Take a Break: Dance it for Five

Some days a five minute meditation break in the middle of the day works wonders. Other days you just want to get up and dance I’ve been having a lot of fun taking 5 minute breaks to different dance videos, which show lots of people having a blast. Even Richard Simmons came out of seclusion during Covid-19 and posted a bunch of his "Sweatin to the Oldies." And who can forget Jane Fonda? Sheeeeeee's back!

Here are some videos to get you started.

Not interested in today’s activities, try the Take a Break Pinterest Board.

Life with Chronic Disease: Epidemics/Pandemics-It’s all happened before

Recently I gave a talk for the Cavendish Historical Society on Epidemics/Pandemics and their impact on history. It was a fascinating topic to research.

Knowing there is nothing really new in how people respond in situations like Covid-19 has given me a better outlook, helped me to not be so judgmental, not to overly stress about headlines as well as comments made to me, and over all gave me hope. Most of all it’s the reminder that this has happened before, will happen again and we’ll get through it.

In the mean, we can only control what we have control over, and be responsible for how we respond to the current crisis.

The pandemic began in the East, sweeping through cities and towns, disrupting daily life and sowing fear and uncertainty throughout much of the known world. 

Sound familiar? However, it is a description of the Antonine Plague, which lasted for 15 years during the 2^nd century.

Whether it was small pox, measles or a combination of the two is unknown, but the reaction of people then, during the Black Death (Plague), the small pox epidemic that killed almost 90% of the indigenous Americans, the flu pandemic of 1918 and even Covid, are surprisingly similar. After all, they have the same common denominator, humans.

While Covid hasn’t caused anywhere near the deaths of plague (the number one pandemic killer) and other epidemics, it’s impact on society and culture will be just as significant.  

Below is a list of 10 characteristics these type of events share.

1. Panic & fear result in fight, flight, blame, despair, and cruelty. As much as possible, people flee where the outbreak is happening to a place perceived to be safer. Unfortunately, this helps to spread disease. 

Jews being killed

They also will “fight” in an effort to have some sense of control over a situation that is very much out of their control. This can have disastrous consequences, such as the burning down of the Jewish ghettos during the Black Death. During the Antonine Plague in Rome, people smeared thin needles with infected fluids and tried to stab their victims unnoticed. When they contracted the disease, it was hoped nobody would suspect foul play. The plague literally allowed unscrupulous people to get away with murder.

During the small pox pandemic, Native Americans, like the ancient Romans, looked at it through the lens of their gods and cosmologies. The belief that their gods had forsaken them caused some to commit suicide.

The outbreaks of plague in Renaissance Europe sparked rumors of malicious plague spreaders, thus focusing on a wide variety of insiders and outsiders from high-ranking officers and doctors to the lowest levels of health workers – plague cleaners, cartmen and gravediggers– were singled out, accused of perpetuating the disease for a variety of reasons including self-interested gain.

As recently as the HIV/AIDS epidemic, hate and fear were engendered against the five H’s-homosexuals, heroin addicts, Haitians, hemophiliacs and hookers.

These type of events can cause societies to break apart, scapegoating immigrants, minorities and others who are thought to be suspicious. The poor will often revolt and cruelty abounds.

However, certain factor can mitigate these reactions. The 1918 Flu pandemic and the flu of 1831 that swept through Paris did not lead to any recorded social violence, blaming or hatred. In both cases, there were other major factors at play-WWI in 1918 and the July Revolt in 1831.

While the extremes seen in past epidemics/pandemics are not as pronounced during Covid, they are none the less at play and concerning to many. Without normal routines and jobs, dwindling finances, the mandates to “stay at home” and reduce travel,  combined with fear and anxiety, people can act in ways they normally wouldn’t. The recent influx of calls to suicide hotlines, protests, riots as well as a fierce “cancel culture,” are very much in line with how people respond during pandemics.

