Last week I wrote about COVID fatigue. This week I thought I would write about COVID awareness. I did a similar Q&A to this one early on in the pandemic, and in retrospect, it has proven to be accurate. That blog post was based on available data at that time. This blog post is based on more current information. My goal is to present these questions and answers in an understandable format, as I believe that knowledge is power.
I am a physician who trained at Northwestern’s Feinberg School of Medicine. Although I specialized in treating disorders of the mind (psychiatrist), I was trained in all areas of medicine as a medical student. Before becoming a medical doctor, I obtained a graduate degree, where I studied microorganisms’ biochemistry. I have also worked in research centers, where I participated in basic research on cancer and multiple sclerosis. Years ago, I was part of a research team that used monoclonal antibodies as a research tool. It is incredible to see these agents now being used to treat medical illness. Although I’m not a specialist in infectious disease, I can read scientific information and determine good data from bad information.
What is this virus?
This virus belongs to a large family of viruses called coronaviruses. These viruses have a common characteristic: they have a “crown” (or corona) of protein spikes on their surface. These spikes can attach to specific receptors on host cells, which allows the virus to inject its contents into the cell. The virus uses the “machinery’ in the host cell to reproduce (or replicate). This process, and how the body reacts to it, can cause illness and death.
How does one contract this virus?
The virus has to enter a host’s body through a vulnerable site. These places include the mouth, nose, and eyes. You cannot contract the virus by just touching it. However, you can touch a contaminated surface and then rub your mouth, nose, or eyes to inoculate yourself with the virus. You can also contract the virus by more direct means. If someone with the virus coughs, they send a spray of droplets into the air. The virus can exist in very high concentrations in these droplets. If they land on your face, they can infect you. These droplets are pretty heavy, and most of them will fall to the ground within a few feet of being “coughed up.”
It now seems likely that the virus can also float in the air. In these situations, the virus can travel further.
Can you tell me more about airborne spread?
It is likely that the virus can be spread in smaller particles that are expressed when a person exhales. These particles are lighter, so they can travel further and potentially infect a person who is further away than 6 feet from the infected individuals. However, the conditions have to be just right for this to happen-I’ll talk more about that later.
If you understand the answers to the following question, you will have a firm understanding of the relative risk of any activity that you may want to do.
The most important answer in this post:
What are the factors that make it likely that someone will get infected by this coronavirus?
The number one factor is called “the infectious dose.” That is the number of particles of virus needed to cause a successful infection. Different viruses have different infectious doses. It is unclear how many virus particles are required to cause a COVID infection, but the number is likely considerable. In other words, if you somehow accidentally inoculate yourself with only a few viral particles, you won’t get sick. Four main factors determine if exposure to the virus will infect you.
The concentration of the virus-the higher the concentration, the higher the infection rate.
The length of exposure to a virus-the longer you are in a place contaminated with the a virus, the more virus you are exposed to.
The viability of the virus-viruses are fragile. A freshly expressed virus will be more potent (virulent) than one that has been drying on a surface.
The vulnerability of the host. For instance, individuals with weakened immune systems can be infected by fewer virus particles than a person who has a robust immune system.
How likely is it that you will infect yourself with a virus by touching an inanimate object (like a package) and then touching your face?
It is doubtful that you will infect yourself in this manner. If there is a virus on a surface, it is likely that the virus’s concentration is low and that the potency is low. However, there are some cases when the risk can be higher. For instance, an infected person coughs into their hand, which you then shake. You then touch your face and inoculate yourself. Or a person coughs on a hard surface like a credit card touchpad. Immediately afterward, you use the same touchpad for your transaction. You then rub your nose.
Beyond specific cases, it is unlikely that you will contract the virus from an inanimate object. There is no compelling evidence that you have to wash your groceries or sterilize your mail.
Then I don’t have to wash my hands?
NO, YOU HAVE TO WASH YOUR HANDS AS RECOMMENDED. It is a simple precaution that is easy to do. We are always touching our faces with our hands. By making hand washing routine, you eliminate those times when you could be exposed to a high virus concentration.
Why should I socially distance?
Remember that it is proven that you can contract the virus by respiratory droplets and that these droplets can only travel a short distance. By staying at least 6 feet from individuals, you place yourself in a safer zone, as most large droplets will have fallen to the ground before then.
This airborne thing frightens me? Do I have to be afraid to breathe?
NO. Airborne transmission seems to be most significant in specific situations that cause higher viral exposure to the recipient. These are situations that increase small particles in the air, such as talking loudly, shouting, and singing. These airborne particles then need to be trapped in an enclosed space (like a room). Lastly, a person needs to be exposed to this environment for a more extended period. Here are a couple of examples where airborne infections could occur:
Attending a church service where there is singing.
Hanging out at a bar where there is a lot of loud talking and shouting.
Having a leisurely meal in a noisy restaurant where everyone has to “speak up” to be heard.
What is a super spreader, and what is a super spreader event? Why do these individuals and events occur?
There seem to be specific individuals who can spread the virus more effectively to others. Also, there appear to be situations that seem to spread the virus to more individuals than in other cases.
We understand some of the reasons for this (see my answers above), but we still don’t fully understand why some people or situations are more infectious than others.
What can I do to protect myself when flying?
Airplanes have effective air cleaning systems, and so it is most likely that you will become infected by a person who sits close to you on an airplane rather than someone who is many rows away. Therefore it is critical that everyone on a plane wears a mask. Also, try to keep your hands to yourself and consider some eye protection. Wash or sanitize your hands as needed.
Are outdoor rallies safe?
In general, a well ventilated outdoor event will be safer than a poorly ventilated indoor event. However, you can make such an event even safer by socially distancing, hand washing, and wearing a mask. Remember, if someone close to you has COVID, they can quickly transfer the virus to you by their proximity in any setting.
Why should I wear a mask? The CDC initially said I didn’t need to. What about my civil rights?
The CDC based its initial recommendation on two factors. The INITIAL data didn’t support layperson mask-wearing, and there was a shortage of masks needed by first responders. Their recommendations changed when it became abundantly clear that masks (even homemade ones) could prevent the spread of COVID. This fact has been shown over and over; it is not in question. Masks save lives.
As far as your civil rights, let me be direct, if you believe that not wearing a mask somehow demonstrates that you are a patriotic American, I am here to tell you that you are being played, and played most cruelly. This simple act (mask-wearing) can not only prevent you from getting sick; it can save the lives of others.
We do things all of the time necessary for both our’s and the greater society’s safety. It is illegal to drive while intoxicated, you are not allowed to smoke in public places, and factories are not allowed to dump toxic chemicals into our public water systems. These are just a few of many examples. Please don’t be played by others. Masks save lives.
Why do some people die from COVID, and others have no symptoms?
There are likely many factors, but the answer to this question is that we don’t completely know. However, we do know some groups are more vulnerable than others. Older individuals and those with certain medical conditions are at the highest risk. However, sometimes young and healthy individuals die from this disease too. It also appears that some younger individuals develop problems after they recover from their initial infection.
Do we have a cure for this virus?
Contrary to what you may be hearing from politicians, the answer is no. However, data has been examined from many thousands of cases, and we have been able to refine our treatment of this disease based on that information. We know that certain drugs, like steroids and anticoagulants, can help with recovery when given in the right situations and at the right time. Other modalities, like serum treatments and monoclonal antibodies, may help some individuals. We are getting a handle on when a person needs assistance with their breathing and what works best to treat particular issues. As our knowledge improves, so does the survival rate of infected individuals.
Is it true that we have more cases because we are doing more testing?
This is an outright lie, a manipulation to make things sound better than they are. There is no other way to say this. We know that we have more infections based on multiple streams of information that include testing results and hospitalization stays, community information, and COVID mortality numbers.
Testing gives us a window into the virus’s activity at any location and also lets us know how successful our efforts are in combating a virus in any particular area. Any action to limit or discourage testing is criminal, in my opinion. Limiting testing allows the virus to flourish. Limiting testing makes it worse for everyone. Imagine if someone said that they were going to limit unwanted pregnancies by limiting pregnancy tests. Ridiculous, no?
I need to get on with my life, but how can I?
Go back to the “most important answer” above. What we can do for a week is different from what we can do for months. What is the safest way to work? How can I socialize responsibly? How can I modify my life to get what I need while being safe? Base your decisions and actions on thoughtful reflection and reliable data. In life, there are reasonable risks and foolish risks.
Why are some people asymptomatic and others very ill?
At this time, we don’t know.
Can asymptomatic people spread the virus?
It is unclear how infectious asymptomatic people are, but YES it appears that they can infect others. Some asymptomatic individuals genuinely have no symptoms. Others may have mild symptoms that they ignore. Still, others may be infected and will show signs in a day or two. If you practice CDC guidelines, you are in the best position to protect yourself.
Will I be back to normal once I recover from COVID?
We are seeing cases where individuals have long-term effects that range from neurological complications to breathing problems. It is unknown how these individuals will be impacted years from now.
I don’t follow CDC guidelines and I’m fine. Therefore, COVID is a hoax!
I’m glad that you are both healthy and lucky. However, a single (or small group) of individuals does not determine a pandemic. The data is out there, the numbers are in the millions.
Is a vaccine the solution to all of our problems with this virus?
NO, but it is a critical step. At this time, we still don’t know how effective a vaccine will be, or how long its effectiveness will last. However, once it is determined to be safe and reasonably effective, I plan on getting innoculated.
Will we get through this?
Of course, we will. However, we need to use the information we obtain from this pandemic to implement changes to deal with future pandemics effectively. Remember, knowledge is power.
I hope this Q&A has answered some of your questions on COVID. To the best of my knowledge, the answers are accurate as of 10/29/2020
BTW Comments have been turned off as I was getting hundreds of SPAM messages from a Spanish bot. If you want to email me, you can take my web address prefix and add @gmail.com.
How many months has it been? It started for me sometimes in March. Or was it earlier? I remember talking about it in February because we thought about traveling to New Mexico, but I still wasn’t focused on it. I believe it really hit home when I returned from New Mexico on March 11th and saw that the airport was nearly empty. On that flight home, I discovered that my daughter and son’s universities were transitioning to online classes. Then, a few weeks later, Governor Pritzker shut down Illinois by issuing a shelter-in-place proclamation.
That order added a level of fear, but also a strange sense of odd excitement in me. The isolation order brought back memories of the 1967 Chicago blizzard. A time when everything was closed and a time when everyday life was on hold. I didn’t yet comprehend the difference between a 5-day snowy shutdown vs. months of lockdown.
When I came back from New Mexico, I was surprised to see empty shelves at Walmart… and there was no toilet paper! I couldn’t even buy a pack online, so I resorted to buying a case of industrial, commercial stuff- the TP that no one wants to use. Twenty-four hours later, Amazon sent me a notice stating that I had canceled that order (which I did not). I went on another online search and bought a case of TP from a hotel supply company. Several weeks later, that case plus the one that Amazon said was canceled BOTH arrived. Two cases of sandpaper quality TP. Bonus or bogus?
The kids were back at home, and Julie and I had gone from empty nesters to a family of 5 in a matter of a week. Spaces had to be re-allocated to accommodate them and their particular needs.
Everyday grocery items like pasta and white flour were nowhere to be found. Hand sanitizer and Lysol products had gone missing but could be bought if one was willing to spend ten times their average price (I chose not to). People were walking more; they would wave and say hello to me as they crossed the street to avoid me. The kids and I found some construction paper in the house that we cut into hearts, and on which we wrote inspirational sayings. “Breathe,” “Joy,” “Be Strong,” and dotted the front windows of our house with them.
The stock market, which is my primary source of retirement income, took a tumble, and I panicked. However, I tried to remind myself that I was still more fortunate than many.
I relied on my medical and scientific knowledge as the COVID threat intensified. Wrong information and spurious conspiracy theories were flying, and so I sorted through the facts vs. fiction. I did my best to educate others.
Initially, there was a temporary feeling about the crisis. It would end soon…but it didn’t. Days blended into weeks. Weeks turned into months. Holidays muted. Get-togethers canceled. The initial “crisis novelty” wore off.
