Long-Haul COVID: We Need to Do Better

Symptoms from COVID-19 can last many weeks, even months, and manifest in strange and unexpected ways. In Britain, the National Health Services (NHS) has formed clinics for long-covid, as they call these persistent cases, as well as support groups. The United States (U.S.) should follow their lead. At the moment, in the U.S, where we refer to prolonged symptoms as Long-Haul Covid, people have been searching for and forming their own support groups through Facebook and Slack. By reaching out to other COVID-19 survivors with symptoms lasting two weeks or longer (the definition of “long-haulers”), people have even taking research into their own hands via surveys amongst the group. 

While people experiencing long-COVID report a list of 64 or more potential lingering symptoms, the top 10 include shortness of breath, chest tightness, fatigue, chills, sweats, body aches, dry cough, low grade fever, headache, and “brain fog” or difficulty concentrating.  

Of note, “long-haulers” who have persistent symptoms generally did not require hospitalization when they first caught COVID-19.

There is much to learn about this condition; with “citizen scientists” taking the lead, they are learning from one another. But, similar to England, the medical community in the U.S. should be finding ways to better support and care for COVID-19 sufferers with long-term complications.

Do you have a story to tell about your symptoms of long-haul COVID-19? Please share with us here.

 By Jacki Hart, MD

COVID Poses Unique Challenges for International Students, Minseo Reflects

My Covid Story:

Minseo shares her story as an international boarding student from South Korea at the start of the COVID-19 pandemic. Early on, when things looked worse in her home country, she and her parents grappled with what made more sense: staying in the United States (U.S.) or going home. Thankfully, Minseo made the decision to return to her own country because the statistics quickly began to turn.

COVID Poses Unique Challenges for International Students, Minseo Reflects

Mid-February 2020, I sat at a table in my school’s grand dining hall and received a call from my parents. They expressed concerns (that I shared)  about my going home to South Korea over the upcoming spring break. At that time, Korea was experiencing hundreds of Coronavirus cases each day, with numbers continuing to rise. Despite our initial trepidation, I soon found myself bundled up at the Incheon Airport waiting for my parents to pick me up to drive home, along with my luggage, hand sanitizers, ethanol spray, and three packs of KF94 masks — including the one I was wearing.  

Spring term of my freshman year was a mess, but I felt relieved about the early decision to return to my family before strict travel restrictions ensued a couple weeks after my arrival.

Since the outset of the pandemic, I’ve been grateful for South Korea’s well-designed healthcare systems. For example, anyone, including foreigners, were reassured that they could enter the hospital and receive treatment if they tested positive for the virus. They also  quickly established systems and processes that halted the spread of COVID-19 and reversed that initial spike, including successfully stopping a recent outbreak that could have led to a resurgence.

Pros and Cons of Remote Learning

Meanwhile, the pandemic was heating up in the U.S. causing nationwide school shutdowns from March through May 2020. Now faced with learning from home unexpectedly during my spring term, I took the time to explore areas that I don’t normally have the luxury to examine due to a packed daily school schedule. I researched architectural design like the Burj Khalifal; watched Netflix movies, COSMOS, and quantum mechanic documentaries; and reached out to teach coding to students. I tried to make the best of what could be done during self-quarantine.

I took the time to explore areas that I don’t normally have the luxury to examine

However, as an international student in South Korea, I faced many difficulties during that semester. Due to the 13-hour time difference between the Eastern Standard Time (EST) operations for my school courses and Korean Standard Time (KST), I grappled with the arrangement of my schedule: Should I wake up early before dawn or should I just stay up through the night for my 4 AM class and then sleep until noon?

Should I wake up early before dawn or should I just stay up through the night for my 4 AM class and then sleep until noon?

With continual disruption to my sleep-wake cycle, and countless sleepless nights, during spring term and into summer break, I never settled into a routine, healthy sleeping pattern. Instead, I struggled through sporadic intervals of disjointed sleep and rest. When I got the chance to connect with friends from either South Korea or the U.S. over video calls, we lamented about our collective fatigue, mental stress, and interrupted sleep schedules. It was clear that many international, as well as regional U.S. students, were having similar troubles.

