Background

Context

Hope you are well.  95+% of us will get through the current ☣⚕︎ COVID-19 coronavirus disease pandemic of 2019-202x.

✋︎ On the other hand:

Bring down those COVID community-transmission numbers!

✋︎ On the third hand, life today is way better than in years , , , and especially the year the year (and the year or 5 or 10 after that).

Don't be scared.  All of this is new to you, and new can be scary.

    — #DoctorWho 13 premier.
image of The Plant Disease Triangle, select to read

☣ ⛬ The Disease Transmission Triangle

For disease to be transmitted, all three of these must be present in the same place and time (kinda like the ⛬ Fire Triangle):

  1. A 👤︎ host susceptible to the disease.
  2. A ☣ disease-causing agent.
  3. Environmental conditions suitable for transmission of the disease to the host, and growth of the disease in the host.

So if we want to not get the disease, we must reduce one or more of these factors, at least so all three factors are not present in the same place and time.  For example:

  1. Make ourselves less susceptible to the disease.  E.g., by getting 💉︎ vaccinated to the disease-causing agent, and by staying otherwise healthy.
  2. Reduce the amount of ☣ disease-causing agent in our environment.  E.g., by doing anything that reduces the number of people in our community sick with the disease, or the amount of disease-causing agent they shed, perhaps by having them use the measures listed ↑↓ above and below.
  3. Reducing the space and time where conditions are suitable for transmission and growth of the disease.  E.g., by masking;  and going into the community less often, for shorter periods, and/or during quieter hours.  These latter tasks all involve much better planning for shopping and other visits into the community.

Detailed analysis of how this affects me, my family and COVID-19 today.

Early life during COVID-19

image of people wearing masks during the 1918 flu pandemic, select to view more 👤︎👥︎ To protect yourself and others,
⚕︎ Dr Fauci [1] and ✈︎ Alaska Airlines say we need to:

  1. Wear a mask consistently and correctly.   😷 Mask up! Why?   😷 Masks and other PPE.
    [ Details on when to 😷 wear masks. ]
    [ Indoor air-handler filters are also important.]
    [We also wear 👓︎ eye-protection, to protect other mucous membranes!]  👍︎

  2. Avoid crowds.     X 👥︎👪︎👥︎👪︎ X     👍︎

  3. Distance yourself.   👤︎ — 👤︎
    [By 2020-April, known to be less important than the other actions, due to COVID-19 being transmitted primarily by very-small aerosols, not big droplets. [2] ]
    [Although later, the Omicron variant was shown to attack the upper-respiratory tract more than the lower- like Classic and Delta, so social distancing/physical distancing outdoors is, for the first time, useful. ]  👍︎

  4. 🏞 Outdoors, if you can.   ☀︎
    [By 2022-January, outdoors is known to be 19 × safer than indoors against transmission of the Omicron variant. [4] ]
    [Later shown to be 18–20–200–1000 × safer than indoors. ]  👍︎

  5. 🧼💦︎👐︎ Wash your hands.
    [By 2020-April, known to be less important than the other actions, due to COVID-19 being transmitted primarily by very-small aerosols, not big droplets. [2] ]  👎︎

Seems they know about ⛬ The Disease Transmission Triangle.

= For full effect, select the ✈︎ Alaska Airlines video image above or to right, then icons  fullscreen,  captions,  ▶︎ Play, and ⏯︎ ☒ Skip Ads.

👤︎ Protecting yourself as above includes protecting yourself from:


I read that those infected with the virus have a 33% chance of developing Long Covid, even if symptoms during the initial infection were extremely mild. [citation needed]

By taking precautions to not catch the virus, you have a 0% chance of developing Long Covid (or a low chance).  Helped a lot by also taking the vaccine.

Chart of symptoms.   Predicting who gets Long COVID.

If you don't want Long Covid, you don't want Covid.
  If you don't want Covid,        get vaccinated.

