Sunday, April 26, 2020

Calm down!

I’m reluctant to write this, but here goes: I don’t worry about getting Covid-19. Here’s why: I don’t know anyone who has the virus. In my county (population 275,000), there are, as of this writing, only 115 cases; two have died.

In Washington state, one of the first people to be diagnosed with the disease is a man who had traveled to Wuhan, China, in January. None of the people he was with on his return home contracted the disease—not his Uber driver, his lunchmates at a restaurant, or the other patients at the clinic where he was first seen. In New York City, one of the first people to die of the disease was a doorman. Except for his mother, with whom he lived, none of his family, friends, or co-workers contracted the disease. His mother’s case was mild. Prince Charles had the disease; his wife, Camilla, did not get it. And so on.

As a rule, to become infected, you inhale virus-laden droplets from an infected person who has sneezed or coughed, or maybe shouted. If you get the virus on your hands, you can get the disease by touching your face (it enters through your mouth, nose or eyes). 

In response to the question of whether you can get the disease if the virus lands on your clothes or hair, one infectious disease expert describes the process: “You have to have someone who sneezes [or coughs, or whatever], and they have to have X amount of virus in the sneeze. Then there has to be so many drops that land on you. Then you have to touch that part of your hair or clothing that has those droplets, which already have a significant reduction in viral particles. Then you have to touch part of your face. When you go through the string of events, that makes it a very low risk.”

In Washington state, a bunch of square dancers contracted the disease, as did revelers at Mardi Gras in New Orleans as well as attendees at a Bar Mitzvah in New Rochelle. In these close-contact environments, a sick person has plenty of opportunity to spread the disease. But of course, we are no longer in close contact with crowds. By the way, in New York City, there are 28,000 people per square mile.

I know. Laboratory studies show that the virus droplets can become aerosolized and linger for a bit in the air, and that the viruses can live for a time on hard surfaces. But what are the chances of your catching the disease that way, especially if you live in an area where few people (relatively speaking) have the disease? Pretty slim, I’d say.  

I take this disease seriously: it’s deadly and widespread. I’m all for sheltering in place and social distancing. Still, if your circumstances are similar to mine, I think your chances of getting it are remote. So don’t go overboard with the Clorox. According to poison control centers, people are poisoning themselves with it.

For an introduction to this blog, see I Just Say No; for a list of blog topics, click the Topics tab.

Sunday, April 19, 2020

The rapacious behavior of big chain pharmacies

As a rule, the big chain pharmacies strive to increase profits by understaffing and devising performance “metrics” that must be met by pharmacists. Basically, the performance metrics amount to dispensing as many pills as they can. To sell more drugs, the pharmacists are required to call doctors and doctors’ patients—dozens a day—to persuade them to prescribe more drugs or, in the case of patients, to request additional refills. Doctors complain that pharmacies bombard them with requests for refills that patients have not asked for and should not receive. The refills are closely tracked by the pharmacy and can factor into employee bonuses. In addition, pharmacy personnel are supposed to persuade patients picking up prescriptions to sign up for automatic refills, switch from 30-day supplies to 90-day, and contact their doctor with a “proactive refill request” if a prescription was expiring or had no refills.

As to understaffing, in addition to the tasks described above, pharmacy workers are expected to give flu shots, tend the drive-through, answer phones, work the register, and counsel patients. One pharmacist said that on one day he filled 552 prescriptions—about one every minute and 25 seconds. (He quit the next day.)

Of course, plenty of mistakes are made. Here are some examples: blood pressure medicine instead of asthma medication; ear drops instead of eye drops; a chemotherapy drug instead of an anti-depressant; estrogen instead of an anti-depressant. The woman who took the chemotherapy drug died. When people sue, they’re required to sign non-disclosure agreements in order to get their settlements.

In the US, people spend more than $300 billion on prescription drugs every year. About 70 percent of of these are dispensed by chain drugstores. CVS garners a quarter of the country’s total prescription revenue and dispenses more than a billion prescriptions a year. Near as I can tell, they're the worst. Best avoid them.

For an introduction to this blog, see I Just Say No; for a list of blog topics, click the Topics tab.

Sunday, April 12, 2020

Coronavirus taxonomy and nomenclature

A virus consists of nucleic acids (DNA or RNA) enclosed in a protein coat. Because viruses can replicate only in living cells (bacteria, fungi, protozoa, plants, animals, humans) they exist in a gray area between living and nonliving.

There are a gazillion viruses living everywhere on earth. Most of these have not been identified.  Scientists identify viruses by sequencing their genomes. So far, they have identified only 6,828 species. A novel virus, such as the coronavirus that causes Covid-19, is a new strain that has not been previously identified in humans.

 Coronavirus is a family of viruses having the distinct covering of spikes (crown).
It contains 39 known species. Other coronaviruses include those that cause the common cold, “bird flu,” SARS (severe acute respiratory syndrome) and MERS (Middle Eastern respiratory syndrome).

The name of our current disease, Covid-19, stands for Coronavirus Disease 2019.

Covid-19 is caused by a virus called SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2). It belongs to the same species as the virus that causes SARS (hence the name).

SARS-CoV-2 is a betacoronavirus, which means it had its origins in bats.

OK, sort of boring, but clarifying maybe?

For an introduction to this blog, see I Just Say No; for a list of blog topics, click the Topics tab.

Sunday, April 5, 2020

Worry, stress, and anxiety

Worry, stress, and anxiety are different emotions and have different effects on your body. Worry happens in your mind; stress happens in your body; anxiety happens in your mind and body.

Worry is your mind dwelling on negative thoughts, uncertain outcomes, or things that could go wrong—inability to pay the mortgage, failing a test, and so forth. It’s a way for our brains to keep us safe. Unpleasant as it is, worry stimulates our brains to take action or solve problems. However, worry is only helpful if it leads to change. It stops being functional when it leads to obsessive thoughts. If you’re stuck on obsessive thoughts, research has shown that writing down your concerns helps to calm the brain.

Stress is a physiological response to a stressor, such as a work deadline or scary medical test. It’s your body reacting to a changed situation. In prehistoric times it was a useful response to a threat, such as a nearby predator. It releases adrenaline and cortisol to help our brains and bodies deal with a threat. Today it stimulates the same behavioral response, but if the stress becomes chronic, your body stays in this fight-or-flight mode continuously, making you more prone to health problems, such as digestive issues, heart disease, and a weakening of the immune system. Research shows that exercise is a good antidote to stress, as is focusing your energy on what you can control and accepting what you can’t.

Anxiety is a sort of combination of worry and stress: its cognitive element is worry and its physiological response is like stress, but in the absence of a specific stressor. Basically, anxiety is what happens when you’re dealing with a lot of worry and a lot of stress, such as financial concerns, or relationship issues. Feeling anxious is normal, but an anxiety disorder is different. It’s a serious medical condition affecting 40 million people in the US. For normal anxiety, research has shown that wiggling your toes breaks you out of your anxiety loop.

I’m fortunate in not being particularly prone to feeling stressed or worried, even in the face of the coronavirus. Of course, like everyone else, I worry about this or that, such as whether our cat will pee on our bed tomorrow morning, something she does from time to time.

For an introduction to this blog, see I Just Say No; for a list of blog topics, click the Topics tab.