COVID19

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August 10, 2021

Mind

Yesterday was re-entry after a week off. I would not say it went well.

Reasons:

  1. I did not get adequate sleep the prior 2 nights (in part due to anxiety about re-entry. #%(*$(@)
  2. I had great plans to not stress about getting everything done at once, but felt like I was surrounded by people asking me why things were not done. BECAUSE I WAS ON VACATION. AND NO, I CAN’T CATCH UP ON ALL OF IT INSTANTLY, ESPECIALLY WHILE I AM SEEING PATIENTS.
  3. I developed a migraine around 2 pm that is still mildly present as I type this.

Furthermore, like everyone else I am in a news-refreshing frenzy. Our adult hospitals are bursting with COVID cases, surpassing numbers from last July (which in this region was a terrible peak). This is having ripple effects in GME, and further lowering morale for basically everyone.

Then of course, there is back to school. I agree there will absolutely be a lot of COVID in school next year. I expect many quarantines; our school’s most recent policy also quarantines siblings of exposed (though I cannot find any recommendation about these ‘secondary contacts’ on the CDC’s site) which — playing COVID roulette with the current case numbers in our area suggests to me that all 3 will be constantly home.

I know many are very concerned about the risk to children from COVID in general. This is not really my biggest fear, and as always, I feel moved to mention that our prior COVID experience surely impacts my thought processes around this and may not be generalizable. I am instead much more upset/anxious about a year of constant quarantine and homeschool. Because it was so, so miserable. And while it was fine for C to miss half of K, he’s now entering 2nd grade and I have legitimate concerns about his ability to write a coherent sentence, let alone without throwing a tantrum while doing it. (We are — and have been — working on it, with the help of professionals. Which is also painful and pricey. But the last thing he needs is a year of spotty inconsistent school.)

We are also in an area where there has been MUCH drama about masks. I am absolutely for mask mandates in school (though there is zero chance I will attempt to put my kids in N95s, given that I feel like utter #*$ when I wear one myself). But our governor certainly isn’t. I feel like this is just one more polarizing piece of BS that is distracting everyone and adding to the stew of angst and drama at the start of this school year.

I wish vaccinations were available for kids. If they were generally as effective as they are for adults — even with Delta — things would be so much better.

Coping Mechanisms

Being honest, yesterday was terrible. I was all excited for a fresh start and instead spent every non-working minute doom scrolling even though it was making my headache worse (though everything was making my headache worse). (At least I almost never drink anymore! If wine was my drug of choice — rather than my phone — I’d probably be in liver failure by now.)

Today is a new day though and I am determined to make it better. I will try very very hard to focus on one task at a time and will catch up on the many things currently fragmenting my attention and stressing me out.

Well! I was going to do a whole “Mind” “Body” “Soul” thing but this went on tooooo long (thx covid) so we will save the latter categories for future days.

coming at you live from COVID epicenter. sigh.

47 Comments

  • Reply Aly August 10, 2021 at 6:34 am

    šŸ™ This too shall pass, someday.

  • Reply Gillian August 10, 2021 at 7:24 am

    I would push back at school on the secondary contacts not coming to school. It is really silly. Those kids don’t have to stay home, so they can be out in the community. They are better off at school following rules around masking etc. One of our schools had this policy last year and I spoke to the school’s director and she changed it.

    That said cases were high in our area last winter during the school year and we didn’t have a single case of in-school spread.

    Hang in there. Vaccines will come for kiddos…

    • Reply nicoleandmaggie August 10, 2021 at 7:52 am

      Itā€™s easier not to have in school spend when thereā€™s masking and social distancing. Which there isnā€™t this year in a lot of states, even ignoring delta.

  • Reply Seppie August 10, 2021 at 7:34 am

    Not everyone is in a news-refreshing frenzy! Which of course, you already know, but thoughts are sneaky. It’s like the compare and despair thing in a different direction.

    The alternative I’ve chosen is to deliberately curate my news sources and deliberately limit engagement with those sources. I spend 10-15 min every morning listening to NPR’S Up First while I get ready. When I sit down at my computer and check email, I scan the NYT newsletter. I don’t ever click on more than 2 links. Once a week I listen to the Slate Political Gabfest and twice a week I listen to Pantsuit Politics – usually while walking or doing housework.

    Total time spent – <5 hours, mostly while doing other things, and I am way more informed on most topics than any of my friends who engage in doom scrolling.

    My kids would read this summary and take it as evidence of my liberal bubble, but I'm ok with that. I do get multiple perspectives through books and long-form online articles (on Friday evening or Sat morning I usually give myself an indulgent date with my phone – once a week is all the scroll time that feels good to me) but short form arguments/headlines are usually reductive and designed to evoke a negative emotional response.