As a retiree, my position was different than many. I didn’t need to renegotiate my work life. So I focused some of my technical energy on Julie by setting up a secure video conferencing platform for her to see some of her patients remotely.
It slowly started in me, a strange feeling. It wasn’t depression, but I didn’t feel happy. It wasn’t laziness, but I really didn’t want to do anything. It wasn’t anger, but I was irritable. It felt like I was separating from the world around me. I wasn’t disconnecting; it was more of a sense of not connecting. It didn’t feel terrific.
It was time to put on my psychiatrist hat and to make changes in my attitude. I would like to tell you some of the ways that I have been coping and share some general concepts that may help you emotionally deal with the pandemic and its resulting isolation.
Our home went from 2 individuals (one who was still working) to 5 individuals at home 24/7. We each found spots where we could have some private space. For example, I used my study and built a “nest” in a leather chair next to a window. My daughter claimed as her own a section of public space, our family room. She “built-out” a chair and end table with those things that were important to her-her phone, computer, and water bottle.
For those of you living alone, it is also essential to have zones to do different things. This can be accomplished in any sized space, including a studio apartment. Where you sleep should be different from where you eat and work.
Keep it clean!
When you have nowhere to go, it is easy to let yourself go. After all, who cares! The reality is that you should. I feel fortunate that I can step into a steaming hot shower whenever I please. I feel better about myself when my body is clean, and my teeth are brushed.
Tidiness goes beyond personal hygiene. A disordered house makes you feel disordered. Keeping surfaces clean and dusted, and putting things away can add a sense of serenity. It is especially important to keep things orderly when you live with others. Messes can accumulate quickly, and with them comes resentment. Disorder can prevent you from doing things that you need to do. You are less likely to make yourself a healthy dinner if you have to first wash pots, clean dishes, and clear off a messy countertop left from the morning’s breakfast.
All individuals in a home have to work together to maintain such an environment. This is not only necessary, but it also adds a sense of teamwork. Kids feel better about themselves when they accomplish tasks.
You may be a team of one, or you may be living with many. If the latter is the case, it is imperative that basic ground rules be established. Naturally, everyone should share in everyday tasks, or at least accept responsibility to accomplish joint goals. For instance, one family may decide that they are going to cook their meals together. Another family may determine that one person will cook meals, and someone else will clean the bathroom.
Perhaps one parent did all of the house cleaning in the past. Is it still fair for that individual to do all of the work now that others create greater mess and have more free time? These are the kinds of questions that have to be addressed during any significant life-change.
Two of my kids have returned to university, so there are now three adults (including me) remaining at home. I still do most of the house cleaning, but we share more meal-making tasks, and everyone is expected to clean up after themselves. Your needs and rules may differ.
When possible, it is essential to vary your environment. In the beginning, I walked a lot, but that wasn’t enough. I started to spend time with my friend, Tom and incorporated him into my COVID circle. Just seeing a different human improved my morale. As time has grown, I have gently increased my circle further. On occasion, I will visit my siblings. These visits have been in COVID safe settings. I also call people regularly (some daily), and I email my in-laws once a week. Doing these things has helped normalize the last few months.
A touch of the old life.
I live in an urban area that is rich with carry-out and curbside options. A cup of coffee from Dunkin Donuts’ drive-through or a delivery pizza on a Friday night can add a little normalcy to my day.
Projects and tasks.
At the beginning of the year, I was heavily involved in doing some odious tasks-like cleaning out my crawl space. Once shelter-in-place started, I lost all interest in these extracurricular activities. However, I have been slowly trying to return to “extra” jobs. I have made a few modifications to my campervan and have slowly started to rid myself of needless junk. It isn’t much, but accomplishing even a small task makes me feel like I’m moving forward instead of backward. I would suggest that you come up with some things you want to do and then do them. Spending a few minutes a day on a task that you need to do (but don’t want to do) can give you a sense of control.
View the whole picture.
Is it possible that there is some sort of an upside to this crisis? As strange as it may sound, the answer is yes. My wife has a friend who says she formed a deep new friendship with someone she met right before COVID. They have been communicating through emails and phone calls and have really gotten to know each other.
I’m cooking a lot of meals with one of my daughters, and we are not only having a lot of fun, but I feel like I’m getting to know her on a totally new level. Every coin has two sides.
Politics and pandemics.
Our greater community can help all of us adjust to change. I love watching videos about the homefront efforts that brought our country together during WWII. When we feel like we are part of the greater good, it is easier to accept imposed limitations. Local, state, and federal governments need to focus not only on physical practices (like mask-wearing) but also on the patriotic side of doing the right thing.
Over the years, I have known folks who lived in isolated parts of the country. They had to travel great distances to go to the grocery or hardware store, and their nearest neighbor was miles away. Yet, they were happy and content. They didn’t feel deprived; instead, they felt blessed with what they had. We create our expectations, and we determine what is satisfying and rewarding.
Don’t be an ass.
COVID, COVID isolation, COVID shortages… the list goes on. Yes, life with COVID can make people irritable. Several folks have told me of customer service interactions where the person on the other end of the phone was rude, inflexible, and downright mean. During times of stress, it is MORE important to make an effort to be kind. Kindness is not a weakness; it is a strength. When you are kind towards someone, they will often respond similarly to you. Even better, they may pass on their goodwill to someone else. Being angry may temporarily make you feel powerful, but the overall destructive energy it generates is poisoning to all parties, including the perpetrator. Consider doing random acts of kindness.
It is not all or nothing!
The longer someone has to do something, the less likely that their actions will be perfect. It is also expected that their efforts will need to be modified over time. You may have enough food in your cupboard for a few days, but eventually, you will need to go to the grocery store and break your perfect isolation.
It is easy to let go of the safeguards that you had in place. A safe gathering can grow to one that is unsafe. You may decide that you really don’t need to wear a mask or thoroughly wash your hands. An internal desire to return to normal may turn reasonable changes into foolish actions that put both you and your loved ones at risk. Assess how you can expand your world with an eye on what is safe and what is not. I just visited my brother-in-law and my sister. The three of us met on their semi-enclosed, well ventilated back porch. This was safe. However, it would be unsafe to have a big family party in their kitchen.
Be radical with your acceptance.
I talk to people who regularly say to me, “When will this be over!” They are waiting for everything to go back to normal. They are putting their lives on hold. The fact is that things may go back to normal, or they may not. However, the best approach is to radically accept our current life situation; otherwise, a “why is this happening” attitude can turn into sadness and anger. Radical acceptance is not “giving up.” It is an acceptance that there are things that we cannot change in our lives. Radical acceptance allows us to move forward and prevents us from being stuck in an endless cycle of self-pity.
Gratitude is the attitude.
Turn your cup from half-empty to half-full. Start your day by writing down 4 or 5 positive things about your life or situation. Then read your list and ponder on it.
Consider some of these thoughts, and make your day a little bit brighter.
BTW Comments have been turned off as I was getting hundreds of SPAM messages from a Spanish bot. If you want to email me, you can take my web address prefix and add @gmail.com.
During the pandemic, I established a personal goal to talk to some of my close relatives daily. It feels good to stay in touch with them as we share our lives and support each other. Each of us has different knowledge that we bring to our conversations, mine being a strong background in medicine and science.
One of my relatives was upset that she couldn’t buy Dial antibacterial liquid soap. When she had tried to purchase it early in the pandemic, she was shocked that a gallon refill was selling on Amazon for $70. When she revisited that product a few weeks later, it was sold out.
I reminded my relative that consumer-level antibacterial soaps were no more effective than ordinary soap and that all soap-like handwashing products were equally effective in destroying the coronavirus.
As the pandemic lumbered on, it became impossible to buy any liquid hand soap. My weekly trips to the grocer showcased bare shelves that pump bottles and refills of liquid hand soaps once called home. This elimination of usually plentiful products got me pondering.
My siblings and I are obsessive. We get pleasure from overthinking solutions and learning about topics that most would consider trivial. Anyone who knows me understands my obsessive passion for photography. However, beyond photography, I enjoy learning about many other topics that capture my interest.
My relative’s concerns about the lack of Dial liquid soap incited me to learn more about soap, so here is my “deep dive” on the topic. It is more complicated than you may think.
Soap can be a very inexpensive commodity, yet some people spend $25 or even $100 on a bar with similar cleaning qualities to brands that sell for 40 cents. Some of this additional cost can be accounted for by extras like packaging and exclusive fragrances, but those manufacturing expenses are relatively minor. What sells a product is how it is perceived, and how a product is perceived is often determined by advertising. Advertising and reality and not always bedfellows.
Why do we need soap?
Our skin has glands that secrete oil to protect our bodies from excessive water loss. We also have glands that produce sweat that helps us regulate our body temperature. These secretions are essential, but they also make us “sticky” to dirt, allergens, and microorganisms.
The microorganisms that typically reside on our skin are harmless, although they do contribute to odor. However, our skin can sometimes become contaminated with organisms that cause disease. Keeping our skin clean not only helps us smell nice, but it also protects us from illness.
Before the invention of soap, people relied on other ways to clean themselves. Most commonly, they just used water or water plus an abrasive (like pumice). Oil and water don’t mix, and this method of cleaning isn’t very useful. Like the Romans, some cultures used scented oils that they spread on their skin and scraped off using a unique gadget called a strigil.
History of soap
Archaeologists have discovered recipes for soap dating back to 2800 BC. Soap was likely being used before that time. These soaps were not the colorful scented bars that we use today, but they functioned as soap.
Animal fats and plant oils are made up of triglycerides. The molecular structure of a triglyceride looks like an “E.” The three horizontal arms consist of fatty acids bound together by a glycerol (glycerin) molecule (the vertical line of the E). When a triglyceride is reacted with a very strong base like sodium hydroxide (Lye), the bonds between the glycerol and the fatty acids are broken. This results in fatty acid “salts” and glycerol. We call these fatty acid salts “soap.”
These salts have a unique property. One end is “lipophilic,” meaning fat-loving. This end easily mingles with fats and oils. The other end is “hydrophilic” or water-loving. This end mixes well with water. Fatty acid salts (soap) can bridge the gap between oil and water, allowing us to quickly wash away the gunk and funk. Also, the mixture’s glycerol is an excellent humectant; it attracts water to our skin, keeping it moist.
Soap is one of humankind’s most significant discoveries. The practice of cleaning our bodies has had untold benefits to our health. How would you feel if your surgeon didn’t wash their hands before operating on you?
Soap has been manufactured for hundreds of years. Still, mass production of soap and the resulting reduction in cost happened in the late 1700s. By the 1800s, consumer brands like Ivory soap started to appear on store shelves.
During WWI, Germany needed to use soap making ingredients in their war effort. Their scientists created other compounds that performed similarly to soap but didn’t use animal fat or plant oil. We now know these agents as detergents, and there are now more than 1000 types in use today. Detergents offered qualities that made them superior to traditional soap. They could be made more concentrated for industrial applications, or significantly gentler than soap for personal care products. Detergents were more neutral in their pH (a measurement of how acidic or basic something is) than soap, making them less irritating on skin. It was also easier to add things to detergent products. Moisturizers and conditioners could be added to personal care products, while powerful cleaning chemicals could be mixed into industrial products. Importantly, traditional soap reacts with calcium and magnesium in water to create soap scum; detergents don’t do this, making them perfect for a variety of products ranging from laundry detergent to shampoo.
Some detergents had branched hydrocarbon chains making them less biodegradable. However, many common detergents have linear chains similar to fatty acid salts (i.e., soap) and are readily biodegradable. Although some detergents are made from petrochemicals (oil), many are now made from renewable plant oils.
Both soaps and detergent products alter their ingredients to create mixes that serve different needs. For instance, the addition of fatty acid salts made from coconut oil in soaps and the addition of the detergent sodium lauryl sulfate (SLS) in detergent-based products makes these respective products more “sudsy.”