Christians aiding the sick 2nd century

This does not mean that good does not occur during these events. The Christians during Antonine Plague converted many to their beliefs as they saw how they cared for the sick. Today, many individuals and communities have done an incredible job making sure people are safe and have access to food and care.

It’s not surprising that people are more concerned about the damaging effects of the pandemic rather than the incredible contributions many are making. Our brains are wired for a negative bias, as remembering threats to safety and well-being were key to early human’s survival. 

2. People act in their own interests. In the most extreme situations, such as the Plague, surrounded by death and suffering, inevitably people begin to question the rules of law and morality. During the 1918s, there were "anti-mask" meetings. When there was a polio outbreak in Vermont in 1917, and quarantine was ordered, a civil suit was filed  by Community Chautauquas. Today there are groups who believe mask wearing is a civil liberties issue with little regard to public health.

3. Scammers abound. The more risky the situation the more snake oil salesmen surface. With the Internet, they're having a field day at the moment.

Statue of Glycon

Alexander of Abonutichus started the cult of Glycon in the 2^nd century. A mystic, magician and charlatan, he literally was pedaling snake oil. He created Glycon, a snake god, that was basically a glove puppet. Among his sales items was a charm that could be hung over the door to your house to protect you from plague. Turns out those who had the plaque over their threshold were more likely to die from the plague, probably because they went about business as usual thinking they were protected.

4. Misinformation abounds. Causes, treatments, cures are all over the map. Many do not take the time to separate fact from fiction and untold damage is done by misinformation and the spreading of it.

 As seen in 1-4, the humans can treat each other terribly. As Marcus Aurelius, Roman emperor,  noted in the 2nd century, however bad the physical disease surely was, one thing was even worse-the mental plague of corruption, vice and moral decay.

5. The health impacts won’t be known for decades. “Look back” studies show that those that had the flu of 1918 as children had considerably more health issues as adults then non infected counterparts . Interestingly, flu survivors were less likely to get cancer. You can't get shingles unless you had chicken pox at some point. On the plus side, descendants of plague survivors seem to carry a gene that made them more likely to be “non progressors”-don’t develop full blown disease- when they contracted HIV, the virus that causes AIDS.

6. Most at risk are those living on the margins: The reasons are varied but can include: inability to escape from where the pandemic is occurring; poor living conditions, including overcrowding and dense pack; more likely to have other health issues; malnutrition; no access to information due to language and literacy barriers; inadequate finances; and discrimination.

Depending on the epidemic certain groups will be more at risk than others. In the 1918 flu, the most at risk group were young adults, particularly those in their twenties and thirties. Pregnant women were at particularly high risk.

7. Every storm runs out of rain (Maya Angelou) Pandemics/epidemics don't last forever

8. Change follows. The Antonine plague was the beginning of the fall of the Roman Empire while at the same time ushering in Christianity. The black death of the middle ages made the Renaissance possible. It also paved the way for

- literacy (all the clothes that were left could be turned into paper)

- a middle class (they needed a work force and the serfs demanded a living wage)’

- the beginning of the shift from the “old scholars” approach to medicine to empirical based evidence.  

The flu of 1918 made major changes in health care in the US and historically, because of the damage it did to Wilson, the treaty of Versailles laid the foundation for WWII.

AIDS activist protesting

The AIDS epidemic revolutionized health care, from new means of treatments for cancer and other diseases, to how the FDA fast tracks drugs and allowing compassionate use. It also ushered in the age of HIPAA and confidentiality.

We’re only at the beginning of how this pandemic will change our culture and society, but already we are seeing a lot more people telecommuting. Businesses are learning that it's cheaper for them to have their employees telecommute so office buildings are being closed. There are those that prefer remote learning and so a hybrid approach to education is potentially here to stay. Thanks to forecasting and remote learning-snow days may be a thing of the past. Masking will become part of flu season etc.

9. All of this has happened before. And will happen again As noted by Marcus Aurelius,—the same plot from beginning to end, the identical staging.

Marcus Aurelius

10. No matter the situation-war, extreme loss, devastation, crisis-the number one response of the humans is resiliency. This is true across the board for all cultures. It's wired into the human DNA. It would have to be because of reactions 1-4.