That is huge.  And continue to take some precautions …

For me, I find:


This tells me a lot!

Since these conditions are independent of each other, we multiply their odds.

For example, versus attending an indoor event with food while not-vaccinated, attending an:

  • Indoor event with food (restaurant meal?), where I am fully-vaccinated-and-boosted reduces my odds of catching COVID-19 by about                 20  =     20 ×.
  • Outdoor event,  with food (a restaurant patio?), where I am fully-vaccinated-and-boosted reduces my odds of catching COVID-19 by about         20 × 20  =   400 ×.
  • Outdoor event,   no food,              where I am masked and fully-vaccinated-and-boosted reduces my odds of catching COVID-19 by about 20 × 20 × 2½ = 1,000 ×.

Now I know what to do!

image of children's book Why We Stay Home: Suzie Learns about Coronavirus, select to read

🚼︎ For kids!  Free book Adobe Acrobat Reader file  Why We Stay Home:  Suzie Learns about Coronavirus, full contents at image above or to left.

🚶︎ For adults: "Medical students write, publish illustrated coronavirus children's book"
  by Janelle Ringer.  Loma Linda University.  .
  "A book that teaches children 'Why We Stay Home'."  NewsHour.  PBS.  .

If you are a healthy young person, who wishes to 🚶︎🏠︎ travel to visit someone who is immuno­compromised or otherwise medically-vulnerable …

Consider that whatever guidelines come out from the 🇺🇸 USA CDC, or your state or local governments, to be general guidelines meant for the general population.

  • Your immuno­compromised / medically-vulnerable person is not in the general population.

As long as community transmission levels remains "not-Good," your vulnerable person probably would be happiest to see you, if you …

Are 💉︎ vaccinated, to the maximum extent allowed by our society.


Prior to 14 days prior to your visit, your immuno­compromised / medically-vulnerable person, probably don't care what you do:

  • Go to work, mingling with coworkers, if you wish.
  • Eat and drink with others, indoors or outdoors, as you wish.
  • Go to 💪︎🏊︎ gym, if you wish.  Work out maskless, if that makes you happy or makes for a better workout.
  • Go 🗣 sing with your group, masked or not, if you wish.
  • Have a ball.
  • Your vulnerable person may be self-isolating pretty tight during weeks of high community transmission, but you may have other criteria.
  • But it you catch anything, you want it to clear up before the start of the 14-day washout-period described below.
       So you might choose to start ramping up a few days early — treat it as practice

For the 14-day washout-period prior to visiting your immuno­compromised / medically-vulnerable person, you quarantine / self-isolate yourself equivalent to what they are doing.   This may include (among other things):

