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The Spring of Our Discontent

Illustration of George Floyd

The three most indelible images of the spring of 2020 will be shuttered stores, socially distanced Americans wearing masks, and a white cop murdering an unarmed, handcuffed black man by kneeling on his neck.  As I write this, protests over the death of George Floyd are continuing across the country and beyond.  Most of the protesters are peaceful, but some have vented their rage or taken advantage of the chaos by rioting and looting.  The nightly scenes of burning cars and buildings and lines of riot police and National Guard troops shooting rubber bullets and tear gas at surging crowds recall the worst riots of America’s troubled legacy of slavery and the oppression of minorities.  It astonishes me that more than one hundred and fifty years after the end of the Civil War, some Americans still cling to the inane belief that ethnicity and skin color matter, that one race can be superior or inferior to another.

photos of burning cars
The rage provoked by George Floyd’s death was an unfortunate but inevitable outcome of simmering racial injustice and police brutality

The turmoil following George Floyd’s murder is no doubt exacerbated by months of enforced pandemic isolation, record unemployment, and the dread many Americans must feel, not only about dying from this pandemic, but about the prospect of losing their homes or apartments and feeding themselves and their children.  When forty million working Americans are out of work and watching their savings dwindle, and when hundreds of thousands of small business people are closing their doors, many of them forever, and when we witness a corrupt and incompetent president failing to address the pandemic seriously until it’s too late—the general malaise in our communities manifests itself in depression and systemic anxiety.  Then another black man is killed at the hands of a white cop, and this time the look on the cop’s face is one of smugness and superiority as he kneels on the black man’s neck for almost nine minutes, even after his victim lies unresponsive.

It is a sad commentary on our society that this could still happen in 2020, that such police tactics as restraining a suspect by kneeling on his neck haven’t been outlawed decades ago.  The murderer, Officer Derek Chauvin, is a 19-year veteran of the Minneapolis Police and has a long record of using excessive force.  With that record, why was he still employed as a policeman?  How could the Minneapolis Police Department not recognize his penchant for violence and either fire him or take him off the streets?  A week after Floyd’s death, we watched as two members of the Buffalo Police Department shoved an unarmed, white, 75-year-old protester to the pavement and then walked on, along with a dozen of their fellow officers, as the man lay there with blood pouring from one ear.  What, in God’s name, has happened to the idea that our police are sworn to serve and protect?

It is gratifying to see so many white faces among the hundreds of thousands of protesters who have taken peacefully to the streets.  For systemic racism and injustice is truly not an African-American problem.  It is an American problem.  It is a human problem.  And at this moment in our history, it is a political problem.

We have a president whose pettiness, racism, misogyny, and self-service are not only blunting an effective federal response to the crisis but actively abetting the divisiveness and anger Floyd’s death prompted.  Trump’s decision to use of the American military to contain the protests is what petty dictators do when their citizens rise up.  And his cynical photo op at St. John’s Church was one of the low points of his dismal presidency.  Holding up a Bible as an appeal to his base was callous and reeked of insincerity and political calculation.  Anyone who believes that Donald Trump is a Christian, or has even read the Bible, is drinking the Kool-Aid.  This is not to say that Trump is without religion.  The evidence from his life and behavior indicates that he does believe in a holy trinity:  Himself, Money, and Power.  That is what he worships.

He is a malignancy, but even worse are the banana Republicans who have compromised their Republican ideals—and Constitutional responsibilities—to placate him, feather their own nests, and avoid offending his base by criticizing him or opposing him in any way.  As shocking and sad as George Floyd’s death was, it has been more painful to watch the slow erosion of our democracy at the hands of a disgraceful president and Republican senators who have failed, despite Trump’s repeated assaults on our institutions, free press, allies, and treaties, to resist his unquenchable thirst for power and exercise their responsibilities as a key branch of our government and a check his excessive use of executive power.

Photo of lines of police
Police and National Guard troops were out in force to quell the worse of the rioting, but Trump wanted to mobilize even more troops to dominate the streets.

The banana Republicans have stood idly by as this wanna-be autocrat has taken greater and greater liberties.  Now we’re facing an existential crisis on multiple fronts.  The Covid-19 pandemic has taken over a hundred thousand American lives, many of which were unnecessary deaths, because Trump ignored the signs and dismissed the virus when it was clear to the experts that it posed a lethal threat.  Now millions of Americans are out of work, perhaps permanently, and hundreds of thousands of small businesses (and some big ones) will fail because of Trump’s belated recognition that the pandemic was real and would not, as he asserted, disappear through some miracle.  Now we have serious civil unrest because the racism and white supremacy Trump coddles has led to a black man’s death that has finally ignited the level of acknowledgement and activism that could lead to significant change, if not in the hearts and minds of those who support Trump, at least in the policing practices that led to Floyd’s death.

