Bivalent COVID boosters are available & exciting

An article I read in the New York Times says that many Americans aren’t even noticing that the new, bivalent COVID-19 vaccines are now available. The public has lost interest in all things coronavirus, and the government is running out of funding for effective reminders or elaborate, coordinated delivery campaigns.

It falls to us, concerned citizens, to spread the word about how we can protect ourselves and others. In the interest of fighting misinformation, I will also share reputable resources for those wishing to do their own research.

The new boosters, authorized by the F.D.A. last month, are “bivalent” because they protect against:

  1. the Omicron subvariant still circulating in addition to
  2. the original version of the COVID-19 virus.

The Latin root bi– means two.

Merriam Webster dictionary page highlighting prefix definition of BI means TWOPut simply, a single shot now offers two kinds viral defense: more of the same protection from the original booster, plus, for the first time, the specific power to fight Omicron. That named strain of the virus, also known as lineage B.1.1.529, caused the enormous spike in coronavirus cases early in 2022. It’s estimated that the “mild” Omicron strain was responsible for killing 117,560 people in America. Source: MedRxiv.

More than one million Americans have died from COVID-19 since the pandemic began. This virus has been far deadlier than any recent influenza outbreak. The worst annual flu statistics in the past decade saw 52,000 people die in the US, for comparison, while an average year sees  ≈34,000 flu deaths. Source: CDC.

Allow me to do the math for those who struggle with the subject: with COVID-19 having a major impact over the past three years, one million lost lives (1,000,000) averages out to roughly 333,000 American deaths in a single pandemic year. (1,000,000 ÷ 3 = 333,333 ¹⁄3) This means COVID kills 10× as many as an average annual flu does in the U.S.A.

  • 34,000 × 3 = 102,000 this is how many flu would probably have killed over three years
  • 102,000 × 10 = 1,020,000 this is how many flu would probably have killed if it were 10 times worse
  • 1,020,000 is close enough to one million to be considered the same for this kind of analysis

Flu vs. COVID death rate comparisons are usually the work of the innumerate… or liars.

It’s vaccination, not vaccines, that saves lives.

Personally, I’m with Zeynep Tufekci, whose opinion piece in the Times marveled at the awesomeness of vaccination’s potential… while exploring the inadequacy of current messaging to motivate our citizens.

Tukekci writes: “[I]t’s vaccination, not vaccines, that saves lives.”

And she’s right about that.

bandage on upper armThe most impressive technology can solve no problem if it isn’t deployed where it is needed and at the right time. Safe, modern, effective vaccine boosters against COVID are being provided at no cost by the U.S. government. Those shots are available today.

As of now, everyone over age 12 in America is entitled to a free bivalent booster shot as long as at least two months have passed since the most recent dose.

Boosters reduce your chance of catching Omicron, and they substantially reduce an infected person’s risk of being hospitalized with—or dying of—COVID-19. Sources: New England Journal of Medicine, CDC, United Kingdom Health Security Agency.

Boosters will also help you avoid long COVID. Source: JAMA.

Aside from spreading personal misery, long COVID is also costing our economy hundreds of billions of dollars, with just lost wages from the disease estimated between $170-230 billion annually. Note that this figure approaches 1% of the total U.S. gross domestic product. Sources: World Economic Forum, Brookings Institution, Federal Reserve Bank of MN

Getting vaccinated and boosted is a patriotic choice as doing so protects our faltering economy.

I was delighted to take my teen in for a bivalent booster dose this week. His previous shot was last winter, he attends classes in person while being the only kid in most rooms electing to mask, and our household includes a high risk loved one. A few hours with a sore arm and one long nap later, my child has no lingering side effects, but he can more safely spend time with his grandparent.

There’s no way to put a price on the value of those hours. COVID vaccines are a miracle, a blessing, and quite literally wonderful.

The rest of my family will be getting bivalent boosters soon, having had age- and risk-related doses more recently than a healthy teen.Redacted official CDC COVID-19 Vaccination Record Card

Opting in for your bivalent booster dose is choosing life over death, wellness over infirmity, civic engagement over cynicism, and family values over selfishness. Vaccination protects our society by safeguarding both individual health and overall economic function; sick people are less productive.

