Halloween

I always look forward to Halloween - it's a fun holiday everyone can enjoy, with costumes and candy, and no religious or family obligations. We treat it as a fun night to see our neighbors and be generous with kids. Despite the many precautions we've taken this year, I felt like trick-or-treating was a relatively safe activity for both givers and receivers of candy.

But everyone started talking about cancelling trick-or-treating, and instead organizing "trunk or treat" or other events. To me that makes no sense - why would you cancel a dispersed, nightlong activity, and instead gather people at a specific place and time to congregate?

Also, many people created (and some communities mandated) little bags of candy and treats, rather than handing out loose candy. Candy is already individually wrapped, and we give out full-size bars anyway, which I figure are equivalent to a handful of the mini ones.

So I bought some chocolate and decorated and made a plan, unsure of how it would go. Our street is relatively quiet and easy to skip anyway, and it sounded like a lot of people in our area weren't going to participate.

I am happy to report that, in our neighborhood at least, Halloween was a success! We created a path down our front yard with lights and signs. My husband stood in the yard and directed kids to a table on the front porch, where I handed out one candy bar at a time (contactless), with hand sanitizer in between. Then kids exited to the side and down the driveway, to avoid passing people coming up the yard. We played fun Halloween music throughout, and sang and danced between groups of kids. We ended up with 54 trick-or-treaters, which is about what we'd get in a usual year, but it seemed like there were more small groups throughout the night, rather than a big rush all at once. And the kids were very well behaved and most wore masks (some even worked it into their costume, like a doctor or a ninja). Most groups seemed to have parents with them - even the older kids - which I'm sure helped.

The only disappointment was that we usually hand out hot apple cider for parents, and since there's no good sterile way to do that, we opted not to offer it this year. But one mom came up with her own mug, which we usually fill for her! Hopefully next year 🤞

Voted

It feels like nothing is new or different because in my life, it's not. However, infection rates around the country (and world, actually) are increasing dramatically, reaching and surpassing previous highs. Many cities are recording new highest daily infection rates every day. One of the problems this time as opposed to the earlier spikes in cases is that cases are less centralized to specific cities, and more rural. That means that 1) resources and medical professionals can't just be directed to a certain place to provide support, and 2) many rural areas don't even have hospitals or sufficient healthcare facilities. Utah is having a major spike in cases and people are worried and upset, but politicians are basically doing everything short of mandating masks and shutdowns. Idaho is sending patients to hospitals 600 miles (!!) away because they don't have facilities there. Many places are talking about hospitals being at capacity and having to ration healthcare.

...And yet I still see people arguing that things should be more open than they currently are...

Photo by Tiffany Tertipes on Unsplash

In other news, the US election is now one week + one day away. I chose to do mail-in voting, to reduce exposure to other voters and poll workers, and to stay home and out of any potential mess on election day. I already returned my mail-in ballot at a drop-box last week and received confirmation that it was received by the county, but in my state they can't start counting the mail-in and absentee ballots until election day. Even though I've heard some counties are prepared with enough people and equipment to count all their early voting ballots in one day, we're still expecting that it will be at least a few days (maybe weeks) before all the votes nationwide are counted.

Notable

This morning I had meetings with two of my colleagues based in Wuhan. Of course we had to take some time to chat about current events. Both of them mentioned the news of the new outbreak in the Chinese city of Qingdao - notable because it's the first time in several months that transmission between people was recorded within China.

One colleague also told me about the recent autumn holiday they celebrated - usually people would travel to visit their families, but since he was locked down with his extended family for several months earlier this year, I don't think he was eager to travel back and see them again! 

My other colleague told me more about their day-to-day life - as the number of infections have increased in China and Wuhan, they're starting to wear masks more, decontaminate items they bring into their home, etc. Her daughter has been going to school, where the young children don't wear masks, but she said recently she came home with another kid's mask in her backpack!

