.
    • As we plan the details of when and how to reopen more spaces and activities going forward, we face two critical issues.
      • How to lower the risks as much as possible
        • This involves
          • finding ways to maximize both hygiene (think masks, hand sanitizer, and extra cleanings) and distancing (think single-occupancy spaces, and socially-distant cafeterias).
          • We must also have a workable plan for what to do when people inevitably become sick. How do we detect infected people quickly, and how do we responsibly and efficiently identify their contacts? For colleges and universities, how do we quarantine sick students?
          • And how do we protect the most vulnerable?
      • Determining what level of risk is acceptable
        • With the tools we currently have, it’s not a question of whether creating lower-density campuses or businesses is safe. It’s a question of whether it’s safe enough. That’s not a scientific question, and it doesn’t have a scientific answer.
      • ❗R t versus R nought ❗
        • The effective reproduction number Rt is different from Ro (R-nought), though they’re related. Ro is the number of cases that would arise if an infected person was in a population in which everyone else was susceptible to infection. In theory at least, it’s an immutable property of a pathogen. In contrast, when some people are immune, through prior exposure or vaccination, or when people take active steps to reduce transmission (like washing hands or social-distancing or wearing masks), we need a different number. That’s Rt. It’s a measure of the number of new cases that are actually arising from each infected person, and it can change based on our behavior.

The Future of Feeding Ourselves

Food for Thought: Can we continue to rely on the decades-old means of growing, harvesting, shipping and buying fruits, vegetables, meats, dairy and other products when COVID-19 impedes this complex web of frail links in every segment of the grocery-chain?

This article appeared in the Floyd Press (Floyd, VA) on April 31, 2020.

If you read it there, you probably did NOT go to the resources page, and you should at least give a look for links to planting, gardening and online ordering for local food.

Feeding ourselves through and beyond the current contagion must take on a new priority right away.

The COVID-19 pandemic is creating previously unknown problems we must deal with regarding all aspects of food and eating. It has exacerbated existing deficiencies in the commerce and consumption of food; and it has caused consumers and land-stewards to look again at the agri-business history of broken links in the chain between fertile soil and hungry bellies.

Let’s take a quick look at threats to our food supply, and then consider food choices we can make now that require the fewest food miles, provide the highest nutrition and offer the healthiest means for us to buy and eat local food, and all this, while supporting our farmer-neighbors.

The present and future impacts of COVID-19 on our at-risk food supply are many. In this short space, we can only paint concerns in the “grocery cycle” with a broad brush. What might go wrong?

–Border issues and COVID19 risks brings about a lack of workers to plant and pick

–Timing failures in harvest, shipping, shelving and purchase of perishables

–Lack of healthy truckers to transport food across the continent

–Bottlenecks in supply chain fail to route shipments to areas of greatest need or workers (meatpackers etc.) become infected creating weak links in delivery channels.

–A rigidly-structured food system fails to repurpose product for end-buyers- — from empty cruise ships, universities, restaurants and Disney World to local grocery stores where demand is high.

–Food protectionism suspends exports and prevents imports

And looking at the consequences of just this short and partial list of issues, the likely outcomes include:

–Massive Food waste. Fresh vegetables being turned into mulch. Millions of gallons of milk being dumped. Slaughterhouses idled by sick workers.

–Maldistribution of available food not reaching the most needy and at-risk

— And soon to come: Much reduced variety for non-local and out of season fruits and vegetables, and…

–Worsening shortages and a significant increase in food prices

In the midst of these concerns and increasing agri-biz dysfunction, a revolution is rapidly unfolding in the local-foods landscape. Online orders have increased enormously, nationwide, in the past two months.

Access to locally-grown and available meats, cheese, fruits and vegetables has become a digital priority. With the requirements for social distancing, plans are being made by individual providers to take online orders and provide for safe exchange in the US, including Floyd county.

The existing social and natural resources in rural SWVA put us in good position to take immediate action in this time of urgent need to move ourselves back towards food sovereignty and security.

The season for The Floyd Victory Garden has arrived. And our local farmers and gardeners can help both nourish and educate us in this community effort to feed ourselves. What can we do now?

— Use the Floyd Market Guide to find local vendors, many of whom have online ordering. Support our Food Champions and join them working the soil.

— Learn how you can shop safely with social distancing at our Farmers Market, opening May 2.

— Find out what the needs are for donations to local food banks such as Plenty! where volunteer services are complicated by COVID19.

— Ramp up your backyard garden with extra rows for surplus to give to neighbors. Ask for help and information for tending larger and more productive gardens and orchards. Let’s do it now!