I’m fully vaccinated—and boosted—because I love America, and because my religion teaches that life is a sacred gift.

What’s your reason?

Sustainable masks & face coverings for 2022 & beyond

My personal evaluation of three consumer grade elastomeric respirators is available further down in this post: Breathe99 B2, FLO Mask, and ZShield Reveal.3 brands of reusable face mask: B2, Reveal, FLO

As of July 2022, many people claim to be “over COVID;” I’m not one of them. I continue to mask regularly. I cover my face to protect a high risk member of my household, and because I have enough uncomfortable health issues of my own already. The specter of long COVID looms large enough to make indoor masking my preference.

Long COVID is most common in middle aged people, affecting as many as one in four recovered patients according to a Nature news feature. The CDC gives me better odds than 25% in their Data for Long COVID section, but, the fact is, no one yet knows the true prevalence of the condition.

Long term, I see no reason to ever stop masking in crowded conditions such as boarding a flight or on mass transit, though my specific level of vigilance will probably vary as this pandemic wanes and flu season comes and goes.Disposable surgical mask

The particular genesis of today’s post was a New York Times article by Andrew Jacobs published July 3, 2022. It’s worth reading, but the gist is that American hospitals should have learned the supply chain lesson of the COVID-19 pandemic and switched to elastomeric respirators for essential healthcare workers by now.

Elastomeric respirators are reusable face coverings using replaceable filter elements that work as well as disposable N95s to block the flow of germs. Many are domestically produced, to boot, in marked contrast to the largely imported supply of disposable masks.

Widespread adoption of elastomeric respirators would solve the problem of being dependent upon a hostile foreign nation for vital supplies while offering equal or better protection to each wearer with a better fit and simultaneously creating less waste.

Win-win-win.Merriam-Webster online dictionary defines elastomer as a noun, "any of various elastic substances resembing rubber"

The “elastomeric” part of the elastomeric respirator just means the body of the filtering face mask in question is stretchy or otherwise like rubber.

If the NYT article is to be believed, elastomeric respirators are often judged more comfortable by the wearer than N95s. Disposable filters are still required, but they might require only annual replacement for a few dollars, while the main body of the device—composed of washable silicone—should last a decade at a one time cost of $15-40 each.

For about two thirds of the money spent by the Trump administration attempting to sterilize and re-use N95s, we could have outfitted each of the nation’s 18 million health care workers with an elastomeric respirator according to Nicolas Smit as quoted in Jacobs’ article.Pile of money

Or, to harp on the affordability point from a different angle, a paper published in the Journal of the American College of Surgeons showed: “Outfitting… workers [with elastomeric respirators] was one-tenth as expensive than supplying them with disposable N95s. A separate study found that after one year, the filters were still 99 percent effective.”

And, given the chance to switch back to N95s after the study period in question, none of the employees opted to do so. I take that to mean those healthcare workers found the alternative masks easier to wear or use.

Toward the end of the New York Times piece was a mention of just one particular small business that’s giving up in the face of the healthcare system’s irrational insistence on sticking with disposable, imported masks. Breathe99—whose elastomeric respirator made the cover of Time magazine in 2020 as an innovation prize-winner—is winding down operations at the company’s Minnesota plant.

I followed the link, and found that I could purchase Breathe99’s B2 mask at retail as of early July 2022. Since I still see daily death reports in my newspaper, I remain in the market for comfortable, effective face coverings. I decided to resume exploration of better Personal Protective Equipment (P.P.E.), hoping I can reduce waste while staying safe.

I don’t buy disposable water bottles or accept single use plastic cutlery when I get takeout food, so why should I continue to rely upon paper face masks when more comfortable, equally effective alternatives exist?

One caveat: there are officially approved elastomeric respirators for clinical use, but consumer grade options are unlikely to be officially NIOSH approved. Whether this is due to pandemic backlogs or if it is just a regulatory grey area, I’m not informed enough to say. Just be aware that we still have no official designation for effective, FDA-approved consumer grade face coverings.

