2 years of Covid-19

13 Sunday Mar 2022

Posted by Un po' di pepe in Uncategorized

Tags

Coronavirus, COVID19, COVID19 pandemic, Sottosopra

As we slowly emerge from our cocoons and restrictions, it is hard to believe 2 years has passed since COVID-19 started a planetary health crisis that took over our lives. 2 years ago today, I wrote my first covid related post. While at my local coffee shop, I overheard too many conversations discussing the cancellation of sports games being ‘drastic and fear-mongering, since more people die of the seasonal flu’ and ‘only sick people over 80 are dying’. As a health care professional, I felt I needed to publish the facts.

At that time, no one could have imagined we would still be here 2 years later-even though the Spanish flu lasted at least as long. At times, it seemed things were improving, then another crisis would strike and we took a step backwards. There was little time for recovery.

Covid-19 has affected life for everyone. The loss of life, paralysis of the world economy, and mental health effects of this pandemic have been devastating. The stress, isolation and anxiety of quarantine, the fear, confusion, uncertainty and frustration with constantly changing recommendations and regulations have taken their toll and it will take time to recover.

Along this covid journey, differing opinions have also caused stress. It is good to see Facebook is no longer full of self-professed medical experts. Now they have become combat strategy experts. In North America, there have been protests for ‘freedom’ and infringement of rights. My colleagues and I risked our own health to administer covid vaccines, so I have absolutely no tolerance for covidiots. If I was in charge, they would all be given a one-way ticket to the Ukraine to witness firsthand what REALLY losing your rights and freedoms looks like. It is reported that 6 million people lost their lives to Covid-19, although the real number is probably higher. To put it in a grim perspective, this is the same number lost during the Holocaust. Yet there are still conspiracy theorists who believe this is fake news.

Where I live, masks are no longer required, although in some places they are recommended. Next month, we will no longer require proof of vaccination to enter restaurants and public events. 90% of the population is vaccinated, and enough people have had mild cases to build up immunity. Are we mentally ready to return to normal, or to get used to a ‘new normal’ though?

Everyone will come out of restrictions on their own time. We are all facing challenges that may not be visible. Do not assume to know what others are going through. For some, wearing masks, avoiding crowds and other precautions will be a safety net to cling to for a while longer. Extra helpings of patience and kindness will be required.

There are not many positive things to come out of a global pandemic. Even so, I have felt humbled by the outpouring of kindness, humanity, cooperation and creativity that has come out of this terrible situation to emphasize the resilience of the human spirit. This has also been a time for many of us to reflect on what is important. This will be my final Covid-19 related post. Continue to be patient and kind, hug your loved ones, have that extra sfogliatella, and stay safe. Ciao, Cristina

Reflections from a COVID immunizer

21 Saturday Aug 2021

Posted by Un po' di pepe in Canada, Inspiration

≈ 33 Comments

Tags

COVID19, COVID19 pandemic

Syringes Many of you readers have probably noticed that my blog has been neglected since April. This is mainly because I have been working a few days a week on the Covid immunization team with the local health department. I thought I it was important for me to do my part for the cause. I also thought it might be nice to actually have the opportunity to talk to live humans. British Columbia is doing well-84% of the population 12 years of age or older has had one vaccine, and 75% have had both doses. These stats are amazing-so the clinics are reducing capacity as the number of fully vaxxed people increases. My temporary extra job will be coming to an end soon.

The experience has been overwhelmingly positive. What a pleasure to work with people who are mostly positive, appreciative, respectful and relieved, …..I don’t think I ran into a single grumpy person! Many were anxious, confused and uncertain, even still hesitant and afraid-but not grumpy! What a nice change. I was continually thanked for my service and I also thanked everyone for showing up!

I worked at several different clinic locations in Vancouver, and also Whistler, but my most frequent location was the Vancouver Convention Centre ‘under the sails’ at Canada Place. Here is the venue, the lineup and the view from my lunch break.

Vancouver Convention Center My first day at the convention center we had 3500 vaccine appointments booked in 10 hours. In June, the number of appointments was increased to 5000 per day! It was crazy busy, but ran like a well-oiled machine.

