200,000

The number of known COVID-19 deaths in the United States is over 200,000.

It’s hard for me to grasp the total, knowing that each of these was someone’s child, parent, sibling, co-worker, neighbor, friend.

A few days ago when I was working on this post, I needed to look up the population of Broome County, New York, where I live.

It’s about 190,000.

I am imagining the city of Binghamton empty, the University and all the other schools without students and staff, all the towns and villages without people, just the wild creatures and birds alive.

It’s sobering.

In reality, Broome County has lost 85 residents to COVID, each person a loss to their family and community. Somehow, though, my thought experiment in concentrating the loss to our country as the obliteration of our entire county has given me a sense of scale and of grief that the statistics alone did not elicit.

What does 200,000 deaths mean to you?

unmasked

Last week, I needed to bring one of our vehicles to a dealership for a recall. The one we usually use wasn’t certified to work on the electrical/battery system of our hybrid, so we made the appointment at another dealer in a neighboring county. We live near the county line, so it’s just a couple of towns to our west.

Tioga County is a rural county; Broome, where I live is a mix of rural, urban, and suburban, although Binghamton is a small city by most standards with a population of about 46,000. Broome County’s population is about 190,000 in 716 square miles; Tioga’s is 48,000 in 523 square miles.

Your geography trivia for the day!

So, I arrive at the service department of the dealership, wearing my mask. There is a sign on the door that face coverings are optional for customers but required for staff, which seemed a bit odd as New York State rules are to wear a mask whenever people are closer than six feet (2 meters). I was surprised to walk up to the service desk to find that there was no plexiglass barrier to protect the employee and he was not wearing a mask.

I tried to maintain distance as best I could. I checked in, walked past unmasked customers in line, and sat in the waiting area with unmasked customers while unmasked employees walked through several times. When the repair was complete, the employee doing checkout hastily put on a mask after the window that separated her desk from the hallway was opened.

The experience left me feeling not endangered, because I was masked and maintained social distance most of the time, but disrespected. While the business knew that its employees should be masked when in proximity to another employee or a customer, they were not complying.

As the designated shopper in our house, I’m used to visiting businesses which have implemented careful measures to keep their employees and customers as safe as possible. The result has been that our infection rate in the state has remained very low as we methodically re-open businesses and services. If I am ever in a similar situation that I have to use this car dealership, I’ll make arrangements to drop the car off the evening before so that I only need to go inside to do the final paperwork when it’s ready.

I hope that there won’t be any outbreaks from the disregard that I witnessed at the car dealership, which, presumably, was considered acceptable to others in that community. For me, it seemed a small taste of what I hear on the news from other states, that folks don’t believe that masks and distancing help prevent COVID infections or that masks infringe on their liberties or that COVID doesn’t exist, all of which contribute to the appalling rates of illness and death in the United States.

At least I know that no one there will have contracted COVID from me.

September 11

Nineteen years ago today, terrorists, most of whom were from Saudi Arabia, attacked the United States, killing thousands of people and destroying airplanes and buildings in New York City, Arlington, Virginia, and Shanksville, Pennsylvania. I remember those killed, the many who acted valiantly to try to save lives, often at the cost of their own, those who worked in the aftermath of the disaster, many of whom suffered illness as a result, and the many thousands, both military and civilian, who were impacted by the wars in Afghanistan and the rest of the Middle East that sprang from the 9/11 attacks.

Nine years ago, my area was suffering from a record flood of the Susquehanna River, brought on by the remnants of tropical storm Lee. What many people don’t realize is how long it takes to recover from such an event – and that some things aren’t recoverable. It took years to repair homes that could be and tear down those that couldn’t. There are neighborhoods with patches of grassland where homes once stood, interspersed with homes that managed to survive. Those neighborhoods have changed character, with fewer older folks in them as they were the most likely to move to higher ground or leave the area after the flood. Our own home was not flooded, but there was standing water three blocks away and significant basement flooding one block away. We had long carried flood insurance on our house, although it isn’t required by the (still outdated) flood maps; we will continue to do so, hoping that we never have to use it while realizing that the increased strength of weather systems and changes to the upper-level wind patterns brought on by global warming may someday send us another record-breaking flood that will reach our home.