Personal care products will add chemicals that attract water to the skin, serve as an occlusive barrier that prevents water from leaving the skin, or act as an emollient to soften the skin. Some products will add abrasive agents for more robust cleaning (Lava soap); others will dilute a cleanser making it milder (Dove with ¼ moisturizing cream). Other additives include water softening agents like EDTA, colorants to make the product look pretty, and fragrances to make the product smell nice.
Most consumer soaps are created for “mass appeal” they work great for healthy skin or skin that is slightly dry or a bit too oily. Some ingredients in soaps are there to differentiate them and offer little unique benefits. Growing up, I recall a product that touted “mink oil” and a shampoo that contained “placenta extract.”
Not all bars of soap are soap!
To label a product soap its cleaning agent has to be made of the salts of fatty acids created by a chemical process called saponification:
Triglycerides + water + a strong base = fatty acid salts (soap) + glycerol (glycerin)
Real soap mostly exists in “bars.” However, if a soap chemist uses potassium hydroxide instead of sodium hydroxide, the resulting soap will be a liquid instead of solid. That is how Dr. Bronner’s liquid soap is made. However, liquid soap represents a minimal market share of the soap industry.
Almost all liquid hand “soaps,” body washes, shower gels, and shampoos are made from detergents. Detergents have more desirable properties than soaps, including the fact that they don’t cause soap scum. Anyone who has tried to wash their hair with a traditional bar of soap will attest to the fact that detergent-based shampoos are vastly superior.
If a bar doesn’t use soap as the cleansing ingredient, it can’t use the name soap on its label. Instead, it will be called a “cleansing bar” or a “beauty bar.” The most popular bar, “soap” in the US, is Dove. Dove is a syndet (synthetic detergent) bar and does not contain soap.
“Lies” that soap makers tell us
If you search Google using the keyword “soap,” you will come across many websites from cottage soapmakers, beauty gurus, and “natural” experts. They often repeat the same incorrect and misleading information concerning soaps vs. detergents. I’m guessing that some of this is due to a desire to promote their products, and some are due to poor understanding of the scientific literature on the topic.
Many of these sites seem to use the same wording, suggesting that they are cutting and pasting information. They sometimes use “scary psychology” to frighten consumers from buying cheaper, mainstream products. I like handmade soaps. However, I think consumers should buy them because they like them, not because they are afraid to use cheaper but equally effective commercial items.
I’m only going to touch on some examples, as there are too many to list in this already long post.
-Soaps are natural; detergents are not.
Both soaps and detergents are made from naturally occurring substrates. Both undergo chemical reactions to make the final product. Fats don’t turn into soap “spontaneously.” By the way, many think that natural always means better. That is a bias, not a fact.
-Soaps are biodegradable; detergents are not.
Some detergents were created using branched-chain hydrocarbons. These take longer to biodegrade. However, the structure of many detergent hydrocarbon chains look very similar to soap and are readily biodegradable. With that said, no soap or detergent should be used directly in a clean water source (such as a clear stream or lake). If you are hiking, dispose of your wash water at least 200 feet away from such a source.
-Detergents remove your skin oils.
That is precisely what both soaps and detergents are supposed to do. The key is to remove as little as possible while still cleaning you. The gentlest skin cleansers are made from detergents, not soaps.
-” Our soaps are gentler to the skin than commercial products.”
It is possible to make a gentle hand-crafted soap, but overall soap is harsher than syndet bars like Dove or Cetaphil. Soap has a higher pH (9-10), while syndet bars have a pH closer to skin pH. High pH can be irritating to sensitive skin.
-Manufacturers use detergents to cut costs.
Detergents cost more, which is why Dove costs more than Ivory.
-Detergents are made from petroleum, but soaps come from living things.
Petroleum is natural as it comes from algae and plankton. Many detergents are now made from plant oils instead of petroleum.
-Sulfates cause cancer, cataracts, etc.
Some detergents contain sulfur. One of the common detergents in personal care products is sodium lauryl sulfate (SLS). This agent is used because it is good at removing grime, and it also foams well. Consumers like products that foam (suds) because foaming gives the impression of cleaning. However, foaming has little to do with removing grease and dirt.
Products will advertise that they are “Sulfate-free” as an advertising ploy. There is no credible evidence that sulfates cause cancer, cataracts, or other problems. I have also seen “experts” claim on webpages that sulfates are harmful because they can burn if you get them in your eyes and that they can dry out your skin. Well, duh… so does real soap!
-” Our products are phosphate-free!”
Another gimmick. Phosphates were effective water softeners and had been used in products like laundry detergent in the past. As far as I’m aware, they were never used in personal care products. Phosphates can serve as a nutrient for plants, like algae, causing overgrowth, which can be damaging to other aquatic species. Because of this, phosphates have been banned in consumer products, like dishwasher detergent for decades. Many states in the US have total bans on the use of phosphates.
-” We only use essential oils to scent our products.”
Essential oils smell great, but they are also significant allergens for many. These plant products contain dozens of compounds that can increase your chance of getting inflammation of the skin (dermatitis). I love essential oils, but I don’t think that they are risk-free.
-” We are paraben-free.”
Parabens are preservatives used in some cosmetics, and some of them can mimic the hormone estrogen. However, the strongest estrogenic paraben is only about 1/10,000 as potent as real estrogen. Besides, some parabens do not act like estrogens at all.
-” We are 100% natural”.
The term natural is a marketing term and doesn’t mean anything. However, I have to admit that it sounds nice.
-” We use pure (fill in the blank) essence in our products.”
Essence is another term that has no real meaning.
It’s great to support small soap-making operations, and you may love their products. Buy because you like their stuff, not out of fear or guilt.
As I said above, almost all shower gels, shampoos, and body wash are made from detergents. This is because detergents don’t leave a soap scum film. It is possible to create washes and gels with a more neutral pH and build in extra moisturizers (good things). However, some products have a lot of colorants and fragrance added. Consumers like colorful products that have a strong smell. However, these two characteristics are the leading causes of skin irritation in cleansing products. If you have sensitive skin, use a mildly scented product or one that says it is “unscented” or “fragrance-free.” However, both terms have no legal definition. Products listing themselves as “unscented” or “fragrance-free may still include masking fragrances that block unpleasant smells or have an added fragrance to make them smell more beautiful. Confusing, I know. With that said, lightly scented products are less likely to cause an allergic skin reaction than strongly scented ones. You can use your on-board chemical analyzer to determine if a product is strongly scented. Press your nose to the item and give it a good sniff.
Overall shower gels are more colorful and fragrant, and body washes are more “moisturizing.” People like using thick body washes and gels. However, their thickness is caused by a thickening agent and has little to do with the concentration of other ingredients.
In general, consumers tend to overuse liquid cleaners, and a lot of these products wind up going straight down the drain. Although a bottle of wash should last (roughly) the same as a bar of soap, they typically have to be replaced more often. I scanned the internet for comparisons, and it seems like a bar of soap lasts many consumers about twice as long as a bottle of shower gel or body wash. When it comes to teenage use, the difference is even more significant.
More soap facts
The gentlest bar soaps aren’t soap at all; they are syndet (synthetic detergent) bars.
Dove is #1 selling “soap” by far in the US, and it is a syndet bar.
Other gentle bars like CeraVe and Cetaphil are also syndet bars.
Syndet bars can be very gentle cleansers.
Both soaps and syndet bars clean effectively. Certain brands add ingredients to differentiate them from other products, color, and fragrance being the most obvious.
Different fatty acid salts and detergents have different properties. For instance, soaps that are manufactured with added coconut oil and detergents with SLS foam more. People like sudsy cleansers.
You can add extra fat to make a bar of soap “more moisturizing” and less effective as a cleanser (less drying).
You can add humectants like glycerine and honey to help keep moisture close to the skin.
You can add barriers like oil and waxes that reduce moisture evaporation from the skin.
Some ingredients, like oatmeal, are calming and reduce itching (Alveeno). Others are abrasives and help clean oily/dirty hands (Lava soap).
These ingredients change some of the properties of “soap,” and you may find that one brand may suit your skin type or use needs more than another. However, the base product is the same.
Liquid soap has been promoted as being more sanitary than bar soap. Some of these claims may be due to soap manufacturers’ desire to sell these more expensive products. However, bar soap is sanitary. Researchers deliberately inoculated bar soap with bacteria and then had people wash their hands with the soap. Afterwards, they didn’t find the bacteria on the subjects’ hands. Why? When you wash your hands, you are also cleaning the soap. The bacteria doesn’t go on your hands, it goes down the drain. However, liquid soaps are neater when used in common areas like kitchens and public bathrooms.
Soap is soap
You can spend $2800 for a bar of Qatar soap, which is infused with gold and diamond dust. It is easy to find very expensive soap that sells in the $40-$100/bar range. Is this cost justified? These soaps will be made of high-quality materials. They may be milled many times to provide better blending and a harder bar; they may be a few ounces more in weight than a traditional bar. They may have more beautiful scents and come in a nicer box. These upgrades do justify a higher price, but certainly not $40-$100. Why are some willing to pay that much? Perception and image. Cause? Advertising at its best.
You can buy many brand name soaps for around a dollar a bar, and most are formulated to be gentle and effective. For people with healthy skin, a forty-cent bar of IVORY or a dollar bar of Dove will meet their hygiene needs.
More fun facts
Consumer antibacterial soaps are no more effective than regular soaps in controlling germs. However, they may pollute the environment more. Many brands that had antimicrobial agents have quietly removed them and now use confusing terms like “Washes Away Bacteria,” All soaps do this.
Although people have been using soaps for thousands of years, the commercialization of soap is more recent. Soap factories were known to exist in the 12th century. It wasn’t until 1811 that Eugene-Michel Chevreul determined the exact amount of fat needed to make soap. Before this, soap making was a guessing game. This finding plus other discoveries revolutionized the commercial production of soap.
During WWI, Germany needed oils and fats for their war effort. German chemists developed detergents made from petrochemicals during that time. Detergents are still made from petrochemicals, but many are also made from renewable resources, like vegetable oils.
In the 1930s, Procter and Gamble introduced a continuous process for the manufacturing of soap, which increased production and decreased manufacturing time to less than a day. Before this, many soaps had to “cure” before they could be packaged and sold. Large scale soap manufacturers still use this method.
Soaps, cleansing bars, shower gels, shampoos, and body wash may contain additional ingredients that may make their products more desirable. Color and fragrance are two apparent additions. Others may include conditioners, anti-static agents, sudsing agents, thickening agents, humectants, moisturizers, water softening agents, exfoliants, gritty additions, and preservatives.
A Historical Timeline
Ivory soap was introduced in 1879 to produce an inexpensive but good quality product. To reduce costs, Proctor and Gamble extracted the naturally occurring glycerol (glycerin) from the soap and sold it separately. They also whipped air into the product making a less dense soap in another cost-cutting method. This aeration allowed Ivory to float in water, a happy coincidence that was used to create the tag line, “So pure it floats.” The lack of glycerin made Ivory more drying than other soaps (despite its claim that it was gentle). It was eventually added back into the soap’s manufacturing process several decades ago. You may think that Ivory smells like soap. However, what you are detecting is a mild citrus fragrance that is added during the soap making process.
Dr. Bronner’s Magic All-In-One soap was introduced in 1946 and emphasized simple, quality ingredients. It is a soap product and comes in two forms, liquid and bar form. With quirky advertising and emphasis on simple ingredients, it has gained a following among people who think less is more. The real Dr. Bronner wanted humanity to unite as one, and you can find some of his thoughts on Dr. B’s soap bottles and bar soap wrappers. He also claimed that his soap had 18 uses, including as a toothpaste. As a person who once tried to brush his teeth with this stuff, I can tell you that it is a no go. However, it is a lovely soap.
Dial soap was the first antibacterial soap, and it was introduced in 1948. The original antibacterial agent was hexachlorophene, which the company called “AT-7.” Hexachlorophene was removed from the soap in the 1970s as it was determined to be dangerous. It was replaced by triclocarban, which was removed from the soap in 2016 due to FDA concerns. Dial soap bars now contain benzalkonium chloride as its antibacterial agent. At this point, it can be assumed that their antibacterial additions are more marketing than science. Dial was the most popular bar soap in the US from 1953 to the early 1990s. It is now the second most popular soap. Beyond antimicrobial additions, the soap is relatively mild and has a pleasant nostalgic scent that people associate with clean.
