The Importance of Earnest Service

Photo: ny.curbed.com

New Yorkers were used to crowds. Before the pandemic hundreds of us would routinely enter a concert, game or theater at once, while others would similarly board rush hour subways, commuter trains and buses daily.

I don’t like crowds so if possible I’ve been strategic to avoid them. When I depended on a subway to get to the office I’d leave early or late and always missed rush hour at day’s end by working until well after 6:00 pm. Even if at a protest, I’d go alone and plant myself at the crowd’s edge so I could leave promptly.

In line for discount theater tickets @ TKTS Photo: en.wikipedia.com

In addition to a feeling of loss of control created by walking among a mass of people, these days there’s the potential danger of exposure to virus-infected droplets if marchers, ignoring social distancing, wear masks or not. That’s why I was alarmed when I couldn’t cross 50th Street and Second Avenue on my way home on Tuesday afternoon. Vehicular traffic and bicycles were stopped at the street as if at the starting line of a race, backed up for blocks making a giant parking lot.

We–me at a distance from them and other pedestrians standing appropriately apart–watched an enthusiastic throng of mostly youngsters protesting against police brutality and racism who only by the virus and their proximity to one another posed any danger. There was nothing to do but wait or come face to face with marchers by struggling past a tight line of them to reach the other side of the street. Finally there was a slight break and we raced through it to continue downtown on fairly empty streets.

Washington State June 2020 protest Photo: en.wikipedia.com

I empathize with the marcher’s goal of solidarity but NYC isn’t theirs alone. It’s mine too. I didn’t like feeling trapped. This morning on WOR 710 radio Arthur L. Caplan, Ph.D., Professor of Bioethics at New York University Langone Medical Center, warned in an interview that the marchers must take care not to block ambulances from reaching the hospital which he said has happened.

The Democratic National Committee, which moved its convention from July to end August, is exploring some kind of virtual convention. In “If Democrats Hold a Big Convention, Will Anybody Come?” in The New York Times Reid J. Epstein wrote: “Interviews with 59 members of the Democratic National Committee and superdelegates who will formally nominate former Vice President Joseph R. Biden Jr. in August found that the vast majority of them don’t want to risk their own health or the health of others by traveling to Milwaukee and congregating inside the convention facilities.”

With the uncertainty around the spread of Covid-19–we’re now hearing that the heat of summer may have no impact on lessening it as hoped–I wondered if anyone has asked the some 50,000 Republicans, of which 2,550 are delegates, that the president expects to attend the August convention if they still plan to stand shoulder-to-shoulder for hours under one roof?

Do you hope as I do that there will not be an uptick in Covid-19 cases as a result of the marches in spite of dire predictions by many in the medical community? That would be a big relief to both parties and all Americans.

Republican 2016 convention. Photo: politico.com

We are all collateral damage to this virus, some more than others.

For starters restaurants, airlines, retail and small businesses of all kinds, museums, theaters, consequent furloughed/fired employees and retired citizens living on savings all suffer. In addition to and as a result the country’s mental health has taken a terrible blow. Heading the list: substance abuse; domestic violence, alcoholism and suicide. The headline from a Well Being Trust & The Robert Graham Center Analysis: “The COVID Pandemic Could Lead to 75,000 Additional Deaths from Alcohol and Drug Misuse and Suicide.” People are understandably desperate.

Heather Long and Andrew Van Dam at The Washington Post reported last Friday that April job loss at 20.5 million with unemployment rate at 14.7 percent is “the worst since the Depression era.”

Policymakers have to make Russian Roulette-like decisions, the most difficult of their careers: Life loss over jobs? Jobs over potential sickness and death? The data on which to make decisions and forecasts of where this unpredictable tornado-like virus will go is mercurial: Every week we learn of new twists and turns as experts struggle to recognize symptoms and cobble together remedies. And too many interpretations appear to be political which doesn’t feel right in a crisis.

Between the squabbling and posturing I’m not sure who is leading the charge which is troubling. The president tossed the ball to the governors. CDC standards to determine when it’s wise to reopen businesses are followed by some but not all governors and nothing is done to enforce them.