Now that mask mandates have ended and masking is a voluntary, personal choice in most settings, the up side to all of that reckless abandon is that no one is likely to complain about any specific face covering I acquire or wear. There should be no push back to the lack of an official protection rating for any mask I select.

On the down side, I’m left having to hope these products actually work as designed, and as represented by their manufacturers. I’m “doing my own research” here because I have no choice if I want a comfortable, well-fitting, effective face covering. I do go all the way to published papers from scientific journals and material spec sheets whenever possible.

For example, here’s a USA Today fact checking story about why filter media with a physical pore size of around 0.3 micron can be quite efficient at stopping SARS-CoV-2 viral particles which are themselves closer to 0.1 micron.

One clear takeaway of the past couple of years is that any mask offers better protection from airborne viruses than a bare face does. I do feel confident that I won’t end up worse off than I would be wearing a cloth mask or an ill-fitting surgical one when I don a tight-sealing face covering utilizing an effective filter medium at the point(s) where all my breath enters or exits the device.

The author wearing an improvised home-made face covering in 2020

This improvised face covering was my first attempt at masking when the idea was introduced to the general public in 2020. This loose, single layer of fabric is obviously not protective in the way a fitted non-woven medical mask would be, but I crafted it for passing strangers on walks around my neighborhood, so, in hindsight, I wasn’t at high risk when I wore it.

I will compare and contrast three intriguing designs that I’ve purchased at retail and tested for myself for the reader’s convenience. Because these elastomeric products are relatively expensive—from $60 to 90 per starter kit—I hope my comparison will help others pick a useful style.

Because of the note of doom sounded by the NYT article that sent me down this path, I advise anyone picking up one of these expensive face coverings to stock up on specialized, custom fit filters while they are still available. We as a society seem to have learned very little from the deprivations and death wrought by COVID-19. Even top quality, well designed products may be dropped from the market if their makers go out of business.

I ordered three different face coverings direct via their manufacturer’s web sites, paying the stated retail price. Here’s the list including the July 2022 list price:

  1. B2 mask by Breathe99 as referenced in the NYT article ($59.99)
  2. FLO Mask for adults or children though I’m only testing the adult version ($89.99)
  3. ZShield Reveal rigid mask which I pre-ordered and got in 2021 ($89.99)

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PDX airport renovation poses new challenge for those with mobility limitations

This post will benefit those of us who fly in or out of Oregon’s major international hub, PDX. The airport, it is a-changing, and if you think you know it and how to navigate it, but you haven’t traveled much during the pandemic, think again!

Until now (December 2021), perhaps my favorite thing about PDX was the elegant simplicity of all airside (post-security) amenities being accessible to each other. There used to be a connector between this airport’s two sides. Adding 150 feet of space inside the terminal is displacing the old walkway.View of construction at PDX from Lounge

R.I.P. airside connector!

The good news is that this generally sensible airport will regain such a connection when the major construction is done. The bad news? That is scheduled for 2023.

As of 2021, travelers need to exit security and re-clear the TSA checkpoint to go from the B/C side to the D/E side. That’s a bummer, and a change, but it makes PDX similar to many other poorly designed airports.

Note: Crossing from B/C to D/E always has been a long-ish walk, and those with difficulty walking should get assistance or allow lots of time here even when the option comes back. Fortunately, most domestic connections don’t require crossing the airport in this way.

Here’s something that had an even bigger impact on me, a person who travels with some mobility limitations due to chronic illness: the walk from check-in to gate before departure, or from gate to baggage claim upon arrival, has grown from manageable to torturous according to my abilities.

This update may also affect families with young children. Little legs on very tired, very young people may also find the new trek difficult.

If you think you already know you can comfortably handle the walking distances at PDX, please look at updated construction maps and reconsider before travel if it’s been awhile since your last transit of this normally pleasant airport.PDX airport winter day - 1

I flew into PDX in the summer, visiting my dad, and the modern “one way valve” security exit didn’t seem so very different from before. The walk was longer, yes, and around to the side whereas one used to enter and exit the secure area from a central location, but at that point the airport still felt familiar with a slight redirection.

