Ghosts and Radios/Happy Fathers Day

 

Ghosts and Radios

My dad was the youngest of four brothers. These brilliant men were all physicists and they all played the violin. Someone once referred to them as the vio-physicists; I loved that. Sadly, my dad ended up with dementia and even though he was the youngest, he was the first of the four brothers to die. We lost him in 2007 at the age of 80. His older brothers remained sharp and mostly healthy for many years. The third youngest, my Uncle Melvin, is 99 and doing great. The year after daddy died there was a large family party for his second oldest brother Elmer’s 90th birthday in Houston. The remaining brothers, along with my sisters and every one of my first cousins decided to gather. The Jewish term for a happy occasion is a 'Simcha'. This translates to happiness. In our extended family, people make it their business to travel far and wide for these events. There were multiple generations in attendance from all over. It was wonderful being together, but my dad’s absence was like a gnawing toothache. He left such a gap. It was a lovely weekend. Houston is an enormous sprawling city, so getting from place to place was a bit of a hassle. This was before google maps or Waze and we spent more time than we wanted getting lost. We were constantly calling Sandy back in San Francisco to get out a map and navigate for us. On the last day of the trip, we were on our way to a BBQ at the home of Uncle Melvin. I was in the car with my mom and both of my sisters. My older sister was driving. We were having a conversation about how much we missed dad, but somehow felt his presence. We all realized that while we were talking, Marjie had missed the exit. We immediately started giving different directions to poor Marjie. “Go straight, go right, go left” At the SAME moment, with all of us shouting out, we realized that the car radio was now blasting. Rap music was pulsating. It was cacophonous. There was no way we would have been able to talk over that. Marjie reached over to turn off the radio. “Did any of you turn that on?” None of us had. The radio had simply turned on. It happened right when we were thinking about dad. “Dad? Was that you? Rap music? Really???? That’s the best you could do?” We found our way to Uncle Melvin's and of course we were all buzzing about how the radio had seemed to spontaneously turn on. They all looked at us sideways. I don't blame them. If I hadn't been in the car I would have had a hard time believing it. During the course of the afternoon, I asked uncle Melvin what the classical station was, so that we could listen to that on the way to the airport. My dad would have preferred classical to rap, hands down. “That would be 88.7 of course” A few hours later, when we returned to the car, the radio was already on as soon as we started the engine. I know that we had turned it off when we left the car. It was no longer tuned into the rap station. It was set on 88.7. Vivaldi was playing. Wow, so had someone snuck the keys away from Marjie, gone into the car and changed the station? I didn’t think so. I really felt like this was a hug from my father. It didn’t need to make sense, my heart was full from it. Later that week, my cousin shared an article about uncle Elmer, the birthday boy that had been written in a local paper.. In the interview, he recounted that when he and his brothers were young, someone had given them an old broken radio. It had become their hobby and passion to fix it and learn all about how it worked. This started them all on the path that lead them to become scientists. This was the first I had learned about my dad’s early fascination with radios. It made me feel even more certain that I had gotten a message from him. Several days later when I was back in San Francisco, my dear friend Melanie came over for tea. She was a pathologist and scientist to the core. I told her the story of the radio that seemed to turn on by itself and she smiled gently. “If it makes you feel good to believe that it was your dad, that is fine, but I think somehow, something turned it on. Maybe somebody nudged it without realizing it. There is usually an explanation. She headed home but called me later that day. “Uncle! I concede!” “Excuse me?” “I was driving home from your house and I swear to you, my radio was suddenly playing. I know I didn’t turn it on” Well done Daddy!!! If one accepts that spirits are energy and are looking for ways to communicate, radios continue to be easily managed by my dad. When Alana was away at school, her radio routinely turned on without human touch. It still happens, but he has moved on to cell phones. Mine is completely possessed and makes calls at random without being touched. 

Air safety for your classroom, office, or home

This post is a collaboration between me and Dr Anne's husband Sri.. 

All of these wonderful links are courtesy of Sri's hard work. We are approaching another potentially scary fire season. During last year’s wildfire season, on some days, San Francisco experienced some of the worst air quality in the world. There was one day when the daylight sky was an eerie dark orange. It felt like something out of the ten plagues. 

Fingers crossed that there won’t be a repeat of that, but in any event it is better to be prepared. That means it is time to make sure you have a good supply of N95 masks that fit properly, as well as adequate Hepa Filters (air cleaners) for your home, school, daycare, and office.

 I know from past experience that once it is apparent that there is smoke in the air, the availability goes down and the prices go up. Just the thought of it is anxiety producing, but simple wishing won’t keep us safe. 