Some governors on the east coast are coordinating the acquisition of personal protective equipment so they don’t compete and achieve the best prices but that seems to be it. They are not in sync when it comes to opening beaches, businesses and restaurants which Governor Cuomo has previously said is essential due to their proximity and the fluidity of citizens armed with cars.

• Connecticut expects its restaurants to welcome patrons–with restrictions–on May 20. Whether town beaches are open depends on each mayor according to ctpost.com. For example Greenwich beaches are open to residents and Norwalk’s on a “case-by-case basis.”
• New Jersey’s sun lovers will visit its beaches Memorial weekend.
• NY State parks and beaches are closed at least until May 31 according to a NYS parks website. In order for a region to open under Pause New York, which expires May 15, it must meet CDC criteria: “a 14-day decline in hospitalizations and deaths on a 3-day rolling average. Regions with few COVID cases cannot exceed 15 new total cases or 5 new deaths on a 3-day rolling average. A region must have fewer than two new COVID patients admitted per 100,000 residents per day.” The NY State website spells out the priorities regarding business openings. In Phase I: construction, manufacturing & wholesale supply chain, select retail using curbside pickup only, agriculture, fishing. Only in Phase III do we see restaurants and food service that many other states have long opened. A crucial component: A region must keep an eye on data and be able to pull back and shut down again if the numbers of Covid-19 cases increase.

Do you feel secure that your state is interpreting the criteria for raising the gates to reestablish the economy while protecting workers, citizens–and you?  With the exception of NY Governor Cuomo, who has said time and again “hold me accountable; blame me,” the handling of this pandemic is like watching a child’s game of hot potato where some leaders don’t want to be holding the spud when the music stops. Who has a handle on the true full picture? How will the federal purse control/disperse life and worker-saving funds when regional criteria differ so drastically? Will exacerbated mental health issues be given their proper due by government and insurance companies?  And most important, who will ultimately determine which comes first–the economy or risk of death?

Cats sheltering in place in a neighborhood pizza parlor, hungry for company.

Photo: accuform.com

For a moderately good housekeeper these are stressful times especially since I can’t find the ideal products recommended for coronavirus whistle-cleaness.

So I wonder: “Did I clean the plastic bags correctly? Are my apartment keys virus free? My credit card? Do I really have to wash my hair every time I go outside? Did I catch every nook and cranny of that tuna can or OJ bottle? What about my jacket pocket where I keep my phone? And the phone itself?”

Photo: physicscentral.com

And then I remember what happened one summer vacation in high school. I was in southern Italy with two classmates and the mother and brother of one. For our safety, Mrs. G was scrupulously careful about the water we drank–it had to be bottled. At the time we didn’t care for fizzy water but that seemed to be the only kind available. One day we found a restaurant with bottled still water. We were gleeful. As we sipped our drinks through a straw–real straw–we suddenly realized that the ice in our drinks was made with local water. None of us got sick.

Fact: My home will never be as clean as an operating room–live with it [I hope].

Joseph G. Allen’s Washington Post opinion piece “Don’t panic about shopping, getting delivery or accepting packages” put some of my concerns in perspective. He claims low risk for “box delivered by UPS, touch packages at the grocery store or accept food delivery.” Allen is at the Harvard T. H Chan School of Public Health in its Healthy Buildings Program.

He wrote “First, disease transmission from inanimate surfaces is real, so I don’t want to minimize that. It’s something we have known for a long time; as early as the 1500s, infected surfaces were thought of as ‘seeds of disease,’ able to transfer disease from one person to another.”

Today a New England Journal of Medicine article is trending [and scaring]. “The coronavirus that causes covid-19 ‘was detectable . . . up to four hours on copper, up to 24 hours on cardboard and up to two to three days on plastic and stainless steel.’”

Photo: amazon.com

Allen shared an example of an Amazon package delivered by an infected driver who wiped his/her nose, didn’t wash hands and touched your package. “Even then, there would be a time lag from when they transferred the virus until you picked up the package at your door, with the virus degrading all the while. In the worst-case scenario, a visibly sick driver picks up your package from the truck, walks to your front door and sneezes into their hands or directly on the package immediately before handing it to you.”

Allen then described a model–think pieces of pie. “For disease to happen, all of the pieces of the pie have to be there: sick driver, sneezing/coughing, viral particles transferred to the package, a very short time lapse before delivery, you touching the exact same spot on the package as the sneeze, you then touching your face or mouth before hand-washing.”

