Noble defender against the SARS-CoV-2

Dear readers and fellow bloggers:

Good morning. The very best food for your first meal of the day (be it breakfast, late breakfast or lunch) is half an orange or grapefruit squeezed in fresh water; the other half should be treated like we did when we were kids and our dear mothers or grandmothers gave us one. Just suck it and eat the pulp. splashing you face with its powerful vitamins.

Jugo de pomelo

There is empirical data about the healthy effects of the citrus fruits – lemons, limes, oranges, grapefruits – to fight the SARS-CoV-2 producing the horrible world pandemic.  Why not follow the wise counsel of so many physicians and dietitians that observed it? Take the first step by picking some lemons and oranges next time you visit the market. Thanks to the wise recommendations of our “personal physician” (our son Gian Luca) this is how we have been starting our days at home ever since the middle of March.

Salute!

Stay distant. Stay safe. Stay beautiful.

What do you think? Please tell us.

Don’t leave me alone.

School closures are worsening Food Inequality in poor American children

Last Sunday, Betsy DeVos, the US administration’s Education minister showed up in a TV political show to defend the call of President Trump to “open the schools.” In a recent Washington Post article, Jennifer Rubin criticized her avoidance of the hard choices and expensive policy/administrative measures that the government has to previously put in place before allowing millions of children back into classrooms. “No, she does not have a plan. Does she want schools to follow the CDC guidelines? She talked in circles but really could not say. If there is an outbreak, should schools go back to distance learning? More double talk. Well, how about teachers who cannot go back because of their own health risks. More mumbo-jumbo.”

The Trump administration might be trying to play politics with such a delicate issue by trying to steamroll the opening of schools across the state and local authorities, but there are other voices from a different political stance that are asking the same. The American Academy of Pediatrics has called for their immediate re-opening. In a guidance paper published in their website, they said: “ Schools are fundamental to child and adolescent development and well-being and provide our children and adolescents with academic instruction, social and emotional skills, safety, reliable nutrition, physical/speech and mental health therapy, and opportunities for physical activities…” They enumerated several policy measures to make re-opening feasible.

The draconian socio-economic measures taken in the past four months to enforce the needed Social Distancing, including the closing on countless small businesses and myriad services across the country, has worsened wealth disparities in the USA. In a Yahoo Finance brief, Andy Serwer said: “According to a report earlier this year from the non-partisan Pew research Center, the richest families in America now take home 48% of aggregate income in the U.S. versus 29% in 1970, (with the top 5% faring best of all) Middle-class income fell from 62% to 42% over the same period.”

The closing of schools for so many long months will exacerbate the food insecurity already experienced by millions of US households before the pandemic; a survey of the U.S. Department of Agriculture stated that 14% households had children with food insecurity. For all those of us who are witnessing the incredibly long lines of drivers waiting in their cars for their turn to open their trunks and have food items stashed by the delivery stations’ volunteers from food banks/ charity organizations, we know that the income inequality and poverty are getting worse in our society. Sadly, the unemployment rate after the pandemic will affect Minorities much worse as the areas most resiliently affected will be Education, Care and General Services.

In an online comment in The Lancet, Wim Van Lancker and Zachary Parolin said: “research suggests that non-school factors are the primary source of inequalities in educational outcomes. The gap in mathematical and literary skills between children from lower and higher socioeconomic backgrounds often widens during school holiday periods. The summer holiday in most American schools is estimated to contribute to a loss in academic achievement equivalent to one month of education for children with low socioeconomic status; however, this effect is not observed for children with higher socioeconomic status.”

Stay safe. Stay distant. Stay beautiful.

What do you think? Please tell us.

Don’t leave me alone.

 

Are we becoming indifferent to Death?

-“Doctor…my mother got infected in her New Jersey nursing home— she died alone.”

The patient (whom we will not identify even with a fantasy name) mentioned this terrible piece of news “a la pasada” [i], without even a hint of emotional angst. We do not doubt that, whatever the circumstances of their bonding, she might have been saddened by the loss, compounded by the cruel isolation of the pandemic. However, her tone of voice clearly expressed the exhaustion we suffer with the interminable list of new infections and deaths in the USA, the hardest hit country due to Public Health mistakes.

