What is The Situation in India – View of Indian Doctors

TLDW – It’s hell.

It looks like the Indian government made the same mistake that the Czech government has made – the first wave of the pandemics was so well handled that politicians got the feeling that it is all over now. And communicated this to the public, who were all too eager to believe it. And because India has both a lot more people than Czechia and fewer hospital beds per capita, the disaster is proportionally worse.

I have never expected to see the truth of the saying “you should not rest on your laurels” demonstrated in such a tragic way.

Medlife crisis is an excellent and entertaining science and health-oriented YouTube Channel. This video, however, is not of the entertaining and funny kind. I do recommend his other videos too.

Good News! Partially.

Today I took my father to the hospital for six-week-long radiation therapy. From that, you can guess that he is not going there with a nasty cold. I do hope his prospects are good, the tumor is well defined and there are no signs of it metastasizing anywhere in the body. There are several problems though – his age, his heart, and his overweight. I won’t be particularly well-off, mentally, for the whole time probably.

But the genuinely good news is that my mother got today her first shot of the Pfizer vaccine and is scheduled for her second shot in three weeks. Our government seems to be slowly getting its act almost together at least on this issue and the vaccinations are starting to roll more than just a few people a week.

Another good news is that my sister has had Covid without even noticing it. She was tested due to an unrelated health problem and it was found that she has antibodies. She was a high-risk person (autoimmune disease, severely damaged lungs, asthma), and she had a really, really bad bout with the 2009 pandemic swine flu. She was isolating as much as possible and wearing a mask whenever she could, so probably she caught a very low dose of the virus – not so low as to not develop immunity, but low enough to not cause anything more severe than a runny nose for a few days.

So my worries are at least a bit alleviated with regard to two members of the family.

Whinge, Knives, Whinge

It took me four months to finish the batch of knives that I started in July. I have documented every hour that I have worked on knives, and the results are not good. I have only managed to work about 20 hours a week. Plus some hours that I have not counted, like when I was making new tools, repairing or improving them, etc.

Please allow me to whine a bit about the causes of that.

I either have chronic fatigue or I am a chronic hypochondriac. I am reluctant to go to a physician right now, partly because of the ongoing pandemic and partly because of last year when after several months of pain, I never got a conclusive diagnosis – and the pain only subsided after a course of steroids that I got for a really bad but unrelated virus (possibly flu) that snuck up on me right before Covid hit Europe. So I am not all too optimistic about our GP being able to help me with this.

I have been more or less tired ever since that possible flu. You remember that short walk in the forest in August when I brought home two full shopping bags of ‘shrooms? It took me three days to get over that, and one of those days my legs hurt so much I was barely able to go to the loo. After just several hours of hand-sanding knife handles my back and hands hurt for two days. Etc. etc. ad nauseam. Add to that the necessity to spend time carting my parents to/from doctors, stacking firewood to the cellar, caring for my trees, and the result is that I do a lot less work than I want to.

I have never seen the point of exercise because my body never reacted to it the way other people’s bodies seem to. I did get stronger, but only in relation to my starting point. In high school, when I could exercise under professional supervision free of charge, after months of work I was barely getting just below the level where my schoolmates have started. This year is that – only worse. I am not going exactly downhill, but just barely. Plus my hands started to hurt again two weeks ago. With the sun gone, I have at least looked at what safe dose of Vitamin D I can take in supplements and I am taking that because it seems to help a bit.

Whining over. I hope it gets better. At least it is not getting worse.

The last knives I have finished are four universal kitchen knives from a batch of five blades. One of those blades was not suitably hardened after all- near the tang was about 2 cm soft part. I do not need to toss it, but I do need to try and quench it again with the next project.

These are a bit heavier and thicker (3mm) than my previous knives of this type because they are made from what was left over from the slabs for chef knives. I have also changed the geometry of the handle a bit – instead of a rounded rectangular profile it has a rounded trapezoid profile. They are also about 2-4 mm thinner overall and 5 mm thinner and shorter at the front to better allow a choked-up grip with thumb and index finger on the blade. And they are pointy this time.

One knife has the handle from apricot wood and I have tried tubular pins filled with the same wood. I think it looks good and I will use that idea in the future again.

© Charly, all rights reserved. Click for full size.

© Charly, all rights reserved. Click for full size.

Two knives have the handles from pickled black locust. It is perfidious wood, in the future, I have to be more careful – the scales were probably not fully dried when I ground them to final size and they shrunk on me a tiny bit when I was finishing the surface with resin. So the tang does exceed the handles a tiny bit. That can happen due to a bad shaping job too, but that was not this case – they were perfectly flush originally, I swear. Lesson learned I have to put this wood in the oven for an hour or so before glue-up and grinding the outline. Now I can forget the lesson before finishing the next batch.

