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Researchers have been trying to figure out why large numbers of COVID-19 cases occur in some areas but only a few cases in others. Here in New Brunswick, we are getting about 1 new case a week (almost all travel related) while, next door in Quebec, there are over a thousand new cases daily. COVID-19 sometimes spreads to many people all at once and other times it is only passed to 1 or 2 people…or none at all. This is different than the flu, where it usually spreads evenly through a community and you’re almost guaranteed to catch it if you get too close to someone who has it (barring having been vaccinated, of course…got mine this week!). Researchers think this difference may be an important key to what we need to do to control this novel coronavirus.

You may have heard references to the “R0” measurement (pronounced “R-zero” or “R-naught”), sometimes also called the basic reproduction rate. This number indicates the average number of people who are infected by each new case of an infection. If each sick person infects 1 other person, the R value would be 1 and the number of cases would remain constant, with each case replacing itself. If less than 1 is infected on average, the number of cases will reduce over time; if more than 1, the number of cases will grow.

The R0 factor has been called a key factor in understanding what is happening with the pandemic, whether it is getting better or worse. But the problem with the R0 system, is that it is based on averages, while COVID-19 spreads mostly in batches at “super spreading” events, so it doesn’t show the true picture of what is happening.

But there is another type of measurement for disease spread that you may not have heard about: the “k” value, a measure of dispersion or how a disease spreads. Does it spread in a steady manner or in big bursts? The k factor, although complicated, captures viral behaviour that alternates between super infectious and noninfectious. Data collected in the first 9 months of the pandemic suggest that COVID-19 is an “overdispersed” pathogen, one that spreads in clusters. We need to take this into consideration when we assess the risk we will encounter from any given activity we are thinking of attending.

A study done in New Zealand found that only 19% of 277 separate introductions of virus resulted in more than one new case, while analysis of outbreaks in other countries have shown a single person to have infected as many as 5,000 known cases – that one occurred at a megachurch service in South Korea. The scientific term for this type of disease spread is “stochastic” – dominated by a small number of individuals and driven by super-spreading events. Even if the virus spread in a population is relatively under control, just a few super-spread events can turn that around quickly, as we are seeing in Quebec and Ontario right now.

The key to controlling spread

Multiple studies have suggested that as few as 10 to 20% of infected people may be responsible for 80 to 90% of transmission of COVID-19 through super spreading events. These include long-term care facilities, meat-packing plants, fish factories, cruise ships, family gatherings, house parties and night clubs. Researchers have realized that, if they want to get the pandemic under control, they need to prevent these super-spreading events that are driving the increase in cases. This is now believed to be the key to controlling the coronavirus.

This concept of unevenness is sometimes referred to as the 80/20 Rule or the Pareto Principle (named after economist, Vilfredo Pareto, who first noticed the phenomenon) , where approximately 80% of effects are often generated by about 20% of the causes. In addition to occurring in nature, we also see it in various human activities like 80% of business coming from 20% of customers or 80% of taxes being paid by 20% of citizens. If you’re interested in reading more about the 80/20 Rule, Wikipedia has a good explanation.

The three C’s of superspreading events…

So, what made events that resulted in many cases, different from similar gatherings that resulted in no new cases? Researchers found 3 factors in common, referred to as the 3 C’s:

• Crowd – Many people at an event increase the chance that one will be carrying the virus. Holding an event in a community where the virus is less controlled also increases the chance someone who is highly infectious will be included in the group.
• Close – Not being able to maintain a distance 2 meters or 6 feet from others increases the chance of viral spread, as we all know now. Prolonged contact is also known to increase the chance of the virus passing from person to person. It is believed that a contact time of 15 minutes or longer of contact increases the chance of passing on the virus.
• Closed space – An indoor venue with poor ventilation allows tiny droplets containing viruses to hang in the air as an aerosol for much longer. Singing and loud talking (for example, talking over loud music in a bar) readily generate these aerosols, but normal talking and even just breathing also generate droplets. A mask of any kind, even a homemade cloth one, will trap these particles and reduce the chance of viral spread. Masks generally were not being worn at super-spreading events.

Backward contact tracing

Since this coronavirus spreads differently, we should be looking at contact tracing and testing differently, too, researchers say. Because only 20% of cases or less are responsible for most of the spread, it is important to identify those 20%. Statistically, It’s more likely that the person who gave the virus to a new case will be a super-spreader than the case at hand.