Take a Break: Watch Comet Neowise

With so much closed down due to Covid, it's nice to know the skies are wide open and we've been enjoying watching the Comet.

Comet NEOWISE has been entertaining space enthusiasts across the Northern Hemisphere. Although its official name is C/2020 F3, the comet has been dubbed NEOWISE after the Near-Earth Object Wide-Field Infrared Survey Explorer (NEOWISE) space telescope that first noticed it earlier this year. This “icy snowball” with a gassy tail made its closest approach to the sun on July 3 and is now heading back from whence it came: the far reaches of the outer solar system. Its long, looping orbit around our star ensures that after passing closest to Earth on July 22, Comet NEOWISE will not return for some 6,800 years. Scientific American 

With today being July 22, what better way than taking a break and checking out the comet in your neighborhood. Here are some links to help you with that:

• The BestWay to Watch Comet NEOWISE, Wherever You Are Scientific American: 

• How to see Comet NEOWISE from Earth Sky 

• How toSee Comet NEOWISE from NASA: This site includes a video

Not interested in today’s activities, try the Take a Break Pinterest Board.

Journal Watch July 2020

COVID

We’re Nowhere Near Herd Immunity with COVID-19, Experts Say: Experts say we’re nowhere close to achieving herd immunity against COVID-19 in the United States. In addition, a new study suggests that antibodies developed during an infection may only last for a few months. Experts say personal behaviors, such as wearing masks, washing hands, and physical distancing, are the best ways to stop the spread of COVID-19. Healthline

CDC Updated List of Those with Higher Covid Risks: The Centers for Disease Control and Prevention (CDC) has updated its listTrusted Source of underlying conditions that may lead to more severe outcomes from a COVID-19 diagnosis. CDC now warns that among adults, risk increases steadily as you age, and it’s not just those over the age of 65 who are at increased risk for severe illness. Other conditions include: Chronic kidney disease; COPD (chronic obstructive pulmonary disease); Obesity (BMI of 30 or higher); Immunocompromised state (weakened immune system) from solid organ transplant; Serious heart conditions, such as heart failure, coronary artery disease, or cardiomyopathies Sickle cell disease Type 2 diabetes

Repurposing MMR vaccine for COVID-19 New research shows that the common vaccine that protects against measles, mumps, and rubella (MMR) could help prevent inflammation in COVID-19, which leads to severe symptoms. mBio

Common heartburn drugs may be tied to higher COVID risk: Popular heartburn medications such as Prilosec (omeprazole) and Nexium (esomeprazole) may inadvertently up your chances of catching COVID-19, new research suggests. An online survey of more than 53,000 Americans found that those taking a PPI once a day saw their risk for contracting COVID double. Those taking a PPI twice a day saw their COVID infection risk nearly quadruple. The American Journal of Gastroenterology

One in three young adults may face severe COVID-19, study shows: As the number of young adults infected with the coronavirus surges throughout the nation, a new study by researchers at UCSF Benioff Children's Hospitals indicates that youth may not shield people from serious disease. The impact of smoking surpassed other less common risks, the UCSF researchers reported in their study, which publishes in the Journal of Adolescent Health

Asthma does not seem to increase the severity of COVID-19: “People with asthma -- even those with diminished lung function who are being treated to manage asthmatic inflammation -- seem to be no worse affected by SARS-CoV-2 than a non-asthmatic person. There is limited data as to why this is the case -- if it is physiological or a result of the treatment to manage the inflammation." Journal of Allergy and Clinical Immunology

Physical distancing interventions cut incidence of COVID-19: Physical distancing interventions are associated with a reduced incidence of COVID-19 globally, according to a study published online July 15 in The BMJ.

   
COVID-19: Considering meditation and yoga as adjunctive treatment: The anti-inflammatory and other beneficial effects of meditation and yoga practices make them potential adjunctive treatments of COVID-19, according to the peer-reviewed journal JACM, The Journal of Alternative and Complementary Medicine. Click here to read the article.