We must confess that we personally do not watch or read the about the latest developments all day long, every day. In the morning we dutifully peruse the online editions of The Washington Post and The New York Times while we are having some breakfast. When we are working in our office we might alternatively tune in to radio programs from France, Italy, Spain, Argentina, and Uruguay. Finally in the evening we watch the news in CNN, RAI, France 2 and Telefe for two hours. Really? That much?However, in the late evenings we prefer to enjoy a Netflix series or a movie. On Sundays we read the papers in the morning and then binge-watch all kind of sports.

Even tough we are well informed about the daily tally of victims in many parts of the planet, we noticed that we are becoming a little bit more numbed every day to the sheer magnitude of the terrible sanitary and economic tragedy we are bearing. Recently we were shocked when we learned that a parking attendant in the Miami facility (where we do consulting work) had contracted the disease and passed away a few days later. However, we are trying hard not to be overwhelmed by the daily stories of suffering. Sadly, it might be the only way to control our anxiety and remain operational for the daily tasks we are supposed to carry on with integrity, endurance, and expertise. Given that this pandemic will last many more months, how will we end up emotionally?

There are a few critically important books that you read early on and then for some catastrophic circumstances like this pandemic, you feel obligated to go back to. The short novel L’étranger [ii]created by Albert Camus early on his career is one of them. We first read it in one of our clandestine raids of our dear father Mario’s library and we absolutely did not like it due to its unabashed nihilism throughout its pages. We  forgot about it until two years ago our son Giani gave us another copy as a gift. We looked at it with curiosity but put it in a bookshelf without much afterthought.

During the forced Social Isolation we have endured, we snooped at many books we have largely ignored, for various reasons; it did not take long to catch our attention. There was and still is a good reason: its brutal nihilism is in sync with our mood. The central character, succinctly named as Meursault, is a lower level functionary in the French bureaucracy of colonized Algeria that commits an irrational crime in an ordinary day and is tried for it. The narration is anchored by three major instances of indifference:

  1. Indifference No.1: the death of his mother. The book start with this line: “Today, mother died. Or yesterday, I can’t remember.” [iii] The initial 30 pages are filled with he mechanically detached account of his “participation” in his mother’s funeral, without ever expressing a hint of sadness or desperation.
  2. Indifference No.2: the killing of the Arab. During a Sunday outing to the beach with friends, Meursault provokes a fight with an innocent and murders him. The exact moment of the crime is described as: “all my being tightened up and I wrapped my hand around the revolver. The trigger ceded…” [iv]
  3. Indifference No.3: the end of his life. After the initial deception of being condemned to death, instead of being acquitted with a short prison sentence, Meursault accepts his end with resignation. The book ends like this: “In order for everything to be consumed, in order for me to feel less lonely, the only thing I had left was to hope that there would be a lot of spectators the day of my execution and that they greet with shouts of hate.” [v]

Meursault is marked by a triple indifference that conveys the idea that there is no sense in human existence and that we should not waste any time trying to find it. He incarnates the philosophical movement of Existentialism that was totally seducing  the European intelligentsia when the book was first published in 1942. Dismissing the great humanistic heritage of the Old Continent and the religious experiences of many faiths, that intellectual mode infected and paralyzed many learned spirits. Why bother to study, work, make families, etc.,  if everything is finally senseless? Better do nothing and rest.

There are two major ways in which the same Albert Camus renege from that failing philosophical stand. First of all, his prose—initially considered too simple and worthy of a simpleton by the French intellectual mandarins of that time—shows a richness of details that turn it into a truly sensorial tour de force. In the program L’heure Bleu [vi] of Radio France Inter for four consecutive days they presented a recording of the very same Camus reading chapters of this book. His clear voice, his rhythmic progression of the story and his unrelenting enthusiasm showed that he was satisfied with his writings, for which he had certainly invested a lot of time and efforts. Nothing is casual there.

Camus died prematurely after a fatal car accident that fortunately spared his kids. He showed until the very end of his life an uncompromising intellectual stand and participated in progressive causes, surely minding the future of his children. He nonetheless believed that Algeria, his country of birth, could remain as a French colony, albeit with many civic and economic improvements for natives. Until today. Algerians have a difficult, ambivalent attitude towards his figure and influence in their society.