Working as an immunizer involves much more than just giving the vaccine. It also involves explaining how the vaccine works, potential side effects and obtaining consent, answering all sorts of questions, assessing allergies, needle anxiety and anxiety in general, monitoring in the aftercare area for 15 minutes, delivering vaccines to immunizers’ tables and often even drawing up vaccines. Drawing up the vaccines is stressful as every last drop needs to be squeezed out of a vial so that the remainder left in 3 vials can be combined to make 1 extra dose! No wastage, but talk about pressure! My first day, there were 3500 appointments booked. Anyone who has previously fainted, felt faint with a vaccine or is really anxious is taken to the First-aid area so they can have their vaccine laying down. Some people are still unsure and confused when they arrive at their appointment and they need more time and reassurance. Canada Place

A surprising number of people booked their appts on their birthdays so they could extra celebrate. They tried to make it fun. Families and roommates showed up together, sometimes in costume or dressed in a theme colour! I loved when young adults brought along their 12 to 18 year old siblings. Stickers where available on the way out.

VCH Covid vaccine stickers
You can imagine the interesting responses from people during or after their immunizations. I kept track of them in a sort of ‘covid immunizer journal’ on my phone, and am including my favourites here. Details have been altered, removed and in some cases combined, to protect identity.

The Convention Centre is right in downtown Vancouver. I was amazed at the vast amount of intricately tattooed arms that were presented to me. These often required extra thought re landmarking and placement. It is totally OK to give an injection on a tattooed area, but I tried to avoid doing nasty things like stabbing angels and kittens in the eyeball! I enjoyed asking about the significance of tattooed images because I find this information fascinating, and it also served as a good distraction technique. I had some requests to give the vaccine into a particular tattoo, usually a religious or medical image. I saw a few Plague Doctor tattoos, which are considered ‘dark and edgy’ according to the internet. Plague Doctors treated victims of the Bubonic Plague. They wore big black hats, long black coats, and bird masks with large beaks. The beaks were filled with herbs and spices to mask the stench of death and disease. The large beak also prevented getting too close to the ill person. I suppose this was the 16 th century version of PPE and physical distancing?

As the eligible age to get vaccinated decreased, the amount of anxiety and needle anxiety seemed to increase-even among the tattooed. I tried to be empathetic, but since I know tattooing is painful, I found myself quite often wondering ‘were you unconscious when you got those tattoos?’. Several did lightheartedly comment that they were so drunk or high that they didn’t remember a thing! Travel was my favourite distraction topic. Many of my vaccinees had travel plans, either for real, or in their minds. It is amazing how animated and relaxed one can get while describing a potential vacation.

I was jokingly asked questions like ‘Did you just give me 3G or the microchip?’ and ‘Do you have a magnet I can use to check?’ Some of the more enthusiastic responses include: ‘I can feel the freedom coursing through my veins!’ ‘It feels like I just got my wallet and keys back after being in jail’ ‘Now I can go lick door handles’…my response- ‘Please don’t!’.
One of my most enthusiastic reactions was from a university student-probably a research scientist. She had her eyes closed and an orgasmic look on her face while she took deep breaths and said she was imagining all of the science, research and hard work that was going into her body at that very moment. For some, getting the vaccine was actually anticlimactic….’I endured 15 months of hell for that?’

We had either Pfizer or Moderna vaccine on any given day, depending on the available supply. People often wanted to know which vaccine they would be getting. The most interesting presentation of this question was ‘So, what’s in your candy dish?’ The cutest presentation of this question-which I was asked several times-was ‘Will I be getting the Madonna vaccine?’ I really wanted to respond ‘We only have Lady Gaga on the menu today’, but I don’t think any of them realized what they had asked. Moderna vaccine and syringes

In the aftercare area, it was obvious who had seen the TikTok video on how to move your arms and body to decrease vaccine side effects! FYI this does not help at all, but does no harm and some of the moves made me laugh.

A lovely 80ish year old woman expressed her happiness to be getting her second dose as she had ‘been through this all before’. She told me about surviving the Polio epidemic in the early 1950’s and how some of her classmates were not as fortunate. They did not get the new Polio vaccine because their parents were distrustful and afraid. Now Polio is almost eradicated. She hopes everyone will listen to the science!

Trust Science not Morons
My cousin sent me this amusing text wondering if I was still giving vaccinations. It was altered by autocorrect! I actually like their version better!

Text from Maria
I hope you enjoyed reading my Covid immunization diary notes. I also hope that where you live, vaccines are available and accessible to all. Please get out and get yours ASAP! Remember…..follow the science! As our Provincial Health Officer likes to say ‘Be safe, be calm, be kind’.

VCH vaccine sign Ciao and stay safe, Cristina

Reflecting on 2020

30 Wednesday Dec 2020

Posted by Un po' di pepe in Blogging, Inspiration

≈ 26 Comments

Tags

Coronavirus, COVID19, COVID19 pandemic, Sottosopra, Street art

Addio 2020! Is that too polite? How about vai via 2020? Via al inferno 2020? Vaffanculo 2020 may be the most appropriate send off to this year that most of us would like to forget. COVID 19 has affected life for everyone. Even in my weirdest dreams, I never imagined plague and pestilence in the form of a planetary health crisis during my lifetime…..yet here we are.

