Is the US flattening the curve? Yes and No? Who knows.

How do you describe that feeling of watching numbers climb and realizing that you’re watching in real time the most global example of what you’ve studied and taught your entire adult life?

Dread? Excitement? Existence?

When teaching about pandemics we teach students to look retrospectively at the data on the numbers of those that have recovered versus those that have died. At about 6:00PM on 27 March 2020 twice as many people had died of covid-19 in the United States as have recovered. Seeing those numbers broke my heart for a moment, so I had to talk it out to myself somewhere.

https://coronavirus.1point3acres.com/en as of 6:26 PM MST 27 March 2020

It’s too early to call what it will look like in the United States in terms of our final numbers with covid-19. At this time these numbers are skewed by post-mortem testing and testing criteria that limits test accessibility to those already in need of medical intervention over home care.

Things might look scary, but don’t give up hope. Update 30 March 2020: and reporting started coming in of recoveries!

https://coronavirus.1point3acres.com/en as of 12:47 AM MST 30 March 2020

The criteria most are going by: 2 negative covid-19 swabs with a minimum of 24 hours separating the tests. The reason for this standard is that there is a very high false negative rate with the rt-PCR based test. If anything goes wrong along the way – say there’s a bad reagent, too low of a sample of viral particles, or something goes wrong that invalidates the test it will come back negative. This is the bane of every graduate student that has ever done rt-PCR. They will tell you their horror stories, especially if they were from poorly funded labs.

For some additional hope.

There’s this amazing power of graphs.

I started keeping these to track the projection if we stayed on an exponential number of cases reported (aware of typo – did not plan on using this graph for anything originally)

Even as we have expanded albeit limited testing across the United States the overall rate of growth of total cumulative cases is slowing. While this hope is based on very limited data, could it be that we may actually be flattening the curve?

Equation is changing – are we flattening? I’m not sure. We added a zero. [Does some math]. I don’t know if that’s significant yet.

We’re able to see the slope change as the day to day number change. We can see when our efforts are working. This is part of why we need accurate reporting above anything else. The numbers that only require home care matter to retrospective numbers and for accurately understanding the danger of a disease. This influences anticipatory healthcare planning decisions for patients and facilities.

Update 30 March 2020: Exciting New Graph! If we start looking at the growth in the number of reported cases since improved surveillance across the United States started around March 19th – Yes, the US is kind of flattening the curve. But not enough. We’re also not far enough in to predict the peak.

We can be hopeful. It’s not the fault of our healthcare workers and everyone needs to show massive gratitude. Diagnostic testing has massive barriers – Point of Care rapid testing is a luxury afforded us over the past century to strep throat, influenza, drug screenings, and other common “ailments” that bring you in to say hello to someone like me (only using quotes because I included drug screenings).

I’ll do a better analysis of my numbers as we get better testing, but for now, can I even trust that data? How many people are dying at home untested? Remember that across America we have incredibly diverse customs about death and dying. In the American South (where I’m from) families conduct home hospice even during severe illness out of pride and the cost of healthcare. Once the family member has died they will contact the local mortician. While it might no longer be legal to do home embalming and many states have prevented home burials, this has never stopped families from caring for the dead. Caring for the ones we love as a final act is one of the most essential acts as a family member that is often robbed of Americans elsewhere across the United States. In twenty to fifty years will we need to do go all paleovirology/anthrovirology (actual fields!) on disinterred bodies to get the actual numbers? Or will we go the route of China and the US during 1918 – burn it all.

Other questions I hope we answer as we roll out Point of Care testing:
Are healthcare workers on PReP faring better?

If people are interested in hearing me rant about the topics I’m actually an “expert” (by degrees and academic research/teaching background only) in let me know. If you are I’ll actually go back and edit this rant and dress it up a bit.

Thank you to anyone reading this. Without you this is just a shout into the ether.

Short Story Announcement: “Waking Up” Part 1 “The First Day” and Life Update

My first multipart series is upon us! It went live on Monday, but I’ve been preoccupied with this whole coronavirus thing and writing book reviews.

This first part is short.

I didn’t mean to time the release of a story related to waking up in a hospital with a pandemic. Today is Day 17 of a fever of ~100-101 F (37.7 – 38.3 C). I have ice on the back of my neck as I write this. There will be a delay in the release of part 2.

It’s all surreal, right?

