Tag: health

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Book Review: Immune by Philipp Dettmer

Immune

Given the current state of a global pandemic that can severely affect your health (and given the fact that we recently tested positive to the pathogen responsible), this book was an especially relevant read.

It’s an easy to read (and often hilarious) look into how our immune systems work. The incredible complexity of our bodies is amazing, but Dettmer uses all sorts of analogies to make things easy to digest.

For example:

“You can imagine the MHC class II receptor as a hot dog bun that can be filled with a tasty wiener. The wiener in this metaphor is the antigen. The MHC hot dog bun molecule is so important because it represents another security mechanism. Another layer of control.”

The book goes into various detail about how our bodies fight off bacterial and viral infections, the response to an allergic reaction, and how things like vaccines work.

In fact, the whole section on vaccines was especially interesting and particularly devastating to those of the crazy anti-vax persuasion. Prior to the COVID-19 epidemic, one of the biggest anti-vaccination campaigns was against the measles vaccine.

I’ll admit to not knowing much about measles and took it for granted that I was immunized from it. After reading this book, all I can think is, holy crap, what a horrible disease to have willingly chosen to get! Measles actively destroys your immune system and makes you lose immunity to other diseases.

“So in the end, being infected with measles erases the capacity of the immune system to protect you from the diseases that you overcame in the past. Even worse, a measles infection can wipe away the protection that you might have gained from other vaccines, since most vaccines create memory cells. Therefore, in the case of measles, what does not kill you makes you weaker, not stronger. Measles causes irreversible, long-term harm and it maims and kills children.”

Overall, this was a quick, easy and enjoyable book. Highly recommended!

Immune by Philipp Dettmer

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One year and counting

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It’s crazy to think that as of this week, we (at least inside our house and at our respective companies) have been working from home for one year now. I don’t think that even in our wildest or scariest dreams, we thought that we would be doing this one year on.

In hindsight, it makes perfect sense, because of course. Of course no one would listen to social distancing guidelines. Of course wearing a mask would become a way to definitively predict your political preferences. Because, of course.

It’s interesting to go back and read through some of the emails our company had sent, giving us some guidance on our updating and ever changing work from home policy in the early days of the pandemic.

March 1st, 2020:

As you’ve most likely seen, Coronavirus, COVID-19, became more of a concern over the weekend as additional cases were reported. To date, there are more than 60 cases in the United States, including new cases in the Seattle area.

Our plan is to operate our business tomorrow (and for the foreseeable future) as close to normal as possible. It’s important to stress that your health is of utmost concern.

March 4th, 2020:

Based on local risk factors and active conversations with peer organizations, we are taking extra precautions around Seattle and the San Francisco Bay Area. We are encouraging employees to work from home (WFH) where possible in these offices through at least this Sunday, March 8, at which time we will re-evaluate. This guidance is voluntary. There are no plans to close any of our work locations at this time.

March 5th. 2020:

However, based on local risk factors and active conversations with peer companies, we are extending our guidance of encouraging employees to work from home (WFH), from Seattle and San Francisco to all other California offices. We are also extending the time-frame until next Friday, March 13. Going forward, we plan to update WFH guidance each Friday through the end of March.

We are also increasing limits on work travel to and from Seattle. Please do not travel to or from Seattle for work.

March 8th, 2020:

At this time, there continues to be no confirmed cases of Coronavirus among our workforce. However, out of an abundance of caution and ongoing monitoring of local situations, we are extending our guidance of encouraging employees to work from home (WFH) to our New York City and Phoenix offices. This is in addition to our continued WFH guidance for our California and Seattle offices. This WFH guidance is in effect until this Friday, March 13. We will update our guidance each Friday through the end of March.

March 10th, 2020:

However, based on the rate at which we’re seeing this unfold and recommendations of the CDC and other health organizations for ‘social distancing’, the Senior Leadership Team has decided to expand ‘encouraged work from home’ to all our offices starting tomorrow, March 11 through March 20, 2020. I want you to feel empowered to do what is best for you and your situation.

All of our offices will remain open and employees who feel comfortable coming in are able to do so. We will also continue with our increased, proactive cleaning protocols. During this time, we have advised teams to discontinue large group meetings and all employee lunches will be cancelled. Our offices are being cleaned regularly and are open for business when you need to be there.

March 16th, 2020 at 11:00 AM:

Based on recommendations from the CDC and other health organizations for ‘social distancing’, SLT has decided to expand our ‘encouraged work from home’ recommendation through at least April 10. Local conditions and school closures play an important part in our decisions about extending WFH guidance. With schools and businesses closing rapidly, we know this might impact you on a very personal level. Let’s work together. We all need to be flexible and understanding with each other right now.

