Thursday, April 2, 2020

Time on Your Hands: Something to Do (for 40 years)

https://www.youtube.com/embed/HyuE1XnYO0

Compromising on Corona

George Freeman, GeoPolitical Futures
March 11, 2020

Battling the coronavirus is essential. But the battle has costs, which are invariably measured against the gain. “No matter what the cost” – the approach many countries appear to be taking – is a principle that can be disastrous, particularly when the cost is so high that it cannot be borne socially. With the coronavirus, like all new and lethal diseases, alarm shapes the responses. As the cost starts to emerge, there is an inevitable recalibration. We are approaching that point of recalibration.

First the risk. The coronavirus seems as difficult to contain as other coronaviruses like the common cold. Some people do not know they have been infected, and many who never fall ill carry the disease. Everyone is suspect. The only safe course is complete social isolation. That is of course impossible. Jobs must be worked, children must go to school, food must be bought and consumed, and so on. Humans are inherently social animals, and the perpetual threat of infection undermines a fundamental human imperative: to be with other people.

Coronaviruses are persistent; they appear, disappear, reappear, mutate. There will be no clear moment at which the virus is eradicated, no moment at which the dread of a handshake or of a kiss on the cheek will go away. Obviously, there may eventually be a vaccine that can minimize if not eradicate the virus, but that is a ways away. In the meantime, fear will continue to haunt.

The virus is deadly, of course. In South Korea, which has maintained by far the most comprehensive statistics on the disease, the mortality rate for those infected is about 0.7 percent as compared to 0.1 percent for the flu. As with the flu, the death rate is higher among the elderly, especially those with other afflictions. As someone over 70, I can be permitted to say that this is a bearable risk compared to other risks.

In the United States, about 39,000 people died in automotive accidents in 2018. That is a bit over 3,000 people per month or 100 per day. It is a significant risk that most of us accept daily. We understand the risk, we take prudent precautions like not drinking while driving, and we live with it. We live with it because the price of not living with it is more than we are prepared to pay.

Life is a calculated risk, and the question is whether protection against the coronavirus is possible, and if possible, whether it is worth it. I raise the number of automobile deaths to drive home the fact that we do take calculated risks. There has not been an overwhelming demand to create automobiles that allow passengers to survive crashes beyond the point where we are – with airbags, seatbelts and better engineering. We demanded steps within the framework of the cost of increased protection, and the price of decreased mobility.

When the virus first appeared, the natural public response was to demand that the government stop it. Governments are useful things, but public expectations are sometimes extravagant. The next phase was to blame the government for failing to protect them. The third phase will be attacking the government for taking the steps it took to protect them. We are not there yet, but we are close.

The cost of the protections is not merely disruption of how we live, but also a significant economic cost.

The crisis has contributed to massive damage to the Chinese economy and, to some degree, to the decline in oil prices, since China is the leading oil importer. It has almost certainly contributed to the massive decline in equity prices. All of these will extract human costs as global economies move toward recession.

Recessions are common. Uncommon is the refusal to attend public gatherings, which has caused significant economic loss. Here in Austin, South by Southwest laid off a third of its staff on Tuesday after the festival’s cancellation. In New York, the governor has decreed that containment sites be set up to protect people from people who have the disease. In Italy, the solution has been to divide the country into different parts and forbid the movement of people between them.

The more sequestered the population is, the less efficient the economy becomes not merely for financial reasons but also because to produce things, even ideas, workers must be at their jobs, goods must be moved freely and so on. The coronavirus is frightening, but a recession that is more than just a cyclical event is also frightening, for it can extract a massive social cost as jobs are lost, banks fail and so on. The sequestration of larger and larger groups of the population cannot become a long-term feature of society without repercussions.

If the virus has a higher mortality rate than it does now, the risk-reward calculus changes. If the virus can be quickly eradicated by current measures, the calculus changes. But if the mortality rate remains the same, and if the virus persists in spite of best efforts, the risk-reward ratio remains in place. What will emerge is not a bloodthirsty indifference to life. All our lives are at risk. Rather, it will be the process of accepting a new risk and staying our social and economic courses.

The current imposition of increasingly intense measures, unless successful or unless the disease proves more dangerous, will lead to social adjustment and, of course, holding the government responsible for all prior fears.