    Which, of course, you also know! I think the alcohol comparison is apt – even people who don't like the results have a hard time quitting. I just read Soundtracks by Jon Acuff and he talks about thinking about broken soundtracks as a dial that you have to manage over time, not a switch that you can flip once and be done.

    This is kind of the same thing. It seems, from reading your blog over time, that when you can turn down the news/social dial, it's better for your life, but the dial is broken so it doesn't stay down without active management.

  • Reply nicoleandmaggie August 10, 2021 at 7:47 am

    That all sounds pretty awful.

    Re: quarantines: It could be worseā€¦ it sounds like our current schools policy is to NOT quarantine anyone ever. We think they also just changed their minds on notifying parents as well in that theyā€™re not going to tell us if an unmasked unvaccinated kid sitting next to our unvaccinated daughter for an entire class period has covid. Weā€™re calling today to get clarification on that but itā€™s sounding more and more like weā€™re going to need to homeschool. So basically theyā€™re trying to set it up so that all kids get covid but nobody knows thereā€™s been an outbreak until everyone has been infected.

    • Reply Sarah Hart-Unger August 10, 2021 at 8:21 am

      I guess I’d vote for middle ground. Masks, distancing when possible, quarantine when there are clusters (and not siblings). Truthfully, I think my concerns are not entirely aligned with yours. To be completely transparent, I’m more worried about a year of homeschooling than I am about the kids getting COVID again. I’d of course prefer they didn’t and plan to vaccinate all at first opportunity, but it’s just not my highest worry.

      • Reply nicoleandmaggie August 10, 2021 at 9:05 am

        What are the public schools in your area doing re: quarantines? Maybe that would be preferable for you?

        I would love a middle-ground that follows science. If my school had the same protocols in place that they did last year, I wouldn’t be worried. Covid would spread, but it would spread slowly and with warning. There weren’t quarantines last year because with masks and social distancing they weren’t necessary. This year they will be necessary but they’re not going to be done, meaning that kids who don’t know they are covid positive yet will be spreading covid, meaning more families will be losing out on work because of illness rather than quarantine.

        Zero quarantines with no masking and no informing people means that eventually everyone gets covid and there’s a potential for new variants. Even if my kids don’t die, someone’s kids will get long covid and some may die or cause immunocompromised family and friends to die.

        Entire schools will covid and hospitals will be even more overrun than they already are. Last year one of my (early 60s) colleagues had a heart attack during a covid spike and died. I have to wonder if he would have survived if the ICU hadn’t been at over 100% already.

        It is entirely possible that a new worse variant will spread before it has a name because the spread is so fast under zero masking or quarantining conditions.

        And even if covid doesn’t lead to hospitalization, I’m worried about lost of sense of taste and smell in growing bodies.

        I’m sure you’ve seen the worst that happens with kids with covid. I’ve seen the entire spectrum with my college students. The thing is, you just don’t know which version someone is going to get. You don’t know if it’s going to be like a milder flu that they recover from in a few days or if they’re going to drop a grade level in their ability to do mid-level math and following basic instructions.

        So, I do think that being under-cautious is worse than being over-cautious if schools and the government is going to ignore sensible guidelines that could make schools safer. And that’s with my knowledge of the extensive research on the negative effects on domestic violence and women’s labor force participation.

        Yes, it would be great if schools could just get it right, but I’d rather an unnecessary 10 day quarantine than more deaths and all the other negatives that come from covid.

        • Reply Sarah Hart-Unger August 10, 2021 at 9:13 am

          The public schools are staying mute thus far, though school starts in a week. So I don’t know!

          Everyone in my area is obsessed with growth and as a ped endo, I have seen exactly zero cases of growth failure due to poor taste/smell (and this area has certainly already seen its share of COVID though it was not delta). I’m all for science, but that isn’t science – it’s pure speculation.

          I HAVE seen a significant rise in new cases of type 2 diabetes related to massive weight gain that correlates (unclear causation, I grant you that . . .) with staying home from school all year. We are in the process of publishing this data. Most of the cases are in families with low resources.

          • nicoleandmaggie August 10, 2021 at 9:35 am

            It’s only been a year, would you see negative outcomes on growth yet? You’re thinking catastrophic FTT kinds of situations, but it’s more likely to show up in kids not reaching their height potential (and other things that are correlated with that but not as easily measurable), which we won’t know until they’re 25. I’m sure someone will do an interesting economics study on it in the future. Although with delta, more truly little kids will be getting symptomatic covid and from a scientific standpoint it will be interesting how their malleable tastebuds interact with scent/taste loss and their food preferences for the rest of their lives, but I wouldn’t want my kid to be a test subject.

            Staying home an extra 10 days because a sibling is in quarantine is unlikely to cause diabetes! Families with low resources are also more likely to die from covid. And they’re more likely to be unable to quarantine themselves when a kid brings covid home, spreading it further at their workplaces. Two of our secretaries lost family members (one a father, one a brother) from covid last year.