My word of the year is sottosopra (sot•toh•SOH•prah)…..upside down. I doubt I am alone feeling like an extra in a bad science fiction movie, where everything in the world is upside down. Kisses and hugs spread disease, lounging on the couch binge watching Netflix is responsible adult behaviour, NOT visiting family is a sign of love, and losers are the ones who DO go out on New Year’s Eve!

The loss of life, paralysis of the world economy, and mental health effects of this pandemic have been devastating. It has been more stressful than most of us are willing to admit. Each of us copes differently with the confusion, fear and stress of quarantine, distancing, and finding distraction from all things 2020. Some of us are madly productive, and others slow right down. As long as our activities help us cope and we follow local guidelines to help everyone stay safe, it does not really matter.

This has been a time for many of us to reflect about what is important, especially so in this quieter of Christmas seasons. There are not many positive things to discuss during a global pandemic. Even so, I have felt humbled by the outpouring of kindness, humanity and creativity that has come out of this terrible situation and speak to the resilience of the human spirit. Just a few of my favourite examples include:

The adaptability and creativity of businesses, workplaces, schools and social groups, offering their services differently and online. I have been doing zoom yoga 3-4 times a week! Many of these practices will likely continue in some form when the world is no longer sottosopra!
The world becoming emotional watching videos of neighbourhoods throughout Italia singing in solidarity from their balconies and windows. This uplifting show of unity and community support spread positivity around the world.
Collective rounds of applause and banging of pots for frontline health care workers. As a healthcare worker, I thank you all for your enthusiasm! This video ‘A Violin flies over Cremona’ of Lena Yokoyama playing Ennio Morricone for health care workers on the roof of the hospital in Cremona makes me cry. The full 15 minute documentary, with English voice over by my amica Anna Ambrosini is available here

Pandemic street art! A creative response to the pandemic, often with a dose of humour. I wrote about street art for International Nurses Day and have another post planned soon.
Volunteers helping the elderly with groceries and errands, sewing masks, donating blood and many other wonderful things.
Nerdy science geeks are finally cool!
The elementary school near home had to cancel their Christmas concert. They walked around and sang in front of the homes of the older and housebound neighbours instead. Singing with their antlers and little masks on-they were adorable. My parents were so thrilled, as was 98 year old Pasquale across the street.
The extra effort to spread Christmas cheer this year with outdoor decorations and lights. Tree lots here sold out the in first week and many stores almost sold out of seasonal stuff by mid-December. My lights and decorations always help me get through the cold, wet, dark, depressing days of winter, so I have really appreciated this.

2020 was consistent…ha fatto schifo dall’inizio fino alla fine! It sucked from beginning to end!

Please remember the global Christmas message of goodwill towards everyone. We are all facing challenges that are not visible. Do not assume you know what others are going through. As our Chief Medical Health Officer Dr. Bonnie Henry says ‘Be safe, be calm, be kind’.

Wishing all readers of Un po’ di pepe a safe, healthy, happy, better New Year, where the world is not upside down!

Tanti auguri a tutti i lettori di Un po’ di pepe per un migliore Anno Nuovo piena di gioia, salute e sicurezza, dove il mondo non è sottosopra

Forza! Hang in there everyone!

Virtual baci e abbracci, Cristina

Street art images from the artist’s instagram:
No need to shit yourself @johndohart
Trust Science, not Morons, Mike Dellaria @dellarious
Il Bacio @TVBoy

COVID19-Insieme ce la faremo

22 Sunday Mar 2020

Posted by Un po' di pepe in Italia, Italian life

≈ 28 Comments

Tags

#insiemecelafaremo, #iorestoacasa, COVID19, COVID19 Italia, COVID19 pandemic

What a week it has been! The COVID 19 pandemic has changed life for everyone. Last week, I wrote about COVID 19 and the situation in Italia. Then the world became emotional watching videos of neighourhoods all over the country singing in solidarity from their balconies and windows. There was also a collective round of applause at noon for frontline health care workers. This uplifting show of resilience and community support was much needed. Rainbow paintings by bambini, and the positive messages #iorestoacasa and #andratuttobene spread positivity throughout the country in a show of mass cooperation and unity.

