Kampuchea Crossings

Bump to baby on the beaten expat track

covid-19

Commuting and office work in the time of Covid

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After nearly a year of working from home, 10 days ago I started that commute back to an office environment at the hospital. Rapid-fire emergent findings, compounded by active misinformation and sabotage by the trump administration, and now these variants(!) make it very difficult for the average office worker to make sense of how best to protect ourselves.

So here I talk about what I use and what’s recommended: masks (always outside the home), goggles (for public transport, grocery store runs, or other crowded spaces), fans (to maintain air flow in the office) and, if needed, a portable air cleaner with HEPA filter for the workspace.

My commute is in the NYC subways where that ‘rush hour’ is still fairly crowded. In this age of mutant viruses, I am all about the protection cuz we are SO CLOSE to getting a vaccine(!) so here’s what I do on the commute and at the office:

Walking down the street with the wind blowing (usually), I just wear a mask. The double mask guidance is a stopgap, but effective: the surgical mask does not give a good fit so the cloth mask over it gives a better seal. If you can afford it, get yourself a good mask that satisfies three criteria:

  1. Fit – your breath should not fog your glasses or goggles – your breath should go through the mask and not escape out the top or sides of the mask
  2. Filtration – 3 layer tightly woven fabric is the current consensus for best filtration, until official criteria are released
  3. Breathability

Some great resources for masks guidance are below:

Here’s what Joseph Allen has to say about masks (he’s an epidemiology professor at the Harvard School of Public Health:

For that subway ride, I use GOGGLES. These are my favorites for the fit (small face, low nose bridge):

Below are my go-to MASKS for when I use public transport, for the office and any grocery store runs. I have several of each on hand and bring a spare with me when I go out. For work, I use one mask for the commute and switch to a fresh one for the day.

  • Livinguard 3-layer Safety mask with hygiene technology that uses negatively charge ions to trap and destroy germs. They aren’t cheap at $29.95 but their designation and the studies supporting the claims seem legitimate.
  • Rafi Nova 3-layer Performance mask, which comes with toggles to pull tight either the top of the mask or chin. They are 2 for $22.

In a hospital building, regulations require frequent air change so the ventilation systems are good. In an office environment, especially older buildings, we’re on our own. There aren’t many people in our office (all nurses and healthcare staff), and minimal visitors since the pandemic began (also all clinicians). I feel ok just having a variety of FANS moving air around, including this on my desk:

If you can afford a portable air cleaner with HEPA filter for your desk / cubicle / office, it can help cut down on your exposure. Below is what Dr. Allen has to say. And if you

And the tool referenced below, for determining the size of air cleaner needed, is in this link:

The Defense Production Act combined with the work done by the CDC should soon provide standard criteria and guidance, as well as a stable supply of reliable, certified masks at scale.

Stay safe..!

Until Covid-19 messaging improves, who do you turn to?

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It’s February tomorrow – a snow day here, yey!! – and over a full year into this pandemic. It’s frustrating that to manage every new situation, the general public still has to scour Twitter for a prevailing consensus. We don’t have better guidance on masks (like what type and where to get them) and managing risky situations like public transportation. I fully agree with this piece in the NYTimes: It’s been ten months, and I still don’t know when to replace my masks!

“Quickly synthesizing emerging evidence and providing practical guidance for the public and communicating it well is what the C.D.C. should be doing, and should have been doing. The new administration seems to have hit the ground running, and I hope that this is what it will be doing going forward.”

https://www.nytimes.com/2021/01/29/opinion/coronavirus-masks.html
Began using these when I started a new project; the NYC subway is packed at rush hour!

So, like many, I often field questions from friends and family (or push unsolicited advice to counter clearly misguided or false information). Since national messaging might take a while to cohere (there’s been active sabotage on our national systems and infrastructures, after all), below is a list of regularly updated and easy-to-understand resources that distill the rapidly changing Covid-19 advice for us lay folks. I’ve been referring folks to these same sites and experts for months cuz they’re who I turn to. Hope it helps!

On Masks, now that the variants are a real threat. Your mask criteria are FIT, BREATHABILITY, and FILTRATION. For example, if your glasses are fogging up then your FIT is off. See the below for great advice:

  • Great mask guidance for these precarious next weeks, in anticipation of the variants–> Friendly Neighborhood Epidemiologist (27 Jan 2021).
  • I’ve tried tens of masks on my family over the past year, e.g., masks from Etsy or retailers in the $5-30 range. I’ve put the others on a ‘backup’ bin and highly recommend these below. Note each one’s specific washing instructions to maintain full efficacy.
    • Livinguard mask – Their 3-layer Safety masks have the best fit and breathability for me and my family. The hygiene technology is based on positive and negative charges to trap and inactivate the microbes’ protein structure (destroying the virus) on contact. Read their FAQ for more info.
    • Rafi Nova – Their 3-layer Performance masks come with toggles to pull either the ear or chin seal tighter. We really love these masks and love the family’s philosophy on giving back to and helping the community. Some of their textiles are sourced from the minority communities in Laos.