He wrote to cut the chain: leave the package outside or right inside the door for a few hours and wash your hands. He continued: “you could wipe down the exterior with a disinfectant, or open it outdoors and put the packaging in the recycling can. (Then wash your hands again.)”

Regarding grocery stores: “Keep your hands away from your face while shopping, and wash them as soon as you’re home. Put away your groceries, and then wash your hands again. If you wait even a few hours before using anything you just purchased, most of the virus that was on any package will be significantly reduced. If you need to use something immediately, and want to take extra precautions, wipe the package down with a disinfectant. Last, wash all fruits and vegetables as you normally would.”

Feel better? What precautions are you taking? Any shortcuts? Can you share examples of when a goal of perfection fell short yet all was well in the end?

Photo: smartsupp.com

Photo: montsinai.org

I was given every chance to show talent for drawing or painting when young. Sadly I’m like a tone deaf person who loves music: My stick figures are not convincing and I admire people who can translate on paper or canvas a thought or scene.

Nevertheless I see material for cartoons all over the place. Here are recent examples that a sketch would capture far better than I can with words.

Achoo

I was passing an urgent care office—they are at street level all over Manhattan, many with large windows neither frosted nor with shades drawn.

Behind the reception desk at one was an attractive staffer blowing her nose into an enormous wad of Kleenex. Struck me funny.

Ying &Yang

Photo: lenoxhill.northwell.edu

Walking to the subway this week on 77^th Street between Park and Lexington Avenues I passed on my left a Christian Science church and on my right, Lenox Hill Hospital. The contradiction brought a smile.

Seating Arrangements

The subway car was jammed the other day. A little boy about 10 sat next to his mother. She didn’t suggest he give up his seat to fellow passengers encumbered with packages, disabled or elderly. The scene inspired this invented scenario: In every seat are kids and 20-somethings. Standing are people with canes, crutches or pregnant.

Do you come across scenes that would make poignant or amusing cartoons? Do you have a favorite cartoon?

Photo: Alamy.com

Photo: redbookmag.com

I’ve written about office friends and those whose names you don’t even know; buddies as good company, splitting the check, hugging and protecting them. Tara Parker-Pope wrote about friendship from a different perspective in her New York Times article “How to be a Better Friend.”

She reported results of research that showed that students in pairs estimated the slope of a hill they were expected to climb to be far less onerous than those who were alone. Another study supported “the notion that social support helps us cope with stress.” Friends in a room made the heart rate of women faced with solving a math problem go much slower than those approaching the task alone.

Photo: barewalls.com

Parker-Pope claimed that friendships, more than romantic partners, positively impact health. Here’s one of three studies she chose to illustrate the point: “In a six-year study of 736 middle-age Swedish men, being attached to a life partner didn’t affect the risk of heart attack and fatal coronary heart disease, but having friendships did. Among risk factors for cardiovascular health, lacking social support was as bad as smoking.”

She wrote that “proximity was not a factor in the benefits of friendship” though its obvious that local friends can run errands and help in other ways if necessary. People with friends get fewer colds which might be related to experiencing less stress.

The effect of peer pressure can be good or bad. Some participate in exercise routines and other healthy activities with their buddies while others may gain weight together. If a person did the latter, a 2007 study showed that there was an almost 60 percent risk that their friends would too.

Photo: runnersworld.com

In Japan, Parker-Pope wrote, “people form a kind of social network called a moai — a group of five friends who offer social, logistic, emotional and even financial support for a lifetime.” Women in Okinawa, Parker-Pope reported, have an average life expectancy of 90–the longest in the world.

Dan Buettner, a National Geographic fellow and author who studies health habits of people who live longest told Parker-Pope “Your group of friends are better than any drug or anti-aging supplement, and will do more for you than just about anything.”

The title of Parker-Pope’s article–“How to be a Better Friend”–didn’t match the information in it. Just being a friend is what counts. As I am blessed with life-saving friends I can vouch for how their support is an effective passport to joy and an antidote to stress and anxiety. Who knew there might also be health benefits?