Despite these prior events, September 11, 2020 feels even more fraught. The global pandemic has exacted a terrible toll on the United States. We are over six million cases and closing in on 200,000 fatalities. The economic impact, especially on those on the lower end of the socioeconomic spectrum, has been severe, with rising rates of hunger and housing crisis. The pandemic also made more prominent existing problems with the health care system, racism, environmental degradation, education, infrastructure, jobs, wealth, taxation, and social programs. While some of the effects have been buffered by living in New York State, where Governor Andrew Cuomo has been leading an effective response to the crisis, I am appalled by the lack of leadership from the president and the callous intransigence of Senate Majority Leader Mitch McConnell, which are prolonging and deepening the suffering in the country as a whole. Because the Senate hasn’t passed the HEROES Act which the House passed in May, additional federal assistance to households, state and local governments, the post office, and the election system isn’t available. As a result of the national inaction, states are going to have to lay off front-line personnel and the vote count in November’s elections will take a long time.

To make matters worse, this week has seen new evidence that the president’s failure to address the pandemic was not due to lack of understanding the crisis. A just-released recorded interview on February 7 with Bob Woodward makes clear that the president knew that the virus was highly contagious, deadly, and spread through the air, yet he continued to intentionally downplay the threat rather than mount an effective and protective response. If the president had lead the nation in the kind of efforts that Governor Cuomo did in New York, there would have been millions fewer cases of the virus and thousands upon thousands fewer deaths. There would be widespread testing and contact tracing. The test positivity rate would be below one percent, as it has been in New York State for over a month. Businesses and schools would be thoughtfully and carefully re-opening, ready to re-adjust if cases start to rise. Instead, Dr. Fauci, director of the National Institute of Allergies and Infectious Diseases, is telling the United States to “hunker down and get through this fall and winter, because it’s not going to be easy.” I only hope that people take the advice to heart in their own lives and at the state and local level, because Trump and McConnell are still not helping us mount a national response.

The Trump/Bob Woodward interview I mentioned above was just released because Woodward has a book coming out, part of a spate of books about Donald Trump being published with less than two months to go before the presidential election. These books reveal information that, while perhaps suspected, had not previously been confirmed about the president and his staff. The picture isn’t pretty. While there is some straight-up incompetence and inexperience at play, there is even more corruption, selfishness, greed, and disregard for the Constitution and laws, morals, ethics, and the common good.

Time for the pitch. Make a plan and vote! We need there to be a President Biden in January 2021 in order to have any hope of reclaiming our democracy.

Which brings me to another fear. While there is widespread and credible polling both nationally and in battleground states showing that Biden is leading Trump by several percentage points, the election process itself is under threat. The most frightening is that the Russians, along with several other countries, are once again attempting to interfere with election. This week, a whistleblower came forward with evidence that the administration is knowingly tamping down revealing the extent of the Russian interference, in particular. At the same time, the administration and the Republicans are filing lawsuits to disrupt mail-in voting. The postal service is slowing mail delivery, which could make ballots arrive too late to be counted. The president keeps saying that mail-in ballots lead to widespread fraud, which is absolutely a lie; states and local election boards have numerous, proven safeguards in place to prevent fraud. It is true that the final vote tally will take longer, especially in states that don’t count mail-in votes until days after Election Day. (Of course, some of the delays could have been averted if the Senate had acted on the HEROES Act which would have provided more training, machinery, and personnel to count ballots more quickly.) People need to be aware that we may not have final election results for a couple of weeks. This does not mean there is fraud; it means that election bureaus are diligently following their procedures to report an accurate tally.

Nineteen years ago, despite sorrow and shock, the people of the United States pulled together to help us get through the crisis. Nine years ago, our local community drew together to assist those impacted by the flood. Unfortunately, I don’t see that same sense of solidarity in the country as we face the pandemic, government corruption, and economic catastrophe, along with the long-standing problems of racism, lack of equal access to good-quality education and health care, environmental ruin, and other injustices. Granted, it’s a lot, but we can improve our lives and our nation if we act together. When we say in the Pledge of Allegiance “with liberty and justice for all”, we have to mean it.

vaccine trial – injection 2

This week, B, T, and I are receiving our second injections of the Pfizer/BioNTech experimental COVID vaccine or placebo, three weeks after the first round. There is COVID testing and general health screening but no blood draw, which will wait for the next visit to see the antibody response. Throughout the two years of the trial, we will continue with a weekly diary of possible COVID symptoms, although we would contact the trial staff immediately if we suspected we had COVID. We each have an emergency test kit at home to collect samples if we are directed to do so by study personnel.

