What comes after emergency?

As someone who participated in a COVID vaccine clinical trial, who has other vulnerable people in my life, and who tries to be a diligent and responsible community member, I’ve been following the science, public health information, and news about the pandemic over these last, long 3.5 years. I’ve done so many blog posts about it, I’ve lost count.

As you may know, the World Health Organization and the United States are winding down their public health emergency declarations.

This does not mean, though, that the pandemic itself has ended. COVID-19 is still widespread across the world and hundreds die every day as a result. There is still the potential for new variants and COVID is not yet seasonal, like influenza. Eventually, COVID will become endemic, as the flu is, but we aren’t there yet.

While some US programs, such as tracking hospitalization rates and wastewater testing, will continue, others will end. I will miss the COVID maps and risk ratings that the CDC has been providing. Besides the overall community risk assessment, the transmission rate maps were important to me in deciding how much public masking I needed to do or whether large, indoor gatherings were advisable at all. It’s true that, with so many COVID cases discovered through home testing and never officially recorded, the statistics are not as comprehensive as they were during the months of testing centers, but, for example, it’s helpful for me to know that my county has a moderate transmission rate but the county to our east is currently at the highest transmission rate level, two notches higher than here. Having that information could inform a decision between using a drive-through or dining in on my way through the county, as well as alerting me that the higher infection levels could spread in my direction. After Thursday, that information will not be readily available to me.

I’ll still follow the science and public health advice as best I can and will get my next booster when recommended. I’ll test at home if I have symptoms and avoid being in public when I’m sick with anything, COVID or not. I’ll keep a supply of KF94 masks in my size nearby for high-risk situations that may arise. I’ll try to do all the things we should be doing all the time, like eating well, getting enough rest, and practicing good hygiene.

I still, though, don’t want to get COVID if I can help it. To the best of my knowledge, I’ve never been infected, although I could have had an asymptomatic case at some point. I know very few people who are in that category these days.

Will the end of the emergency declarations and the resulting decline in data be a factor in my eventually contracting COVID?

Impossible to predict, but fingers crossed.

SoCS: new eyes

“Yes, it is strange not to wear glasses.”

Since I had my cataract surgeries earlier this month, I’ve been asked many times if it is weird/strange not to be wearing glasses every waking moment – and it is.

I’ve worn glasses since I was six because I was near-sighted. As I got older, I also developed presbyopia, which meant I was also having trouble seeing close up. For the last couple of decades, my glasses have had progressive lenses, which means they have a zone for far, mid-range, and close vision. I also have astigmatism in one eye which was built into my prescription. As I developed cataracts in both eyes, I was also having a lot of difficulty with glare.

And, I also sometimes had trouble with dry eyes, so a lot going on.

I decided to have cataract surgery last year. It took several months to get an appointment with the doctor who had done spouse B’s cataract surgeries, and my parents and mother-in-law’s. He uses advanced laser techniques and gives options to use advanced lens that deal with multiple issues.

B had had good luck with his multifocal lens and only uses glasses for very fine print and low-lighting conditions. In the five years since his surgery, they have added astigmatism correction to multifocal lenses, so I chose those.

The timing of the surgeries was awkward, as they happened while the UK branch of our family was visiting for Easter, but I’m happy with the still-developing results. My distance visit was clear within a day of each surgery. (They were a week apart.) My mid- and near-vision are improving day by day. I’ve used supermarket/drugstore cheaters for a few tasks, although now even the weakest ones are too strong for my “new eyes.” I also have been adjusting the size of my text on screens, although I’m typing this at my prior screen settings, so improvement is definitely happening. It will probably continue for a few more weeks as my eyes heal and my brain adjusts to the new, clearer input.

As I am adjusting to life without glasses, people I know are adjusting, too. I’ve had people comment on it. A few have said I look younger without my glasses. I had thought I might look older – or, at least, more tired – because you can now see all the wrinkles around my eyes and I don’t use make-up so, if I have dark circles under my eyes, they are now easier to see. Of course, I don’t think anyone would tell me I look older without my glasses, even if that is what they thought.

