Category Archives: Covid-19 help

COVID Q&A-October 2020

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. 

My background:  

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

Peace

Mike

Simple and inexpensive items can keep you safer from this virus.

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. 

Bomb Shelters And COVID-19, More Related Than You Think.

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.

Peace,

Mike

The “new” house built in the 1970s.
The view from our bedroom.
The “new” house sits on a ridge overlooking this lake.
We toured around the farm “hayride” style. Ralph is an expert at driving a tractor.
One of several ponds.
Only a few of the original log cabins remain, and they are returning to nature.
Transportation consists of one of several 1950s tractors.
A huge bonfire often ends the evening.
View of the lake from the patio.
Getting ready for an adventure.
Many stairs down to the lake.
Wandering in the forest.
Wandering in the field.
Going down to explore the old bomb shelter.
Our ride.
“The Death of Cleopatra” Image courtesy of the Smithsonian.

Honest Answers Concerning the COVID-19 Pandemic.

As far as I’m aware the following post provides accurate information as of 5/19/20. I have heard so much bad, inaccurate, and dangerous false information on this topic that I felt it necessary to address this topic. If you read all of the questions you will have a good and reasonable understanding of this pandemic as of this date… Dr. Mike.

What is a virus?

A virus is a microscopic parasite that consists of an outer protein coat that houses genetic material. Think of genetic material as a set of instructions. Some viruses also have a lipid (fatty) outer coating. For instance, the coronavirus has a lipid outer coating. A virus is very different from living organisms as it does not have the internal machinery to build those things necessary for life and to create useable energy molecules that are needed to live. Also, a virus cannot reproduce/replicate on its own. 

A virus is simple in its structure. Many viruses have projections on their outer surface that allow them to connect to the host’s cells. Once connected, the virus injects its genetic material into the host cell and tricks the host cell into making more viruses. It hijacks the cell to do its bidding. Once the host cell fills up with newly manufactured virus, it bursts (and dies), releasing many new copies of the virus. These copies infect other cells, and the process repeats.

Is a virus a living organism?

Many scientists would say that all living things have specific characteristics in common:

  1. All living things are made up of cells.
  2. All living things have the machinery needed to metabolize. In other words, they can make things that they need, like proteins. They can also create energy molecules needed to power their internal machinery.  
  3. All living things can reproduce/replicate themselves.

Viruses do not have any of these characteristics, so most scientists would say that they are not living. However, some may argue that they are living, but very different from all other forms of life on this planet.  

Are bacteria and viruses the same thing?

No. A bacteria is a single-cell organism that has the internal machinery to metabolize and reproduce. Bacteria are considered living. Also, bacteria are usually much larger than viruses. 

What is a coronavirus?

Coronaviruses are a group of viruses that have a crown of spikes on them. Corona means crown. These spikes allow the virus to connect with the host cells and infect them. There are many different types of coronaviruses, and some have infected humans for millennia. The most common human coronaviruses cause mild upper respiratory symptoms (they are one of several virus groups that can give you a common cold).

Different types of coronaviruses infect different organisms. Most are species-specific. In other words, a virus that can infect your dog won’t infect you. However, this is not always the case. Sometimes a specific virus can mutate, which allows it to infect other species. When this happens, it can be dire to the new organism as it may not recognize the virus, which allows it to spread further and cause more damage. This is the case with the coronavirus that is currently causing global problems. It has never infected humans before, so its impact is severe.  

What is immunity?

When we are exposed to a dangerous agent like a virus, our bodies launch a defense against that agent. If we survive the infection, our bodies can remember the virus. If we are reinfected again with the same virus strain, we quickly recognize the agent and launch a counter-attack to neutralize it. This ability to neutralize a formally dangerous agent is called immunity.

How do vaccines work?

In most cases, a vaccine contains unique parts of the virus, but not those parts that can cause disease. When injected with a vaccine, our bodies recognize those parts as foreign and launch an attack to eliminate the invader. Once exposed, our body remembers these parts as dangerous—exposure to the real virus at a later date now results in the rapid elimination of the virus.

Do vaccines cause autism?

NO, NO, NO… this has been researched many times. Don’t believe bull**t.

Can vaccines cause illness or death?

Vaccines are generally very safe. A tiny percentage of people receiving a vaccine may experience an adverse reaction, and some of these reactions could be serious. Overall, vaccines have saved millions of lives and have reduced or eliminated many terrible diseases.

What is herd immunity? 

Everyone in the group has resistance to a virus. This is often done by immunization. When done effectively, herd immunity can eliminate a virus. A virus needs a host to reproduce. If there are no hosts, it will disappear.

What is the official name for this coronavirus?

Severe acute respiratory syndrome coronavirus 2 

(SARS-CoV-2)

What is COVID-19

This is the name for the illness caused by SARS-CoV-2.

How do you catch this virus?

This is a respiratory virus. A sick person will shed the virus in respiratory droplets when they cough, sneeze, sing, or even talk. The particles infect the next person by entering that person’s body through their eyes, nose, or mouth (not the skin). If you have a high concentration of the virus on your hands, you can transfer the virus to your eyes, nose, or mouth by touching your face. This is why handwashing is important.  

Does wearing a mask protect me?

It’s complicated. Special masks (N95) can filter the air that you breathe and prevent the virus from entering your nose or mouth. However, these are in short supply and are reserved for people who are working on the “front-line,” like doctors and nurses.

Other types of masks have only a limited ability to block the virus from entering. However, they do reduce the travel distance of an aerosol (spray) when someone coughs. Less spray means a safer environment for those around you. If I wear a mask, I protect you, and if you wear a mask, you protect me. If we are all wearing masks, we are protecting each other.

What is an ACE2 receptor?

This is a particular part of the surface of a human cell that is involved with blood pressure regulation. This receptor is found in abundance on lung cells, but it is also present in many other parts of the body. The novel coronavirus that causes COVID-19 binds to this receptor, which is the first step to cause an infection.

What is zoonoses?

This is when a disease in an animal infects a human.

Where did this virus come from?

All scientific indications point to a bat as the original host for this coronavirus. It is likely that the virus mutated and then infected another type of animal and that a human caught the virus from this secondary host.

There is NO evidence that this virus was created or modified in a lab.  

Do all pandemic viruses come from China?

Not at all. For instance, the Spanish Flu of 1918 likely originated in the US, and the MERS pandemic of 2012 started in the Middle East. 

Are coronaviruses common?

This is a large class of viruses. Most of this class of virus doesn’t infect humans, but several do cause the common cold. However, the coronavirus that causes COVID-19 is new to humans, making it much more dangerous.

Why are health officials concerned about this novel coronavirus?

No humans had ever been exposed to this virus before 2019. This allowed the virus to run rampant and allowed it to cause life-threatening problems in those who were infected. This virus also seems to be very infectious. There are people who can contract the virus who are symptom-free, but they can still spread the virus to others. 

What does the term pandemic mean?