Zest was introduced in 1955 and emphasized that it didn’t produce soap scum in its commercials. “You’re not fully clean if you’re not Zestfully clean!” Zest was a combination bar of both soap and detergents. The detergent portion of the bar prevented soap scum. Zest was reformulated in 2007 and removed the detergents, likely to reduce production costs. They countered this change by adding more color and fragrance to the bar.
The Dove Beauty Bar was introduced in 1957. It was the first commercial bar to rely totally on detergents instead of soap as its main ingredients. Advertised as being gentle because it contained 1/4 cold cream, its real strength was in using detergents, which were gentler and more pH balanced than soaps. Dove bars are now (by far) the most sold bar soap in the US.
Irish Spring was introduced in Europe in 1970 and came to the US in 1972. It is a soap-based bar with a strong citrus/woody/clean smell. I was 19 when this soap came to the US and loved the scent. However, within a shower or two, I started to itch. I’m guessing I was sensitive to the overpowering fragrance.
Coast bars are also soap products, and the original scent was introduced in 1976. This is another bar that smelled fantastic and clean. I thought I would be a Coast user, but after a few showers, I scratched my skin off. Again, I believe my itching was due to the pleasant but powerful fragrance.
Liquid soap has been around since the 1800s. Its use in a home environment became popular in 1979 when Softsoap was introduced (a detergent, not a soap). Softsoap solved the age-old problem of the wet communal soap bar and became an instant hit.
The 1980s saw the emergence of liquid body washes followed by shower gels. These are almost exclusively detergent products. These products have decimated the bar soap industry, with about 80% of consumers using them in preference to bar soap. Manufacturers are happy with these numbers as body washes and gels are more expensive to buy than equivalent bars. It should be noted that their ingredients are very similar to shampoo, which is why many claim to be “body and hair cleaners.”
In 1999 the Deb company introduced the first foaming hand soap. Foaming soap is a diluted soap pumped through a special aeration pump that turns the liquid into a soft foam. Foamers use less soap, and you need less water to wash the foam off. I like foaming liquid soaps because there is less drippage on counters and sinks. I’ll give you a recipe to easily make DIY foaming soap later in this post.
My history (and Hack 1)
I have moderately dry skin, and dry winters used to be brutal. I would scratch my skin to the point of bleeding (usually not realizing that I was doing it). When I was a kid, I used whatever soap we had at home, the typical national brands. Once my father brought home an entire case of an unmarked and unwrapped green soap that was harsh, I referred to it as “rash in a bar.” Eventually, the whole family refused to use it even though my dad said it was, “Just fine.” By the way, he also stopped using it after we did!
As soon as I had a little spending money, I started my long journey to find a soap that would solve my dry skin problems. Some soaps, like Irish Spring and Coast, made my pruritus worse as I was sensitive to their strong fragrances. Other soaps like Dove and Camay felt like they left a coating on my skin, which was still dry and itchy. When body washes and shower gels came out, I was the first in line to try them. I enjoyed their pleasant smells, but I was still scratching. It didn’t seem to matter if I was using inexpensive Dial or high end shower gel, I kept scratching.
Decades ago, I decided to switch to more basic hygiene products. This process started with shaving. In the past, I would buy a razor and blade set at the drugstore. Although the cost of a razor was inexpensive, its replacement blade cartridges were not. Every few years, another blade would be added to a cartridge product, and the prices kept on going up. I didn’t see any benefit to the new razor designs; they seemed like gimmicks that forced me to stay within a particular brand. I decided it was time for a radical change and went back to using a simple double edge safety razor. I liked that the replacement blades were less than a dime apiece and that the system was more eco friendly. At that time, I also switched from aerosol shaving cream to shaving soap. I was no longer dumping plastic blade cartridges and aerosol cans into landfills.
My success with the “new” shaving system got me thinking about other products that I was using, and I decided to leave shower gels and go back to bar soap. I genuinely like using a good old bar of soap in the shower. I love the smell of bar soap, and the way a bar feels in my hand. Another win was the cost, as a bar of soap that can be up to 10 times less expensive than an equivalent body wash. For me, the combination of preferring bar soap plus some small savings has kept me in the bar soap camp for the last few decades. I like to switch brands, going from typical consumer products to imported bars and back again. I get tired of one scent and enjoy switching to another. Although I could tolerate just about any mild bar soap, my skin was still dry and itchy during the winter months.
I needed to think outside of the box. Our skin is soft and supple when it is well hydrated. Soaps and detergents remove a lot of the protective oils and dehydrate our skin. Formulations with milder surfactants (soaps and detergents) leave more oil behind, but they didn’t make me feel particularly clean. Products that contained substances like glycerin and shea butter were a bit more moisturizing, but I was still scratching.
My wife had told me to use a body lotion for years, but I hated rubbing all of that gunk on me. It seemed to take forever, and my skin would be white with the greasy stuff. Many years ago, I had an idea. What if I put on lotion as soon as I got out of the shower while I was still wet? That was a game-changer. First, because a little lotion or cream goes a long way and glides on your skin. Second, because it traps water on the surface of your skin, precisely what you want. When you apply lotion this way, you need to use very little, so you have no white greasy skin. It also works much better than toweling off and then applying a lotion.
I like two products, and use whatever one is that is on sale. My favorite is CeraVE moisturizing cream, and my second choice is Cetaphil moisturizing cream. Both come in tubs, and a little goes a long way. When you spread these creams on yourself, you also flatten out the water droplets on you, sort of like you are squeegeeing yourself. By the time that you are done, you are dry-no towel needed.
Foaming hand soap is convenient, it doesn’t drip onto your counter, and it requires less water to wash off your hands. It is diluted hand soap, so why does it cost as much as hand soap? It is easy to create your own foaming soap for about one-fourth of the price of the purchased stuff. Simply fill your foaming soap dispenser one-quarter full of regular liquid hand soap and then add water. Distilled water is the best, but I have used regular tap water too. Add the top, give it a shake, and you have just made foaming hand soap. Typical “Softsoap” detergent type refills, as well as liquid Castile soaps like Dr. Bronner’s work well. You can vary the amount of soap to water ratio a bit to meet your particular tastes.
During the pandemic, it became hard to buy any liquid soap refills. However, body wash was in plentiful supply, some selling for as little as $15/gallon. Body wash is hand soap with added skin conditioners. It also foams more, which can be a pleasant experience. You can use body wash just like hand soap in a traditional pump dispenser, or dilute it (as in Hack 2) to use as a foaming hand soap.
Body wash and shampoo are also very similar. A lot of body washes say “hair and body.” A cheap shampoo can be an excellent hand cleaner, and if you are out of shampoo, you can use many body washes. However, don’t try to wash your hair with regular soap as the soap scum will leave your hair a dull and tangled mess. If you have to do it, you will need to use an acid wash (like diluted lemon juice) to get rid of the gunk.
You can wash your hands using liquid dish soap, and you can also dilute it to use in a foamer. Liquid dish soap is relatively mild but more robust than traditional hand soaps (After all, it is designed to degrease pots and pans). Using dish soap would be my least preferred choice as it is more likely to dry your hands. If this is your only option, follow up your handwashing with a hand little lotion.
You can easily make liquid soap. I have never done this, but there are many YouTube videos on the subject, just type in DIY liquid hand soap, and you will be flooded with videos. The process is simple, shred a bar of regular soap and dissolve it into some hot water. Then add more water (often a gallon total). Let the mixture cool and gel, then beat it into a smooth consistency with a hand mixer. Sometimes recipes call for a couple of tablespoons of glycerine. Distilled water is best to use in this case.
There is a lot more to most things when you scratch the surface.
Soap is something that we use every day, but most of us rarely think about it. However, our lives would be very different if we didn’t have soap and detergent products. From body wash to toothpaste, soaps and detergents touch every aspect of our lives. The use of surfactants made surgeries safer and our populations healthier. We can all be thankful for soaps when we are forced to sit directly next to strangers on a commuter train or airplane.
Soap is not magical; it does its work using understandable principles of chemistry. Did you think that the chemistry class that you took in high school was useless? Here is an example of how chemistry is real, and how we encounter it every single day of our lives.
Soap like products are big business and individuals have made fortunes manufacturing the slippery stuff. Soap makers, both big and small, have used manipulations and untruths to differentiate their products from the rest. Small companies claim that the ingredients that big manufacturers use are dangerous to health, incorrectly citing research literature. Big companies promote their more expensive products while ignoring their equally good but cheaper offerings. Go to any store, and you will find more expensive body washes and gels at eye level while less expensive bar soaps languish on the bottom shelf. We have also been led to believe that bar soap is unsanitary, despite scientific evidence to the contrary, and not to mention the fact that it has been used safely for hundreds of years. You have to admire the advertising genius that convinces someone to spend $100 on a product that is very similar to one costing under $1.
I touched on many aspects of these products. Still, in the end, I was most interested in the psychology of soap, and how we believe things when we are told them enough times, even if they are false.
There appear to be two common links that are necessary to convert fiction to “facts.” The first is an air of expertise or authority, and the second is a sense of trust. You see these characteristics when you read the FAQs of soap maker’s websites. They are also present when you scan a “filler” article in a magazine. It seems like many of these authors never read primary sources; they just copy other’s interpretations. Individuals with no actual expertise in an area claim it, and we believe it. Someone who has “Twenty years in the beauty industry” is unlikely able to fully understand a scientific research paper. Yet we believe them. When we hear something enough times, our minds accept that information as fact. Once we accept a fact, we rarely question it. The sky is blue; water is wet… we don’t need to think further on these topics.
Another way to influence us is by associating something with something else that we believe is true. Bar soap must be unsanitary because people who are dirty touch it. Something that was associated with being clean is now associated with being dirty. This “guilt by association” way of influencing others is classic. It can be seen used in many aspects of daily life. Unfortunately, it has also been used to denigrate entire groups of marginalized individuals.
Lastly, another way to manipulate someone is to create a problem and then offer a solution. Antibacterial soaps did this by making us believe that we didn’t need just to clean our bodies, we had to sanitize them so we wouldn’t offend. A non-related example of this problem/solution model can be seen in Portland, Oregon. Relatively peaceful protestors were labeled as terrorists, and so the solution was to arrest them “secret police” style. This later use of this technique is far more frightening to me than if I needed antibacterial soap to avoid having BO.
We are a naive and trusting culture, and our ideas are often formed by others who do so for their gain. Cult leaders and politicians gain huge followings by lying to our faces. They tell us that they have the answers while convincing us that any information contrary to their monolog is suspect and dangerous.
The next time you pick up a bar of soap, push a shower gel pump, or squeeze a tube of body wash, think about the complexity of this simple pleasure. Soap helped civilization prosper and likely had a stronger impact on infectious disease than antibiotics. Soap making is one of the first practical uses of organic chemistry. The selling of soap demonstrates how an essentially similar product can be differentiated and promoted by manipulation and trickery. More importantly, it demonstrates how easily we humans can be controlled. Is it possible for us to still be led to believe falsehoods in this age of facts and information? The sad news is that it is easier than ever before. We want to believe that we understand the world around us, and we look to influencers and leaders to guide us in this pursuit. Unfortunately, this desire leaves us vulnerable. We accept lies as the truth and then feel forced to defend our erroneous position. If you understand the history of soap you also understand the strengths and weaknesses of humans. Think about that the next time you plunk down a few bucks to buy a block of bars at Walmart.
I know that this is a very long post so thank you for reading it. I’ll be away from an internet connection for the next couple of weeks and I won’t be posting because of this. Have a great day! Mike
I arrived back in Chicago from a trip to New Mexico in early March. I was met by escalating panic around COVID-19. I had heard stories of shortages, and so I checked our pantry and freezer. I found a reasonable amount of food, but many items were things that we didn’t eat. Yes, we had stuff, just not the right stuff. I decided to go to the store and stock up.