          • Sarah Hart-Unger August 10, 2021 at 9:40 am

            Children do not generally grow until 25 (or even close). !? Unless you were referring to non-growth outcomes.

            I am certain my understanding of childhood growth outweighs yours since I deal with it every day. And yes, we had a surge last July with plenty of pediatrics positives in the area. If significant changes in nutrition occurred, yes, effects would be evident by now. Please do not try to school me in the physiology of childhood growth. It is literally what I do all day many days.

            Also, if (and I’m not saying this is a likely scenario, but IF, in theory) kids ended up 2″ shorter because of COVID, would that be the end of the world? Tall people are not inherently superior or healthier contrary to what some might believe.

          • nicoleandmaggie August 10, 2021 at 10:07 am

            Thereā€™s catch-up growth. You donā€™t know except in catastrophic situations if an individual kid is just waiting for the next growth spurt. Certainly not over the course of a year. Maybe in babies and toddlers, but prior to delta they werenā€™t so much a covid concern, and I havenā€™t seen research on that one way or the other, I assume because sample sizes are too small for economists to do anything.

            Itā€™s not the height thatā€™s the important thing so much as all the underlying things that arenā€™t as easy to measure that are correlated with not reaching your height potential. If youā€™re genetically short thatā€™s different than being malnourished. Yes I know youā€™re a doctor but this is a big area in economic history and demographic economics and, without going into details, I am active in this area so Iā€™m not talking out of my posterior. (You should have heard the gasp of my 4ā€™11ā€ friend in grad school when the professor asked if everybody who was short was malnourished.). And yes, being short can lead to a longer life under certain circumstances. Its complicated. Epi-genetics are important too. But, when thereā€™s something short term like a famine or the 1918 flu etc height correlates with other health outcomes. I assume weā€™ll see the same cohort analysis on covid in the future. Probably using military records from a country that requires service of all citizens.

          • Sarah Hart-Unger August 10, 2021 at 10:18 am

            Just for the record, I’m not just “a doctor”, I’m specifically a pediatric endocrinologist and in my geographic area, >50% of the patients that come to us are for growth, for better or for worse. Anecdotally I will say over the last year some of the pickier eaters did have more normal weight gain (and growth) and their parents would tell me it was easier to feed them frequently throughout the day when they were home.

            I do think that the theoretical discussion of changed taste/smell leading to later growth differences is just . . . not really important nor is it even really relevant. It strikes me as distracting at best, fear-mongering at worst.

          • nicoleandmaggie August 10, 2021 at 10:40 am

            Yes, I am aware you are a pediatric endocrinologist. I also don’t think that being “just a doctor” means that people who aren’t specialists are bad in any way. I hope acknowledging that someone has an MD isn’t considered an insult because it certainly wasn’t intended to be one.

            I am also highly educated (PhD, economics, first name basis with many famous economists) and do research in demography, and more importantly, follow the research that better people than I do.

            Like I said before, the height differences isn’t the important thing, it is just a signal of other underlying bad things that are correlated with cohort-level height drops. These things affect morbidity and mortality, particularly at later ages. There’s a whole interdisciplinary field that studies this topic (it started with the Barker hypothesis about in utero effects on life expectancy, but has grown tremendously). The 1918 flu was not great for people even if they survived. Ditto many other short-term negative events.

            Look, I need to get to work so I am going to stop this discussion. There are a lot of unknowns, and there can be disagreement about what cohort level vs individual outcomes are important and short-term vs. long-term outcomes. We will not know what true effects are until a lot of time has passed and different people have different levels of risk-aversion. Yes, it would be great if school districts followed CDC recommendations, but many are not.

          • Kay August 10, 2021 at 10:48 am

            Thank you this is reassuring…and yes on the weight gain! I don’t even recognize a lot of the my son’s classmates when I see them. They have all gained so much weight!

          • Sarah Hart-Unger August 10, 2021 at 10:54 am

            The picky eaters gained more weight, and the non-picky eaters unfortunately also gained more weight.

            https://www.wsj.com/articles/kids-weight-gain-in-the-pandemic-is-alarming-doctors-11620673200

            https://pediatrics.aappublications.org/content/147/5/e2021050123

        • Reply Sarah Hart-Unger August 10, 2021 at 9:22 am

          Though I do absolutely agree with you that the “no quarantine, no disclosure” policy is going way too far and seems like it could have dire consequences.

          • anonymous economist August 10, 2021 at 2:32 pm

            I read this blog and generally do not comment, but I couldn’t help myself after seeing this comment thread. I, also a PhD-trained economist, would tend to believe Sarah if she says she hasn’t seen exacerbated growth issues in her pediatric patients over the past year, on average. This whole “I’m a PhD-trained economist and I know important people and can understand their work and therefore I’m right” argument is just sad.