After reading several books that he wrote later, we believe that Camus outgrew that initial phase of Existentialism and he came to appreciate Life’s value. Similarly we must understand that one day this horrible pandemic will cease, and we will be able to resume our lives, albeit in a rather modified and weird way. The fact that Death is so omnipresent in our daily lives does not mean that we have to give up living and working towards the future of our children; on the contrary we must strive more forcefully to create a much better society for them. Thank you Giani for giving us this opportunity.

Featured image is a famous scene form Ingmar Bergman’s The Seventh Seal. Death and Antonius Block chose sides for a game of chess.

By Source, Fair use, https://en.wikipedia.org/w/index.php?curid=23256490

Stay distant. Stay safe. Stay beautiful

What do you think? Please tell us.

Don’t leave me alone.

 

References

[i] Expression in the Castilian language that would mean: “something done as if you were passing by it and peeking from the side of your eye.” It gives an idea of emotional detachment, of hurriedness, of not really caring about it.

[ii] Albert Camus, L’étranger, Editions Gallimard, Paris, 1942.

[iii] Ibidem as above. Page 9. Our translation.

[iv] Ibidem as above. Page 93. Our translation.

[v] Ibidem as above. Page 93. Our translation.

[vi] https://www.franceinter.fr/emissions/l-heure-bleue

Just a little delay

Dear readers and fellow bloggers:

Good morning.  For the past few weeks, many readers contacted us to find out if we had already finished editing our new book Emotional Frustration – the hushed plague and when it would be finally published as both a physical and e-book formats. We proudly announce that we have finished that task and will send it to the publishing house.

In early March we had just sent a supposedly final version of the book  but the dramatic moments we went through thereafter, both personally and professionally due to the pandemic, made us re-consider our decision. It would have been dishonest to ignore the dramatic effects of the Social Isolation and Economic breakdown we were witnessing.

Not only we reviewed our previously finalized writings but, based on new articles of our page, we added more than fifty pages of new material with many updated references. Moreover, we dared to discuss some of the startling features of the coming “new reality” that will bear little resemblance to the familiar world we used to consider “as ours.”

Women will play a decisive role in rebuilding our lives inside and outside our homes, like they did after the Great Plague of 1348; their more assertive socio-economic role will bring major changes at the family, financial, labor and employment, civic realities. If we rely on them to help us get out of this morass, we should at least respect them more.

We present you a new page, which was added at the beginning of the new manuscript.

If only one person reads this book…we would feel very satisfied.

If only one person gets the message…our mission would be done.

If only one person is distracted from the Horror…we would be happy.

We were about to deliver the final edited version of this manuscript for its publication when the SARS-CoV-2 pandemic brutally broke in the public scene of the United States. Initially shocked like the rest of the population, we went into strict social isolation. However, as a practicing physician, we had to continue our duties as best we could. In the relative safety of our desk, we pondered whether we should publish it or not. We knew that there had been a complete shutdown of most publishing initiatives.

People cloistered at home deserve the possibility of substantive reading. Terrified by the darkness swirling around, they might like this little piece of light. Emulating the heroic example of Anne Frank, we should garner our moral strength. Dismissing any commercial considerations, we will go ahead with its publication.

In one of the poor quarters of Nàpule —where some of our kin had lived —a neighbor lowered, with a little rope, a basket with a sign from the balcony: inside it, passers-by could drop groceries they wanted to offer for others to pick up.

Chi può metta…Chi non può, prenda[i]

[i] In Italian, it means “Whomever can, put something…Whomever needs it, take it.”

PAPA_LIBRO_HushedPlague_Cover_V3

Stay distant. Stay safe. Stay beautiful.

What do you think? Please tell us.

Don’t leave me alone.

Anger displacement during Social Isolation

-“Doctor…when I arrive home, I can’t help lashing out at the kids—feel so guilty.”

Verschiebung. This German term can be translated as “Shift” or “move.” It was used by Sigmund Freud to describe a particular psychological defense mechanism; it entails the shifting or displacement of an aggressive and potentially dangerous emotion from an important person or object into other ones that are less relevant and often lame. [i] Our patient had many situations of emotional frustration in her blue- collar job with her despotic boss and his unreasonable demands at work but she hid her anger towards him and the system, fearful of losing her job in tough  times. On many occasions, she scolded her children a little bit too much for not completing their homework or for just some obnoxious but inconsequential pranks.