Over the last few years, I had been doing more grocery shopping, and I had narrowed down my purchase locations. If I needed to pick up something quick, I would go to the Fresh Thyme Market, a small grocer around the corner from my house. However, if I needed to buy a significant haul, I would head over to my local Walmart Supercenter.
I can’t say that I enjoy shopping at Walmart. It is big, crowded, and it always seems to need a little tidying up. However, despite my complaints, Walmart has some positive attributes. The grocery store is part of a Walmart, making it easy to buy anything from camping supplies to printer paper. Walmart’s house brand, “Great Value,” is decent, and I know the store’s layout well enough to make my trips efficient.
However, that early March stock-up trip was different. The store was significantly more crowded, and its shelves were bare. No toilet paper, no paper towels, no rice, no flour, no pasta, no tomato sauce, no oatmeal. The list went on.
That week I also “hit” a few other stores, including Aldi and Jewel. I wanted to have food in case the world was about to shut down. Different stores had different stock items, so I was able to buy enough essential foods to secure my family’s immediate future. Although I felt good about “providing,” I experienced a less than enthusiastic reception from Julie. She saw my stockpiling in a more negative light.
Based on this, I turned the job of grocery shopper over to her and settled into other tasks. Shortly afterward, Governor Pritzker ordered that Illinois shut down; I spent the next few weeks isolating in my house, only venturing to leave for a daily walk.
Julie did assume shopping duties, but her own busy life hampered her ability to take on these tasks fully. At the same time, our adult kids were complaining that we lacked food items again. It became clear that I had to shoulder some of the shopping burden, a task that I was not looking forward to.
I felt that shopping at Walmart held a higher than acceptable risk, as it was huge and always crowded. The sheer numbers of individuals made me concerned that the place was a cesspool of viral particles. I could order groceries online, but most of those services have an upcharge, and feeding five adults is already an expensive proposition. I thought about returning to Aldi, which is the least costly grocery in our area. However, Aldi isn’t a full-service store, which would mandate that I would have to shop at least two different stores every week, and I didn’t want to do that. The most reasonable plan would be to buy at a regular grocer, like Jewel. Jewel is a full-service grocery store that also houses a drug store. Also, it appeared that their sanitizing standards were high, and their shopper density was low.
Once a week, I would drive to Jewel, shopping list in hand. I organized my list into food zones and shopped as quickly as possible. I didn’t hunt for the best prices, and I bought what was available. If they only had designer tomato sauce, that is what I purchased. The idea was to balance viral exposure with economy and convenience.
Overall, the strategy worked. I was able to get in and out relatively quickly. Naturally, I took all the necessary precautions along the way. However, this was not a total “win” strategy as my grocery bills were extraordinarily high. It wasn’t uncommon for me to spend over $400 in a given week, without buying a lot of meat. However, it still was the most reasonable option at that time.
One month dragged on to two, two months dragged to three, and three dragged to four. Along the way, I found myself assessing and reassessing what I could do. I expanded my “social circle” to include my friend, Tom. I visited my sisters “from a distance.” I traveled to “safe spots” to take photographs. I started to live again but in a more cautious way.
My grocery bill was out of control, and I needed to evaluate if there were more cost-effective options. I was aware that Walmart was making efforts to keep its stores as safe as possible, including requiring face masks. It also seemed reasonable to assume that the first hoards of COVID panicked shoppers had subsided, and that food stocks had been replenished. It was time to return to Walmart.
One of the tricks that I do to make a tedious task more palatable is to include family members. Before the pandemic, I would often take one of my kids on my grocery shopping trips. This addition turned a chore into an adventure. We would joke, laugh, and explore as we shopped. Also, my co-participant received special status. If they wanted to buy a frivolous or special item, I almost always capitulated. I know that CDC experts suggest solo shopping, but I’m more efficient in having a helper. Both Grace and Kathryn agreed to assist me on my return Walmart trip.
With masks on our faces and a small bottle of hand sanitizer in my pocket, we arrived at Walmart. I was happy to see that they were limiting entrance to a single monitored door. As we entered the store’s vestibule, we were handed a shopping cart by an employee who had just wiped it down with a sanitizing solution. It did seem like they were making efforts to keep things as safe as possible.
We approached our job with purpose as we divided and conquered each grocery section. The store was stocked, but there were still areas that were showing shortages. Toilet paper was available, but only one brand and in limited quantity. Flour was present, but only a few bags were on the shelves. Cleaning products were there, but any brand that claimed that it was antibacterial was missing.
Although I bought quite a few groceries, my card was not overflowing. I purchased very few “high ticket” items like steak, and I stocked up mostly with the “Great Value” house brand. All in all, my grocery bill was just over $260. I would have spent more with a comparable Jewel haul, but it was clear that Walmart’s prices had increased significantly since my last trip there. With that said, I’ll likely return as I estimate that I saved anywhere from $50-$75 over a similar Jewel shopping trip.
So, where am I going with all of this? During a short crisis, it is easy to make a radical change because you know that things will soon be back to normal. However, as a crisis continues, it transforms into a way of life. In past posts, I wrote about how I moved from trying to replicate my previous experience to living in my current one. Part of that process involved returning to Walmart. Before the pandemic, such a trip would be routine. Still, I had to think carefully if the risks of going into a crowded big-box store were reasonable. I had to think about how I would make such a task as safe as possible.
I believe that this is a reasonable way to approach life in our brave new world. I have no intention of going to a crowded restaurant or a packed church service. However, I know that I have to continue to expand my horizons as this pandemic continues. Naturally, I will uphold whatever laws dictate. I understand that I am not only doing this for my health but also the greater good.
I feel that this is a balanced approach that avoids politics and ideologies. How are you making life decisions during this crisis time? How will your actions change if this way of living becomes the new normal?
After we got home from Walmart we washed our hands. The kids and I put away our food. I divided and sealed up the hamburger that I bought, but reserved some for meatloaf that I made last night. Since I have been sharing recipes, I thought I would share this one too. It is a classic that originated from the Quaker Oats company. It is super easy to make and pretty tasty.
1-1/2 Pound(s) lean ground beef or turkey
3/4 Cup(s) oatmeal
3/4 Cup(s) finely chopped onion
1/2 Cup(s) catsup
1 Egg, lightly beaten
1 Tablespoon(s) Worcestershire sauce or soy sauce
2 Clove(s) Garlic, minced
1/2 Teaspoon(s) Salt
1/4 Teaspoon(s) Black pepper
Heat oven to 350°F. Combine all ingredients in a large bowl; mix lightly but thoroughly. Shape meatloaf mixture into 10×6-inch loaf on the rack of broiler pan. Bake 50 to 55 minutes or until the meatloaf is to medium doneness (160°F for beef, 170°F for turkey), until not pink in center and juices show no pink color. Let stand 5 minutes before slicing. Cover and refrigerate leftovers promptly and use within two days, or wrap airtight and freeze up to 3 months.
(a little substitution never hurt anyone)
I only had 1 pound of ground beef in the spirit of substitution, so I added a little more oatmeal. I also upped the garlic a bit, chopped a medium onion that I didn’t measure, and reduced the catsup a little. I baked it in a loaf pan instead of on a rack. It turned out just great, and the kids ate it up.
In the 1960s, Swiss-born psychiatrist Elisabeth Kübler-Ross introduced the “five stages of grief” based on her work with dying patients. In case you have forgotten, they are denial, anger, bargaining, depression, and acceptance. Although some aspects of this work are now in question, she did bring to the forefront the idea that we work through significant changes of life in stages. Those stages may be different from event to event, and from person to person.
In many ways, I have gone through various stages of loss during the COVID crisis. I feel I was in a stage of denial at the start of the crisis. Before the Illinois stay-at-home order, I traveled to New Mexico convincing myself that the trip was safe since (at that time) there were no reported COVID cases in that state.
During the early phase of stay-at-home, I entered a fear stage fueled mostly by the panic I witnessed around me. It was impossible to buy toilet paper, then paper towels, then facial tissues. Everyday pharmacy items such as rubbing alcohol, hand sanitizer, and ibuprofen became purchases that were only available at exorbitant prices on Amazon. Essential foods like flour, pasta, oatmeal, and rice were impossible to buy.
I had five adults living at home, and I’m a person who takes caretaking seriously. I did my best to adapt to other foods. Tom helped out by finding a big bag of flour for me, and I even bought a sack of pinto beans, “just in case.” My preparedness can be a point of ridicule in my family, but I had to be true to myself. I am hardly perfect, but I have become successful in life by moving past what other people think that I should do or what I should be.
I had a depressed phase around that time. Although I’m an introvert, I still need contact with others in my life. Luckily, I was able to safely expand my social connections and experiences to lift my down mood.
I moved into an “approximate” stage where I tried to “simulate” what my life was like before the pandemic. COVID Easter, COVID birthdays, COVID Mother’s Day. I pretended that I could have the same pre-COVID experience by recreating those special days sans outside adventures and people. In many ways, this strategy worked, but in some ways, it did not. I discovered the latter fact when I did the self-exploration that I chronicled in last week’s post.
Life seems to be moving into a new normal, and there doesn’t seem to be a clear path back to the way it was. It has been exhausting for me to rationalize that by (fill in the blank) date, I would once again be able to do those things that I used to do. As the numbers of infections and deaths have escalated, I have moved into a new stage of acceptance. I am no longer trying to approximate my former life. Instead, I am trying to live life.
I had an unstructured day. My friend, Tom, was busy, and Julie and the kids were doing their things. I spent the morning writing and making phone calls, but by the early afternoon, I was feeling unsettled. What I wanted to do was to take some street photography, but in this new era, that wasn’t a very practical solution. Instead, I went to our local Herrick Lake forest preserve. I have photographed Herrick Lake many times; there are only so many different shots that you can take. I thought that I had taken all of them, but did I? I decided that I would up the creative game by shooting only in black and white. Because of this restriction, I had to view the landscape in a very different way. My creativity was sparked.
The forest preserve is close to my sister, Carol’s house. I have been calling her daily, but I missed seeing her in person. Was I only going to have phone contact with her from now on? Carol is older than I am, and she is rightfully concerned about continuing her excellent health. I phoned her and asked her if she would be comfortable seeing me in person. She said she would be as long as I could maintain a social distance from her. We had a delightful time as we sat on her patio, masks on, and 8 feet apart.
On my return home I got a call from my friend, Tom. He was at a project close to my home, and he wondered if I could stop by. Tom is in my “bubble” of contacts, so there was no problem stopping by and giving him a hand with his job.
At dinner, I reflected on my day, noting how full it was and how much I enjoyed it. I didn’t feel like I was trying to pretend that it was a pre-COVID day; it was an enjoyable day.
My daughter Gracie sent out a group text to our immediate family, asking us if we wanted to have a 4th of July party. Julie and I had already planned to have a barbeque, but Gracie wanted to expand on that idea. She wanted to make some treats, play yard games, and have a bonfire. I thought it was a great idea.
Grace made some desserts, Will offered his frisbee and “Spikeball” game, Julie and I took over various dinner making tasks, Kathryn did some cleanup, and Will and I built a fire. I didn’t feel like I was substituting; I felt like I was experiencing a good day.
It is possible that this pandemic will have the same culture-changing power as the 911 event had on our country. Things may never be the same. I was willing to put my life on hold for months, but I’m not ready to place myself in suspended animation. Yet, I am acutely aware that to go back to pre-COVID behaviors would be both dangerous and foolhardy.
Life requires continual adjustment. There are things that I could do at age 30 that I’m unable to do at 67. With that said, there are things that I can do at 67 that I could not do at age 30. My goal has always been to live the best life that I can in any situation. I need to apply that same logic to my current life.
I have always loved nature, and I have always loved being in the country. I have taken trips where I am living in a space that is smaller than my walk-in closet. Places where the nearest Walmart is 4 hours away. Areas where there is no cell phone coverage. I have traveled to these places deliberately and savored the simplicity of my life. I didn’t feel deprived during those times; I felt liberated. I focused on what I had and what I could do instead of what I didn’t have or what I couldn’t do. I was happy living my life in the here and now. It was great.