COVID-19 Sparks Innovation

While the COVID-19 pandemic has brought much suffering, it has also brought some pockets of hope and opportunities

While the COVID-19 pandemic has brought much suffering, it has also brought some pockets of hope and opportunities, especially in terms of  development in technology and bioengineering. Coronavirus has become a catalyst for scientific initiatives like telemedicine. Along these lines, many inspirations have stemmed from college students and fellow high schoolers who have been discovering solutions to combat the Coronavirus, such as COVID-Map and informative apps. As a problem-solver myself, I wanted to contribute too with my own knowledge about software programming and product-creation.

Together with a close friend from Korea, we designed the DreamCatcher Lab team, entered an artificial intelligence (AI) competition called POSCO 2020 AI Challenge; as participants, we began to develop a smart app and product in order to help patients with partial and chronic insomnia, and anyone having trouble getting a good night’s sleep in general. My own disrupted pattern, as well as many of my friends and schoolmates, was the impetus to search for a solution to maintaining good sleep cycles. In the span of three months, we successfully created the DreamCatcher app with pink noise music therapy, a wireless device, and a novel AI technique, called ElectroCardioGram (ECG) estimation from a PhotoPlethysmoGram (PPG) wave, to help monitor user’s sleep. Ironically it felt like I had insomnia from staying up nights debugging the program; but it was amazing to see the idea become a reality.

Trying to Make Sense of the Inconceivable

As a quantum mechanics enthusiast, I’ve learned to appreciate the unruly subatomic universe as “orderly chaos” — sensible things made up of objects that follow senseless rules. Trying to decrypt the phenomena and reach mathematical proofs, leads to one of two opposite places: either scientific properties with definitive answers or somewhere even more surreal.

The past several months have been the latter: bizarre,  unimaginable, even incomprehensible. As the pandemic and public health crisis impacts all of us globally, cyclic relapses of racial discrimination — George Floyd, Breonna Taylor, David McAtee — persist in a fundamentally-corrupt system. Asian gaslighting and violence serve as another inconceivable reminder. Add to that, burning infernos, first in Australia then across the West Coast of the U.S. like some blistering plague. The events collectively unfolding like a morbid tale or tragic playbook. Is there order to this chaos and destruction?  Worse yet, these outcomes probably won’t remain confined to the year 2020.

How Does this Relate to My School?

Following a couple weeks of online learning from Korea, my school is (at least tentatively) reopening for the start of fall term. I’ll be flying back to campus in October. Despite the degree of disaster and upheaval, I’m relieved to see changes in the school’s approach. We now have an Anti-Racist Workshop period in the weekly schedule and have regular talks and interviews about race during assembly. 

Overall, the concept of online zooming for math or even orchestra class isn’t as awkward anymore. With back-to-campus protocols, I’m curious (and a bit nervous) to learn whether the school’s meticulous planning to prevent Coronavirus outbreaks will prevail. Routine dormitory sanitizations, check-ups, food pick-ups and social distancing, meeting restrictions, 24/7 health center operations, and more comprise the plan. Upperclassmen already moved into the school dorms several weeks ago.

Honestly the precautions aren’t nearly enough to put my mind, nor my parents’ and friends’ minds, at ease.

Honestly the precautions aren’t nearly enough to put my mind, nor my parents’ and friends’ minds, at ease. The thought of an influx of hundreds more students to the campus and positive cases continuing to pop up in nearby towns worry me. 

Despite these legitimate concerns, I’m committed to trying, along with my peers, to focus my thoughts and energy on continuing to create, innovate, and solve problems. Taking my cues from visionaries, scientists, activists and classmates, I’ll thrive to make sense of the situation, and to discover solutions. Creating and inventing, like I did with the DreamCatcher, offers the possibility of practical solutions and provides a sense of hope. 

“The past is our present,” as the saying goes. Unravelling the twisted strings and determining viable solutions, from global warming to the battle against new, more-resilient viruses to centuries old and ensconced problems like racism, may sound insurmountable. But, if we’ve learned anything from this pandemic, we definitely ought to try. 

Reported by Anoushka Mahendra-Rajah
Written by Minseo Kim
Edited by Dr. Jacki Hart

A Thin Cloth Line: Debunking the Myths Surrounding Masks

The use and effectiveness of masks have been questioned by those who do not believe they are necessary – often referred to as “anti-maskers.” Some argue that masks don’t properly filter the virus and others claim that they restrict proper airflow. These positions are based on pseudo-science and have led down a divisive, if not dangerous, path to rejecting the wearing of masks. Research and analysis consistently support that use of masks slows the spread of COVID-19 and saves lives. 