Landing in early December, 2021, however—after an, admittedly, much longer-than-average flight time due to a fierce jet stream—walking from arrival gate to baggage claim felt like personal judgement by a cruel god. I thought I might have to stop and rest at one point. I regretted failing to ask for a wheelchair escort before I was halfway out.

Checking in, just before the New Year, to fly home again, I asked an Alaska Airlines representative if the way in was now as convoluted as the exit route had been.PDX airport Alaska Airlines gate C11 - 1

“For the next four years,” she chirped. I opted to visit the special assistance group over by the windows and take a ride to spare my feet.

If you struggle with walking long distances, I strongly advise electing wheelchair assistance at PDX until its renovations are complete. Arrive very early, and accept the help that is available.

As it happens, there was no free assistance agent to help me at 07:30 on New Year’s Eve, though someone was present with the flock* of empty wheelchairs checking boarding passes and explaining the process.

Lucky for me, they gave us the option of having one of my able-bodied kids push me in an airport-owned chair, so we were off within five to seven minutes. An elderly couple traveling on their own who’d arrived before us was still waiting as we left.

I didn’t ask for an official estimate for how long the process of being assisted might take, but I’d add at least half an hour to one’s airport dawdling allowance if traveling alone with special mobility needs requiring an airport-provided wheelchair and attendant.

It goes without saying that one’s teen may not steer a wheelchair as expertly as an experienced, paid professional. Then again, I’ve had my feet bashed by at least a couple of strangers in the past, so a strong kid who loves you isn’t the worst option at an airport.

The “traffic cop” airport employee who directs passengers into the correct TSA security line did cause us some confusion by pointing to the “Express” lane when we were actually eligible for the “PreCheck” lane.TSA Precheck logo

It’s worth knowing that PreCheck trumps Express as far as convenience goes, so use that lane if your boarding pass indicates you are eligible.

Travelers transiting the airport from one no-longer-connected terminal to another are eligible for “Express” lane priority, which did have a markedly shorter line this December morning when compared with the standard security queue. PreCheck, on the other hand, allows one to leave shoes and light jackets on one’s body, keep liquids and electronics inside one’s bag, etc.

Fortunately, the split between Express and PreCheck was very close to the body scanners and X-ray machines so we backtracked only 15 or 20 feet.

It is possible that simply being in a wheelchair caused the “traffic cop” airport employee to direct us to the Express lane. In the past, I’ve noted that wheelchair assistance often allows one to skip the security queue. If this policy is universal, that could shave off a bit of the time “wasted” waiting for an assist. Then again, I didn’t stop to interrogate the employee in question, so don’t count on cutting the line due to mobility limitations without consulting a higher authority than me.

When I make use of airport assistance in the United States, I do tip any wheelchair attendant $5 per ride.

This is not a mandatory fee—services for travelers with disabilities are the responsibility of places of public accommodation—but it does seem to be expected, particularly in the northeast region. In foreign airports when I’ve relied upon similar services, I’ve gotten baffled looks from employees less accustomed to our tipping culture, with gratuities being politely refused in New Zealand, for example.

If you only occasionally need an airport mobility assist, and haven’t typically taken advantage of one at PDX, reconsider your habits there for trips from 2022 to 2024. If your toes are anything like mine, they will thank you!Red walker on hardwood floor in home

Airport assistance is a public good meant to serve all of us who travel; don’t be ashamed to take advantage of services designed to allow everyone equal access to the world.

*What is the correct plural noun for wheelchairs, I wonder? If I get to choose, let’s go with a “roller” of wheelchairs.

Facing pandemic persistence, I’ll spend where safety dictates policy

We have made it to August 2021. Sadly, the pandemic is not over, though the most vulnerable people in America have been tricked into behaving as if it is.

Decisions were made to re-open all venues while simultaneously dropping every protective precaution. Some of us believe that choice was precipitous, even reckless. I feel vindicated as my logic proves sound… but also so deeply disappointed.