Lopinavir/Ritonavir COVID-19 Treatment Linked to Bradycardia: Lopinavir/ritonavir (LPV/RTV) treatment of COVID-19 is associated with an increased risk for bradycardia. Patients with bradycardia were older, had increased RTV concentration at 72 hours, lower lymphocytes. July 9 in Circulation: Arrhythmia and Electrophysiology.

Variety of Symptoms Reported for COVID-19 Patients: Nearly all symptomatic COVID-19 patients experience fever, cough, or shortness of breath, and a wide variety of other symptoms are reported, according to research published July 17 in the U.S. Centers for Disease Control and Prevention Morbidity and Mortality Weekly Report. Gastrointestinal symptoms and other symptoms (such as chills, myalgia, headache, and fatigue) were also commonly reported.

COVID-19-Related Symptoms Persist After Recovery: Most patients who have recovered from COVID-19 report persistence of at least one symptom, according to a research letter published online July 9 in the Journal of the American Medical Association.

Even People With Lung Disease Should Wear Masks: Experts: People with chronic lung disease may worry about being able to breathe freely with face masks, but they should wear the coverings if possible, four leading medical groups say. "Individuals with normal lungs and even many individuals with underlying chronic lung disease should be able to wear a non-N95 facial covering without affecting their oxygen or carbon dioxide levels," the American College of Chest Physicians, the American Lung Association, the American Thoracic Society and the COPD Foundation said in a statement released Thursday. The groups acknowledged that some people with lung diseases might not be able to tolerate breathing with a mask and will seek a mask exemption from their doctor.

K-State study first to show SARS-CoV-2 is not transmitted by mosquitoes: A new study by Kansas State University researchers is the first to confirm that SARS-CoV-2 cannot be transmitted to people by mosquitoes.

No Big Increase Seen in Loneliness During U.S. COVID-19 Outbreak: Social distancing during the COVID-19 pandemic has not led to an overall increase in loneliness among Americans, according to a study published online June 22 in American Psychologist.

PAIN

New Drug Combo May Help Ease Fatigue Caused by Rheumatoid Arthritis: In a 2-year study, the drugs methotrexate and prednisone were effective in reducing the fatigue of participants who took them. Experts say relieving the unrelenting fatigue allows people with rheumatoid arthritis to live more pain-free and productive lives. 2020 conference of the European E-Congress of Rheumatology

Low Back Pain Also May Resolve in Some After Hip Replacement: Symptomatic low back pain (LBP) resolves in 82 percent of patients with hip and back pain who undergo total hip arthroplasty (THA), according to a study presented at the American Academy of Orthopaedic Surgeons 2020 Virtual Education Experience. 

Physically Demanding Jobs May Raise Risk for Knee Osteoarthritis: Occupational lifting, kneeling, climbing, squatting, standing versus sedentary work linked to knee OA. Arthritis Care & Research

Tanezumab Improves Pain, Function in Chronic Low Back Pain: Low back pain intensity at week 16 was improved with tanezumab 10 mg versus placebo. PAIN

Significantly less addictive opioid may slow progression of osteoarthritis while easing pain: A novel preclinical study by Keck Medicine of USC researchers, published in Arthritis & Rheumatology, reveals that a potential new opioid medication may have the ability to slow the progression of osteoarthritis while being less addictive than commonly prescribed opioid drugs.

