COVID-19: Flattening the Curve

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Medical / Uncategorized

Today we’re going to talk about COVID-19, what I’m doing, my personal tips on staying sane while social distancing, and what else you can do to help during this pandemic. I hope it’s helpful.

So here we are, Nico and I are back in isolation! For those who don’t live in New York City or a place where COVID-19 feels like a sleeping giant ready to take us all down, you might think I’m overreacting. So far, I feel like the responses to COVID-19 fall into two camps: people who are taking it very seriously, and people acting annoyed that other people are taking it very seriously. To those of you who are annoyed, please do your homework. Read things! Respect the decisions of people trying to stay safe, and ask yourself how you can help.

This article is a GREAT place to start if you’re wondering why people are staying home. It’s not just about YOU not getting sick, it’s about flattening the curve, suppressing the rapid spread of the disease so our health system doesn’t become overwhelmed. Protect your community if you are able to do so. Also: taking precautions does not mean we’re panicking–it’s being deliberate and mindful that we live in an interconnected world. https://www.vox.com/2020/3/10/21171481/coronavirus-us-cases-quarantine-cancellation

Because here’s the thing: we don’t have the health infrastructure—adequate testing, ways to quickly increase hospital ICU capacity, accessible and equitable health care— to handle a pandemic.

For those with privilege—health, racial, economic, to name a few—there’s a lot of talk about using privilege for good. I think sometimes this is a way to comfort ourselves that the privilege we have isn’t an all-bad thing, even though it’s probably the result of structural violence, racism, etc. Setting that argument aside because it’s a whole can of worms, I think most of the time “using privilege for good” looks like donating to the ACLU. Which is fine! But this is a moment when using privilege and taking immediate action can directly save lives: if you are able to work from home (I know this is a big IF), to cancel commitments, to practice social distancing without it being a major financial burden for you and your family, you should do it.

Think this is just about older people and sick people? Maybe you’re perfectly healthy and you can’t quite imagine how this would affect you. Know that that is its own form of privilege. Think you don’t know someone who is in danger? If you’re reading this, you probably know me somehow. My immune system has not recovered from treatment and I’m still considered immune compromised—and my counts at my last bloodwork visit 6 weeks ago were the lowest they’ve been since treatment.

I also traveled to a wedding this weekend because when I emailed my oncologist asking if it was safe for me to go, they said they follow the CDC guidelines, which were not yet telling people like me to avoid crowds and travel. The guidelines literally changed while I was at an airport in Montana about to board a very long flight home, after being around hundreds of people at events all weekend. Now I’m sick—not with COVID symptoms, thank goodness—but this means my immune system isn’t fighting things off and I was vulnerable during all of that contact. It turns out that the CDC tried to change the instructions earlier,  and the Trump administration overruled them for no scientific reason. I would never have attended the wedding had the administration listened to the CDC. Our federal leadership always matters.

I can’t change the last week, but right now I can stay home, and so can Nico. Google has recommended that people work from home until at least April 10th. He is privileged to be able to work remotely and have an employer who sees action as necessary and provides health insurance. So we are home. I am trying to get less sick to get my immune system up before we come into contact with basically anyone else. We are flashing back to my chemo time. Fun, right?

But you know who cannot stay at home? A LOT OF PEOPLE. 25% of American workers do not have paid sick leave, and others have employers who won’t create systems that allow people to work from home or to take time off preventively: this is inhumane for a lot of reasons, and we’re about to see how dangerous these policies can be. It means that many people are going to have to keep going to work to pay bills, support their families, and not lose their jobs. It also means that people who can’t take preventive measures are going to need medical care.

A lot of folks also do work that keeps our society functioning and as long as they’re healthy, can’t stay home–this includes health care workers who will be putting themselves at risk to take care of others (and who have not been supported by sweeping protective policies). So if you can stay home (and I’m going to acknowledge again that a lot of people simply cannot and this is messed up): DO IT. Help preserve medical care for those who can’t take preventive measures. Help us keep our health systems from becoming overwhelmed. FLATTEN THE CURVE.