This suggests, especially if tests are limited, that it would be most efficient to trace the source of an infection and then test the source’s contacts, rather than try to test everyone’s contacts and not be able to keep up. If more than 1 or 2 cases are found amongst the contacts of a source, then there’s a good chance that a super-spreader may have been found. In lieu of testing all of the source’s contacts, isolation can simply be recommended when sufficient tests are not available. Tracing back to the source then checking their contacts is called “backward contact tracing”.

Using this information

This weekend is Thanksgiving in Canada, and many families will want to celebrate together. In some provinces, where the virus is spreading quickly and many new cases are being reported daily, governments are telling people to stay at home… and instead to share the holiday remotely, by video chat or phone call, instead.

But what about our “Atlantic bubble” where we have had very few new cases daily here in Atlantic Canada and no community spread for months? This week, we had an outbreak in a nursing home in a nearby city…15 cases there plus 2 family members who work at Costco and St. Hubert’s restaurant, plus 3 other separate cases that were travel related and already in quarantine. They are still trying to identify the source of the nursing home outbreak (backward contact tracing!) and the extent of the spread, and have finally mandated that masks be worn in all public places in our province.

So, although it might seem to be fairly safe to gather in small groups, we can’t let our guard down. The pandemic is still at our doorstep and it’s looking like the second wave is beginning its spread around the globe. We can’t forget that the virus is potentially everywhere…and we need to continually improve our systems and practices until we stop the spread and protect the most vulnerable.

References:

This Overlooked Variable Is the Key to the Pandemic – Medium.com

Stochasticity and heterogeneity in the transmission dynamics of SARS-CoV-2 – B.M.Althouse, et al, Institute for Disease Modeling

and live a happier, more productive life!

Wulastukw/Saint John River by Victoria Moon Joyce (Fredericton, NB)

What is Flow?

Flow is “a state in which people are so involved in an activity that nothing else seems to matter; the experience is so enjoyable that people will continue to do it even at great cost, for the sheer sake of doing it.” This is how researcher, Mihalyi Csikszentmihalyi describes this mental state. (His name is pronounced “Me hi Chick sent me hi” in case you’re wondering…) He also calls it a state of ecstasy, meaning stepping into an alternate reality or entering a mental state where you feel you are not doing your ordinary every day routines, and has spent much of his life studying artists, athletes, gamers and others who experience this regularly.

He was fascinated by people who could spend hours doing an activity they love, losing track of time and even bodily needs like hunger as they focus completely on what they are doing. He named this mental state “flow” because so many described the experience as effortlessly floating down a river, or as a sense of fluidity between the body and the mind.

Flow gives a general sense of well-being and a lasting sense of happiness and fulfillment, a pleasure that comes with being in the moment and doing something that you are passionate about. It’s a positive experience, known to produce intense feelings of enjoyment, lowered anxiety, raised self-esteem and improved mood. Getting into a state of flow regularly sounds like the ideal way to be happy and productive. It’s a state of optimal experience, and has been referred to as an active, moving form of meditation.

Here are 8 characteristics of flow:

1. Complete concentration on the task
2. Clear goals, value and reward of the task, and immediate feedback
3. Transformation of time (speeding up or slowing down)
4. A reward that is intrinsic (i.e. the reward is “inside” you)
5. Effortlessness and ease in performing the task
6. A balance between the challenge and your skills, with just enough challenge to keep you focused
7. Actions and awareness are merged, a loss of self-consciousness
8. A feeling of control over the task, and performance is improved

Anyone can get into a state of flow, but it is easier for some personality types. Those who are curious, persistent, have low levels of self-centeredness, and like to perform activities for intrinsic reasons only (for the personal satisfaction they get from it) tend to slip into flow more easily. Csikszentmihalyi describes such people as “autotelic” (from the Greek: autos=self, telos=goal or end), those who seek the experience itself as the goal rather than some future benefit.

How do you get into a “state of flow”?

You need to:

• Know what to do and how to do it (i.e. have a goal and plan of action).
• Care about the task at hand.
• See or get feedback on how well you are doing, including when doing it well.
• Have an activity that stretches your skills at a manageable level (so you don’t become distracted or bored) but not so difficult that you become anxious, stressed and frustrated. There needs to be a balance between the challenge and your skills.
• Have freedom from distractions so you can focus totally on the activity, although once in flow, it becomes easier to resist distractions.
• Focus on the process of the activity rather than on the outcome.

