Brand matters when arthritic hands administer COVID tests

Until this weekend, I had only personally administered two brands of COVID-19 home tests on myself or my children. All of my earlier home testing experience was with:

I wrote a detailed review of the Cue Health product a few months ago for those who can afford a more accurate, but much more expensive home test.iPhone running Cue App next to Reader device with COVID-19 test plugged in

Both the Abbott and Cue coronavirus tests were easy for me to use, had straightforward directions, and required only moderate hand strength and dexterity. I highly recommend either of these brands to those with less-than-average manual abilities.

I say this as a person living with a diagnosis of mild, seronegative rheumatoid arthritis whose small joints do not always cooperate with my intent. Those with profound disabilities may require assistance for even these tests, and near-normal eyesight is necessary for every COVID-19 test I’ve tried.

That said, if you can still brush your own teeth effectively, you can probably manage either Abbott or Cue home COVID-19 tests.Open COVID-19 test box with post it note reminder to test twice, 72 hours apart

In our busy household of five, we keep all of our coronavirus test kits on a dedicated table at the side of the living room, stacked up in order of expiration date.

Having flown cross country in March to visit my father, I consumed several tests in quick succession upon my return, and we quickly worked through our locally purchased Abbott test kits to the more recent Roche branded ones we received free from the United States government.COVIDtests.gov offers free at home COVID-19 tests to Americans

Every home in the U.S. is eligible to order 2 sets of 4 free at-⁠home tests. Click here to order yours if you haven’t already.

We test my younger child—the one who attends high school in person—every weekend before he goes downstairs to visit his paternal grandfather. Дедушка lives downstairs in our home, but he has his own dedicated space, kitchen, and a separate entrance. Still, age and health status leaves Deda especially vulnerable to a severe case of COVID-19.

We feel grateful to have the means to protect him from an infection we might unwittingly visit upon him by going about our own public lives.

On Saturday, we used one Roche COVID-19 At-Home test kit from a box of four. Fortunately, it was conducted by my hale and hearty teen, administering his own test. I did not anticipate how difficult this test would have been for me, had I been taking one myself, and I was happy to be merely an observer and reader of directions.Roche COVID-19 test instructions, box, cartridge

Steps five and six of the Roche process would have stymied me, but my healthy child had no real issue with them or with the test in general. There’s a lot of firm pinching involved in those steps, which would be beyond my arthritic fingers.

Our older home educated teen took a test later the same day, and I asked if he wouldn’t mind trying the fourth brand in our personal arsenal: the ACON Labs FlowFlex test even though this meant using test out of expiry order.

I was curious if it would present similar issues. It did.

FlowFlex was the brand sent out by our health insurance via its preferred mail order pharmacy, Express-Scripts.8 FlowFlex COVID-19 antigen tests

We are entitled to eight “freei.e., included with our employer-provided health insurance COVID-19 tests every month for each covered member of our plan. I ordered those for the two household members going to work/school as soon as the benefit was published on the website, and they were delivered about four weeks later. In the meantime, I’d ordered a batch of tests each for the other covered members of our household.

If I order directly from the preferred prescription provider, I don’t have to wait for reimbursement. Paying nothing out of pocket seemed like the best option. Now I know better.

For our household, in the future, if I’m the one who requires testing, I should go to a local pharmacy and purchase Abbott’s BinaxNOW tests instead of accepting the option available via mail-order without any out-of pocket expense. This will be a smarter choice given my manual limitations.COVID test tube in stand awaiting insertion of swab and drop-dispensing cap

I believe it is highly probable that Abbott’s BinaxNOW, Roche’s COVID-19 At-Home test kit, and ACON’s FlowFlex have similar probabilities of correctly detecting the novel coronavirus responsible for the chaos and societal disruption of 2020-2022. That said, I doubt the ability of the latter to work for me, with my limited hand strength.

Both the Roche and the ACON FlowFlex test require a user to firmly pinch the included vial between one’s fingers for an extended period of time to get an accurate result. I doubt I could do this reliably, repeatedly, for accurate test results.Fingers squeezing plastic test tube for COVID test

I did experiment with my teen’s FlowFlex vial post-test to determine that I’m capable of dispensing the mixed drops with that product without too much discomfort, but dispensing four drops into the test cartridge is less effortful for some of us with weak phalanges than holding tight to the tube while spinning the test swab therein.Hands squeezing to dispense drop of liquid for COVID test onto cartridgeI felt compelled to compose and post this particular piece as quickly as possible to share my experience with the world. Had I only tried that first test brand, that I happened upon at my local pharmacy last fall, I would have no idea how tricky other versions of COVID-19 tests might be for those of us with more limited mobility.

It is worth reporting that, if I did not have such limitations to my dexterity, I would prefer the more compact packaging offered by Roche and ACON Labs over Abbott’s fairly bulky box, especially for travel. The Roche multi-pack uses far less packaging for four tests than two boxes containing two each of the BinaxNOW. Roche/FlowFlex’s volume will be decidedly less if packed in a suitcase.