            Take for example this sentence “Thereā€™s catch-up growth. You donā€™t know except in catastrophic situations if an individual kid is just waiting for the next growth spurt. Certainly not over the course of a year.” In other words, if you see a bunch of kids who’s parents are concerned about their growth (presumably too little growth), the whole catch-up growth argument would say, that after a year, it’s too early to tell if there IS a problem. Sarah has said that based on her observations, there doesn’t seem to be any problems brewing. For this catch-up growth theory to be in favor of Nicoleandmaggie’s arguments against Sarah, the takeaway would have to be that “after a year, it’s too early to tell there ISN’T a problem,” which may well be the case, but just not supported by this catch-up growth discussion.

            Please stop throwing around your PhD economics credentials unless you’re going to use it responsibly.

          • Irene August 10, 2021 at 3:23 pm

            Iā€™m really sorry you just got talked down to on your own blog like that Sarah. I am not a doctor but those I know I know who *are* in the field of pediatrics are concerned about the weight gain happening in kids. I donā€™t see it mentioned much in the press but seems important to me in my non expert opinion!

          • E August 10, 2021 at 3:32 pm

            This is really interesting. My nearly 7 and a half year old gained a lot of weight this year and is probably now considered chubby (obviously non-medical term). She’s always been stocky and genetically tends toward me who was stocky and chubby as a kid. But this year of being home so much has lead to a lot of unhealthy food habits (constant snacking and not really eating meals because full from all day long snacking). When she is gone for the whole day, I have much more control over what she is eating (its generally what I pack) and she is more distracted by outside stimulus and not bored/preoccupied with eating. I have tried to gently nudge her in a more healthy direction, but I am loathe to become the food police and deny her snacks/food. I don’t want her more preoccupied. We’ve tried things like alternating healthy snacks (carrots and hummus / toast + PB) with more processed things, but she obviously prefers the junk food. I never really thought of it as a huge issue, but it is definitely one of the reasons why I’m glad she’s at camp this summer and why I want her back in school full time in the fall.

          • becca August 10, 2021 at 3:34 pm

            I think this is a really interesting exchange, because I respect both of you as experts in your own domains.

            It seems to me that in addition to differences in your personal risk tolerance differences/lived experiences, there may also be a real distinction between “Covid, as a (manageable) threat to one individual family” and “Covid, as an (uncertain but large) threat to a population”.

            Because I found it interesting, when I was writing the background/significance sections of my dissertation (on innate immune responses in malaria) I got into the weeds of disability adjusted life year calculations a little. There are places where virtually everyone gets malaria, repeatedly, until they get antibodies to all the many flavors of var. It’s just kind of a taken as matter of course. But the cumulative impact on societies is enormous.

            I suspect we’ll see Covid emerge as having pretty significant impacts on very vulnerable populations at some point soon. It’s going to go endemic, and we’re only 28% of the way through the world’s population with vaccines (and in some ways, we’ve already gotten the easiest/richest 28% and it’s only going to get harder).

            Anyway, I skimmed the pediatrics paper and I think it’s quite interesting. Sarah, are you testing for Covid antibodies in your study population (or Covid non-Spike antibodies in the over 12 patients)? I ask because I’ve wondered about diabetes increasing post-Covid, because the basic cellular biology is pointing to that https://pubmed.ncbi.nlm.nih.gov/34081912/
            Anyway, it struck me as kind of obviously “missing” from the pediatrics paper, and maybe your research could include that question.

          • Sarah Hart-Unger August 10, 2021 at 4:20 pm

            We have antibody data (nucleocapsid) on some but not all esp early on. Itā€™s retrospective chart review so it just depend whether our ICU thought to send it.

  • Reply Ann August 10, 2021 at 8:00 am

    I just want to say that I wish it wasn’t so hard.

  • Reply Katy Rotman (@katy246) August 10, 2021 at 8:11 am

    Hugs. The last year of sort of school was absolutely suboptimal, to put mildly ,for my two non neurotypical kids and now with the elder one starting middle school and there being talks again ( I live outside US) of lockdowns, so Zoom school again….

    I feel that its…. Not getting either of them on a good start šŸ™

  • Reply KT August 10, 2021 at 8:19 am

    With you re: anxiety over the uncertainty about this coming year. I’m in Ontario, Canada, and there has been no guarantee from government that public schools won’t be completely shuttered AGAIN when case numbers inevitably increase. Due to a bunch of circumstances not really worth getting into, I haven’t been in the work force for longer than I’d like, but I can’t in good faith take on a new job with the possibility that my 3 kids will all be sent home every time someone has a runny nose – my husband works FT, we have no local family, and the kids aren’t old enough to be home alone. And my neighbour, a social worker, tells me that the worst-impacted local children are now measuring three years behind developmentally. šŸ™

