Season’s Greetings to all people of goodwill

Season’s Greetings to All!

I’d like to offer a Merry Christmas to everyone celebrating today, but also Warm Winter Wishes to the rest.Mom's idea of a restrained Xmas with dozens of gifts piled high under tall tree

I believe we all win when we give others the benefit of the doubt: if I tell you Happy Holidays instead of Merry Christmas, I don’t intend to denigrate your savior. Instead, I hope you recognize that my own beliefs differ, but you have my respect for your Joyeux Noël.

My favorite Christmas lyric is “peace to men of goodwill!” May this message find every reader safe, secure, feeling cozy and full of joy.

A December 23rd article in the New York Times informed me that for many—especially women, people aged 18-44, and independents or Republican voters with modest incomes—2021 might be the source of even more stress over the holidays than 2020.

So many are exhausted and demoralized.

I immediately sent a text to my sister-in-law upon reading that story. I thanked her for all that she does, especially when I’m on the other side of the country, and told her how grateful I am that she married into our family. What a delight to enjoy—and like!—one’s relatives.

It’s easy to overlook kindness when life feels hectic. Extending a hand to someone else is a surprisingly effective way to find one’s own balance.

Let someone know they are appreciated today, and perhaps you can ease some of that holiday stress afflicting a loved one or yourself. If your home is beautifully decorated or you’re dining in relative splendor, make sure whoever provided such bounty to you knows it matters.

And offer to do the tidying up if someone else arranges most of your holiday cheer! A shout out to my kids who washed all the dishes after our festive dinner last night.

For all that I am firmly aware of the rising caseload of the Omicrom variant, and the lingering specter of inflation punishing our pocketbooks, December of 2021 offers good news that I feel compelled to acknowledge. Let’s look at those sunny spots on the horizon.

Without being totally divorced from reality, it is definitive that we are seeing some of the highest daily COVID-19 case rates of the entire pandemic. I agree that this sucks! Omicrom is a rip-roarin’ beast of infection; it’s many times more infectious than Delta, which superseded those original strains of SARS-CoV-2 from early 2020.

In spite of that ugly, hospital-cramming fact, the amazing step forward of mRNA vaccinations means that the novel coronavirus is now, finally, actually only approaching the flu in terms of order of magnitude of lethality.

According to David Leonhardt’s Dec. 23rd article in the New York Times, here’s some hard data on the current degree of risk from COVID-19:

The risks here for older people are frightening: A rate of 0.45 percent, for instance, translates into roughly a 1 in 220 chance of death for a vaccinated 75-year-old woman who contracts Covid.

You’ll want to view the article to see its excellent graphs to get the fullest picture.
That is frightening, but what about when we consider other common ailments? From the same article:

One reassuring comparison is to a normal seasonal flu. The average death rate among Americans over age 65 who contract the flu has ranged between 1 in 75 and 1 in 160 in recent years, according to the C.D.C.

Until I read this story, I wasn’t aware that COVID-19 has become, for a vaccinated senior citizen, less deadly than an average flu. What a powerfully reassuring data point! I find this a reason for great hope.

bandage on upper arm

Before I go on, allow me to make obvious this other point: the unvaccinated are not nearly so safe. COVID-19 is much deadlier for the unvaccinated than flu is.

The last flu outbreak to kill millions, plural, was the “Asian flu” of the mid-1950’s, with a total death count estimated around 2 million souls worldwide.

An otherwise similar unvaccinated elderly woman is 13 times more likely to die of COVID than the vaccinated hypothetical person above. There remains a much, much higher probability of death for that unvaccinated 75 year old woman than she would face in a typical flu season.

COVID-19 leaped onto the charts as the third leading cause of death for Americans in 2020, and the elderly bear the brunt of this burden. We lost 1.8 years of life expectancy last year; that’s the worst decline in over 70 years, since WWII saw so many killed between 1942-43.

It is wonderful that we’re moving toward taming the novel coronavirus from killer of millions to “only” fatal to hundreds of thousands. While not enough, that is good, and it should be appreciated…when it actually happens.

As of November 22, we’d lost more Americans in 2021 than we did in 2020. No one should ever forget that.

Yet savor the positive news as much as you dwell on the negative and your life will be better. If you are fortunate enough to have been vaccinated, your personal risk now pales compared to those who’ve mostly been tricked out of taking a life-saving inoculation

happy face smile
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In addition to the lifesaving wonder of vaccines that measurably reduce deaths amongst our most vulnerable population, we’ve also seen two new drugs approved as treatment options for COVID-19 in the USA this week. Where the latest variant has rendered ineffective some of our most effective earlier therapies, these new treatments arrive just in time.

They could also save us a lot of money.