© Charly, all rights reserved. Click for full size.

© Charly, all rights reserved. Click for full size.

© Charly, all rights reserved. Click for full size.

© Charly, all rights reserved. Click for full size.

And last was fitted with padauk wood that I have again got for free with steel shipment. A prime example that there really is no need to use tropical woods, it does not look that much better than the black locust.

© Charly, all rights reserved. Click for full size.

© Charly, all rights reserved. Click for full size.

Knives are a bugger to shoot, I will have to build myself some better lighting system. Either the blade is over-exposed, or the handle is under-exposed, or the colors are off, or all three.

If you are interested in knife making, on Sunday I will start a detailed series about my next knife-making project. Not because I am qualified, but because I want to.

Don’t Rest on Your Laurels.

Covid resurgence across Europe even in countries that managed the first wave so well it did not de-facto happen – like Czechia and Slovakia – is in part a consequence of exactly that. The governments got the impression that everything is over and experts were no longer listened to. Common people, who never were used to listening to experts anyway, were glad to hear the soothing messages from governments because they told them what they wanted to hear.

“It is OK now, you can go on a holiday, you can go to a bar, you can mingle all you want”.

And let’s not forget the toxic influence of American right-wing politics spreading throughout the world.

When our then health minister and his expert advisers said at the end of August that there should be introduced some mild preventative measures to assure the disease does not get out of hand, the strongest opposition came from our right-wing parties, who still propagate the long ago falsified idea of trickle-down reaganomics. They objected that the minister is fearmongering and that businesses suffer as a consequence and all that. Oh, and also the old chestnut that it is just like the flu and we do not do any such measures against flu either.

Two months and two new health ministers later, and Czechia is eleventh worldwide in infections per capita, and only second among countries over 10 million. Finally, we surpassed even the USA, as our right-wing parties wished we did, only in a metric even shittier than wealth inequality. And now we have not only businesses closed, we also have a curfew – and the talk is that even stricter measures might be needed because the virus does not seem to be slowing down that much.

Unfortunately, the only measures against a pandemic that are adequate are those that are perceived as too much by the general public. Unless the grumblers grumble, not enough is being done – a lesson learned in the past that will be forgotten in the future when the next pandemic hits.

An Important Petition from Iris

Iris at Death to Squirrels has a post up regarding the cruel treatment and unjust imprisonment of a young bi-racial girl with mental health problems. It’s an ugly story about a family looking for help and finding horror instead. It’s not only an indictment of the American mental health system but another urgent example of why Black Lives Matter really does matter. The more I read, the angrier I became, and I encourage you all to go read the story and get angry, too. Then, go sign the petition. I did, but I’m not an American, and the petition needs American voices – lots of them. At the very least, it will let this family know that they are not alone, but maybe collectively, we can get this child the help she desperately needs and offer her a future. Thanks.

Is a Homemade Face Mask Better Than Nothing?

The best thing an amateur can do in times of crisis is to follow experts, specifically the expert consensus and not the hand-picked cherries who pander to one’s preconceived ideas. Not that the consensus is automatically true, but it probably is the best that human knowledge can offer at the moment. What we are seeing right now is a consensus shift regarding the wear of facemasks, as more and more countries recommend them or even make their wearing mandatory in some places.

This is accompanied by new research, and one such research in the Czech Republic focuses on comparing various materials. The findings are not published yet, but one such preliminary finding is mentioned in the Czech article – five layers of ordinary t-shirt fabric are effective at catching nearly all particles of the size that have droplets exhaled/coughed out. That is huge since it is nearly equivalent to a surgical mask. And since the main argument for widespread use of face masks is that they should slow the spread of disease from those who have it (especially those who might be asymptomatic), then yes, even such self-made masks are better than nothing, if everybody has them.

But the article mentions another thing, which is even more interesting. One layer of t-shirt fabric was able to stop 11% of the much smaller sizes, those that are expected for the dry incoming particles. And five layers would stop nearly 46% of such incoming particles at maximum breathing speed (i.e. during intensive exertion). Slow breathing increases their efficacy.

That might be significant. There is some evidence that the initial viral dose of SARS-CoV-2 might have an influence on the severity of the illness. That seems logical – the illness has several days incubation period during which the virus grows in the body exponentially. A smaller viral dose thus might give the immune system may be a whole day or even more to develop appropriate antibodies, as is the case with influenza. But I could not find any study looking at whether there is a correlation between the incubation period and the severity of the disease.

It is a work in progress, but to me, it seems the answer to the question in the title is “very probably yes, possibly even for your own protection”.