Records show air quality (PM 2.5) severely deteriorated in the Bay Area between August to October, and around August is when essentials (HEPA, N95) became hard to find. This year the fire season could start earlier, so the time to prepare is now before the rush. Parents, teachers, and principals at San Francisco schools need to know that if they work together they can likely get HEPA air purifiers in classrooms, but they need to act quickly before the start of the fire season when HEPA filters run out of stock. 

 It’s not only about smoke from wildfires. Fresh air ventilation from outside is one of the best ways to reduce viral transmission such as Coronavirus by aerosols. However, access to fresh outdoor air is not always feasible during wildfire season when the source of the aerosol (PM 2.5) is from outdoors. In such situations, a good HEPA filter is not only helpful for smoke, but can also reduce viruses in the air, especially in shared spaces like classrooms and offices according to the CDC and SF Department of Public Health. 

 This is important because kids will be returning to in person learning in the classroom but many schools in San Francisco do not have HEPA filters. If they do, often these portable units are tagged as “most popular” or “Amazon’s choice,” but tend to be vastly underpowered for the size of the classroom.

 Dr. Anne’s husband Sri decided to take some action when he discovered their children’s school had inadequate HEPA filters in the classrooms. Because HEPA filters were not in the school budget, he took it upon himself to collaborate with other like-minded parents at the school and convince the parent’s association to raise money to get them purchased. Given past difficulties in fundraising for other causes at the school, the parents association leadership had doubts they could fund HEPA filter upgrades for the entire school. But to their surprise, within a week, 23 families (5% out of 400 at the school) plus one anonymous corporate matching donor funded the necessary HEPA air purifier upgrades for every classroom exceeding the original goal. This shows there is broad community support for air safety. It is nice to know that most people can agree on something! 

 A common mistake that people make is to use a HEPA air purifier that is too small for the size of their room so ends up not having the intended effect. Sri created a calculator to help people figure out how large of a machine they need in each classroom and for the entire home, school or office. It is not surprising that many teachers at his kids' school had assumed the HEPA filter they already had was good enough. Also because they were so busy with numerous other duties, few teachers had responded to the initial request asking whether they wanted to upgrade the HEPA filter in their classroom. It was not until he sent a follow up message with the attention-grabbing subject “VERY IMPORTANT -- THANK YOU FOR YOUR CONSIDERATION” and pointed out unless teachers responded affirmatively to the request the parents association would not upgrade their HEPA unit that every teacher in the school confirmed they wanted the upgraded HEPA unit in their classroom. 

 In addition to helping me with this post, Sri put together the following list for parents who want to take action. It is amazing how much positive change even one or two active parents can make in a school! If you are a parent and concerned about air safety and interested in helping your child’s school get some HEPA filters Sri recommends the following steps: 

 Contact the principal and explain the need for adequately sized HEPA filters in each classroom Estimate the size of HEPA filters needed for each classroom and for the entire school by first measuring the size of the classrooms and use the calculator. 

 Check and confirm with each teacher 1:1 that they will accept and use the upgraded HEPA filter in their classroom (or not). In each case of principals and teachers don’t equate non-response with a “no”: Without bringing the issue to the attention of the primary stakeholders (parents, principals and teachers), and operators (teachers) of the HEPA filter units, many of them may be unaware and miss out on the opportunity for cleaner air. However, for such an important issue as HEPA filters, it is critical to provide both informed consent and receive a response from each and every stakeholder rather than to assume non-response is a ‘no.’ They may simply be busy and not have had the time to understand and respond. If necessary write to them with all caps to get their attention: “VERY IMPORTANT -- THANK YOU FOR YOUR CONSIDERATION” 

 Work with the parents in the school to fundraise for the HEPA air purifiers. Consider using a need-specific fundraiser to rapidly raise funds from the parent community rather than general fundraisers. Contact them via in-person and online networks at your school (e.g. ParentSquare). 

Seek funds from matching corporate donors as well. Get creative. 

 Important: In shared spaces like classrooms or offices if the HEPA air cleaner to control Coronavirus particles accumulation in the air it is very important to override the “auto” setting and set the HEPA air filter’s fan speed to the maximum speed (or if max speed is too noisy then then the next one down) because the built-in sensor does not detect Coronavirus particles.

 Sri can be reached by email at sri@patientknowhow.com if you have any questions. He will also hold a Q&A session on on June 17 at 4pm (Zoom link https://us02web.zoom.us/j/83869310710) These days it feels like we have so little control on all the things swirling around us. It is nice to have something actionable that you can do. Go out and kick some butt!!! Even if you are not up for the Butt Kicking, at the very least take care of your own needs and make sure you get those masks and filters now.