  • Everyone in your household adheres to these rules.
  • 🚶︎🏠︎ Outside your home, be ready with a mask at all times.
       When I leave the house, it is around my neck (all my earloop masks have add-on neckstrap and bracket).
       Backup masks in car and briefcase.
       When I drive somewhere, I park, then don and adjust my mask while still in the car.  I don't have to, but I find it easier to do this before filling hands with briefcase, shopping bags or whatever.
      Masks are effectiveN95[?] or other rated masks, engineered medical masks, or (before Omicron) 3 layers of tight-woven cotton (no knits).
      Mask fits and seals well against your face.
       Set all that up at home.  I use a neckstrap and bracket on all mine.
       If indoors with non-household members, you are fully-masked, full-time.
       Minor exceptions for occasional meetings with very-small groups of people who are self-isolating as well as us.
  • Outdoor activities are fine, in any location with lots of fresh air, and low–moderate density of people.
       Chatting and eating on patios, walks in parks, and walk-and-talk meetings, are all fine.
       Does not include sitting in a crowd in stadium bleachers.
  • Never rely on a building's HVAC system (heating, ventilation, air-conditioning).  These spread small particles very effectively.  6 feet or 60 or 600 -- does not matter.
     ◦  Stay masked.
     ◦  No going to 💪︎🏊︎ gym without being masked.  I don't care about the layout or air circulation pattern — see note on HVAC above.
     ◦  No potlucks with coworkers.  Unless you chat while masked, assemble a plate, then go back to your separately-filtered-office to eat.
       If you have an office with a door:
        Get or make a portable room air filter device, MERV=13 or better, or HEPA.  We have one in our bedroom (helps with allergies), and another by the bird (helps catch feather fragments).
          Assemble filter unit, and place in your office where it blows vaguely toward your face at your desk, and sits between you and the door.
          When you get to your office, drop your stuff, turn your filter on High, go chat with others, get your mail and whatever, and pour some coffee.
          When you return to your office, turn the filter to Low or some reasonable level of noise.
          When 15 minutes are up, you can drop your mask, drink your coffee, work, eat lunch, whatever.
          If someone comes in to talk, mask up again, until they are done, gone and some minutes have elapsed.
          When leaving for day, can turn off your filter.
          Many 🏫︎ teachers have done this since 2020-March.
  • No eating or drinking indoors with others.  Minor unavoidable exceptions for:
     ◦  ✈︎ Airplanes (wait until wheels-up [engines spinning for a while], and all others nearby have finished their juice and cookies and restored their masks, — thank you for this suggestion, daughter).
     ◦  ✈︎ Airports (find a very-quiet spot to have your breakfast bagel and drink), mask up immediately when done or between bites.  Or bring it on your next plane.
       Occasional meetings with very-small groups of people (e.g., 1) who you know are self-isolating as well as you.
  • Minimize trips to indoor venues:  food shopping (masked up, good list, in order of your path around the store), medical (masked up), etc.
  • Any possible exposure to individuals with COVID-19, and any symptom of anything, will restart your 14-day washout-period at the beginning.  After the exposure or symptoms end.
       Presumably means you must waive off your planned visit.
       Possible exceptions for seasonal allergies and other well-understood conditions.
  • For additional assurance, 7 days into this 14-day washout-period, with enough time to get the results before you leave (perhaps 48 hours for PCR, plus another 24 hours of overhead involved in your testing appointment and getting your results), get tested for COVID-19.
  • If your visit is for a single day, you can get an at-home Rapid Antigen Test RAT, perhaps having people wait masked or outdoors for the 15–30 minutes it takes to get results.

Then when you arrive, you can all feel safe and happy, and have a great visit.  Unmasked!  Reconnect happy, without fear!

Sorry, that is how I see life today.  I hope that we can return community transmission to low levels, with adults now getting newly-vaccinated again, with Elementary-age kids now being vaccinated, backed up with better mask-wearing by our communities.

Don't panic, [it's] not the end of the world.  Well, it could be the end of the world, but one thing at a time.

    — #DoctorWho 13 premier.

image of Tyrannosaurus Rex, Couldn't wash hands, is now extinct, select to see CDC findings and recommendations on the coronavirus that causes COVID-19 image of Everything will be a little weird, a bit challenging, different than what you had imagined, manageable, select to see source

It is important. "A closer look at how COVID-19 damages human lungs."  News Medical.  . DOI: 10.1038/​s41467-021-23533-x   Accessed .

To protect 👤︎ yourself, 👪︎ family, 👥︎ friends, coworkers, elders, and 👥︎🌐︎ all other residents of our planet, please help break the chain of transmission — flatten the curve and push it downward — by following recommendations from 🇺🇳 UN World Health Organization WHO, 🇺🇸 USA CDC (expert version), Consumer Reports magazine, Doctor Who, 🏞 parks, Michigan, Kent County, local healthcare provider Spectrum Health, and your local authorities.