To have new treatments people can self-administer at home—thus sparing exhausted, overburdened hospital staff while our total case numbers reach record heights—is another blessing. It’s hard for me to quantify how much I would prefer to pick up a prescription from my local pharmacy for a few days’ worth of pills if I had COVID over making repeated visits to a hospital or clinic.

The antiviral COVID pills from Pfizer and Merck will initially cost the federal government around $700 per dose. This represents an enormous savings spread over millions of doses vs. pricier monoclonal antibody treatments all of which cost $1200 or more at the heavily discounted government bulk purchase rate.Pile of money
Patients will also be spared unpredictable fees for visiting those staffed locations necessary to administer IV therapies. In an era of high inflation—and personally facing a mandatory switch to a new health insurance plan from a different provider starting January 1st—I find this a great relief.

I’ve never had a confusing or even shocking bill after visiting a pharmacy, unlike every time I’ve been a patient at a hospital. Reflecting on the fact that I’m so incredibly privileged that I’ve never had a gap* in my insurance coverage, it seems likely that others fear surprise bills far more than I do.

The pandemic isn’t over. Thoughtful individuals should still be wearing masks and making efforts to improve ventilation while meeting with those outside their households. That said, we understand more than ever about how COVID-19 spreads. Many of us are vaccinated, thus protected against the worst outcomes of the disease. Available treatments have expanded from desperate guesses to multiple effective therapeutics.

This ugly, lonely, uncomfortable period in history will end, though those of us who’ve lived through it may well spend the rest of our lives processing the experience. For example, many of us grew up with grandparents whose behavior was permanently affected by surviving the Great Depression.

Right now, on Christmas Day, 2021, I encourage you to look for the positive anywhere you can. Experiencing terrible events isn’t the only predictor of future suffering; so is how one responds to those challenges, and what one makes with the memories.

Things could be better, but, of course, they could also be worse. Having made it to my father’s house and remained in good health in spite of the journey, I find so much to celebrate this year.

May all these little celebrations be less fraught in 2022.

Wishing every reader good health, good cheer, and a large measure of optimism for the year ahead!

It was a painfully frustrating message replete with disinformation from an old friend the other day that prompted me to research and think about these comparisons. For the vaccinated, COVID may now be similar to a “mere” flu; for the unvaccinated elderly, endemic COVID-19 is still a virulent threat to be taken seriously.

Publicly available data makes all of this very clear. In 2020, 3 million people died from COVID-19. In a usual year, flu kills between 290,000 and 650,000 around the world. No math degree is required to calculate that somewhere in the ballpark of four to 10 times as many deaths occurred in 2020 than we would have expected from “mere” influenza.

The two most commonly prescribed antibody treatments, those made by Eli Lilly and Regeneron, don’t work against the Omicrom variant. Only GlaxoSmithKline’s sotrovimab—the most recently approved monoclonal antibody therapy—offers protection from Omicrom. These therapies cost thousands of dollars per dose (retail of ~$3000-5000 according to this news story, though other sources state that the federal government bought in bulk for $2100 per Regeneron dose and $1250 each for Eli Lily’s) and are administered intravenously, requiring a trained health care professional’s presence for every dose.

*Though the Affordable Care Act has led to a major increase in how many Americans have health insurance at any given time, in 2020, 9.5% had some coverage but also experienced a “gap” in continuous care, whereas another 12.5% remained completely uninsured.

COVID vaccination: appointment & liberation

Add me to the ranks of the partially vaccinated in America. Today, I received dose one of two of the COVID-19 vaccine available at a location convenient to my suburban home. Within three miles, which is “reasonably close” even by my auto-phobic standards.

Redacted official CDC COVID-19 Vaccination Record CardMy state redefined its list of eligible health conditions the day before my turn would have been due anyway. I don’t believe that the state knew* I went from one to two eligible conditions overnight—the system asked one to confirm only from the original list of “certain medical conditions” as I pre-registered—but that change moved me up one “priority group” within the current phase of eligible citizens.

I pre-registered with the state’s mass vaccination system on Sunday, receiving notification three days later that my chance at snagging an appointment would open up within 24 hours. I was offered a turn to register for a mass vaccination site appointment at 09:49 on Thursday. I had until Friday at noon to take advantage of the option.

As it turns out, the state system only offered me appointments over 20 miles away. Given my continuing ability to shelter at home, I almost left it at that, planning to wait for my next invitation and hope it would be for a local site. Our state doesn’t have truly centralizing vaccination booking, however; the state system only books one in to seven major centers churning out thousands of doses per day.

I tried “the other way” of booking Thursday evening, i.e., last night. A local physician’s group had three appointments open for this morning. I took that as a sign that it really was my turn to book. Screen shot of COVID vaccine appointments confirmed at CVS PharmacySomeone else I know with one underlying medical condition was able to book via the CVS Pharmacy website. That screen grab makes a prettier picture than the black and white, all text shot from the doctor’s office where I went, so here is a CVS vaccine jab appointment confirmation. In both cases, the second, follow up appointment was automatically scheduled by the computer for the correct (3-4 week) wait after dose one, but the doctor’s office only shared my next appointment time with me after I’d arrived in person.