At some point, I suppose I will have to replace the much-beloved headshot I use for Top of JC’s Mind, which B originally took to go with this poem for Silver Birch Press.

Someday, when I’m more used to my new look.

Yes, someday.
*****
Linda’s prompt for Stream of Consciousness Saturday this week is yes-. Join us! Find out more here: https://lindaghill.com/2023/04/28/the-friday-reminder-and-prompt-for-socs-april-29-2023/

How low can you go?

This month, my county (Broome in New York) has finally made it into the low community risk level for COVID-19, using the current US Center for Disease Control tracking method. Our community transmission rate is still in the medium category, the second lowest of four categories. Both of these are the lowest levels that I recall seeing since this tracking model went into effect.

In recognition of this, I’ve begun to back off from masking in indoor public spaces. For example, I went to church on Easter and this weekend unmasked. On Friday night, I ate and sang unmasked with Madrigal Choir at a retirement dinner in honor of a Binghamton University professor who is a long-time choir member.

It feels a bit strange after masking for so many months.

I know there is still risk. A friend came down with COVID a few days ago. I had not seen her recently, so I wasn’t exposed, but it’s definitely a reminder that I may not be able to stay COVID-free forever. The number of people I know in the never-been-infected category is tiny at this point.

I don’t want to get sick and I especially don’t want to transmit COVID to someone else but I’m feeling that, with the community risk level at low and major personal events like my two cataract surgeries and visit from our UK branch of the family completed, I can let down my guard a bit. I’ll still be tracking our local statistics so I can put more precautions back in place as warranted.

Madrigal Choir is going into a busy week, getting ready for our final concert of the season next Sunday, so fingers crossed…

sneaking in a post

A quick update while JG is napping and ABC is enjoying her first ever trip to the cinema with her parents. Also, while I can almost see mid-range things like computer screens before my second cataract surgery tomorrow.

Things have been very busy here. Daughter E, son-in-law L, and grandchildren five-year-old ABC and two-year-old JG have been visiting from London since April 2. It’s great to have them here, enjoying typical things like playing outdoors in the yard or at the park or indoors at home. We went to Easter morning mass together and had an indoor egg hunt afterward, with leg of lamb for Easter dinner. Uncle C from West Virginia was able to make the trip up for E’s birthday last week.

Our biggest family event was Friday into Saturday when my younger sister came up along with her family. We got to meet the significant others of our niece and nephew, as well as their dogs, which led to lots of cuddles, laughter, frolicking, and shrieks from ABC and JG.

When we knew that our London contingent was going to visit, my sister had organized a memorial for our parents, known here as Nana and Paco. The last time E and her family had been here was shortly before Paco passed away. Distance and the pandemic made it impossible to gather again until now. We started our observance outside the building where Nana and Paco’s cremains are inurned. My sister had arranged for military honors for Paco, who served as a US Navy SeaBee during World War II and the Korean Conflict. There was an honor guard and a 21-gun salute using WWII era rifles, prayers, the playing of taps on a trumpet, and the folding and presentation of a large United States flag. We were grateful to all the veterans who came out to honor Paco’s service so long ago.

We went inside to visit the niche and see the memorials that we have placed there. Then, we went to the room that was reserved for us at the hotel where my sister’s family was staying. In the photo, you can see the folded flag in its special case.

My sister had organized our remembrance, which included music, pieces that our niece and nephew had written as children, poems from me and daughter T, a photo book that my sister had assembled, and lots of personal stories from everyone who knew Nana and Paco. It was wonderful to be able to share all of this with the more recent additions to the family. We were sad that our other sister wasn’t able to make the trip to join us. but we thought of her often over the course of the day. After our sharing time, we had lunch together, including one of Paco’s all-time favorites, lasagna. We also enjoyed one of Nana’s favorite desserts, tiramisu.

So, things have been very busy here, but they were complicated by the fact that I had cataract surgery on my left eye last Tuesday. Everything went well. My far vision was clear by the next day but my mid- and close-range, as expected, are taking longer to develop. My newly implanted lens is an advanced design that addresses vision at all distances plus astigmatism. There are healing issues to consider plus the visual part of my brain needs to adjust to the new conditions.