The possible date of vaccine approval in the United States has become a hot topic. The president has intimated that a vaccine could become available before Election Day, November third. Local health departments around the country are supposed to have plans in place for distribution by November first.

However, that timeline doesn’t jibe with the amount of time needed for preliminary Phase III trial results. Yesterday, Pfizer, BioNTech, and seven other drug companies involved in COVID vaccine development signed a joint pledge to uphold their rigorous testing measure and not request authorization without the requisite data showing safety and efficacy.

I’m pleased that they made this commitment to the public. When vaccines do become available, it is vital that billions of people around the world receive them so that we can end the pandemic. If only a small fraction of the world’s population receive it, the pandemic will not end because there will still be a large pool of potential victims for the virus. Some of those victims will be people who were vaccinated, as no vaccine is 100% effective. The vaccine should lessen the severity in those people who do contract it, as we see with current flu vaccines. It’s important to remember, though, that part of the way vaccines work is by creating herd immunity so that a pathogen can’t create an outbreak. Vaccines offer a safer, less lethal path to herd immunity than just allowing vast swaths of the population to be infected.

I suppose it’s possible that a vaccine might receive emergency use authorization this fall so that it could be used by front-line medical workers and extremely vulnerable individuals before long-term safety and efficacy could be established, but widespread vaccination isn’t possible until next year, at the earliest.

The wisdom of moving forward scientifically and methodically was illustrated this week by AstraZeneca, which put their COVID vaccine trial on hold in order to investigate a possible adverse reaction. It may be that the reaction had another cause, but, until that can be determined, they don’t want to risk the health of their participants. Rushing the swine flu vaccine out to the public in 1976 caused enough serious complications that it had to be suspended after ten weeks; no one wants to repeat that experience with COVID.

Meanwhile, our family will keep doing our small part in advancing the science in hopes that COVID-19 can be brought under control, saving as many people as possible from illness, disability, and death.

COVID vaccine trial update

Last week, B, T, and I each had our initial visit for the Pfizer/BioNTech vaccine trial for COVID-19. There was a lengthy informed consent document, medical history and physical exam, COVID test, blood draw, and injection with either the trial vaccine or placebo. Two of us had some mild side effects and one of us did not, so we are surmising that one of us received the placebo, but the study is triple-blind (participant, care provider, investigator) so we don’t know for sure if that is the case.

The Pfizer/BioNTech vaccine is a messenger RNA vaccine; this type of vaccine has not previously been approved for widespread use. It works by enclosing a strip of messenger RNA in a lipid shell. When it gets into cells, it manufactures the spike protein that the SARS-CoV-2 has on its exterior, so that the body recognizes it and makes antibodies and T-cells to combat it.

The phase I data looks promising, so I hope that this vaccine will be found effective. RNA vaccines are able to be manufactured quickly, which will be a plus if they are approved for use. I am hoping that a number of vaccines will be able to complete Phase III trials and earn approval, so that we can get as many people around the world vaccinated as quickly as possible. It’s the only way to gain herd immunity without a horrifying level of illness and loss.

The Pfizer/BioNTech trial is expected to finish its primary collection of data needed for approval in mid-April 2021, although the trial will continue to follow participants through November 2022 to see how well antibodies and T-cells persist.

Science takes time and the COVID vaccine is being developed at a blindingly fast rate in terms of past vaccine development. Remember that we are still looking at months before approval, not weeks. Even when one or more vaccines are approved, people will need to keep up with distancing, masks, sanitizing, etc. to keep the disease at bay while vaccination production and distribution campaigns occur.

Please, everyone, do your part to keep yourself, your family, and your neighbors as safe as possible, while vaccines and effective treatments are developed. I’ll post more information about our trial as time goes on.