Humans can process about 110 bits of information per second. When what you’re doing totally consumes your focus, there’s no brain processing ability left to even be aware of your “self”. Conversation requires 60 bits of information per second so, in most cases (unless the conversation is part of the activity, for example in team sports), it’s impossible to get into flow while distracted by talking. Flow is possible in a team setting, however, and is reported to be even more enjoyable than being in a flow state by oneself, whether at work or in sports.

Getting into flow at work and school

Another characteristic of flow is improved performance and productivity. This makes flow a desirable state to achieve in the workplace. Matching challenges and skills, giving training regularly to increase these skills, and gradually increasing challenges to maintain focus and avoid boredom is a recipe for engaged and satisfied employees who produce the highest quality work in the shortest time. Workers need to also understand where and how their individual task fits into the overall purpose of the workplace, and to receive immediate feedback, both when they do a good job and when they need to improve.

Artists, musicians, writers, dancers, and gamers benefit from flow and this can make the activity even more pleasurable and rewarding. Spiritual practices like yoga can make it easier to learn how to get into flow as they include a meditation component. Some people even have a routine they do to clear their mind and set themselves up for flow.

In online education (and social media too, for that matter…), a goal is to keep the person’s attention as much as possible for as long as possible. An ideal goal for any learning environment is to match challenges and skills, always feeding just enough information to continually stretch current skills at a manageable level to maximize learning, without overloading and causing anxiety or frustration. The Montessori school system is noted for successfully using this individualized approach with young children.

My experience…

I think I’m fascinated by all this because I’ve experienced flow many times. When playing classical guitar, I find myself essentially listening to myself play rather than thinking about what I’m doing and, if my concentration wanders even a bit, I’m lost and have to start the song over. I’ve always felt this was just a little weird and could never understand quite what was happening until I read about flow.

A happier life

Experts tell us that, once basic needs are satisfied, material things like a bigger house or a new car bring only fleeting enjoyment and not long-term happiness. But learning how to get into flow and making the effort to get into this mental state regularly sounds like an ideal way to create a happier and more productive life.

How about you?

Have you ever been so absorbed in an activity that you lost track of time altogether? Do you have a routine that prepares you slip easily into flow when starting an activity?

End note:

The photo above is of a painting by New Brunswick artist, Victoria Moon Joyce, entitled “Wulastukw/Saint John River”. I enjoy the serenity of hints of sunlight on the flowing water of the Saint John River (near where we lived for several years) every day… I am so fortunate to have it hanging in my living room. Enjoy more of Moon Joyce’s art on the Gallery 78 website.

References:

3 Hours of Creative ‘Flow’ Every Day Is All You Need to Change Your Life – Medium.com

‘Flow’ Can Help You Achieve Goals – Very Well Mind

What is a flow state and what are its benefits? – Headspace

Flow, the secret to happiness – TED Talk

Flow – Wikipedia

Victoria Moon Joyce — Gallery 78

Two studies, one in Canada and another in Australia, have found plastic in supermarket seafood – not just in the stomachs of the fish, but in the flesh too. This means we are eating plastic when we enjoy a tasty nutritious seafood dish. But how much? And is it harmful?

For many years, the eye of environmentalists has been on plastics found floating in our oceans and lakes. We’ve all seen photos of sea life and birds being tangled in plastic rope or strangled by loops of plastic packaging. And that’s a concern.

But, at the same time, sun, wind and waves have been breaking down these plastics into smaller and smaller fragments that even the tiniest water creatures can consume. Research is just beginning to look at what effects this may be having on marine life.

However, there’s a good chance this plastic could be affecting us too when we eat seafood. Besides the content of plastic itself, which is composed of many chemicals, these microplastics are carriers of other chemicals, like PCBs, pesticides, flame retardants, and many kinds of hormone-disrupting compounds. And they’re all through the fish, not just in their digestive system, so gutting out the digestive organs doesn’t remove the plastic. How much does this affect our health? Scientists don’t know yet but, at least, they are staring to look at the problem.

My story…

I’m probably aware of the potential health effects more than most. Years ago, I thought using a Tupperware tumbler with a “sippy” lid (that my kids no longer needed) as a car coffee cup was a great idea. It fit in the car cup holder and didn’t spill all over the place in the car. And I had lots of them so they could just go into the dishwasher afterward.