A widely spread epidemic. In this case, worldwide.

Is COVID-19 just another flu?

NO! Strains of the influenza virus cause flu or Influenza. COVID-19 has respiratory symptoms that are similar to the flu, but a coronavirus causes it. It is more dangerous and appears to be more infectious than the flu. However, the flu is also pretty dangerous in its own right. Remember that the “stomach flu” is just a generic slang term for GI distress and has nothing to do with respiratory flu. 

Why is COVID-19 more dangerous than the flu?

For many reasons, it is likely more infectious, more lethal, and impacts more organ systems than the flu. The respiratory flu is a severe illness, but COVID-19 is worse.

Was the Spanish flu of 1918 caused by a coronavirus?

No, it was caused by a mutated influenza virus that initially came from birds.

Is this the first time that humans have been infected with a novel coronavirus?

No, the SARS outbreak happened in 2003, and the MERS outbreak happened in 2012. Different members of the coronavirus family caused these. MERS killed about 40% of those infected, but it was harder to spread than the virus that causes COVID-19. As of the time that I’m writing this post, over 3 million people have been infected, and over 300,000 have died. The highest number of deaths have occurred in the US, with (at the time of this writing) over 90,000 deaths.

Do viruses mutate, and how does that change them?

All viruses mutate. Many mutations result in an inactive virus. However, some mutations can make a virus more infectious or deadly. 

What are the symptoms that COVID-19 cause?

The classic symptoms of this virus are fever, shortness of breath, and dry cough. However, many other symptoms can occur, including mental fogginess, pink eye, sore throat, loss of smell, blood clots, strokes, heart attack, skin conditions, GI distress, and more. 

Some of these symptoms happen directly due to the virus, others due to overactivation of our body’s defense systems, and others due to unknown reasons.

What is a cytokine storm?

This term is used when the body launches such an aggressive attack against a virus that it also starts to destroy parts of itself. Think of this as “friendly fire.”

Is it dangerous to take ibuprofen (Motrin) if I’m ill with COVID-19?

There is NO credible evidence that taking ibuprofen will worsen a COVID-19 infection.

What increases my chance of getting sick with this virus?

The only way to catch COVID-19 is to be exposed to the virus. The higher the concentration of the virus and the longer the length of exposure to the virus, the higher the chance of infection. If a sick person coughs in your face, that is a load of virus! If you spend time in a confined space with a moderate concentration of virus (church service, crowded bar, airplane), that’s a lot of exposure. Either scenario increases your chances of getting the illness. 

The virus has been found on everything, from cardboard boxes to the soles of shoes. However, these are unlikely to cause an infection due to the above reasons. 

However, if someone with an active infection coughed on a hard surface (like a keypad) and you touched that device shortly after that, you could transfer the virus from your hands to your face and infect yourself. Bottom line, wash your hands!

What is the kill rate?

Deaths divided by the rate of infection. 

Other viruses have higher kill rates, so why are we so worried about this virus?

Because this virus is so infectious. The more individuals infected, the higher the actual death rate!

Many people die from the flu, so why are we so worried about this virus?

Is this a serious argument? Really? We already have 90,000 deaths in the US, and the number will probably approach 120,000 by summers end. These are not just numbers; these are human beings. Are you willing to sacrifice your mother, or father, or favorite teacher, or great co-worker, or best friend unnecessarily? 

Do I have to have symptoms to spread this virus?

NO, this fact makes this virus very dangerous for obvious reasons.

Did China withhold information about this coronavirus, and why?

It appears that they did. I don’t know why, but it was likely for economic reasons, and also to stockpile equipment (like PPE and respirators) needed to treat the illness. 

Did China’s delay in telling the world about this coronavirus worsen the epidemic?

Yes.

Why is the outbreak so much worse in the United States than in other countries?

I am despondent to say this, but the US response to this pandemic has been shameful. We had all sorts of data from past pandemics. We also had data from this current pandemic. Yet much of this information was ignored. We never had a cohesive strategy and never used the full power of the federal government to direct us. Experts were ignored, rumors were deemed as important as facts. The list goes on. History will look at this time very unfavorably. It is so sad to me.

Can I get this virus from touching packages or the mail?

This is very unlikely, and there have been no reported cases of transmission by these routes.

Can I get this virus from having sex?

There have been reports of infected men expressing virus in their semen. Is this a problem? The answer is unknown, but it is MUCH more likely that you will catch the virus from an infected person by all of the other things related to having sex—proximity, deep kissing, etc. 

What are the best practices to avoid becoming infected with the virus?

  1. Stay away from sick people and from places where you can have long exposures to lower concentrations of viruses (large assemblies, bars, planes, etc) when at all possible.
  2. Socially distance. The virus only travels a few feet when someone coughs before it falls to the ground.
  3. Wash your hands thoroughly. Soap inactivates the virus.
  4. When you can’t wash your hands, use an alcohol-based hand sanitizer at the right concentration (many DIY sanitizers on YouTube won’t work).
  5. Wear a mask when you can’t socially distance (for instance, when grocery shopping).
  6. Limit trips to places like the grocery store. Shop deliberately and quickly.
  7. Use on-line services if possible.

Should I wear gloves?

I have seen so many people misuse gloves that it is hard to recommend using them. If you know how to use them, gloves can help protect you in some situations. However, misusing them could potentially increase your chances of infection.

What kind of soap should I use to wash my hands?

Any type of soap will work well. Just wash for at least 20 seconds and try to rub all parts of your hands as this increases the chance of breaking down the virus.

What kind of hand sanitizer should I use?

The hand sanitizer must have (by volume) 70% isopropyl alcohol or 60% ethyl alcohol. Commercial sanitizers that are alcohol-free won’t kill this virus. DIY sanitizers that don’t have this concentration of alcohol (by volume) won’t be effective. Rub your hands for 20 seconds to help destroy the virus.

I hear that the virus can survive on surfaces for a long time, should I worry about this?

In most cases, this is not an issue. However, it can be a problem if the viral concentration is high and the “seeding” is recent. An example would be an infected person coughing on a touch screen that you touch and then rub your eyes. In this case, you would be infecting yourself with a high concentration of fresh virus. Always us sanitizer when you get to your car, and then wash your hands when you get home.

People are telling me to take certain supplements or remedies, should I do this?

People are making money off of this tragedy. No remedy or supplement is helpful.  

Is it important to eat well, get enough sleep, and try to do those things that generally keep us healthy?

Yes, a healthy lifestyle, along with good practices, can increase your chances of staying well.

Why did states need so many ventilators? Was this a scam?

No, there was no scam. Many of the early deaths from COVID-19 were due to respiratory failure. In these cases, a respirator would be the only option. However, we are now learning that some individuals with low oxygen in their blood do well with more conservative treatments, like CPAP or O2.

Why did states want us to shelter-in-place?

This is a tried and true (Think Spanish Flu of 1918) way of reducing the rate of infection. If everyone got sick at once, the health care system would become overwhelmed, and more people would die due to reduced access.