The murder of George Floyd provoked a greater outpouring of rage than any of the previous killings of black Americans by white cops, and as I watched the video of that cop kneeling on Floyd’s neck, I wondered why this killing had so much impact.  I believe it’s for several reasons.  The image of a white man kneeling on a black man’s neck represents not just a single instance of racial violence but is emblematic of centuries of oppression—from the slave trade to reconstruction and the birth of the KKK, and from Jim Crow and segregation to police violence during the Civil Rights movement of the sixties.  Also potent is the image of a black man dying by an assault to his neck.  The neck is a highly symbolic part of the human anatomy.  People are executed by being hanged by the neck.  African slaves, particularly males, were often restrained by collars around their necks, and in one of the most disreputable periods of our nation’s history, blacks were lynched by white mobs.  Photos of those lynched bodies are a painful reminder of the racial fear and hatred that are part of America’s legacy.  Black lives do matter.  All lives matter.

Photo of a woman wearing a mask
Compounding the anguish over George Floyd’s murder is the pandemic that has left many Americans feeling isolated and depressed.

Our nation is in crisis, and the only hope we have to reverse this ruinous course will come in November with the general election.  No significant change will come from a racist president whose response to these protests has been to call the protesters “terrorists,” order the military to dominate the streets, and threaten violence by proclaiming, “When the looting starts, the shooting starts.”  No significant change will come from a national leader who lacks empathy, has no understanding of the Constitution, and views himself as an all powerful dictator.  And no change will come while we have do-nothing Republicans in the House and Senate who remain silent and cower when their master speaks.

We need to vote Trump out of office.  Equally, we need to vote out the complicit Republicans who have actively or passively colluded with him.  Maybe, if enough Republicans are defeated, the remaining members of that grand old party will regain their senses and return to the Republican ideals that have made them essential partners in our democracy.  Thereafter, we pray that we will be reunited as a people, that we will finally make real strides toward racial equity and equal justice, that our government will act in a non-partisan manner and return to responsible free-world leadership, and that the Administration will benefit all Americans instead of one man and his family.

 

Photo credits:  George Floyd vector art:  ariyantodeni / Shutterstock.com; burning cars: Micah Casella / Shutterstock.com; line of police:  Claudio Schneider | Dreamstime.com; tearful woman wearing mask:  Andy Dean Photography / Shutterstock.

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Pandemic Life by Robert Greenberg

Photographer Robert Greenberg, who lives outside Washington, D.C., has captured some haunting black and white shots of life during the Covid-19 pandemic.  We all seen the masks, the covered faces, the looks of resignation and wariness in the eyes, the slumped shoulders, and safe distance between people.  Bob’s photographs put a partially concealed human face on the tragedy, as well as the despair of shuttered stores and lives and the emptiness of streets in a time when we dread continued isolation and pray for a return to normalcy.  I am offering these photos without comment.  They speak for themselves.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Photographs courtesy of Robert Greenberg.  Copyright 2020.  All rights reserved.

 

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April 13, 2020. Covid-19 continues to ravage our country

April 13, 2020.  During the past month, Covid-19 has galloped along, infecting more than 1.9 million people globally and killing 118,623.  The United States has 572,587 cases that have been counted, but because testing has been so inadequate (and remains inadequate), the exact number of infected people in America is unknown.  Likewise, more than 23,000 Americans have been declared dead because of the novel coronavirus, but that number is also suspect because it doesn’t not include people who may have died at home of the disease.  The economy is in free fall because so many businesses have been shut down.  Virtually all restaurants are take-out only, and all gatherings of people over a very small number have been banned.  None of the major league sport are playing, schools have been shuttered, retail stores are empty, and the disease is spreading rapidly among the military, firefighters, and police.  Most distressing is the situation at hospitals.  In areas hardest hit, hospitals are operating like third-world countries–with ragged staff, too few supplies, and precious few ventilators for the most seriously ill.  Trump and his allies continue to blame everyone but themselves for their slow response to the crisis and their inept handling of it since it began, but it’s clear to anyone who’s conscious that Trump has mismanaged this crisis from the start.  Initially, he dismissed the threat, saying that only a few Americans would become infected and claiming that a “miracle” would occur to wipe out the virus.  In his ignorance and arrogance, he has continually deflected criticism, given ventilators as political favors to Republicans like Cory Gardner of Colorado, and claimed that while he saw himself as a wartime president, he and the Federal government were “backups” to the states.  His horrendous misjudgments have cost lives, yet his staunchest supporters continue to think he walks on water.  His administration is a colossal farce amidst one of the greater natural disasters of the modern era.

