"MILD" WRONGLY DEFINED AS NOT NEEDING HOSPITALIZATION
https://www.nature.com/articles/d41586-020-02335-z
People who don't get hospitalized don't get medical follow-up either. We all know that some seek hospital care more willingly than others.  Some of us refuse to go to the hospital; we know it is full of antibiotic-resistant infections and stressed-out doctors and staff. I had a pneumonia that could have been Covid but I did not go to the hospital; I self-treated at home. My pneumonia was not "mild". I thought about going in. Many people who've survived the virus at home are having longterm after-effects. This author is absolutely right that we need a better way of categorizing and tracking the cases that did not result in hospitalization.

THE KIND OF MASK YOU USE MATTERS
https://www.sfchronicle.com/bayarea/article/Does-your-coronavirus-mask-work-New-study-15473251.php
I've noticed that many police, highway patrol and fire department personnel are using what I would call "neck gaiters" for masks.  These are a single thin layer of polyester with some lycra for stretch. They drag the thing up over their mouths and noses when in close proximity with others. This kind of" mask" doesn't stay up well. Thin layers of fabric may stop large droplets but they are definitely not catching the aerosols which have turned out to be a major route of infection. Public servants who are in direct contact with the public should be wearing quality masks. Well, everybody should, but "should" doesn't get very far in America.

OVER 900 HEALTHCARE WORKERS HAVE DIED OF COVID
https://khn.org/news/exclusive-over-900-health-workers-have-died-of-covid-19-and-the-toll-is-rising/
POC's dominate the count and you can see from the photos that many victims of all colors are obese.  To reduce this grim outcome perhaps we should use front line workers who have fewer risk factors. Smokers shouldn't be on the front lines. People with hypertension, obesity, diabetes or a heart condition could (and should) be exempted from front line work. There's a great emphasis on PPE (personal protective equipment) and it is important, but the healthcare worker's baseline level of health and resilience is just as important.  People with immune compromise of any origin should not be expected to work with COVID patients. Period. There are so many obese nurses! They should not be put in this position. I heard on a podcast yesterday that 70% of our BMI is due to genetics: no point in punishing people for being heavy. We should evaluate the immune sufficiency of healthcare providers and place them accordingly. Those on the front lines of the pandemic should have top notch immune systems--and be most likely to survive the virus with minimal negative effects. Yes, I know there's a shortage, but seriously sending all these fine people to their deaths trying to help others?  This is murder.

ABOUT 10% OF COVID VICTIMS HAVE PROBLEMS AFTER 3 WEEKS
https://www.bmj.com/content/370/bmj.m3026
We're just starting to collect information about the after-effects of this virus but for a lot of people recovery is extremely slow.  This report has some excellent resources (links) for patients who are having trouble after they are supposed to have "recovered".  The list of possible lingering symptoms is long, and you are not malingering if you have chest pain or "lung burn" and would like to get some help.

A GREAT TIME TO QUIT SMOKING: EVEN YOUTH HIGH RISK IF SMOKE
https://www.jahonline.org/article/S1054-139X(20)30399-2/fulltext
Vaping is not protective. Using it just once in a while is not protective.  Inhaling smoke at all increases your risk, even if you're young. There has never been a better time to quit and quit for good.

The return from my last excursion was rough.  We were in a great wilderness for 4 days and 3 nights.  The day after I returned a dear one in my family died.  He died of being hospitalized.  He was urgent to escape but was unable to.  He was sedated to death. 

Then a white eye cop with hands in his pockets murdered a beautiful black man.  The living rage of so many black lives mattering roared in spite of generations of hateful treatment.  Then the agendas of all the whites interfered with the clarity of their message, damaged their communities. And always this horrendous potus tweeting his ego, tweeting his malfeasance plain as day.  These times are beyond "interesting".  They are fucked.

I would like to help with all of it but at this moment I feel the need to save myself.  I save myself by turning it off.  Meditation, yoga and walking help, but getting out of the city and away from the roads is my medicine.  Getting to where there is no phone to ring, no media to read or watch, no news, is the very best medicine.

For all of you who are sad, angry and overwhelmed, you are normal.  To feel crazy in crazy times is normal.  Perhaps the best thing you can do for yourself is to take a time out.  Go sit in the sun.  Take deep breaths.  Walk in the rain.  Feel the raindrops.  Watch the birds and hear them sing, or float down a river if that suits you. 

When you are quiet inside you can see more clearly.  When you are centered and strong you are a better ally.   Do not let the constant news cycle rule you.  Get out, and I will see you on the other side.

You probably don’t want to think about it.  It’s gross, it’s difficult, it’s sad.  Most people who get CPR are goners.  Maybe you never want to take another class.  OK, I can accept that.  What I can’t accept is that you might not even try to do CPR, or that if you do try, your efforts could be ineffectual and wasted.  I’m writing this to encourage you to know the basics of quality CPR, even if you don’t get the certification.  You wouldn’t stand idly aside if someone were dying in front of you.  We would all do what we could.  CPR is what we can do.  So please read this and make mental notes, just in case.  Print out the steps at the end and stick them in your car or first aid kit.  If you try to help and do the best you know, you are protected from liability by the Good Samaritan Law.  Some people get CPR and live.  You could save a life.

The American Heart Association updates their teachings each five years, and the last update meeting was in 2010.  This is what they have taught since then.  The next meeting will be in October 2015 and the update will come out in April 2016.