Why are we supposed to stay 6 feet away from others when we are out and about?

The virus spreads by respiratory droplets, which typically don’t travel farther than this. When out in public, keep your distance. The 6-foot rule doesn’t work when you are in a confined space, like a church. There have been reports of many people who were more than 6 feet away from an infected person getting sick and dying in such situations. Although they were exposed to a lower concentration of virus (likely expelled in smaller droplets when the parishioner sang), they were exposed for a longer time.

Do I need to sanitize everything?

Use common sense. Clean things as you usually would, wash your hands frequently or use hand sanitizer when you are out and about. Higher precautions are needed when people work in highly contaminated areas (for instance, a doctor working with COVID-19 patients in the hospital). 

What should I do when I go to a grocery store?

Wear a mask, keep as socially distant as reasonable, shop quickly and deliberately, wash/sanitize your hands as soon as possible when you leave the store. Consider using on-line services, “senior store hours,” or other ways to keep those most at risk safe.

Is it safe to go to church, bars, concerts, or other enclosed experiences?

I answered this above. At this time, I would avoid these places. Remember, it is not all about you. You may get sick and recover, but are you willing to kill your spouse, child, or friend as an expression of your independence?

Does the time that I’m in a risky place matter?

Yes. More time equals more exposure.

What is more important, the virus or the economy?

This is not an either/or choice. Both have to be addressed concomitantly. 

I don’t like the government telling me what to do; they are not the boss of me!

Really? If you can’t move to a deserted island, suck it up and grow up. It not just about you and your wants. This virus is a big deal. I could go on, but I would just get progressively more pissed off.  

I’m young; I don’t care if I get COVID-19 because it won’t kill me.

First, it could kill you. Second, it could kill someone you love. Third, it could kill someone who could help you in the future (like a doctor). We live in societies for a reason.

If I’m older and get COVID-19, will I wind up on a ventilator?

Older people are more at risk for respiratory failure, but we are now learning that some of these patients can do well with less invasive treatments, like CPAP.  

What is happy hypoxia?

Some patients with oxygen levels so low that would typically be in a coma have been alert and appear almost normal. The reasons for this are unclear. However, it may mean that some individuals who would usually be placed on a ventilator may do well with more conservative treatment.

Are there treatments for COVID-19?

At this time, the only known treatment is supportive care. However, new treatments are being explored, and some appear promising. This history of medicine is full of examples of things that were thought to help particular problems. However, when put to rigorous study, they either didn’t help or caused more harm. PLEASE, let health care professionals do what they have been trained to do. A video on YouTube or an endorsement from a celebrity means little and could potentially harm you.

Can I catch this coronavirus a second time?

Despite some reports, this seems unlikely. Successful exposure to a virus typically leads to immunity that can last for years or longer.  

Will there be a vaccine for this coronavirus soon?

In the past, it would take many years to create a vaccine. New biochemical methods have reduced this development time. Remember that a vaccine has to be developed, tested to see if it works, tested to see if it is tolerated, and then it has to be made in high quantity. A vaccine in 12-18 months could happen if all goes well. 

Why are some countries that seemed to stop the virus now seeing a re-emergence of the virus?

This is expected as countries start to open up. The goal of social isolation is to reduce the rate of infection, so there is available medical care and to give time for vaccine development. However, foolish openings will result in unnecessary deaths. We need to look towards those countries that have had the most success and follow their lead. 

Are containing the virus and reopening the economy two separate things?

Both have to be considered. They are interconnected in every way.

Isn’t it worth having a few old people die to save the American economy?

As we now know, COVID-19 affects every age. However, it does seem to be that older individuals are at higher risk. As an older person, I can say that I’m still relevant to the people who love me, and I’m contributing to the world at large. Stop using the term “people” instead substitute the name of a real person. “Isn’t it worth having my mother die to save the American economy?” That little substitution makes a big difference, doesn’t it?

Will this virus go away?

The virus will not go away. It may fade for a bit during the summer (or not, depending on how states reopen). It is likely to return during the flu season. This will be rough as hospitals will already be taxed at that time. However, treatments will be developed, and a vaccine will become available. Over time COVID-19 will become a preventable disease.

Will we ever have another pandemic?

Yes, with 100% certainly. It is critical to learn from our successes and failures in treating this pandemic. I can’t emphasize enough that we will need a strong and clear direction from our experts and leaders. Without this, we will have a repeat of our current disaster. 


Dear readers, we will get through this crisis. We need to be sensible, and we need to look at the entire situation. The economy does need to open up, but it needs to open reasonably and rationally. Individual rights are important, but so are the rights of those impacted by others. This is not our first pandemic rodeo The playbook is already available; we need to look at it.

Peace

Mike

A COVID-19 Mother’s Day

Yesterday was Mother’s Day, COVID style.  My daughter Anne was 8 when I re-married, so Julie started to celebrate Mother’s Day the very first year that we were husband and wife.  Initially, our celebrations varied, but after a few years, we were in an established routine. This was especially the case when we started to have our children 23 years ago.

A typical Mother’s Day would include some sort of breakfast in bed. At the same time, the kids would sing “Happy Mother’s Day To You,” using the familiar birthday melody.  Church followed, and then we headed off to my niece Karen’s house for a fabulous brunch. Karen would make everything from scratch and did not want guests to bring dishes. Instead, she wanted the moms to feel special and pampered.  Note that Karen has three kids of her own. 

After several hours of partying, we would head home.  Julie would request a special dinner, and we would make it for her that evening.  It was a pretty standard celebratory day, and it has become a family tradition.

COVID-19 has put a few obstacles in our Mother’s Day program this year, but our efforts were not deterred.  Our main obstacles included limitations in grocery availability, difficulty in getting gifts, and the cancellation of both in-person church and my niece’s brunch.  We have already navigated a COVID Easter. It seemed appropriate to follow a similar course for a COVID Mother’s Day.  The plan was to do what we could to maintain our traditions while adding new “fillers” to round out the experience.

The morning started with breakfast in bed.  My kids are now young adults and value their sleep, so I stepped in and prepared this simple meal.  I couldn’t get our usual yeast cinnamon rolls, but I did find some ready-to-bake ones that were pretty good. I cut up some fruit and made strong coffee.  I woke up the kids, who were happy to join in.  I sent one of them on a mission to find our “breakfast in bed” tray.  It was missing, and we decided to make do with a red cafeteria-style plastic tray. I tried to glam the tray up by using other red items on it.  The idea being, “Look, we did this on purpose.” As we have for decades, we marched up the stairs loudly singing, “Happy Mother’s Day To You.” As Julie has done for decades, she gasped with excitement and surprise. Score!

Breakfast in bed on a cafeteria tray.

Later that morning, our oldest daughter, Anne, phoned to wish “Step-Mom” a Happy Mother’s Day.  Julie was delighted to take her call, which was terminated early due to the needs of Anne’s small children.

