What Covid Has Taught the World about Ethics | NEJM

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Perspective from The New England Journal of Medicine — What Covid Has Taught the World about Ethics
— Read on www.nejm.org/doi/full/10.1056/NEJMp2210173

Wondering why everything to do with the pandemic triggered controversy? This article sums up most of the ethical am moral dilemmas.

Volunteering- Be very careful about what you choose.

I’ve had quite a few volunteer experiences since I retired in 2017 and I am here to report on them all. I did a post on volunteering when I first retired. Nothing like real live experience to see how things work.

Clinical Trial at UBC

My first volunteer gig was being part of a clinical trial at UBC. The idea was to test an iphone App called BrainHQ to see if it improved your memory. There were already many studies on this app so I am not sure what was new about this study. The study involved two groups, one that used the app and one that did not. Sadly I was in the group that did not get the app until the end of the 6 week study. Of course you want to know the results but so far they have not published the results. There were many cool things about this volunteer gig. If you are interested in participating in clinical trials, some are online. Here is the link.

  1. I could walk because I was close to Vancouver General Hospital’
  2. We attended an activity three times a week for 6 weeks that included some exercise, games, spreakers and conversation.
  3. I got tested on a whole lot of cognitive function tests and they gave you the results at the end so you can see if you are loosing it.. or by how much you are loosing it compared to people your age. The testing included an MRI which is why I took one point off.
  • Rating
  • Fun factor 7/10
  • New friends 0/10
  • Worthwhile use of my time 10/1
  • Treated with respect 9/10
  • Overall Rating 9/10

BC Science center tried to recruit me to stand in the lobby and click a clicker to count the people coming through. You much be joking.

ESL tutoring

The next volunteer gig was assisting at English as a second language classes at Mosaic in Vancouver which is a huge organization. I have recently recertified as a teacher in British Columbia so I thought I could get some recent experience. I was supposed to be a teachers assistant to the real ESL teacher. I was assigned to a class with about 10 people who had close to no English comprehension and were from multiple different countries and from ages 20 – 90. One elderly person was deaf and cognitively impaired. Another person had some learning disorders. There were about 5 people who had potential to learn English. My job was to help students when they were doing small group work. This will rank as my worst volunteer experience ever.

  • Long bus trip to the classroom.
  • Waste of my time
  • Was told I was not to make any suggestions to the 25 year old tutor.

Rating

  • Fun factor -1/10
  • New friends 0/10
  • Worthwhile use of my time 1/10
  • Treated with respect 1/10
  • Overall rating 1/10

Review of the literature on non- symptomatic Covid 19.

I volunteered for this as my real job had involved a lot of health care research and it thought this would be a good use of my talents. I was assigned and the question and wrote a paper on the topic for a group at UBC. This was early 2019 and there were not many papers on the topic so it was rather a short job but interesting. I have been very interested in the whole COVID 19 process. About 2 years later a received a lovely thank you letter from UBC that I am thinking about framing. I was invited to an online think tank on Zoom but there were about 30 people talking over each other.. OMG. Won’t do that again I said to myself. So I decided I had had enough of this project. It was overwhelming. It was my first experience with grandstanding.

Rating

  • Fun factor -9/10
  • New friends 0/10
  • Worthwhile use of my time 10/10
  • Treated with respect 7/10
  • Overall rating 7/10

Immunization clinics

Fast forward to Covid 19. I volunteered at the immunization clinics for Vancouver Island Health Authority in Courtenay. I was responsible to herding people through the lines to the nurses and making sure everyone was feeling comfortable with the process. Then I would site in the after care space chatting with people. I feel that this has paid all my debts to society. It was very well organized. I was hard to stand for 4 hours. But I enjoyed chatting with the wide variety of people coming through the clinic. The big surprise at the end was the goody bag given to all the volunteers at the end include many gift cards and a bottle of wine. Who knew????