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Covid-19 Bulletin #5

Covid-19

By now, the coronavirus pandemic is firmly embedded in our national consciousness.  The pandemic has infected well over 150,000 people globally, including–at last count–3,000 Americans and around 60 deaths.  The numbers keep climbing dramatically, and no one knows how many people are actually infected because our country lacks adequate testing.  Trump and his administration have tried to blame the lack of testing on Obama, but we all know this is not true.  Trump’s failure as a leader is entirely to blame.  Nonetheless, here we are with a dramatically changed life.  Most sporting events have been cancelled, along with concerts, museums, Broadway, cinemas, conferences, Disneyland, and other large gatherings of any kind.  Schools have been closed in many states, including NYC, the country’s largest school system.  Universities and colleges are moving from classrooms to online education.  France has closed restaurants, bars, cafes, and clubs across the entire country.  Italy is on lock down, and Spain has ordered its citizens to stay home.  Many companies in the U.S. have told their employees to work virtually.  Most cruise lines have shut down, and airlines have cancelled flights or restricted them to certain locations.  The lines at Costco and WalMart stretch around the block, and many store shelves are empty.  It’s nearly impossible to find hand sanitizer, toilet paper, paper towels, and cleaning products like Lysol and Clorox.  In one of the grocery stores in my hometown, men were seen stuffing grocery carts with nothing but bags of potato chips.  It seems the world has gone mad–and we aren’t anywhere near the peak of this pandemic yet.  

 

This is Covid 19 Bulletin #5 from Dr. Sheila Sund.  The news about Covid-19 has been so ubiquitous that the content of Dr. Sund’s bulletins has now become glaringly familiar to anyone who is paying attention.  However, it is to her credit that Dr. Sund began sounding the alarm weeks before the general public became aware of the potential severity of this outbreak.

Dr. Sheila Sund is a retired hospice and palliative care physician in Oregon.  She became involved with disaster medicine following the H1N1 influenza outbreak in 2009. As part of a statewide workgroup, she helped developed Oregon’s Crisis Care Guidance—guidelines to direct healthcare response during a public health crisis such as pandemic or mass trauma. She served as Director of the Marion County Medical Reserve Corps and physician representative on Oregon’s Region 2 Coalition for Healthcare Preparedness. She has given over one hundred presentations to community, healthcare, and business groups throughout the Pacific Northwest on topics ranging from earthquake preparedness to pandemic response.

 

Chinook CERT Plus – COVID-19 Bulletin #5, March 9, 2020

 

Don’t focus on numbers

“Marion County confirms first case of COVID-19.” “Cases in Oregon double in one day.” When we see this, it triggers an acute feeling of alarm. But these numbers tell us nothing new—they reflect increased testing, not increased disease spread. That doesn’t mean the risk isn’t real. It’s just confirmation of what we should have already known—COVID-19 is “here.”

So far, we have no way of knowing where we are on the growth curve – day 5, 15 or 30. Our best clue will be increasing cases identified in Marion County hospitals. In the meantime, your best action remains hand washing, disinfecting, and minimizing time spent in large groups, particularly if you are older or have underlying medical problems.

Most importantly, if you feel sick, STAY HOME, even if you suspect it’s just a cold or the flu! If possible, isolate yourself even from family members until symptom free for 24 hours.

 

We’re all going to get it, so let’s just get it over with. FALSE!

I’m hearing this sentiment more and more, but it is incorrect. It’s true that most people will get through this pandemic with just a week or two of illness. But in the meantime, COVID-19 could decimate the population over age 70.

Age US population Fatality rate Potential deaths
70-79 23 million 8% 1.8 million
80 and above 13 million 15% 1.9 million

(Based on current COVID-19 estimates)

For comparison, annual seasonal flu deaths in the US 2010-2019 ranged from 12,000 – 61,000.

Most deaths occur after 1 or more weeks in the hospital. So even if you feel callous about this specific demographic group, their use of medical resources will affect everyone. The more we can slow the spread of coronavirus, the better off everyone will be.

 

Mitigation Instead of Containment

The goal of mitigation is to decrease the expected number of new cases infected by one current case (the reproductive number). If it drops to less than one, the pandemic fades away. In practical terms, mitigation is anything that decreases interpersonal contact in the community, including cancellation of group gatherings, work and school closures, isolation of known cases, and even limitation of travel or quarantine of entire communities.