You can view and/or download helpful information on these food-centric actions and more at this link: https://www.are.na/fred-first/food-beyond-the-pandemic

Gramps Gets Night Cramps

coffee, copy, maker icon

I not uncommonly fall asleep on the love seat in the front room at bedtime, especially if the wood stove is glowing and radiating sleepiness into the darkness.

As usual, last night I woke up after an hour or so, and proceeded to head off to bed, after undressing. I was down to my Carhartt work pants, and do not remember doing anything particularly unusual, movement-wise.

And at once my left leg locked in the most violent and unrelenting cramp I have ever had. The inability to break this spasm was due to two reasons: it was in a muscle that never in my life had cramped before, and worse, I was trapped with my pants around my ankles.

Vastus Medialis Muscle: How to do vastus medialis exercises
Yes, these are my legs! The vastus is the “teardrop” shaped muscle near the knee.

The cramp was in my medial adductor—not in the rectus femoris of the quadriceps femoris that runs straight down the front of the leg to the knee. The rectus femoris is not an uncommon site for leg cramps—that and the gastric-soleus “calf muscle”. I think most everybody has these muscles seize up on them at least once in a lifetime—some of us more frequently than that, unfortunately, because the pain is like no other.

And so in the first seconds of the sudden out-of-the-blue cramp, even in my groggy state, it occurred to me that I should do a quad stretch for the rectus femoris. Since if lifts the knee, the stretch is to the opposite—to straighten the knee and move forward with the foot on the involved side firmly on the floor, putting tension across the front of the thigh. Or if possible, do the runner’s stretch by bending the knee and pulling the heel towards your butt.

Vastus Medialis Stretches. Approved use hep2go.com

But the vastus (sometimes referred to as the VMO–vastus medialis obliqus) works to adduct (pull the leg toward the midline) and flex (bend) the thigh. To stretch it requires the opposite motions: abduction and extension. Move the leg out away from the body and back.

That is very helpful knowledge, but worthless is you have pants around your ankles. I would have certainly tried the runner’s stretch, but was miserably hobbled, wanting to scream, with Ann sleeping blissfully unaware in the next room.

I braced myself on two pieces of furniture in the dark room. Nothing I could do would stop the agony. It seemed to last for 15 minutes, but might have been 10. Even so, the pain over this vast eternity of suffering was sufficient to make me diaphoretic—breaking out in a cold sweat, feeling like I might pass out.

The spasm cascade finally burned itself out and I finally was able to wobble into bed, and lie there for an hour, in fear of more spasms. I shook uncontrollably, as if I had the chills—which I think was a kind of mild shock, that at last abated and I slept through the night.

In the midst of this torture I tried to explain why such spasms, and came up with the first conclusion that I had come down with Lyme disease, sure enough, from the recently embedded tick I’d found a few days earlier. Now, I think it was due to dehydration from spending four hours with the surveyors walking hard terrain and not drinking the water I took with me.

So, given the extreme unpleasantness of my experience, I truly hope than no one I know ever has a severe, sustained cramp in their vastus medialis muscle. But if you’re going to do this anyway, take off your pants first.

Butt wait: There’s More!

Seems I am not the only one in the world to experience what is described universally by my fellow sufferers as “almost unbearable pain that made me scream and think I was going to pass out.”

You can read the testimonials here:

Inner thigh cramps that make me pass out | Undiagnosed Abdominal Pain discussions | Body & Health Conditions center | SteadyHealth.com

And so in addition to getting your pants off before cramping, according to these victims:

1) chew an aspirin
2) use moist heat (hot bath)
3) take a potassium pill
4) drink tonic water (that contains quinine)
5) drink pickle juice
6) and don’t eat gummy bears

To Mask or Not to Mask

Facing the Enemy: Cover yours

If you don’t already have a supply of facemasks, it might not be the right decision to even bother to find them. But if you have them on hand (say, from previous work in health care) then I’m starting to think it makes sense–especially in those instances when you might not be able to control social distancing or might have contaminated hands that go to your face–to wear the cussed things.

They may not be fashionable; and they may not be attractive; but they sure as heck are an unavoidable, uncomfortable, inconvenient necessity just now, if you happen to have one.

And read the last article I pulled from–regarding reuse after UV decontamination. To research based on this: could hanging a mask after use on the clothes line in the SUN for a few hours help kill remaining viruses? I don’t see why not.

Blocks below are all pulled directly from articles referenced. FF

More Americans Should Probably Wear Masks for Protection – The New York Times

There is very little data showing that flat surgical masks, in particular, have a protective effect for the general public. Masks work by stopping infected droplets spewing from the wearer’s nose or mouth, rather than stopping the acquisition of virus from others.