Social Distancing

This Twitter thread is wonderful and illuminating as we talk about deciding to make changes to our day-to-day lives. Yes, it is hard to take these measures. But if I could have changed my behavior, whether short or long term, and prevented myself or those I love from getting cancer and being truly sick in a life-threatening way, I absolutely would have done it.

Even if you can’t work from home, you can take steps to not be in crowds–encourage institutions to stop having large gatherings, cancel your plans, and make people around you feel comfortable making the choices that are right for them. If someone else cancels, don’t act like they’re being crazy. Ask yourself what is truly necessary to be at in-person.

Think social distancing sounds annoying and not fun? As someone who did it for almost 9 months, I hear ya! Did you read this blog and think my having to stay home didn’t seem like a big deal? Now you get to try it out for yourself. I would be lying if I said I wasn’t a little fascinated to see how other people respond to it, since people often just nodded along, acted like my having to stay home for the better part of year seemed normal and fine. So welcome to the world of living only in your house.

Yes, you will miss things. It sucks. So far this week I’ve had to cancel my attendance at a workshop with an author I love, which was sad for me. I missed 13 weddings while I was sick. I (mostly) got over it. You’ll get over it too. If you’re lucky, life will go on. It’s been hard to not get annoyed with people already complaining about this because once again, welcome to my world!

And yes, you’ll get cabin fever. Social distancing is not like normal working from home. Maybe you’ll do things during the day, and then there’s not a ton of reprieve from the world of your home. You’ll spend a lot of time alone (unless you have kids, in which case I recommend finding a way to have some time alone, even if they’re home too, so you don’t lose your mind).

Here are some things I did to stay sane, and I recommend to everyone:

  1. Make your home or space livable: clean up, tidy, move stuff around so it is more workable for you. This is what Nico and I are doing today as we prepare to be home together for at least the next month. When you are stuck at home, those piles of stuff will drive you crazy: get at them now. Clean those floors. Make this a space you want to be in. We are moving a tiny desk into our bedroom so I can work somewhere while Nico is on calls—we have a 700 square foot apartment (huge for NY, TBH) and a postage-stamp sized bedroom, but we’re moving some furniture to make it work better. We’ve actually never been isolated this long or this often together, I was mostly solo, so that part is new for us. Stay tuned for how it goes.
  2. Worrying about germs is scary and hard. Creating a system for yourself when you leave the house and come back in helps. When you do need to leave, have a system for how to touch or not touch things, when to use hand sanitizer, etc. When anyone comes over, tell them your system: “hey, I ask everyone to take off their shoes and wash their hands, I know it’s annoying but it’s what I do!” When I come home, I do those things, wipe down my phone (please folks, phones are GERM BRICKS–we keep cotton pads and a bottle of rubbing alcohol by the door for this),  think about what in my bag needs to be sanitized immediately, and put any bags and coats away. Don’t leave them out to constantly get germs everywhere. That way, I can relax afterward. I also wipe down things I touch a lot around the middle of the day—sink handles, fridge handle, doorknobs. AND WASH YOUR TOWELS. They’re germ factories. It’s all part of my usual higher-caution routine. This is much easier than feeling like you’re making up rules as you go or like you haven’t done enough (this can start to eat at you in particular). You want to feel safe once you’re settled in, and you’ll feel better if you have regular precautions that you take.
  3. Have a rhythm to your day. Get up, make coffee, give yourself a schedule for what you do and when you do it. Create a fake new normal. This sounds basic and un-sexy but it helps.
  4. Start watching a show or listening to a book in tandem with people you know. You are no longer going to have as much stuff to talk about—what happened at work, where you went, what you did. When Nico got home from work while I was sick, I used to hear about what he did all day, and then I’d be like “um yeah so today was just like yesterday? Here’s what I read on Twitter?” It got better when we were reading something together or watching a show. I also watched shows a few friends of mine knew like the back of their hands. I could be watching alone (I was mostly alone 5 days a week for 8 hours a day for 9 months, so this was often the case), and I would text them observations or commentary. One of my friends has seen all of Cheers and Frasier and knows the characters and story arcs well, ditto for another friend with the West Wing, and another with the Nanny. I would just spark up random conversations with them about the shows. They were always willing to shoot the shit about these fake worlds with me. I also read the same books as some of my friends (particularly a super-hero-ish YA series called Keeper of the Lost Cities) and would text all my thoughts about it to them. It felt like socializing. This time around, my nephews and I are long-distance watching all of the Marvel movies in chronological order (the order in which they happened in the Marvel universe, not when they were released–apparently an important distinction for Marvel People).
  5. On that note, read! I couldn’t really read for a lot of treatment due to chemo brain and some floating proteins in my vision from the drugs; they made pages pulsate slightly and I’d get headaches if I tried (I am a big reader and this was particularly punishing for me). I listened to books instead, but this time around I can read. Reading will set you free! And if you don’t usually read fiction, now is a good time to start. Inhabiting other worlds for a little while each day will help. Don’t forget to order books from independent booksellers—NOT AMAZON—because this pandemic is going to hit small businesses hard. Indies ship! Use Indiebound.org to find stores, or order directly from your local bookseller. Guess who is definitely not giving their workers paid sick leave? Fucking Amazon. Those books are important but don’t act like you absolutely need them tomorrow. You’re fine.
  6. Give yourself social media limits: do not—DO NOT—spend all day on Twitter or Facebook or Instagram. If you don’t usually work from home, this a big temptation. Don’t read every single article, don’t get involved in Facebook fights. Give yourself social media boundaries and challenge yourself to use your time differently. Otherwise, I can personally attest you will become an internet gremlin and hate the world.
  7. If you are physically able, take walks, and create regular walking routes that start to feel good to you. This is currently a little difficult for me because my nerve pain is pretty bad, and it was even more difficult for parts of treatment when I was in bodily pain and not breathing well—but I did it anyway. I had one short neighborhood walk I did, and then a longer lake walk for better days. I probably did these about 4-5 times a week. Getting out and being in fresh air—no matter how bad the weather—is important. I did it with some pretty major restrictions, and I’m guessing many of you can too. I took some COLD lakefront walks in Chicago but I think they were what kept me sane, kept my blood moving, and ultimately helped my body utilize my tiny supply of white blood cells to stay healthy. Find ways to move: workout videos, online yoga (I used Yoga with Adrienne), walks–if you aren’t physically up for it, even sitting by a window is helpful. Pick a workout video and do it in tandem with your friends. Get creative.
  8. Video chat! FaceTime is great, but the app I l really love is called Marco Polo. You leave video messages and can continue an ongoing conversation with people—this takes away the need for everyone to be available at the same time. It’s also great for groups of people, so if you’re feeling isolated and just NEED TO SAY THINGS, this app is awesome. One of my friends has had a chronic illness for two years and we Polo pretty much every single day. I honestly can’t recommend it enough.
  9. Create occasions. As I was writing this post, I came across this great Twitter thread that has some similar recs to mine. I think her rec of finding “small things to look forward to” is perfect. I had cooking projects (made homemade pasta last time, I’m going to try to learn to make bread this month because why not), I read a lot of food blogs to fuel my experiments, and I watched the Bachelor with some friends regularly. These nights became the equivalent of mini-parties for me. Do that long-distance! Declare that you and your friends or family are going to have Taco Tuesday or soup day or pizza night and then text photos, talk about it, watch the same movie together long-distance. Create reasons to feel like you are on the same page and do something small intentionally together. I know this sounds dumb and not that exciting..but social distancing will change your bar for what is interesting and exciting, I promise.
  10. Set hydration goals: hydration is key to remaining healthy. I have a big 30-ounce sippie cup and I count how many times I fill it per day. My goal is three times by the afternoon. Add lemon, mint, whatever makes you want to drink more water. Goals in general—number of walks, amounts of water, baking a perfect loaf of bread—are good and prevent the crazies.
  11. Don’t drink alcohol during the day. This is a slippery slope.
  12. Change out of your pajamas in morning! Nico could tell what kind of day I’d had based on whether I was still in the same pajamas and robe he’d seen me in when he left for work in the morning. Brush your teeth (also important for keeping bacteria out and your immune system strong) and ideally wash your face (live your life though). Even if you change into something just as comfortable as pajamas, which is definitely what I do, it’s still helpful to reset yourself.