Our offices remain open with elevated cleaning protocols, but we want to continue supporting guidance of ‘social distancing,’ so please only come into the office when necessary.

March 16th, 2020 at 1:49 PM:

As I’m sure many of you have already seen the article in the Chronicle asking folks in the Bay Area to shelter in place starting tomorrow Tuesday, 3/16 at 12:01AM. I want reiterate in light of COVID-19 concerns, we are encouraging our employees nationwide to work from home. The safety and well-being of our employees, customers and partners across the country is our highest priority, and we are closely monitoring the guidance of the Centers for Disease Control and Prevention (CDC) and local authorities.

April 1st, 2020:

We are going to extend our WFH direction until at least May 1 for all office locations. We made this decision based on recommendations from health authorities, school closures and to continue to do our part around social distancing. Some schools will be closed beyond May 1 and we know this will impact many of our employees with school-age children. We will continue to support you by extending WFH options until you have access to reliable and safe child care. We’ll continue to monitor the Coronavirus situation across the country and will update our direction as needed.

April 24th, 2020:

Our decision to re-open offices will depend on a number of factors, including the safety of our employees, the public health situation in each local community, and being flexible based on the type of work and productivity of teams and individuals. While we hope to officially reopen offices over the coming months, we don’t see a scenario in which large groups will be able to return at once – we expect any opening to be gradual.

Given these considerations, we have made the decision to give you the option to work from home through at least the end of 2020. We want you to have flexibility to navigate this situation and do what is best for you and your family. We know some would prefer to work from the office as soon as possible whereas others might prefer to alter living arrangements to be more comfortable and productive.

July 29th, 2020:

We won’t continue to announce temporary extensions of WFH. Until COVID-19 is no longer a threat, we will continue to encourage WFH as we are today. In addition, ‘post-COVID’, our new flexible working arrangement categories (outlined below) will enable ongoing WFH options for the majority of our workforce – indefinitely. This means that the majority of us will not be expected to return to work at an office full-time, save for a few hundred employees in heavily regulated or office-specific roles.

What a surreal period of our lives. Hopefully, hopefully we are turning a corner on this thing and we can visit with our coworkers, friends and family again.

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Relevant excerpts from “Spillover”

In light of the current COVID-19 pandemic, I’ve been reading “Spillover: Animal Infections and the Next Human Pandemic” by David Quammen, published in 2012 (!!).  It takes a look into various zoonotic viruses that make the jump from animal to human. There have been a number of passages that have just jumped out and resonated with me as I’ve been reading.

One further factor, possibly the most crucial, was inherent to the way SARS-CoV affects the human body: Symptoms tend to appear in a person before, rather than after, that person becomes highly infectious. The headache, the fever, and the chills—maybe even the cough—precede the major discharge of virus toward other people. […] That order of events allowed many SARS cases to be recognized, hospitalized, and placed in isolation before they hit their peak of infectivity.

And a few paragraphs later:

“That probably helped account for the scale of worldwide misery and death during the 1918–1919 influenza: high infectivity among cases before they experienced the most obvious and debilitating stages of illness. The bug traveled ahead of the sense of alarm. And that infamous global pandemic, remember, occurred in the era before globalization. Everything nowadays moves around the planet faster, including viruses. If SARS had conformed to the perverse pattern of presymptomatic infectivity, its 2003 emergence wouldn’t be a case history in good luck and effective outbreak response. It would be a much darker story. The much darker story remains to be told, probably not about this virus but about another.”

One section of the book that was especially chilling involved the monkeys that inhabited the sacred monkey temples on Bali. In 2014, Kerry and I took our honeymoon there and I had even posted about the crazy monkeys: “While cute looking, the monkeys here are ridiculously aggressive. It was a bit scary!“

Anyway, the monkeys on the island are all apparently infected with herpes B, which kills nearly everyone.

The monkeys aren’t shy about accepting, even demanding, those handouts. They have lost their wild instincts about personal space. Enterprising local photographers run a brisk trade in photos of tourists posed with macaques. “And here’s me in Bali, with a monkey on my head. Cute little guy, just wanted that Snickers bar. But the cute little guys sometimes bite and scratch.”

Engel, Jones-Engel, and their colleagues gathered two interesting sets of data from this place. They surveyed the monkey population, by way of blood samples; and they surveyed the human workforce at Sangeh, by way of interviews and also blood samples. What they found says a lot about the scope of opportunity for virus spillover between Asian monkeys and people.

The team drew blood from thirty-eight macaques, of which twenty-eight were adults, the rest youngsters. They screened the blood serum for evidence of antibodies to herpes B, the same virus that killed William Brebner and most of the other people ever infected with it. The results of the lab work were chilling: Among adult long-tailed macaques at Sangeh, the prevalence of herpes B antibodies was 100 percent. Every mature animal had been infected.

