Category: 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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Positive COVID

Well, this was probably inevitable at this point.

There was an outbreak at our kid’s daycare center a week or so ago, and ended up bringing it home. Now, we’re all positive and hunkered down.

Definitely frustrating, as we’ve really tried to limit our interactions with others and keep the surface area of our bubble as small as possible. Outside of our youngest, we’re all max-vaxed, thankfully.

Here’s to hoping our symptoms are mild and that we’ll be better soon.

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Book Review: Empire of Pain by Patrick Radden Keefe

What a fantastic book about a horrible family.

The first half of the book is a true rags-to-riches story, following the life and rise of Arthur Sackler and his brothers. The son of an immigrant, he came of age during the Great Depression. This man could hustle and there was nothing that could stop him.

The second half is about the pharmaceutical company they purchased and ran. In the 90’s, they created a ridiculously powerful pain killer (OxyContin). In an effort to maximize profit, they pushed the drug onto unsuspecting patients and physicians despite knowing (and hiding) how addictive and dangerous it was.

The damage is jaw dropping. And like most crimes involving the ultra rich, the family members who ran the company (and used it as their personal piggy bank) got away with it.

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Book Review: The Code Breaker by Walter Isaacson

At first glance, this book seems to be a biography of Jennifer Doudna, a biochemist and one of the pioneers of CRISPR research.

While there is some focus on her upbringing and the things that may have driven her to become a fantastic scientist, the book is really about the wide range of characters who helped discover CRISPR DNA sequences and their potential applications in modern medicine.

I’ve heard CRISPR and CRISPR-based technology mentioned in various things I’ve read and how it is something that could potentially revolutionize medicine. But that’s really all I know about it.

This book digs into how Jennifer and her team of researchers discovered the CRISPR process — essentially duplicating the way that bacteria has fought off viruses for eons — and how it could ultimately be used for various therapies, treatments and even diagnoses.

The book briefly mentions its use in the Moderna and Pfizer vaccines for COVID-19 as well as some of the more controversial and ethically questionable uses — editing the genes of a fetus, for example, to choose certain traits (which will then be passed down to its own children).

This was an enjoyable and informative read and it covered all sorts of things from the science of CRISPR, legal issues related to patents, and the use cases for CRISPR based technologies today.

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One year and counting

biohazard warning

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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For those who appreciate clean air…

It seems like every year, late in the summer or early in the fall, the air in the Bay Area fills with thick smoke from raging infernos happening around northern California. The air is hazardous to breath, preventing you from taking kids to the park, walking your dog or even opening your windows.

Last year, we made the wise decision to purchase an air purifier, which admittedly, looks like a giant iPod shuffle.

As fires continue to burn around these parts, we’ve started to rely on air quality data from PurpleAir, which monitors air quality data from a series of IoT sensors that people can purchase for their homes or businesses.

You can view a map featuring realtime data collected from their sensors. Here in the Bay Area, the sensors are quite ubiquitous and can give a more realistic pictures of air quality near your home.

For example, here is the current air quality around the Bay Area from PurpleAir while I write this post.

For comparison, here is the current air quality map for Bay Area Air Quality Management District (BAAQMD), which we used to reference when trying to determine local air quality.

The fidelity you get from PurpleAir is pretty amazing.

Knowing this, I decided to write a Node app that periodically queries PurpleAir for air quality data from a sensor located a few blocks from our house. It continuously runs on a Raspberry Pi setup in our entertainment center and sends me a text message to close our windows when the AQI crosses above 100.

I’ve made the source code available on Github. Check it out!

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This might explain why I enjoy washing dishes

Fun fact: I like washing dishes.

In light of current events, I’ve found myself doing it much more than usual. However, I’ve never really been able to explain why I’ve enjoyed it so much but I’ve felt there is something relaxing and even meditative about it.

It turns out, I’m not alone in this line of thinking and it’s been mentioned by Thích Nhất Hạnh as a way to cultivate mindfulness.

Adam Hanley randomized two groups of college kids and had half read Thich Nhat Hanh’s instructions for mindful dish-washing while the others read simple, mechanical instructions.

After the students washed the dishes, members of the group that had read mindfulness teachings reported having a better experience, a joyful experience, and had lost track of time.

Hanley’s study was published in 2014. Some notes from the abstract are below:

This study sought to investigate whether washing dishes could be used as an informal contemplative practice, promoting the state of mindfulness along with attendant emotional and attentional phenomena. We hypothesized that, relative to a control condition, participants receiving mindful dishwashing instruction would evidence greater state mindfulness, attentional awareness, and positive affect, as well as reduce negative affect and lead to overestimations of time spent dishwashing. A sample of 51 college students engaged in either a mindful or control dishwashing practice before completing measures of mindfulness, affect, and experiential recall. Mindful dishwashers evidenced greater state mindfulness, increases in elements of positive affect (i.e., inspiration), decreases in elements of negative affect (i.e., nervousness), and overestimations of dishwashing time.

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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.