The other complicating factor is that my right eye has been functioning without glasses. It can really only see clearly at very close range, so things like reading and using a computer have been very difficult. I’m managing this post because my mid-range in my left eye has improved enough that I can see my laptop screen with an enlarged font.

Tomorrow morning, I will have the cataract surgery on my right eye. I anticipate that my far vision will be really good by Wednesday. I’m hoping that my mid-range will continue to improve with my left eye so that I can easily see my score to sing a gig with Madrigal Choir on Friday night. I think it will help to not have the distraction of a totally blurry right eye, as I have now. Fingers crossed.

I must say that my ophthalmologist, Dr. Daniel Sambursky, is amazing. He has developed advanced techniques using lasers that give superb results. Spouse B had cataract surgery with him five years ago and has enjoyed his new vision, only needing glasses for very fine print or low light conditions. I’m looking forward to that, too. I’ve worn glasses since I was six. I admit it is a bit strange to see myself in the mirror without them and it will take time for friends and family to get used to seeing me without them.

Eventually, I’ll get around to changing my headshot…

One-Liner Wednesday: cataract surgery

I had my first cataract surgery yesterday and it’s very weird to adjust to that while not being able to wear glasses to help the other eye see clearly.

This informative post/excuse is brought to you by Linda’s One-Liner Wednesday. Find out more here: https://lindaghill.com/2023/04/05/one-liner-wednesday-time-flies/

COVID-19 origin stories

A leak of a “low confidence” assessment from the United States Department of Energy that COVID-19 originated from a lab leak in China has set off another round of upset.

The base problem is that no one has access to all the data to come to a definitive conclusion and likely never will.

Most epidemiologists, researchers, and US government departments think that the most likely origin is from markets in Wuhan that dealt with wild animals that harbored the virus which then jumped to people. This article in Science is representative of that opinion. The animal to human route is a common mechanism which we have seen with diseases such as ebola and SARS-CoV-1.

Rather than arguing about lab leaks, we should put our energies toward strategies that will help to avoid or contain future illnesses. Yes to tightening controls at laboratories doing research on pathogens. Yes to limiting exposure to wild animals that can carry diseases to humans. Yes to rapid response and open sharing of information about emerging diseases.

No to wild speculation that is not grounded in fact. For example, there is no evidence that SARS-CoV-2 was lab-engineered rather than naturally occurring. It is irresponsible to share disproven theories.

As I know from public health statistics and recent cases among friends, COVID-19 is still out there, sickening millions and adding to the global death toll of over 6.8 million people. Protect yourself in accord with your local conditions and resources. Vaccinate and receive the bivalent booster if it’s available. Increase ventilation in indoor spaces. Avoid crowds. Wear a high-quality mask indoors when transmission rates are significant. Wash your hands. Take extra caution if you or someone you live with or visit is especially vulnerable due to age, medical condition, etc. Make sure you have accurate, scientifically valid information behind your decisions. Be respectful of those who choose to mask in public. They are trying to protect themselves and their loved ones. It’s possible they are getting over an illness themselves and are being cautious in order to protect you.

At some point, COVID-19 will become endemic. We aren’t there yet. Do your best to be a help, not a hindrance, to that end.

XBB.1.5

A new COVID subvariant has emerged here in the United States. It is designated XBB.1.5 and is considered the most transmissible Omicron variant to date by the World Health Organization. It is also considered to be highly immune evasive, which means it is more likely to cause infection among those who have COVID antibodies, whether from vaccines or prior infection. However, the vaccines should still be effective in reducing hospitalization and death rates from infection.

XBB.1.5 is especially prevalent in the northeastern region of the US. It is powering the rise in regional cases accounting for 72.7% of cases in the past week. It is also likely the driver behind Broome County, New York, where I live, again moving into the CDC’s high community risk level classification. (That will mean mandatory masking at our concerts this weekend.)

The XBB.1.5 subvariant orignated in the US, but has spread to some other countries. Meanwhile, China is suffering through a huge infection wave, although there is no reliable official data on its extent.

In many places, especially in the Northern Hemisphere winter, there are also high rates of flu and RSV.

