Tag Archives: public health

Remembering September 11, 2001

On September 11, I took a picture of the contents of my pockets. Three items. A mask. A rubber glove. Crumpled tissues. This sums up my experience of the 20th anniversary of 9/11. 

THE MASK: Covid is surging again. The joyous “breakout summer” we hoped for turned into one visit (from my sons) and two road trips (MI and VT) for me. All good. I’ve started testing occasionally. I wear a mask for any indoor activity that might include an unvaccinated person or someone who is particularly vulnerable. I worry about “breakthrough” infection. 

9/11 cost us about 3000 lives. The number of lives lost to Covid is so high. We lost 671 people this year on 9/11. Our Covid total is approaching one million, if you factor in some uncounted deaths, like those of people who postponed medical care. The official death toll is about 700,000. We’re numb from loss.

THE GLOVE: Early in the Covid shutdown, we wore rubber gloves because we feared contact infection. That turned out not to be a big problem. I now have a small gash on my thumb from carelessness in the kitchen. I’ve got a huge supply of gloves from earlier. I protect my hands from dishwater, dirt, etc. This is about getting old. The skin on my hands is easily nicked. I’m grateful that I can use rubber gloves whenever I want. 

THE KLEENEX: I’ve been weepy. I listened to the Verdi Requiem live streamed from the Metropolitan Opera House on Saturday evening. The wrath of God. The pictures of the 9/11 memorial, with the lights on. The names of those who died. A woman’s name followed by “and her unborn child”. I cried. I just learned of another (non Covid) death, my good friend’s aunt, last of her generation. Funeral preparations. Covid interrupted our patterns of grief and commemoration, but I think this recent death will be ritually marked according to the traditions of the family. 

So that was my 20th anniversary of September 11, 2001. 


Shirley Jackson, are you laughing? Lotteries in American life – a RANT

The Lottery and Other Stories (FSG Classics)

I’ve entered the NJ Covid vaccination lottery six times over the past five weeks. Three times, I wanted to schedule my husband and myself for vaccination. We started out using two devices, and worked up to five. No luck. 

An unexpected excess of doses at a local non-profit enabled us to get our first shots early in February. 

Three times since them, I’ve used a now standard “hack” to try to help friends get appointments. ONCE it worked, to my intense gratification and my friend’s very great relief. She got her first shot two days after the lottery.

Another effort came close, but the appointment scheduling site shut down prematurely, without explanation. Not a computer crash or site freeze-up, just an announcement that no more appointments were available, an instantaneous drop from 40 to zero. One time all the numbers we got (ten devices in use) were too high. Our best (lowest) number was 4350, with about 3190 appointments available. We all closed out and returned to our day’s activities.

We’re getting better at this, nerves not so badly shredded… We give ourselves credit for a good try. Those still unvaccinated return to the on-line vigil, checking on drugstores, clinics, supermarkets, doctors offices and every friend they have. Three days to wait for the next LOTTERY. Just to be clear, my friends and I are age 65 and above.

WHAT IN THE NAME OF GOD IS WRONG WITH THE United States? Why are life-saving drugs being allocated by chance, by lottery? My heart breaks as one Covid death after another is announced, often on Facebook with pictures of the lost loved ones. These are people who received good medical care, not like at the start of the pandemic. The medical community has learned so much, but sometimes the disease wins. These are people who, had they been vaccinated six weeks ago, might not now be dead. I feel sad and tired. 

So, Shirley Jackson, are you laughing? Jackson was born in 1916, hence she survived the 1918 influenza pandemic. I doubt that’s what she was thinking about when she wrote her controversial short story, “The Lottery”, which was originally published in The New Yorker.  Have you read it? I wrote about it in this blog. See post dated November 11, 2018. https://amgreader.wordpress.com/2018/11/11/memories-of-high-school-english-with-mrs-gerhardt-1964-65/ The story’s publication generated hate mail. The plot? In a small town, one person is ritually stoned to death each year. We aren’t told why, aside from that it has long been customary, but is now questioned.

Why were people so upset by the story? (Jackson was taken by surprise.) I guess no one wants to believe a community could do something so awful. Wikipedia offers explanations in its article about the story, under the heading “Themes”. The discussions of “Reception” and “Critical Interpretations” are also interesting. The town in the author’s mind was her then residence, Bennington, Vermont. Riddle that!

The Wikipedia article is well worth reading.