    • Reply Nicole Benbow August 11, 2021 at 12:20 pm

      Hi KT! I’m also in Ontario, and, in some ways, I think we’ve actually had it a bit easier – not EASIER in that it’s been super hard, we’ve had one of he longest lockdowns in the world, and, as you said, there is no guarantee that school will keep open. BUT, reading and following American bloggers (Hi, Sarah!) has definitely been really hard for me over the past six months, because they’ve all been…going back to normal, while we, in Canada, keep on living in the pandemic. And now, Americans feel like “the pandemic is back,” while we’re still living it (along with the rest of the world). I would argue that it has never gone away, as another commenter said above, only 28% of the world has been vaccinated – but it’s so easy to live in our own bubbles and assume our experience is the same as others. Anyways, just wanted to say that I feel you, and also have so much anxiety about what will happen with my three kids and school + daycare. But, I’m somewhat grateful that we didn’t experience what Americans seem to have experienced – being told it’s over, publishing lots of content about their “post-pandemic” lives, and then being thrust back into it this Fall.

      Perhaps we’re lucky that Ford et al have made no guarantees, keep mask mandates stringent, and don’t talk as if “it’s all over”?

  • Reply Irene August 10, 2021 at 8:33 am

    My concerns are somewhat similar to yours. Our numbers are thankfully better and kids will be required to wear masks, which is good. But considering our county had one of the lowest numbers of days of in person school in the entire country I think it will take very little for the board to throw us back to virtual or hybrid. I donā€™t care too much about academics at this point but the mental health impact of virtual school on my oldest really cannot be overstated and we have been working hard this summer to recover her. Sheā€™s so excited about the idea of a normal school year where they can have *balls* during gym class and not sit in front of a laptop so the teachers can talk to the kids at home 75 percent of the day. The idea that that could be taken away again is crippling me. I understand there is a very real risk from this disease and that should be taken seriously but at this point the flip side of making her sit in front of a laptop in total isolation is not a risk- is a real and active harm that has already had significant consequences. I hope so so much we donā€™t end up there again. I can live with her being out intermittently if it means there is actually school. I am beyond angry at so many people all over again- those who wonā€™t get vaccinated or be careful as well as those who want to avoid any COVID risk at all and are fine to ignore the fact that some kids were really suffering last year. I know not every kid struggled as badly as mine last year but I also know she was not the only one.

    • Reply KGC August 10, 2021 at 9:04 am

      Sounds like we are in a similar situation re: concern about school shutting down. I live in a county with high vax rates and our transmission is relatively low (for now) AND our schools have a mask mandate for all students and teachers regardless of vax status. I feel pretty good about sending my oldest to kinder and am hoping he can have a relatively ‘normal’ year (albeit with masks) but am so so so fearful that the school will shut down. We didn’t have to experience virtual school previously since this is his first year but so many of my friends did it and I watched everyone suffer. My husband and I work full-time but I am the ‘on-call’ parent since his job is more demanding/higher paying/he is literally not reachable during the day due to working in secure areas with no access to phone…so I am selfishly so concerned for the disruption to MY work life should we either have to switch to virtual schooling and/or have to keep him (and younger sib?) home for quarantine several times during the year. And then there’s the concern about COVID itself! I sort of just can’t believe we’re back here again, after I (finally) made my peace with keeping them in full-time daycare last year and thought we were done with the hard decisions!

      • Reply Irene August 10, 2021 at 9:22 am

        KGC – from one of your other comments I think we are in the same general geographic area. Iā€™m livid my daughter was robbed of a real kindergarten year and will not stop hoping for a better year for all our kids!

        Also I totally hear you about being the coverage parent. My husband has done more this year than ever before which I appreciate so much but yep itā€™s generally me more of the time and I am dreading it!

        • Reply KGC August 10, 2021 at 10:55 am

          We may be near each other! I’m in the mid-Atlantic and actually have generally been pretty pleased with how our state, local area, and my (large, academic, not typically known for being super accommodating to employees but has surprised me pleasantly) employer have handled the pandemic. I also haven’t had to pay much attention to what the schools are doing since it didn’t impact us but…now it does! At this point, all I can do is cross my fingers that the school boards prioritize keeping kids in school, even if that means masking and distancing!

  • Reply Marina August 10, 2021 at 8:54 am

    Thanks for sharing your thoughts, Sarah. I think most parents are with you at this point – another school year of hybrid/virtual would just be awful and worse for kids than just being in a consistent spot, with some risk of catching Covid (but that can be minimized with masks and decent distancing). I think the CDC’s guidance for a “close contact” doesn’t include those who are masked and at least 3 feet apart, so in theory kids shouldn’t have to quarantine every time they’re near a positive case in school, and I really see no reason for siblings to also quarantine. Our school will be enforcing masks for everyone – kids and all staff, which I hope will reduce a lot of the risks and need for quarantines.

    It’s an extremely difficult situation but just know that you’re doing the best that you can.