But studies of influenza pandemics have shown that when high-grade N95 masks are not available, surgical masks do protect people a bit more than not wearing masks at all. And when masks are combined with hand hygiene, they help reduce the transmission of infections.

they found that washing hands more than 10 times daily was 55 percent effective in stopping virus transmission, while wearing a mask was actually more effective — at about 68 percent. Wearing gloves offered about the same amount of protection as frequent hand-washing, and combining all measures — hand-washing, masks, gloves and a protective gown — increased the intervention effectiveness to 91 percent.

Classified data from the Chinese government that was reported in the South China Morning Post indicated that up to a third of all people who tested positive for the coronavirus could have been silent carriers.

What we do know is that individuals can shed virus about 48 hours before they develop symptoms and masking can prevent transmission from those individuals.”

Wearing a mask can also reduce the likelihood that people will touch their face,

In many Asian countries, everyone is encouraged to wear masks, and the approach is about crowd psychology and protection. If everyone wears a mask, individuals protect each other, reducing overall community transmission.

Masks are also an important signal that it’s not business as usual during a pandemic. They serve as a visual reminder to improve hand hygiene and social distancing. They may also serve as an act of solidarity

Live Coronavirus News and Updates – The New York Times

The World Health Organization asserts that masks should only be worn by people who are sick and those who are caring for them, and that there is little data showing that they protect the general public in everyday life. But some experts and government officials say they could offer some protection.

some places that adopted nearly universal mask-wearing and intensive social distancing early on, like Hong Kong, were able to contain their outbreaks. George Gao, the director-general of the Chinese Centers for Disease Control and Prevention, has called not wearing face masks “the big mistake in the U.S. and Europe.”

As Coronavirus Looms, Mask Shortage Gives Rise to Promising Approach – The New York Times

Masks are certified for one-time use only. But on Thursday, the center began an experimental procedure to decontaminate its masks with ultraviolet light and reuse them. Administrators plan to use each mask for a week or longer.

That change would seem to mean it is now acceptable for hospitals to decontaminate and reuse masks during the coronavirus pandemic, said Shawn Gibbs, a professor of environmental health at Indiana University.

Doctors and administrators at the University of Nebraska Medical Center calculated that if they continued to use masks only once, they would run out of masks in just weeks.

“The data is very clear that you can kill and inactivate viruses with UV germicidal irradiation,” he said. “It is also very clear that you will not damage the respirators.”

Researchers have tested a variety of methods — ultraviolet light, bleach, ethylene oxide gas, moist heat — and have concluded in published papers that decontamination can work.

UV light was the Nebraska hospital’s choice because it is effective and convenient. Hospitals already use UV light to decontaminate rooms after patients with dangerous infections, like C. difficile, are moved.

“We bring in large UV lamps, hit ‘start’ and leave the room,” Dr. Lowe said. “We let it shine for three to five minutes. It disinfects anywhere it can shine.”

the protocol Dr. Lowe designed uses three times the concentration of UV light needed to kill coronaviruses.

For now, staff members will use each mask for a week before disposing of it. But the medical center may decide to keep using the masks for 10 days, or even two weeks, Dr. Rupp said.

Morning Pages ~ 20 March ’20

A Garden Grows Hope

DREAMING IS FREE

It is good again to have a dream: We will be able to start a symbolic (if not a vastly productive) garden at The Other Place. It was preying on me–that we would be helpless and dependent there compared to our relative independence on Goose Creek. No wood heat. No water without power. No garden until year two.

So I asked permission to till up a patch to start enjoying the full days of sunlight and warmth we will have there that we have not had here. We give up much to move away from here, but we make some gains, too, and a garden whose soil warms before June is one benefit.

I will begin carrying over the tomato cages, T-posts and cattle panels I will use to make a crude 8 x 24 foot enclosure. A narrow fenced area seems to make it harder for deer to jump in. Chicken wire around the bottom will keep the rabbits out. There is a spot near the house with access to well water that gets good south sun and is protected by planted evergreens from the north wind.

We have a plan. We imagine continuity in the transition. We have hope, at least of vegetable life the way it used to be, if not our own. For cats or carrots, Coronavirus is not a thing. I will choose to be cat-minded when I can get away with it, and curl up–in my imagination–in front of the future wood stove that is not. Yet.

And regarding the water: Yes it is possible to retrofit an existing well (that is dependent on electricity) with a manual pump. We have some local folk who have offered their set-ups for us to look at (when people are at ease around people again) or the actual Y2K-holdover hardware. This will work out, and might be something we can begin to set in motion before taking possession over there on June 1.

The other missing piece in our anticipated new setting is wood heat. This might not get done until Winter Number 2. It might not get done at all if our former nest egg continues to be poached and scrambled into oblivion. We knew the move was going to be a financial challenge. And that was BC–before CoronaVirus.

But we can dream for free.

Earth and Sky: Build it, And They Will Come