To be honest, I agonized a bit over whether it was really fair for me to take my place in line for the shot. There are many people who are more exposed than I am due to their working or living conditions. There are many people older, sicker, and at greater risk of dying from COVID-19 than I am. Those realities were reflected, however—if, perhaps imperfectly—by the state’s eligibility phase system.

I did not wangle, finagle, lie, cheat, or even fudge to make my appointment. I read and re-read the eligibility criteria, looking for any reason to find against the evidence that my government thinks I’m at higher than average risk from COVID.

I’m grateful to the reporting I’ve read in a variety of newspapers and magazines about the ethical considerations of “taking a shot from someone who needs it more.” The consensus is: if you meet the qualifications for the shot for which you’re signing up, it is your turn, and it is just and right to take it. To date, about a quarter of adults in my state have had their first shot, and closer to one third are fully immunized, similar to the national average.

No amount of logic erases the tendency to worry from those of us who are anxious, but I do fret less when I can ease the factual side of the equation. My worries on this issue are also alleviated by living with my frail, elderly mother-in-law. Her history of reacting to multiple vaccines and medications combined with a specific diagnosis she’s dealing with now makes her vaccination perhaps more risky than doing nothing.

It helps that my father-in-law has been fully vaccinated for awhile, reducing the threat that her closest companion could unwittingly expose her to the virus, but the kids’ gradual return to public life is already beginning. We’re scheduling dental cleanings again after a year of neglect, and some of DS1’s summer courses seem likely to include in person labs. We hope that DS2 will be get to finish out the year back with his friends at school.

With case rates coming down and vaccination ramping up, it no longer feels fully fair to expect my kids to give up all outside activities due to the adults’ choice to live in a multi-generational household. Even my introvert has confessed to missing the act of going somewhere to attend a class; my extrovert seems quite eager to start at a bigger, busier, fully “in person” school next fall.

Alaska Air account view showing trips in December 2021It may have been premature, but one of the first things I did, after booking my vaccine appointment, was to jump right onto Alaska Airlines’ website. I booked tickets—based upon DS2’s new school calendar—for us to spend Christmas 2021 with my dad in the state where I grew up.

Dad’s latest favorite joke is that he’ll “be immortal in just x more days,” where x stands for his distance from reaching a full two weeks after his second dose of the Moderna vaccine.

“I’m not sure that’s quite the right word, Dad,” I tease him. “Maybe don’t take up skydiving.”

“I-m-m… something!” he responds. “I’m pretty sure they said immortal.”

Somehow, he didn’t appreciate it when I suggested the word he was looking for could be “immature!” Not at his age, he retorts.

God and the pandemic willing, we will be heading west to see Dad over the summer, but I’m not quite ready to book an airline ticket for June just yet.

December, though?

I’ve got high hopes for December. And now I’ve got some airline tickets to go with them.

* I did add a comment to my submission stating that I was unclear whether to use their provided list vs. the new one the governor had just announced. It is possible that a human “corrected” my data after the fact, nudging me closer to the head of the line. I suspect that this comment box exists primarily to help the software developers improve the system, however. A newspaper article I read today suggests to me that availability is simply opening up across my state.

Here I must acknowledging that those rates have remained stubbornly higher than everyone had hoped due to the emerging COVID-19 variants, and that cases are currently kind of level in our own community. I speak more to the overall trend from the winter peak. We remain a “more cautious than average” household, I believe, even with 1/6 of our number fully immunized and 1/6 of us partially so.

The fact that many airlines have moved to discontinue the practice of charging exorbitant change fees to modify tickets helped tremendously in my decision to book now.

Reading The Plague and playing Pandemic to cope with COVID-19

Some people like to distract themselves from a worldwide disaster, like, say, a viral pandemic. A few of us instead double down and dig in. I’m easing my anxieties over COVID-19-induced uncertainty by looking to the past and playing Pandemic.

Maybe this kind of deep dive is perverse, but I’ve always been the sort of person who fixates on one particular subject until I’ve had my fill. I also tend to find life infinitely fascinating, so my next obsession is a matter of when, not if. Examining any source of anxiety helps me ease my mind.

What could be more natural than studying up on what’s threatening to take me down?

I’d guess I’m not the only bookworm who has cracked a copy of Camus’ “The Plague” or Boccaccio’s Decameron” in recent months. I’m reading Defoe’s “A Journal of the Plague Year,” too.

For those who prefer their erudition by video, The Great Courses’ “The Black Death: The World’s Most Devastating Plague” by Dorsey Armstrong, Ph.D., is a fantastic and informative production. My public library offers this title on DVD to borrow for free, but it can also be had instantly at a cost via Amazon or from the publisher’s own site (Course No. 8241) .