A furrysocial robot can reduce pain and increase happiness: Researchers have discovered that a single, 60-minute interaction with PARO actually improved mood as well as reduced mild or severe pain. When participants touched PARO, they experienced greater pain reduction than when it was simply present in their room. Scientific Reports

COMPLEMENTARY & ALTERNATIVE MEDICINE

Medical pot mayhelp many battle insomnia, pain and stress: In a survey of nearly 1,300 people with chronic health conditions, researchers found that those using "medicinal cannabis" reported less pain, better sleep and reduced anxiety. They also tended to use fewer prescription medications and were less likely to have been to the hospital recently. The results do not prove, however, that medicinal cannabis is effective. It's also unclear whether certain products were linked to particular benefits. Cannabis and Cannabinoid Research

Factors maximize impact of yoga, physical therapy on back pain in underservedpopulation: New research shows that people with chronic low back pain (cLBP) have better results from yoga and physical therapy compared to reading evidence-based self-help materials. While this finding was consistent across many patient characteristics, a much larger effect was observed among those already taking pain medication to treat their condition and those who did not fear that exercise would make their back pain worse. Led by researchers at Boston Medical Center and published in Pain Medicine, the findings also showed that individuals who expected to do well with yoga were more likely to have a meaningful improvement in their function if they received yoga compared to receiving physical therapy. 

Meditation linked to lower cardiovascular risk: Meditation was linked to lower cardiovascular risk in a data analysis by Veterans Affairs researchers and colleagues. American Journal of Cardiology.

Cannabis shows potential for mitigating sickle cell disease pain: Cannabis appears to be a safe and potentially effective treatment for the chronic pain that afflicts people with sickle cell disease, according to a new clinical trial. JAMA Network Open.

FDA ACTION

• Approved Inqovi (decitabine and cedazuridine) tablets, an oral outpatient treatment option for patients with myelodysplastic syndromes and chronic myelomonocytic leukemia

• Approved a new type of antiretroviral medication, Rukobia (fostemsavir), for people with HIV who have not had success with other therapies

• Approved Phesgo to be given to a patient at home by a health care professional after completing chemotherapy for breast cancer treatment

PREVENTION: Exercise

Stretching your legs may help prevent diseases such as heart diseases and diabetes: New research in the Journal of Physiology shows that 12 weeks of easy-to-administer passive stretching helps improve blood flow by making it easier for your arteries to dilate and decreasing their stiffness. Passive stretching differs from active stretching in that the former involves an external force (another person or gravity) stretching you, whereas active stretching is performed on your own.

Mortality risk down with meeting recommended exercise levels: The risk of all-cause and cause-specific mortality is reduced for adults who engage in leisure time aerobic and muscle strengthening activities at levels recommended by the 2018 physical activity guidelines, according to a study published online July 1 in The BMJ. 

Study links increased exercise with lower sleep apnea risk: A study published online as an accepted paper in the Journal of Clinical Sleep Medicine found that increased physical activity is associated with a lower risk of obstructive sleep apnea, a common sleep-related breathing disorder. The study is the largest to date focused on the relationship between sleep apnea and levels of physical activity in the general community.

   

PREVENTION: Diet/Nutrition

A Small Amount of Fruits, Whole Grains Every Day Can Slash Type 2 Diabetes Risk: Two studies show that a modest increase in fruits, vegetables, and whole grains can reduce the risk of developing type 2 diabetes. One studyTrusted Source, dealing with whole grains intake, was conducted by researchers in the United States. The other studyTrusted Source, which analyzed fruits and vegetables, was authored by a team of European researchers. That increase can be as simple as consuming one or more servings a day of whole grain breakfast cereal or slightly increasing fruit and vegetable intake. The whole grains study found that those who consumed two or more servings of oatmeal per week had a 21 percent lower risk than those who had less than one serving per week.

Raw milk may harbor antibiotic-resistant germs: Analysis of raw milk samples bought in the United States found small numbers of beneficial bacteria alongside potentially dangerous antibiotic-resistant bacteria, which increased in number when left at room temperature. The findings, published in the journal Microbiome, suggest that raw milk could lead to the spread of antibiotic resistance, particularly if the product is not appropriately chilled.

Not All Food Sources of Fructose-Containing Sugars Raise Risk for MetS: The adverse association of sugar-sweetened beverages and incident metabolic syndrome (MetS) does not extend to other major food sources of fructose-containing sugars, and yogurt, fruit, 100 percent fruit juice, and mixed fruit juice all have a protective association with MetS, according to a review published online July 9 in JAMA Network Open.

