CV🦠News – Week of June 15, 2020 – The Village Doctor

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CV🦠News – Week of June 15, 2020

Reflective greetings, TVD friends,

Juneteenth.

Juneteenth marks the day in 1865 when, more than two years after the Emancipation Proclamation, Union soldiers landed in Galveston, Texas, and announced the news of the proclamation to enslaved African Americans there. That coastal area of Texas, the most remote of the slave states, was the last to hear that the Civil War had ended two months earlier.

Celebrations date back to 1866, becoming more widespread in the 1920’s and 30’s, and recognized as a “holiday of significance” by the Texas legislature in the 1970’s, and finally a Texas state holiday in 1980. In the late 1980s there were major celebrations of Juneteenth in California, Wisconsin, Illinois, Georgia, and Washington, D.C.. In 1996 the first legislation to recognize “Juneteenth Independence Day” was introduced in the U.S. House of Representatives.

Did you know that? I did not. Again, thank you to my team for opening my eyes. I encourage you to read more here (on Wikipedia) or here (The New York Times).

Speaking of eyes, do you know about Jane Elliott? I did not, either. Ms. Elliott taught third graders at a school in Riceville, Iowa, a small town in rural northern Iowa. The day after Martin Luther King, Jr. was assassinated (April 5, 1968), she felt compelled to address the moment, and racial prejudice, with her class. She divided the children, who were all white, by eye color, and then she told the children that people with brown eyes were smarter, faster and better than those with blue eyes. Like Stanford’s famous Prison Experiment (why is this so much better known?) the results came within hours.

“The children with brown eyes were suddenly more confident — and condescending. They hurled nasty insults at the blue-eyed kids. The children with blue eyes made silly mistakes and became timid and despondent. The two groups stopped playing together. Fights broke out.

‘I watched them exhibit all the behaviors the significant adults in their lives modeled for them,’ Elliott said. ‘I didn’t like what I saw.’ What Elliott said she learned from the exercise was that people are not born prejudiced but learn the behavior. And if it can be learned, she said, it can be unlearned.” Read more here, or even more importantly, take a few minutes to watch her actual students in class here, or watch Ms. Elliott reproduce her experiment on “Oprah” (in 1992!) here.

Eye opening.

Lastly, Tulsa. June, 1921. The “burning of Black Wall Street”. We actually dropped bombs on our fellow citizens. Beyond eye opening, rather eye popping. Learn more here.

So on this Juneteenth, 2020, as many of us are still sheltering in place at home, please take a few minutes to read, learn, and open our eyes to the history of racism and racial injustice in our country. No matter brown, green, or blue, with open eyes we can work on making our world a better place for all members of the one true race, the human race.

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SHOULD WE CONTINUE TO GIVE OUR CHILDREN ROUTINE IMMUNIZATIONS DURING THIS PANDEMIC?
Yes, definitely. It is important to do your best to keep your child on schedule with their routine childhood vaccinations. Through 18 months old, most pediatric well child checks include vaccinations and it is important for your child’s health, and public health, to keep your child up to date. Since the Coronavirus pandemic began, childhood vaccinations have dropped off significantly both nationally and globally. The anti-vax movement in the US has already led to declining rates in recent years, but the pandemic’s toll on vaccination rates will be even harder to recover from. Globally, mass vaccination programs have been disrupted including 24 countries who have paused or postponed those programs. Based on the disruptions, the WHO estimates that “more than 100 million children worldwide could be vulnerable to measles. The[se] declines set the world up for a public health crisis.”

Here in the US, many pediatric clinics were able to quickly shift to telemedicine and made plans to continue vaccinating the youngest patients, however parental fear of exposure still limited well child checks and vaccines. Some clinics tried to adjust by creating drive-through vaccinations or quick outdoor vaccinations, but some could not do this for insurance or staffing reasons. At The Village Doctor, we have been fortunate to be able to keep our babies and young patients close to on schedule through drive-up vaccines, outdoor visits and strategically timed in-office visits to keep our staff and patient families safe. We are grateful for our patients who have trusted us to protect their families and will continue to do our best to keep all of our members safe. To read more about the importance of routinely scheduled childhood immunizations and the effects of the pandemic on vaccination rates, please click here.