I used these for months, enjoying my morning coffee daily on my way to work. But eventually, my coffee started to taste more and more like plastic. I remember stopping one day and dumping it, because it tasted just awful…

But through this time, I had started getting some health issues. A bad PAP test, breast lumps that, fortunately, were just benign fluid filled cysts (not considered dangerous), and even a little cervical cryosurgery. But a few months after I stopped using the sippy cups, the problems all went away.

I didn’t make the connection to the plastic cups until I went to a showing of a documentary film about the connections between the environment and breast cancer with a long-time friend who’s a cancer survivor. It was organized by the local breast cancer support group and open to the public. The documentary was called “Exposure: Environmental Links to Breast Cancer” and the producer and director were there to discuss the film and answer questions afterward. I have included a link to the full 53-minute documentary in the references below, if you’d like to watch it. It’s worth an hour of your time…

One of the environmental links discussed, was plastic or chemicals from plastic that make their way into our food through contact. They explained that simply microwaving food in plastic, especially fatty food, could leech hormone-disrupting chemicals into your meal. These chemicals can mimic the action of our own hormones, over-stimulating organs like the breast that respond to hormones. They can also block the beneficial actions of hormones, leaving us with a dangerous hormone imbalance.

I quickly made the connection between the coffee cups I had been using and my health problems. The coffee was leeching ingredients from the plastic, helped along by the heat and oils in the coffee, and I had been giving myself a daily dose.

A story about alligators

An additional problem is that these chemicals, those in pesticides and herbicides as well as plastics, are fat soluble and tend to be stored in fatty tissues in our bodies. Animal studies suggest that small exposures over a long period of time can add up and become equivalent to a large exposure. Studies on alligators in Florida lakes, comparing those in Lake Apopka (which was exposed to a chemical spill) to those in Lake Okeechobee (which had low levels of pollution over time) and Lake Woodruff (which was still pristine), demonstrate this.

The same health changes were found in alligators in the first two lakes, although more severe in the lake that received the large chemical spill. Animals in both lakes had disruptions in hormones: low testosterone and small penis size in males, malformed “burned out” ovaries in females; all had altered thyroid hormone levels. This showed that low level chemical exposure accumulated over time, resulting in health problems similar to those caused by a single large exposure.

Alligators are considered worth of study and comparison to humans because we are both at the top of the food chain and tend to concentrate the environmental chemicals consumed by the chain of organisms that create our food. Lowered testosterone levels have been reported in humans, fertility problems are on the rise and thyroid issues are rampant in humans. The thyroid replacement drug, Synthroid, is among the most prescribed medications.

Back to plastics…

I read an article this week about how campaigns to reduce single-use plastics have had to be put on hold during the pandemic. To protect cashiers in stores, they were told to begin using disposable plastic bags and this is understandable (although one should be asking, why not paper bags!). However, I never stopped using my reusable bags and simply asked to pack them myself. In Costco, we pack our bags as we put our goods into the car. We need to get back on track with reducing our use of plastics and find a way to do it safely.

There are so many ways for chemicals from plastics and other sources to be introduced into our food supply. Microbeads in toiletries were banned in Canada and elsewhere 2018 but much more microplastic makes its way into the environment through plastic bags, Styrofoam containers and plastic cutlery, according to Chelsea Rochman, University of Toronto ecologist. “It has infiltrated every level of the food chain in marine environments…and so now we’re seeing it come back to us on our dinner plates.”

Is it affecting our health?

Researchers say they don’t fully understand the risks to human health yet, but new methods of detecting microplastics in food will make it easier to find out. However, microplastics and the tinier bits called nanoplastics have been found in sea salt, beer, honey and bottled water. They can also be deposited on food as dust particles and during processing and packaging of the food, so there’s a good chance it’s in more than just fish. Even opening plastic packaging can result in shedding of microplastics in your home.

It’s very difficult to avoid all exposure to environmental chemicals now, but we do have some control on the level of exposure in our personal environment. I wrote about strategies to do this in my August 3, 2018 blog: Plastic? Think twice.

We can also demand that our governments find safe ways to continue the process of reducing and eventually eliminating sources of plastic that end up polluting our environment and our food. And we can change our personal use of plastic items, starting with avoiding single-use plastics and purchasing foods that are not wrapped in plastic. Stores respond to demands of consumers… Think of it as a sort of “voting with your wallet.”