 Plant Protein Intake Linked to Drop in Overall, CVD Mortality: Higher plant protein intake is associated with reductions in the risks for overall and cardiovascular disease mortality in men and women, according to a study published online July 13 in JAMA Internal Medicine.

Soy and wheat proteins helpful for building aging muscles, but not as potent as animal protein: On a gram for gram basis, animal proteins are more effective than plant proteins in supporting the maintenance of skeletal muscle mass with advancing age, shows research presented this week at The Physiological Society's virtual early career conference Future Physiology 2020.

   

PREVENTION: Supplements

Probiotics may reduce symptoms of depression: A new review has found that probiotics, or a combination of prebiotics and probiotics, may help reduce the symptoms of depression. However, the review found that prebiotics and probiotics did not have a statistically significant effect on anxiety. Also, prebiotics on their own did not significantly reduce anxiety or depression symptoms. BMJ Nutrition, Prevention & Health

Supplements with potential to prevent Alzheimer's affect blood, but less so the brain: In the first Alzheimer's prevention study to compare levels of omega-3s in the blood with those in the central nervous system, findings suggest that higher doses of omega-3 supplements may be needed in order to make a difference, because dramatic increases in blood levels of omega-3s are accompanied by far smaller increases within the brain. Among participants who carry a specific mutation that heightens risk for Alzheimer's, taking the supplements raised levels of a key fatty acid far less compared to those without the mutation. EBioMedicine

PREVENTION

Experts strongly recommend varenicline over the patch for adult smokers hoping to quit: Smoking cessation initiatives notwithstanding, along with provocative public health campaigns and clinical guidance, quitting tobacco has remained elusive for many smokers. The American Thoracic Society's new clinical practice guideline on treatment for tobacco dependence in adults addresses how clinicians may deal with patients' reluctance to quit, one of a number of issues not previously assessed in the older guidelines. American Journal of Respiratory and Critical Care Medicine. 

Flu Vaccine Cuts Cardiovascular Mortality in Adults With Diabetes: Vaccination was significantly associated with reduced risks for all-cause death, cardiovascular death and death from AMI or stroke. Vaccination was also associated with a reduced risk for being admitted to the hospital with acute complications associated with diabetes, like diabetic ketoacidosis, hypoglycemia, or coma. Diabetes Care

 

TREATMENT

Medical management alone better for brain AV malformations: Among patients with unruptured brain arteriovenous malformation, medical management alone is superior to its combination with interventional therapy for prevention of death or symptomatic stroke in the long term, according to a study published in the July 1 issue of The Lancet Neurology.

Risk for Heart Failure Increased for Women Taking β-Blockers: Women taking β-blockers for hypertension have an increased risk for developing heart failure when they present to the hospital with acute coronary syndrome, according to a study published online July 10 in Hypertension.

   
Baloxavir prevents spread of flu to household members: The antiviral drug baloxavir (Xofluza) prevented influenza in household contacts of infected patients, according to a study in the New England Journal of Medicine

Ticagrelor-aspirin beneficial for mild-to-moderate stroke, TIA: Ticagrelor-aspirin is associated with a reduced risk for the composite of stroke or death within 30 days of mild-to-moderate acute noncardioembolic ischemic stroke or transient ischemic attack (TIA), according to a study published in the July 16 issue of the New England Journal of Medicine.

Roflumilast Cream Promising for Chronic Plaque Psoriasis: Roflumilast cream is superior to placebo vehicle cream for reducing psoriasis severity, according to a study published in the July 16 issue of the New England Journal of Medicine.

