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Brand matters when arthritic hands administer COVID tests

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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 “free” i.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.

Is grief reflected in (un)polished silver?

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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

Remote school works best for YOUR child? You have the RIGHT to continue!

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Late spring polls—and the blessed waning of the COVID-19 pandemic, in the USA, at least—have prompted headlines like this one from the Boston Globe:

“After a difficult academic year, the majority of Mass. parents want in-person school this fall”

Boston Globe article headline with "the majority" highlighted by this bloggerThat unambiguous headline hides the whopping 31% of parents who disagreed with the sentiment. Almost a third of the 1,619 parents polled by MassINC Polling Group are NOT eager for mandatory, full-time, in person education just a few short months from now.

That’s more than three out of every ten people. In my childhood classrooms that averaged around 30 kids, that would have meant nine or 10 were attending against their families’ best instincts. I don’t think numbers this significant can be dismissed as a “trivial” minority over whose preferences the majority can ride roughshod with impunity.

An earlier Gallup poll restricted to 14 to 18 year old high school students in the same state of Massachusetts showed similar dissonance with an equally head-scratching headline:

“Few Massachusetts Students Prefer Remote Learning”

The data in that case also shows that most people, shown a few narrow options, prefer to travel the path of least resistance and do what they’ve always done. Half (50%) of the kids polled, if given these three choices, would attend “in person full-time.” Only 16% would choose “remote school full-time.”

Then again, 34% in the Gallup poll selected the third option: a hybrid “in person/remote” approach. That third of the student body can’t necessarily be described as “preferring” in person education. A more accurate headline would have been: Half of Massachusetts Students Prefer Full-Time, In Person Learning.Backpack with textbooks and school supplies spilling out

“Half of Massachusetts Students Prefer Full-Time, In Person Learning”

Some of these students might’ve been reacting more to a lousy remote education experience—one they got stuck with during a worldwide crisis—rather than alternative learning in general. Even with widespread reports of low quality remote instruction in 2020, from this data, I see that half of the polled teens expressed an interest in at least some education outside of the traditional brick school building.

From yet another source, I offer a press release from National Parents Union including a third poll (poll data here) producing similar statistics. The NPU poll shows 56% of surveyed parents “value having a choice between in-person and remote” learning. Roughly half prefer in person classrooms, but 17-25% of parents depending upon geographic region would prefer a hybrid model.

As with the other polls, 20% of these respondents would prefer full-time remote learning in 2021-22.

The right to an education

Before I say anything more, let me be clear: I do believe that opening schools this fall looks likely to be safe enough for most. The decision to do so appears to be based upon a sound assessment of current conditions in the USA.

Families who want to send their children back to schools in person should absolutely have that option based upon currently available data.

American children have a right to an education. Maybe even a constitutional right to at least basic literacy. In no way am I looking to dictate the best way for other people’s children to learn.USA flag - 1

I grow frustrated by the outright dismissal of the reasonable preferences of a sizeable minority of parents and children who want continued access to remote learning options for those who prefer them.

If even “just” 16-20% of students would choose remote learning, that’s 4.8 to six students in my hypothetical classroom of 30. I find it interesting that 20% of respondents in the NPU poll (see question 14) also reported their pupils “learning more than they normally would” during remote classes† than they felt they had attending school in person.

These are real outcomes from American students for whom remote education works well.

The 31% from the first poll of families who don’t want to send their kids back to traditional school buildings—for now, or perhaps forever—deserve to be heard and accommodated by the public system. They may not be the majority, but the group is large enough, and the stakes are high enough, that ignoring the needs of these families is a dereliction of a very reasonable duty of care.

Let’s face reality: it’s not as though our system has been offering an excellent education to every child who wants one up to this point. (An example: the fierce fighting over scarce seats at Boston’s best public schools.) We have a lot of room for innovation and improvement. The point at which 16-31% of participants in the system ask for an alternative seems like an ideal time to start.

Parents usually judge best what works for their own kids

Barring extreme dysfunction, parents know their own children best. While most moms and dads aren’t professional educators, they are experts on the subject of their offspring.

I have two kids, and only one of them was educated at home before the pandemic. 2020-21 was as much of a wild academic ride for us as it was for students everywhere!

I posted about my family’s educational choices here—Home education as a radical act—back in 2017. I was also grateful to take advantage of my son’s school’s outdoor classes during the pandemic.

I mention the different choices made on behalf of my two children because I’m not a rabid proponent of homeschooling at all costs. My sociable younger son is enrolled in school because he prefers learning in a group, and evidence suggests the system works… for him.

My other kid has definitely found his groove, but even my homeschooler didn’t love the shape of every part of learning through a pandemic. That child, too, is eager to return to some classrooms for some subjects; my kid can’t wait to have choices again.

Home education allows for remote learning

This rambling? preamble has served to get me to the following point:

Families who aren’t well-served by the public system are entitled to remove their kids from it. Aside from expensive private institutions, home education is a legal right in all 50 states. Remote classes—many taught by trained professional educators—can be a part of homeschooling.