I know that we will eventually develop a vaccine, and I’ll be the first person to get it. However, I don’t know if life will be the same as prior to the pandemic. I am determined to move forward and to live life. What can you do to enjoy your new “today?’
My writing process is simple. I base my post on whatever I happen to be thinking about, and what I am thinking about is often stimulated by world events or personal activities. I never seem to lack for a topic. However, that appears to be changing. My life has become so routine that new activities are limited, and exciting writing topics are on the decline. COVID-19 stories dominate the news, and I have written quite a few posts connected to that topic. But how much can I write about COVID-19? Hold on to your seatbelts; here is another post.
The current health crisis has dramatically changed my lifestyle. I’m not bored, and I’m still productive. However, a routine day is, well…very routine. Yesterday, I walked to my friend’s townhouse project. We chatted for a bit before I took his MacBook Pro and started to write a blog post for his construction website. Tom kindly went to get bagel sandwiches for breakfast. I was left alone to write about home remodeling, a subject where I can’t claim expertise. It’s not that I’m unable to put a coherent story together, I’m more concerned that I’ll phrase something incorrectly and somehow embarrass my friend to his more knowledgable readers. With that said, I wrote the post to which I added the construction photos that I had taken over the last few days.
Before Tom had a chance to review my writing, his friend Wess arrived. Wess is a talented carpenter who has worked with Tom for decades. He was “volunteering” his Saturday to help Tom remove a large bay window, that space being repurposed for a sliding patio door. Tom and Wes usually converse in Polish, a language that I have no comprehension of. Recently, Wes has made an effort to talk in English, which has been much appreciated, and it allows me to join in.
The morning transitioned into the afternoon, and I headed back home and emersed myself into one of my obsessive interests, technology. Julie had given me a pair of AirPods at the beginning of the year, and I love them. When I become interested in a topic, I want to know everything about it. In this case, I was interested in the difference between my costly device and much cheaper clone products. I understand that most would find such an exploration utterly dull, but it held my concentration for hours.
After a few telephone calls to loved ones, it was time for dinner; the offering was Domino’s pizza. Domino’s has a low ranking on my pizza desirability chart, but my kids love it. The group’s lively conversation quickly extinguished any negative feelings about the pizza dinner. As a family, we have worked hard to eat dinner together and to focus on interacting with each other. Our meal was filled with talk, laughter, and a lot of kidding.
Julie suggested that we all play a game, but board games are not my thing. We reached a compromise; I took a shower, and the others played a game. Later that evening, we were glued to the family room TV, rewatching a few episodes of Battlestar Galactica. We viewed the show with the same enthusiasm as some might when watching a football game. The show concluded it was time for bed.
A perfectly routine day.
I have had disturbing dreams as of late. I wouldn’t call them nightmares, but they are unsettling. A recent one had me repeating both graduate and medical school, as I wondered if I could still take on these arduous tasks. Such dreams are a window to my subconscious and suggest hidden stress to me.
I pondered the question of stress this morning as I sat in the big chair in my study. I contemplated my current life and asked myself, “What is wrong? What is missing?” I centered myself, closed my eyes, and opened my mind to a stream of consciousness. At first, my mind was blank, but it soon was flooded with images and sounds. These are some of the ideas that flowed over me.
Despite talking to my siblings daily, I was missing them terribly. Before COVID, we had developed many in-person activities, “Sibling Breakfast,” “Sibling Lunch,” and random visits for coffee and conversation. I longed to see them in person.
Although I see my friend Tom nearly every day, I missed the spontaneous and crazy things that we did before the pandemic—driving into Chicago at sunrise just to have breakfast at our favorite greasy spoon, going on camping adventures and road trips, exploring locations.
My friend John had invited me to spend a few days at his Florida home. Julie and I had booked a flight before the pandemic but had to cancel it months ago. Speaking of trips, Julie had I started to go on them as a couple. We would find a cheap airfare to somewhere, and the two of us would explore our destination. I missed traveling.
Three of my children have returned home, two from college and one from the Peace Corps. My college kids had to complete their spring semesters on-line. My Peace Corps daughter had to leave Africa and a teaching job that she loved. Their loss makes me feel powerless.
Last year I took Violet the campervan on many adventures. She currently sits idle in my driveway. There is no place to go during this explosion of infection. I feel guilty about Violet. I feel like I’m letting her down. I invested a lot of time and money into her. Once a symbol of my retirement freedom, the pandemic has reduced her into an icon of what I can’t do.
I am a photographer, and I have continued to do photography work. However, I have a keen interest in landscape and cityscape photography. However, it isn’t feasible to travel to a town or bucolic pasture to photograph these subjects during this time.
I’m not much of a shopper, but I miss the ability to go to a store for a single item. I now limit my shopping to only grocery stores, which I go to once a week. Trips are currently done as purposefully and quickly as possible. There is no time to try or discover exciting new products.
I miss my daily walks to Starbucks and the quick but pleasant chats that I had with my favorite baristas and the early morning coffee crowd.
I miss going to the movies, and “sneaking” in a bag of popcorn.
I miss going to cheap restaurants—places where I could sit down and enjoy my food without the worry of preparation or clean up.
I miss making new friends. I miss family parties. I miss catching up with my cousins. I miss getting dressed and going to church on Sunday. I miss the act of standing next to a neighbor when chatting with them on the street. I miss the smell of a campfire. I miss… I miss so much.
I explored all of these thoughts and pondered how they were connected. Many contained a grain of spontaneity and a sense of a future. What would I do tomorrow? How can I plan for my next activity? Before COVID, I could anticipate an adventure with Tom, or a trip with Julie, or an upcoming photo project. This has changed with the routine regularity of my current life.
I like to shake hands. I want to give hugs. I like to push my creativity. I like to feel free. I want to feel safe. I like to be responsible, and I love being mischievous.
Activities that I do have an impact on who I am. I am in the process of grieving over who I no longer am. My world has changed in a matter of months. I want my old life back, but I may have to accept the ways things are now. I think this is the conflict that fuels my sense of “missing.” and “missing” is just another name for loss. With loss comes grieving.
Dear reader, I have worked hard to simulate those things that I can no longer do. However, a simulation is like saccharine, still sweet, but with a bitter aftertaste.
As the crisis has continued, I have tried to keep my interests alive. I do order food from those restaurants where I formally dined-in. I have made an effort to take creative photos. I call my sisters and connect with my friends in many ways. It is all good, but these good things still have the aftertaste of a synthetic solution.
That is to be expected. Will life return to normal, or will I need to accept my current situation as the new normal? Either way, I plan to make the most of it. Every day is a gift, never to be repeated. I can’t waste today pining over what I have lost. I have to accept my feelings as real, and I need to respect them. However, I cannot submit to them. I have to live in the present and plan for a new future. That will be my effort.
I was preparing to spend a few days with Ralph at his summer home, which is about an hour west of me. I tapped his address into my iPhone, put the phone into Violet the campervan’s phone holder, and started my journey. Since I was bringing dinner, I made a quick detour to the Fresh Thyme Market, a small grocery store just down the street. Being lazy, I left the phone in its holder during my grocery adventure. When I returned to the camper, I tossed steaks, watermelon, and salad into the 12-volt fridge and hopped into the driver’s seat to continue my journey. I looked up at my phone and saw a bright fluorescent green vertical line across the screen. Crap, my phone’s display was busted! Over the short time that I visited Ralph, that single line morphed into multiple lines making reading anything on the screen impossible.
On my return home, I investigated my repair options. I contacted Apple customer support, who told me that the screen needed to be replaced and that the estimated cost for the repair would be an astounding $560.00! My iPhone X is three years old, but I’m not ready to buy a new one, so I explored aftermarket options and found a store in Naperville that would replace the screen for $150.00… a much more realistic price. They said that they could replace the display in under an hour, which sealed the deal.
There were no surprises with the repair, but I was surprised by what I saw in the small and cramped shop. Both technicians were mask-free, as were three customers. One of the customers was sitting in a chair waiting for a repair suggesting that his exposure time in the store was significant.
Yesterday I took Violet in for routine service at my local Dodge dealer. The staff was wearing masks (although several had their noses sticking out). However, two customers were mask-free. In Illinois, we are required to wear masks in confined spaces like retail stores and shops, so why were all of these people ignoring the law?
When I read the news, I see photos of people in bars, churches, and nightclubs all shoulder to shoulder and all mask free. I recently saw pictures of several political rallies where both the candidate and the majority of the audience were bare-faced.
We are in the midst of a worldwide disease pandemic. Entire countries have shut down, almost half of a million people have died worldwide, and one hundred and twenty-four thousand souls have been lost in the US alone. That is more US deaths than during the entire First World War.
We are gaining more knowledge about this illness. A few medical treatments are starting to emerge that may help some patients. We are getting a better understanding of the best treatment practices. Worldwide efforts to develop a vaccine are in hyperdrive. However, we are nowhere near a cure.
Countries have tackled the spread of this disease in different ways. Their varied approaches have given us a window into what works and what doesn’t contain the virus. Unsurprisingly, the most beneficial methods are those that we have known about and used for over 100 years. Those methods include social distancing and isolation, hand washing, contact tracing, and wearing a mask when you can’t control social distance. Regions that have successfully implemented these changes have had greater success at containing the virus than places that have been laxer.
In the US, we have had conflicting information concerning the virus and how that impacts opening the economy. Also, there seems to be a stream of half-baked recommendations that confuse the general population. A YouTube video from a Michigan family practice doc that foolishly recommended washing fruits and vegetables in soapy water had over 20 million views in its first week. Even the premier source of infectious disease information, the CDC, erroneously told citizens not to wear masks, only to have to backpedal on that wrong information.
Any competent physician knows that wearing an appropriate mask can help prevent the transmission of disease both to and from the mask wearer. Most citizens don’t have access to medical-grade masks and have to make do with “dust” style hardware store masks or homemade cloth masks. These masks dramatically reduce the spread of COVID-19 from the wearer and depending on the composition of the mask, offer some protection to the user from getting the virus from an infected individual.
The most contagious places to catch this coronavirus are indoor locations, with poor air circulation. The higher the density of people in these places, the higher the chance of infection. Indoor parties, crowded bars, packed in-house church services, and the like are high risk and should be avoided at this time. However, there are other places like grocery stores that can’t be avoided by most. That is why everyone must wear a mask when you can’t control social distance. If everyone wears a mask, we can dramatically reduce the rates of viral spread. This is not a theoretical idea; it is a proven fact. Wearing a mask is a no brainer. So why are people actively refusing to do this?
Before I explore this question, I need to examine other phenomena present in this country. We have lost nuance, and have become a country of absolutes. For instance, some have taken social isolation to the extreme, and others have entirely cast it to the wind. We have developed an “us vs. them” mentality when it comes to many things in daily life. We have lost the ability to work together. We have become more concerned with personal gain over what benefits our greater society. We have developed a culture of mistrust. We have become an “all-in” society. If someone believes in one tenant that a particular group espouses, then they are expected to become a follower of all of the other ideologies that the group promotes. We have assumed a “contest” view of life that supports that the only way one group can prosper is by decimating another group, which then becomes the opposition. We believe that the ends justify the means, no matter how dangerous the ways are.
As a Christian, I find such splitting behaviors abhorrent. As a psychiatrist, I understand them to be destructive and dangerous. These ideologies play into many of our decisions, including our willingness or unwillingness to wear a mask. The question is, how do these beliefs and other factors cause us to take a position that is so contrary to our well being?
Masks are uncomfortable, that is a fact. They are hot; they fog up your glasses; they make it difficult to be understood. As a physician, I can tell you that just about everyone quickly adjusts to these inconveniences. But, yes, they do suck.
When I was researching this post, I came across articles that noted that people refused to wear masks because they felt that wearing one made them look weak. This is one of those reasons that are hard for me to comprehend. Why would a mask make anyone look weak? Wearing one makes them look responsible, and their actions help the wellness of their fellow citizens. In my mind, mask wearers are strong and patriotic.