Wednesday, April 1, 2020

Friday, March 27, 2020

Simply Southern: Now on our Vimeo Channel

In case you haven’t yet seen this feature, you can watch it now.

Monday, March 16, 2020

Public health

Seth Godin

[For members of the public, staying at home and sheltering in place isn’t selfish, it’s generous. Social distancing helps keep the virus from infecting others at the same time that it flattens the curve of the spread of the pandemic, giving health facilities a chance to provide care over time.]

Public health is efficient, a culture changer and a commitment. It’s not simply a more expensive version of private health.

When the water supply is reliable, the air is clean and the public health system is working well, we hardly notice it. Nutrition, access to healthcare and the safety of transport are easy to take for granted. When we hire the government to be responsible for public health, we give up small amounts of independence and money. But it creates enormous benefits, worth far more than they cost.

First, it’s cheaper and more reliable for a few trained engineers to test and maintain the water etc. than it is for each person who consumes it to do so.

Second, health, like the weather, is something that people bring up in conversation but rarely do anything about. By centralizing action, we make it more likely that something actually gets done.

Third, individual humans are bad at long-term thinking. Patient systems often outperform individual actions when it comes to public health.

Often, it’s only coordinated action that can help the entire community. And coordinated action rarely happens without intentional coordination. Don’t do it because you finally got around to it. Don’t do it because it is in your short-term interest. Do it because we all need it done.

It’s difficult to overinvest in building and running competent public health systems and management. And sometimes we don’t realize how important the system is until we see how unprepared we are. [Which is why, alas, today is a good day to stay home].

Thank you to every public health worker and medical professional who is on the front lines right now. We’re grateful for a lifetime of sacrifices and commitment.

Thursday, March 12, 2020

People ‘shed’ high levels of coronavirus, study finds, but most are likely not infectious after recovery begin

Helen Branswell, Staff Writer, STAT


People who contract the novel coronavirus emit high amounts of virus very early on in their infection, according to a new study from Germany that helps to explain the rapid and efficient way in which the virus has spread around the world.

At the same time, the study suggests that while people with mild infections can still test positive by throat swabs for days and even weeks after their illness, those who are only mildly sick are likely not still infectious by about 10 days after they start to experience symptoms.

The study, by scientists in Berlin and Munich, is one of the first outside China to look at clinical data from patients who have been diagnosed with Covid-19, the disease caused by the coronavirus, and one of the first to try to map when people infected with the virus can infect others.

It was published Monday on a preprint server, meaning it has not yet been peer-reviewed, but it could still provide key information that the public health response has been lacking.

“This is a very important contribution to understanding both the natural history of Covid-19 clinical disease as well as the public health implications of viral shedding,” said Michael Osterholm, director of the University of Minnesota’s Center for Infectious Diseases Research and Policy.

The researchers monitored the viral shedding of nine people infected with the virus. In addition to tests looking for fragments of the virus’s RNA, they also tried to grow viruses from sputum, blood, urine, and stool samples taken from the patients. The latter type of testing — trying to grow viruses — is critical in the quest to determine how people infect one another and how long an infected person poses a risk to others.

Importantly, the scientists could not grow viruses from throat swabs or sputum specimens after day 8 of illness from people who had mild infections.

“Based on the present findings, early discharge with ensuing home isolation could be chosen for patients who are beyond day 10 of symptoms with less than 100,000 viral RNA copies per ml of sputum,” the authors said, suggesting that at that point “there is little residual risk of infectivity, based on cell culture.”

Public health officials and hospitals have been trying to make sense of patients who seem to have recovered from Covid-19 but who still test positive for the virus-based in throat swabs and sputum samples. In some cases, people test positive for weeks after recovery, the World Health Organization has noted.

Those tests are conducted using PCR — polymerase chain reaction — which looks for tiny sections of the RNA of the virus. That type of test can indicate whether a patient is still shedding viral debris, but cannot indicate whether the person is still infectious.

The researchers found very high levels of virus emitted from the throat of patients from the earliest point in their illness —when people are generally still going about their daily routines. Viral shedding dropped after day 5 in all but two of the patients, who had more serious illness. The two, who developed early signs of pneumonia, continued to shed high levels of the virus from the throat until about day 10 or 11.