Photo: welovecycling.com

In my line of work, I’m thrilled by the stories I bring to media that they embrace. I’m critical of some I read, see or hear when I think of a few appropriate leads I’ve proposed that were rejected by key players. The most glaring example of “how did this get past the editor/producer?” is the constant coverage by legitimate media that gave credibility to the shenanigans of the current chief of state when he started his campaign.

Photo: boldomatic.com

But PR, with its constraints, is the game I’m in and when I hit pay dirt I still get a thrill; when I don’t I try harder.

Richard Whitman’s commentary on Mediapost.com struck a nerve because he wrote about the advertising world that unlike PR pays for its communications and if what it sells is legitimate, gets in. The commentary dealt with an uncooperative gatekeeper setting up a roadblock for dissemination of essential information that could save young lives.

In “Cancer Awareness Campaign Supported by Google, But Apple Won’t Play Ball,” he wrote about an advertising campaign for the Testicular Cancer Awareness Foundation to “raise money and awareness to fight the disease via a set of testicle emojis that consumers can download for $3.99.”

Photo: emel.com

Whitman reports the foundation’s findings: There’s a 95 percent survival rate when the disease is detected early. Also, it is the leading cancer for boys/men 15 to 24.

The ad agency, Oberland, prepared the sticker packs to launch with April, Testicular Cancer Awareness Month. Oberland reported that Apple’s reason for declining was: “Your sticker pack is not in compliance with the App Store Review guidelines.” Whitman commented: “Whatever that means.”

Photo: emojiisland.com

He wrote: “Oberland appealed, even sharing a note from the founder of the Testicular Cancer Awareness Foundation — Kim Jones — which included a personal story of the passing of her son Jordan from the disease at the tragically early age of 22. But the appeal was denied.”

He concluded: “And Apple seems to be going out of its way to prevent that message from being heard by more people than it otherwise might. That’s a head scratcher.  What gives, Apple?”

Photo: psychmechanics.com

I once reported to an editor who would wrinkle her nose, hand copy back to me and say, “I don’t like it.” I’d ask what she didn’t like—the topic? the headline? the lead? It was my first magazine job and I was flummoxed when her only response was the look of disgust. Apple acted just the same. Someone could have said to Oberland, “this is what you must do for the app to be accepted.” Nobody did.

Advertising is a different game than PR. It’s more costly and those doing it have control of the message and where/when it plays. Or do they these days—when the gatekeeper to a crucial target audience is a giant corporation that carries a lot of weight? Is this a healthy precedent?

Photo: everydayinterviewtips.com

Photo: the nibble.com

I love sipping from a straw: Always have. Straws are associated with happy drinks and times. On hot summer nights my mother made scrumptious ice cream sodas for dessert which we’d sip through straws. A whiskey sour with a straw makes a celebration of an ordinary Saturday night.

To read they may be an endangered species because they are considered a “‘gateway plastic’ in understanding the pollution problem,” makes me sad. They come in cheery colors. The paper ones, in mostly stripes, cost a fortune and disintegrate. Bars that use metal straws claim customers take them. One company makes biodegradable plastic straws. Wonder how much they cost.

Photo: hanfordsentinel.com

The gateway plastic quote above, by actor Adrian Grenier, was in Cara Lombardo’s Wall Street Journal article, “The War on Straws Is Coming to a Bar Near You.” Given the years since I first heard plastic bags were to be banned in NYC and still they are not, I may not have to say “bye-bye” to straws anytime soon.

Grenier started a #stopsucking social media campaign and “The Scotch Whisky Association and the makers of Absolut vodka and Tanqueray gin have announced plans to ban plastic straws and stirrers from their events.” Bacardi also nixes swizzle sticks. Pernod has deleted them from images, according to Lombardo.

She also reports that they are banned in some cities and in some bars you have to ask to get one like during the NYC water shortage when wait staff would confirm that you wanted a glass before automatically bringing one.

Photo: pinterest.com

One source estimated that we use 20 billion plastic straws annually. “Mia Freis Quinn, a spokeswoman for the [Plastics Industry] association, says the plastic straw’s detractors should focus on finding ways to recycle and recover them. Plastic straws, she says, play vital roles in everything from her children’s class projects to personal hygiene. ‘My dentist says if you’re not drinking water, you better be using a straw.’ The American Dental Association suggests using straws to prevent tooth erosion, recommending using a straw ‘palatally,’ placing the end behind the teeth.”