Our church attendance has been a streaming event for the last two months, and we fired up a MacBook to Chromecast the Mother’s Day service to our family room TV. I passed out Ritz crackers for communion, but something was wrong with them. Although the package was new, it appeared that some of the crackers had peanut butter on them.  After the service, we solved the mystery by visiting the Nabisco website.  What appeared as peanut butter was just some remains from the baking process.  Whew… our crackers will survive another day.

Much of the afternoon was spend individually and peacefully; until it was time for dinner. At 5 PM, I sent out a group text and was happy to see three smiling faces.  Julie had found a recipe for a Mediterranean shrimp dish in the “Tribune,” but it called for odd (for us) ingredients.  Will and I had gone to “Fresh Thyme” on Saturday. We were able to find Fetta cheese and Kalamata olives without difficulty. Still, we were at a complete loss when it came to the elusive fennel bulbs. A helpful produce man pointed us in the right direction.  

The recipe writer waxed something like, “Easy weekday shrimp and fennel bake.” It was not so easy when you had never made it before.  I took the director’s role and set the kids on various tasks.  Grace sliced the fennel bulbs, Kathryn peeled potatoes, and Will had the job of shelling and deveining the shrimp. I’m a big believer in cleaning as you go when cooking, so I washed as the prep dishes piled up.

The cooking crew at work. Note the newspaper with the recipe on the right.
Grace cutting up fennel bulbs.
Kathryn peeling potatoes.
Will shelling shrimp.
I was slicing and dicing too.

The only asparagus that I could find was pre-wrapped and was slightly past its prime.  I  processed what I could into short spears.  I also tossed together a chopped salad loaded with sunflower seeds and pistachio nuts. Lastly, Grace placed “bake and go” baguettes into our toaster oven for a quick crisping.  While our concoction was baking, we set the table using some of our “better” dishes.  By better, I mean that they matched each other. We were ready.

Freshly “baked” bread from the toaster oven.

Although we couldn’t go gift shopping, I found a few things on Amazon, which I had (thankfully) ordered weeks before, as the pandemic has slowed down deliveries. I quickly wrapped them using some of our pre-COVID-19 wrapping paper stashes.

With dinner on the table, it was time to call down our honored guest.  We had all made the main course, but we had no idea what it was going to taste like.  Shrimp, fennel bulbs, oregano, olives… it was a mystery meal. Thankfully, it tasted pretty good, and Julie was happy with our efforts.

The shrimp dish out of the oven.
Our best job at setting a pleasant table.

Julie often requests an ice cream cake for her special days, and I have traditionally ordered them from our local Dairy Queen.  However, I found one at the grocer and grabbed it as a quick substitute.  I did my best to decorate the small, quarter sheet cake.  It was pretty good, but I still shudder at its $40 price tag.  Price checking has become a casualty of racing in and out of the grocery store.

I poorly decorated the ice cream cake.
The cake was pretty good, but I was stunned at its $40 pricetag.
A new Hydroflask as a gift.
Everyone post-meal.

I don’t particularly appreciate playing games, which, for some reason, makes my participation all the more desired by my kids.  I submitted to card games and dominos and tried to be a good citizen. The evening ended with a group watch of “Alone,” an Amazon reality show that chronicles the adventures of people who are dropped into the wilderness. That ended our day. We did our best to create a special Mother’s Day, and in the end, our celebrant felt special.

A card game with some cards that my daughter brought back from Russia.
Playing dominos.

As I go on my daily walks, I am noticing more Happy Birthday banners in the front yards of houses.  I think that they are taking the place of birthday parties. Others are finding alternative ways to recognize events in their families. 

A neighbor celebrating someone’s birthday.

We celebrate special events for a reason, and it is crucial to attempt to continue traditions during these challenging times. Don’t abandon cherished family activities; modify them instead.

Peace!

Mike   

Dr. Mike, Day Laborer

Shelter-in-place and social isolation are two terms that were new to me but have become familiar phrases in the last few weeks. I’m a person who feels that every event can be a learning opportunity, including our current viral crisis.

In an earlier post, I explored my continued awareness that despite being an introvert, I need people in my life. The first few weeks of shelter-in-place were tough as the only real contacts that I had were with my immediate family, and they had their activities and interests.  Julie was working, Kathryn was adjusting to life back in the USA, and Will and Grace were attending classes online. 

I didn’t feel like doing much of anything, and I spent most of my energy trying to put together a survival plan for the family.  Where could we get toilet paper?  Did we have enough soap? How could I make DIY hand sanitizer and disinfectants?  Emergency planning was all that I could do.

I was prevented from doing things that I loved as I was isolating indoors.  I couldn’t go on a camping adventure with Violet, the campervan.  I couldn’t take myself on a photography safari, and there wasn’t much to write about as my daily life had been reduced to the mundane.  

One of my favorite retirement activities before the pandemic was hanging out with my friend, Tom.  We have always gotten along well, and we saw each other often. We were keeping up with each other electronically, but for whatever reason, that wasn’t cutting it for me.  I mentioned to Tom that I was feeling frustrated and bored, and he suggested that I stop by his backyard for a socially distant barbecue, which I did.  I was surprised by how much better I felt with the addition of a little bit of normalcy. 

Tom recently purchased an older townhome close to downtown Naperville that had never been updated.  He planned to gut the place entirely and to reconfigure the interior into a more modern and efficient space.  He was going to demolish the interior on his own to save funds for the actual remodel. Tom is an experienced contractor who knows the protocols for such a task; however, he is only one person. I was concerned that he would injure himself by tackling all aspects of this enormous job alone. I was determined to help, but my efforts were met by family concerns for my safety due to the coronavirus.  I felt that their worries were unfounded as I would be wearing a respirator and gloves during the demolition process.  Besides, I would take other precautions, like bringing my homemade hand sanitizer to the job site.

I knew that one of my primary functions would be as a photographer to document the process.  We write a weekly construction blog, and photos always make the posts better.  However, this would not reduce Tom’s chance of injury. Multitasking presented the most significant injury risk to my friend. He would be inherently safer if he could concentrate on a single task rather than trying to do everything by himself.  

I have been hanging around construction sites for some time, and I am starting to get an understanding of the construction process. However, knowledge isn’t the same thing as skill.  

During most of my life, I have been thrust into leadership positions. This is likely because I’m responsible, organized, and I have good problem-solving skills.  As a physician, I was a chief resident, co-founder of a successful psychiatric practice, and served as a medical director in several positions. I am comfortable in leadership roles, but leadership was not needed here. I needed to be a follower, a gofer, a grunt. The most helpful thing that I could do for my friend was to become a day laborer.

Some of you may think that it is beneath a physician to do such things, but I disagree with this idea completely. I am many things beyond a doctor, and I feel that all honest work is honorable.  