  • Reply Elizabeth August 10, 2021 at 9:21 am

    I am also sorry to hear about your bad day, Sarah, and Iā€™m wishing you a better one today. I think that the COVID news certainly doesnā€™t help, but also as a long time blog reader wanted to share that I think for you (really, for most of us!), the first day back after time away is often hard. Itā€™s not really a fresh start because of the back log of items (in my mind a fresh start is like a blank planner page, not a page with a weekā€™s worth of to do items AND a full day already scheduled.) So give yourself some grace! For future vacations, is it possible to make your first day back a GME day and block the entire day from both patients and meetings so you can truly catch up and be ready to tackle your job on day 2 back?

    I am also sure your migraine made things worse (I mean, obviously!) but also in a catastrophizing way. This is not a criticism! But just a thought that when you donā€™t feel well physically itā€™s so hard to rise above any other challenges.

    Last thought, I do agree with the earlier poster that not everyone is doom-scrollingā€¦but that said, I donā€™t live in Florida but even I am following the masking political drama unfolding there and despite my living on the west coast, your governorā€™s political decisions are making me crazy so you have nothing but my full sympathy and support for (it feels like) being a casualty of a political game in terms of your school being unable to require masks.

    One of my favorite riddles: what can make the happiest man sad and the saddest man happy? The phrase ā€œthis, too, shall pass.ā€

    Thinking of you! I hope your migraine and anxiety go away ASAP and that today is a little better.

  • Reply Elisabeth August 10, 2021 at 9:44 am

    Oh, Sarah! So tough. I’m sorry you and your family are in the (current) epicentre of this thing. It really does wear one

    Re the quarantining and all the various protocols in schools, it’s so hard to know the right way forward. I think I agree on middle-ground, though even that is hard to quantify since everyone has such different risk tolerances. For example, I was reading a blog post by a mother whose young daughter is currently undergoing cancer treatments. She, understandably so, was furious about low vaccination rates, unmasking and has legitimate concerns about her daughter getting COVID when she’s in an immuno-suppressed state. But the comments on her post telling: while some readers empathized, many others spoke of their children with speech-language challenges falling through the cracks and losing tremendous ground in their schooling, or others who haven’t been able to return to work because of various COVID protocols. It is so hard to balance all of this. Every life is precious and it fills me with guilt that some vulnerable people will get sick and die because of exposure to COVID; but I also worry about all the many people who are struggling to get diagnostic appointments, children who are in unsafe living environments and no longer have the social supports they received pre-COVID. For some people the restrictions aren’t enough to allow them to feel safe; for others those SAME restrictions are causing real problems (a rise in diabetes cases in your patients, for example).

    I don’t have any answer, but just acknowledging this is all…so hard.

    I agree with some other commenters – it is HARD to ease back in to life post-vacation at the best of times and you’re getting a double whammy with all the COVID challenges and understanding how this will almost certainly impact your plans in the future…but now knowing when/how/to what degree. If we all could schedule in: “Full school shutdown, November 1-8th, it would make things a whole lot easier.

    Until then, sending lots of good wishes for your physical and mental wellbeing. And, as always, thanks for broaching these subjects. It’s so helpful to see the responses from your community, especially in this time of uncertainty and isolation.

    • Reply Mrs. Candid August 10, 2021 at 3:00 pm

      I agree with this. The situation is such that no one even knows what a middle ground exactly is. There are no clear answers. We have a saying in Hindi which translates to “caught between a well on one side and valley on another”. Basically no choice is safe and like you say, acknowledging that is so HARD. And when the uncertainty drags for over a year, it’s natural for anyone to lose patience.

      My way of navigating through this is accepting that I really don’t have any control over the spread of this covid thing, govt policies etc. So, I thank God every day that we all remain safe and pray for strength and courage and PATIENCE. And like Dory says in Finding Nemo movie, I remind myself to “just keep swimming”.

  • Reply Heather August 10, 2021 at 9:53 am

    I think you just have to make an active choice not to doom scroll the news. There is so much of this that is outside of our control and constantly scrolling and listening to the news isn’t helpful. Like a previous commenter stated, I have definitely put myself on a diet and choose to curate the ways that I access news media.

    As for school, I am so thankful that our district mandated masks for everyone and students must have a doctors note if they choose not to wear a mask. We are also still following recommended contact tracing, but quarantining will be minimal because of mask protocol. There is one district in our area who WILL NOT be informing parents of close contact and is mask optional, so it will be a COVID party for that district. I think a lot of these headaches about school could be avoided if idiotic governors weren’t making laws banning schools from enforcing masks. I’m glad to see some school districts are going against those idiotic rules. Also as a teacher during the pandemic, I can promise you that none of us enjoyed teaching virtually.

    I’m also hopeful that as the vaccines reach full FDA approval and its required for active military service members that vaccination rates will increase.

