Month: April 2020

I’ve been dealing with a fairly minor medical issue but it was one that required a procedure that could not wait for the Corona virus to run its course in the US. So I had to travel across state lines on a six hour road trip and stay in a hotel for four days, not an ideal thing but unavoidable. Also for 14 days prior to the trip I had to self quarantine to protect the health care workers at the hospital. It did not matter that I live in an area that is nearly covid19 free and the hospital is in a Corona hotspot. But I did not mind the extra precautions at all, we owe our health care heroes all the protection we can provide. However what I saw in my four days in and out of various hospital buildings on their campus did surprise me.

And it was all about the masks. Because I knew I’d have to wear a mask when I was being shuttled around the medical facility for four days I took one with me. I happened to have had a couple of the n95 certified masks at home. One I had bought years ago for use in dusty off-road trail rides and another was given to me by a friend who had a suppressed immune system for a few years and had one left over. He found out I was headed out of state and dropped one off with my wife.

If you aren’t up on all the particular ratings of masks the n95 is the Cadillac of masks, it blocks 95% of 0.3 micron and larger particles. That’s good enough to significantly protect you from the droplets of contagion that an infected person is constantly putting into the air around them. It also protects others from you fairly well. The next most common mask you see in medical settings is a surgical mask. It looks a lot like a n95 but it does not filter out small particles nearly as well. It is primarily designed to prevent the person wearing the mask from spraying droplets out and infecting others. It does not do much to protect the person who wears it from infection. It isn’t useless as far as protection goes but it isn’t very effective. The third common masks are the cloth masks, many homemade. These are the least effective in both protecting others from you and in protecting you from others, but they do cut down some on the amount of droplets containing virus that you might otherwise breathe, sneeze or cough out into your neighbor’s airspace.

I have some familiarity with masks and respirators because as a chemical engineer and former plant firefighter I worked with all levels of breathing protection. I used everything from supplied air self contained breathing apparatus gear to n95 masks because we sometimes had to enter areas with unsafe levels of smoke or toxic dust.

What many people do not realize is that all masks are uncomfortable and all of them restrict your ability to breathe to some degree. In the summer they are crazy hot on your face and it feels like you are rebreathing the same air over and over. For people with asthma, like me, some of the more efficient masks, like the supplied air type (where you carry your own air tank on your back) and the n95 are not feasible to wear. Unless you have good lung capacity the extra restriction n95 and higher rated masks impose on your breathing ranges from highly annoying to dangerous.

I did not fully realize that until I walked to my first appointment yesterday wearing the n95. After all it had been decades since I had worn one on the job so I really did not remember much about the experience. The first question the nurse asked me was if I always looked so flushed? The answer is no, in fact I run 15 miles a week and play high level tennis. I do have some breathing difficulties but I’ve offset those with my endurance training. However, add just a little more restriction to my ability to breathe with a n95 mask and I became absolutely miserable.

And maybe you would toss that off to my particular condition but as I walked the medical center campus I noticed that every person in the facility was wearing the same kind of mask. And it wasn’t an n95 like mine. I finally asked a nurse practitioner about it and she said that almost nobody could stand working in an n95 unless they were in direct contact with covid19 patients and had no other choice. Instead they all wore surgical masks as did all the patients they were caring for, like me, that were non-virus cases. They segregated the hospital into covid19 and non-covid19 areas and only the people on shift in the Corona virus areas had to wear the n95’s, which they universally detested due to how annoying they felt. She gave me and my wife a couple of the more comfortable surgical masks, and while I still hate how it feels to wear one, at least I can get enough air to function.

I don’t know the statistics but my guess is that very few medical professionals are wearing n95 masks while they work now. And it may not have much to do with a shortage of masks. Instead it may be due to the huge human factors issue involved in wearing them. I can’t imagine a nurse on a 12 hour shift having one of those things on their face the entire time. I’m claustrophobic anyway and when every breath I take starts with me rebreathing my own hot breath I’m creeped out in a major way. If you wear glasses you also face the fact that the mask fogs up your glasses any time you breathe hard. Oh, and since the masks make you breathe hard that means you are looking at the world in a fog pretty much all the time.

If you’ve got some n95’s stored away you just might want to try to see if you can make it for even three or four hours straight wearing one. I’m guessing there is a fair chance you’ll be climbing the walls after thirty minutes. If that is the case then consider donating the unused ones to those who have to wear them and just get a cloth mask for home use, or make your own. Maybe one positive outcome from this pandemic will be the fact that health officials will realize that having respiratory protection that degrades people’s ability to function at a high level is not satisfactory. There is a need to develop an effective mask or filter system that health workers (like my APN) do not consider highly annoying. Otherwise they are going to opt down to a much less effective level of protection. Which is exactly what I’ve witnessed all week. Because protection that prevents someone from doing their job isn’t much protection at all.

Maybe I’m just crazy, but have you tried an n95 mask or a surgical mask for multiple hours of continuous wear? Could you stand it?

Any medical professionals who will tell what criteria they are using to select the type of mask they are using on the job?

Is anybody working 12 hour shifts wearing an n95 mask? Is it no big deal or are you on the verge of insanity?

After having had almost zero real change in my daily routine due to the virus crisis I’m finally going to have to make a couple of accommodations. While my state has no stay at home rules, the fact that I’ve got an out of state doctor appointment in two weeks does put me under Texas “Stay at Home” rules. I live in Arkansas where there are no such requirements so far, but since it is their state they get to make the rules.