Aside from the need to firmly grasp a plastic tube for steps five and six (Roche)/step 2 (ACON’s FlowFlex), I would not have such a distinct preference for Abbott’s BinaxNOW over the competitors. That being said, my limitations have settled in as a near constant over the past decade, and I no longer expect my own normal to return to a more median average.

From my perspective, if you require an at-home COVID-19 diagnostic test, and you have limitations to your manual dexterity, you should try to get an Abbott BinaxNOW antigen test or a molecular one from Cue Health.

If your hands are crippled by arthritis, and you must use Roche or ACON Lab’s tests, ask a fully able bodied friend for assistance, if possible.


Disclosure: The author of this post owns 51.044 shares of ABBOTT LABORATORIES (ABT) stock at the time of writing. Abbott Labs makes the BinaxNOW test kit product.

I find written directions easy to follow and actually enjoy the step-by-step process of assembling LEGO toys and IKEA furniture kits, so my experience may not reflect that of average people.

Playground rhymes for our troubled times

Do you remember that little song from the playground game, “Ring around the Rosie” from your childhood?

Ring around the rosie,

A pocket full of posies.

Ashes, ashes:

We all fall down!

Now, I wonder if you learned– even as a child, like I did–that this nonsensical-sounding ditty dated back to the bubonic plague decimating Europe’s population in the Middle Ages.

It turns out, the Black Death explanation is apocryphal and didn’t appear until the mid-20th century. Even so, the notion of kids taking notice when the world seems on its way to Hell with an oversized hand basket strikes me as accurate.

I haven’t got a COVID-19 rhyme composed for you today, though I’m now tempted to try my hand at one.Map of Mariupol, Ukraine generated by cell phone GPS app

I did, however, have a politically motivated stab at nasty name-calling in verse! come together in my mind over the past few days. While imperfect–and my apologies to the masterful teacher Michael Clay Thompson, whose MCT Langugage Arts curriculum I used with my home educated child in very recent years, so that I now have the vocabulary to describe how weak my doggerel truly is in form and meter–my not-quite-best self still prompts me to post it here.

I’d also like to ask if others can do better. Please, post your own rhyme in the comments, or tweet away!

I feel as if every child in the free world should have such poems on their lips these days. With luck, the wind will carry them across borders to those less fortunate youngsters growing up under dictators.

The literal future of human freedom lay presently with democratic nations around the world who must confront the warmongering by Russia’s “elected” leader and would-be-czar.

Upon seeing the news report of the bombed maternity hospital in Mariupol, Ukraine, on March 9th, 2022, I brought these words together.

Printed text of verse in historical typewriter font: Pathetic Putin, killer of babies. Can’t defeat soldiers so he bombs ladies

I debated posting something so mean-spirited. It goes against the very nature of this blog. Really Wonderful Things tries hard to be a bringer of light, and a force for good, human and wildly imperfect as its author is.

“Pathetic Putin…

What is Really Wonderful, however, is my right to comment on politics and politicians. God bless America, and hurrah for my freedom of speech! We are not perfect, yet I don’t hesitate to write these words or share them with the world. I am safe, though I express a controversial opinion, and in strident tones.

…killer of babies…

A miracle, frankly, if you know much of history.

How grateful I am that this is so… for me. How deeply I wish everyone shared in this good fortune.

…can’t defeat soldiers…

What I hope to accomplish by encouraging innocents to chant insults aimed at distant autocrats is the absolute, utter celebration of democracy and representation for the common individual.

…so he bombs pregnant ladies!”

Every school kid should know that such a system exists, God-willing, right on his or her doorstep. Every free person alive should be teaching those children the rights and responsibilities of an empowered electorate.

We the people of free nations owe every other human being, potential and living, our efforts toward sharing our ultimate luxury.

The people of Ukraine have made clear their disinterest in being re-shackled to their former Soviet masters. The bravery of those defending their homes should serve as a stern reminder for all who hear the news.

Representation is an inalienable right, but it is ultimately a privilege that must be constantly protected from jealous usurpers. The world will never lack for tyrants, in temperament if not in fact.

I stand with Ukraine.

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.

Is grief reflected in (un)polished silver?

One way I’m still processing my grief, two years and five months after my mother’s death, is by polishing her silver. Today, my hands are sore and chapped from completing that task last night.Tarnished silver showing a coppery glow instead of the whitish glint of sterling

Perhaps it was just the passing of more than the usual time while travel was ill-advised, but I think regional wildfires and their acidic smoke sped up the tarnishing of her sterling tea service. My irrational heart may also feel that these dark stains reflect the deprivations and loneliness of 2020.

If we couldn’t celebrate life’s occasions together, why shouldn’t our heirlooms wither and wilt in their own exile?

Silver heirlooms & family history

I was a girl, but old enough to notice, when my father bought Mom the silver tea set she’d coveted. I think I recall the particular room in the particular house we lived in at the time. I have memories of her excitement upon receiving it.

I’m not sure that Mom ever actually served tea or coffee from it, but it shone with pride of place in every dining room thereafter.Sterling silver tea service with heavy tray, coffee pot, tea pot, sugar bowl & creamer

Some families may own objects for generations; others build their own cache of keepsakes in the moment. It’s the memories that form mementos, not the artist or craftsman at a workbench or in a factory.