This pattern of virus shedding is a marked departure from what was seen with the SARS coronavirus, which ignited an outbreak in 2002-2003. With that disease, peak shedding of the virus occurred later, when the virus had moved into the deep lungs.

Shedding from the upper airways early in infection makes for a virus that is much harder to contain. The scientists said at peak shedding, people with Covid-19 are emitting more than 1,000 times more virus than was emitted during peak shedding of SARS infection, a fact that likely explains the rapid spread of the virus. The SARS outbreak was contained after about 8,000 cases; the global count of confirmed Covid-19 cases has already topped 110,000.

Osterholm said the data in the paper confirm what the spread of the disease has been signaling — “early and potentially highly efficient transmission of the virus occurs before clinical symptoms or in conjunction with the very first mild symptoms.”

The study also looked at whether people who have been infected shed infectious virus in their stool. The report of last month’s international mission to China — co-led by the WHO and China — said that in several case studies in China, “viable virus” had been recovered from stool but that isn’t likely driving transmission of the virus.

The German researchers found high levels of viral fragments in 13 stool samples from four patients in their study, but they were unable to grow virus from any of them. The paper noted, though, that all the patients had mild illness, and the fact that they could not find virus in their stool doesn’t rule out that it could happen in other cases.

“Further studies should therefore address whether SARS-CoV-2 shed in stool is rendered non-infectious though contact with the gut environment,” they wrote, adding that their findings suggest measures to try to stop spread of the virus should focus on respiratory tract transmission — protecting others from the coughs and sneezes of people infected with the virus.

Virus could not be grown from blood or urine samples taken from the patients, the authors reported.

The study also noted that people who are infected begin to develop antibodies to the virus quickly, typically within six to 12 days. The rapid rise of antibodies may explain why about 80% of people infected with the virus do not develop severe disease.

About the Author

Helen Branswell

Senior Writer, Infectious Disease

Helen covers issues broadly related to infectious diseases, including outbreaks, preparedness, research, and vaccine development.

Wednesday, March 4, 2020

More Advice: REGARDING CORONAVIRUS from Dr James Robb - February 26, 2020

“As some of you may recall, when I was a professor of pathology at the University of California San Diego, I was one of the first molecular virologists in the world to work on coronaviruses (the 1970s). I was the first to demonstrate the number of genes the virus contained. Since then, I have kept up with the coronavirus field and its multiple clinical transfers into the human population (e.g., SARS, MERS), from different animal sources.

The current projections for its expansion in the US are only probable, due to continued insufficient worldwide data, but it is most likely to be widespread in the US by mid to late March and April.

Here is what I have done and the precautions that I take and will take. These are the same precautions I currently use during our influenza seasons, except for the mask and gloves.:

1) NO HANDSHAKING! Use a fist bump, slight bow, elbow bump, etc.

2) Use ONLY your knuckle to touch light switches. elevator buttons, etc.. Lift the gasoline dispenser with a paper towel or use a disposable glove.

3) Open doors with your closed fist or hip - do not grasp the handle with your hand, unless there is no other way to open the door. Especially important on bathroom and post office/commercial doors.

4) Use disinfectant wipes at the stores when they are available, including wiping the handle and child seat in grocery carts.

5) Wash your hands with soap for 10-20 seconds and/or use a greater than 60% alcohol-based hand sanitizer whenever you return home from ANY activity that involves locations where other people have been.

6) Keep a bottle of sanitizer available at each of your home's entrances. AND in your car for use after getting gas or touching other contaminated objects when you can't immediately wash your hands.

7) If possible, cough or sneeze into a disposable tissue and discard. Use your elbow only if you have to. The clothing on your elbow will contain infectious virus that can be passed on for up to a week or more!

What I have stocked in preparation for the pandemic spread to the US:

1) Latex or nitrile latex disposable gloves for use when going shopping, using the gasoline pump, and all other outside activity when you come in contact with contaminated areas.

Note: This virus is spread in large droplets by coughing and sneezing. This means that the air will not infect you! BUT all the surfaces where these droplets land are infectious for about a week on average - everything that is associated with infected people will be contaminated and potentially infectious. The virus is on surfaces and you will not be infected unless your unprotected face is directly coughed or sneezed upon.

This virus only has cell receptors for lung cells (it only infects your lungs) The only way for the virus to infect you is through your nose or mouth via your hands or an infected cough or sneeze onto or into your nose or mouth.

