that the only people trying to steal the election are campaigning under the banner “Stop the steal”? Is it just me, or is that the ultimate in irony?
I did it. The first injection of the novel coronavirus vaccine from Pfizer went into my arm Saturday afternoon. My arm did not freeze and fall off. With a substance stored at -70 degrees C (-94 F) I was hoping they’d warm it up a bit. They did. Nothing like frostbite from the inside out. While there are supposed to be only mild side effects (like the pain at injection site you get with the flu vaccine), my employer isn’t taking any chances – I was required to get the vaccine at the end of my Saturday shift so, if I get sick, I’ll be sick on my own time and won’t miss work unless it lasts 3 days. Kinesiotape at the injection site works for the flu vaccine. We’ll see how it works for this.
Twenty four hours after injection I have an achy arm, a lot like after a flu shot. I have a vague sense of dis-ease – slight disequilibrium, subtle visual changes, very mild nausea, and a slight headache – nothing that would have kept me from working if today were a workday. In three weeks I’ll let you know how the second injection goes.
We received our new shipment of PAPRs (Powered Air-Purifying Respirators) so I can dispense with the N-95 mask and patients can see my face for the first time this year (except for a week or two in February when I worked maskless). I still need a mask for the non-COVID patients and when I am doing anything else at work, but that is just a simple mask, not an N-95. They can hear me better, too. (Photo: What the well-dressed therapist is wearing these days. Isolation gown not shown.)
I’m thinking a PAPR could come in handy for the Death Ride. Nothing like extra air delivered under pressure for the thin air at higher elevations while climbing mountains. Not to mention that I don’t expect to be ready to share air at close quarters with a couple thousand other people in July.
We added a new member to the family this week. He was a street dog from Oklahoma and came to us via a rescue organization and a foster home. He seems to like it here so far. He got a little close for this selfie but, lacking thumbs, he did pretty well I think. Especially since he was drifting off to sleep. When our daughter moves out, he goes too, so I can’t get too attached. Maybe he’ll come for sleepovers. (Then again, I got pretty attached to the kids but it was OK for them to move out on their own.)
We had our first real snow and the lake is starting to freeze. Time for the studded tires. For now, I try to avoid the icy spots and ride slowly when there is no choice.
Rumor has it people have started skating on the shallow bay – the first place to freeze and attract ice fishers, who are on the ice before any sane creature.
A couple of days after that last paragraph, it warmed up; and the newspaper included a story about the number of ice rescues performed that day. None were from that bay, but skating will wait, as it has been above freezing for >24 hours.
In our culture, this season is often associated with conspicuous consumption – the TV ads encouraging us to surprise each other with new cars, telling us the only way you can show your love is via diamonds, helping us convince ourselves that joy comes from stuff. Delbert McClinton and friends tell us otherwise:
Check the sky tonight – Jupiter and Saturn will appear very close together, and just in time for the solstice. They will appear in the southwest sky shortly after sunset as long as, in your home on the range, the skies are not cloudy all day.
I was thinking about the last time I saw you. You pulled up in front of my hotel in Santa Monica with the Merlin and the Bike Friday in the car. We rode down to Manhattan Beach, then back up to Santa Monica, where we froze while eating at a sidewalk cafe. Los Angelenos have this thing about hanging out outside, even being in a desert where it’s freezing as soon as the sun goes down. Not to mention that we were in sweaty bike clothes. Neither of us knew you would die before we ever saw each other again. It was a good last visit. I remember the ride, but not what we ate.
I was in town for a workshop led by Dr. Roy Meals (see “About Bone” in “blogroll”.) I’m back in touch with him and he makes me remember you. By the way, while I enjoyed the chance to ride the Bike Friday, the Merlin was one of my dream bikes and I secretly wanted to ride it.
I was living in San Francisco during the last great plague. I lost my boss and my job to that one. It was hard to see Jim wasting away. The last time I saw him, he was blotchy with Kaposi’s Sarcoma and barely clinging to life.
So now we have another plague. This one kills a lot faster, but kills a lot fewer of its victims. When the 1980s plague hit, we weren’t sure how it spread and people tended to avoid each other (or at least certain others) until we knew. This one requires that we avoid each other because it spreads so easily. But like that other one, we’re still learning. We were first told it spread only through droplets and not aerosols. Oops, turns out that was wrong and it can hang in the air longer than we thought. Turns out the virus can live on surfaces long after the droplets have dried.