One interesting way that the Center for Disease Control (CDC) recently addressed these concerns was to evaluate, and then publish a scientific report, detailing how masks and face coverings were able to contain the spread of COVID-19 for a couple of hairstylists while interacting with their clientele.

Two Symptomatic Hairstylists Avoid Spreading COVID-19 to Clients

Conducted in Springfield, Missouri, a real world experience presented an opportunity to assess whether masks successfully prevented the spread of COVID-19 from two hairstylists to 139 of their clients. Both the hairstylist and the person receiving a haircut wore masks or face coverings during the appointments. Each stylist wore double-layered cotton face masks. The hairstylists were both symptomatic while seeing these 139 clients (mean age of 52 years and all willingly seeing the stylist without knowing their COVID-19 status). Despite having some typical, yet mild, respiratory symptoms, like cough and congestion, neither hair stylist had been tested for coronavirus when they saw these particular clients. Haircut appointments lasted for an average of 19 minutes. 

Once the hairstylists learned that they tested positive for COVID-19 (after 8 days of symptoms for one of the stylists, and 5 days of symptoms for the other), they stopped seeing clients  and self-quarantined. The Greene County Health Department in Missouri contact-traced all 139 clients that were exposed to the stylists, recommended they quarantine for 14 days, and offered free testing to all. Of the nearly 50% who agreed to receive a nasopharyngeal swab test, all of them tested negative for COVID-19. 

There were also no respiratory symptoms reported by any of the 139 clients, or their secondary groups, such as family and friends following exposure to the hairstylists. The county health department was able to interview 104 of the identified clients, which allowed for supplementary data to be acquired too, such as age, duration of appointment, and type of face covering used. The only people identified who developed COVID-19 symptoms and/or tested positive for the virus were the immediate housemates of one of the hairstylists. 

Through the use of face coverings, two stylists who were both symptomatic and COVID-19 positive did not transfer the virus to their clients during their respective appointments.

This study bolsters other scientific evidence corroborating the use of face coverings, whether homemade or surgical, in slowing the spread of COVID-19. It is remarkable, and reassuring, that the use of simple face coverings prevented the transmission of the COVID-19 virus from two symptomatic hair stylists to their clients in close proximity.

This study bolsters other scientific evidence corroborating the use of face coverings, whether homemade or surgical, in slowing the spread of COVID-19.

The Data Have Been Consistent

The results of this study parallel previous observational data on the effectiveness of masks. An analysis of “194 countries… found a negative association between duration of a face mask [and other] polic[ies] and per-capita coronavirus-related mortality.” This means that the longer that a country has had a mask wearing policy, the fewer overall deaths and the lower the mortality rate in that country. In addition, countries that did not recommend face masks saw a COVID-19 related mortality rate increase of “54.3%…compared with 8.0% for countries with masking policies.”

An updated count from this same research, along with assessment of other protective measures, compared countries with mask mandates to countries without mask requirements. That gap in mortality rate expanded even further: in countries where citizens wear masks, the per capita coronavirus mortality, since the start of the pandemic, increased by almost 16% each week compared with 62% per week in countries where citizens do not wear masks. In America, this likely translates into parallel differences from state to state — where mask wearing is standard, regulated, and/or culturally accepted versus those where they are not. 

Collectively, these studies affirm that face masks effectively slow the spread of the virus and should be used as a deterrent for the current, and possibly future, pandemics. If you still have friends or family members who don’t believe or consider themselves “anti-maskers,” try sharing this video from Public Broadcasting Service (PBS) scientists called “It’s Ok to be Smart.” PBS explains why and how masks work to protect all of us. Together, we can debunk mask myths, protect one another, and curb the spread of COVID-19. 

Written by Robert Shepard
Edited by Dr. Jacki Hart

Teen Initiatives During COVID-19: Young Adults Support Their Communities

My Covid Story

As the pandemic spread, forcing schools and businesses to close in April, two teenagers in Massachusetts found themselves with time on their hands and a pressing urge to use their skills to help others. With 80% of COVID-19 infections presenting as mild or asymptomatic, masks to prevent the emission of potentially infected particles is crucial to slowing the spread of this disease. Noah Lang (high school class of 2021) and Izzy Klein (high school class of 2020 /college 2025) founded businesses and nonprofits with the aim of making masks as accessible as possible to people in their community. Lang founded the nonprofit Masks4Mass to procure and donate masks to organizations like the Boston Rescue Mission, Margaret Fuller Neighborhood House, and high schools in his area as they have been preparing to reopen. Klein started Masks By Izzy to offer deliveries and pickups of her affordable hand-sewn masks and donate proceeds to the Greater Boston Food Bank.