If 👤︎ you or 👪︎ family members are risk-averse, such as having an attribute that makes them immuno­compromised / medically-vulnerable to the 🔆︎ coronavirus, when 🚶︎🏠︎ you leave home, do so smartly.  Plan carefully.  Have a list.  Reduce your number of shopping trips.  Shop at good times:

  • Our local big-box membership store had minimum shoppers, maximum physical-distancing, and then-99+% 😷 mask-compliance during their "Senior Hour" each day.  Was way better than later.  Now scaled back to two hours a week, and poor mask-compliance.  (Although still better than during regular business hours, with terrible mask-compliance.)
  • Our local big-box grocery store was also best during their "Senior Hours" and pretty good a little after that.  When they had those "Senior Hours".
  • Have not found there to be a best time at our local hardware stores/home centers.  Don't go just before Closing — it's a zoo!
  • From other areas, I hear that grocery stores are good during dinnertime, and at .  Have not tried.

If you come out of this, and you've lost weight, you're just doing it wrong.  🎂︎

    — Margaret Choo, New York Museum of Art, on PBS Inside the Met S1Ep1, 2021-05-21.

My daughter says that during this pandemic, the happiest people on our planet may well be 🌱︎🚶︎  gardeners. [support] [more support]

Practice random [acts of] kindness, and senseless acts of beauty.

    — Anne Herbert.

👤︎ Protect yourself.  👥︎ Protect others.  💉︎ Get vaccinated!

💉︎ Vaccination

Which 💉︎ immunization should I get?
How do I get a 💉︎ vaccination?

How did the 💉︎ first immunization go for me?   Afterward, now what?
How did the 💉︎💉︎ second immunization go for me?
The 💉︎💉︎💉︎💉︎ third and fourth immunizations — the boosts

How do I get a 💉︎ vaccination?

In the 🇺🇸 USA, anyone age 5 and older can now sign up at Vaccines.gov > button Find COVID-19 Vaccines > your ZIP Code.  Check out the 🗺 map!  Or 📱︎ SMS text your ZIP Code to GETVAX.   The vaccine is free!

Or use its sister-site Vacunas.gov > botón Encuentre vacunas contra el COVID-19.  O 📱︎ envía un SMS con tu código postal a VACUNA.   ¡La vacuna es gratis!

But we received the 💉︎ COVID-19 vaccine 4½ months before we were eligible.  Not because we deserved it at that time, but because we dug.

These are all websites.  You can also try 📱︎☎ calling, particularly your local providers.  If trouble getting through, I recommend trying:


People I know found COVID vaccination appointments by signing up with several organizations in parallel.  These sites differ in what they offer you:


People I know found COVID vaccination appointments via their local:


When we got our appointment, we were Registered and on waitlists at several providers listed above.  To reduce risk, we decided to keep our places in line, until the 💉︎💪︎ vaccine was in our arms.

How did the 💉︎💉︎ second immunization go for me?

The 💉︎💉︎ second dose also went smoothly.  What now?

When You've Been Fully Vaccinated from 🇺🇸 USA CDC Interim Public Health Recommendations for Fully Vaccinated People from 🇺🇸 USA CDC

After getting the 💉︎💉︎ second immunization, and informed by the above, we decided to:

  • Continue 😷 masking up 100% in grocery stores, ✈︎ airports and airplanes (wheels down), for the rest of my life.
    I like not ever catching a cold nor the flu!  Nice!  I'm not going back.
    If you can take an action with very little cost [to you], and with some gain [for you or others], why not do it?
  • We will always have 😷 masks in our Everyday Carry (EDC), whenever 🚶︎🏠︎ we leave home.
    [When community transmission increased dramatically, I made sure this includes an N95-or-batter mask.]
  • Not wearing a mask on 🚶︎🏠︎ walks in the neighborhood, 🏞 parks, or any low-density outdoor events.
    Although I will continue to track prevalence in the community (and any proposed travel).

And in the many months since then, we have!

And because local community transmission was Low at the time, we also decided to:

  • Return to the ✂︎ haircut store.
  • Start attending important indoor meetings.  And if a quality crowd (e.g., highly-vaccinated), opting for a 😷 lighter-weight mask.
  • Return to the 💪︎🏊︎ gym.   Yay!
  • Return to ✈︎ air travel.