When you got a cellphone and started calling me on Mondays, we stopped writing letters. I missed that. Since I don’t have your phone number in the afterlife (nor do I know that there is an afterlife), I’m back to writing letters to you. In the children’s book “The Mole Family’s Christmas” (by Lillian and Russell Hoban), Delver Mole decides to write a letter to Santa. He doesn’t know where to reach him, but knows that Santa comes from up, so he decides to send the letter up. In the same vein, I don’t know where to send this, so it’s going to the internet, the 2020 version of up. If you want to hear the story, I recorded it on a CD for my nieces, since they were blind and unable to read. (My kids also got copies, even though I could read to them in real life.) I could maybe send it to you via the internet. The CD also contains my all-time favorite read-aloud story, “Little Tricker the Squirrel Meets Big Double the Bear” by Ken Kesey (yes, that Ken Kesey).
This plague has gone viral. It spread worldwide in less than three months. As of April 2, there were only 18 countries not yet reporting confirmed cases. Does that mean they don’t have the disease? Or that they don’t have testing? “Confirmed cases” is an interesting concept. Since we can’t test everybody, and it is cold and flu season as well as allergy season, we don’t know who has this disease. Some people have suspicious symptoms and don’t get tested. Some people have suspicious symptoms and tested negative (but the false negative rate has been reported as increasing with each day after onset, and ~30% on day ten for nasal swabs per Wikramaratna, et al [worse for throat swabs].) Dr Gary Procop of the Cleveland Clinic calls false positives extremely unlikely. We could talk about Sensitivity and Specificity and Odds Ratios and the like, but overall we lack data to draw any strong conclusions about the tests we have.
There is some reluctance to test, as that would show more people with the disease and possibly lead to greater panic. Criteria for testing vary – my PCP said I didn’t meet criteria, my Employee Health Department said I did. So we don’t know a lot. When people die during the pandemic, but have not been tested, they are not identified as having died from COVID-19. We don’t use up test kits on the dead. If people are getting better, we don’t test them. If people are surviving at home we don’t test them, as bringing them in to testing centers risks spreading the disease.
So every day we see charts with logarithmic curves of the increase in cases; and those curves surely underestimate the numbers. We see daily numbers, not rounded, which makes us think there is a level of precision which is not actually there. Despite that, we’ve crossed the ½ million threshold in the US and are approaching the 2 million mark worldwide. We’re over 100,000 deaths. All of these numbers will be higher by the time you see this.
We’ve lost famous people and unknown people. I’ve alreadywritten about John Prine and embedded several of his songs. I read this tribute today and it made me cry again. It contains a link to Roger Ebert’s review of Prine from 1970.
Much of the world is in some level of quarantine. We don’t like to use that word, so here it is called “Safer at Home”. Only “essential” businesses are open. That means I go to work (hospitals are essential). Grocery stores are essential; though I used to go to the corner store almost daily and I’ve been there once this month. When I go to the co-op, I drop >$150 at a time so I can minimize the number of shopping trips. Restaurants are not essential, but can sell take out. Most of them have “no contact” pick up methods. They set the food outside and you pick it up. Pizza places have “no contact” delivery. They call to tell you when they are leaving it on your doorstep and you pick it up after they leave – same with Meals on Wheels. In some states, gun shops are considered essential. I don’t even want to comment on that. It is like living in a Twilight Zone episode.
Our only president likes to call this the “Chinese Virus” (and he has this weird way of saying “China” – it almost sounds like he wants to say “vagina”, like Austin Powers talking about his character “Alotta Fagina” (itself a parody of a James Bond character name).
Were you still around and not sheltering in place, you would get to see American racism first hand again. Folks would blame you for this disease, even though you were born and raised in L.A.
I don’t remember if I’ve told you about the president. He inherited a real estate fortune and frittered it away. He may be the only person who managed to lose money running a casino. He has declared bankruptcy for more businesses than most business owners will ever own. He was the star of a reality TV show with the catchphrase “You’re fired!” He likes that phrase so much that he regularly fires cabinet members, press secretaries, and other senior officials. He uses Twitter to do it. Almost all in his administration have the word “Acting” in front of their titles. You can’t make this shit up.