This unconscious defense mechanism is an expression of what Freud had dubbed as the mortido—our basic aggressive drive. There are three basic mechanisms:

  1. Displacement of object
  2. Displacement of attribution
  3. Bodily displacements

A – Displacement of object

Some acrid emotions are displaced from one person into another one. Our patient’s anger toward her boss—who has authority and power to decide on her economic survival—had indeed been transferred into her  children—who are totally innocent and incapable of posing a threat to her as they are dependent on her. This situation will sadly become much more common in our modern societies because the SARS-CoV-2 pandemic has furloughed millions of workers worldwide and many of them will not be able to return to their old jobs due to inevitable closure of businesses. In the much more genteel days of Freud’s practice in nineteenth century Vienna, he put the example of children’s animal phobias; in order “to sanitize” their fears towards their parents, some children develop aversion to certain animals: dogs, cats, spiders.

B – Displacement of attribution

A personality trait that we might see in ourselves but that we consider as socially unacceptable or even reprehensible will be transferred to another person or entity. The typical example is a closeted homosexual who engages in continuous joking about gays or other LGBTQ individuals to perform a psychological projection. We can also find extreme examples in History like the horrific persecution of gays in Nazi Germany conducted by Ernst Röhm, co-founder with Adolf Hitler of the Sturmabteilung (SA); he was a barely disguised homosexual that was executed in the middle of an orgy by the German Army—fearful that his formations were gaining too much strength in the street—during the Night of the Long Knives in 1934. [ii]

C – Bodily Displacements

It consists of the attribution of a sensation experienced by one part of the body to another distant one; one of the commonest instances is when an oral sensation “is experienced” as coming from the vagina. John Cleland wrote a book in 1748 titled Fanny Hill or Memoirs of a Woman of Pleasure [iii]where he used funny euphemisms in order to refer to body parts that were not openly mentioned in prudish Albion; he dubbed the vagina as the nethermouth. He was a rebellious writer and some sources claimed that he finished it when he was serving a prison sentence for a bad debt. He printed it in two installments in November 1748 and February 1749; he was released from prison in March 1748 (he graduated from the University of Life…I like him)

“I picked two fights at work. One with a customer and one in a Slack [iv] queue with my colleagues, and I regret both terribly. They are possibly the first two fights I have ever instigated in my life. Wish I could have hashtagged those. #furstfightbearwithme.”

Ms. Chrissie, a lovely, clever, funny fellow writer and blogger [v], honestly shared her unfortunate event in a recent blog, which triggered this reaction from yours truly:

“The little anger that you inadvertently vented against two individuals is part of the humongous one building up in the street. It happened to almost all of us lately.

Unfortunately as we slowly come out of our forced Social Distancing and we interact more with our fellow human beings, we will discover that not only they, but us as well, are displaying a shorter fuse and we might snap at the slightest incident. We might be able to contain ourselves outside our homes, with an occasional “mea culpa” if we allow our emotions to get the best of ourselves in the survival frenzy.  What we have to keep clearly in mind that we cannot—absolutely cannot—bring that heightened state of alertness and potential aggressiveness to our dear families. Maybe we should go back to the old ways from our ancestors to vent off that stress.

Get the punching bag from the attic. Paste the image of your boss right up. 

Go. And do not pull any punches. Sweet.

(This article was based on our upcoming new book Emotional Frustration- the hushed plague)

References

[i] Sigmund Freud, New Introductory letters on Psychoanalysis, George Allen and Unwin, London, January 1940,

[ii] https://en.wikipedia.org/wiki/Ernst-Rohm.

[iii] John Cleland, Fanny Hill, Gray Rabbit Publishing, London, 2018.

[iv] Chrissie described this tool as a fast-paced messenger service that is commonly used in certain offices. https://slack.com/

[v]  https://chrissie.blog/2020/05/13/are-you-okay/

Stay distant. Stay safe. Stay beautiful.

What do you think? Please tell us.

Don’t leave me alone.

Cherchez le fric

You cannot expect most mortals to excel in the über-byzantine ways of Modern Politics.

Except for the Brits. The inhabitants of a little island managed to rule the planet with wits.

Their top diplomats used few words adorned with plenty of elegantly suggested threats.