Tom’s townhouse is an easy walk from my home, and I have been going there in the mornings to do whatever was needed.  I have pried tacking strips off of floors, taken countless loads of refuse to the dumpster, and even sawed through a pipe or two.  My actions have allowed Tom to concentrate on methodically stripping the interior down to the studs.

My stated goal was to help my friend and to increase his safety. However, I also have benefited from my actions. I’m getting a little exercise, I have social contact, and I am continuing to learn by observation.  Hosts on DIY TV shows often state how much fun it is to deconstruct before they construct something.  Frankly, I think their statements are total crap.  The process is physically challenging, filthy, and potentially dangerous.  However, the method also serves as a classroom for an uninformed person, such as myself.  Each layer of the interior has to be removed and properly disposed of.  Appliances have to be recycled, ceilings and walls have to be cut away, insulation discarded, plumbing fixtures removed, and electrical connections isolated. Deconstructing a house is another way of learning how to construct a house, and I find that process very fascinating. By participating in the process, I have gotten a master’s class in home construction.

Soon tradespeople will descend on the property.  Plumbers, electricians, carpenters, and others. I’ll help in whatever way that I can, but, likely, I’ll mostly be photographing and writing about the construction experience in Tom’s blog. However, after all of these years, I know most of Tom’s subcontractors, and they usually don’t mind my picture taking and obsessive questions. 

When I first met Tom, he was surprised that I was always asking questions. “Why do you want to know that it is useless information to you?” He would ask.  I would always respond that there was no such thing as useless information.  Over the years, I have put to use some of that “useless” information, but for me, the process of learning is reason enough to learn. 

I choose to be a competent human being. To me, that means that I am more than just a title or job description. I’m glad that I have had the training to adjust complicated pharmacological cocktails for schizophrenic patients.  However, I’m also happy that I have the knowledge base to make a meal from scratch for my family, fix a friend’s computer, or put together a solar-powered electrical system for Violet the campervan. Each activity has worth, as does picking up clumps of insulation and tossing them into a dumpster. It gives me pleasure to think that in some small way, I am helping my friend.  Every slab of wallboard that I chucked is one less that he had to do.  To me, a friend is someone who is there for you when you need them.  Tom has certainly been there for me, and I enjoy returning the favor.

During this terrible time, it is easy to feel sorry for ourselves.  To think that we are being cheated, or put upon by the world.  This is a perfect recipe for sadness.  I would suggest that it is better to think about what you have instead of what you are missing.  Extend yourself to someone else and try to be supportive of them. I’m not Mother Theresa. Yes, I feel that I’m helping a friend, but I’m also getting quite a bit in return from the interaction.  The result of helping someone has made me happier.  We live in a world of “me,” and with it, we see higher rates of depression, anxiety, and addiction.  In my career, I saw individuals who were always looking for ways to feel better about themselves.  They judged their happiness with their latest purchase.  They would blame others for their unhappiness and take no responsibility for their own dysfunctional behaviors. These patients were almost impossible to help as they expected someone else to do their work.  Their lives could have been transformed by taking some of their self-absorbed energy and “spending” it to make someone else’s burden lighter. During this crisis time, we all need to work together. There is strength in numbers; if we stand alone, we will become dust in the wind.

Tom’s construction blog post can be found at: HTTP://gizmohomecraft.com

The original 1970s kitchen.
The wall between the kitchen and living room.
Original appliances taken to a recycler.
Mike in demolition garb.
The bathrooms will be completely remodeled.
Walls between the kitchen and living room and the kitchen and dining room removed.
getting rid of a sea of “blown-in” insulation.
Stripped down to the studs.

An Introvert Reacts To Shelter-In-Place During the COVID-19 Pandemic.

I always thought that there was something different about me.  I enjoy people, but being around large groups exhausts me.  I prefer having a few friends rather than many connections.  

Early in my medical career, I was certain that something was wrong with me.  Many of my colleagues used friendships to make work connections and to build their practices.  They would form relationships with referring docs and therapists to ensure a steady stream of patients to their office door. 

I would observe their business acumen. However, the thought of doing something similar was impossible for me.  Pretending to like someone was not in my emotional playbill.  I remember when the medical director of my clinic asked me to invite a new doctor over for dinner, as he seemed to be uncomfortable and unhappy in his new job. Apparently, I was supposed to make him feel more at ease. I did what I was told and invited him over.  The new doc seemed significantly more uncomfortable than I was, and any questions that I asked were met, at best, with a one-word answer. Eventually, that doctor not only left our practice but also the state. I think he was packing his bags well before I served him our wild rice casserole, but the memory of that dinner still gives me a shutter.

Over time I understood that I wasn’t defective, I was an introvert.  I form very strong relationships with a few people and I’m a loyal and true friend.  My close circle doesn’t exhaust me in the least and I miss those connections when I don’t see them. However, I’m also very comfortable being alone and I can’t remember the last time that I was truly bored when I was by myself.  I always can find something to do. 

Like many introverts, I can be a functional extrovert.  Put me in a social situation or ask me to give a lecture and I don my extrovert cape and perform.  That last word was chosen deliberately, as my actions are an act. I know how extroverts behave and I do likewise. In many instances, I’ll enjoy these situations, but after a few hours I’ll need to have alone time to regroup and recharge. 

I discovered that I was an introvert many years ago. However, I continue to learn about my personality and my personal needs. Over the last few years, I have traveled solo in Violet, my campervan.  I have enjoyed these trips, but I have often wished that I had someone with me to share the adventure. When I say “someone” I mean someone in my close circle of connections. Being an introvert doesn’t mean that I always want to be by myself.

Although I accepted the fact that I was an introvert, It always seemed that I was shortchanged. My extroverted doctor colleagues had the sales advantage.  They could use their personal traits to attract business, I had to rely on the quality of my work and word of mouth to do the same.  

My extroverted neighbors easily intermingled with each other, partied together, and even traveled together. I would wave to them from the driveway and quickly return to the comfort of my house.  

My extroverted friends always seemed to have a hundred people to see and a million places to go. This was never the case for me.

My friend Tom is an extrovert and has the ability to connect with just about anyone.  It seems that anywhere I go with him he runs into someone he knows who automatically wants to stop what they are doing and have a conversation with him. It is interesting to me that a super extrovert and a quiet introvert would become best friends.

Over time I have not only accepted being an introvert, but I have also come to value it. I may form fewer relationships, but they are deeper and more meaningful. I may spend more time alone, but I always find something to do.  I am a continual learner and explorer, and I like the fact that I have the time to study new things and skills.

When COVID-19 resulted in shelter-in-place rules I thought would be fine.  What would be better for an introvert than being locked up in their house!  However, my assessment wasn’t accurate.

During the first few weeks of being sheltered-in-place, I found that I was feeling irritable and down. I initially attributed these feelings to the obvious.  The stock market, which was the source of my income, was dropping.  In addition, basic supplies that ranged from toilet paper to flour were impossible to buy.  I was feeling afraid and insecure. However, after a week I accepted the situation and let go of the anxiety around it.  However, I was still feeling unsettled. I didn’t feel like learning new things, or writing, or taking photos, or doing just about anything.  It was a difficult time, but also a time for introspection.