One straw proponent, fearing all the communicable diseases around, won’t drink from a glass in a restaurant if he’s not given a straw because he doesn’t want to touch a rim “other mouths have touched.” Another wondered how we’d drink milkshakes [a favorite food group] without them. To be able to drink a strawless frozen margarita a third “learned to tilt the glass to prevent blended ice from spilling on her face.”

Straws are nothing new. Lombardo wrote that the Sumerians used metal ones as early as 2,500 B.C. When I was a kid I was puzzled by the ones you’d get in bars in Europe that were actually made of straw. They were so thin and delicate you had to concentrate to extricate liquid from them.

Would you miss plastic straws if they were prohibited? Considering the huge amount of plastic used in packaging and bottles alone, do you think that barring straws is little more than a symbolic gesture in the face of the gigantic pollution issues we face? What do you like—or dislike—about them?

Paper straws. Photo: ebay.com

Donna Hammaker, Esq & Dr. Thomas M. Knadig, EdD

Did you know that:

• Congress defines what “equivalent” means when it comes to generic drugs and that the therapeutic effectiveness of a generic might actually be half as that of the brand according to this definition? More below.
• About 1/10^th of the U.S. population has no health insurance; most of them are earning middleclass incomes and the lack of coverage causes two deaths every hour?

I learned this at an eye-opening program of the Healthcare Public Relations and Marketing Society of Greater New York [HPRMS]. Nancie Steinberg, president, introduced the speakers Donna K. Hammaker, Esq. and Dr. Thomas M. Knadig, EdD, who addressed representatives of some of New York City’s most prestigious hospitals and health organizations and the marketers and PR professionals who counsel them.

While some of what I heard was shocking, the takeaway as a consumer was nothing new: When it comes to your health, be informed and ask questions.

About the reference to generic drugs above, Hammaker said you could not pay her to take generic drugs from India or Israel. She mentioned “brand generics” by Novartis and Pfizer that seemed to pass muster.

The speakers, on the faculty of Saint Joseph’s University, Philadelphia, and authors of three textbooks for students and health care managers, the most recent of which is Health Care Management and the Law, shared data-driven facts and statistics gathered in the last two years.

Laced in the discussion were factoids about the Affordable Care Act, such as that much of it was first addressed during the Nixon administration and that many people are unaware of what’s in it. Healthcare has been Hammaker’s professional focus as a lawyer and yet even she was surprised by bits that she learned by studying it. [One wonders how many lawmakers are still in the dark and yet they call for changes.]

Photo: racolblegal.com

A caveat: I’ve posted sound bytes throughout this post. On just one of these topics alone, Clinical Trials, Hammaker gives a three hour lecture in which she addresses the differences between brand and generic drugs. There is similar backup in her latest 830 page book and hours-long lectures relating to her other contentions and conclusions. For example in Health Care Management and the Law the authors reference court decisions relating to the use of reprocessed medical devices which, in the interest of brevity, I don’t go into here.

Following are just a few highlights based on a list the authors handed out and subsequent discussion.

• “Reprocessed medical devices are a cause for concern, as the FDA standards are not always strictly adhered to, patients are not necessarily informed they are receiving a reprocessed device, and such devices are often obtained from unregulated sources, such as the Internet.” Hammaker recommended that before undergoing a procedure that a patient specify on the hospital consent form that he/she wants a new device as well as the name of the manufacturer of the device. She explained, for example, that some hip replacement devices are made of cheaper metals that tend to break. In addition, she reported, the FDA is lifting restrictions in this area.
• 

  Photo: WebMD.com

  “Over 60 percent of the yearly $1.9 trillion employers spend on health care costs go toward treating tobacco-related illnesses.” We learned that it is legal for an employer to refuse employment to a smoker. In addition, an employer can charge current employees who smoke more for insurance; force them to take smoking cessation classes as a term of employment and conduct random tests [of hair] to identify smokers.