As always, I’ll repeat my advice. Vaccinate, if you are eligible and vaccines are available to you. In particular, if you are eligible for the bivalent COVID booster, get it as soon as possible because it is much more protective against all Omicron strains than the original formulation. If you are sick, get tested. If you contract COVID or flu, immediately contact a medical provider to see if you can take antiviral medication to cut down on symptom severity. When there is risk in your area, use a high-quality mask in indoor public spaces and avoid crowds. Increase ventilation and/or air filtration indoors. Wash hands frequently and avoid touching your face (more for flu/RSV prevention than for COVID). Try to eat and sleep well. Look out for one another.

We need to work together for this pandemic to end. We are all tired of COVID but we need to fight effectively and continuously. Ignoring the risk and letting the virus spread just gives it even more opportunity to mutate and develop more virulent strains. We are now in our fourth year of the COVID pandemic. Let’s work together to make it the last.
*****
Join us for Linda’s Just Jot It January! Find out more here: https://lindaghill.com/2023/01/06/the-friday-reminder-for-socs-jusjojan-2023-daily-prompt-jan-7th/

supporting those with lymphoma

I admire Rep. Jamie Raskin of Maryland. He is a lawyer and Constitutional scholar just beginning his fourth term in Congress. He served as an impeachment manager in the second trial of Donald Trump and just completed his work on the 1/6 Select Committee.

It’s heartbreaking that he lost his son just days before the 1/6/21 attack on the Capitol. I admire Rep. Raskin’s ability to continue in public service in the aftermath of both personal and national challenges.

He has recently announced a new challenge, a battle with lymphoma. He is about to embark on chemotherapy and plans to continue working while he is being treated. I wish him every success in beating his cancer.

I have a college friend who is also currently in treatment for lymphoma and continue to pray for her full recovery.

I have a lot of hope for their long-term remission because treatment protocols for many types of lymphoma have a good record of success.

My father, known here at TJCM as Paco, was diagnosed with lymphoma about twenty years ago. He received chemotherapy and lived to be 96 without a recurrence. I know my father’s experience is anecdotal, but, for me, it helps to have a personal story to add to the data and statistics.

I invite readers who are so inclined to send out healing thoughts/prayers for Jamie Raskin, for my friend J, and for all those dealing with lymphoma. People who are in a position to make a charitable donation may wish to support the Leukemia & Lymphoma Society , which is highly rated by Charity Navigator.
*****
In one of those bizarre coincidences, I had drafted this post earlier, planning to use it for Linda’s Just Jot It January at some point. When I looked up today’s post to do the pingback, I found out the prompt word is “cancer.” Obviously, this post was meant to be shared today.

two years into COVID vaccines

After yet another period of high community risk level for COVID here in Broome County, New York, we have just today returned to medium level. After a post-Thanksgiving spike in infections, we experienced a hospitalization spike which had increased our community risk level. With the US health system also dealing with an early, hard-hitting flu season and RSV, the dreaded triple-demic, in some areas hospitals are reaching capacity and sending patients to other locations. Additionally, infection rates are predicted to rise as family and friends gather for Hanukkah, Christmas, and New Year celebrations in the coming weeks.

This comes at a time when only 14.1% of people five and over in the US have received the new bivalent COVID booster, which was designed to better combat the Omicron BA.4/5 variants and is proving effective against the current dominant strains, BQ1 and BQ1.1, which are part of the BA.5 lineage.

Furthermore, a recent study indicates that the US vaccination program likely saved 3.2 million lives and prevented 18.5 million COVID-related hospitalizations. The vaccines are estimated to have averted nearly 120 million infections. Another recent study shows that in the two years of COVID vaccine availability in the US, the excess death rate among Republicans is significantly higher than among Democrats, mirroring the difference in vaccination rates, a sad reflection of the politicization and misinformation around vaccines by many prominent Republicans.

It’s horrifying.

The mistrust sown over the COVID vaccine among Republicans seems to be spreading to other vaccines as well. A newly published survey finds that over 40% of Republican or Republican-leaning respondents oppose requirements for the MMR (measles, mumps, rubella) for school children.