Julie was home as were three of my kids, and that was good.  We did do things together, but they were also involved in their own activities. I reflected on what was missing and it was clear that I was concerned about and missing other people in my life.  I decided to come up with a plan.  I’m close to my two sisters and during this time I would call them every day.  I would also have more regular contact with my oldest daughter, Anne.  She has a busy life so daily contact would be a burden to her, but we could certainly talk once or twice a week.  I increased my calls to my childhood friend, John.  We have always been close as brothers, but like many brothers, the time that we spent together has shrunk through the years. I decided that I would call John at least once a week.  I also reached out to my friend Ralph.  Ralph is still in the workforce and busy seeing patients, but I wanted him to know that he was important to me.

My friend Tom presented as a special case.  Prior to the pandemic, I saw Tom almost every day.  During the first week we were still in regular electronic contact, but I was still missing him.  Tom just bought a townhome that is in need of total rehab.  In efforts to reduce his cost, he is doing a lot of the initial work by himself. I’m certainly not a construction guy but I have been hanging around Tom for many years and I have observed a thing or two.  I also knew that demolishing the interior of his townhome would require that I wear PPE which would also provide virus protection.  I could help my friend and have a little social interaction all at the same time!  I like win/win scenarios.  

Lastly, I kept up other social connections with friends and family via Zoom, Facetime, and emails. 

I believe that being an introvert has made it easier for me to shelter-in-place. However, life is not about absolutes. I do need social contacts and I do value those people that I am close to. My efforts to connect with those people who are important to me have been met positively by the recipients.  I’m happy that I am as important to my connections as they are to me. 

During these difficult times, it is important to recognize who we are and what we need. We need to look at what has made us happy in our normal lives and we need to replicate those things to the best of our ability during these difficult times. When I say replicate I don’t mean duplicate. Shelter-in-place orders are there for a reason.  Be creative and explore ways to “normalize” your life.

Making a COVID “Crib”

The COVID-19 pandemic brought many changes to our household, and one of the most significant ones was that our empty nest of two transformed into a full house of 5 adults. In a week, three of our adult children returned home for the duration.  Before their leaving, they had been transitioning to independence.  However, with shelter-in-place as the law of the land, our home has once again become a place of family time.

We are fortunate as our kids are good-natured and considerate.  However, it was an adjustment for all of us to have everyone return to the mothership during a lockdown. We have kept many of our traditions.  I have been doing a lot of cooking with the kids, and Julie has been playing a variety of games with them.  We enjoy each other’s company and conversation, and we all eat dinner together.  I believe that our living situation works as we are respectful of each other’s privacy. Each of us has claimed a zone in the house that we call our own. Julie alternates between the living room and the family room couch.  Kathryn cocoons in her room. Grace has claimed a large chair in the family room, and Will is fond of my old Telepsych studio space in the basement. My zone is the chair in my study.  

My study is a small room that is located in front of our house.  You enter it by taking a left from the foyer.  The place is squarish and has wood paneling around the lower third of the walls.  Directly opposite of the door are built-in bookcases, which are overstuffed with books.  Directly in front of the bookshelves is a large brown leather recliner-style chair.  Next to the chair is a small table holding a traditional brass lamp.  To the right of the chair are two large multi-pane double-hung windows.  The wall directly in front of the bookcase has a desk with a powerful computer and two monitors and wall shelves that contain speakers, a printer, and other functional items.  The remaining wall has my prized roll top desk. The room is crowded but cozy.

My usual working spot in the room is at the computer desk, where I sit in a mesh style office chair.  It is there that I edit photos and videos, watch YouTube videos, and write.  However, this is not the right place for the extended time that a shelter-in-place order commands. 

My go-to chill-out spot is the big brown leather recliner.  That recliner has become my COVID crib.  The chair is supportive, but it also has soft overstuffed goodness. I can position myself in a variety of poses that range from a traditional sit to hanging my legs across the arms as if I was reclining in a chaise lounge. My chair zone offers me everything that I could need for hours of education and entertainment.  If I twist to the right, I can quickly look out the window to the sidewalk and street beyond.  With the lockdown, my neighbors have taken to walking, and there is a never-ending stream of people and puppies marching past my house.  The little table is the perfect spot to hold a cup of coffee, a pen, my iPhone, and the cool Apple earbuds that I got for my birthday.  My phone equipped with the earbuds serves as a communication center for voice calls, FaceTime calls, Zoom calls, and text messages.  My regular computer is too bulky for my lap, but thankfully I also have a tiny MacBook which I use for my Starbucks writing adventures.  That little device is perfect for surfing. The MacBook connects me to social media, the news, and YouTube. I pair the computer with an inexpensive lap desk for an excellent writing system. In fact, I’m writing this post with that very setup.  

Mornings will typically find me sitting in my chair with a cup of steaming hot coffee beside me on the little table.  I like to grind whole beans in a Breville coffee grinder, so it is super fresh and vibrant.  My Bunn coffee pot has a thermal carafe which allows for hours of hot refills. Morning is the time when I check the latest news and catch up on Facebook and the world. 

Afternoon is the perfect time for people watching.  All I have to do is swivel my body slightly to the right for full access to the sidewalk and street.  I live at the end of a T-intersection giving me a comprehensive view of my neighborhood.

In the evening, I enjoy the spot as I call friends and family, write, and think.

Dear readers, to be clear, I am not spending every moment in my chair.  However, it is there for me at any time of the day that I need it.  During a crisis time, it provides me with the comfort and familiarity that I need to get through the day. It is a spot that is functional enough to do real work and cozy enough for a little nap.

I think that it is essential for each of us to have a zone that we can claim as our own.  It doesn’t have to be a room; it can be a location in a room. My site is my overstuffed chair, which I have outfitted to contain items that make it a functional spot.  I hope you have a similar place in your COVID crib. If not, considering creating one.

It may only be a chair to you, but for me, it is my COVID crib. And yes, the green stuff is homemade hand sanitizer.

Our Easter During A Shelter-In-Place COVID-19 Pandemic.

I have celebrated Easter Sunday in the same way for decades. The morning starts with a candy hunt by the kids, followed by a light brunch. We then attend a late morning church service. I rush home from church to make my “signature” cheesy chivy potatoes, which is my contribution to our family’s Easter party. We then pile into our car and drive off to my sister’s house in a nearby suburb. Along the way, I pick up flowers for my two godchildren.

For Easter, my sister and brother-in-law supply their house and a lot of the food. However, most of us are assigned a dish-to-pass. We typically are given the same dish to make year after year, which is how cheesy chivy potatoes became my signature dish. You may think that the recipe sounds disgusting, but many family members have told me that they look forward to it every Easter. Chessy Chivy Potatoes are not haute cuisine. 