Recently, Covid-recovery.org talked to Noah and Izzy to better understand what inspired each of them, how they remain motivated, and ways that their ventures have helped others.

Getting Started

Noah: I came up with the idea of founding this nonprofit, Masks4Mass, after I realized how difficult it was to obtain masks, especially early on in the pandemic. I was brainstorming ways that I might be able to help my community and facilitate the reopening of schools. I wanted to do something that was different and meaningful. As a result, I founded this nonprofit with the hope of ultimately contributing to halting the spread of COVID-19

Izzy: I’ve been sewing since 4th grade through after school classes with a friend. And I’ve always loved creating things, helping people, and trying to make things accessible. My background is in political and community organizing, and communications. With those things in mind, I wanted to find a way to help people right now — with the immediate crisis. Being able to produce something that gives back, that’s functional, and that’s keeping people safe at the same time that it also benefits my community was my goal.

Initial Steps

Izzy: I started sewing and the first few masks weren’t great, but I definitely had a foundation. I started giving them to family and friends, and they really liked them. I originally did an order form and I would get crazy high demand every week – like 40 orders. It was getting a little hard to keep up because I would take the orders on Monday, work on them throughout the whole week, and arrange for pickup or delivery on Saturdays. I realized that with the growth, it would be good to have a website. Now, we are in the process of making my site not only a place to buy masks but also other things made by different members of my community. In the meantime, given that college for me is now online, I decided to take a gap semester to work on this. I’m hoping to expand; right now we’re doing a lot of bigger orders for smaller businesses and for family events and stuff like that. It’s been really good and I’ve definitely enjoyed being able to meet different members of my community. 

Noah: I’m definitely planning on continuing this initiative past the summer. As long as the  pandemic continues, I want to help and try to find ways to make an impact on our community. I haven’t really set an ultimate goal because I see this as an ongoing process. My biggest goal is to get masks to schools because this is a vital aspect to reopening. If all students were able to have access to masks and personal protective equipment I think opening schools would be a lot easier. However, it’s been challenging because public schools haven’t been very responsive. I’ve been reaching out to people that I already know first: parents of some of my friends, coworkers of my mother and my father, people from my own school, etc. I’ve set up a donation page on my website. That way, even people who don’t know me personally are able to contribute to Masks4Mass. 

Growing Process & Pains

Izzy: Seeing people wearing their masks definitely makes me super happy. It’s a lot of young families who have been telling me that the masks that we make are really affordable. A lot of people who placed orders when the idea was just being formed said things like, “You know, your mask is the only mask my kids will wear because your kid size fits so well.” That is super awesome and gratifying to hear because I know it’s really hard to work with younger children on this. A lot of wonderful friends from school have been delivering masks for me as well, so I can spend more time sewing. I have received help with cutting fabric and taking orders from different YMCA’s. It’s gratifying to have  a lot of friends and family helping out.  

Noah: One of the greatest challenges with this learning process is that it’s the first time that I’ve ever formed a nonprofit. I had  to learn how to incorporate my nonprofit with the Commonwealth of Mass. Also, in order to receive tax exempt status from the Internal Revenue Service (IRS) I needed to research and learn how that  works. A smaller-scale challenge has been, again, that public schools have been significantly less responsive than private schools, which is somewhat frustrating. But I’m continuing to try to work my way around that. I’m guessing it’s because they have additional regulations. Another obstacle I’ve had is that some of the masks [we’ve secured have been] pretty low quality. They don’t really seal or fit your face well which allows for openings around the sides of the masks. That kind-of defeats the purpose of the mask, of course. Others are just bad quality in general and that’s something I have to work my way around, too. I have been buying a sample batch of masks before making a bulk purchase. That seems to help  solve the quality control problem.

I have been buying a sample batch of masks before making a bulk purchase. That seems to help solve the quality control problem.