WHEN CAN WE EXPECT TO DO EVERYDAY THINGS AGAIN? (THOUGHTS FROM 511 EPIDEMIOLOGISTS)
I think it is safe to say as we are well into the  COVID 19 pandemic. The changes we have seen as a community worldwide have been epic in proportion and will continue to define this generation. The questions that we face now are related to when is it okay to get on with our lives. If you ask Epidemiologists, the experts on disease modelling and what they would do, here are the answers. For a more in depth review in The New York Times, click here.

When would you get on a plane? Interestingly enough, while the airlines saw a 97% drop in air travel from mid-March to mid-April, air travel has picked up since then and many domestic flights are running near capacity. This reflects people’s individual risk tolerance and less travel that is deemed necessary. As far as the epidemiologists, only 37%  would get on a plane within the year. They feel the precautions one can take right now are not adequate protection. One person interviewed said he will wear masks for air travel all the time moving forward. It is not too unreasonable to think this particular aspect of COVID 19, wearing masks, will remain with us well into the future.

For nearer term questions, 56% said they would vacation overnight this summer and 64% would bring in mail without precautions soon. Only 41% would get a haircut this summer.

The majority of the epidemiologists agree that large gatherings are high risk and will be for a long time. Small groups are safer and outdoor gatherings are recommended. They themselves will avoid gathering indoors and only do so with masks in small groups. Large sporting events are high risk as Steve Mooney, from the University of Washington put it, “This is as much about feelings of social responsibility as about personal infection risk. Large-scale gatherings are a contact tracing nightmare and seem like they should be shut down until we have a really good sense of what’s safe/how to screen people.”

One of the biggest questions remains is school openings. Most experts agree that, if possible, schools can open with many precautions in place. The most important being limiting any large gatherings. Most agree that the deleterious effects of delayed and poor distance learning options for early childhood are too large to continue remotely. School openings are very tricky because they are regulated by counties, states and federal agencies and rely on them for funding. “With a young child, I think the developmental risks outweigh the risk of getting sick with Covid”, said John Nelson with Precision for Medicine.

Finally, hugs and handshakes: most of the epidemiologists in the article say they will not be doing either for a very long time at least until a vaccine is proven effective. Only 42% said they would resume in one year. “I think the handshake is dead. I would likely hug one of a few personal contacts in the distant future as a greeting where appropriate”, said Priyanka Gogna, of Queen’s University.

The world has changed and will be different for a long time. The old normal is likely gone forever, and our new, healthy habits will take time to learn. As individuals, we can follow the guidelines presented by the scientists if we choose for our collective health and safety. But we have seen that personal agency is a strong motivator for Americans, let us hope we make smart choices as we learn more over the coming years.

SORRY, IT’S TOO SOON TO STOP QUARANTINING. HERE’S HOW TO DESIGN A BUBBLE THAT KEEPS YOU SAFE.
The following is an abstract from Melissa Hawkins’ article in The Conversation. She is Professor of Public Health, Director of Public Health Scholars Program, at American University.

After three months of lockdown, many people are turning to quarantine bubbles, or Quaranteams, to try to balance the risks of the pandemic with the social and emotional needs of life.

When done carefully, the research shows that quarantine bubbles can effectively limit the risk while allowing much needed social interactions with family and friends.

Make no mistake, however, staying indoors, avoiding all contact with friends or family, and having food and groceries delivered would be the best way to limit your infectious risk, particularly if you are in a very high risk group. But overall health also includes mental as well as physical being.

The negative mental health impacts of the pandemic are already evident. A recent survey found 13.6% of US adults endorsed symptoms of serious psychological distress, up from 3.9% in 2018.  One quarter of young people 18-29 years old reported serious psychological distress, the highest levels of all age groups. Quaranteams, therefore, are not just a convenient concept to allow us more social interaction. Isolation poses serious health risks — both physical and emotional — that social bubbles can help alleviate while improving social well being and quality of life.

HOW TO BUILD A QUARANTINE BUBBLE
First, everyone must agree to follow the rules and be honest and open about their actions.  Individual behavior can put the whole team at risk, and the foundation of a Quaranteam is trust.  Teams (of less than 12 people) should discuss in advance what to do if someone breaks the rules or is exposed to an infected person. If someone starts to show symptoms, everyone should agree to self-isolate for 14 days.

Second, everyone must decide how much risk is acceptable and establish rules that reflect this decision. This is not a time for shyness or ambiguity, no assumptions should be made, no hesitations undiscussed. Some teams feel OK to have friends visit, but only outside and everyone must wear masks at all times. Other teams with higher risk members might not agree to that at all.