2) Stock up now with disposable surgical masks and use them to prevent you from touching your nose and/or mouth (We touch our nose/mouth 90X/day without knowing it!). This is the only way this virus can infect you - it is lung-specific. The mask will not prevent the virus in a direct sneeze from getting into your nose or mouth - it is only to keep you from touching your nose or mouth.


3) Stock up now with hand sanitizers and latex/nitrile gloves (get the appropriate sizes for your family). The hand sanitizers must be alcohol-based and greater than 60% alcohol to be effective.


4) Stock up now with zinc lozenges. These lozenges have been proven to be effective in blocking coronavirus (and most other viruses) from multiplying in your throat and nasopharynx. Use as directed several times each day when you begin to feel ANY "cold-like" symptoms beginning. It is best to lie down and let the lozenge dissolve in the back of your throat and nasopharynx. Cold-Eeze lozenges is one brand available, but there are other brands available.

I, as many others do, hope that this pandemic will be reasonably contained, BUT I personally do not think it will be. Humans have never seen this (edited: animal)-associated virus before and have no internal defense against it.

Tremendous worldwide efforts are being made to understand the molecular and clinical virology of this virus. Unbelievable molecular knowledge about the genomics, structure, and virulence of this virus has already been achieved. BUT, there will be NO drugs or vaccines available this year to protect us or limit the infection within us. Only symptomatic support is available.

I hope these personal thoughts will be helpful during this potentially catastrophic pandemic. You are welcome to share.

Good luck to all of us!”

ADVICE on the Corona Virus

I don’t mean to bore you, but I thought these explanations and preventative efforts should be widely shared…..surely more will be published as the medical experts see what evolves with this virus…..Concise and well explained!
____________

Last evening dining out with friends, one of the uncles of the dining party is a graduate with a master's degree and who works in the Shenzhen Hospital (Guangdong Province, China) sent him the following notes on Coronavirus for guidance:

1. If you have a runny nose and sputum, you have a common cold

2. Coronavirus pneumonia is a dry cough with no runny nose.

3. This new virus is not heat-resistant and will be killed by a temperature of just 26/27 degrees (C). It hates the Sun.

4. If someone sneezes with it, it takes about 10 feet before it drops to the ground and is no longer airborne.

5. If it drops on a metal surface it will live for at least 12 hours - so if you come into contact with any metal surface - wash your hands as soon as you can with a bacterial soap.

6. On fabric, it can survive for 6-12 hours. normal laundry detergent will kill it.

7. Drinking warm water is effective for all viruses. Try not to drink liquids with ice.

8. Wash your hands frequently as the virus can only live on your hands for 5-10 minutes, but - a lot can happen during that time - you can rub your eyes, pick your nose unwittingly and so on.

9. You should also gargle as prevention. A simple solution of salt in warm water will suffice.

10. Can't emphasize enough - drink plenty of water!


THE SYMPTOMS

1. It will first infect the throat, so you'll have a sore throat lasting 3/4 days

2. The virus then blends into a nasal fluid that enters the trachea and then the lungs, causing pneumonia. This takes about 5/6 days further.

3. With pneumonia comes high fever and difficulty in breathing.

4. The nasal congestion is not like the normal kind. You feel like you're drowning. It's imperative you then seek immediate attention.


SPREAD THE WORD - PLEASE SHARE.

Sunday, February 16, 2020

The State of Physical Fitness: Who Goes Home?


For about as long as we’ve been keeping records of LODDs, sixty percent of our mortality statistics have been attributable to cardiovascular disease. Heart disease is now being eclipsed by cancer, but it is still a huge statistic both in the general populace and specifically within the fire service.

CAD (coronary artery disease) has a familial (hereditary) component and a lifestyle-related origin, meaning that it’s not contagious, nor do you “get it” acutely (instantly). Usually a person has symptoms, but not always. Coupled with hypertension, it can be a silent killer. However, one of the indices is poor fitness, which is anything but silent.

In the manual labor world of work such as construction or mining, virtually all of the heavy lifting has been assisted through hydraulics. But what differentiates fire fighting is the fact that the single heaviest object to be carried is a fellow human being and they continue to get heavier and heavier- and they don’t come with wheels or straps. It is the ability to perform arduous physical activity that differentiates firefighters from the host of other manual jobs. The weight of water is not going to change and for the foreseeable future, this is a job that requires physically capable people.