Lessons Learned

Noah: I think one of the things that is extremely important to me and a main takeaway is the importance of community and the willingness to help others. Prior to this, a lot of the work I had done for my community was with my school; this has felt different because it was organic and not a requirement. I think that’s something that I’m trying to tap into — sympathizing with others and willingly helping them out. This organization has helped me solidify that mindset. As a personal thing, the formation of this nonprofit has taught me a lot about the process of how you incorporate a non-profit into the Commonwealth, and the different steps that you need to take in order to have a legal nonprofit and get tax-exempt status. Another aspect that has also been interesting is accounting. Over the past couple months, I’ve done a lot of accounting because of the fundraising. It seems likely that I’ll use many of these skills later on in my life and it’s [an interesting opportunity] to start learning them now. Overall, I think that running this nonprofit is not only a great way to support my community. It has also taught me a lot about nonprofits in general and the importance of taking an initiative to help others.

Izzy: We’ve never really lived through a time like this in recent modern history. So, I think it’s super important to make sure that we are being intentional about helping others. I feel very privileged – which is not necessarily a great feeling – but I think it also gives me this kind of responsibility to give back, because I have the resources to be able to do that. It’s time to just make sure that we are all being mindful with our choices and with our actions. If you are in a position where you’re comfortable right now, and you don’t really have that much worry in your life, start thinking about ways that you can give back. Whether it’s helping at a shelter or food pantry, or donating somewhere, we need to make sure that we are constantly asking ourselves: What are small things that we can do that, in turn, will have a positive effect on society?

Reported by Anoushka Mahendra-Rajah
Edited by Dr. Jacki Hart

Katarina’s Choice is Hard but Clear: Protect Her Dad

My Covid Story

Being a 21-year-old college student during a pandemic means, for many, worrying about classes, jobs, and friends. I’m lucky to have access to fast, reliable internet and a quiet, safe place where I took the remainder of my UCLA courses online. For me, the hardest change has been the ongoing worry about ways that I might infect my 74-year-old father since moving back home.

There was little known about the novel COVID-19 virus in the early days, other than the increased risk for serious infection and even death for those older than age 70 or with underlying medical conditions. As I carried those facts in my brain, making my way to LAX on route to live with my parents in Rhode Island, I had a panic attack. Although I was fully covered with latex gloves, an N95 mask, sweatshirt, and sweatpants, and even braided my hair up to be out of the way, the following mantra repeated in mind: “I will never forgive myself if I am the reason my family gets sick.” My plane was crowded, LAX was crowded, and I did not take off my mask for a single second of the 6½ hour flight home. As soon as I got out of the airport I removed all of that disposable PPE (personal protective equipment), threw it into a trash bag, and jumped in the car with my mom.
After two weeks of being home, I was relieved to find that I never showed symptoms nor did anyone in my family. Once those two weeks passed, I still avoided seeing any friends or relatives other than my mom and dad for roughly a month. We all agreed that I would do the food shopping to minimize their potential exposure. Once a week, I put on my mask and gloves armed with hand sanitizer in my pocket and head to the grocery store. I continue to wash everything from the grocery store or leave non-perishable foods outside for a week. My philosophy has been that I can’t be too cautious to protect my parents.
During the lockdown period, the experience was almost easier. There weren’t pressures of choices to make, or friends asking me to go out. The protocol, so-to-speak, was clear cut and unwavering. I recognize, and hope that I don’t take for granted, my privilege of having access to shelter, food, WiFi, privacy, and space. While the stay-at-home order was in place, I didn’t have to worry about going anywhere because there was nowhere to go. The risk of my dad getting infected was minimal as long as I stayed inside. That helped me feel calm and in control.
But now, even with reported cases decreasing in Rhode Island, when I go for a run outside and pass by a biker without a mask, I feel a pang of dread wondering whether there is a chance that I just exposed myself to coronavirus. Sometimes, my anxiety eats at me for hours, admonishing myself for making the choice to go running. I know that the chance of contracting coronavirus outside while exercising with a mask on is very low; but when living with someone who could die if they get infected, worrisome thoughts fly through my head daily. Honestly, I feel exhausted.

I’m a 21-year-old college student; it’s summer, and while all of my friends go to bars and beaches, I stay home.