Why did the British born and raised CEO of Sanofi open his mouth a little bit too much?

In an interview with Bloomberg News on May 13, 2020, CEO Paul Hudson said: “The U.S. government has the right to the largest pre-order because it’s invested in taking the risk…(the U.S. expects) that if we’ve helped you manufacture the doses at risk, we expect to get the doses first.” The American government had expanded a public—private partnership by injecting U$ 400 to develop a safe vaccine faster; the company has a vaccine development facility in Waltham, Massachusetts.

The not-so-subtle words of someone that should know better than ruffling the already-excessively-ruffled feathers of the public servants assailed by the clamor of their constituents to bring a vaccine to the market that will deliver us all from this ordeal, landed as a cluster bomb in the elegantly baroque hallways of the French government. Président François Macron expressed outrage at that statement and countered that a good vaccine should benefit all Mankind and should not be sold in a private market.

We watched in Le Journal of France 2—the most popular news program in France—on May 14, 2020, as Serge Weinberg, President of Sanofis-Aventis, made a special appearance to calm the public uproar that his subaltern had maladroitly produced a day earlier. He said: “there will be no particular advance given to any country.” He explained that his company has a small vaccine facility in Waltham but a much larger one near Lyon. They are making arrangements already to produce the vaccine in those two facilities plus several other ones to meet demand in other parts of the planet.

In a Washington Post article, Christopher Rowland, Carolyn Y. Johnson and William Yan said: “Johnson & Johnson’s race to manufacture a billion doses of coronavirus vaccine is ramping up in a small biotechnology plant near Interstate 95 in Baltimore. But even as technicians prepare to lower 1,000-liter plastic bags of ingredients into steel tanks for brewing the first batches of experimental vaccine, international concern is bubbling about what countries will get the first inoculations.” That Baltimore facility is the first one of four company planned ones as the production of a vaccine for the whole of Mankind will take an unprecedented manufacturing effort.

Designing and manufacturing a reliable, safe vaccine for the SARS-CoV-2 virus is a task of biblical proportions with no margin of safety errors for three major reasons:

a) It’s a novel virus that produces multiple effects in various body systems, for which scientists and physicians are still learning “sur le champ” in a paranoid environment.

b) Pharmaceutical companies are developing new biotechnology techniques that had not been tested before and demand caution as there is hardly any long-term safety data.

c) Unlike other pharma products that are eventually consumed by sick people, an approved vaccine(s) will be given to millions of healthy people all over the planet.

Herd Immunity is the indirect immunological protection that is afforded to an entire population by the presence of a sufficient number of immunized individuals in their midst—after they had been infected; this has occurred for measles, mumps, polio and chickenpox due to the massive vaccination campaigns promoted by authorities. As long as the number of immune individuals does not go below a certain threshold, the whole population is safe. If there is a community with lower coverage—like it happened with measles in Disneyland in 2019—there might be an outbreak. Some viruses like the Flu mutate frequently and its immunity only lasts a few months, requiring almost yearly updates. So far, the SARS-CoV-2 virus has not shown that propensity to change frequently, which would extend immunity to several months or years. However, we still do not know much about it and we should be prudent.

There are two ways to develop the Herd Immunity: option A and Option B.

Option A

If we do not enact Physical Distancing and Social Isolation measures, the virus will infect millions of people in just a few months; experts agree that at least 70% of the population must be immunized in order to get the necessary Herd Immunity. This is the approach taken by Sweden, which has not put up any radical measures. We must consider that it is a small country of only a few million people, living apart both from a physical and social standpoint. Have you seen Swedes holding hands in the street? This approach can overwhelm the care facilities and exhaust the available material needed to take care of a surge of critically ill patients in the large urban centers.

Option B

If we do enact those drastic Public Health measures, the incidence of new infections will slow down, which will not overwhelm the already existing facilities and allow authorities to increase their resources, both human and material; this is what is commonly referred as “flattening of the infection curve.” New cases will rise slowly, then plateau over a period of weeks or months before finally coming down. This is the approach that has been taken by most countries in the world at the present time.

For both societal alternatives, the arrival of one (or 2,3) useful and safe vaccines will accelerate dramatically the attainment of a protective immunity shield for all people. That is precisely why many governments (especially if they have vaccine producing facilities in their territory) are fighting a sordid war of words and elbows to be in the pole position once the  frantic race for massive vaccination starts in the near future.