I grew up among hardy people that believed in staying put when the hurricane came and destroyed the town (this literally happened and I was out of school for 2-3 months in high school while we rebuilt the town). One of the places I lived was almost wiped off the map by the 1918 Influenza pandemic. Entire families died – their bodies buried in mass graves next to their homes by the brave neighbors who ventured into the houses later. The houses and all of their belongings were either burned or were left to rot until us, curious, mischievous rural kids with nothing better to do broke in and wandered around those unwired houses like the generations and generations of kids before us. Look but don’t touch. The objects are cursed and haunted by the disease. Even then the belief was that the ghost of the disease persisted and could kill.

On that note, stay tuned for a short story exclusively posted here since I’m taking a week off. Don’t expect it to be edited well because, frankly, I feel like s***.

Take care and I hope everyone is staying well. As always, thank you for reading. Without you I’m writing words into a void.

UPDATE (26 March 2020):

Today WaffleHouse closed 365 of its 1,627 US locations. That thing I mentioned above about being from an area that was regularly destroyed/impacted by hurricanes and my town was DESTROYED by a hurricane?

Check out this thing called the Waffle House Index – it’s used by FEMA to determine how bad a natural disaster is in the United States based on the number of Waffle Houses still open in an area. I’m not joking. It’s a real thing. Waffle House is historically known for being open 24/7/365 and has called itself a “trucker shelter” during inclement weather.

We live in interesting times.

New Short Story And A Lot of Vulnerability: “Stronger”

Wedding picture!

Before you read this post, please take a moment to read my short story on Coffee House Writers here.

Read it? Alright then. Let me take a deep breath. It’s time for me to get vulnerable with you. These emotions are weird and difficult for me.

This piece is fiction, but there are pieces of this story that are true. I left out parts. I toned it down. I changed names, places, and made up new people and circumstances. Hannah is fictional. My partner is my best friend, he would never abandon me, and is one of the most understanding human beings on this planet – don’t you dare think that this story is in any way about him. Time to clarify some things just in case.

What is based on truth is the public transportation incident that the main character experienced as well as other aspects of trauma. I’m unusual. There was never a time in my memory before vitiligo and for that I am grateful. I never experienced loss, though it has grown. When my parents first took me outside as an infant and I started to tan it was there. Family members talked. They knew it affected me, but when I heard the words “deformed” and “disfigured” I internalized it. Growing up in very remote areas of the United States, even today there are people that believe it is a mark of demonic possession or worse. Luckily, I have a loving amazing family.

The public transportation incident in the story is based on when I lived in San Francisco. In 2016, an elderly woman beat me with her cane during evening rush hour while yelling, “Leper,” and, “Stop Touching Me!” I was not touching her. No one said anything or stopped her, but they sure stared at me. I got out early and walked the rest of the way home. Try and imagine the terror of being beaten in public by an old woman in front of a crowded light rail train car in rush hour while no one said a word. You there yet? Cool.

I didn’t include every example of vitiligo changing what someone saw or how they acted toward me in the story. I have been refused service at restaurants because they didn’t want a “leper” touching their plates or tables (this happened in Niagara Falls, ON). Questions like “when were you in a fire?” or later, after years of working in laboratories, “were you in an accident?” are always a fun time. These are the examples that come to mind.

This has been my whole life. And I’m white. Imagine what it would be like for someone with darker skin than mine. Indeed, one review mentioned, “In a study of 53 [vitiligo] patients in India, major depressive disorder was reported in 57% of patients, social phobia in 68%, and suicidal ideation in 28% (high risk 8%; low risk 21%). These findings stress the need for psychological and/or psychiatric intervention (Ramakrishna and Rajni, 2014). Papadopoulos et al. (Papadopoulos et al., 1999) reported that counseling and cognitive behavioral therapy could improve self-esteem, body image, and overall QoL [Quality of Life] in patients with vitiligo.”

Now, let’s flip vitiligo to any other visible disfigurement or disability a child internalizes as being their fault because it impacts a child’s life significantly. It’s your turn to help a kid with a completely different life face that internalization and you’re thinking of becoming involved in foster care like I am. There are additional realities that you need to face. Over 35% of children in foster care have a parent with a substance abuse disorder and have been exposed to substances. Given the age range that my partner and I are looking to foster with intent to adopt, the reality is that our future foster children will likely have been exposed (directly or indirectly) to alcohol, methamphetamine, benzodiazepines and/or opioids at some point. They could have addictions of their own. One study suggests that kids that have been through foster care will develop substance abuse issues later in life if they don’t do so while in the foster care system. It’s complicated.