This week in Italia there is discouragement and low morale, with new cases going up daily. Stats are updated here. Things are getting worse instead of better. There are now more deaths than in China and the numbers keep rising, despite extreme social distancing measures. We all saw the morbid images from Bergamo of a convoy of army vehicles transporting coffins elsewhere because there is no room for them. I feel terrible when I think of all the people dying alone in ICU, without their families, not even given the dignity of a funeral. It is natural to feel demoralized under the circumstances, and the mental health effects of quarantine and social distancing, but it is important to stay positive and hopeful.

What we all have to remember is that the COVID 19 virus can incubate for 14 days. Knowing this, it makes sense that measures taken today will take 2 weeks to have an effect, and the increase in cases were mostly infected before the whole country was in quarantine. Now there are even stricter measures in place.

China has had 4 days with no new cases. We also need to remember they are on day 81 (since Jan 1st), while Italia is only at day 32 (Feb 20th there were 3 cases). If all of this is correct, it should start getting better next week …… if everyone stays home! Movement of people will just keep feeding the virus.

What I do not understand is why other countries are not learning from what is happening in Italia and acting sooner? It is not if, but when. For example, the UK now has more cases than Italia did at the same point, but they only just closed bars yesterday! Despite social distancing measures, we see videos of socially and morally irresponsible spring break partying in Florida, and a packed Bondi Beach in Sydney. The only way to contain this thing is to STAY HOME! Wake up and smell the cappuccino already! The super strict rules need to be stricter and need to be enforced. This cartoon sent to me on Facebook shows what is needed to kick COVID 19. The coronavirus says: ‘I’m leaving, there is no one here’.

I hope the balcony singing resumes, because music is the universal language and it is so important for social and mental health. Forza! Insieme ce la faremo-together we will do it! Stay strong everyone…and unless you are an essential service, STAY AT HOME! Ciao, Cristina

Image: Coffee? used with permission by Martina Heiduczek IG @martina_illustrates

To lighten the mood I am attaching a hilarious video from Rimbamband of ‘Virus Corona’ (pronounced VEE∙roos Corona) to the tune of the 80’s hit My Sharona. The lyrics are hilarious, but even if you don’t understand Italiano, it is still funny.

COVID19-Andrà tutto bene

13 Friday Mar 2020

Posted by Un po' di pepe in Amici e Famiglia, Italia, Italian life

≈ 27 Comments

Tags

#andràtuttobene, #iorestoacasa, Coronavirus, COVID19, COVID19 Italia, COVID19 pandemic

This is a blog post I did not want to have to write. A few weeks ago, I was hoping the COVID19 outbreak in Italia would just fizzle out on its own. That has not happened, and Italia-my other home-has been absolutely devastated. My family and friends there are all safe, but they are worried and confused, with things changing every day.

Yesterday, I overheard a group discussing the cancellation of NBA and NHL games and how that was ‘drastic, fear-mongering because more people die of the seasonal flu’ and ‘only sick people over 80 are dying’. Most of you readers may not know this, but my ‘real job’ is at BC Childrens’ Hospital in Vancouver. As a healthcare professional, I need to discuss the situation and present the facts.

COVID19 stands for ‘Corona Virus Disease 19’ and is in the same family as SARS. Some of you may remember the SARS outbreak in Asia and Toronto in 2003? SARS was more deadly (10% mortality), but COVID19 has far more cases and has been spreading like wildfire. The coronavirus family cause disease in animals. The genetic code for COVID 19 has been linked to bats. It originated in Wuhan, China and likely passed to another animal before being passed on to humans.

The death rate for COVID19 about 3.4%, much higher than the seasonal flu. Death is not likely for those under 60 and healthy, but it can be spread to grandparents, parents, friends who are immunosuppressed or have other health issues. Children do not seem to be affected, but can spread the virus. 20% of cases will develop severe pneumonia and ARDS (acute respiratory distress syndrome) needing oxygen therapy and possibly ICU and mechanical ventilation.

The situation in Italia-as of 13 March 2020, there have been 17,660 confirmed cases, 1,266 deaths, and 1,439 recoveries, leaving 14,955 active cases. This data is updated daily here.

Why are there so many cases in Italia? There are many reasons, including the fact the government has been transparent about reporting the #’s and facts from the beginning and they have tested over 60,000 people, revealing asymptomatic cases. There is a large elderly population, the hardest group hit, and also the fact that Italians are probably the world’s most cuddly, affectionate population-which in any other situation is a positive thing.

For those of you who are not aware, restrictions started on Feb 22nd in Lombardia with the ‘red zone’ areas being quarantined. On March 4^th schools are closed for 2 weeks. March 8^th the red zone is extended to include areas of Veneto and Emilia Romagna, Piemonte and Le Marche.