Mike’s Recipe for Cheesy Chivy Potatoes

  1. Make a whole bunch of mashed potatoes.
  2. Stir in a lot of cheese. This can be any combination of meltable cheeses. Over the years, I have used sharp cheddar, American slices, and even Velveta. 
  3. Add chives to taste. I’ll sometimes saute fresh chives, but I have also used the dried bottled stuff. They both taste the same.

I bring a large pan of the potatoes, and I’ll often leave the party with an empty scrapped casserole dish. Our Easter meal is Midwestern… ham, potatoes, jello molds, rolls/butter, sweet potatoes, Easter lamb pound cake… you get the picture. We do have a few vegetarians in our group, so there are also some vegetarian-friendly foods added to the menu.

My sister’s Easter party is always a highlight for me. Everyone is eager to mingle and chat, the weather is typically beautiful enough for a walk, and the food is comforting. By 8 PM, I’m ready to head home. Easter Sunday concludes quietly, often by watching one of those classic Easter movies. However, all that changed with the COVID-19 pandemic, as many weeks ago, my sister canceled the event due to the virus.

As a family, we decided to do something for Easter, but we weren’t sure what that “something” would be. Our plans slowly formed as the day approached.

Julie made a brunch style egg dish, the kind where you mix bread, eggs, ham, and cheese and let the combination sit overnight in the fridge. It puffs up into a delicious souffle style casserole when you bake it the next day. Also, she proved some Rhodes cinnamon rolls. These start as frozen pucks that you place in a 9 x 13 pan overnight. By morning they are doubled in size and ready for the oven. There is nothing like the smell of baking cinnamony bread to wake you up in the morning. Add some strong hot coffee for a perfect start to the holiday.

Hot Cinnamon Rolls and Overnight Egg Dish

We didn’t buy any Easter candy; I didn’t think that this was a big deal as our kids are adults. I was wrong. This was rectified by Grace and Kathryn, who took a quick trip to Walgreen’s candy aisle the day before.  

Enough Easter candy to make anyone sick.

Later Sunday morning, we went to church…online. Our church had started a streaming ministry to lock-ins, and so they were ready to broadcast when Illinois’ shelter-in-place order came through. I cued up the stream on a Macbook and “Cast” it to our family room TV. The overall production quality was excellent, and they wove in video clips and remote music into the sermon. At communion time, we ate Ritz crackers and had a small sip of box wine. Watching church on a TV is not as engaging as participating in person, but the overall impact made it a worthwhile experience.

An online sermon cast to our family room TV.
Multiple musical collaborators turned our family room into a church concert.

Our early afternoon was carved out for connecting with others. At 2 PM, we all huddled around a computer and logged into a Zoom call to Julie’s family. The group represented members from 4 states and one foreign country. Her family follows rules well; everyone waited to talk, and the conversation rolled along smoothly.  

Huddling around a computer on a Zoom call to the Nelsons.

At 3 PM, I connected to my side’s Zoom call. Kunas are very exuberant, and most have little experience with conference calls. The resulting connection consisted of conversational chaos. It was fantastic to see everyone, but after about 10 minutes I decided that it was time to leave the meeting. Lastly, I was able to connect with my oldest daughter, Anne, via FaceTime. By 4 PM, I had touched base with more people then I would have if I had followed my usual Easter routine. This surprised me.

Reaching out with Zoom to the Kuna side of the family.
A good ol’ FaceTime call to daughter, Anne.

For dinner, Julie made some chicken legs that I bought during a pandemic grocery trip along with some stuffed shells and fresh asparagus. This was not our traditional Easter dinner, but delicious and celebratory none-the-less.

A non-traditional but delicious dinner.

After dinner, I discover new neighborhoods on a walk with my daughter Grace. Our evening ended with a family viewing of episode 8 of “The Tiger King.” We, too, have succumbed to this national phenomenon. I have to say that episode 8 seemed more like click-bait than a real episode, but it still managed to occupy 60 minutes of our evening.

I discovered this cool mid-century home when we decided to go in a different direction on a walk.

There you have it, our Easter during the pandemic. We didn’t go to church or have traditional Easter baskets. I didn’t make cheesy chivy potatoes or go to my sister’s house for a party. However, we managed to incorporate all of the essential elements of our typical Easter into last Sunday. We ate special food, and the kids had their fill of hollow chocolate bunnies and Cadbury eggs. We attentively attended an online church service. We caught up with loved ones, and we did family-centered activities. We didn’t give up Easter; we just modified it. It was a good day.

We may need to change other behaviors during (and after) this crisis time, but that doesn’t mean that we need to give up on life or traditions.  

I’m sure that there are activities or connections that you are missing since you have had to socially isolate. I would ask you to distill the essence of what you are losing into its characteristic elements. Be creative and see how you can reproduce those elements differently so you can transform your situation from one of loss to one of discovery.

Peace

A Shelter-In-Place Life

It has been difficult for me to be creative during these last few weeks. My mind travels to Maslow’s Hierarchy, and I seem to be stuck at “Safety” with a heavy dose of “Love and Belonging.” I’m nowhere near “Esteem” or “Self-Actualization.”

There have been so many changes recently that I feel like I fell asleep and woke up in an alternative universe—a place void of toilet paper and ground beef. A place where we are finally doing something about global warming, not because of a conscious effort, but because there is nowhere to drive.

I was away for a few days right at the beginning of March. By the time I returned home, the COVID-19 crisis was taking off. I went to Walmart to get some necessary supplies and was shocked to find that many of the shelves were completely bare. Yes, there was no toilet paper or paper towels, but other items were also missing…. rice, beans, flour, yeast, instant potatoes, peanut butter, the list went on. As a kid, I remember my mom going to the store early so she could get a big frozen turkey for Thanksgiving, but I have no memory of dealing with such food shortages. It felt very surreal. I bought what I could, and I was grateful for what I found.

Back at home, I used my knowledge of chemistry to concoct a surface disinfectant, and my understanding of microbiology to institute some cleaning procedures, such as sanitizing our eating surfaces both before and after a meal. I also made sure that we were using our foaming soap dispensers instead of the regular ones, as the foamers use much less soap. It seems that liquid hand soap is also in short supply. Since I couldn’t get TP locally, I went online to find that the regular packs were sold out. In desperation, I bought a case of cheap hotel stuff. Three days later, Amazon emailed me and informed me that I canceled the order…I did not. I told Julie to save our daily newspapers, just in case, and I got a quick lesson on how to fluff newsprint from Tom. He was raised in Poland during a time where TP was a luxury item for many.

My kids have always had free reign when it comes to food, and my William can quickly eat an entire broasted chicken in one sitting. I sat the family down and told them to snack only when they were genuinely hungry. Items like pasta needed to be reserved for meals.

I returned to a store and found two, one pound tubes of 70% lean hamburger. In the past, I felt that the frozen tubes of hamburger were suspect, and I would only buy the freshly ground very lean stuff. I thought that I struck gold with my “tube” find, and I plotted how I could use a single tube to feed my family of 5 adults, stretching 2 pounds of ground beef for two meals.