Development of an effective and safe vaccine for millions of people is usually a process that takes many years, even decades. The design of one ( or maybe two or three) vaccines for the SARS-CoV-2 virus is being fast-tracked by several teams around the planet, sometimes carrying out animal experiments and the initial phase of clinical trials at the same time. There are at least four major techniques to achieve that feat in record time:

a) Use of harmless viruses to deliver their genetic material inside the cells so they can form proteins, which will eventually alert the immune system to produce antibodies.

b) Use of killed or inactivated fragments of the virus to engage the immune system.

c) Use of a novel technique of viral messenger RNA in order to stimulate the human cells to produce the viral proteins that will trigger a response.

d) Use of viral DNA to produce the same effect as the above-mentioned technique.

The use of viral DNA or DNA is a completely new scientific approach and there is not any industrial experience about how to manufacture that kind of vaccine in a large scale; if we consider that in order to reach complete immunity, humans might need two doses of the vaccine, we are facing the real need of producing billions of doses on short order. Experts believe that eventually there will be more than one candidate, which will facilitate the tackling of this colossal production of good vaccines in a few months.

In order to dramatically speed up the arrival of an effective vaccine, the American government—breaking all the conventional wisdom and past experiences on vaccine development—has created a special project called Operation Warp Speed. In an article in Science, Jon Cohen said: “The project, vaguely described to date but likely to be formally announced by the White House in the coming days, will pick a diverse set of vaccine candidates and our essentially limitless resources into unprecedented comparative studies in animals, fast-tracked human trials, and manufacturing. Eschewing international cooperation—and any vaccine candidates from China—it hopes to have 300 million doses by January 2021 of a proven product, reserved for Americans.”

On May 21, an article in Bloomberg News detailed the U.S. administration whooping investment of 1.2 billion U$ in the joint AstraZeneca-University of Oxford project to develop a vaccine for SARS-CoV-2, which will start a large clinical trial in 15 days. The details are still coming out but there is already talk of a compromise for 1 billion doses.

If you are trying to guess which country will get the vaccine first, you must remember the answer of veteran sleuths to the question of what the motive of a heinous crime was.

Cherchez la femme!

Cherchez le fric!

Note – We have a little theory why Mr. Hudson committed perhaps the worst mistake of his life: he has spent too much time in the USA, the land of the brutish spitters of “truths.” Except for highly educated regions like New England and well-behaved ones like the Midwest, there are far too many spontaneous sauvages in this country who sincerely yet naively believe that just because something might be “correct”, it necessarily has to be “right.” We respectfully propose to the honorable Sanofis-Aventis board that they should grant their Demolition Paulie a leave of absence for a refresher stint in an English boarding school—with mandatory wearing of a good muzzle at all times, except in the refectory.

Stay distant. Stay safe. Stay beautiful.

What do you think? Please tell us.

Don’t leave me alone.

Is the SARS-CoV-2 pandemic starting to slow down?

In New York City, the number of new cases of infected people with SARS-CoV-2 and the daily death toll have been dropping for the past five days. The gory spectacle of health care personnel hastily talking to the reporters while they are sweating profusely in their Mertian protective gear is fortunately gone from our evening news programs. So are the makeshift hospitals to take care of the patients and the refrigerated trucks holding the bodies of the victims. Some of the hardest hit hospitals like Elmhurst Hospital in Queens and Brooklyn Medical Center in the homonymous neighborhood have much lower Emergency Room visits and less admitted patients for the infection, an unexpected phenomenon that has puzzled Public Health experts and hospital administrators.[i]

Today in an unusually optimistic article in Les Echos—the most respected financial daily of France—Yves Bourdillon affirmed: “the pandemic wave is coming to a close, apparently. The new cases of the Covid-19 atypical pneumonias and the associated deaths decrease in absolute number in al the countries of the world during the past few days. This daily flux only represents no more than 1.2% on average of the total number of the registered cases and 0.5% of the deaths, according to the reference sites of John Hopkins University and Worldometers.” [ii]

Amongst the developed nations most affected by this pandemic, the daily rise of new cases has been 0.5% in the USA,  0.3% in Germany and 0.2% in France, Italy and Spain. Even though they register almost two-thirds of the deaths, their daily rate has significantly slowed down, except for occasional peaks—like yesterday’s surge in the USA that tallied 1500 deaths. We must consider that there must be many more cases than the officially counted ones, but the trend is unmistakable and gives hope.