By the way, the rest of you can read this. Curtis was a friend in LA; the last person with whom I kept up a snail mail correspondence. Since he’s not around to read my letters, that falls to the rest of you.Since he’s no longer on earth, I’ve explained a few things that may be obvious to the living. Another letter to him can be found here.
I was once proud of my home state. Wisconsin, admitted to the union in 1848, abolished the death penalty in 1853. Milwaukee was run by the “Sewer Socialists” virtually from 1910 to 1960, and was one of the most well-run cities in the US as a result. Infrastructure was built and the city was maintained. The Progressive Party rose to prominence under the leadership of Robert M “Fighting Bob” LaFollette, who founded The Progressive magazine in 1910. That magazine is still published in Madison to this day. Superior WI was, arguably, the center of the Consumer Co-operative movement in the 1920s and we have long been a center for farming cooperatives and banking cooperatives (credit unions), housing the world headquarters of the credit union movement; AFSCME (The American Federation of State, County, and Municipal Employees) was founded here in 1932.
Senator Gaylord Nelson was the driving force behind Earth Day in 1970. Russ Feingold was the only US Senator with the sense and the courage to vote against the USA PATRIOT Act, recognizing its dangerous attack on civil liberties. (Among other things, it required libraries to turn over the borrowing records of patrons, and then lie if asked if they did so. As a result, our mayor ordered our library system to destroy all records as soon as books were returned, so if the FBI came looking, there would be no records to turn over.)
But we are now the laughingstock of the nation, if not the world. In 2010 we elected one of the least-qualified governors ever to serve. In 2011, he pushed through Wisconsin Act 10, which effectively ended collective bargaining for most public employees (and explicitly ended it for employees of the state’s largest hospital). Had the Democratic State Senators not left the state, the law would have been passed less than a week after its introduction, before anyone knew what it contained, and with no debate.
He survived a recall election and established the blueprint for the least-qualified president the US has ever seen, a man who similarly survived impeachment. I will simply call them “They Who Must Not Be Named”.
And now we have become the only state stupid enough to hold an election at the height of this pandemic; the only state to hold an April election. A special session of the state legislature to consider delaying the election was gaveled in and out of session within seconds. While we are under a “safer at home” order, in which all but the most essential activities are actively discouraged, we held an election.
Granted, one can (and should) consider an election an essential activity, though time was not of the essence in the way that it is while securing food. An attempt to change the election to all-absentee was quickly shot down. The US Supreme Court intervened to prevent an extension of the deadline to mail in ballots. Mind you, many who requested ballots before the deadline did not receive them by Election Day and were therefore disenfranchised unless they chose to risk infection by going to the polls after requesting absentee ballots (the requesting of which was strongly encouraged by local governments). Absentee ballots require a witness’ signature. An Executive Order waived that requirement, as the governor recognized that a person living alone and sheltering in place can’t get a witness. After ballots were submitted, the Sate Supreme Court struck down that ruling, nullifying those ballots – but since the ballots had been cast, it was illegal for those voters to vote again in person, even if they were willing to risk going out.
The city of Milwaukee was so short of poll workers that they opened 5 of 180 polling places. Lines extended for blocks. A chart was published by NPR noting the anticipated peak of COVID-19 deaths in each state. At the time, Wisconsin’s peak was expected to be April 15. Will we now have to plan for a second surge from the community spread resulting from the election? We won’t know for a week if we set a record for low turnout
Voter suppression is well-known to help Republicans. Donald Trump has even warned that Democrats want so many people to vote that, if they prevail, we’ll never elect a Republican again. Think about that. He says his party’s only hope to stay in power is voter suppression. Democracy is to be avoided at all costs. We knew that, based on the ALEC-written voter suppression legislation passed in state after state, but he said it out loud.
Regardless of the outcome, there are bound to be lawsuits. One of the statewide measures was the election of a Supreme Court justice. The incumbent was appointed by He Who Must Not Be Named. His judicial philosophy could be summed up in his opinion that slavery and affirmative action are morally the same. If the conservative justice is elected and the election contested, will the Supreme Court step in to uphold the result to save its own? Will he recuse himself, or vote to uphold his own election? There are no recusal rules nor written code of ethics to guide the State Supreme Court. There is such a code for all other judges in Wisconsin, but the Supreme Court justices are allowed to decide for themselves. They are above all that, apparently.