Almost nothing has made me feel more lucky to be alive today than confronting the mortality statistics of previous pandemics!
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Working through grief: a view from 4 months after Mom’s death

Much has been written about grief, most of it by people with more experience, expertise, and, perhaps, intellectual interest in the subject than I have.

What I know can be summed up thusly: there are no shortcuts; one must carry on through it, and knowing that fact doesn’t make it any easier to go ahead. Somehow, anyway, most of us do muddle through.

I’ve been muddling for about four months since Mom died.*

As often happens, I find myself abundantly grateful for my extraordinarily blessed life, even at an awful time. Because I am a stay at home parent with a supportive husband whose own parents share our New England home, I had the freedom to spend two whole months with my dad as he grieved the loss of his wife of over 50 years.

Uncountable numbers of friends and family gave generously to support Dad and the rest of us. Mom’s energy and organizational prowess made a difference in so many lives, and people made that clear with their presence and their kind messages. The congregation of my folks’ church, Vancouver Heights UMC, freely provided resources and support far beyond what I would have imagined possible, had I ever been brave enough to imagine planning a parent’s funeral before I was forced to do so.

I can’t begin to imagine how much harder coping is for those with fewer resources. Then, too, losing my mother leaves me exquisitely aware of the universality of this crushing blow. All the resources in the world are a poor substitute for the love of the humblest mom.

Though I tried to be a help to Dad, those two months with him also served as a time apart for me to process my own grief. Oddly, returning home to normalcy hit me with a whole new series of unexpected reminders of loss. For me, at least, lots of things about Mom’s death have been difficult, but the situations I anticipated as particularly challenging have rarely counted amongst the most disruptive or disturbing. Trivial moments have dealt me my most significant blows, perhaps because I couldn’t brace myself for each impact.

Processing grief requires enormous flexibility from its sufferers.

My children, troopers that they are, both spent many weeks helping Grandpa as well. We were all there before the end, Mom’s last days in hospice care being both mercifully and, simultaneously, tragically very limited. The kids needed their own space, their own home, and time to prepare for the upcoming school year, so they headed home to Papa and his parents some weeks before my departure from my parents’ home.

Though I thought often about Really Wonderful Things throughout the summer and fall, I couldn’t find the strength to sit down and commit any of them to the page. Most of the thoughts were disordered; most of the time, my mind played second fiddle to my tumultuous emotions.

Now I know: I’m made exhausted and quite stupid by grief, and also irrationally frightened. I was afraid to approach my own cherished little blog.

Exactly what I’m afraid of is still hard to articulate as autumn decays into winter, but a caring comment from a regular reader did help prompt me to face some of this grief-induced anxiety and scrawl a few words on the page.

If you find this post because you are suffering a loss of your own, I hope my words offer some comfort.

If you’re a regular reader, I hope you haven’t missed my rambling too much. Many thanks for your patience.

*Though I did, in fact, begin this post on Labor Day, nearer the two month mark. An upload failure erased half of what I’d cried over on my cross-country flight home, and I simply couldn’t find the energy to resume until today, in late November.

It turns out that starting my car after school drop off equates in my mind with “call and check in with Mom.” 12 weeks into the school year, the instinct hasn’t left me yet, and it fades so very slowly.

Take advantage of services offered: treat yourself like a friend

Using myself as an object lesson once again, I’ll remind anyone with a less than perfectly functioning self to make use of the services that are offered to you. More than that, be proactive, and request what you need.

It’s amazing how many ways there are to make the trials of modern travel easier, but also amazing how loathe some of us can be to ask for help.

Today’s case in point: having a difficult joint act up while waiting in the Dublin Airport 51st & Green airside (past security) Lounge. This is a lovely, bright airport lounge. There are quite a few worse places to pass a few hours. Its design, meant to evoke the Neolithic tomb Newgrange, immediately made both myself and my husband think of 2001: A Space Odyssey when we (on separate occasions) entered.

Evocative–and attractive–as the long, white entry corridor is, it’s enough to strike fear into the heart (or knee, foot, hip) of an individual struggling to walk without pain. The toilets are 2/3 of the way down, back by the reception desk. Sigh.

I thought about going to ask for a wheelchair escort when the pain struck, then sat down, determined to ignore yet another annoying infirmity. Then I had this thought: if my husband were here, he would demand help for me, because he thinks I deserve it. And he’s right!

If I were watching a loved one struggle with pain, even mild pain, I would seek help, and I would insist s/he make use of it. Why should I do any less for myself?

Am I suggesting that I’m the center of the Universe, that everything revolves around me and my needs? Well, no. But I would argue that treating myself as less than I would a friend or casual acquaintance isn’t brave or valiant, it’s unloving and unwise.

Self advocacy doesn’t equate to self indulgence.