In the face of this evidence, the best that we can offer is the moniker, “Everyone Goes Home.” Part of the problem is that a lot of our people should have stayed home. Can we reasonably expect different results by continuing to do the same things over and over again?

The lack of fitness, or even a reasonable expression of fitness is evidenced in our hiring practices. Fitness, in many cases is not even a component in the selection process. We play games with people’s lives when we substitute interviews for real measures of physical ability. Imagine interviewing the place kicker for a position on an NFL team.

We spend valuable public resources in providing remedial physical fitness in recruit training rather than hiring the people who are already prepared for a career that requires stamina and strength. Published research has already demonstrated the economic benefits of a lifestyle that is based on adherence to a self-motivated program of regular physical activity.

And to cap it off, there is no expectation that firefighters “recertify” with any degree of periodicity in the area of one of the most job-related and perishable skills: physical fitness. But we do retest for CPR skills. What’s wrong with this picture? It’s pretty clear to any outside observer that physical fitness gets nothing more than lip service. Until we get serious about intervention strategies that really matter, it’d be better if we just dropped the pretext that we really care. There’s nothing so helpless as a person who won’t help himself. The bitter pill is the expectation that firefighters get out of the lazyboy and start working out.

Thursday, February 13, 2020

Great Video on “Not Feeling Well”

Mandatory viewing for all firefighters. The biggest risk is denial.

https://youtu.be/SOIWr058RBw

Tuesday, February 4, 2020

This court decision out of a case involving the FDNY will get you scratching your head

Respiratory protection is the cornerstone of the whole PPE initiative. Then, here comes this case from NYC, where a federal judge knows more than OSHA, NIOSH and the NFPA.

This comes from Curt Varone’s website:

Court Rules FDNY Must Accommodate Facial Hair Despite OSHA


A federal judge has ruled that FDNY must reinstate an accommodation granted to African American firefighters suffering from Pseudofolliculitis Barbae that permits facial hair in the chin, cheek and neck area provided it does not cause leakage around the mask’s seal. The firefighters, Salik Bey, Clyde Phillips, Steven Seymour, and Terrel Joseph, filed suit in 2018 alleging race and disability discrimination after the city instituted a new SCBA policy that required them to be close-shaven in the chin area.
Senior United States District Judge Jack B. Weinstein ruled yesterday that city did not commit race discrimination by instituting the new policy, but did violate the Americans with Disabilities Act by not allowing the firefighters an accommodation to maintain “closely-cropped facial hair, uncut by a razor.”
As explained in the decision:
  • Because of their skin condition, Plaintiffs sought a medical accommodation from the Department, allowing them to maintain closely-cropped facial hair, uncut by a razor. 
  • Before the requests were granted, Plaintiffs were subjected to a “Fit Test”.
  • A Fit Test is a standard test designed by OSHA to “ensure[ ] that the face piece of the SCBA gets the proper seal so that … what the member is breathing is the air from the tank and not anything that may be contaminated.” 
  • Observing no leakage from the FDNY-approved mask when it was worn by individuals like Plaintiffs with closely-cropped facial hair, the requested accommodation was granted by the FDNY.
  • [T]he accommodation was fully applicable for two and a half years before the present non-accommodation regime. 
  • There were no reports that it increased the risks to firefighters or civilians:
  • After a review of the Department’s safety standards initiated by then-FDNY Acting Chief of Safety Joseph Jardin, the medical accommodation was revoked.
  • The following criteria were set by the FDNY: If Plaintiffs shaved all facial hair in the chin area, they would maintain their status as full duty firefighters; otherwise, they would be placed on light duty.
  • Defendants now argue that that same accommodation—permitting Plaintiffs to maintain closely-cropped facial hair uncut by a razor—is an undue hardship because it would require the FDNY to be “[non]compliant with the requirements of OSHA and NIOSH and the guidelines set forth by the NFPA.”
  • The court is not persuaded.
  • The only development of significance from when the prior accommodation went into effect, in August 2015, to now is a dispute as to the proper reading of OSHA’s Respiratory Protection Standard (“RPS”). RPS provides, in relevant part:
    • The employer shall not permit respirators with tight-fitting facepieces to be worn by employees who have: Facial hair that comes between the sealing surface of the facepiece and the face or that interferes with valve function; or
  • Defendants admit that no heightened safety risk to firefighters or the public was presented by the accommodation previously in effect. 
  • Two and a half years passed without incident, and Plaintiffs continued to perform their jobs satisfactorily. 
  • The FDNY’s decision to abandon the prior accommodation was not based on any actual safety risks to firefighters or the public. 
  • Rather, driving the calculus was bureaucracy. 
  • Defendants cite no case law indicating that such bureaucratic considerations are a viable undue hardship defense; the court declines to so find.
  • In effect, the fire department’s new shaving mandate presented Plaintiffs with an objectionable “take it or leave it” proposition: shave down to the skin with a razor and risk permanent injury, or be reassigned to light duty. 
  • Placement on light duty, although temporary, was inarguably adverse to Plaintiffs.
  • A blow to those who visualize themselves as public servants, Plaintiffs were forced to eschew a highly-admired and self-fulfilling aspect of their work as firefighters; they endured significantly diminished responsibilities and tangibly worse working conditions. 
  • This establishes that they were subjected to adverse employment action and satisfies the fourth element of Plaintiffs’ prima face case.
  • [As for the race discrimination allegations] Plaintiffs’ disparate treatment claim fails. 
  • Alleged by Plaintiffs is that they were treated differently than Caucasian firefighters who, without accommodations, were allegedly allowed to maintain facial hair despite the FDNY’s clean shave policy. 
  • “If a plaintiff relies on evidence that he was treated less favorably than employees outside of his protected group to raise an inference of discriminatory intent, he must establish that he was ‘similarly situated in all material respects’ to those employees.” 
  • Plaintiffs have not produced evidence showing that they were similarly situated to the unidentified Caucasian firefighters they allude to. 
  • By focusing solely on white individuals employed by the FDNY as full duty firefighters who were allegedly permitted to maintain facial hair, Plaintiffs mistakenly leap to the conclusion that they were subjected to disparate treatment.
  • Plaintiffs’ motions for summary judgment on the failure to accommodate claim and disability discrimination claim under the ADA are granted. 
  • The medical accommodation previously in effect for full duty FDNY firefighters is ordered reinstated.
  • This order and judgment is stayed for ten days to permit Defendants to seek a longer stay from the Court of Appeals.