  • Reply Kay August 10, 2021 at 10:56 am

    Thank you for all your input…I really am excited for my son to be back in school full time! But the covid reality has stolen my joy. I have anxiety about him getting ill with it as he has virus induced asthma that usually requires a trip to the doctor for some extra help when he gets a basic cold. Reading your blog and how your children were barely affected when they were infected with the virus is reassuring. I do like hearing your opinion. Thank you!

  • Reply YS August 10, 2021 at 11:40 am

    What type of professionals have you sought for assistance with C’s learning? I have similar issues with my child, and the entrance into kindergarten last year through Zoom was so depressing.
    I live in a region which has mask mandates, but after drop off this morning, I believe it’s a guarantee that there will be outbreaks/quarantines. It was like wading through a mosh pit at the drop-off gates. UGH.

    • Reply Sarah Hart-Unger August 10, 2021 at 11:49 am

      Psychologist + reading specialist/tutor. He’s actually at a week of reading camp this week.

  • Reply Michele August 10, 2021 at 1:30 pm

    Right there with you, coming from the NC Triangle. What a nightmare this school year is already shaping up to be. Thank you for the laugh re: liver failure šŸ˜‚

  • Reply Marianne August 10, 2021 at 1:37 pm

    One of the things I’m soooo thankful for in this pandemic is that I have a big kid, so she’s been able to be vaccinated, which takes a huge load off my mind. I know this last year+ would have been so much harder with a smaller kid, and I can’t even imagine three! Of course, I also can’t imagine having three on my best day, so…. Anyway, I think you’re doing amazing!

    Mind also happened to be a reluctant reader and writer, and while it’s never going to be her favorite pass time, she is easily on grade level now, and able to do her school work without the struggle we had in the early years. She’s starting high school this year, so we’ll see how it goes with the heavier class load!

  • Reply coco August 10, 2021 at 5:40 pm

    we started distance learning yesterday and it went well. one thing that we are trying is learning pod with a tutor. the idea is to have a tutor assisting a small group of kids 3-4 to do activities together so imitate some of the missing skills from school learning. we are doing this for my younger kid that is starting k, while my older 3rd grader is doing alone and she’s fine as long as we plan playdates few times a week.

  • Reply Brooke August 10, 2021 at 9:00 pm

    Sarah, I love your blog and appreciate you calling out fear mongering about COVID vaccines. I have a high schooler and college student who are both vaccinated. This is a huge relief. Our private school is requiring all teachers, students and staff to be vaccinated. Iā€™m incredibly grateful. But, there are kids who will cheat and create fake vaccine cards. So, the school needs to discipline them the same way they do with cheating. My son plays a varsity sport and several kids on the team are anti-vaccine. The benefit of having older kids is the vaccine and their ability to do a year of Zoom school without my help. The downside is they will remember what a sad, lonely year it was. Iā€™m hoping the vaccine will be approved for under 12 kids soon.

  • Reply Lisa of Lisaā€™s Yarns August 10, 2021 at 9:45 pm

    Wow I did not realize how bad things were in FL! I have been super busy at work this week so have barely looked at the news which is probably a good thing. I have nothing novel to suggest that hasnā€™t been said but agree with others about limiting your news consumption, especially if it wonā€™t change decisions you make about school and such. Since your kids go to private school, hopefully they can mask since they arenā€™t risking losing funding if they go that route (very sad that a public health recommendation is being tied to funding – that is so wrong!!). So maybe the year wonā€™t be as disruptive as you think it will be? I had our baby in early December when our case rates were super high here in MN. I was so sure Iā€™d have our toddler home with me all the time during Mat leave due to quarantining since he quarantined twice in the fall due to a positive case in his classroom. But we never had another positive case at school after our baby was born. So what I expected and sort of stressed about (but not that much because I was distracted by a poor sleeping newborn – ha!) never came to fruition. That could be the case for your kids. There seems to be some evidence based on data out of India that this could peak and then trough fairly quickly (at least that is what has been discussed by strategist where I work which are not MDs but they follow this data to try to determine how Covid will impact economic data here). So hopefully things start to trend downward and school doesnā€™t end up being a disaster of non-stop quarantines. I think I would also push back on the sibling quarantine, too. That wasnā€™t required in our daycare.

    Hang in there, Sarah. Itā€™s really hard to come back from a vacation. Thatā€™s why we always come back on Saturday. We are leaving for my parents tomorrow and come back Saturday afternoon. Itā€™s a bummer to miss out on more family time but it is too stressful for me to come home on a Sunday and get ready to tackle the week – even with me WFH! And having people ask things of you on that day of re-entry – and on a day when you are in clinic seeing patients – just makes it worse!!!

    • Reply Mrs. Candid August 10, 2021 at 10:49 pm

      A valid point : maybe all that we fear and stress about might not even happen. I live in India, and we had a terrible second wave, especially Apr-mid July 2021 was too bad. Now things are much better but the school’s have not opened yet in my state.