Rating

  • Fun factor -9/10
  • New friends 0/10
  • Worthwhile use of my time 10/10
  • Treated with respect 9/10
  • Overall Rating 9/10

Habitat for Humanity online auction

I volunteered to research objects donated to the Restore to see if they are valuable enough to put in their online auction. This involved going into a dark and dusty closet can pawing through cartons of old stuff. Stuff included pseudo vintage snow shows, copper tea post, vintage figurines and other strange things that I could not identify. Since this was a new job, I set up a process to do the online search and set up a file with the results. The Restore is a busy spot and space it at a premium. It was interesting to see why kind of thing people donate. This was a surprisingly time consuming activity. I went to a few meetings. Not my cup of tea.

Rating

  • Fun factor -0/10
  • New friends 0/10
  • Worthwhile use of my time 5/10
  • Treated with respect 2/10
  • Overall rating 5/10

Sitting the quilt

While on Hornby Island I did some shifts sitting in the courtyard among the businesses selling tickets for a quilt raffle. This is the ultimate meet and greet job. You get to chat with everyone passing through Hornby Island for all over the world. What could be more fun?

Rating

  • Fun factor -10/10
  • New friends 1/10
  • Worthwhile use of my time 5/10
  • Treated with respect 9/10
  • Overall rating 9/10

So what lessons have I learned?

  • Volunteer work can be physically demanding so be sure you have the stamina to do the job.
  • Do you like the person who is hiring you?
  • Do you thrive on chaos. Some do! Not me.
  • For me it is important to have some interest in the work
  • I like doing meet and greet and I am good at it. And it makes everyone feel good.
  • Its hard to find a fun and interesting volunteer job.
  • What has been your favourite volunteer gig and why? Or why haven’t you volunteered?

artwork is by ALPIN KELLEY on Hornby Island

Cook books reviewed by bloggers

New publications serve up classics and more, with flair! I don’t know about you, but I am one of those people who loves to read a cookbook from cover…

Constantly Cooking’s 2022 cookbook gift guide

Another bloggers pick: https://thebackfenceblog.wordpress.com/2022/09/10/373-cookbooks-and-counting/

The cookbook of the month club. Recipes tested by friends: https://cookbookamonth.wordpress.com

A review of Mediterranean cookbooks: https://deleciousfood.com/6-best-mediterranean-cookbooks-of-2022-healthy-food-cookbooks/

So what are your favourite cookbooks?

or have you given up on cookbooks in favour of on line recipes?

The Challenges and Opportunities of 2022

It seems like the year has Zoomed by, and I mean that literally and figuratively.

I just Zoomed off a French language meet-up as I couldn’t understand.  But I have been able to understand the DuoLingo conversation groups I have been attending every Wed for the past year and half and I have met many interesting people from all over the world.  We have bonded and I even met one participant from Vancouver while she was on Denman Island and I was on Hornby Island last summer.  We spent a lovely afternoon getting acquainted In Real Life in French.   Unfortunately Duolingo is discontinuing these free conversation groups but one of the groups will be switching to Meetup and still continuing on Zoom.  

And while we are talking about Zooming I have been practicing my mandolin on Zoom with my friend Barb who is learning the Ukulele.  Lessons learned.  Get the music score that includes musical notation so you can play the notes at the same time. My favourite is the Campfire Songs that has the chords for guitar, ukulele, mandolin,  banjo and mandolin.  I look forward to playing with more people more next year as I build up my repertoire.  

When I first started blogging I did a post about all kinds of volunteer opportunities.  Covid19 has made this more challenging.  Nevertheless I volunteered with Habit for Humanity to help out with their on line auction.  This involved going into their deep dusty closet store room and looking at all the weird and wonderful things that people have donated and doing some research on the value of the items.  It was pretty interesting to try to find items in Ebay and determine the value.  The best hit was a silver platter that I was able to estimate a value of about $ 1000.  Looking for vintage dental equipment?  This is the place!

I have been more conscious about how we are all getting older as I see friends and friends of friends passing away as well as seeing the mortality and morbidity from Covid. I have been getting my own affairs since your life can change in a nanosecond.  I found a lawyer in Victoria that manages estates when you die.  I have set up a Power of Attorney with a lawyer here.  I found a company to manage my investments and an accountant who relieved my anxiety about loosing my Old Age Security. 