As all of this was going on, I watched the stock market crash. Investments are my primary source of retirement income, and to watch 30 years of sacrifice evaporate was soul-crushing. My financial advisor suggested that I use alternative sources of income… I told him that I didn’t have alternative sources. I re-framed my thinking, noting that many were in much worse financial straights and that I should be grateful that I had enough money to buy groceries, no matter how limited they were.

Our church canceled in-house services but went online. We gathered in our family room as I cast the service from my Macbook to the family room TV. At communion time, we each ate a Ritz cracker; it was the most “unleavened” item that we had. It was surreal to have the service in one corner of the TV and a comments thread running along the other side of the screen. However, it felt good to be part of a broader community.

During the early days of this crisis, we had to gather our adult children. One day I drove a 13 hour round trip to Ohio to get Grace. I spent most of the next day packing up my son, Will’s dorm room. On another day, we picked up our Kathryn from OHare. She, along with 7000 other Peace Corps volunteers, had been evacuated. She had spent eight months in Africa teaching Physics and Computer Science in Mozambique.

I set up temporary study stations so my two youngest could continue with their college classes online. Kathryn placed herself in “self-quarantine” to make sure that she wasn’t incubating anything from her 20-hour flight from Africa to Dulles in Washington DC.

A few days later, Governor Pritzker issued a shelter-in-place order, and Illinois shut down. I went to the Jewel to see if I could get some more food, and I was surprised to see the number of patrons whose carts were filled mostly with booze of various types. I guess they were going to party hardy in isolation.

Like many, I tried to connect with others via Zoom, and I have been making a lot more Facetime and phone calls. Julie continues to work, even though we have all begged her to see patients only online. She says that some clients don’t have that ability, so now she is seeing about ½ of her clients online and the rest in her office. I have tried to take on more of the household roles to ease her burden.

I’m surprised at how stressed I am doing simple tasks, like making dinner. Normally, I can do such things blindfolded. However, I think that I am using most of my psychological resources to get through the day. This is why making dinner seems like such a big deal, and why I don’t want to practice the guitar, organize my closets, or take creative photos. By the end of the day, I’m done.

I’m calling my oldest daughter more (she lives in another city). She is dealing with her stress. I’m also contacting people who I love and care about on a more regular basis. During the first week of shelter-in-place, the only contact that I had with my friend Tom was via the iPhone. During this second week, we carefully planned some get-togethers that were consistent with the new rules of the land. I met him in his backyard, and at an appropriate distance. I have known Tom for the last five years, but it seems like we have known each other for a lifetime. During life before COVID, we saw each other almost every day, and I think we were both missing that contact. Have you ever had a friend like that? I feel fortunate that I do.

I’m finding that I’m more sensitive as of late. Things hurt my feelings more, and when my kids or wife say something negative about me (even when joking), it cuts deep. I’m trying hard to make sure that we have our basic needs met, and negative remarks about my efforts hurt. I’m trying to process these feelings internally, and I’m making a strong effort to “walk away” when I want to bark back.

Two of my “at home” kids have been extraordinarily helpful—one, less so. I’m trying to focus my energy on all of the great help the first two are doing for the family, and I’m trying to be grateful that the third child is home and safe with us. It would be easy to snap at #3, but it would serve no purpose, and so I find myself praying a lot and walking away. I am making a strong effort to be grateful that my family is mostly together. Things could be so much worse.

Every day is presenting new challenges in this alternative universe called the COVID-19 pandemic. Like most, I’m doing my best. I’m so aware that people are essential, stuff is not. I’m feeling grateful that as of this writing, we are all in reasonably good health. I’m thankful that I had a cup of coffee this morning, and some peanut butter to put on my breakfast banana. I’m also grateful that I am in a warm and secure home. I’m am so happy to love and to be loved.

Priorities have shifted, what seemed so important a few weeks ago appears trivial at this time.

One day at a time.

Julie “seeing patients” from our sunroom.
I put this sign on our front door.
Grace attending an on-line class.
Filling our time with a card game.
I’m going on a lot of walks.
Empty shelves at the grocer.
The kids and Mercury the cat doing a little kitchen floor socializing.
A simple meal of home-baked challah and cream of chicken soup.

Our Covid-19 House Rules

Dear readers, last week I started to write a new post. However, its contents seem trivial based on the Coronavirus pandemic. I’ll finish and post it at some future date.

The pandemic has caused a significant change of all global societies, and just about everyone on the planet has been impacted. On a more personal level, there have been a number of documented cases where I live, and I assume that those numbers will rise when testing becomes more available.

My wife and I became empty-nesters this year, but that has all changed. Our two college-age kids are now home and will complete the final weeks of their semesters on-line. Another daughter will be returning from Africa next week. She worked very hard to have the privilege of serving as a Peace Corps volunteer, and now her dreams have been dashed by this viral outbreak.

Of course, it is wonderful to have our children back at home, but their influx also presents problems. When my kids were growing up they often heard me say, “There are no emergencies for those who are prepared.” This rule also applies to social situations, in our case going from a 2 person to a 5 person household.

Yesterday we had a house meeting to talk about shoring up some of our family expectations. The focus was on acting reasonably and respectfully. I thought I would list some of the points here, as you may find them a nidus to stimulate a family discussion at your home.


House Rules, Covid-19 Edition

1. Our house needs to stay as clean and organized as reasonable. We deserve to have a pleasant place to live in.
2. We have some food supplies, but we need to use them wisely. We need to waste less and reprioritize what we eat. The box of pasta that was formally used as a cheap snack has now become a family meal.
3. We need to live life as normally as possible. {Two of our kids are still in college and we have explored places in the house where they can continue their on-line college experience in peace.}
4. We need to practice “standard precautions” when it comes to general hygiene, safety, and health. {The term “standard precautions” is a hospital term relating to safety and sanitary procedures.}
5. We need to support each other.
6. We need to love each other.
7. We need to be kind to each other.
8. We need to practice the above behaviors to others beyond our family. The world is tense, we don’t need to make it tenser by our rude or entitled behaviors.
9. We need to pitch in and cooperate. All of us need to work together to keep our home running as smoothly as possible. There is no room for a prima donna.
10. We need to keep abreast of the real facts about our current crisis.
11. We MUST avoid buying into rumors, conjecture, bad science, click bate, and crisis mongerers. Theory or conjecture are not facts and can have negative consequences.
12. If we have fears or concerns we need to share them and allow others to comfort and support us.
13. We need to realize that tomorrow is another day. Our city, state, country, and world have gone through worse times and we have survived.
14. Together we are stronger, we need to always remember that. Be kind and helpful to everyone.


Dear reader, during this time I send you my warmest thoughts and most positive energy.

Dr. Mike

My neighborhood streets are empty.
No traffic on a normally busy street.
A popular breakfast joint is closed and dark.