My Summer Vacation: RIP Notorious RBG

We lost an amazing human being this evening; the Notorious RBG passed away from metastatic pancreatic cancer, she was 87. She is irreplaceable. RIP RBG.

I weighed myself first thing in the morning and found I have lost even more weight this week (1.8 lbs) than last week. So even though I kinda messed up on a couple days the keto-carb cycling I lost weight; but it could also be water I am losing which is what happens initially in a straight keto diet. Although it might be more attributable to me trying to keep track of the macros and not eating more than 20g fat when I am on a carb day; when I find I am getting close to the allowable fat amount I revise my eating for the rest of the day and end up eating less calories for the day than my macros intended.

Just before lunch today Ciza called; he wanted to know if I could do a support services case for MRC. I said yes, I did the shopping myself, then he met me to do the delivery; which was a good thing because the unit for the case was on the 3rd floor and there were about 8 bags of groceries and a 10 pound bag of rice. We got to the building and discovered it was 2 buildings connected by a breezeway and multiple entrances; we called to find out which entrance would be closest to the case. They ended up driving to the parking lot to meet us. We set the groceries down on the median; after we got back in our cars they came and picked up the groceries. They really shouldn't be coming out of their unit to get the groceries; and certainly shouldn't be driving around. Both Ciza & I had difficulty talking with them; I sure wish they had interpreters that could help us out on these.

Based on our morning discussion, I followed Ciza to the Department of Health office. Because of the number of cases back in late June (when we were getting 5 to 20 new cases a day) they transitioned the MRC Support Services to having a dispatcher make contact with the families needing support, then finding volunteers to do the shopping & delivery. Since I am one of the more seasoned volunteers, he asked if I would be a dispatcher; I said yes. I went to DOH with him to pick up a phone to use for the dispatching, which is great since it would have an 808 area code so people would be more likely to pick up when I call!

It's a flip phone!

When I got to the DOH offices I realized I had forgotten to get the receipt out of the bag; I told Ciza I would go back and get it. I called the case,m didn't get an answer so I left a message. When I got to the parking lot, I called again; this time the husband answered. It turns out they were not in their unit and had several errands to run, including picking up their son at school! Āue! They're not supposed to be out of their unit! We really need interpreters to be part of the contact tracing! (I don't know why Telli, Diena, & Tracy from our cohort were rejected; it makes no sense since they were specifically recruited for their language skills to work with the Pacific Islanders communities they come from.) I ended up meeting the case at the bank where there were a few people inside and about a dozen waiting in line outside! I picked up the receipt from the husband, the transaction took less than a minute, I was about 5 feet away - my short arms made being 6 feet away impossible! I called Ciza as soon as I got back in the car (and also sanitized my hands and sprayed the receipt!) and told him what happened.

The original plan was for me to run the receipt right back to him; that all changed. He told me to go home and quarantine; he would call Marjorie and let her know what was going on. I was really glad I picked up a can of a new spray disinfectant I found while looking for some for the case. We are fortunate that there is a separate entrance that I can come in from that usually no one uses. That entrance opens in to the laundry room where I place a yukata when I go out for a support services delivery; you never know what you might run in to! I threw all my clothes and my mask in to the washer immediately and got that going. Then I headed for the shower; I was spraying down any surface I touched as I made my way to the shower.

It doesn't specifically say it wills SARS-CoV-2 but it can't hurt.

When I got out of the shower, I first texted Ciza to find out whether the family was an actual COVID-19 "case" (known positive infection) or just a "close contact" (exposed to known case but not showing signs of infection) and how long they had been in isolation or quarantine. Then I called The Roommate Who Likes to Wash Dishes since he was in the house working from home. I explained what happened and that I would need them to provide me with meals, etc., like I did for them when he thought he had been exposed. As I was wrapping up my conversation with the Roommate, a text came in; it was Ciza. He had discussed the case with Marjorie and said, "...the case was brought to us when the individuals have already concluded their quarantine. It was added to the Support Service sheet prematurely which prompted the delivery. ... The individuals are ok to be about the community. I'm happy that is the case."