Yet we can’t really enforce mitigation in this country. Ultimately, it comes down to individuals choosing to put the good of the community over their personal interests, despite economic or social hardship.

If someone is exposed to a confirmed case, they may be instructed to implement one of the following measures immediately. Prepare yourself and your family now!

Exposed, but no “close contact” AND no symptoms:

  • Social isolation – no group gatherings, maintain 6 feet boundary from others. Shopping allowed.
  • Self-monitoring – watch for any signs of illness, possible required temperature checks
  • Active monitoring – public health assumes responsibility for conditions of your isolation and monitoring

Exposed with close contact, but no symptoms:

  • Quarantine, usually at home, for 14 days. No contact with family members or pets. Use separate bedroom and bathroom. Wear mask whenever other people are present. If symptoms develop, 14-day clock resets.

Close contact: being within 6 feet of an identified case for “prolonged” time OR having direct exposure to their respiratory secretions (e.g. coughed or sneezed on).

Exposed and symptomatic, or become symptomatic during self-isolation or quarantine:

  • Isolation, usually at home, for 14 days minimum, under same criteria as quarantine.

 

Other Preparedness Tips

There is no need for a run on the grocery stores or Costco, but if there are things you need or chores you should be doing, it’s time to stop procrastinating. Do them now. The more “caught up” on life you are, the better prepared you will be for any sudden changes.

Manage COVID-19 anxiety!

  • Limit time spent reading about and planning for COVID -19
  • Use reliable sources and avoid social media discussions
  • Continue to follow normal routines as much as possible
  • Take time for reality checks:  What is happening in your life now, not what may happen in the future
  • Do deep breathing or meditation

Perform meaningful actions:

  • Prepare guest bedrooms
  • Organize emergency supplies
  • Think of enjoyable things to do even if social isolation imposed
    • Catch up on book reading
    • Time for home projects, crafts, or gardening
    • Family time
    • Time in nature
  • Address COVID-19 anxiety in kids and teens -what are they reading or hearing in school?
  • Share NPR’s “Just For Kids: A Comic Exploring The New Coronavirus

 

Photo credit:  ID 175225651 © Photovs | Dreamstime.com

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March 12, 2020. Seismic shifts in American life as Covid-19 spreads

March 12, 2020.  The stock market plummeted more than 2,000 points today, after a plunge of 1,400 points yesterday.  We are now officially in a Bear market, stocks having lost nearly all their increased value since Trump took office.  There are now more than 1,500 cases nationwide, with 40 deaths, and the numbers are growing significantly each day.  The truth is that no one knows how widespread the virus is because of inadequate testing, which Trump blames–once again–on the Obama administration.  Yesterday, Trump suspended all travel to the U.S. from every European country except the U.K., which, ironically, has more Covid-19 cases than most other countries in Europe.  Meanwhile:

  • The World Health Organization officially declared Covid-19 to be a pandemic.
  • Italy is on a total lock down.
  • France closed all schools today until further notice.
  • The states of Ohio and Maryland have closed all schools.
  • Broadway has closed all shows.
  • The NBA has suspended its season, as has Major League Soccer and the National Hockey League.
  • Disneyland is closed indefinitely.
  • Princess and Carnival cruise lines have suspended all cruises
  • More than 250 colleges and universities–including Durango’s Fort Lewis College–are suspending onsite classes.  Henceforth until further notice, all classes will be held virtually.
  • The NCAA cancelled March Madness.
  • The PGA tour is proceeding without fans.
  • The NFL is cancelling is annual meeting.
  • Museums around the country are closing, and several movie premiers have been delayed.
  • NASCAR will hold races without fans.

These cancellations are just as of today.  More are expected as the nation braces for more Covid-19 impacts.

 

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Covid 19 (Coronoavirus) Bulletin #1

Photo of a coronavirus

This is Covid 19 Bulletin #1 from Dr. Sheila Sund.  Covid 19, which is the proper name for the coronavirus that is currently spreading around the world, is a far more dangerous virus than the flu.  Despite what Donald Trump said on television several days ago, Covid 19 is twenty times more lethal than the flu, and it is likely that the rate of infection is much greater than what is known and being reported by the media–because no one knows how widespread the infection actually is.