But, there is good news!

The researchers merely estimated that there must be thousands of monkey-bitten tourists walking away from Sangeh each year—and Sangeh is just one such Balinese monkey temple among a handful. The odds of a human contracting herpes B under these circumstances seem vast.

But it hasn’t happened, so far as anyone knows.

I recommended the book to my dad and he asked if it had a happy ending. I shared this passage toward to end of the book with him.

“These scientists are on alert. They are our sentries. They watch the boundaries across which pathogens spill. And they are productively interconnected with one another. When the next novel virus makes its way from a chimpanzee, a bat, a mouse, a duck, or a macaque into a human, and maybe from that human into another human, and thereupon begins causing a small cluster of lethal illnesses, they will see it—we hope they will, anyway—and raise the alarm.

Whatever happens after that will depend on science, politics, social mores, public opinion, public will, and other forms of human behavior. It will depend on how we citizens respond.”

He replied simply, “so much for the happy ending.”

—

I ended up rating this book 5 stars on Goodreads. I probably wouldn’t have discovered it if not for the current global pandemic, but it is something I think I’d have enjoyed before everything changed. David Quammen looks at a number of zoonotic diseases (SARS, Lyme, and AIDS among them) and their fascinating histories.

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My first half marathon

This past weekend, I completed my first official half marathon after participating in the 32nd annual Kaiser Permanente San Francisco Half Marathon! The course was fairly flat and wound its way through Golden Gate Park and along Ocean Beach. You couldn’t have asked for better better weather or scenery! Overall, it was the perfect event for a new runner like myself.

My official result? 2:17:32. That’s kind of the nice thing about your first half marathon — any time is a new personal record. I’ve been training off and on for the last few months (and indeed, I could have trained more) and was hoping to hit 2 hours.

As it turns out, I was on pace to do it until one of my calves started to cramp up exactly half way through the race, forcing me to take a stretching break and limp through the remainder of the course.

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That’s me at mile 8! via @kerryme.

That said, it was still a really positive and fun experience and it’s something I’d like to do more of! Which is good, because I signed up for the Oakland Running Festival in March. Oh, boy!

A couple things I learned:

  • I brought my own water bottle (mainly so I could eat some of the gross energy gels that I brought with me). Overall, I wasn’t too distracted by it — I had brought a disposable bottle just in case it was annoying and I needed to chuck it. However, I skipped a bunch of water stations at the beginning of the race since I figured I had water. Big mistake! I should have taken advantage of the free water and gatorade (and used it to time when I should have consumed the gels). As it is, I ran out of water at around mile 10.
  • The gels really helped! I had the Cliff Bar variety. While they were really thick and gross to consume, I really felt that they gave me energy and I didn’t really hit a wall until the last mile and a half or so of the race. More than anything, I was distracted about my tight calf!
  • Someone else had mentioned this to me in the past, but I basically found someone who was running at a pace I was mostly comfortable with and I ended up sticking close to them for the first 6 miles. Trying to keep up with him was kind of a fun game.
  • I also discovered the “awful truth about jogging that no one ever talks about.” Oh, man is it true!
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Working extra hard for those steps

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I love my Fitbit. It’s easily one of my favorite gadgets that I own. It’s unobtrusive, the battery lasts forever, and its presence subconsciously reminds you to get up and move around a bit more.

In my previous jobs, I’ve been lucky to have the option to walk to work instead of relying solely on public transit. This gave me a chance to get some extra activity in at the beginning and end of each day and reach Fitbit’s lofty goal of 10,000 steps per day (equivalent to about 5 miles). It’s something that I always enjoyed striving for.

With my new gig, I walk around the corner to BART, take that to my stop, hop right onto a shuttle and then get dropped off right in front of our office. This means I lose out on having a built in opportunity to get some activity each day. (The walk from the BART station to the office is a little bit longer that one would want to walk — about 5.5 miles each way.)

Fortunately, our campus has a free gym with some nice equipment. On days where Kerry and I don’t go to the gym in the morning, I try to go here after work and get in those much needed steps. It’s a bit crazy how hard you need to work for them. After a full day in the office, I’ll run 3 miles on the treadmill and feel extra accomplished. At least until I pull out my Fitbit and it says I’m short by about 1,500 steps. Wow.

So, I’ve been trying to make a conscious effort to get more steps each day. Make sure I go to the gym in the morning (and / or evening). Do a lap around our campus at lunch time while calling my parents. Walk to the grocery store in the evening when I get home. (Interestingly, recent studies seem to indicate that walking and running have nearly identical health benefits.)

It’s pretty crazy how much I’ve taken things like my simple morning walk to work for granted. But I’m happy that I’ve been able to make a conscious effort to do healthy things.