Before you submit any argument against wearing face masks, please consider whether said argument could be used with the same weight against the universal and non-controversial recommendation of washing your hands. For example, an argument that many people are wearing masks incorrectly is not an argument against wearing them, just like the fact that most people wash their hands incorrectly and insufficiently was never an argument against hygiene. It is only an argument for making an effort to educate the public.

Like this video, which educates about both.

How Czechia Flattened the Curve (Maybe, Hopefully)

Our current prime minister has been in the past often criticized as akin to Donald Trump re: conflict of interests and use of state resources to enrich himself and his family. And rightly so in my opinion, I cannot stand the man personally and politically.

However, when SARS-CoV-2 hit the Czech Republic, he, unlike Donald Trump, has done the right thing. In response to the pandemic, he has left decisions on the policy to actual epidemiology experts from the very beginning. Thus when CZ had mere 116 cases, 12 days after the first three on March 1., he declared a state of national emergency and just two days later virtually everything was put on hold except the absolute bare minimum (grocery stores, delivery services, apothecaries and some more). It was criticized by the opposition (our equivalent of US conservatives) as needless panic-making and fearmongering and the measures as needlessly draconian and a PR for himself and his party. Especially the order of mandatory face masks (home-made and improvised masks are allowed) was met with scorn.

On March 18. I have taken the data of confirmed cases so far, plotted them on a graph and calculated the best-fit exponential curve. It was at a daily increase of 39%, an effective doubling every two-three days, approsimately the same trajectory it has had all over Europe. This growth meant we should have over 140.000 cases today, but we, luckily, do not. We have less than 5.000. Howso?

Look at this graph:

The red curve is the actual cumulative cases as reported every day at midnight. The blue curve is the exponential best fit that I have calculated on March 18. And then there is the orange curve, which is also an exponential best-fit but only for the last week from March 28. to April 3. You can see that the two best-fit lines intersect on March 21.-22.

That is, in my opinion, the day when the enacted measures started to have a visible effect – eight to ten days after they were enacted. I do not know whether I am doing the right thing here mathematically – I have dabbled in statistics at work, but not in epidemiology – but it does seem right to me.

The new rate of growth is still exponential, but instead of 38% daily it is 8% daily. And although the difference between multiplying the cases daily by 1,08 instead of 1,39 does not intuitively look like much, it means the doubling of the cases is prolonged from mere 2-3 days to 10-11 days. Still not enough for an illness that can take up to 6 weeks to heal and kills 1% of infected people, but a very noticeable drop.

And AFAIK that drop is not due to insufficient testing. Testing has grown proportionally, although still not as much as it perhaps should have. But the ratio between positive/negative tests is getting lower, and that indicates that the drop in overall cases is real.

Now there is certainly much more to it than this oversimplified graph. For example, Germany took longer to enact strict active measures, relatively speaking. That is, CZ government enacted nation-wide strict measures when we had just several hundred people ill, whilst the German government did leave many decisions to individual states and instead of strict orders tried to control the situation with recommendations only at first. This has led to a bit of inconsistent reaction and different measures being enacted (and ignored by people) in different states. It worked, but not as much as was desired. Strong nation-wide measures started being implemented only when there were several thousand people ill already- at about the same time as in CZ. And at about the same weekend the curve began to break in Germany as well.

It was similar in Italy too, there the curve began to break at around March 15. (only estimated, I did not calculate the fit curves for Italy, I am doing this in OpenOffice and that is not the best program for this kind of work), about two weeks after the most-hit municipalities were put on lock-down.

Another quick analysis that can be done just by looking at the numbers – In Italy, it took 22 days for the cases to grow from about 100 to 20.000. In Germany, it took 24 days, in Spain 18 days, in UK and France 25 days and in the USA 20 days. The Czech Republic is now 24 days from its 100th case and we are nowhere near 20.000.

So even these amateurish and quick&dirty analyses show that quick reaction, regardless of what the nay-sayers say, is essential in avoiding the worst in case of an epidemic. The enacted measures work as intended. I only hope that our government and our people do not relax too soon.

Stay safe, stay at home whenever possible, and fingers crossed for you and your loved ones.

“It is just a flu” Should Never be Comforting Phrase in the First Place

I do not know whether this applies to the anglophone world, but in Germany, and to the same extent in CZ, “flu” and “cold” are treated as more or less synonymous. And because the common cold is, well, common, most people when they say they came down with flu, what they really want to say is they had/have a bad case of the common cold.

One of my former colleagues thus thought that flu is something trivial and she always disparaged me when I said that flu is a serious illness and not something to be flippant about. I do not know how she managed to live for over thirty years and get herself a kid without encountering real flu, but she was among the lucky ones in this regard I guess. A healthy, strong woman in her thirties.