• “Estimates indicate 90 million people in the US live with a preventable chronic disease [such as diabetes and hypertension often caused by such factors as smoking and obesity], the ongoing care for which amounts to 75 percent of the annual $3.3 trillion health care budget.” As health insurers are no longer covering illnesses and disease that could have been prevented, Hammaker asked, “Is this a direction we want to take?”
• “While the biggest burdens to the U.S. health care system are depression and gun violence, they receive scant attention in the health care reform debates; yet the cost of gun violence in the US is equal to the cost of smoking, obesity and other preventable health care illnesses combined. Estimates of civilian gun ownership have been as high as 330 million vs. the U.S. military and law enforcement that possess approximately 4 million guns. The nation’s risk pools absorb $1.4 billion yearly to cover anticipated costs of treating victims of fatal firearm assaults.”

There are a lot of hot topics here and no doubt people who disagree with some conclusions. [We know people who suffer from a disease–chronic Lyme–that many physicians and insurance companies don’t recognize.] Were you surprised by any of this information? Are you more assertive in dealing with your health issues and those of family members today than you were in the past? Are you concerned that information like this is not readily available making it hard to protect yourself appropriately?

Photo: techlicious.com

Photo: goodguy.com

There’s a lot to make a person feel on edge these days. Just to mention a few issues:

In healthcare:

• Will Congress change the rules so that health insurance companies can charge what they like—as big pharma can—with the consequence that coverage will no longer be an option for millions including many who’ve traditionally been able to afford it?
• Is insuring preexisting conditions really back on the chopping
  

  Photo: ourgeneration.org

  block in spite of 45s promises that it isn’t? I thought we’d settled that issue to a resounding national sigh of relief, but apparently not.

The economy:

• GDP grew in the first quarter at its slowest pace in three years with a self-proclaimed business genius at the helm, [0.7 percent].
• Who is going to make up the slack when corporations and the 1 percent get discounts on their taxes?
• 

  Photo: zambiainvest.com

  The retail industry is in shambles. There are many reasons for the latter: popularity of e-tailing/online shopping, increased purchases on mobile phones, etc. This is America, land of the chronic consumer and these retailers, too, have their oars in virtual waters. Troublesome also as so many jobs are involved.

• A short article in The Wall Street Journal, “S&P’s Warning: Here Are 10 Public Retailers Most in Danger of Default: Number of bankruptcies so far this year has already come close to 2016 total,” screamed out at me. It wasn’t on the front page, but tucked in a middle one. Some names are familiar–Sears is among those that Khadeeja Safdar listed and daily we read of other household brands not in the article, such as Nordstrom and J Crew, that expect falling sales.

45s strategy to make daily headlines at all costs doesn’t help. To achieve this he is mercurial, says and does outrageous things, takes an unorthodox stance for the fun of it and damn the torpedoes. It works–he’s front page news. His followers aren’t bothered but the approach, in addition to the anxiety-provoking real triggers, is making me uneasy. Am I alone? What antidotes do you recommend?

Photo: totalmortgage.com

You probably know this if you read health journals but I don’t read them and therefore I didn’t know: A side effect of over the counter [OTC] pain meds that contain acetaminophen such as Tylenol or Excedrin can do more than kill pain. It seems that the drug can make an indecisive person resolute and a rejected person feel less castoff and abandoned.

Not all the side effects are that good. As the title of Susan Pinker’s article hints at, “Less Pain, Less Joy: New Look at Acetaminophen,” the drug “muffles your happiness too” as an “all-purpose damper, stifling a range of strong feelings.”

Five years ago, according to Pinker, two psychologists reported that three weeks on one of these OTCs, “soothed social pain like feelings of exclusion or ridicule.” [The article doesn’t say nor do I know whether taking such a drug for that long could negatively affect your stomach or cause other unwanted physical reactions.]

And in a recent study researchers found that the “more intense the emotions, the more acetaminophen muted them.” The drug “alters the circuits that govern our emotional responses,” Pinker wrote.

I’m an Advil advocate–Tylenol has zero impact on headaches or pain for me–and Pinker says researchers have yet to study side effects of OTCs with ibuprofen like Advil or Motrin. Who knows: Maybe if I take Advil over a long  enough period of time I might get good at math or ignore the psychological smacks of thoughtless people. One can always hope.

Are you under the impression that OTC drugs are benign? Have you noticed mood changes or a different outlook if you’ve been on an OTC drug of any kind for a period of time? I doubt psychological side effects are posted on OTC pill boxes, but are you diligent in reading potential side effects on remedies you pick up at the drugstore?