Sunday, January 26, 2020

Challenge Advisory Board (CAB) Action Items

Todd Shelton chaired last year’s annual meeting on the course in Montgomery. We had about 20 suggestions that were advanced and discussed by our staff during our weekly meeting.

I’m going to use this platform to respond to the suggestions, the first of which is the creation of a “Hall of Fame.”

Given that we’re only a year away from our 30th anniversary, it’s about time that we’ve launched this initiative.

To help clear the cobwebs, we’re going back to the very beginning, before we had a website, and digitize the first decade's records. This means that we will have to scan the paper documents, and then convert the files to digital data.

This is going to take some time, but hopefully, we can have the “look-back” to 1991 in the form of a searchable database.

The content that I post here will be linked to our Facebook page and quite possibly incorporated into our irregularly published newsletter.

You can start the process of sending your nominations right now.

Stay tuned.

Tuesday, January 14, 2020

The Low Cost Anti-Car Jacking Solution

Just add rapid gunfire sound effects to your horn






Sunday, January 12, 2020

Gopher Problems? : Try this trick

Just pour some gasoline down the burrow hole and throw in a match. Voila: problem solved.

Saturday, January 11, 2020

Hustle For That Muscle: Danny MacAskill‘s Gymnasium

We’ve seen mountain bikers and BMXers do amazing stunts. And this video is no exception. But the outtakes at the credits roll confirm that the first run-through was not without crashes.

Friday, January 10, 2020

MMA Fighter Seeks To KO Bid To Nix Dietary Supplement Suit

A mixed martial artist suing Gaspari Nutrition for allegedly selling a tainted dietary supplement is fighting to keep his case alive, as Gaspari tries to land a knockout blow by disqualifying lab test results that could provide the "smoking gun" showing the product contained trace amounts of a banned steroid.

Good luck with that. The FDA has a huge backlog of investigations into companies that use banned substances in their products. Specifically, anabolic agents not labeled.

You can’t believe what’s on the label.