So, what will you do differently, starting today, to reduce your exposure to plastics and other harmful chemicals? Comment below so we can all benefit from YOUR ideas…

#Environment #HormoneDisruptors #PlasticInSeafood #EnvironmentalConnectionsToBreastCancer

References:

Exposure: Environmental Links to Breast Cancer – Martha Butterfield, Francine Zuckerman, Dorothy Goldin Rosenberg

Research Finds Alligator Problems Also Evident In Less Polluted Lakes – Science Daily

Microplastics found in supermarket fish, shellfish – CBC News

Study found plastic in every seafood sample it analyzed – Medical News Today

Fight against single-use plastics sidelines by COVID-19, report finds – CBC News

Plastic bans, environmental monitoring get short shrift during pandemic – CTV News

Canada has a new government-approved app, called COVID Alert, to detect possible exposure to the Coronavirus. It is designed to function as an extra layer of protection to add to physical distancing, hand-washing and wearing masks… and privacy for users is built in.

How does it work?

It works by exchanging random codes with nearby phones using Bluetooth wireless technology. Every day, the app checks the list of random codes on your phone with codes from phones belonging to people who later entered a code supplied by Public Health to tell the app they tested positive. If you’ve been near a phone with one of these codes in the previous 2 weeks, within 2 meters for at least 15 minutes, the app will alert you to get tested or call Public Health. The data is stored on each individual phone, not a central server, maintaining each person’s privacy. The user isn’t told where, when or with whom the possible exposure occurred… the app simply directs them to call public health for advice. For most of us, this means calling 811.

The downside of this design is that it’s impossible for researchers to measure how effective the app is… it’s the price being paid for a high level of privacy. However, they can measure the rate of download among Canadians, the number of positive codes given out, and users willingness to follow the advice given by Public Health after making the call.

It’s easy to understand that the app’s success will depend on how many Canadians download the app, and relies on each provincial government to opt in. So far, only Ontario is giving out codes to those who test positive, although Prime Minister Trudeau has suggested that the Atlantic Provinces (eastern Canada, where I live) are expected to join next and several other provinces have indicated that they plan to join. I can’t help wondering what the hold-up is – my husband and I downloaded the app when we first read about it a couple of weeks ago – but it must have something to do with generating the codes when someone tests positive for the virus.

And, of course, there are some people who don’t have a cell phone or who don’t carry it with them regularly. However, a research team at Oxford University suggested that if 60% of the British population downloaded their app it would be effective in stopping the epidemic. This number is believed to apply to other countries also. But the researchers also believe that lower numbers – as low as 15% or possibly less – could still make a difference by detecting cases early enough to prevent spread of the virus.

Within the first 2 weeks, the app had been downloaded almost 2 million times…that represents 5% of Canada’s population. Because of the design, however, it’s not clear in which provinces the users are located. I would encourage all Canadians to download the app so they will be in the system as soon as their province goes online with the system.

To download the app, just go to Google Play Store or Apple’s App Store and search “COVID Alert”. It’s free and secure!

Reusing disposable masks

We all know about the shortage of protective equipment, especially masks. Many (like me!) have been making their own masks and supplying family and friends and we are starting to see them for sale in various locations, both cloth and disposable ones.

However, the top level N95 masks are still a precious commodity, mostly reserved for health care workers. There has been much debate about whether these can be sterilized and reused and, finally, a research team has found a simple way to do this.

The used masks can be stacked and placed in a dry electric cooker (a toaster oven or rice cooker works fine) at 212F (100C) for 50 minutes. They tested the masks afterward and, even after 20 sterilizing cycles, the masks maintained their ability to filter, their shape and still properly fit the wearer’s face. They recommend placing a cloth or towel under the masks to avoid direct contact with the oven’s surface.

Presumably, this procedure could be used for disposable medical masks as well. You’d want to ensure any strings or ear loops are kept away from the heating element. Cloth masks, however, are still recommended to be washed in hot soapy water after each use. I swish then soak mine in a bucket of water for 10 to 15 minutes, rinse, then roll in a towel to absorb excess water so they’ll dry faster and hang them to dry overnight. I also press mine with a steam iron for additional heat sterilization and to make them look nice!

If you’re a Canadian reader, please go to your phone app store and download the COVID Alert app right away so you’ll be ready for implementation in your province. If you live elsewhere, join your country’s warning system or encourage your local politicians to initiate one, and we’ll all work to stop this pandemic in every way possible.

References:

Download COVID Alert today – Government of Canada

Misconceptions persist about the effectiveness and privacy of Canada’s COVID Alert app – CBC News

Dry heat can effectively sanitize N95 masks – Medical News Today