March 9^th the whole country is declared a red zone. 60 million people are in quarantine until April 3rd-including travel restrictions and a ban on public gatherings. The hashtag #iorestoacasa (I am staying home) is started to encourage limited movement and social distancing. Travel between towns requires printing an online ‘autodeclaration’ form stating the reason-medical appointment/going to work/family emergency. Everyone has to stay 1 m apart and bars and restaurant close at 6pm. Meanwhile, cases continue to climb. ‘Smartworking’ is the buzz word for those able to work from home.

March 11 Prime Minister Giuseppe Conte extends the restrictions to what is basically a complete shutdown. Only essential services are allowed to stay open –pharmacies and stores selling food and other essential items. In his words:

Rimaniamo distanti oggi, per abbracciarci con piu calore e per correre insieme piu veloci domani/Let’s keep our distance today, to hug each other stronger tomorrow.

March 11 the WHO declares a pandemic. A pandemic is ‘the sustained and continuous transmission of a disease in 3 or more different geographical regions at the same time’. This does not necessarily refer to how lethal the disease is. In less than 2 months COVID19 has spread to 116 countries.

At the macelleria (butcher/meat shop) in Orsara di Puglia, my Zia reports that only 1 person is allowed to enter at a time and everyone else has to stand in line outside, 1m apart from each other. Many shops have attached tape lines on the floor 1m apart. Below is a photo from my cousin’s store selling cleaning products. They have sold out of hand sanitizer, alcohol and mascherine-facemasks, but have lots of toilet paper left.

The containment measures may seem drastic, and they are, especially since it has been only 20 days-but it is the only way to stop cross contamination. Without hosts, the virus cannot spread. It will be contained if people are isolated. In epidemiology lingo, intervening to try and slow the spread and prevent the # of severe cases is called ‘flattening the curve’. This is also to prevent system overload and ensure that health care resources can keep up. 20% of cases will develop severe respiratory distress, possibly needing ICU and ventilation. This is not the seasonal flu and will overwhelm the system. In Italia on March 10^th there were 600 people in 55 ICU’s. The median age is 65, meaning that there are younger people in ICU too. An ICU physician in Lombardia calls it ‘worse than a bomb’. ICU beds in the north are full and doctors have to make decisions about resource allocation.

Many other countries are now where Italia was on February 22^nd and need to follow her example and implement measures early. Today in Canada, our Prime Minister is in isolation as his wife has come back from the UK and tested positive. This is unfortunate, but has got people listening. There needs to be a balance between staying calm to avoid panic and hysteria, but also being proactive and prepared.

COVID19 is not an airborne disease. It is spread by droplet and close contact with an infected person. Respiratory droplets are produced by a sneeze or cough. They can travel up to 1.8m (6ft) and directly enter the body through the eyes, mouth or nose. Contact refers to touching an infected person or object such as doorknob or railings directly. Unwashed hands contaminated with COVID 19 can introduce the virus into the body when touching eyes, mouth and nose. With these facts in mind, here are the most important things to help prevent the spread of the COVID19:

Wash hands! Soap and water or alcohol based hand sanitizers are both effective.
Avoid touching the face
Keep 2m away from sick people
Cough and sneeze into sleeve/elbow
If you are sick, stay home! There is no treatment for viruses-stay home, rest and drink fluids.
Go to the Dr or emergency department only if you are truly unwell. Call your local public health service first to ask what to do/where to go.
Depending on your location and the number of cases, follow the local health department recommendations re physical distancing, mask wearing, travel, etc.
Masks will not prevent you getting sick, but should definitely be worn if physical distancing is not possible-especially indoors.
Do not stockpile disposable masks and hand sanitizer-they are needed by hospitals.
Make sure you have 2 months supply of any medications. There is no need to stockpile other food and supplies-and especially not toilet paper!

Short term pain for long-term gain. There will definitely be short term repercussions to the economy, but health and safety have to come first.

Let’s hope that things settle down in a few weeks to a month. Today, Friday the 13th at 6pm in Roma, Firenze and several other cities, balcony flash mobs occurred, with everyone banging pots and pans and singing out on their balconies! Warmer weather creates a less friendly climate for viruses, so bring on the sun! These will be happening all weekend. Once this is all over, those of you who had to cancel trips to Italia will be able to rebook. The economy will need you. Remember #andràtuttobene-everything will be all right. Forza Italia/Stay strong Italia! Grazie mille to all of the front line health care workers! Please read the next post: COVID19-Insieme ce la Faremo Ciao, Cristina