Friday, July 31, 2020

PUBA 446 Day 2

Today was the second day of PUBA 446 with Dr. Ric. But before class I looked at several videos today's morning guest speaker sent us yesterday to view to become more familiar with contact tracing. I think you might like them, too. The video, A lot of detective work, explains what it is like to do contact tracing.


One of the videos sent to us is about the start of the contact tracing training program that I am currently in. It was recorded in late May when we were only having new cases in the single digits; the entire month had only 45 new cases. My understanding is the Track 1 professionals training was done in early June; Dr. Ric says there are over 300 of them now trained to do contact tracing. Then the more extensive Track 2 training began on June 22nd with the initial cohort of 50. In the video LG Green says the state needs at least 500 contact tracers to handle an outbreak. The health department had 80 before the trainings started, so we are well on our way to reaching the goal of 500.


This video also shows how contact tracing is done.


Contact tracing is not new; it is an old tool used in public health to reduce the spread of communicable diseases. Contact tracing has been widely used in sexually-transmitted diseases and HIV/AIDS. Contact tracers who have worked on all these diseases say it's much easier to get information from people about COVID-19. Here's a video on this aspect of an old public health tool.


This is how contact tracing is being done in some parts of the US; in other parts, it's too late because the number of cases is too high. We're trying to avoid that here; Dr. Anderson of the health department says if we get up to 900 new cases a day as seen in some parts of the country, the hospital system will be overwhelmed and contact tracing is not going to be what we need.


During our pre-class team meeting only Malia, Jean, and I showed up; we think it was because not everyone was on email last night. We decided to try again for a meeting right after class.

We started out the morning session with Dr. Ric playing the guitar in the 10 to 15 minutes before class starts. During the "of the Day" slides, Justin & I had a brief private chat; his emails last night were only coming to me. I relayed information between him and Malia; she was quickly able to help him figure out what was going on with his phone so that he can now contact all the team members.



You will have to check out the Hawai'i statistics here in class; I forgot to look at the state department of health website during our class break.
Worldwide yesterday.
Worldwide today.
Nationally yesterday.
Locally on Thursday.
Locally yesterday.

For the Medical Word of the Day, Dr. Ric chose iatrogenic. The x-rays show the lungs of COVID-19 patients. In the early stages of the pandemic, patients having difficulty breathing were put on ventilators; later they found that was doing more harm than good. Now the treatment of choice is moving towards providing additional oxygen to the patient and using a ventilator only as a last resort.




Dr. Ric. showed us the team names and mottoes for Cohort #1v2. (The original cohort had 30 people, about a week after the training started the spike began so 20 more people were added.) There are no repeat names or mottoes; he is wondering whether there will be any repeats in the 5 upcoming trainings to be held over the next year or so.



Our morning guest speaker was Dr. Lynette Williamson; she taught us about teamwork and team building. It was a very informative training.



I liked that she started out telling us her presentation style.





She said community seems to have a slightly different meaning here. Some people thought it might have to do with being on islands. Others brought up the different cultural aspects of community.






At one point, when I was taking a photo of the screen, Dr. Lynette asked if I had a question. I told her no, I'm a visual learner so taking a photo, then looking at it later (and being able to tell you about it) helps the information to stick in my brain. She said she is also a visual learner. After that Zoe started a private chat with me and taught me how to do screen shots! Now I no longer have to use my phone to get great photos! Mahalo, Zoe!
This is from my phone photo.
This is from the screen shot; so much better! Mahalo, Zoe!


I especially liked this video, 7 Strategies for Virtual Teams. It brought up things I would not have thought about.


She also talked about different leadership styles and how the strengths and weaknesses of the different styles.





Emotional Intelligence is also a good quality for a leader.



We took a lunch break after Dr. Williamson's presentation. I spent some of my time harassing S'mores; she was sleeping so soundly she was easy to catch.


The afternoon session again started with Dr. Ric playing guitar in the 10 or 15 minutes prior to class; he said that is part of his Friday ritual.

Dr. Ric stressed the importance of not freaking out when you are in a stressful situation. 


I knew what this medical term was; I even spelled it correctly for the Everett Public Library Adult Spelling Bee!



The Medical Image of the Day showed a person with their heart on the left side of the body rather than the right side. It is a condition known as situs inversus.


Here's what the x-ray usually looks like.


The location of Dr. Ric's Favorite Pic of the Day no longer exists. It is one of the places covered over by one of the lava flows. It shows his wife and son at the beach.