I know I like redundancies more than most, but this seemed so obvious. “Better safe than sorry” may be trite, but it’s also wise where human lives are on the line.

How ’bout making one change at a time? After each change, observe the effect. It works for scientists, after all.

Oh, right, science is a tool for the liberal elite! Yet fools parroting such nonsense do it gasping through their fluid-filled lungs, crowding into our hospitals—institutions steeped in modern medical knowledge derived via the scientific method.

Some feel their lives aren’t worth living if they have to wear a mask to go shopping. Safety goggles, cloth face mask, and disposable gloves

I wonder how those precious snowflakes would hold up under conditions of true adversity. I imagine the oppressed population of Myanmar—or the people in Haiti or Tunisia, watching their fragile governments wobble under anti-democratic onslaughts—could offer lessons on what really constitutes a hardship to pampered American crybabies.

I would recognize that wearing a mask pales in comparison to being the target of genocide even had I never visited Auschwitz.

What a summer we could have had! If only we’d been cautious enough to resume access to theaters and restaurants, but with our masks in place for crowded, indoor conditions from the outset. It might have been the joyful reunion we all dreamed of during 2020’s isolation, loneliness, and despair.Woman hugs child

Hugging my grandma with a mask on didn’t lessen the joy of it. Visiting with my aunt over coffee on the patio instead of in the kitchen offered equal satisfaction. Espresso in demitasse cup on cafe table

Watching as my father’s “elective”—yet quality of life preserving—joint replacement surgery was postponed once, and then a second time, because no hospital bed was available was yet one more cost of the pandemic, but, this time, caused directly by bad actors, not a novel disease with unknown characteristics.

Now that stung.Analog wall clock showing 12:06

Frankly, I believe libertarian freedoms should be available… but only at a reasonable price. Partakers in those freedoms must give up the right to extort payment from the sensible majority.

Refusing vaccines? Fine, but wear a mask in public settings. Also, public funds—and even private insurance—should eventually cease to pay treatment costs incurred by those rejecting approved vaccines for endemic disease sufficient to be flagged by public health authorities.

The price of ignoring experts when an entire society experiences extreme events should be borne by those who choose to heed only their own counsel. That’s a fair trade off.

During outbreaks of any vaccine-preventable, endemic illness, refusniks must also give up the freedom to enjoy entertainment venues and public conveyances for all but essential purposes. Take your bus across town to work—while masked—sure, but recreational jaunts and all air travel unless, say, to receive urgent medical care out of state ought to be curtailed for those likely to spread disease.

NZ Chch bus MetroUnvaccinated kids should learn remotely unless masks are shown to be sufficient in preventing the spread of measles, chickenpox, the equally transmissible delta variant of COVID-19, and any future outbreak of similarly easily spread viruses.

If masks prove to work as well as that, I am 100% fine with unvaccinated kids—wearing masks—in schools forever. The point is to keep vaccine-preventable germs contained, not to dictate personal decisions that affect only oneself.

It should go without saying that the vaccinated should always be prioritized over the voluntarily unvaccinated when medical treatment becomes a scarce commodity that must be rationed. I hope and pray it doesn’t come to that, but, today, I fear for the people of Florida, Louisiana, and Arkansas. Mississippi and Alabama look pretty terrible, too.

Pandemic illness currently strains the pathetically insufficient “just in time” commercial hospitals in these and other states. An August 5th AP news story describes one Broward County hospital cramming beds into auditorium, cafeteria, and conference rooms to accommodate surging COVID-19 caseloads.

How pathetic that we allowed ourselves to fall back to this point more than a year after learning how and where this virus spreads!

Speaking to business owners and service providers, I reiterate that my personal spending will be concentrated in locations with high rates of vaccination. Pile of money

I will preferentially patronize restaurants and stores that demand proof of vaccination before letting anyone remove her mask.

It shouldn’t fall to commercial interests to manage a public health crisis, but dysfunctional politics brought us to that point. Re-opening—with precautions—allows for increased economic activity without excessive deaths. That’s the course I’ll vote for with my wallet.

Here’s hoping leadership by accounting departments can make up for the inadequacies of incompetent elected officials.