This is going to take longer than we think, and that’s ok

General

[Skip this if you don’t like bad news. I don’t enjoy saying this one bit. And I don’t want this to be true. I’d like things to go back to normal next month. But they are not.]

I believe things will not get back to normal until we have a vaccine.

The various treatments undergoing trials will help, but they are not “cures”. They help reduce the duration and the mortality rate by some percentage. But they don’t reduce the numbers enough to allow us to end social distancing.

We have flattened the curve. But that just means we have pushed the surge further down. We are propping up the dam walls. The minute we ease up, the waves will come crushing through. We have to keep holding up the dam until we have a vaccine. Even gradual easing will result in the numbers surging again. We are talking millions of lives in months if we let go.

We need to do everything we can to ease the stress it creates for all of us. We need to provide a monthly “stipend” to all that empowers everyone to sustain themselves and keeps commerce ticking and for new patterns and behaviors to emerge spontaneously from the bottom up. We need to adapt society to this new reality so that it becomes easier to live through it.

It’s like a meteor about to hit earth. And we are using a tractor beam to delay the hit until we have time to build the lasers to disintegrate it first. We can’t fall for the false sense of safety that the delay creates. We cant turn off the tractor beam.

Think of the movie Independence Day. When aliens attack, we don’t talk about the economy. We figure out how to defeat the enemy. And we all make sacrifices.

Now for the good news. At worse this takes 24 months. Which is really nothing if we can detach from it and see the big picture. And the more quickly we can embrace this possible reality, the easier it will be for us. This is a test for us. Can we demonstrate the human ingenuity and adaptability that has made us one of the most successful species on the planet? Can we help each other get through this?

A simple explanation for why it’s important to wear a mask to stop the spread of a virus

General

So intuitively, when we sneeze we put our hand in front of our face right? And CDC and WHO says that instead it is better to sneeze into our elbow?

So if we could somehow take our elbow and always hold it in front of our face, according to CDC and WHO it would be a good thing?

So if we take some barrier that is not our elbow and put it always in front of our face … that’s a mask!

Any mask is better than no mask. It’s obvious! Please always cover your face with a barrier when in public. When in doubt, remember this cat 🐱

Here’s a more detailed and comprehensive explanation for why masks work. And why many of us were told they don’t work.

My personal experience with the current US response to COVID-19 (Mar 2020)

General

More than a week ago I had low fever and cold-like symptoms and dry cough. But most of those symptoms subsided. Then 4 days ago I had extreme fatigue and I couldn’t even get out of bed for almost 2 days. Very bad headache. I never take meds for headaches but I had to take an excedrin last 4 days. But no fever. And no real cold and very minor mostly dry cough. Then yesterday I had tightness in my chest and I felt my breathing was slightly labored. Today just before waking up I felt I wasn’t breathing well. When I sat up I was able to breathe better. But I felt a shortness of breath. And my voice was weaker than usual. But I wasn’t breathless or struggling to finish sentences. It just felt markedly worse than the day prior. And then I also threw up. But I didn’t have diarrhea.

None of the symptoms were serious on their own. But this quick development of things made me concerned. And I have never had panic/anxiety or asthma or allergies.

That’s when I became curious to see what it’s like to navigate the system for someone who has more severe symptoms. I was disappointed to find out that testing was highly discouraged here in the US for the same reason that wearing masks is discouraged – there are not enough of those to go around. Germany, South Korea etc would at this point direct you to get tested. The US is still catching up. Hopefully it looks like we will be there in April. Wide testing is very crucial from a public health perspective. It will help us understand the extent of the outbreak, get a truer picture of mortality rates, and more quickly and more confidently help us open up the economy. Lack of testing has severely handicapped our response here in the US.