Finally, everybody has to actually follow the rules, comply with physical distancing outside of the Quaranteam, and be forthcoming if they think they may have been exposed. The rules can change over time as we learn more about this virus, so communication should be ongoing and dynamic, so everyone can completely understand and agree to any new rules.

THE RISKS OF JOINING A QUARANTEAM
Any increase in social contact comes with more risk. Understand two important considerations in deciding how much risk you are willing to accept in joining a bubble.

First is asymptomatic spread. Current data suggest that at any given time, up to 45% of infected people are asymptomatic or pre-symptomatic and able to transmit the virus to others. The best way to know is to get tested, and some teams might want to require testing before joining.

Second is that the consequences of getting sick are not the same for everyone. For people in higher risk groups, the risk must be seriously considered in relation to how strictly observant a Quaranteam to join, how many members it has, or whether to join at all. The consequences of a high risk person getting sick is much more serious.

One of the most unsettling aspects of this pandemic is uncertainty about this virus and what lies ahead. But some things are known. If individuals are informed and sincere in their quaranteam efforts and follow the regular guidance of social distancing, mask wearing, and enthusiastic hand-washing, Quaranteams can offer a robust and structured middle ground approach to manage risk while experiencing the joy and benefits of friends and family.

HOPE AND GRACE
If you have made it this far, time for a reward, something to lighten your day, and acknowledge the human spirit. Find some escape, or perhaps even inspiration, in this collection of works and perspectives gathered from around the world. Please contact me directly if you have come across something that has lifted your heart today.  Dr. Eric Weiss

In closing, please read this new and timely piece from my friend, Nichola ‘Nirmala Devi Maa’:

IGNORE = IGNORANCE

I have been in the process of stripping away the layers of my life…..a bit like ripping off a bandaid. And yet, underneath is a newness, a rawness, a pristine surface. Life is like that. Layers upon layers we construct. In some cases the construction simply deadens our sensitivity to the aliveness of life.

I knew an art consultant, actually considered the leading expert in the US on artist Willem de Kooning, who shared a personal story with me. The story was about his Limoges collection. He had a large Limoges collection arranged on the top of a side-table in his apartment in NY. One day his wife was cleaning the Limoges and one was broken. She put it aside, to share with her husband when he returned home. When he entered the door to their apartment, he instantly felt unsettled. He asked his wife, ‘Did something happen here today?” She showed him the broken Limoges. He told me that, for him, every piece of art (life) had a vibration. He had felt the disturbance when he entered his home.

Why I share this story is to say that life is subtle. Not everyone will feel the presence or absence of one piece of Limoges; however each of us can attune ourselves to be sensitive to life around us. This is why we practice meditation and pranayama. So that we can discern small shifts in vibrations. We can not avoid the vibrations of life around us, we can simply ignore them. Ignore = ignorance. To not attune yourself to see or to block that which you are capable of seeing, feeling and knowing is avoidance.

To live with this avoidance and not be pained by it, we acquire layers upon layers which deadens our experience of the world. The layers look different for each of us. We can call the layers distractions. How many distractions have you invited into your life? Possessions, relationships, control, perfectionism, racism, or judgement of self/other.

These distractions keep us from fully experiencing ourselves. They become impediments to our spiritual growth. To grow spiritually we must expand and touch the fire of life. We must touch the intensity of being embodied and in relationship with the entire cosmos. We can not construct adequate layers of distraction to fully cut out the ‘unpleasant’ pieces of life. We can only dim our experience of them. This also results in dimming our experience of the beauty of life.

Racism is an example of this. Many of us have simply deadened our perceptions so we do not have to see the burden of the color of one’s skin, the bias of education, and the prejudice of opportunity. NOW is the time for us to spiritually embrace the fullness and aliveness of life including that which is painful and difficult for us. To break the barriers of self and truly become a global citizen.

This can only happen individual by individual. We must choose to let go of the layers of our lives which cocoon us in a false reality. The constructed layers that insulate and isolate. Begin today by listing the distractions in your life. Being aware allows us to deconstruct these distractions. Let go of old paradigms and embrace reality.     Blessing, Nirmala

FINAL NOTES:
Newest Podcast is a lovely 20 Minute Guided Spirit Breath Meditation. Link
I am now offering one-hour guidance, spiritual discernment sessions. To Schedule

*****

Yours, in health and resilience,

Eric and the TVD MD team…