When local community transmission increased dramatically, we reversed these decisions.  All of them.

We also came up with some criteria we expect visitors to abide by.

Maybe I will write up more differences of living in our brave new living-with-COVID world.

Thinking about it, us choosing to:

  • not wear a mask much 🏞 outdoors,
  • reduce our time indoors with non-vaccinated people (such as by shopping during "Senior Hours", or using the 💪︎🏊︎ gym when relatively quiet), and
  • when sharing indoor space with non-vaccinated people, 😷 wear a mask whenever practical to do so (such as in 💪︎🏊︎ my gym before and during warmup, and after some point in the cooldown) (and the eating part of a rare restaurant indoor meal),
is an attempt to reduce our odds of catching COVID (while meeting our other goals), as expressed by my calculations up in Analysis.

Historical context

In the 🇺🇸 USA, in the absence of federal guidance, every state or other jurisdiction is handling 💉︎ vacci­nation differently.  In late 2020 and early 2021, this process was so disorganized, it felt like us vaccine-seekers were participants in ♐︎ The Hunger Games.

Unlike a real immunization effort in -, where our society immunized:

  • 84%  of the entire population [versus 67% so far in this immunization effort (77% partly-immunized)], with
  • 3 doses given to each person [versus 2 doses     in this immunization effort (1 dose for J&J)],     in only
  • 6 days, spread over 3 months [versus 515 days, spread over 17 months so far in this immunization effort]!  [5] [6] [ [7] ]

And in that operation, no one had to drive across the county to a stadium — they did it in high school gyms.  Everyone can get to their nearest high school.  OK, if the vaccine-athon can travel to high schools, it can also travel to 🏥︎ hospitals and Long-Term Care Facilities LTCFs , to handle their specialized populations.  But why, this time around, do we have to reinvent every wheel, and do such a bad job of it?

OK, Public Health officials in 1962 had several advantages that we don't have this time around.  Still, their process was the exact opposite of what we are doing now.

More applicable to today's situation is smallpox;  like COVID, it requires an injection.  Anthony Fauci has a great story about New York City immunizing 5 million New Yorkers in a single week! [citation needed]

Fortunately, as 2021 progressed, we got much more organized.  Yay!

image of White House memo on COVID-19 pandemic, select to read it image of White House playbook for infectious disease threats, select to read it
Yes, we really did know all this!

Above or to left, view White House memo from , White House Playbook from , and videos from and .

For full effect, select a video image, then icons  fullscreen, 💬 captions,  ▶︎ Play, and ⏯︎ ☒ Skip Ads.

image of graphic novel Germ Warfare: A Very Graphic History by Max Brooks, select to hear audio or see video or read
"'All Of This Panic Could Have Been Prevented':
 Author Max Brooks On COVID-19."
 Fresh Air with Terry Gross.  NPR.  .
which mentions 🦠 "Germ Warfare:  A Very Graphic History."
 Max Brooks.  April 2019.
> ▶︎ Play audio, ▶︎ Play video, or button FREE Download for Graphic Novel.Adobe Acrobat Reader file 

There is a theory which states that if ever anyone discovers exactly what the Universe is for and why it is here,
it will instantly disappear and be replaced by something even more bizarre and inexplicable.

There is another theory which states that this has already happened.


    — Douglas Adams, The Restaurant at the End of the Universe.


For full effect, view the video above or to left by selecting the video image, then icons  fullscreen,  captions,  ▶︎ Play, and ⏯︎ ☒ Skip Ads.  ▶︎  Trailer.

References

[5]  Yes, my sister and I remember — we were there!  Personal communication, various dates, including .

[6]  "Cuyahoga County had best record in the nation for Sabin polio vaccine distribution".  Cleveland.com.  .   Accessed .

[7]  "COVID-19 Vaccinations in the United States".  CDC.  .   Accessed .