Then I found out through a friend that CA had setup a drive-through testing center 20 min from where I live. They yesterday expanded their criteria to include my symptoms. So I was curious to see how that was working. I was too late to get there yesterday in time, but I went anyway just to see. It was an impressive setup and they had managed to get more than 200 people tested in one day. (https://www.hayward-ca.gov/discover/news/mar20/results-announced-first-day-covid-19-testing-city-hayward).

I found out that they still don’t have enough tests and though I qualified I decided I didn’t want to take away from folks who might need them more urgently.

I then called an urgent care and described my symptoms and told them I didn’t want to come in for something unnecessary as I didn’t want to overload the system. They said I should come in and they could see me in half an hour. I was surprised at the promptness of this. This is something I am not used to with healthcare here.

So I went in. The parking lot was empty. I was the only patient when I walked in for my 7pm appointment. They had set up outdoor triage with social distancing and masks. And they had a separate entrance to the building for folks with respiratory symptoms like me.

(I was surprised that I had to touch the door bell to enter. I used my hand sanitizer to wipe it clean before pressing the button. The last thing I want is to spread it to folks who come in here!)

I was led into an air-tight examination room. It had a ball in a tube in the wall that helped indicate when the room was air-right. Not sure exactly how it works but that’s what they said it does.

The nurse was wearing proper PPE and she took down my cell phone number and said the doctor will call me from another room. He called me and did the whole consult from next door. I repeated what I had earlier told the nurse before coming in for the appointment. He then directed the nurse to swab me for Flu A & B. So they did that. It takes 15 mins and that came out negative. My temp was normal and my blood pressure was slightly elevated. And my blood oxygen was normal.

Then the doctor who was also wearing proper PPE came in and checked my lungs etc. He said since I am not at risk of complications/death they were still rationing out the COVID tests. He said regardless I should self quarantine for 14 days.

I told him that makes sense and I told him I was even reluctant to come in as I know you are swamped. He said it was very good that I came in. And he said that if my symptoms get worse we could consider an x-ray to see what was going on there. He also recommended I get an inhaler and use it if I have trouble breathing. I have never used one before but decided to take a prescription for it as it seemed like a useful thing to have.

I asked him about how they were doing on supplies, masks etc. and he said they are running low and could use donations. I asked him how many they might need and he said someone brought in 3 today and they are immensely grateful. They specially need the N95 ones as those are the hardest and they have been burning through those. He said they are not overwhelmed yet but are expecting a huge spike in ER, hospitalizations and ICUs in a couple of weeks as the initial wave of infections in CA enter that phase.

I thanked all the nurses and the doctor individually for all the brave and heroic efforts they have committed to. Everyone was cheerful and waved at me as I was walking out.

I came home and I was able to sleep better last night. Today I don’t have the headache. I still feel unwell, and fatigued. I still feel tightness in my chest but it doesn’t feel like it’s getting worse. I still don’t have a temperature. And I have very little phlegm. Overall, in net, I feel a little better than yesterday, and it could be a placebo effect. I will keep you posted if I notice anything get worse.

In some ways I am glad I got to experience the calm before the storm. Seeing how empty and non-busy it was made me feel less guilty about going in. But I still feel slightly embarrassed.

Our doctors and health care workers are doing their best to prepare for what’s coming. They are facing a lot of stress. Let’s be extra kind to them and wish them the best luck. If you have any extra masks please consider donating them to your local hospitals.

I was already self-quarantined but I was going out for essential errands, or a walk in an empty park etc. Now I will be fully inside for at least 2 full weeks.

Coronavirus: Bad news are coming exponentially, we need to prepare

General

Friends, coronavirus is going to hit us really bad. A lot of us are going to be affected disproportionately. The really bad news is that those of us who are struggling financially are going to be hit even worse.

When bad news is coming exponentially, things still seem kinda fine until suddenly they are not. We need to brainstorm and problem solve and be as proactive as we can to make it through this.

I am trying to check in 1-1 with as many people I know. Please also feel free to reach out to me with any concerns you have about what’s going on.