Podcasts:

  • In the Bubble is a great podcast from Andy Slavitt, an advisor in the Obama administration and now a senior advisor on Biden’s Covid-19 Team. The conversations between the science, health and medical experts are designed for practical consumption by the general public. The January 18 episode is particularly useful, given the variants’ debuts and threats to impact the US (no new guidance, just double down on what we should already be doing). Slavitt’s Twitter stream is also excellent.
  • Unbiased Science talks about current issues in the sciences, and in the past year the topics have been mostly about Covid-19. But they still occasionally cover other items, like dismantling the myths around organics or helping to understand GMOs, etc.

Twitter streams:

  • Zeynep Tufekci – Turkish sociologist and writer, focusing on ‘the social implications of new technologies, such as artificial intelligence and big data, as well as societal challenges such as the pandemic using complex and systems-based thinking.’
  • Andy Slavitt – tirelessly engaging both professionals and the general public in conversation since this pandemic began, to offer all of us some practical guidance. From his profile: ‘White House Sr Advisor for COVID Response – Let’s Work Together to Defeat COVID-19. Past head of Medicare/Medicaid for Obama/Biden. Personal account.’
  • Michael Mina – Covid-19 diagnostics, like gold standards for testing and thoughts on public health approach. From his profile: ‘Epidemiologist, Immunologist, Physician, Harvard Public Health/Medical School. Discuss vaccines, immunity, infectious diseases, public health, and tests‘
  • Angela Rasmussen, PhD – From the latest studies to the newest guidance, her stream is very useful. From her profile: ‘Excessively direct virologist. Affiliate @georgetown_ghss. Soon @VIDOInterVac. Emerging virus host responses. 1X Jeopardy! loser. Rep: @anniescranton. she/her’
  • Peter Hotez, MD PhD – From his profile: ‘Vaccine Scientist-Pediatrician-Author-Combating Antiscience, Prof Dean @BCM_TropMed @TexasChildrens, Univ Prof @Baylor, Hagler Inst @TAMU, Founding Ed @PLOSNTDs‘
  • Eric Feigl-Ding, PhD – From his profile: ‘Epidemiologist & Health Economist. Senior Fellow, FAS. Fmr 16 yrs @Harvard. Health justice advocate. RoomRater 10/10. COVID19 updates since Jan ’20′

Facebook pages – and they are all women scientists from various fields, US states and backgrounds! They have also consulted each other to coordinate their content and messaging:

Pandemic winter activities

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It’s the holly jolly season year 2020 and we’re looking for things we can do safely, outside the house.

In NYS/NYC we’re thankfully not seeing the catastrophic surge that the rest of the country is now reeling from. But we’re seeing spikes across indicators (indoor activities will be restricted in NYC in a few days). And the vaccine rollout seems to agitate everyone into increasingly careless behavior. It’s like we’re in limbo – help’s on the way, but there are so many caveats and really we’re still in the throes of incompetence until that stupid buffoon is dragged kicking and screaming out of the White House. With all the mediocre-white-guy stupidity within the GOP my diet has often been reduced to late night popcorn and bubbly.

So sad but our exit strategy has been blocked all year 😭:

It hasn’t been too cold yet, thankfully, so we’ve been able to do outdoorsy stuff and aren’t cooped up as much as the spring.

With the newly-bald fauna, birds are all about the handouts. You literally only have to find some bramble anywhere in the city and put some feed out, and you’ll be the happening spot for warblers, titmouse, cardinals, chickadees, etc.

Tufted titmouse (Baeolophus bicolor)
Black-capped chickadee (Poecile atricapillus)

And why waste an opportunity to keep these kids out and tire them out? We brought the grill and had a picnic while they scrambled around Central Park’s geological quirks. Did you know that vast sheets of ice age glaciers once plowed across Manhattan, dragging and dropping a trail of rocks, today known as glacial erratics? You can see a lot in Central Park. (I took a fascinating tour once through the iconic park with Sidney Horenstein, a geologist from the American Museum of Natural History. RIP.)

Mourning in the time of Covid

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The kids had a sweet Grandma. She pushed her comfort zone to hang with us – she got on that 30-hour trip to Bangkok for our first kid and tried everything (durian, street foods, even a tuk-tuk ride straight out of the movie Ong Bak!). She always had a thoughtful gesture – I’d forget my own birthday and anniversary if it weren’t for her cards. And she loved our friends. She was always there.

Working with the upsides of this crisis

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When we transitioned back to the US five years ago I thought turbulence was the new normal, given all the changes in healthcare (mergers, acquisitions, hospital closings and new value-based arrangements that lead to all sorts of complex partnerships). There was a lot of restructuring in the sector and especially in the public hospital system where I worked. But that pace of change pales compared to this 2020 pandemic.