Another piece of notable news this week is that the first case of COVID reinfection in the US was recorded. The young patient had a mild case earlier this year, and a more severe case several months later, but has since recovered. A handful of reinfections have been confirmed worldwide, but I wouldn't be surprised if there were more that we don't know about - it's probably an anomaly that a reinfection is worse than the original case, or that it's noticeable at all, because most people's bodies are doing what they are supposed to and fight off the virus as they learned to do the first time around. Just goes to show that it's unlikely having COVID makes you "immune," regardless of what the president says...

New Highs

New coronavirus cases in my state, and much of the country, are reaching new highs - as high as they were during the first surge in the spring, or even higher. Covid Act Now just downgraded us from yellow "slow disease growth" to orange "at risk of outbreak." Similar patterns are occurring in other countries that were previously hit hard earlier this year. I guess this is the local "second wave?" 

Yet we're not hearing about hospitals being overwhelmed like we were in the spring, and the death rates aren't soaring [yet]. Why not? Maybe now we just know more about the disease and how best to treat it; maybe it's because people getting sick now are generally younger and healthier; maybe people are getting less sick with less of a viral load (e.g. just inhaling a couple loose particles, rather than getting a sneeze in the face). More widespread mask use is probably likely for the last theory, though I still see people diligently wearing them around, then pulling them down to speak - that's the opposite of how it works!

My county is still yellow, according to CAN, with an infection rate just under 1 (i.e. each infected person is infecting fewer than one other person, so disease growth should gradually slow...). I've been keeping graphs of new infections in both my state and county, and while the 7- and 14-day averages of the state has been sloping upward for some time now, my county has remained pretty stable.

New cases in my state

New cases in my county

The Dentist

Yesterday was my long awaited trip to the dentist. It was just for a cleaning (that had been postponed from August), and according to this article about when to go to the dentist during a pandemic, they say it's safe if the positive testing rate in your area is below 5%. Right now, it's 4.4% for my county, and while cases in the country and my state are going up, they're remaining steady or even going down in my local area. So I felt like it was ok to keep my appointment. 

As usual, they called in advance to remind me of my appointment, but also gave me a health screening over the phone (have I had a fever, have I had a cough, have I traveled in the last 14 days, have I been around anyone with a positive diagnosis, etc.). When I arrived at the office, someone was sitting at a table outside to take my temperature and ask me the same screening questions. She checked off my responses on a paper, which I had to sign and hand in at the front desk when I entered. I used a pen from the "clean pens" cup and placed it in the "used pens" cup when finished. The office door was propped open so we didn't have to touch the handle.

At the front desk, a plexiglass panel covered the opening, except for a small slot through which I slid my form. They'd removed most of the chairs, and all magazines and decor from the waiting room; and a small air purifier device had been installed on a central column. The door into the treatment area was also propped open. There was hand sanitizer all over, which I took advantage of using.

My hygenist came out to call me back. She was wearing two masks, goggles, a cap over her hair, and a surgical gown over her scrubs. (She later told me that they had on-site laundry services, so she could change out of all her clothes before leaving.) This office has about 8-10 chairs for patients, all separated by kind of partial walls. My hygenist works out of the last seat, so it was actually enclosed on 3 sides. Again, all decor had been removed from the area, and everything that used to be stored in the open or on countertops is now inside drawers. Each work area had its own air purifier, which she said run 24 hours a day. I was given a tray lined with paper to lay my mask on, and the chair was protected with a disposable plastic cover (but she said they also wipe everything down between patients - this is just an extra layer of protection that some of them choose to use).

Before beginning the cleaning, I rinsed my mouth with a special antibacterial mouthwash that she said could kill viruses and prevent germs from coming out in an aerosol spray. The rest of the treatment was pretty typical - they always open a new, sanitized kit of tools, all the steps were done, etc. One difference was that instead of cutting a piece of dental floss from a roll, she opened an individually wrapped packet of pre-cut floss.

When she was finished, the hygenist called in the dentist for his exam. Because the dentists now have to don and doff PPE, they each take an hour-long block to do any exams, so they don't have to keep changing in and out of gear, so it wasn't my usual dentist. But the exam was uneventful, and I was cleared to go.

I took my mask from its tray and put it back on, and went to the front desk by myself (usually the hygenist would accompany a patient back out, so maybe they are limiting their movements and contacts, or taking this extra time to disinfect between patients). I set up my next appointment from behind the plexiglass window, and exited through all the propped open doors. 