Science has shown that it’s more important to get the blood moving right away than it is to try and push air in.  They’ve cut the beginning part short to get you doing compressions sooner, because it makes a big difference in survival.  The sooner you start moving blood, the better the victim’s chances.  There’s enough oxygen already in the blood to keep the brain alive for a while, you just have to get it there.

Before you dive into the assessment process, look around to be sure the scene is safe.  Think about it and take care of yourself.  If you have to, move them.  CPR works better if they are laying on a hard flat surface, and if you cut or lift any interfering clothing including a bra.  Don’t have a committee meeting about it, just do it.  Don’t torque the neck if there is a risk of head or neck trauma.  Look for any life threatening injuries, like heavy bleeding or a broken neck.  It doesn’t help to save a person from one threat while another one kills them.

Quickly make sure they’re not napping.  If they don’t respond to a light touch and loud voice, assess for responsiveness by rubbing a knuckle on their collarbone or breastbone, or flick the foot of a baby.  If there are no obvious signs of life and consciousness, have someone call 911.  Next check for a pulse in their neck (the carotid artery).  This is something to practice, so that you know where that pulse ought to be.  If you aren’t sure, or can’t find a heartbeat, start compressions.  If there’s a defibrillator (AED) around, send someone for it.  Likewise it’s very nice to have a face mask of some kind if it’s available. Positive pressure oxygen can also help.

They’ve stopped telling us to measure our hand position on the chest.  Just mash hard on the bottom half of the breastbone with the heel of your hand.  Using straight arms and both hands, drop your upper body weight to compress the chest at least 2 inches on adults.  The compressions should be less for small people; compress no more than 1/3 the body thickness.  Lift up in between compressions to let the chest rebound as far as it will.  This gets to be the hard part when you are tired; don’t lean on the chest.  The best quality compressions get about 30% of normal blood flow.

When you start doing CPR on an adult, you can expect for cartilage and ribs to make crunching sounds.  Don’t let it stop you.  You can expect the patient to vomit; don’t let it stop you.  You can expect to get tired.  Switch positions every 2 minutes if you have help.  If you see this going on, rotate in.  You could save a life.

The rate of compressions is at least 100/minute (max 120), same as the BeeGees song “Stayin’ Alive”.  If you know it, sing it internally and get the beat.  The ratio of compressions to breaths for adults is 30:2 for both one and two person scenarios.  The person doing compressions is supposed to count out loud. This keeps you from going too fast.  

Getting air in requires that you open the airway, pinch the nose shut, and blow in the mouth.  The head tilt chin lift is the standard way; bend the head back and pull the jaw forward with fingers under the chin.  It is possible to tilt the head too far and close the airway.  You will know if you are getting air in.  Blow in a smallish normal breath, about 200ccs of air, just enough for the chest to rise.  Don’t overventilate.  If you blow too much air in you fill the belly instead of the lungs, increase the vomiting, and decrease the freedom of the diaphragm to move.  If they vomit, roll the victim on his side and finger sweep out the vomitus before blowing more air in.

There are differences for children up to the age of puberty.  The ratio 15:2 if there are two rescuers, but the same 30:2 for one rescuer.  If you are alone and don’t know how long the kid has been down, do 2 minutes of compressions (5 sets of 30) before you even go for help.  Be extra careful not to overfill them with air; small puffs instead of breaths is all you need to make the chest rise.  Instead of compressing an infant’s chest with both hands, use two fingers.  Also, if you have two people working on a baby, the person doing the compressions can put both hands around the sides of the baby’s chest and do really good compressions with the thumbs.  The air person stays by the head and blows air into the mouth and nose, two breaths at a time with the head gently tilted back, watching for chest rise and no more.

New research shows that in a hospital setting, extended CPR increases a patient’s odds of going home by 12%.  The lesson: don’t give up too fast.  Keep going for at least 15 minutes, and for 30 minutes if you can.  It’s a workout, so help each other, take turns, take breaks.  You can stop when paramedics take over, the victim wakes up and starts breathing again, there is a danger to yourself, or you are too exhausted to continue.


CPR STEPS

1. Practice finding pulses on yourself and others; develop a feel for them.
2. PERSON DOWN!  Assess scene safety, move if needed.
3. Assess for responsiveness.
4. If no obvious signs of life, get help, call 911.
5. Check pulse in neck for adults, upper arm for babies.
6. If no pulse or uncertain, begin 30 chest compressions, at 100bpm+ and 2”+ deep on adults.
7. Ventilate with 2 gentle breaths (see chest rise) for each 30 compressions.
8. Keep going at least 15 minutes or until relieved by more trained people.
9. After it’s all over, find a way to decompress emotionally.

http://www.chitari.org/    <----Here's the link to the org that is creating the Naturopathic Hospital in Oregon.  This is going to be awesome.  =-]   (Chitari means meeting place in Nepalese.)

I just received word that Satya Ambrose and her team have finally found a suitable site for our dream hospital.  It is 84 acres of old growth forest beside the mighty Clackamas River here in Oregon.  The hospital is intended to be a lovely inpatient facility where one can go to heal, recover and renew.  Imagine a room with a view of the forest and river, excellent fresh organic food, cheerful staff and supportive treatments, instead of invasive procedures, benign neglect and crappy hospital food!  At this point we need investors and contributors who can help purchase the property and break ground on the facility.  We need to raise several hundred thousand dollars in a few weeks.  Do you want to help?  Please contact Satya.  Comment and I will provide you with phone numbers.