Moving on to another American lottery… To determine which young men would serve in the Vietnam era military, the Selective Service System (aka the Draft, aka conscription) conducted a lottery, first drawing numbers on December 1, 1969. Men born from January 1, 1944 to December 31, 1950 were subject to that lottery. My generation. The idea of the lottery was to abolish the complex system of classifications and deferments and establish a more fair and universal system to provide soldiers for the increasingly unpopular Vietnam conflict. The first date selected was September 14. Men born on that date were #1, at the top of the list. The lottery had unexpected consequences. Unwilling soldiers can be fractious.

I remember an argument I had with a friend. I referred to the Lottery as a way to “pick people to die”. She pointed out that most draftees would come home alive. I said that if you die, you’re 100% dead. 

I don’t like the “all volunteer” military better than the Lottery. The Lottery forced every man, even the rich and well connected (some of whom ultimately found loopholes), to face up to the consequences of war. Conscription is still with us. Every American male must register with Selective Service at age 18. 

So here we are again, using chance to allocate a valuable resource. As far as I know, the AtlantiCare Lottery for appointments at the Atlantic City vaccination megasite is the only such mechanism in the State of New Jersey. Should we be happy that it provides a chance for a person to act on this or her own behalf? We know it adds new meaning to the concept of the “digital divide”. 

We could have, should have done better. 

Shirley Jackson died rather young, in 1965, so I can’t ask if she foresaw either of these lotteries that have impacted me.

“Real Simple” magazine, before and after. Covid19 #3

Real Simple | Women's Lifestyle Magazine Subscription from Magazine.Store

About 10 days into my voluntary “quarantine”, a magazine arrived in my mailbox. I take only a few print magazines… I like “Real Simple” for its recipes and it’s crisp, colorful layout. Often I feel like the lifestyle it portrays isn’t “mine”, too stark… But what I pondered this month is that this “April” issue clearly comes from “before”. Full of cheerful, friendly articles about spring cleaning and freezer organization.

You know, before “all this”. Before the pandemic and shutdown. Before “social distancing” and “shelter in place”. How will we refer to “before”?

  • The Age of Innocence?
  • Back then?
  • The old normal?
  • The bad or good old days?

Some writers refer to our current status as “The Pause”. They hope something good will come out of it.

I remember, in 2001, the arrival of my first piece of mail that reflected the post 9/11 reality, the “Nation” magazine cover showing a very simple, stylized graphic of the two burning towers. I felt a dark sense of finality. I’m never going to get away from this…

News cycles spin faster now, and are far more internet dependent. There wasn’t one image to jar me into a new reality, although the cascade of events late on March 11 came close – NBA season suspended, Presidential travel ban, press conference… March 11 was my personal turning point. I wrote in my personal journal “This is an emergency.”

The next time “Real Simple” arrives in my mailbox, it will be different. (In fact, it will never be the same. The website has already morphed.) All of us are “coping”, dealing with changes we never expected. The dangers of an epidemic have caused anxiety to skyrocket, and maybe depression, too. There are plenty of sages who remind us to look for the advantages in our situation. Sometimes I can find them… sometimes not.

Personal History – Epidemics in my Life – COVID19 #1

I was (sort of) born during an epidemic. I was born in 1949. According to an article I found, polio (infantile paralysis) was rife in the 1950s, and there were 60,000 cases in the United States in 1952. Three thousand victims died. How many more were left unable to walk and dependent on wheel chairs, crutches, etc?

One of my earliest memories was the arrival at my home of school aged children for tutoring by my mother. These were polio victims on the road to recovery. Some wore leg braces. My mother’s job was to help them catch up on their school work. She enjoyed teaching them. I was supposed to stay quiet and out of the way.

In 1955, Jonas Salk introduced a vaccine and thousands of children became “Polio Pioneers”, the first large group to be vaccinated. My sister, three years older than me, was vaccinated at school. I was too young for that cohort. My parents were worried. They arranged (somehow) for me to get the shot from a physician married to a friend of my mother. I was driven to his house one evening for the injection.

So polio was not an issue in my life after age 6! Very fortunate, since we lived near a lovely public park with an enticing pool. I would happily have played there all day, every day. Over time, I spent MANY summer days there, eventually joining the swim team, marinating in the chlorinated water and earning money for college working as a lifeguard. Once in a while, my mother would remark that it could have been different. That we could have stayed home all summer, fearing polio. Perish the thought!