So now you see why my pride has changed to embarrassment.
Here’s what the cool kids are wearing these days; at least those who work in hospitals. Shopping for groceries after work today was a lot like work – gloves and mask, just no face shield. Awareness of where your hands have been is paramount. Driving to work (so I could use the car to shop) I found myself reacting emotionally to the various COVID-19 stories on the news. Preparing for “the surge” is stressful, but others are actually facing death. It took another shot of John Prine to make me realize…
Our one and only president has accused healthcare workers of stealing PPE (personal protective equipment), such as masks.
I confess, Mr President. Current precautions (subject to change) at my place of work require me to wear a mask (plain surgical mask, not N95) with all patients, and a face shield over that to protect it so I can use the mask indefinitely unless I see a patient actually in isolation, in which case I am to discard the mask but clean the face shield. For known COVID-19 patients we use a fit-tested N-95 mask or a PAPR (powered air-purifying respirator).
As a result, I used one mask last week, as well as one face shield. I have cleaned the face shield more times than I can count, so I’ll confess I’ve also used some Cavi-Wipes, alcohol wipes, and Purell. Oh, I stored the mask and shield over the weekend and will use them again this week. There are several thousand other employees in the same hospital who are equally guilty. In fact, one of my co-workers replaced the elastic band on his face shield because it wore out, so he will confess to using a foot of Coban.
(Image from 3M)
So in one little ol’ midwestern hospital we used maybe 10,000 pieces of PPE more than in a normal week. Gee, Mr President, do ya think it’s possible that there is a legitimate reason hospitals are using 10 times more PPE than usual? If we used to use it for, say one in 50 patients, and now we use it for every patient, maybe a ten-fold increase means we are actually conserving equipment. [ed. note: these numbers are seat-of-the-pants estimates.]
John Prine has been intubated and ventilated for COVID-19. Having survived two cancers (including a lung), he may be too tough for this virus. Prine demonstrated more genius in his first album than most of us do in a lifetime. I still remember the first time I heard that record, at the apartment of a co-worker after a meeting in 1971. I thought I had a crush on her at the time, but it might have been John Prine instead.
The album opens with “Illegal Smile” – “it seemed like total silence was the only friend I had.”
If that wasn’t good enough, he followed with “Spanish Pipedream”, in whch he told us to “blow up the TV…”
He showed more insight into our neglect of the elderly than a man of 25 had any right to in “Hello in There” – “You know that old trees just go stronger and old rivers grow wilder every day. But old people just grow lonesome waiting for someone to say ‘Hello in there, hello.'”
“Sam Stone” told the story of a man returning from Viet Nam with PTSD and a monkey on his back: “There’s a hole in Daddy’s arm where all the money goes…”
“Paradise” told the story of Prine’s parents’ childhood home, now an open mine – “‘And Daddy, won’t you take me back to Muhlenberg County, down by the Green River, where paradise lay.’ ‘Well I’m sorry my son, but you’re too late in asking – Mr Peabody’s coal train has hauled it away.'”
I could go through the whole album this way – every one a gem, including “Your flag decal won’t get you into heaven anymore”. Instead, I’ll leave you with “Angel from Montgomery”, also recorded by Bonnie Raitt (speaking of crushes), and here as a duet.
As of this writing, Prine’s family says his condition is stable.
A bike club I ride with just deleted a few weeks’ worth of rides from their website. Another club posted their rides but urged people to start at different times and ride in different directions. Our “safer-at-home” order allows outdoor exercise, though not in groups.
It was one of those days. No matter which way I turned, and I rode in a loop, I never seemed to have a tailwind. It was a headwind or headwindier. The spring peepers were not practicing Social Distancing. They seem to get loud right around maple surgaring weather.
There also seemed to be a lot more cars out than I’ve seen in a while. The number of new cases of COVID-19 has leveled off in the past few days around here. That is not say we’ve turned the corner. The number of total cases is not decreasing or even leveling off. The number of new cases added each day has, at least for the past few days, leveled off. That appears to say that staying home is working. Keep it up. Go listen to the rest of the John Prine album.
Oh yeah – I sent in my absentee ballot today. Remember to vote.