We’re not looking for a perfect child. We will love a child with an addiction – even if it was a choice of coping mechanism in the moment or however it started. We already love people with addictions. They aren’t broken and they can be successful if given the support they need.

Readers don’t like ugly stories and I get it. The world is ugly enough as it is. They don’t like thinking about the fact that therapeutic foster care homes are severely underfunded. But here’s the thing, foster care produces brilliant minds if given the chance, and, as a reminder, here’s a list of successful people that survived the American foster care system. Any names look familiar? Steve Jobs? Colin Kaepernick? I have met successful doctors, scientists, and lawyers that fought their way to where they are now through this underfunded system. I love people from this system and look forward to loving more of them.

Want to help make change? Donate your time as a mentor or become a foster parent. Respite care can be for anything from a couple hours to a couple days and helps kids in foster care and families within your community that may need temporary childcare. Mentoring involves spending time with a kid to provide them with a role model and someone to spend time with. Multiple organizations, such as the Boys and Girls Club and Big Brother Big Sister offer mentoring opportunities. CASA (Court Appointed Special Advocates) is a great way to support children going through the legal system – a terrifying process for kids. Before donating money, look to your local community first.

Anyways – this story is dedicated to an incredible young person named Olivia. There’s my soapbox. I’ll get back to writing my short stories and book reviews. These emotion things are weird.

What does everyone do with these stupid referral links and codes? Why not experiment with manipulating search engines.

Haskell is on a heating pad under a blanket, hiding from the Montana winter

Like everyone else on this planet on the internet involved in the modern economy, I have started accumulating referral links and codes for products I actually use. I am left with a giant question: WHAT THE HECK AM I SUPPOSED TO DO WITH THESE?

In my opinion, referral links are used to feast upon social capital and provide some monetary reward in exchange – primarily in reducing the cost of products to the person sharing the link.

Fine.

I have such mixed feelings about social marketing. As indie authors and reviewers, we rely on social marketing. I decided to devise an experiment. In many ways, this post is about passive social marketing. Happy to explain – someone wants to try out a product and gets on a search engine looking for a referral link. By searching for a referral link they end up on a blog. By ending up on that blog, they click around a little bit more and discover they want to buy someone’s book thanks to a review I’ve written (at least, that’s the goal).

So here’s the referral link post. I will update it occasionally. It will contain referral links (not affiliate links – there is a difference). These are all products I (or my partner) am actively using and am happy to answer questions about if you ask me directly – Twitter will get you the fastest response. I will not talk about them otherwise – I am not an “influencer”. DO NOT TAG THE BRAND. As a friendly reminder, I talk about books and I’m sticking to that. You can use these links with or without talking to me first. Once I stop using these products, I will remove the links.

If this doesn’t seem to benefit anyone (including authors – please let me know if you see no increase in sales) I will edit it with an update on what I learned. The fun thing about WordPress is that I have access to analytics tools that give me the ability to look at insights specific to this post.

If this does seem to benefit everyone in getting more books sold and increasing overall website traffic, I will start requesting additional referral links and codes from other indie authors and reviewers. Same rules as above will apply.

Referral Links/Codes:

Hum Nutrition Referral Code: 1E4424
Details – $10 off first order + $10 off next order for the referrer

Update (3/26/2020): This code has worked (in terms of both drawing traffic & resulting in at least 1 referral)

ClassPass Referral Link: http://class.ps/ncJRh
Details – discounted first month of membership (it is an auto-renewing subscription) + $30 off next month of membership for referrer (based on my current geographic location)

Phlur Referral Link: http://fbuy.me/v/laura_6621
Details – $5 off first order + $10 off next order for the referrer (I have opinions on this one)

Basic Man Referral Link: https://www.getbasic.com/refer/Jacob-HXEXXQSD
Details – $10 off the first order + $10 off next order for the referrer (okay, this one is actually my partner’s subscription)

Tesla Referral Link: https://www.tesla.com/referral/jacob11641
Details – $250 off of a solar panel or 1,000 miles of free supercharging. (If ANYONE uses this one, I will be flummoxed)

ThredUP Referral Link: http://www.thredup.com/r/HPIG6E
Details – $10 off first purchase + $10 off next purchase for referrer

I don’t have any more referral links to add between the two of us, so I need your referral codes for products you actively use. I do not want to list more than 10 codes/links to start, so I have 4 open spots.

Preference is given to authors I have previously worked with or am working with in the immediate future.