Dr. Sheila Sund is a retired hospice and palliative care physician in Oregon.  She became involved with disaster medicine following the H1N1 influenza outbreak in 2009. As part of a statewide workgroup, she helped developed Oregon’s Crisis Care Guidance—guidelines to direct healthcare response during a public health crisis such as pandemic or mass trauma. She served as Director of the Marion County Medical Reserve Corps and physician representative on Oregon’s Region 2 Coalition for Healthcare Preparedness. She has given over one hundred presentations to community, healthcare, and business groups throughout the Pacific Northwest on topics ranging from earthquake preparedness to pandemic response.

On February 28, Dr. Sund published the following bulletin on Covid 19, and she has graciously allowed me to reprint it on this blog.  As she publishes future bulletins on Covid 19, I will reprint them here as well.  Stay tuned.

 

Chinook CERT Plus – COVID-19 Bulletin #1, February 28, 2020

How bad is Covid-19?

Based on evaluation of 72,000 cases in China:

“Mild” symptoms (not hospitalized): ~81%.   Mild cases can still be sick for up to 14 days

Serious illness (hospitalization): ~14%

Critically ill (intensive care): ~5%

Fatality rate ~2% overall.   < 1% if young and healthy, 14.8% if age 80 or above

My note: serious illness does not usually occur until the second week of the illness

Covid-19 is already a pandemic by the traditional epidemiology definition:

Uncontrolled spread of an infectious agent on at least two continents

My note: there are strong social/political/economic reasons why official organizations and governments avoid labeling something as a pandemic – even when it is!

Official case counts are misleading, both in the United States and internationally.  Patients are counted only if they have a positive test, yet:

  1. The availability of testing is limited in many places
  2. Testing is limited to the sickest patients or those with known case contact

Before Feb 27, a sick patient could only be tested in the United States if they had visited China or had contact with a known case.  On Feb 27, criteria were expanded to travel from six countries, but otherwise, patients without known exposure can still only be tested if they are not just hospitalized, but critically ill.

My note: Given the rapid spread of cases around the world, it seems highly likely there are already clusters of infection with community spread within the United States. However, with current testing limits, these will not be identified until someone within the cluster becomes critically ill (such a patient was identified just today in Lake Oswego). Given the typical time course of the illness, these patients will already have been infectious for at least seven days.

 

Personally, I am taking this illness very seriously. I implemented my family’s infection control plan this week, which affects four households (including one in Lake Oswego!). I’m working on putting it all in writing, and then will share with you. But in the meantime, here is the most important tip of all – WASH YOUR HANDS! (Read on.)

 

YOUR COVID-19 PREVENTION TIP OF THE DAY

WASH YOUR HANDS, WASH YOUR HANDS, WASH YOUR HANDS.

 

Hand washing instructions (yes, there is a correct way!)

1) Wet hands with clean, running water (warm or cold), turn off tap, and apply soap.

2) Lather hands and rub front and back to wrists, between fingers, and under nails

3) Scrub hands for at least 20 second (hum “Happy Birthday” twice)

4) Turn faucet back on and rinse your hands well under clean, running water.

  5) Dry hands using a paper towel

 

Hand washing at home

Pump liquid soap at every sink

Does not need to be antibacterial

Use paper towels even at home during times of increased infection risk

Damp hand towels can harbor germs

Dispose of paper towels in non-touch trash can – foot pedal, magic hand wave.  Not inside cabinet

Use hand cream frequently

 

Hand washing in public

Gather paper towels before washing hands

Use one paper towel as barrier from counter – set other towels on it

          Wash hands as above, drying completely with paper towels

Avoid touching public surfaces after hand washing

Use paper towels to turn off sink, open trash cans, and open doors

Option: Ziplock bag with hand soap, paper towels, and hand sanitizer for public use.  Keep plastic bag “clean” – store inside purse/bag

No touch public surfaces – set on paper towel

 

When to wash hands in pandemic

Every 1-2 hours when out of home in public

Before leaving public location – avoid contaminating your car

          As soon as you enter house (touch as few things as possible first)

Before touching any food, including packaged snacks or restaurant food

After contact with potentially contaminated things in home (groceries and supplies, outside door knobs, shoes, backpacks/purses)

Toilet, etc – just like always

 

Hand sanitizer

Use only if you can’t wash your hands!  Why? You can’t disinfect something that is dirty!

Germs hide in oils and grime…and hands get dirty very quickly.

Sanitizers work best if hands are clean

Sanitizers must be at least 60% alcohol

          Rub gel over all surfaces of hands and fingers until dry (~20 seconds)

 

Photo credit:  Coronavirus (ID 171082256 © Dgmate | Dreamstime.com)