It’s now eight weeks into “New York on Pause” (our lockdown). We’re patiently waiting, yet aware that nothing will be “normal” again soon, if ever. It’s easy to descend into existential despondency at the state of the US (abysmal levels of incompetence and obstruction from the White House, anti-Asian discrimination and crimes, etc.). But we’re also at a critical threshold of opportunity. Conversations I’m having these days is how this crisis is impacting career, work, and raising kids, given that all long-term goals have to be re-evaluated now. And wow, where to start, so I will skim through the leading thoughts.

The unifier-in-chief in all this is New York Governor Cuomo. His daily briefings are so valuable because there’s new information every time I look at the news. Most of it has been bad (new pathologies were emerging almost every day for weeks) but there’s also a lot of good (so much neighborly efforts, like helping elderly people who are at highest risk get their groceries). But always, even through the roughest patches, he looked at the positives. He looks for the things that are doable, he asks for help and ideas, and he tugs on your sense of community and shared values. Whatever the shortcomings of his approach, he brought us all together on this. His briefings are broadcast daily across the globe.

And if you followed these briefings, there are a lot of things to learn about how the future is shaping up, at least in New York State. The leadership here at least seem to recognize the golden opportunity at this juncture to re-imagine and re-shape the future of this region. It’s not a stretch to think how our careers, lives and our kids’ education will change to accommodate all of this.

Cuomo frequently refers to the upstream factors around our epidemic and the response. Why are specific demographics more vulnerable? Why are hospital systems not coordinating? Why is the distribution of needed equipment and supplies so poor? The problems are so disparate, so far upstream, and yet they converged to create so much disruption and deaths in NYC. Cuomo identifies a lot of these, including issues of equity and social justice:

  • Over-reliance on the federal capacity
  • Too few geographic sources of raw and finished products and equipment (China)
  • Industries’ ability to coordinate (healthcare workers) and pivot production to where things are needed most (ventilators and masks)
  • Lack of resilience of community infrastructures
  • The role of systemic environmental racism, which consistently puts communities of color at higher risk of health issues – more crowding around homes and workplaces, associated poor quality of home and work spaces, the type of service work our communities typically take, unstable access to food / childcare / healthcare. This is just to mention a few!

Given the national political landscape, it’s so refreshing to have a regional coalition of governors who coordinate data-driven initiatives to 1) get us out of this mess, 2) guide the re-opening, and 3) lead the recovery.

(The daily briefings – over the course of two months now – literally touch on all the principles of population health. Watching them are like a refresher course on public health and epidemiology.)

These briefings and other developments in the country offer clues as to where all of us will be pivoting. In New York State and the Northeast, there is the creation of new industries to source our own products. This doesn’t have to revolve around manufacturing factories. There are plenty of maker space opportunities. In healthcare, hospitals will start coordinating more across the public-private-civil sector space, for more effective responses to crises. For education, California State University and others will conduct all Fall classes virtually. In business, NYC’s largest finance, consulting, banking, research firms won’t be returning their workforce to the office this Fall, and are contemplating a much reduced commercial real estate footprint in the future.

Notwithstanding current challenges, the implications are massive. These developments will be upending opportunities and re-organizing the entrepreneurial ecosystem.

In civil society / community-based organizations / communities, for decades there have been dialogue about the importance of cross-sector partnerships, and attempts at institutionalizing arrangements that incorporate voices from civil society. Who else knows how to navigate our communities and channel synergies at the grassroots? Certainly not the executives or academics or politicians! In this recovery phase, our communities’ role in the policy sphere is a no-brainer.

  • How do we get our community-based organizations and non-profit groups to become crisis-adaptable?
  • How do we tap into the sense of civic duty and shared social responsibility?
  • How do we build organizational capacity and the civic infrastructure to channel grassroots response? Hong Kong got through their epidemic despite their government! Why couldn’t we?!

For education and homeschooling, what does it mean to go through this period where all of society had to pivot to address a crisis where we have no idea what we’re up against? And then there’s the sheer pace of technological advancements during this time. Global crowdsourcing of clinical observations, preliminary research findings, emerging pathologies mean we’re deluged with information that is unfiltered and haven’t gone through rigorous peer review. How do we teach our kids:

  • To be data-savvy, literate and math-literate?
  • To expertly navigate the massive amount of information and to incessantly fact-check all information?
  • To stay current with advancements, such as the practical emergence of big data, the use of artificial intelligence and virtual reality technologies?
  • To navigate collaborative spaces, and work across industries and disciplines?

There’s so many opportunities here, at all levels of personal and work space, in community dialogue and the policy sphere. This experience with covid-19 has scarred a lot of us, where most of us in NYC do not know at least one person who died. It is a numbing experience, but it is a chance to turn all this into something positive, and it starts with each one of us who is navigating careers while raising kids. We just have to remember, no matter how bad things look, there’s always an upside. And we create opportunities from that.