Now that Rhode Island has opened up its restaurants, bars and beaches, it has been more stressful. I’m a 21-year-old college student; it’s summer, and while all of my friends go to bars and beaches, I stay home. For me, the choice isn’t easy, but it is clear: my dad’s life takes precedence over my ability to socialize and hang out with friends. I think the hardest thing for me has been trying to keep everybody happy. Running or walking outside is essential for my own mental health; but I worry and feel strongly about not doing anything to put my parents at risk. It is challenging to explain to my friends why I don’t feel comfortable going out or spending time with them. People don’t always understand or fully appreciate my concern for my parents’ health.
It hasn’t been the summer I expected; that is true for most people. Removing myself from my usual social life and watching it happen without me can take a toll. It’s difficult to watch my friends having fun as I tune in from a screen. But I feel clear that I would rather miss out on a beach day than cause any harm to my Dad.

Hate and Coronavirus Spread Together

My Covid Story:

In February of 2020, the first signs of coronavirus sounded an alarm to epidemiologists in the United States (U.S.) as they watched China go into full lockdown. By March 2020, the pandemic caused by COVID-19 began to proliferate throughout the U.S. Sadly, along with the spread of the virus came racism directed at Asian Americans. Sinophobia, the dislike or fear towards Chinese people and Chinese culture, heightened as rates of coronavirus began to rise.

Life under quarantine is hard for everyone; but the widespread escalation of Anti-Asian harassment and assault have caused undue fear and anxiety for this community. Reports reveal that incidents occur throughout the country and are not confined to specific locations. The Anti-Defamation League (ADL) and other organizations have been tracking the frequency and details of related occurrences from San Luis Obispo, California to Queens, New York with more than 1,500 reported cases since the start of the pandemic. Keep in mind that these represent only the incidents that are documented, with hundreds, perhaps thousands, of reports not recorded. 

Aileen, an Asian American who lives in Manhattan, experienced racism related to COVID-19 firsthand. One early afternoon, before New York City went into full lockdown, Aileen was hopping onto the subway, heading for an appointment. She recalls that the train was not very crowded; as she got on, a white woman shoved her out of the way, gave her a dirty look and covered her face to signal fear of infection. Aileen, who has been healthy throughout the entire pandemic, was shocked. How could someone treat her like less of a person because of her race? Unfortunately, Aileen’s story is not uncommon. Asian business owners have reported graffiti and hate speech along with vandalism. Slurs such as “Go back to China, you brought the virus here” or “Stop eating bats” have been hurled at countless Asian-Americans. 

A Chinese employee of Women, Infants, and Children (WIC), who helps provide services to low income families with eligibility for the federally funded nutrition support program, recalls her similar pandemic story. In March, this person, who prefers to not be identified, fell ill and thought it was related to allergies. She was sick enough, however, to take time off from work; her children — two in high school and the one in college — took care of her for a week, as she recovered from her symptoms of dry cough, loss of taste and smell (very specific for COVID-19), and low-grade fever. She was worried about her job, but received paid time off and felt grateful since many others have not been as lucky. More than a month after she had properly quarantined and fully recovered,  she was in the grocery store buying flour for her daughter who wanted to bake.

I never thought I would be on the receiving end of racism

she said. But while she was waiting to purchase the flour, she heard a woman behind her say “You brought the coronavirus to New York, you are so disgusting for eating bats!” Stunned and deeply insulted, she did not reply nor did she report the incident. The remarks were painful; she froze in disbelief, wondering how people could be so cruel and uninformed.

Damage from, Causes of, and Response to Sinophobia

During a time where mental health is challenged due to isolation, losing those we love, and facing financial and physical hardships, anti-Asian violence and harassment is emotionally draining and hurtful with serious psychological and physical consequences. Attacks involve verbal abuse, offensive graffiti, spitting, coughing or attacking. There is no evidence of Asian Americans and Pacific Islanders having higher infection rates from COVID-19 than other ethnic groups; in fact, according to the Centers for Disease Control and Prevention (CDC), Asian Americans and Pacific Islanders have the second lowest infection rate of all ethnicities in America.

Factors supporting and spreading racist rhetoric include certain news channels and government officials. These constitute large platforms that deliberately scapegoat Asian Americans by using racist terms like “the Chinese Virus” or “Wuhan Flu.” Speaking with those who have been directly affected by discrimination, they report how disheartening and distressing it is when one hears prominent spokespeople, especially POTUS or surrogates from the administration, use racist terms  which, at the very least, excuse racism towards Asian Americans and, at worst, encourage it. 