Fortunately, Texas rules are not as limiting as some other states, they allow you to go outside all you want as long as you practice social distancing. My wife and I will still be able to run on the streets and also to play tennis with each other, not with other people though. We can still take the boat to local lakes and fish together. And we could hike, though hiking season is basically over here, unless you love poison ivy, mosquitoes and poisonous snakes, which we don’t.

The things that we can’t do are not much different than before I fell under Texas rules. My board meetings are by phone now. They tried Zoom but it was just too complicated for some of our less tech savvy members. Church is broadcast now, so is Sunday School which works fine on Zoom. Hmm, so my Sunday School class is smarter than my board directors? No pickle ball, you just get too close to your partner at that sport. Basically the main new restriction is that I can’t play tennis with my regular singles opponent and friend, that’s over for now.

And when I drive to Texas I will have to drive out of my way, around Louisiana, because they are stopping cars coming out of that state at the Texas border and forcing them to turn around or to check into a Texas hotel for two weeks and self-quarantine. But if you come in from Arkansas you are just fine. At least for now. Of course my appointment is two weeks off, I would not be surprised if it gets cancelled if things get much worse in either Texas or Arkansas.

It is hard to know how to think about the covid19 epidemic. I’ve seen people call it the most serious crisis of our lifetimes. I’m sorry but I don’t think it is even in the top ten. The latest models show maybe 80,000 predicted US deaths. Cancer deaths this year in the US will be around 600,000. Now that’s a crisis, that’s almost ten times as much grief and it is inflicted on a much younger set of victims.

But the virus has caused more inconvenience to a much larger audience because cancer is not a thing to most people, unless they have it or a family member or close friend does. The covid19 disease has disrupted the lives of many millions of people who will never be infected, and because it is highly contagious, it has created more fear than something like cancer. Cancer generally has no known cause, and isn’t spread by doorknobs and hugs. You could also compare the virus to heart disease. It too dwarfs covid19 in victims claimed.

Accidental deaths, death by car crashes or other accidents, total almost twice the projected Corona toll. In fact the common (non Corona) flu varieties kill 60,000 in the US each year, almost as many as covid19 will likely take from us.

So why is this such a big deal in our lives? It is new for one thing. It is also invisible and unpredictable. And because it is contagious it has caused our national and local governments to react by imposing formerly unthinkable restrictions on our democracy. It may turn out that the economic damage from the restrictions designed to flatten the curve could do more harm than the disaster they are intended to avert. Or maybe they were perfect or maybe they were not nearly enough? We may never know, since there is no way to try it more than one way. I suppose you could compare the way different countries handled things versus their results but there are way too many uncontrolled variables to get much hard science out of that. Or at least it appears that way to me.

There is also plenty of statistical data that proves economic hardship kills people just as dead as any virus. Poverty and stress kill people, they shorten lives. It isn’t arguable, it is factual. So there probably is an optimum response that balances the economic pain to the people with the viral death toll. However, nobody knows exactly what that looks like. Any time you start comparing dollars to death tolls, it becomes a very complex and morally dangerous calculus.

Me, I’m a compulsive rule follower and I’ll live by my Texas imposed guidelines until I get my Texas appointment taken care of, then I’ll be free to go back to my state’s rules. I do not profess to know what state policy should be, but I will continue to follow it as it is laid out by our governor and health department.

And at some point in the next few weeks or months the pressure will start to mount, especially in places like my rural area, for a return to normalcy. Our county has a land area of nearly eight times that of New York City yet we have only twelve confirmed cases to date compared to NYC with 65,000 cases. We may see a rapid escalation of infection here, or we may not. There is some efficacy inherent with living in the middle of nowhere when it comes to not catching communicable diseases.

It isn’t unlikely that our curve here would be much flatter than a metro area curve, even if we had not taken a single step to slow the spread of the disease. Maybe we are even hurting our chances because when and if the disease does peak here in the sticks, maybe weeks or months from now, will there even be any medical supplies left over for our sick people?

All those questions are unanswerable right now. There is no shortage of people who will express an opinion but nobody really knows because this is such a new thing. My advice is follow the rules, including utilizing the exceptions they include. That means I’ll still be spending a lot of time outdoors and away from other humans. But for city dwellers it may mean just staying inside, period. Whatever the case, I’d advise following your areas’ requirements because it is the right thing to do. Look for ways to help others, even if it is just a phone call or dropping a hot meal off for older friends, especially if they are living alone. Maybe doing a grocery pick up for them, grocery delivery only exists in cities. We do not have that option in rural America, you have to go to the store at the very least for curbside pickup. Many rural locations do not even have that available.

My concerns are for others. We have months worth of food, we have decades worth of money and we do not have to work to pay our bills, just for entertainment’s sake. We don’t have kids at home to educate or entertain. We don’t have living parents to care for. But many of you, maybe all of you younger than us, do have some or all of those things to be concerned about. My advice, which is worth exactly what it cost you to read, is this. This will pass, and it likely is not as bad as we think it might be. Nobody ever got a page view on the internet or sold a news story by playing down how bad something might be. Good luck and follow the rules and odds are things will work out fine.

What do you think, is shutting down the world to flatten the curve the solution or the creation of an even bigger problem?

What is the biggest change in your own personal world that the virus pandemic has caused.

What is your biggest worry, your family’s health, your finances or your job?