      The big difference I see about how parents view online school in US and in India is, here, parents do not seem to bother too much about online schooling. I wonder if it is because the working women in India is hardly quarter of the population whereas in US it is half of it. So, maybe there isn’t a urgent need to send kids to school. Even when mothers are working, grandparents are usually there to take care of the kids. Of course there is a lower economic class where kids are learning virtually thru TV channels. This section of the society do not have computers or smartphones to attend classes online, so the Govt has arranged for classes to be telecast on the TV channels. The families in this group struggle to keep their heads afloat, so they don’t actually bother much about the quality of online education.

      I might have made some generalizations above, and that is only based on my experiences and knowledge. So, kindly excuse if there are any mistakes.

  • Reply Jessica August 10, 2021 at 10:07 pm

    I am getting a little stressed about fall too. Our district is doing literally nothing for Covid. My older two are vaccinated and I am not so worried about my elementary school kiddo as he will be with the same kids all day. I am very stressed about my too young to be vaccinated 6th grader who has 8 different classes each day. How is that safe at all? It is basically just asking for everyone to get Covid and hope they are all lucky and have mild cases.

  • Reply Mrs. Candid August 11, 2021 at 12:11 am

    In a recent interview by Gretchen Rubin, the authorĀ Oliver Burkeman said something that will help us all navigate through these unpredictable times, I am sharing the same.

    Q : Is there a particular motto or saying that youā€™ve found very helpful?
    Ans : I love basically any quote that points to the way so much of our unhappiness arises, not from whatā€™s happening, but from our insistence that it ought not to be happening, or our refusal to acknowledge that it actually is happening. Charlotte Joko Beck says ā€œWhat makes it unbearable is your mistaken belief that it can be cured.ā€ Mel Weitsman says ā€œOur suffering is believing thereā€™s a way out.ā€ Sam Harris points out somewhere that the problems most of us have to deal with are bad enough without the internal demand we put on top of them ā€“ that we ought not to have any problems at all.
    Life certainly brings plenty of sadness and difficulty. But itā€™s so much worse when you mistakenly believe youā€™re entitled to some other kind of life, one that would be entirely sadness- and difficulty-free ā€“ because then every ordinary setback becomes a kind of terrible insult and an outrage, something that shouldnā€™t be happening. Thereā€™s vast freedom and empowerment in accepting the truth that this life, with all its irritations and annoyances, is the only one weā€™re going to get a shot at.

  • Reply Ali August 11, 2021 at 10:28 pm

    Hi Sarah, Just wanted to commiserate and say I like reading your balanced perspective. I think so many people are either all-or-nothing when it comes to Covid prevention/ mitigation, and I know for my family taking a balanced approach is the best thing we’ve been able to come up with so far. Keeping my kids out of school for long periods of time is impossible for ALL of us, but I am also disheartened by the lack of prevention happening around me. I live in an area where my county at 50% vaxxed rate is “good” for the state…and just judging from parent behavior at various school functions makes me scared for the next few weeks. (I am fully vaccinated and at a meeting last night, I was one of TWO masked parents…out of approx 20.) Our county just passed a mask requirement for elementary kids (which I am glad for as I was making my kids mask anyway), and doctors were met at the school board meeting with threats. It is NUTS. (But I also invite anyone who thinks I should just keep my kids home given that environment a chance to spend an entire day with my children and tell me how realistic that is–ha!)

    Best wishes to you and your family as you navigate this!!

  • Reply Alyce August 18, 2021 at 7:53 am

    Although Iā€™m super late to this conversation, but I wanted to weigh in on news consumption. I had this huge epiphany many years ago while visiting the Newseum in DC. Looking at all the major headlines and news events over the last century, it was blatantly obvious that the news is all about highlighting everything thatā€™s going wrong in the world. Itā€™s just really fucking depressing/anxiety inducing. I stopped reading/listening to the news in 2015 because I was so annoyed by the 2016 election coverage. It felt a little too privileged to not know what was going on during the Trump administration so I started again, but my consumption is significantly scaled back. I donā€™t read or follow the news daily. We have the paper delivered on weekends, and thatā€™s my preferred method for checking out the news. You get fewer headlines per page, typically only 3-4, and the sections are grouped in such a way that you see a wider variety of headlines as you skim through. Reading news in print feels less like a firehouse of super awful shit than you get online. Engaging feels less traumatizing and anxiety inducing. I only read the news online when Iā€™m in a really good place and can withstand an onslaught of really horrid news. And what I see now is how slowly the news actually changes. Checking in weekly or biweekly is more than enough to be informed enough to meet my needs. Plus, so much online news is actually just a couple of stories then a bunch of pundits talking about the same story. Like do we need to read 15 opinion pieces about the same issue? Itā€™s totally overkill. The quality of my life is so much better with way less news.

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