In response to anti-Asian violence and harassment, the hashtag #IAmNotAVirus has been created.

This represents a movement among Asian Americans and Pacific Islanders to share their stories and allow their voices to be heard.

Taking active steps against hate and discrimination towards Asian Americans requires vigilance about what businesses you support and holding accountable those who incite racism and use “irresponsible rhetoric.” Facebook has recently come under fire for both disregarding voter suppression and not applying their moderation policies to hate speech and racism on their website. A coalition of anti-hate organizations have collaborated to create an initiative called #StopHateForProfit designed to implore Facebook to change their policies. Four hundred large and small companies, as of this writing, are collectively boycotting advertisement on the social media platform. 

Along with not supporting companies and businesses that encourage, support, or allow racism, speaking out against racism must become common practice. Asian Americans Advancing Justice created a bystander intervention training that can educate people on what to do while witnessing racism. 

There is no doubt that COVID-19 has profoundly impacted everyone’s life. It is imperative to remember that we are all human and should treat one another with respect and equity, no matter your race, ethnicity, age, gender or economic position.

Reported & Written by Katarina Ho; Edited by Dr. Jacki Hart

The Ripple Effect of Hydroxychloroquine Shortages

My Covid Story:

Like many with health conditions requiring hydroxychloroquine, Anoushka had trouble filling her prescription after many started erroneously using the medication for COVID-19.

On March 21st, Donald Trump tweeted that a combination of hydroxychloroquine (brand name Plaquenil) and azithromycin have “a real chance” to be a cure for COVID-19. Within this same week, fills of hydroxychloroquine/chloroquine rose 214% from the same week in 2019. Soon, the American Society of Health-System Pharmacists was reporting confirmed shortages across the country. When I read news about the stockpiling and hoarding of hydroxychloroquine in late March, I checked my Plaquenil bottle and counted the 13 pills I had left. My local CVS had a shortage, and my refill would be delayed. 

I was in the 55% of lupus patients who were experiencing challenges with filling hydroxychloroquine prescriptions according to a study conducted by the Lupus Foundation of America. Out of the 3,000 study participants between March and May of this year, 25% of the patients were only able to receive a partial refill and more than a 100 people were not able to get a refill at all. For many Americans living with systemic lupus or rheumatoid arthritis, hydroxychloroquine is essential for preventing flares of the disease, reducing symptoms, and protecting against irreversible organ damage.

90% of people living with lupus are women, and women of color are two to three times more likely to develop the disease.

90% of people living with lupus are women, and women of color are two to three times more likely to develop the disease. These shortages have been catastrophic for people who have been unable to travel to larger pharmacies or pay out of pocket for drugs essential to their long-term health and survival. Within the Lupus Foundation of America Study, people reported having to “pay cash out of pocket” for refills, “get [their] refills out of state via friend/family networking”, and just “wait to refill due to $450 cost.”

Separately, it is clear that the risks of hydroxychloroquine as a treatment for COVID-19 far outweigh its potential benefits. The March study (cited by Trump) by French microbiologist Didier Raoult and his colleagues was small and non-randomized, leading the International Society of Antimicrobial Chemotherapy to officially express their concerns about the design and presumptive results. In addition, hydroxychloroquine can prolong the QT interval (a heart rhythm measure) and lead to fatal cardiac arrhythmia. When patients are given this in combination with azithromycin, there is a high risk of them developing serious changes in their heart rhythms.  

Even though the Food and Drug Administration (FDA) revoked their emergency-use authorization of hydroxychloroquine on June 15, the lupus and arthritis communities have not felt the effects of these shortages lightly. Thankfully, the FDA’s safety warning helped decrease the number of corona-related hydroxychloroquine fills across the US. During the past month, I’ve been able to get my medication without waiting too long, as have others with lupus. But, hydroxychloroquine is not the only medication that has been subject to shortages. Certain medications, such as sedatives like midazolam and propofol, are in greater demand because they are essential for patients on ventilators. The increased need is coupled with reduced production given measures taken to slow the spread of the virus worldwide. Compounding supply limitations across the global market, the United States (U.S.) also has significantly fewer generic drugs approved by the FDA than other countries. This not only exacerbates reduced drug availability, it also drives up cost. The Oregon Health and Science University and Mayo Clinic advocate for efficient authorization of generic drugs from outside the U.S. and a funding increase for nonprofit generic drug manufacturing to fix this problem during the current pandemic. These obstacles demonstrate that the scope of the COVID-19 public health crisis and its impacts on individuals, families, and communities go beyond those directly infected by the virus. Sharing the breadth of our experiences and perspectives raises awareness and helps each of us consider informed solutions.