All of these things will help you end the day thinking to yourself: “I did things today! I’m a person!” That was my goal—to still feel like a person who did things, no matter what. If this lifelong extrovert who loves parties and being out in the world could stay home for most of a year (while feeling like they could die any day!), you can do it for a few weeks. Buck up. Don’t complain too much. Recognize your privilege and have some grace and respect for those in other situations.

My amazing grad school classmate turned these tips into a series on Instagram. You can see them all on her feed:

What else can you do?

Ask people in your life if they need help. If you’re healthy, ask if they need a grocery pick-up or a meal made. This is going to be difficult for lots of people, and especially difficult for already-overwhelmed caretakers. The idea of something like this happening while I was on treatment and we were already coping with so much is tough to even wrap my head around—think about the people you know who might need help.

Pissed off about worker’s rights? Donate to the action funds of unions like SEIU, the National Domestic Workers Alliance, and to local worker’s rights organizations like the Fair Work Center in Seattle, the Workers Defense Project in Texas, and TakeRoot Justice in NYC (where some of my brilliant dear friends work—thanks guys!). They fight for worker’s rights and better life conditions every damn day.

Wondering how people without savings and other resources are going to manage quarantines because we have no safety net in our country? It’s going to be awful and hard and I hope we keep this in mind as we go into the 2020 elections. Economic inequality is at the heart of all of this. Right now, you can also donate to local food bank projects. They are mobilizing and they need support. I’m donating today to God’s Love We Deliver, an organization in NYC that provides meals to people living with illnesses (it is non-sectarian, and many recipients are living with HIV/AIDS and cancer).

I encourage everyone who can to take action. Talk to your friends and family. Order from local Chinese restaurants, don’t be racist, and buy gift cards to small businesses. Read all the books. Don’t spend all day on social media. Stay safe out there! Thank you for coming to my TED talk!

11 Comments

  1. Stephanie Custis says

    You missed all the people the “privileged” count on for doing things society needs to function and who therefore can’t stay home. Sanitation, grocery, supply truck drivers, health care, mail, et cetera, ad infinitum.

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    • Hi Stephanie! I think I made it pretty clear that there are lots of people who cannot stay home, sorry if you think I wasn’t pointed enough about societal inequalities.

      Like

  2. Mary Beth Bazzanella says

    Thanks for sharing! I’m not yet able to work from home as I’m currently developing plans for remote learning for the 86,000 students in the district I work. Should it come to us working remotely, I’m definitely going to implement several of your great ideas. With John working at the fire department, Robbie working as an EMT, and Lisa as a surgical nurse at the VA, they won’t have the luxury of working from home. So much love coming your way from all of us. We love you and miss you and Nico! I’ll let you know if I find any great new books or new shows.

    Like

    • Mary Beth it’s amazing that you’re working on that plan! And yes—all of our health and emergency services people are going to be at the forefront of all of this. I hope everyone is doing okay. Love you!

      Like

  3. Joy Walsh says

    Thanks Nora! I am definitely utilizing this article to help keep morale up with our therapy group practice as we work towards utilizing telehealth sessions. All of these tips will be put to great use for both our clients and clinicians!

    Like

    • Thanks so much, Joy! It means a lot that this was helpful for you all. Good luck with the telehealth sessions, I know doing things remotely is a huge challenge!

      Like

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