High-fatdiet with antibiotic use linked to gut inflammation: Combining Western diet and antibiotic use is a pre- IBS (irritable bowel syndrome) risk factor. Cell Host & Microbe

World-first technology breathes new life into cystic fibrosis detection and treatment:  World-first research, led by Monash University, has developed radical non-invasive X-ray technology aimed at helping diagnose, treat and manage people with cystic fibrosis. The technology can pinpoint localised areas of deficiency in a lung, offering potential for faster and more accurate diagnoses. Researchers can track the movement of air through the lungs, improving their capacity to assess lung function in both healthy and diseased lungs. Scientific Reports

New guideline: Don't routinely screen for EAC in patients with chronic GERD: A new guideline from the Canadian Task Force on Preventive Health Care, based on a rigorous systematic review of the latest evidence, found no benefit of routine screening for esophageal adenocarcinoma (EAC) and precursor conditions (Barrett esophagus and dysplasia) in patients with chronic gastroesophageal reflux disease (GERD). The guideline, published in CMAJ (Canadian Medical Association Journal), recommends physicians in Canada continue current practice to not screen routinely

Medication Use Linked to Weight Gain in Postmenopausal Women: For postmenopausal women, antidepressants, beta-blockers, and insulin are associated with weight gain over three years, according to a study published online July 15 in Menopause.

OTHER

Surgery in older adults does not up risk for Alzheimer disease: Older adults who have surgery with general anesthesia may experience a modest cortical thinning in the brain, but it does not appear to be tied to Alzheimer disease, according to a study recently published in the British Journal of Anaesthesia.

Electronic Health Records Fail to Detect Many Medication Errors: Though broadly used in U.S. hospitals, EHRs fail to detect up to one-third of medication errors JAMA Network Open

Many OlderAmericans Face Ageism Every Day, Survey Finds: A new poll finds that most older adults encounter at least one form of this "everyday ageism" in their day-to-day lives and that more frequent encounters may affect their health and well-being.

 

 

 

 

 

 

 

Take a Break: Read Samuel Pepys Diary

As part of a talk I was preparing on Epidemics/Pandemics, I read quite a bit of Samuel Pepys’ Diary from the year 1665. It was fascinating. This website contains the diary and a lot more. 

In 1660 Samuel Pepys, an increasingly-important 26 year-old civil servant in London, began writing his diary. He stopped a decade later.

This site  contains the full text of his diary, along with several letters sent or received by Pepys, plus thousands of pages of further information about the people, places and things in his world.

The diary entries were published on this site daily, in real time, from January 2003 until May 2012, with readers discussing events each day. From January 2013 the diary entries will again appear on the front page at the end of the day (London time), starting with 1 January 1660.

Not interested in today’s activities, try the Take a Break Pinterest Board.

Life with Chronic Disease: Mask Wearing 101

At the beginning of Covid-19 pandemic in the US, the public was not encouraged to wear face masks for two reasons:

1)    Not a lot of data was available to know of its effectiveness

2)    There was a major concern the public would horde N95s and other types of personal protective equipment (PPE), which were in severe shortage, thereby jeopardizing the front line worker.

By late March, the Centers for Disease Control (CDC) had reversed their initial message and urged all Americans to wear cloth facial coverings while reserving higher grade protective equipment like N95s for hospitals and health care workers. They viewed this as altruistic prevention, since wearing a covering would protect others from the germs that could be carried by the wearer.

Since then, new data has come out which shows that not only can masking stop the spread of Covid and even the flu, but even a cloth covering will provide some protection to the wearer.

• May 27 Nature, Surgical face masks significantly reduced detection of influenza virus RNA in respiratory droplets and coronavirus RNA in aerosols, with a trend toward reduced detection of coronavirus RNA in respiratory droplets. Our results indicate that surgical face masks could prevent transmission of human coronaviruses and influenza viruses from symptomatic individuals. 

 • June, a World Health Organization study  found that masks may protect the wearer more than originally thought and that social distancing of 2 M (a little over 6 feet)  is more effective than 1 M (a little over 3 feet) in stopping the spread.

In the last week, a letter was sent to WHO, signed by 239 scientists from 32 countries, stating that the coronavirus can stay aloft for hours in tiny droplets in stagnant air, potentially infecting people as they inhale. WHO responded by saying "The possibility of airborne transmission in public settings, especially in very specific conditions — crowded, closed, poorly ventilated settings — cannot be ruled out. However, the evidence needs to be gathered and interpreted."