The guest speaker for the afternoon was Dr. Garry Roy; he taught us about vital signs. He went though the vital signs taken upon intake and at various points in the patient's care. For each one he ran through what was normal, high, & low and the various ways each one is measured.

He also likes to start his presentations with illustrations by Dr. Ric's wife!
Here are the 4 vital signs he presented.



































The pulse oximeter won't work on fake nails.


BJ shared with the class that there have been tests on a system that does this so it is closer than you think to coming in to everyday use.


After Dr.Royʻs presentation, we had a short wrap up session with Dr. Ric; new COVID-19 cases were again over 100. He said if the trend continued he anticipated things would get shut down on Oʻahu next week; he advised us to take inventory to see whether we had enough supplies. If not, he advised us to make a supply run this weekend. Almost all the new cases during these record 100+ days have been on Oʻahu. Dr. Ric said we want to avoid what is happening in much of the rest of the nation where the numbers are so high, contact tracing is ineffective.

After class Malia, Jean, Justin, & I met up to talk about our "of the Day" presentation; Michael had a prior appointment so wasn't able to attend. Our presentation is due next Friday! We found that out at just before the start of the afternoon session when Jean asked when Team #1 was presenting; good job Jean! Malia suggested setting up a Google Slides page for us; she said its like PowerPoint but in the Cloud. I volunteered to play with it tonight and create a page for each "of the Day" topic; over the weekend each of us will enter our suggestions for each. Malia is also setting up a group meeting on Tuesday before class for us to discuss the suggestions and decide on what we will be doing.

In the few minutes before the afternoon class started, BJ asked me about the virtual background that I have been using. It is one that Zoom comes with and has moving surf and coconut tree fronds rustling in the wind. I said if I could figure out how to put my own photo on I would put up Grandma's anthuriums. Brian chimed in and told me how to do it! After class I played with it and got it work! I forgot to take a screen shot, but here is the photo I am now using as my background for Zoom meetings.
I really need one with more flowers at the edges & less in the middle.

On Wednesday and Thursday mornings I woke up with a sore throat; I decided to be conservative about what it might be since it was only 6 and 7 days after my flight here. This morning my throat was a little scratchy; I had gotten up in the middle of the night because it got too warm and turned on the A/C. I was going to turn it off after it cooled the room down so I could sleep, but I was asleep! Āue! I decided to see if the A/C could be put on a timer. It turns out there are actually a lot of variations on timing that can be done with these units. I am now experimenting with it going off around midnight then coming back on about 2:30 in the morning for 30 minutes or so to cool the room back down. It will go on for the morning at about 5 am.
This is just the On and Off function.
This one is set with multiple On & Off periods.

I made a quick shopping trip after class; I was going to do it even if Dr. Ric had not advised us to do so. I wanted to pick up some silicone muffin pans so that I could make a bunch of individual omelets, then freeze them for a quick lunch option on Mondays and Tuesdays when we have about a 15 minute break for lunch.


I also stopped at Longs, the chicken poppers were on sale again. But I was out of luck. The guy stocking shelves said they had been having trouble getting them in, I wonder if the COVID-19 shut down of the chicken processing plants in other parts of the country had affected the production of the chicken poppers?


While at the mall, I stopped at Whole Foods. Besides their version of Parmesan crisps, I also picked up granulated erythritol and some deli items. I had blackened salmon and roasted Brussels sprouts for dinner!


By the way, I always spray the kitchen counted down with a bleach solution to disinfect it. Here is why; this photo below is a single piece of litter from the Cat Genie. It means someone jumped up on the table soon after exiting the litter box! Āue!


On the news this evening there was a piece on concerns various leaders are raising about there not being enough contact tracers here. There seems to be a disconnect between what is happening in the training program and what the media is saying is happening. The people who have been trained now need to shadow a contact tracer before the newly trained person is turned out on their own. I don't understand why the health department is not pushing back harder and talking about the contact tracing training that has occurred, how many people have already been trained, where they are in the process of getting them out on the street, and how many more are in the pipeline being trained.

I'm not sure why he isn't talking about the program that is underway right now.

After dinner, I got in to the Google Slides page Malia created for us and played around a little, I decide to make a title page with a map of the Big Island; it took me a while but I was able to finally find a nice map that showed all of the communities that we are from. I made 2 versions for team members to look at.
Version 1.
Version 2.

Once again I forgot to look at the state department of health's COVID-19 site. But in class today, Dr. Ric gave us information on what's happening.

Hauʻoli lā Hānau e Jim!

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