Our public schools operated on a schedule that was supposed to “break up epidemics”. Instead of a long Easter break, we got a week off at the end of February and another week-long break eight weeks after that. Sometimes it didn’t work. I remember concerns over Rubella, aka German measles, which led to high absenteeism when I was in middle school. I never caught it, but thought I must surely have had a subclinical case. Nope. Decades later, when I told my OBG I wanted to start a family, I was tested and found to lack immunity. I accepted vaccination before trying to get pregnant. I remember controversies (1981?) over County Public Health testing employees for immune status and requiring vaccination of employees who worked with the public.

Growing up, I seemed not the get influenza when it was epidemic. I had at least two cases, one around 1961 and another in the summer of 1969. One year in college, I was wandering, dazed, through endless registration lines when my path was blocked by a person with a clipboard, demanding to know if I was allergic to chickens or eggs. Startled, I denied any allergy. Bang! Shot in the arm. An early influenza vaccine!

I suppose many of us are using our time in COVID19 “social distancing” quarantine to ponder our health histories and how they might have been different without various medical advances. I’m so glad my children have been spared at least five diseases from which I faced risk.

The public hearing from hell – a rant

Trigger warning – grouchiness ahead!

Last week I saw a notice about a public hearing on the development of a “plan” to manage a particularly serious disease in my state. Without worrying about which disease or even which state I’m talking about, I want to describe what was wrong with today’s public hearing.

A ninety-minute meeting to garner 18 minutes of public input is BAD.

The schedule of the event was completely backwards. If you want to hear from the public, then members of the public need to be treated like honored guests, and above all, their time must not be wasted. Repeat – the public’s time must not be wasted. So… don’t talk at me!

The citizen willing to speak at a public hearing is rare. Rare and fragile. I know this from personal experience on both sides of the podium. Most people would rather go to the dentist, say, than testify in public, even before a group that works hard to solicit their input. As a public health official, I once recruited a man with a contaminated well to go with me to the state capital (two hours away) to discuss water pollution. We drove together. But he could not, would not, did not, speak into a microphone in front of a room full of strangers.

I couldn’t blame him. A “hearing” sounds judicial. The physical setup was unintentionally confrontational – experts in business attire peering down at the speaker. “Insiders” tolerating the humble offerings of “outsiders”.

This afternoon, “the public” was sternly warned that each of us would be limited to three minutes, and only one person from an organization might speak, though all were encouraged to submit comments in writing.

The hearing was announced for 2:30 pm, and that is when I arrived. I signed in and was told I was the fourth person to register to speak. Fine.

Then I was told the hearing would start at three, to allow for latecomers. What?! This is not a notoriously unpunctual part of the world. This is a college. We do things more or less on time. The +/- is about five minutes. (Okay, nothing actually starts early, but neither is anything very late.) So there went half an hour of my precious time. I could have stayed where I was, at my desk.

Then the hearing convened. We were welcomed. A brief video was shown. Then we heard from an expert. She told us about the disease in question. She gave statistics and introduced some vocabulary. She said she wanted us to be in the “right frame of mind”. Why did she assume anything AT ALL about my “frame of mind”, much less that it needed correction?

Then we heard from six members of the state commission on said disease. They were mercifully brief, but there went another fifteen minutes.

The amount of background provided seemed to imply that the commission figured we were relatively ignorant.

By the time the first member of the public spoke, 75 minutes had elapsed from the announced starting time. The panel chose to respond to EACH SPEAKER. A judgement call. I don’t think it was a good decision in this case. A little clarification does no harm, but “response” can easily drift into “correction”, telling the speaker he or she didn’t get it right. That’s not the point. The commission said they had come to LISTEN, and that’s what they should have done. If an error or misperception was really important, they would easily be able to contact the speaker about it later on.

Around 4 pm, I rose and spoke. I was asked one quick question. Wanting to leave but also wanting to show respect for the other speakers, I sat back down.

There were only two more speakers for a total of six. SIX! The hearing need not have lasted more than half an hour. Each guest could have been allowed five minutes! Presentations by experts and commission members could have been offered afterwards for those who wished to stay. Or, better yet, the most interested and motivated participants (on both sides of the process) could have sat down together for a REAL CONVERSATION. We could have gone to the coffee shop together.

This well intended commission will be holding more meetings at other locations. I hope they change their format. Getting public input is difficult, but worthwhile.

Sex clubs, convenience stores and “The Wawa Way” by Howard Stoeckel

This is the story behind MY Wawa in Galloway Township, NJ. The one in the Cologne neighborhood.