The internet began offering amazing online opportunities to homeschooling families many years ago, and the pandemic actually increased and enhanced the quality of the choices found thereon.

  • You don’t have to be a trained teacher to do a fine job teaching your own child.
  • You can purchase ready-made curricula for a term or a year, by grade level, or for individual subjects.
  • If your kid excels in one area while struggling with another, you can tailor everything to his or her needs on your own, or with targeted help by hiring tutors or joining group classes.

Here’s a post about a particular online foreign language program that worked out well for my kids: YES! CLV’s Virtual Village is great remote language learning for kids. I’m also a fan of the affordable online courses offered by Royal Fireworks Press.

Roughly 2.5 million American students were learning from home before the pandemic; by March of 2021, that number doubled to 4.5 – 5 million. (Homeschool statistics from NHERI) Plenty of families rejected their schools’ responses to COVID-19 and took the plunge at the time; all of us can make that choice today based on what we’ve learned over the past year and a half of disruption.

If you know that returning full time to a classroom isn’t the best decision for your child, I encourage you to try home education… if you believe it might be a good fit. Making this choice now doesn’t commit you or your child to this course forever; many kids transition in and out of homeschooling every year.

The NHERI link I gave above offers more detail on the subject of the success of home educated students, but the short version I believe everyone deserves to know can be summarized thusly:

  • Homeschoolers as a group perform better on standardized tests than those educated in public schools— 65-80th percentile for the home educated vs. 50th percentile for public institutions (Ray, 2015)
  • Homeschoolers as a group “succeed and perform statistically significantly better than those who attended institutional schools (Ray, 2017)” as functioning adults
  • “87% of peer-reviewed studies on social, emotional, and psychological development show homeschool students perform statistically significantly better than those in conventional schools (Ray, 2017)”

Oh yes, and, add to those points: selective colleges are generally very accepting of well-prepared home educated applicants because they also tend to perform as well as institutionally-educated enrollees at the university level.

Beyond these general facts gathered prior to the ravages of the coronavirus over the 2020-21 school year, it is worth acknowledging that a child who doesn’t feel safe at school is less likely to learn well. A parent who fears for her offspring’s health and safety is likely to perform less well in her own work. These are not insignificant issues; these feelings deserve to be dealt with in a constructive way.

Where state governments or boards of education dismiss out of hand the wishes of 20-30% of their enrolled families, I offer the option of parent-led home education, not as a prescription, but as a valid choice available for those who want it.

Though I’m not a home education focused blogger, per se, I’m happy to answer any specific questions that I can, or to provide links to specific types of resources that have worked for my family, if asked. Ask away in the comments!

♦

†If one fifth of students learned more during the pandemic, it seems obvious to me that public schools have an obligation to understand why that happened, retain that advantage going forward, and incorporate remote options for that sizeable chunk of their constituents.

Homebound senior wants COVID vaccine yet can’t get shot doctor prescribed

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Here’s the story of one elderly American citizen who agreed to be vaccinated against COVID-19, yet hasn’t been able to receive a shot as of mid-June, 2021.

Someone I care about has a very complex medical situation. Her health is fragile, and her immune system is compromised.

My loved one is frail and almost completely housebound; it is a struggle even to get her to scheduled doctors’ appointments with ample notice. Sometimes, her body simply won’t conform to the constraints of sitting in a passenger vehicle. Hospital bed in dining room

She certainly would not be able to wait 30 minutes on a hard chair in a physician’s practice—let alone standing in an aisle at a local pharmacy—the way my kids and I did after our jabs. At the same time, due to a history of severe allergic reactions to drugs and vaccine components, the risk of an adverse reaction is higher than average for this patient.

Consultations with her various specialists resulted in a consensus that the Pfizer product is the only recommended COVID-19 vaccine for her.

Thus far, none of her providers has been able to offer access to a prescribed dose of COVID-19 vaccine during a routine visit. Internet-savvy family members continue searching for a solution that will accommodate her specific needs with no luck to date.

The patient’s state of residence now offers at-home vaccinations for those who are homebound. Unfortunately, the program sends its providers out with the Johnson & Johnson single dose vaccine only. According to the toll-free hotline, there are no exceptions unless the patient is under 17 years old.

This patient, though unable leave home for a shot, cannot take advantage of her state’s offering for housebound residents. According to the Journal of the American Medical Association, approximately 6% of U.S. seniors were completely or mostly homebound as of 2015.

Without a doubt, American wealth and power has provided a tremendous benefit to average citizens who’ve been amongst the earliest to access life-saving vaccines against the novel coronavirus. Public health, however, relies upon the breadth of its network to protect every resident. Many of our most vulnerable are still waiting as vaccines near expiration dates in medical center freezers.

Evidence of widespread vaccine hesitancy proves we must keep working to remove barriers to access for those willing, yet unable, to be vaccinated in currently available settings. Lives—and our loved ones—depend upon it.

♦