As it is, what is known is that the most effective way to transmit Covid is via droplets- A virus-filled particle of breath or spittle that comes out of the nose or mouth of an infected individual when they breathe, speak, cough or sneeze. Droplets generally fall to the ground within a few feet of the person who expels them. If the droplet lands on your eyes, nostrils or mouth-the person coughs in your face-you run the risk of becoming infected.

Aerosols probably have some contribution to the spread but to what extent isn’t known at this time. Viral spread via air currents has been documented in certain indoor environments: a restaurant in China where people were sitting downstream from an air conditioner and at a March choir practice in Washington state. In the latter situation, choir members became sick after most likely breathing in tiny airborne particles generated by individuals who were infected but symptom-free at the time. How long the virus lingers in the air, how far it travels (possibly through a room but not down the street) and how commonly it spreads this way are unknown.

In short, the best way to protect yourself is wear a facial covering, stay at least six feet away from people and avoid crowded places as much as possible. If you still have questions, watch this video. Actually watch the video as it's pretty amazing how they've been able to demonstrate the impact of wearing a mask. The photography/video is amazing.

So now for the myth busing portion of the program. Continued or prolonged use of face masks results in breathing too much of one’s own exhaled carbon dioxide, which can cause health problems, including hypoxia. Not true. Surgical and cloth masks do not fit tight enough to cause problems. Neither the CDC nor the World Health Organization have issued warnings suggesting the use of surgical face masks would result in dangerous oxygen level depletion within the general public.

Wearing a cloth or surgical mask does not cause you to breathe in unhealthy amounts of carbon dioxide.

Sore Throat from wearing a mask?: Recently, I was at a Memorial, were I wore a surgical mask for about four hours. I found that I had a sore throat and an ear ache afterwards. However, this was because the ear pieces were causing pressure. If I wear a tied mask, I have no problem and I’ve worn them for up to 5 hours at a time.

If you do not clean your mask, or your hands are dirty when putting on your mask, you can take in bacteria from the environment causing a sore throat. So be sure hands are clean when putting on your mask.  

How to wear a cloth face mask: Mayo Clinic offers some good tips on this.  Place your mask over your mouth and nose.

• Tie it behind your head or use ear loops and make sure it's snug. (Really hate it when peoples’ noses are sticking out)
• Don't touch your mask while wearing it.
• If you accidentally touch your mask, wash or sanitize your hands.
• Remove the mask by untying it or lifting off the ear loops without touching the front of the mask or your face.
• Wash your hands immediately after removing your mask.
• Regularly wash your mask with soap and water in the washing machine. It's fine to launder it with other clothes.
•  

When masks are not advisable: Don't put masks on anyone who has trouble breathing, or is unconscious or otherwise unable to remove the mask without help.

• Don't put masks on children under 2 years of age.
• Don't use face masks as a substitute for social distancing.
•  

Can I get a face mask exemption or waiver?: There is no such animal, even though fake cards and flyers abound. 

What kind of mask should I wear?: Look for masks made with at least 2 layers of fabric, preferably thick cotton. Hold the fabric up to the light. The fewer tiny holes you can see, the better it will work. It should cover your nose and mouth without large gaps. Look for a mask with a bendable border around the top so you can bend it to around the bridge of your nose.

What about creating my own filter?: Data is inconclusive on its effectiveness and some of the filters people are posting on-line could actually cause problems

Surgical Masks: These are often given out by hospitals and clinics and are designed for one time use. However, if you are careful, they can be reused, though not every day for weeks on end. Also you can’t wash them.

Check out the CDC’s Use of Cloth Face Coverings to Help Slow the Spread of Covid 19

What to do if you encounter people not wearing masks Yes, you want to shout at them but don’t waste your breathe. Just move as far away from them as possible. If they continue to move towards you, just tell them you are social distancing and back away as quickly as possible.