SoCS: check-up

One of the many things that got deferred in 2019 while we were dealing with the final months of my mom’s life and the first months without her was going to the doctor for a check-up. I wasn’t being totally health-delinquent as I had other reasons to visit the doctor’s office, but I didn’t have the standard wellness exam that someone my age would usually have every year.

Next month, I am going to have a check-up, though, preceded by lab work so we can go over the results at my appointment. I may also need to have a bone density scan. I have crossed over into a diagnosis of osteopenia, which isn’t surprising. At 59, I don’t expect to have the same bone density as a woman in her twenties. I’m hoping that I can avoid taking Fosamax or some other bone-builder medication, at least for now. I prefer to save that until I actually develop osteoporosis, if I ever do. One can only take those types of medications for a limited amount of time and I don’t want to use up my quota too soon.

I also know that I should be thinking about getting a new shingles vaccine. I have had a bout of shingles and have had the older vaccine, but the new one is supposed to be much, much more effective. I will probably need to wait longer to get it, though, because, in the next few weeks, B, T, and I are all scheduled to participate in a coronavirus vaccine trial. The trial is supposed to last for two years, but I’m sure there will be a window for me to get the shingles vaccine at a time when it won’t interfere with the trial.

I’m sure I’ll be posting about the trial when it begins.

2019-2020 SoCS Badge by Shelley

Linda’s prompt for Stream of Consciousness Saturday this week is “check/cheque/Czech.” Join us! Find out more here: https://lindaghill.com/2020/07/24/the-friday-reminder-and-prompt-for-socs-july-25-2020/

Sad stats

The horror show that is the United States and coronavirus continues.

My state, New York, was the world epicenter in the early spring. Through good leadership informed by science and metrics and residents who took the policies seriously, we were able to get the pandemic under control. Through a careful, phased, and data-driven process, we have also been able to keep our transmission rate low as we have opened more of our economy.

Still, when the map of case numbers would be released every day, New York, the fourth most populous state, showed the highest number of total cases, over 400,000, because our initial outbreak had been so severe.

Until this week.

California, which is the most populous state, passed New York this week on confirmed COVID case numbers. (All the public health experts agree that the actual case numbers are much higher, but the official count uses only testing results and death certificates.) While California had had early success in containing the virus, it re-opened businesses too quickly and many people abandoned needed precautions like masks. Hence, their caseload is soaring. I’m hoping that New York will continue to keep the virus from resurging so that we never again reach the top number of cases, but Texas and Florida, second and third most populous states, are also in the midst of major outbreaks and might surpass California’s numbers in the coming weeks.

It’s appalling.

What saddens me is that it didn’t have to happen this way. New York and some of our partner states in the Northeast learned a lot of lessons through our experiences this spring and, in the absence of a national program, have been offering to help other states deal with the virus and the economic/social fallout. This has resulted in some positive news in the states being hard-hit now, for example, the mortality rate is lower, in part because of improved treatments for the severely ill. Most of the news, though, is bad: overwhelmed hospitals, people not wearing masks and attending large gatherings, bodies being stored in refrigerated trucks because mortuaries are backlogged, more and more states where the number of cases is rising.

Meanwhile, there is still no national plan. The House of Representatives, led by the Democrats and Speaker Nancy Pelosi, passed the Health and Economic Recovery Omnibus Emergency Solutions Act or the HEROES Act in mid-May, which would address some of the current problems with testing, contact tracing, and treatment of COVID, as well as a host of economic and social impacts on individuals, families, businesses, agencies, and state and local governments. The Senate, under the leadership of Republican Majority Leader Mitch McConnell, didn’t act on the bill this spring and just returned from a three-week break without their own version of a bill and, after a week’s work, they still don’t have a Republican proposal, much less a bill that has been negotiated with the Democratic and Independent senators so that it is ready for debate and vote.

Meanwhile, people are sick and dying, out of work, not knowing how they are going to be able to pay their bills, scared, and bewildered about their country’s dysfunctional state. The United States has become an object of pity around the world.

I’m disappointed that, even when the crisis is monumental, the Republican leadership can’t muster the will and/or competence to do their job and govern for the good of the people. If they had integrity, they would resign to make way for leaders who can and will serve the people and the Constitution. Resignations would be less disruptive than the current inaction.

a vaccine trial

Our family physicians’ practice has a research department that works in conjunction with national trials. I have done several studies with them in the past, including vaccines for seasonal flu and adult RSV (respiratory syncytial virus).