These obstacles demonstrate that the scope of the COVID-19 public health crisis and its impacts on individuals, families, and communities go beyond those directly infected by the virus.

“ Weekly prescriptions from February 16 to April 25, 2020, were compared with those from February 17 to April 27, 2019. Each date on the x-axis refers to the last day of the week. EUA indicates Emergency Use Authorization; FDA, Food and Drug Administration; and WHO, World Health Organization.”

– From Vaduganathan M, van Meijgaard J, Mehra MR, Joseph J, O’Donnell CJ, Warraich HJ. Prescription Fill Patterns for Commonly Used Drugs During the COVID-19 Pandemic in the United States. JAMA. 2020;323(24):2524–2526. doi:10.1001/jama.2020.9184

COVID-19 Testing Overview

While not foolproof, testing is an important tool to help each country, state, and region safely re-open. The data shows us that countries most successful at keeping down the numbers of COVID-19 infections and deaths have applied testing, contact tracing, and robust preventive practices. Together, these measures can help guide us to return, step by step, toward some normalcy in our economic and social lives. The use of testing coupled with key preventive approaches can also help avoid a second surge of millions of additional COVID-19 cases and 100,000s of deaths.

While there are new approaches coming soon, viral testing is generally performed via nasal swab. The sample is sent to the laboratory where a polymerase chain reaction through what’s called (PCR) test is performed to detect genetic material of the virus itself. Contact tracing involves a process to notify those who have been in contact with someone who tested positive for the COVID-19 virus. Contact tracing can also be applied for those who have been exposed to someone who has typical COVID-19 symptoms, but doesn’t get tested and, therefore, carries a presumed COVID-19 diagnosis. Antibody testing (also called serologic testing) is a blood test that checks whether someone has developed immunity to (protection from) COVID-19 at least temporarily. While the antibodies may not be present forever, or the COVID-19 virus might mutate (change) over time, there is scientific evidence suggesting that characteristics of the virus allow for antibodies, if they develop, to help fend off reinfection for a period of time — possibly up to 1 to 3 years. Since COVID-19 is newly discovered and hasn’t been infecting people for very long, more research will emerge as the virus is further studied and better understood.

The amount of testing being conducted varies from country to country, and from state to state. This impacts steps taken in the opening of regions across the globe. Interestingly, there is a form of testing that is talked about less often but may also be applied to guide recovery: Fecal Testing.

Not at Risk; Or So Luiz Thought

My Covid Story:

My name is Luiz. I am 38 years old, young, healthy, physical therapist and Pilates instructor. Because of my profession, I make exercises every day. And because I was not high-risk patient, I was thinking the COVID-19 for me could be like a ‘big’ flu. IT WASN’T! The COVID-19 started with a sore throat, muscles pain and fever like a common flu. I took medicine against fever and it is gone. But the fever came back every day stronger until the medicine didn’t make more effect and the fever stayed continuously between 38-40°C [100.4-104°F].

After 9 days with symptoms, I went to the doctor and I tested positive for COVID-19. In the total it was 12 consecutive days of fever. I also had diarrhea, a lot of vomit, smell and taste lost, nose burning, abdominal pain, muscles pain, heavy eyes, headache, cough and difficulty breathing. I had shortness breath but because my oxygen saturation was 98%, I didn’t need oxygen mask… After 14 days with [treatment from my doctor including LOTS of fluids], the disease, the fever was going out and the symptoms started to decrease. Now I am ok; but I would like to advice you stay home, wash your hands and face all the time, use mask and gloves and hear all the recommendations from healthcare workers. They want to help you!

Swab Testing

Using a long swab that is mildly uncomfortable when placed through your nasal passages, the clinician (e.g. nurse, doctor, or physician assistant) performing the test (wearing protective equipment or PPE) will twist the swab for 10 to 15 seconds (roughly 5 times) in order to get an adequate sample for the lab to look for the COVID-19 virus under the microscope.

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