Since I could now leave my room, I worked on clearing off the desk and adjacent filing cabinet top; I created a space for my old Mac. Now I have 2 computers set up so I can be watching a video or Zoom or whatever on the MacBook Pro and look up references on the old Mac.

Before.

After.

The orchid has continued to bloom; it now has 7 open blooms and 2 buds. I found the tag in the pot when I was watering it. The tag says this is P. Ben Yu Lace Princess. From what I have been able to find out, the blooms can last for 3 months!

Yesterday's video on masks referenced the more in depth interactive video on mask effectiveness called, The Multiplicative Power of Masks. They cite some amazing statistics about how many virus particles an unmasked infected person spews when they breathe (roughly 1000/minute), talk (10,000), cough (100,000), and sneeze (1,000,000). This is the "viral load" that I mentioned a couple days ago. The cartoons showing the virus particles being spewed is great! They also have several illustrations where you can vary the effectiveness of masks and percent of people wearing masks to see how much the virus load is lessened.

This is one of the interactive illustrations.

The 2nd Office of Minority Health Symposium breakout I watched on Thursday was Leveraging Data & Sharing Expertise to Fight the COVID-19 Pandemic by Johnnie (Chip) Allen from the Ohio Department of Health.

A driver licensing clerk has tested positive, but since all the licensing offices have been shut down to the public since the stay-at-home order started no public were in exposed. This shows the value of the stay-at-home order in breaking the transmission route.

The CDC finally came to its senses and rescinded its weird guidance on testing. There was so much backlash from scientists, the public, and the administration's own experts, it had to get walked back. But the damage has already been done, it just gives the people who don't want to believe in science more ammunition to say the CDC doesn't know what its doing so why should they listen to anything the CDC says.

Some good news for people of color, there appears to be a new use for an old drug that looks promising for POC. The rheumatoid arthritis drug tocilizumab appears to reduce inflammation so the need to put people on ventilators is lessened. This is good news since ventilators themselves can cause additional damage to a person's lungs; hopefully larger reviews will continue to show its efficacy so doctors have some place more than between a rock and a hard spot.

Scientists in the US & Israel are examining whether a vaccine that has been in use for decades against tuberculosis can train innate immune cells to respond to new invaders. In places with a high rate of BCG tuberculosis vaccination, researchers found that hospital workers that had gotten their boosters in March had no cases of COVID-19 while unvaccinated hospital workers had an 8.6% infection rate. This isn't they way I was taught that vaccinations worked; I'm still trying to understand this.

The cases where seemingly healthy people or youth sustaining very debilitating or fatal cases of COVID-19 may have to do with immune deficiencies. Scientists are studying this possibility; DNA sequencing is helping them in their search for answers. But this is not a new question, throughout history diseases only kill a small percentage of people that are infected; the 1918 flu pandemic is estimated to have only killed 2.5% of the people it infected. And the question has always been, why those people? Breeding for disease resistance in plants has been going on a long time, so we have known there is a genetic component to illness; COVID-19 is pushing us to really examining how it works in humans.

I love data! And good data can help with health equity I think that is why I post about the data that I can find, which has holes. I hope the Hawaiʻi Data Collaborative can work with Dr. Roberson to provide better data so the public can see how we are doing.

Hopefully the proper data for the leading and lagging indicators is being collected and its just a matter of releasing it to the public. I have not been posting much data from the new Department of Health dashboard because it still says (PROTOTYPE) and also is lacking a bunch of data or the data provided is very old, like from early August but you would only know that if you read the "fine Print" at the end of the dashboard. The items in blue font below are the data that can be found somewhat easily. The indicators on the right end, the lagging indicators, are data you collect after the the disease has come through an area. The data at the left end of the spectrum help a community to get better control of the disease.

There were 114 new COVID-19 cases today for a total of 11,217 known cases. The tally from the veterans nursing home in Hilo has finally come in, raising todayʻs death toll to 13 for a total of 120 deaths statewide.