I got a call the other day because they are signing people up for a SARS-CoV-2 vaccine trial. This is the virus that causes COVID-19. It will be a two-year study looking at the effectiveness of the study vaccine. I qualified and enrolled in the study, as did spouse B and daughter T.

We don’t know whether this vaccine will prove to be effective or for how long, but we are committed to being part of the process to find out. Even if it isn’t protective, that information will be helpful in the search for finding a vaccine that is.

They are looking for more participants. If you are in the Binghamton NY area and are interested, please contact me for a referral to the researchers who can provide full information about the study. You may leave a message in the comments so we can work out how to communicate privately or contact me through Facebook Messenger or email if we are already connected.

SoCS: New York State re-opening

I live in the Southern Tier region of New York State (USA), where we are undertaking a methodical re-opening of businesses after we successfully drastically lowered our number of COVID-19 cases.

Every day, I listen to the press briefings from Governor Cuomo. He has been very transparent on what the state is doing and what the role of the public is in protecting public health during our stay-at-home period and now our phased re-opening.

The Southern Tier region is about to enter Phase 3. One of the services that is allowed in phase 3 is nail salons. Hair salons were allowed to resume, with masks and other safeguards in place in phase 2, but nail salons had to wait for phase three as it involves longer face-to-face interaction.

I don’t do manicures, but I do have an appointment for a haircut in a couple of weeks. After that, I’ll be able to go without the headband that has become part of my wardrobe in order to keep my bangs out of my eyes.

Long bangs is an infinitesimal price to pay for what has been great news for New York State. Unlike other states that were less careful about re-opening businesses, our infection rates have continued to decline. The numbers are constantly monitored with widespread testing and contact tracing for positive tests so that we know we are not starting an outbreak. As soon as the numbers in a region start to creep up, there are plans in place to cut back on the re-opening until the infection rate is under control again.

I’m proud of everyone in New York and our leadership team for the thoughtful, caring, science-based, and successful way we have tackled this challenge. I hope that more states and countries, seeing our approach working so well, will follow our lead and be able to save their people from further suffering from the pandemic.
*****
Linda’s prompt for Stream of Consciousness Saturday this week is “nail.” Join us! Find out how here: https://lindaghill.com/2020/06/12/the-friday-reminder-and-prompt-for-socs-june-13-2020/

2019-2020 SoCS Badge by Shelley!
 https://www.quaintrevival.com/

Memorial Day 2020

Today, the United States observes Memorial Day. It originated as a day to honor Union soldiers who died during the Civil War, but expanded over time to include service members who died in any armed conflict.

I am also thinking today of all the civilians who lose their lives in wars. Perhaps, this is because I just finished watching World on Fire on Masterpiece, which is about people from various countries in World War II Europe.

As the country continues its struggle with the COVID-19 pandemic, we often hear politicians and media describe it as a war. The medical personnel, first responders, and caregivers are called the front line, a term that is sometimes also applied to other essential workers, such as transit, delivery, and grocery workers. I am confused, though, by the use of the term “warrior.” Sometimes, it seems that the general public are considered warriors, serving others by staying at home to avoid spreading the virus further. Others are using the term warriors to describe those who are giving up on stay-at-home orders and going back to “normal” whether or not the public health officials say it is wise.

I am extraordinarily grateful to be living in New York State, where our governor and other leaders are methodically working to expand economic activity while safeguarding public health. National news reports have shared data that twenty-four states are re-opening their economies with the rate of infection still increasing, even though the national guideline is that at least two weeks of declining infections is required first.

While I remain unsure of who the “warriors” are, I am painfully aware of who the casualties are in this war. As I write this, there are 98,000+ confirmed COVID-19 deaths in the United States. The number will surely reach 100,000 within the next two days. Over these last few months, the United States has lost more lives to coronavirus that it has service personnel in all the wars since the end of World War II combined.

Today, I am commemorating all the service members and civilians who died in war and all the pandemic victims. May their memories strengthen us to serve others.