For myself, I take pains to use lovely things such as china and silver as often as possible. Regular readers may recall that I worked on my novel by candlelight last summer while sitting at my parents’ dining room table and keeping one ear open to Dad as he recovered from surgery. I know that five-branched candelabra was one of their Silver Anniversary gifts.

The use of three different styles of mismatched candles is entirely my own choice, and my mother, it must be noted, would be scandalized by such cacaphony.

5 branched candle holder with two gold beeswax tapers, two rust colored beeswax candles, and one smooth taperI use a silver tray to carry Dad’s post-surgical medications upstairs every night now* just as I did in August.**

It’s the right size to fit on his bedside table, lighter than wood, and less breakable than a plate would be. Some old-fashioned objects remain just as useful as their modern alternatives.

How to remove wax residue from silver

Before I polished all the silver, I had to pour hot water over the tray I placed beneath that 25th anniversary candelabra in order to remove all the wax I’d spilled thereupon.

Please note that, never, in Mom’s lifetime, could such a mess have been left for four months or more before being attended to! That, too, is entirely my responsiblity, and does not reflect the way Mom raised me.

If undertaking such a wax removal exercise, make sure you place a paper towel between the wax-stained item and your drain to avoid expensive plumbing repairs down the line. Very hot water does very effectively remove wax from even the most detailed metal surface.

I used water just off the boil, and the tray from which I was removing wax had no heavy, weighted areas to avoid heating. Be careful if treating candlesticks or other items which may contain meltable fillers as counterweight if you try the hot water method!

Amongst the almost innumerable blessings of my highly charmed life, I include the fact that my mother died in the summer of 2019, well before the pandemic. The children and I were able to spend the first holiday season after her passing with my father, accompanying him through what was a difficult time for all of us.

Frankly, anyone who knew my mother would recognize at least this irrefutable fact: she would have hated being locked down and isolated from society. Mom liked to be busy, and she reveled in the company of other people.

I don’t know if I could have survived such a loss in 2020 when travel took on new risks. The idea of Mom’s hospice care taking place while we were thousands of miles away is intolerable. I can’t even express the gratitude I have for the fact that I wasn’t challenged in such a way.

In spite of the mild miseries of my own experience of the pandemic, I know firsthand that heroic caregivers continued to minister to the dying in spite of the job’s personal risk. The long illness that plagued my mother-in-law came to an end in 2021. Hospice workers—and an investment in long term care insurance decades ago—gave her the dignity of dying at home, as she wished, though there can be no real respite from the ravages of grief.

It ranks high on the list of ways I consider myself luckier than I deserve that we six shared a household, thus having no question about our ability to be as involved as my father-in-law wished with her daily care at the end. Being there for a terminal loved one is difficult; knowing you can’t be must be excruciating.

How to polish silver without damaging it

While products abound, these days, promising quicker, less effortful removal of tarnish from cherished silver, experts universally decry the lazy man’s dips and hacks. Polishing silver isn’t particularly difficult, but it is best done with a bit of elbow grease and zero “quick fixes.”

Removing tarnish means, fundamentally, stripping away a thin layer of the valuable metal itself. It is best to tackle the job gently.

Apply a high quality silver polish using cotton balls, a sponge, or a rag. Rub until the dark stain of tarnish disappears, changing out your cotton or rag when it blackens. Finally, rinse or rub off the remaining polish, depending upon the type of object you are cleaning. A tray can be wiped dry or rinsed, then buffed; silverware or items you put in your mouth want washing after polishing.

Silverware as a shelf for memory

I have less memory of how this three-tiered silver tray came into my parents’ possession, but it does define the space for receiving Christmas cookies in my mind. Now that I’ve polished it, a bit of baking does seem to be called for.

When is it not better to confront a pleasing array of delicacies arranged on a silver platter? Or trois? When is a display not improved by height, texture, and depth?

While I wish my father weren’t recuperating from a painful operation, and I wish my mother were here, in her house, doing a better job of decorating, polishing silver, or tidying up than I every could…

Well, suffice to say that I am grateful for Dad’s recovery. I’m happy to spend the month of December surrounded by Mom’s things with at least the possibility of realizing a tiny fraction of her joy in the Advent season.

It’s a constant ache and awareness of loss to live amongst the remnants of my mother’s life, but such a gift that I have the luxury of time and access to process my feelings about everything she was, what she loved, and what she left behind.

The finer things in life only achieve that definition because we acknowledge how they add to our delight, or enhance our appreciation of the lives we lead. Even gold has only so much luster outside convention.

I would trade every precious metal for my mother’s presence if I could, but that’s not how living works, and that’s not a bargain anyone gets to make.

Grief is not the garland we expect for our holidays, but it is one most of us will hang one day. Whether personified by tinsel or a sterling silver tea service, holiday grief is a likely inheritance to everyone blessed by the chance to love and be loved.

It’s hard to make a family without generating holiday memories. Vanishingly few conduct an entire life without loss. Learning to live with grief throughout the holiday season is the burden—and the gift—of those who’ve been loved.

*For knee replacement number two

**When Dad became a cyborg, as he likes to say