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 Omicrom is a rip-roarin’ beast of infection; it’s many times more infectious than Delta, which superseded those original strains of SARS-CoV-2 from early 2020.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.

Flu

Just one word: flu.

I never use one word when one thousand will do, so, naturally, I will elaborate.

As if winter’s lingering darkness and New England’s coldest temperatures in years weren’t enough, we have to add widespread influenza infection to the list of legitimate complaints for still nascent 2018.

If my local children’s librarian* is to be believed, our corner of our state is the hardest hit in the area with this more-severe-than-average flu.

My situation isn’t even so bad. We are a house divided: only one of us has flu. I’m hunkering down with the sick one while DH keeps his distance and manages the healthy one. They leave us trays of food outside the door and occasionally send word about the outside world.

flu gear - 2The good news is that we have space enough to almost completely quarantine the sick kid. He hasn’t been downstairs for several days. Our over-the-top 1980s house came complete with a wet bar in the spacious master bedroom; between the mini fridge and the microwave, I can cover most of our needs without venturing forth myself.

We’re also lucky that the vicious cold spell is over. I can crack a window for ventilation between the child’s Petri dish of a nest and my frequently wiped down seat on the other side of the room. He isn’t lonely, and I haven’t caught the Plague yet. The separate heating zone for this room also assuages some of my guilt about sending so much heat literally out the window.

The bad news is that it’s the kid with the underlying condition making flu particularly dangerous that caught it.**

The doctor didn’t even want me to bring him in, citing the risk of exposure for others. He called in a prescription for Tamiflu and told me to plan on spending four to five days at home. The drug is the best thing medicine has got for reducing flu symptoms, but it only knocks half a day or so off the illness’s expected duration.

flu gear - 1Since the only side effect we’ve noticed is mild nausea and the evidence suggests Tamiflu reduces my son’s risk of hospitalization, I have no regrets about following this course of action.

An interesting aside: my husband’s doctor recommended getting the nasal swab flu test, but the pediatrician did not want to risk exposing others at a medical facility. DH’s internist would also have prescribed Tamiflu as a preventative to the rest of our household. The pediatrician did ask if my other son needed an Rx, too, but didn’t suggest Tamiflu for the adults.

We generally prefer to avoid taking drugs until they are absolutely necessary, so none of the rest of us are taking antiviral medication, but I found the variety of approaches interesting.

I should add here that, though I have a chronic illness, I am not considered immunocompromised at this point. If I were, I would take the Tamiflu without argument; as it is, I will play the odds.

We’ve increased the dosage on my son’s usual meds as directed, and I know the danger signs of severe illness for which I should watch, but the primary treatment for my sick kid is the same as for the rest of us unlucky enough to catch the flu: plenty of fluids and lots of rest at home.

I’m keeping myself sane by the following means:

  • Alphabears app on my iPad ~ the best word game I’ve played since my paid version of Bookworm stopped being supported after wretched EA bought innovative game developer PopCap.
  • Skullduggery Pleasant audiobooks ~ a great story that amuses both mom and child in the sickroom, but my older son had to jump through hoops to get the later books since they were only released in the UK. Read what you can get your hands on here in the USA, then agitate for the rest of Derek Landy’s series to be readily available where ever it is wanted.
  • Refining my packing list—and taking photos of same—for an upcoming trip that I will blog about after the fact ~ if you see better than usual pics after my next big adventure, you can thank 100 hours or so of enforced idleness wherein the closet became a welcome break from the monotony of the bedroom.
  • Wiping down doorknobs, light switches, and remote controls with disinfectant ~ okay, so that one isn’t so much fun as functional, but it does keep my brain occupied. “What did the child touch?” Right. Just about everything. Sigh.

Stay healthy, dear readers!

Wash yours hands often, or use hand sanitizer. Humidify your air if it approaches arid arctic conditions. The influenza virus is weakened at normal to high humidity levels aim for 50% RH***, and simple soap and water or the alcohol in sanitizer are sufficient to deactivate it on your skin before you transfer it to your vulnerable mucus membranes (i.e., nose and mouth, where the virus usually gets in.)

And if you do get sick with the flu, please, stay home until you’re no longer contagious.

Not sure if it is just a cold or the dreaded flu? Call your doctor!

If you’re not willing or able to do that, your best clues are:

  • sudden onset of symptoms,
  • severity of symptoms, and
  • presence of a fever.

When in doubt, stay home while sick. You are most contagious during the first few days with influenza.

If you have flu, you are spraying a cloud of virus into the surrounding environment with every breath. The person standing next to you could have a compromised immune system or a preemie at home.

Keep your germs to yourself. Let’s all work together so that this flu season winds down soon.

*I didn’t ask if she’d used her librarian superpowers to find out this fact, or the same gossip mere mortals employ to assess epidemic illness trends, so that might just be hearsay. As it served my preexisting notions, I just assumed she was correct.

**When I called his school to let them know he would be out sick, I learned that several other children from his class had the same symptoms. Ah, children. They’re the cutest little vectors for disease.

***Relative Humidity