There have been many hypotheses about this phenomenon, including the benefits brought by a change of weather with the arrival of summertime; however, in New Zealand located in the Southern Hemisphere, the same trend is observed, with hardly any new cases. The Social Distancing and Isolation have certainly contributed to the betterment of the statistics but this trend occurs in countries with differing policies; it is observed in countries like Switzerland and Norway that have enacted a light version of Social Isolation and countries like Japan and South Korea with more draconian versions.

Some scientists are wondering if this “ralentissement” [iii] is really an expression of a mutation of the virus to become a different infecting agent. Less infectious or more? Veteran physicians and administrators are warily watching the sudden decline of clinical activity in their now eerily vacant hospital beds and the spreading calm. Is it just a temporary reprieve before a second wave hits them? Nobody really knows.

What do you think? Please tell us.

Don’t leave me alone.

Stay distant. Stay safe. Stay beautiful.

References

[i] https://www.nytimes.com/2020/05/20/us/coronavirus-live-updates.html?campaign_id=9&emc=edit_nn_20200520&instance_id=18629&nl=themorning&regi_id=57802664&segment_id=28532&te=1&user_id=459dba66f3e7ac37fa87a73994317eab#link-598d056

[ii] https://www.lesechos.fr/monde/enjeux-internationaux/la-pandemie-sessouffle-presque-partout-dans-le-monde-1204511

[iii] Term in the French language that means: “slowing down.”

Leftover victims of the SARS-CoV-2 pandemic

On May 8, 2020, the U.S. Department of Labor issued its monthly employment report, which showed that the national unemployment rate jumped to 14.7% in April, its highest level since the Great Depression of the 1930s; it said that 20.5 million people had suddenly lost their jobs due to the country’s lockdown, erasing a sustained rise of employment of the past ten years. A more detailed analysis of those that are abruptly working part-time instead of full-time and those that are not counted showed that the unemployment rate might even be higher. Moreover, the tightening of the federal, state and county budgets will inevitably furlough many more people.

In the previous recession of 2007-2009, the majority of lost jobs belonged to men, as the construction and manufacturing sectors ground to a halt; but this time the real losers are often women as thousands upon thousands of their positions as clerks, secretaries, hairdressers, health care aides, travel consultants, stewardesses, airplane and ship chandlers, restaurant servers and cashiers, dry cleaning employees, etc., evaporate. Once the lockdown is finally levied, albeit in various progressive stages according to the local public health characteristics, many of the once thriving small businesses that used to predominantly employ women will be gone. And there will be hardly any credit for entrepreneurial initiatives as the banks will be reluctant to lend.

Not only did women hold most of the positions offered in the Education and Health Care realms—the hardest hit sectors—but they were also furloughed in greater numbers than men. In a Washington Post article, Heather Long and Andrew Van Dam said: “Before the pandemic, women held 77%of the jobs in education and health services, but they account for 83% of the jobs lost in those sectors…Women made up less than half of the retail trade workforce, but they experienced 61% of the retail job losses. Many of these women held some of the lowest-paid jobs.” A large proportion of those workers are single women with children and members of the Latino and Black minority groups.

These disadvantaged single women usually lack a strong social or family support, for which they disproportionately rely on their children’s school services for their care, instruction, and meals. If they cannot take their kids to school, they will not be able to resume their previous positions, even if they are asked back to work.

In order to re-start our economies we must first help the women that sustain it.

Stay distant. Stay safe. Stay beautiful.

What do you think? Please tell us.

Don’t leave me alone.

 

Thanks for your fabulous service

Dear readers and fellow bloggers;

Good afternoon. As a physician that has worked uninterruptedly during this terrible pandemic (even though we follow the Social Distancing protocols enacted by the City of Miami and State of Florida authorities) we must acknowledge that our dedication has been buttressed by the countless workers that have stood their ground and helped us.