Wearing a mask highlights that things are not back to normal. This is undoubtedly true, but the reality is that things are NOT normal. Denial isn’t the name for the longest river in Africa (…old AA joke).
Some people feel that wearing a mask is anti-God. How masks and God are connected is anyone’s guess. I know that early on, some religious leaders said that God would protect their churches and congregations, which may play into this belief. I also watched a video of citizens voicing their concerns about mandatory mask-wearing during a Miami city council meeting. One individual said that the council was doing the work of the devil by requiring masks. The citizen seemed firm in her belief but did not give any evidence as to why she held them.
The wearing of a mask has taken on political implications. Statistically, Democrats are more likely to wear a mask than Republicans. Masks seem to have become weaponized in this regard. I recently viewed photos of a rally in an Arizona church that was packed with over 3000 young people. They were shoulder to shoulder, and I estimate that the number of mask wearers was under 5%. I hope that this meeting doesn’t turn out to be the source of a super-spreader infection, but that certainly could happen. Placing politics over health is a real tragedy.
Some people strongly feel that wearing a mask is a personal choice. “If I get sick and die, it is my choice,” they imply. As individuals, we are allowed to do stupid things, as long as they don’t impact others. We can smoke cigarettes, which are known to cause many diseases, but we can no longer smoke in public places because this would harm others. Shouldn’t that same logic apply to wearing masks?
Some don’t wear masks because they think that COVID-19 is overblown or a hoax. Some groups have promoted these false ideas, and a person’s local experience additionally amplifies them. I have heard people say, “I don’t know of anyone who has gotten COVID-19,” as if this limited information can be generalized to the entire population. Alabama Governor Kay Ivy famously said, “Y’all, we are not Louisiana, we are not New York state, we are not California. Right now is not the time to order people to shelter in place.” I guess the idea was that the virus was somehow not impacting Alabama at that moment, so WTF. Sadly, if you take a look at the number of Alabama cases, they are on a steep increase. These numbers would likely have been significantly lower if there had been better direction from officials in that state.
Some refuse to wear masks for reasons that seem entirely bizarre. Watching the same Miami city council meeting, I witnessed one furious man, saying that he would defend our flag to the death, implying that wearing masks was somehow going to destroy our country. This, along with the idea that Satanists are promoting masks, just seems crazy. It is challenging to explain crazy.
Some are afraid that wearing a mask damages our economy. Well, this is sort of right… but indirectly. The global pandemic is harming our economy, and wearing a mask reminds us of that pandemic. Wearing a mask may make certain activities more complicated, like going out for dinner on a date. However, the more we control the virus, the sooner our economy will return to normal.
So what is the solution?
We have not had a unified message about the necessity of wearing a mask. This needs to be done on all levels of government and from both sides of the aisle. We know that wearing masks can reduce the number of infections as well as the number of deaths due to COVID-19. All people who have a voice need to be echoing this reality.
We need to emphasize the benefits of wearing a mask with transparent statistics. One study showed that if everyone wore masks, the rate of infection would drop to 1/12th of a population where no one wore a mask. As an example, let’s say that 100 individuals contract the virus in a non-mask wearing group. In a statistically identical group of mask wearers, only eight individuals would get sick. Staying well benefits the economy.
Similarly, we need to publicize situations and cases where lack of safeguards, including masks, has caused outbreaks, and we need to personalize these situations. It is one thing to say that 53% of participants became ill when they attended a choir practice in Washington. However, these numbers would be much more compelling if actual people told their stories about this event. I am in no way trying to exploit victims of this disease, but I’m confident that many individuals would gladly speak up about their COVID experience if they felt that it would help others. Numbers always have more impact when they are attached to a relatable situation or person.
We have to model good behavior. Our officials should all be wearing masks in public settings, and they all should be practicing social distancing. “Do as I say, not as I do,” doesn’t fly.
We need to nationalize standards. Yes, we have guidelines, and yes, a cookie-cutter approach doesn’t work well in a country as vast as the US. However, standards can be customized to accommodate different needs and regions. Let’s say you want to bake a chocolate cake. You will have the best results if you follow a standard recipe. However, you can customize your results to fit your needs. A little more chocolate? A little less sugar? A different frosting? Any reasonable changes will still result in a good cake. Imagine a scenario where 100 people need to bake 100 chocolate cakes, but they aren’t given a recipe. Some will have baking knowledge; others won’t. In the end, there will be many different cakes, but many of those will be inedible.
The cost of non-compliance must be emphasized. What is the actual price to the economy if we can’t get this virus under control? What is the emotional damage of losing a loved one? We need reasonable guidelines, and these can change as we gain more knowledge. It is unreasonable to expect everyone to stay behind closed doors, but it is foolish to open up the country altogether. Our leaders need to not only inform us but to re-emphasize what we can and can’t do. We were able to mobilize our country during WWII by using various methods that emphasized safety, patriotism, and sacrifice for the greater good. Many feel that the WWII generation was our greatest generation ever. People think proudly about those individuals and their sacrifices. How is it that we are divided over a potentially more deadly crisis? This does not have to be the case. We need leaders who can lead and have the ability to place the needs of the greater society above short-term gains.
It has now been over 12 weeks that Illinois has had a shelter-in-place order, and although some of the restrictions are easing, life is not back to normal. Also, COVID-19 is still a threat. This dynamic duo has impacted us on many levels, ranging from economic to physical well-being to emotional health. It is this latter point that I would like to address today.
As a psychiatrist, I worked to explore ways to reduce the emotional impact of this crisis on my family and me. That is not to say that the pandemic has not impacted me. On a personal level, I have noticed a higher amount of irritability and sensitivity. Although I’m usually an optimistic person, I have had a few more down days. Most significantly, I’m experiencing more nightmares. This latter fact is an expression of anxiety that I’m effectively masking during waking hours, but seeps out when I’m sleeping. As Illinois restrictions have lightened, new challenges have emerged. Toilet paper scarcity is no longer an issue, but now I have to decide how much social interaction is safe.
I’m not psychologically perfect, but I do believe that I have done well by utilizing a variety of psychological techniques.
Here are some of the coping tools that I have used. You may find them helpful when dealing with your social isolation.
Accept your feelings
It is normal not to feel normal during a crisis. This is an unprecedented time in world history. You may find yourself more irritable, slightly more depressed, or a bit more anxious. These feelings are not failings; you are reacting to a difficult time. With that said, if these emotions are pulling you down, it is essential to try to control them. Many of the suggestions below can help you feel healthier. However, if your emotional state is severely compromised, you must seek help.
Maintain a routine.
Over the last 12 weeks, have you had times when you weren’t sure what day of the week it was? I have. We are creatures of habit, and most of us do well when we follow a routine. A routine not only gives us structure, but it also frees up psychological energy. We don’t have to think and plan mundane activities when we follow a pattern of behavior. There are many ways to develop a routine. An excellent place to start is to mimic your regular wakeup time and bedtime. Another easy routine activity is to make sure that you get dressed in street clothes as soon as you get up.
Keep up with hygiene.
Shelter-in-place rules have made it more challenging to keep up with traditional grooming, such as getting a haircut. As rules relax, it is essential to assess your particular needs and risks when deciding to return to a barber or stylist. However, hygiene issues have a more basic side. When you are isolating alone, it is easy to put off washing your hair, taking a shower, or even brushing your teeth. However, it is critical to do these activities just as you would if you were out-and-about.
Even during the height of restrictions, it was OK to leave your house for a little fresh air. The risk of getting COVID-19 during a socially distant walk is extremely low, but the benefits to your emotional state are significant. I try to go on a walk by myself or with family members every day.
Reach out to others.
One way to feel less socially isolated is to be less socially isolated. But how can you do that when you are required to have limited contact with others? Facebook is OK, but my feed has turned mostly into ads and memes. The more connected that you can make any communication, the better. A text conversation is preferred to reading your Facebook feed; a phone call is better than a text message; a video call is better than a phone call. There are some individuals in my life who I have made of point of calling every day. My goal is to show them that they are important enough for me to reach out to them regularly. Some of my contacts are video calls; some are voice calls. I try to augment my voice calls with photos sent as text messages or email attachments. Regular calls to people who you love is a win/win way to spend your time.
Find your own space.
If you are sharing your living space with someone, it is not only important to share time; it is also important to have alone time. Find a place in your home where you can be alone. I go to my study and my wife “chills” in our sunroom. We have five adults living together, and we are fortunate that our residence has enough space for each of us to have a private spot. I understand that not everyone is as lucky as we are. However, even claiming a comfy chair can give you a place to get away.
I isolate myself in a chair in my study. To the right of the chair is a window where I can explore what is happening on the street. To my left is a small table with a lamp. At the moment the table is holding a cup of coffee and my phone. On my lap are a lap table and the MacBook that I’m typing this post on. It is a simple set up that allows me to have some private time where I can be as productive or unproductive as I choose.
Limit the news.
News in the US tends to be sensational. “If it bleeds, it leads.” Too much news can be agitating and does little to enhance or inform. Try to limit your news to known reliable sources and “ingest” it no more than twice a day. Having a cable news service on 24/7 will likely make you feel more agitated and depressed.
Learn new skills, revisit old ones.
I have a friend who is spending some of her isolation time learning about house plants. I know others who are tackling simple home projects.
Before the pandemic, my wife and I were empty nesters. We have had to readjust to having a full house with the return of three of our children. When it was just the two of us, it didn’t make much difference if we cooked or went out to dinner. However, with the return of the kids came daily meal preparation. I am a competent cook, but coming up with a regular meal has been a drag. With that said, the thought of an exclusive diet of microwave meals or fast food burgers turns my stomach. I have returned to alternating cooking meals with my wife. When I cook, I involve my kids in meal preparation. Their participation makes the task more enjoyable. I have also resorted to conjuring memories of my mother’s weekday cooking. She was an excellent cook, but many of her meals were simple or one dish concoctions. Cooking for my family has made me feel productive, and I’m glad that I can provide them with something that they can look forward to.
Institute conversations at home.
Although there are periods where I need my alone times, there are other times where I want to connect with my immediate family. We try to eat dinner together, and we do this at the dinner table. We limit electronics during dinner, and we often use “conversation starters.” One of our favorites is “rose and thorn.” Each family member talks about something good and something bad from the day. Rose and thorn helps us know what is going on in each of our lives and serves as a springboard for additional conversation.
Institute activities at home.
There are many options here, and it is crucial to find an activity that everyone enjoys. A family movie, family game night, family craft night… the list goes on. Structured activities allow for easy interactions.
Redefine holidays and important events.
There have been several important events that have happened during our shelter-in-place time. In our case, we celebrated Easter, several birthdays, and Mother’s Day, but we modified the events to fit our new restrictions. We have made an effort to extract those traditions that are important and changed them to fit our current situation.
In our neighborhood, I have seen an explosion of lawn signs celebrating everything from birthdays to graduations. Our neighbors are tackling the same issues that we are. Do what you can to keep special events special.
Be kind to yourself.
You would think that shelter-in-place would be a perfect time for me to tackle all of the household projects that I never seem to have time to do. However, I can tell you that I have been less likely to do heinous projects during COVID-19. I simply don’t have the desire or energy to do repetitive or borning tasks. Why? I believe that it is partly due to the fact that I’m expending a lot of energy coping with life in a pandemic.
By all means, clean out a closet or organize a spice rack if you have the desire to do so. However, be kind to yourself and back off the guilt if you don’t want to. That stuff will be waiting for you.
Expand your social circle responsibly.
Most things that we do have both risks and benefits. The secret to success is to balance these two oppositional forces. During the first few weeks of isolation, I found myself feeling more irritable and somewhat depressed. I was missing the daily contact that I had with a friend. He was also socially isolating and was at low risk for being a coronavirus carrier. I started to visit him in his backyard for short chats, which made a world of difference in how I felt.