But in 2008 her luck ran out. In the morning she came to work as normal, but just mere two hours later she began to have fever and chills and got a splitting headache. She excused herself from work at noon and went home and did not return for two weeks.

When she came back, a rare thing happened – she acknowledged that she was wrong and I was right in our previous discussions about this. She just had a case of real flu and for a few days during that time, she actually feared for her life, because there were times when the fever made her see double and she was barely able to go the loo.

It is a sad reality that some people – I dare say many people – actually, really need to experience some hardship first hand to be able to believe it is real. Be it flu, or poverty, or discrimination.

When some people were saying that Covid-19 is just another flu in a derogatory and dismissive way, I rolled my eyes so hard I nearly strained them. Even if Covid-19 were just a new strain of flu, a new strain of flu would be terrifying. Even old and established strains of flu can be terrifying when they encounter an unvaccinated person who never got flu before.

“It’s just another flu” should have been a call to arms, not a placating head pat, even if it were true.

Corona Crisis Crafting IV: Face Masks

Around the world hospitals are asking for volunteers to sew masks and I started already for my sister and her colleagues, as well as the relatives who care for her elderly patients.

I’m using this pattern and it’s super easy. Time needed is probably 15-20 Minutes per mask, so grab your fabric stashes and start sewing (finally you have the justification for keeping all those letter sized fabric pieces).

BTW, I guess that some protection nobody could measure in their experiments is that wearing them really keeps you from touching your face.

©Giliell, all rights reserved

I’ll also hand out instructions with them that read as follows:

Hello,

I’m a washable cloth mask. I am not a medical product and should not be mistaken for one. I am especially no substitute for other measures like washing hands and staying at home. Please wash me before you first use me and after each use. I’m 100% cotton and can be washed at 60°. Caressing me with a hot iron is a good idea as well. I’m free. If you want to say thanks please stick to the guidelines put forward by the authorities. But if maybe you have some elastic lying around, that would be nice, so many more masks can be distributed.

Best wishes and take care

 

Youtube Video: Is China’s Coronavirus the Next Pandemic?

My personal view of the coronavirus is that outside of China, the mortality rate might significantly rise above what it has now (which is already several times higher than influenza), just as it did with the swine flu pandemic in 2009 (which my sister barely survived, but luckily nobody else in the family got). My reasoning for this is – people in China were probably at least somewhat exposed to the said virus in its non-human-infectious form, or some of its less dangerous relatives, which would give them at least partial immunity. Once the virus spreads to populations that have no immunity to its or to viruses similar to it, it will become much worse.

Since it is a pulmonary disease, our whole family is especially susceptible and in danger, since all of us have asthma, my parents are elderly, my sister has already damaged lungs and my brother is a heavy smoker. I certainly hope not to encounter it, I already had viral bronchitis this year for two weeks and I did not enjoy it in the least.

Recovery: The Condition(ing) of Being a Woman

I’m making slow but real progress, but everybody and their dog keeps telling me to take it slow and I’m really trying to. But I also know that I’m far from “functioning normally”, not to mention that my current level of mobility is also due to generous amounts of anti-inflammatory drugs and painkiller. Anyway, one good aspect of German health insurance is that I’m entitled to a household aid  for as long as I’m recovering. And my most wonderful sister organised everything with her care service and this morning the wonderful S. showed up.

Everything about my working class woman upbringing was uncomfortable. First of all letting a stranger in when my house is a complete mess. I know, I know, the woman came because there’s a mess and I can’t clean, but try to tell that to your subconscious. The other one is to have somebody clean your shit while you’re mostly watching. (I did help as much as I could). I know that many working class men have absolutely no problem with watching women clean while they’re lying on the couch, but for a woman? I’ve been both raised with some traditional crap about cleaning and quite some deep seated hatred against people who watch women clean, since I’m just two generations removed from women who had to go out and work as maids, being abused by master and mistress alike.

Still, I’ll need a household help after recovery as well because I think my body just told me that it is done with playing nice and putting up with my psychological issues of having to do all my cleaning myself.

Hospi-tales: Stink

You’ve all been waiting for this topic, right?

For somebody working with teenagers, I still got a very sensitive nose, especially when the body concerned is mine and it’s also “amazing” what your mind can fixate on. Here’s the truth: being sick stinks. First of all, while my brain knew what happened, my body was still trying to run away from a sabertooth tiger that had just pierced my leg or something. In other words, it was ramming up the response, trying to mobilise as much energy as possible, resulting in me sweating like an ox. The second, and more lasting thing is medical stink. All the medication needs to get out of your system again and part of it just goes out via your skin. And it’ll keep doing that for a while, so I#m off to take a shower first and use some very sweet smelling body butter afterwards.

You’ll excuse me.