This does not bode well for public health measures. It’s frightening how many people will believe politicians or media figures rather than doctors and public health experts on these important issues. People have been infected because they weren’t up to date on vaccinations. People have been hospitalized, developed long COVID, experienced complications, or died at higher rates because they refused vaccines or boosters. The data show this.

Please, get a bivalent COVID booster if you are eligible. Begin or continue the primary vaccination series if you haven’t completed it. If you get symptoms, test immediately and contact a health professional if you test positive to see if antiviral medication is right for you. Don’t go out and expose others if you sick with COVID, flu, or anything else. Mask indoors when infection levels for COVID, flu, RSV, etc. are high in your area. Avoid crowds. Increase ventilation. Wash hands and avoid touching your face – more for flu/cold prevention than COVID. Try to eat and sleep as well as possible.

If you are someone who has been getting health information from pundits, please turn to your personal health care provider, public health department, or national health organizations, such as the CDC. Look for data and advice from public health experts, not anecdotes.

For readers outside the US, turn to your public health experts to see what measures are available and appropriate for you.

Reminder to all: COVID 19 is still a global pandemic. Act accordingly for your health, your household’s and community’s health, and global health.

Triple whammy

There are a lot of people sick with respiratory viruses here in the US.

We are still struggling with COVID. Today’s (Oct. 28, 2022) statistics from the Centers for Disease Control show a weekly case count of 265,893 with 2,649 deaths. The case count is almost certainly low, as many at-home positive tests are never reported to health departments and some jurisdictions don’t gather data at all. The uptake of the reformulated boosters has been poor, with only 7.3% of people age five and over having received an updated booster.

While the community risk level map shows the majority of the country in the low (green) level, the community transmission rate is substantial or high in much of the county. You can see the various maps using a drop down menu here. The community transmission rate is based on case counts and/or positive test results; the community risk map also includes data on other factors, such as hospital admissions and stresses on the health care system. A personal illustration: Although the community risk level in my county (Broome in New York State) has been low in recent days, I have had a rash of friends being sickened with COVID. This is explained by our community transmission rate being high, which is the highest of four levels. (As I was writing this post, the maps were updated. Due to the emerging strains on the health care system, our county community risk just shifted from low to high.)

Meanwhile, the flu season has hit earlier and harder than usual. The predominant strain is H3N2, which is known to have a high incidence of complications, especially among young children, elders, and the medically vulnerable. Like many other illnesses, the effects of inflammation from the flu raise the risk of heart attack and stroke for weeks following the initial infection, further endangering not just personal health but also the stability of medical institutions, such as hospitals. So far this flu season in the US, the CDC reports 880,000 flu cases, with 6,900 hospitalizations and 360 deaths. Generally, flu season starts in October but this year it is running about six weeks earlier than usual.

The third virus that is currently surging is RSV (respiratory syncytial virus). For most people, RSV is like a cold but for infants, young children, and elders it can progress to lung infections. These can lead to hospitalization and even death, especially among elders. Unfortunately, there is not yet a vaccine against RSV. I actually participated in a clinical trial for one a few years ago but none has yet reached a level of effectiveness to be approved.

The triple whammy of COVID plus flu plus RSV has already pushed some pediatric hospitals to the edge of their capabilities. Ironically, the RSV rate is a critical factor. Because so many infants and young children were isolated due to COVID risk and lack of day care/school interaction during the pandemic, there is a much larger group than normal that is vulnerable to RSV infection.

There is also concern that the rate of new cases of all three viruses may climb even higher as the weather gets colder and people spend more time indoors.

Some things that people can do to help: Vaccinate as appropriate. Wash hands frequently. Avoid touching your face. Cover coughs and sneezes. Stay home and away from people as much as possible if you get sick. Mask in crowded places or avoid going to them. Get adequate rest and eat healthy foods. If you develop symptoms, talk to a health care provider so you can get testing and supportive treatments to help keep you from developing more severe symptoms and avert a hospital stay, if possible.

I know some level of sickness is inevitable but we can help cut down the case numbers if we watch out for ourselves and our communities.