I recently posted a link to a friend’s comments on “The Wawa Way”. (Read it if you never heard of Wawa.) The book was published to celebrate the 50th anniversary of this chain of convenience stores.

I’m a Wawa regular (if not exactly an addict), and a few weeks ago my morning coffee was free, in celebration of said anniversary. And “The Wawa Way” (subtitled “How a Funny Name and 6 Core Values Revolutionized Convenience”) appeared beside the checkouts. I grabbed a copy for a birthday gift.

Moving through the line, I heard the young man working at the register try to convince a customer that the very Wawa in which we stood had been RIGHT HERE for 50 years! I got the giggles and walked out laughing. I know the real story.

I think the oldest Wawa in our area dates back to 1975. It’s a tiny store (no gas pumps, no bathrooms) in a town four miles down the road. Yes, it’s still there, unchanged, with just eight parking spots.

In 1980, I took a job with the county public health agency, supervising (among other things) food service sanitation. I shortly realized the restaurant inspectors were snickering about certain facilities. One was a “health club” that seemed to operate on a “clothing optional” basis. The proprietor greeted inspectors without a stitch on. The club was called the “Avant Gard”. Their food service was impeccable. No food related hazard to public health was found on the premises.

One day a local resident got a surprise. A relative from a few states away called to taunt “You’ve got a sex club in your town!” Say what?? The relative sent a clipping advertising party space, fantasy rooms, adult fun, etc. Yes, it was the Avant Gard. We aren’t so far from Atlantic City (at that time the only legal gambling venue on the east coast) which may have generated the demand for these services. But they were carefully NOT advertised locally.

There followed a mighty tempest in our Township. How had this happened? Who issued a business permit? What defines a health club? The proprietor claimed that sex is healthy… Public debate accelerated, leading to the memorable statement by an elected official, “We don’t want kinky sex in Galloway Township!”

The Avant Gard couldn’t take the heat. The health/sex club closed, and the building became a corporate training location.

I moved to my present home in Galloway, near the intersection of Route 30 and Tilton Road, in 1993. Around that time, a small Wawa appeared there, across from the corporate training location. “It’s a sign!” we said. We were meant to move here, and enjoy Wawa coffee.

A few years passed and “our” Wawa outgrew its location. It moved, in a much expanded version, across the street to the former location of Galloway’s one and only sex club.

Does any other Wawa have such an interesting land use history? I doubt it!

I like Wawa for its coffee, and because somebody there has a sense of humor. I sent them a copy of this post. They thanked me cheerfully, and gave me a twenty dollar gift certificate.

Everybody talks about…the weather

The Year Without Summer: 1816 and the volcano that darkened the world and changed history by W Klingaman and N Klingaman.

Here we sit worrying about global WARMING… But global cooling could be just as bad! One message of this book is that there’s a good deal we don’t know about atmosphere and climate. Research should be supported.

In 1815, Mount Tambora in Indonesia exploded. Dirt and dust were flung into the upper atmosphere. The particles were big enough to block sunlight and too small to drop rapidly to earth. So the next year, the world’s weather was cold and stormy. Many areas experienced frost in every month of the year 1816. 

I’m from New England, so I paid particular attention to what was written about Maine and the surrounding areas. It was grim. Crop after crop was destroyed after planting, or before harvest. One consequence was the exodus of many residents, who decided to leave their rocky farms and head west.

One chapter of this book is entitled “Poverty and Misery”, and that sums it up. In Ireland, as hunger spread, civil authorities bemoaned that fact that the Irish clung to their habits of charity and community. They continued to shelter (and try to feed) wandering beggars. The beggars had fleas, which carried typhus. As people died, their families hosted traditional wakes, which offered another opportunity to spread disease. Along with food crops being lost, the Irish had difficulty harvesting the turf/peat they used for fires, so they were cold as well as hungry.

This book makes clear the changes that have come with improvements in communications and science. Nobody knew why summer never came in 1816. The extent of the problems wasn’t clear. The authors believe problems also arose in Asia and elsewhere, but there’s no documentary record.

We are fortunate to be able to predict some disasters. Imagine if we hadn’t know that Hurricanes Katrina and Sandy were coming! The loss of life would have been (even more) staggering. 

This book is well written. No scientific background is assumed. I would have liked a little more meteorology, but the history is detailed and interesting. Read and enjoy!