Today we are introducing the beautiful Ms. Bre Wyche, star cashier at the Publix Supermarket branch at Mary Brickell Villlage in downtown Miami; last week she took care of us gracefully and diligently when we staged a quick foray to do our monthly shopping spree there. Today we went back for a refund and to buy certain items, for which we insisted on taking the opportunity to get her picture. (she is a very shy girl)

Beautiful Bre

Isn’t that smile bewitching?

After our incursion last week, we felt obligated to send an email to Mr. Todd Jones, CEO of Publix, to let him know what an outstanding service she had gently provided to us. According to his biography, Mr. Jones started in 1980 at the very low-end of the ladder (he was a front service clerk, a.k.a. bagger of groceries, in the New Smyrna Beach facility) and worked tirelessly until becoming the top executive of the largest employee-owned grocery chain in the USA. He should know a thing or two about merit-based progress.

We wrote to him: “when we were almost done, I suddenly said:’Oh, I forgot to pick up the garbage bags.’ You know what she said:’Don’t worry…I’ll go get them for you.’ And took off…She asked me what the specifications of what I wanted where and went out to get it. Can it get better? Yes, indeed. She came back with five variants of the perfumed Glad bags AND laid them out for me on the conveyor belt to chose from. I chose the lavender. This is what I call outstanding service. Please nominate her for employee of the month.”

Mr. Jones kindly answered my message, thanking me for sharing the anecdote as they love to hear that their committed employees are doing a great job every day of the week. As a front-end employee, Miss Bre is relatively exposed as she touches what we do.

Thank you very much to all the employees and administrative personnel of Publix Supermarkets for showing us, with big and little details, that they care for our families.

Stay distant.Stay safe. Stay beautiful.

What do you think? Please tell us.

Don’t leave me alone.

Multi-system inflammatory disease in Covid-19 infected children

On April 27, 2020, The Sun, a British newspaper with an American edition, published an article about a National Health Service warning about a new presentation of the Covid-19 infection in children; it even had flashy pictures of the new syndrome. The alert was sent to general practitioners in North London where the chiefs of health care delivery said: “there is growing concern that a Covid-19 related inflammatory syndrome is emerging in children in the UK…Over the last three weeks, there has been an apparent rise in the number of children of all ages presenting with a multi-system inflammatory state requiring intensive care across London and also in other regions of the UK.”

On April 27, 2020, the Pediatric Intensive Care Society of the United Kingdom issued a statement warning health care providers and parents that there was “an increased number of novel presentations of a multi-system inflammatory disease in critically ill children infected with Covid-19.” They recommended parents to seek proper professional help if their children had any of the following symptoms:

  1. Becomes pale, mottled and feels abnormally cold to the touch
  2. Has pauses in their breathing (apneas), has an irregular breathing pattern or starts grunting
  3. Severe difficulty in breathing, becoming agitated or unresponsive
  4. Is going blue round the lips
  5. Has a fit/seizure
  6. Becomes extremely distressed (crying inconsolably despite distraction), confused, very lethargic (difficult to wake) or unresponsive
  7. Develops a rash that does not disappear with pressure (the Glass test)
  8. Has testicular pain, especially in teenage boys

On May 4, 20220, the New York City Department of Health issued its Health Alert #13 stating that 15 children in New York City hospitals have been identified with a multi-system inflammatory syndrome that resembles Kawasaki disease and/or toxic shock syndrome. The NYC experts said that: “clinical features vary, depending on the affected organ system, but have been noted to include features of Kawasaki disease or features of shock; however, the full spectrum of disease is not yet known. Persistent fever and elevated inflammatory markers (CRP, troponin, etc.) have been seen among affected patients. Patients with this syndrome who have been admitted to pediatric intensive care units (PICUs) have required cardiac and/or respiratory support. Only severe cases may have been recognized at this time.”

On May 9, 2020, Governor Andrew M. Cuomo of New York informed in his daily update that three children had died of this multi-inflammatory syndrome in the New York area hospitals. Moreover, they had already identified up to 75 children with the syndrome. They were initially admitted without any respiratory symptoms but they all tested positive either for the virus or its antibodies. He warned that it is a developing serious situation.

Sadly, the emergence of this Kawasaki-like syndrome might just be the tip of the iceberg.

Stay distant. Stay safe. Stay beautiful.

What do you think? Please tell us.

Don’t leave me alone.