This is nothing to kid around about. Recently published research from UC San Diego says the effect of wildfire-specific pollution on respiratory health is up to ten times worse for children (particularly for children aged 0 to 5 years) compared to other sources of smoke.

https://pediatrics.aappublications.org/content/147/4/e2020027128.long

How to make sense of the ever changing covid guidelines

So many parents are struggling to navigate the tricky balance as some of the quarantine restrictions are lifted. I have gotten many questions about this. 

Having kids that are too young to be vaccinated and little ones who are too young to comply with masks, makes it even more complicated and stressful. As wary as we might be about normalizing, many folks have not seen their extended families since 2019 and are busting to finally visit important people they have been separated from. Zoom is a poor substitute for an enormous, in person hug.

 I started out looking for answers by asking an expert, my friend Dr. Bob Wachter who has been a respected voice during this pandemic. He shared a recent podcast. Here is the link if you want to listen to the hour. It is worthwhile. https://podcasts.apple.com/us/podcast/toolkit-safe-or-not-safe-summer-edition/id1504128553?i=1000517710799 

Dr. Bob had two very bright epidemiologists as his guests. The striking thing about listening to them was that they were grappling with the questions of travel, mask/no mask...etc. and they didn’t always agree on how they would answer some of the questions. Alas, there are not always clear answers. 

Every family is unique. People have various levels of concern as well as different levels of risk. Interestingly these don’t always correlate. I know of some at risk families who are fairly bold and families who are really at minimal risk but remain extremely cautious. 

 This is not going to come as news for folks who have read my previous posts, but as usual, it comes down to a risk/benefit analysis. Think about this - I have so many parents who are really nervous about having their babies start eating solids. They are worried about choking. If they had their way, they would only feed pureed food for the first several years! Obviously that isn’t a reasonable choice. Kids need to learn how to eat and chew. Parents need to learn the safest ways to feed and how to do a choking rescue maneuver if needed. 

 In the same vein, there might be some risk involved in leaving the safety of your quarantine bubble, but kids need to be social. Keeping them at home is not an option that I would agree with.

 In an effort to reach a larger audience, Dr. Ted and I did a live Instagram event on June 3rd, and I will do a little summary here for those of you who were not able to join us. 

I am not going to address all of the specific questions that we tackled; instead I will review the basic guidelines that I have used to find the answers. 

 As we grapple with the choices here are some things we know: 

 Outdoors is safer than indoors when it comes to Covid transmission You are unlikely to get COVID from a surface; it spreads from close person to person transmission. At the beginning of the pandemic, I know people who left mail and packages untouched for 72 hours as if they were radioactive. The data came in pretty conclusively that that was unnecessary. No one seems to be doing that anymore. Of course people can still pick up other nasty germs from surfaces, but that is not the focus of this post. 

 Handwashing a great. Make sure you use soap and water for 20 seconds. If you are using hand sanitizer use at least a dime sized amount. No, you don’t have to follow your kids around and wipe down their hands every second, but I would do a good wash when coming in from outdoors and also prior to every meal. 

 Most kids who end up getting COVID are not terribly ill. While there is the very scary multi system inflammatory syndrome, it is incredibly rare. Vaccinated people are mostly safe from getting severe illness or dying from Covid.

 Keep in mind that prior to covid, we frequently made the choices to travel during flu season. The risk to young kids is similar. In some instances influenza is actually harder on the little ones. 

 No person’s situation is exactly the same as another's. If you opt to be more cautious and want to keep your mask on, there is no need to apologize or defend yourself. 

 As you look at the risk benefit here are essential questions that will make a difference in the answers. Are eligible people in your family fully vaccinated? 

 Are there family members who are at high risk? 

 How are the numbers in your area? 

My advice to someone in the Bay Area would differ from that to someone in Brazil or India. Find a trusted resource where you can keep tabs. Everything could change if a new variant comes along or numbers spike up again. 

 To close, I love gathering pearls of wisdom from sources that I trust. Emily Oster just did an article about this same issue. For data lovers, she is fabulous, but one thing she said that really resonated with me was that people ask “should I be worried?” She suggests that that is the wrong question. Instead people should ask if there is an action that they can or should take that is different from what they are doing. Once you figure out what feels like the best path for your family, march on down it, knowing that you made the best choice at the time. 

Choosing to be worried is a choice that will only leave you feeling helpless. I know I know, easier said than done. https://emilyoster.substack.com/p/family-planning-unmasked-offices My mom’s favorite piece of wisdom is always worth repeating. “It is what it is, do the best you can.” Gather the data, and don’t get frustrated if the data changes as new information surfaces. Make the choices that feel best for you.