It's probably overkill, but just to be super safe, my husband and I are trying to distance from each other for the next few days. We're not wearing masks in the house and I'm still cooking dinners, but just in case I would have become infected, at least if we're staying apart he wouldn't be exposed to as high a viral load as he would if we were kissing, sitting next to each other, breathing on each other in bed, etc. His dental appointment is in a couple weeks, so we'll get to do this all over again then...

What to Believe

Photo by Polina Zimmerman
from Pexels

Nobody knows what to believe right now. The president returned from the hospital to the White House last night, after receiving various experimental treatments. Was he even sick, or was he faking it to stage his triumphant "recovery?"* If he was sick, he surely can't be better already, and why is he putting people at risk by going for joyrides during his hospital stay, tweeting that people shouldn't be afraid of COVID, and whipping off his mask for a photo op as soon as he got home? This could have been his chance to convincingly turn around his messaging, say, "You know what, this disease really is serious and we should take precautions to prevent others from suffering like my wife and I just have," get his supporters on board the public health train, and possibly turn around the trajectory of this disease before the election - but he didn't take advantage of that opportunity.

How about voting? If people go in person, will they be stuck waiting for hours in an unsafe crowd situation? If they vote by mail, will their ballot be delivered in time? Even if they return their mail-in ballot in person, will it be counted in time, and will their signature match the one on file for it to count at all?

Are shut-downs even worth having? In Europe, where very restrictive lockdowns in the spring brought infection levels way down, they're now creeping back up (for example, France's infections per capita are actually way higher than the US's right now). If that's what happens after a "successful" shut-down, maybe just keeping everything limping along at partial capacity like the US seems to be doing now is the best option 🤷‍♀️

Also, today is the day I finally go to the dentist, and while I don't plan to isolate afterward I do plan to be "distant" from my husband for a few days just in case I should pick something up there. I know the dentist and hygienist are more afraid of me than I am of them, but I'm still not into the idea of having someone inside my mouth right now...

* I personally do believe he was actually infected, he was doing all the right things to catch COVID, plus there's too many other people in his orbit who are also sick, including ones who don't make political sense to put under quarantine right now. But I don't believe that he's recovered already.

Presidential

The big news today is the the US President has the coronavirus. It actually was announced around 1 AM this morning - I was having trouble falling asleep, so happened to hear it live.

As the president and first lady are now infected and isolating, it raises a lot of questions: What happens with the rest of the election campaign? Wasn't he taking prophylactic hydroxychloroquine? Does this mean masks actually do work and large gatherings are a bad idea during a pandemic? What happens if a presidential candidate dies before the election, or sometime after being elected but before being sworn in? 

Some people think it may be a hoax, announced for sympathy, to get out of the next presidential debate (the first one was this week and... did not go well), or to show how easy it is to "recover." Apparently someone predicted that his "October Surprise" would be an announcement like this, intended to dominate the news and then show the success of his promoted treatment.

I believe he is infected, though. A very smart friend of mine pointed out that the ~4 hour time lapse between when it was announced that his very close advisor tested positive, and when the president announced he was also positive, was just enough time to have performed several rapid tests followed by a PCR RNA test to confirm. I'm not sure why everyone is surprised, as he's been downplaying the virus for months and generally refuses to take even basic precautions like wearing a mask. He's also been on the campaign trail, attending rallies and events packed with other like-minded, unmasked attendees, where other people have been known to have picked up the virus. It was really only a matter of time, in my opinion.

People are also wondering if he may have infected his opponent at this week's debate. From what I heard, they were both tested and negative before the debate, so the assumption is that he picked it up afterwards. If he did already have it then, there is a slim chance that someone could be undetectably infected and still be infectious to others, but it doesn't sound likely.

Even though he's at risk due to his age and likely health conditions, he also has access to probably the best medical care in the world, so I'm curious to see how this turns out and if it either encourages skeptics to take this virus more seriously, or just shows that anyone can get it and recover and be fine. If things weren't interesting before, they are definitely becoming interesting now...