As restrictions ease, it may seem like the battle is over, and life is returning to normal. That is not the case. It is important to connect socially, but it is also essential to weigh the risks and benefits of any social interaction. Remember, it is about both the viral load and the length of exposure. Places that maximize both of these factors are the most dangerous to be in, places that minimize them are safer. Do get out and enjoy life, but do so in a responsible way. Naturally, common sense activities like wearing a mask and handwashing are critical musts. Remember that the ultimate loss of freedom is death.
Reach out for help if needed.
The above tips can help you deal with the COVID blues. However, some individuals will experience depression and anxiety that goes well beyond the typical. If you are experiencing significant depression, debilitating anxiety, or thoughts of harm, it is imperative that you seek professional help. Contact your doctor, hotlines, or your local hospital if needed.
I hope you have found these mental health suggestions helpful in dealing with the stress and anxiety that this global disaster has brought us. We will get through this; tomorrow is another day.
I tried to write posts that are informative and positive. I think that there is enough shocking news in the world. I attempt to avoid controversial pieces, as they tend to alienate readers. I’m not sure if this piece will be considered controversial, or it will alienate others. However, this is what I feel compelled to write about today. It is as simple as that.
This year has started with a bang, and it continues to spiral out-of-control. The COVID-19 pandemic has altered how we function in our society, killed countless individuals, and divided our country. That last statement surprises me the most, but it is sadly true.
Social distancing and the wearing of face masks have been demonstrated to reduce infection rates. Sweden’s approach to social distancing was laxer than its neighboring countries. Deaths in Sweden due to COVID-19 were almost 40/100,000 residents compared to 6/100,000 residents in adjacent nations that had stricter orders. In the U.S., we have seen individuals and groups promote behaviors contrary to good public health. These forces were countered by health officials and media outlets that emphasized the importance of viral containment. However, coronavirus news has been pushed aside and replaced by another crisis.
On May 25, 2020, a black man, George Floyd, was detained by police under suspicion of passing a counterfeit $20 bill. He was unarmed and did not appear to be a threat, yet a police officer obstructed his airway for 9 minutes. This action killed him. Watching the video account of his arrest was horrifying to me, but it also haunts me. It is a vision that I can’t get out of my head. That video launched a world-wide protest against police brutality. There has been a surge of other videos of police violently attacking citizens who appear to be of no physical threat to them. The officer’s attacks in these videos seem to be rageful and out-of-control. Like everyone else on the planet, I watched in astonishment as the police and military used chemical agents and bullets to disperse a peaceful demonstration in Washington, D.C., so that the president could take a photo-op. Equally disturbing are officers without name tags or organizational insignias who were part of the military force in Washington. Where are they from? Who are they accountable to? There was no way to identify them. Scenes like these have made me feel like I am witnessing events in a totalitarian state, not the USA.
Not all police have acted brutally. In my hometown of Naperville, a protest for George Floyd/BLM was scheduled. The authorities had determined that there was the potential for violence. Based on this information, many businesses boarded up windows and secured their establishments. I walked down to witness the protest and saw a peaceful assembly. The police were en masse, but they were off to the side. Their presence was undeniable, but they were agents of calm, not violence. I continued to follow the evening’s events on a video feed from our local cable T.V. channel. The peaceful protest transitioned, and a different element roamed the downtown, breaking windows and looting stores. At some locations, the police formed a physical barrier to protect stores; at other spots, they pushed out looters and sealed them off from those areas. I am in no way supporting the looters’ actions, and I feel terrible that over 30 businesses suffered damage. However, the police’s sensible and calm behavior in Naperville contained the problem and did not escalate it. There was damage to property, but no one died on either side. It was a fantastic example of the excellent work that thoughtful police do.
I have known a few police officers well, and two generalities have stood out. They are just regular people, and they have a strong commitment to serve and protect their communities. So how is it that we see videos of police officers practicing such terrible brutality? I feel that rogue cops represent a tiny percentage of the police force. Unfortunately, some police follow a code of protecting their fellow officers at any cost. Because of this, these bad apples continue to abuse their power. Cover-ups can be systemic in organizations. Former Chicago mayor, Rahm Emmanual was implicated in suppressing video evidence of the fatal shooting by police of Laquan McDonald. Initial police reports said that Laquan was acting aggressively, but the court-ordered release of police video showed that he was walking away when he was shot 16 times by officer Jason Van Dyke.
I believe that we have mostly peaceful protesters with a small percentage of looters and we have primarily good police with a small percentage of corrupt cops.
A small group of bad apples can spoil the reputation of the larger bunch.
As protests have continued, some choose to focus on the protesters rather than the reason for the protests. It sickens me to hear leaders talk about dominating others to justify abusing their power. It also upsets me that thousands feel that they need to put their lives on the line for our leaders to hear them. Every protest group offers the potential of becoming a COVID superinfection zone. It is a frightening prospect.
You may think that this post is a veiled condemnation of President Trump. I will not deny that I feel that has continually stirred the pot of divisiveness to the detriment of our country. However, I believe that a more significant issue is our societal views of different minority groups. As a nation, we spend an extraordinary amount of time identifying groups who we perceive as different from us as our enemies. We determine that entire categories of individuals should have fewer rights than ours and that their very existence poses some threat to us. Some use this separation to incite fear in others to gain power and influence. They make our country weaker. However, we, as a society, accept these lies. Can you think of any minority group that has not experienced prejudice? Women? Hispanics? Blacks? Gays? Jews? Chinese? Fat people? Muslims? It doesn’t take much to qualify as an outsider, and with this designation comes fewer rights than the majority.
If you are in any minority group, it becomes more challenging to achieve your goals. The American Dream is that you can determine your destiny. I do believe that the individual is responsible for their fate. If you want a good job, you need to obtain the skills necessary to achieve it. To get accepted to a top university, you need to study hard. If you want a beautiful house in a safe neighborhood, you have to save the down payment. However, for the American Dream to be real, everyone needs to be on the same playing field. If we are all dealt the same cards, it is up to us to play them. However, if the deck is stacked, some players always lose.
Groups in power want to keep their power, that is a fact. They justify their actions to maintain control. Their fear of losing power may cause them to act in ways contrary to their values. A fellow officer may feel compelled to corroborate a false story thinking that someday his own life may depend on the lying officer’s protection. Politicians and others may justify their prejudicial and inhuman behaviors of groups by dehumanizing them. Children in cages become unlawful, illegal invaders. Muslims become terrorists. Women are labeled frumpy, ballbusters, dumb blonds, and girls. Once designated as “less than,” it becomes OK to treat these groups as “less than.”
As a country, we gained world power status because we were a melting pot of creativity and ideas. Our diversity has always been our strength; it is foolish to think otherwise. The limitation of large segments of our population may temporarily benefit a few. Still, its overall effect is the weakening of our country. The more we divide and alienate, the more we erode the basic tenets of our Constitution. The Constitution is the foundation that our country is built on. Erosion of a foundation results in the collapse of the overall structure.
We are creatures of novelty. Now that there is a new story to capture our attention, the ongoing pandemic has receded into the background. I fear that the same will happen with police reform. The protests will end, and our collective minds will focus on the next big story. We cannot let this happen.
I grew up in the 1960s, a time of great Soviet hubris. I remember a quote by Soviet Prime Minister, Nakita Khrushchev who said, “We do not have to invade the United States, we will destroy you from within.” Unity creates strength; division creates weakness. As we justify the abuse of others, we deem different; we move ever closer to his prediction. The group of marginalized individuals grows ever larger; it is only a matter of time that those who are marginalizing will become marginalized themselves. Perhaps, that has already happened. Who will be left to protect our values and our country when we are all considered the enemy?
I read the email from Ralph. He was inviting my family and me to his farm for the weekend. I felt reasonably confident that Julie would want to go, but I was less sure of my kids. To my surprise, they were eager as they had fond memories of outings there when they were younger. Our invitation was at the beginnings of the lifting of shelter-in-place restrictions in Illinois; I knew that both Ralph and Anne had been carefully isolating.
Ralph is my former business partner, and his wife Anne is my dentist. They live in a nearby suburb, and the farm is their get-away place. To call it a farm isn’t exactly accurate, but that descriptor is about as good as any other.
Ralph’s father was a famous researcher who was a professor at a prominent university. Along with his pediatrician wife, he decided to purchase the farm in the 1960s. This move was stimulated by several factors, including the fact that a few of his colleagues had bought vacation cottages on the nearby Rock River. However, his father had bigger plans and eventually obtained 650 acres of land that included fields, forests, and a former rodeo. The rodeo’s site had a main house, nine log-style cabins, a two-story barn, and various other outbuildings. It was situated on an idyllic pond and became the family’s weekend home. In the 1970s, Ralph’s parents built a new home on a ridge overlooking their lake. This is the place that I have visited over the years. The first time that I saw the old homestead was last year as it is about a mile walk from the “new” house.
Visiting the farm is a unique experience; in reality, it is a private preserve. There are expansive open fields, densely wooded forests, ponds, creeks, and a lake. The site also contains a helicopter landing field, an abandoned caboose, and a 7-foot plaster-cast statue of Cleopatra. Edmonia Lewis sculpted the original sculpture (The Death of Cleopatra). Ralph’s dad donated it to the Smithsonian American Art Museum in Washington, D.C. but had a cast made to keep for himself.
The property’s most unusual feature is a buried, multi-room bomb shelter that even includes a garage to store a car. Under a hill, the shelter has several entrances, including a secret tunnel to the main house. That opening was located in one of the bedrooms, and to reach it you had to propel yourself down a hidden slide.
Current observers would likely view the building of a massive bomb shelter as eccentric or possibly even a little crazy. However, I would disagree with both descriptors. To understand why someone would go to great effort and expense, you need to understand the era when the shelter was built. The Cold War was in full swing in the 1960s, and the treat of a nuclear attack from Russia was a genuine fear. Many people had makeshift bomb shelters in their basements, and students practiced “duck and cover” exercises in school. In fact, in 1962, it was revealed that Russia was building missile launching pads in Cuba, only 91 miles away from the U.S. mainland.
Ralph’s father’s actions were consistent with the fears of the time, except he had the financial means to protect his family on a grander scale than most. Thankfully, for all of us, the family never had to use their hidden bunker.
I am also trying to protect my family, not from a nuclear blast, but a novel coronavirus. I have instilled in them the need to socially distance, and they know the importance of handwashing. I have laid in some extra food and supplies so they would be safe and fed if, for some reason, I couldn’t go to the grocery store. I have kept abreast of the latest news and medical research since knowledge is often the most potent weapon against any adversary.
Now that the country is opening up, it is important to know what situations are safer and what situations are more dangerous.
Most research has shown that the best practice is to stay far away from others, as individuals can be infected while exhibiting no physical symptoms. The 6-foot rule is an excellent place to start. The more open the setting, the safer the environment. The more confined the setting, the more dangerous. The more talking, singing, coughing, laughing, sneezing, the worse the setting. Short periods spent in places offer less viral exposure than extended periods. To put this in practical English:
-Outdoor open spaces with few people are relatively safe.
-As outdoor spaces become more crowded, they become less safe.
-When you can’t maintain at least 6 feet of distance, wear a mask. Even a homemade mask offers some protection to the wearer and benefits those around the wearer.
-If possible, avoid closed spaces with poor air circulation (bars, churches, movie theaters). Such places are even more dangerous when people are singing, shouting, or doing other activities that move a lot of air.
-Eye protection may be useful in “trapped” spaces, such as an airplane.
-Washing your hands regularly is one of the most important things that you can do to stay healthy. Do this often, and every time you return home, even in situations where you think you haven’t touched anything.
-Use an appropriate hand sanitizer when you can’t properly wash your hands.
– The amount of time that you spend in a given place counts. The chance of getting coronavirus from a short visit to the grocery is relatively low. If you work in a grocery store for 8 hours a day, being infected by a coworker is higher.
As the country opens up, it is essential to choose your activities wisely. You don’t need an elaborate bomb shelter to protect you and your family, just some masks, a little soap, and a heavy dose of common sense.
BTW, we had a great time at the farm. Instead of writing a narrative about it, I thought I would end today’s post with some photos.