I was also concerned about what would happen to me if I ended up in the ER without being conscious.  After several inquires online I discovered a package called My Voice you can download  from the Ministry of Health.   You can designate a Responsible Person to make some decisions about your health care on your behalf.   The document requires signatures by the responsible person and two witnesses.  I called several notaries and they would not witness the document.  I then called 3 friends and we had a signing party at the Griffin Pub.   The final part of this process was a document called MOST.  Medical Orders for Scope of Treatment. It is a document that your doctor signs and keeps a copy.  In theory if you end up in the ER, they can access your medical records with your GP.  I remain skeptical about this really happening. But all you can do is put the pieces in place. I was advised that I should put all this information on my fridge door in case EMS came and apparently this is where they look for information.  I’ll believe it when I see it.

I continue to find condo living to have it challenges.  Most recently I received a 63 page document for the annual general meeting. You would think that after 40 years of condo living I would have it all figured out but alas, this is not the case.  No one can truly process 63 pages of legal-ese about what you have to do if you renovate.  I really think that a single family dwelling might be less irritating.  Some friends have opted for a rental situation and both have 4th floor units with a view.  However, there are no shortage of stories of hostile neighbours in single family neighbourhoods as I found out when parking in a no parking zone in Comox.   I did a short drive around looking for non condo options and there are some. But I finally decided all you can do is manage how you react to the nit picky strata council and neighbours.  After looking at the alternatives around town I come back to the great river walk beside the condo where I live and decide it’s too good to move.  It is different every day of the year and continues to give me solace all year round.

One of more challenging project of the year was participation in a choir.  We had performances in the spring and Dec that required a lot of work and time to master the music.  Here is a link to the performance from the spring on You Tube.   My favourite part of Christmas is the music.  I just can’t enough of it.   COVID has inspired many online events including an online choir out of the UK.  If this doesn’t bring goose bumps nothing will.  Best wishes to all my followers for a better 2023.

Here is a 2 hour podcast of Christmas music compiled perhaps in 2020 or 2012 by a departed friend DJ David Wiseman on Hornby Island.

Turning down the heat Volume 2 2022. I investigate the discontinuation of corded blinds.

I recently tried to upgrade to cellular blinds in my condo. These blinds are marketed as being able to block heat from the outside and keep heat inside. This was an opportunity to replace the broken cord on the mail order blinds from Select Blinds. I contacted Home Depot and they sent someone out to measure and show me samples. At the time, they told me that corded blinds were being discontinued since Health Canada was about to pass regulations in 2022 banning corded blinds because of deaths of children due to the cords. About 3 months later the blinds arrived it and they installed them. At about 6 months, the first of the 5 blinds would not longer open, so I sent it back. Then about 11 months later the same thing happened and this time I had to uninstall it, package it and mail it back to Levolor in Arizona. Home Depot agreed to cover the $ 50 in postage when I asked.

Ok this is not the end of the world. I suspect everyone is having similar hassles or worse. But being the inquisitive sort of person, I wanted to find out more about the ban on corded blinds because I could not believe that magnitude of infant deaths could really be justified in removing so many products off the market. So I set out to do some research on the issue, which is of course easy in todays world but very time consuming as there is a very deep rabbit hole here. And what is the point of all this dear reader?? It is more about getting it out of my brain rather than sharing my experiences with everyone. But everyone I talked to expressed irritation at the changes. I’m not going to change anything. I also wonder if the effort is justified.

Here is what I discovered:

Canada has banned corded blinds.(1)

According to the Canadian Gazette(2) “Over the next 20 years, this would mean the strangulation death of up to 26 children in Canada. It is estimated that adopting the proposed Regulations would prevent the death of 20 of those 26 children over the next 20 years, as well as prevent other non-fatal strangulation injuries. The proposed Regulations would result in a socio-economic benefit valued at approximately $1 million per year starting in the first year, increasing to almost $10 million per year once risks are fully eliminated in the tenth year and beyond. Over the next 20 years, this would provide a social benefit valued at approximately $73 million.” This document estimated 1.3 deaths due to blind cords per year in Canada but did not describe methods to calculate the rate.

“The proposed Regulations would also significantly reduce testing requirements for industry, which is estimated to be a saving of $5.7 million per year, resulting in cumulative savings of $64 million.
The total benefits of the proposed Regulations are estimated to be $138 million over 20 years (2016 price level, discounted at 7%).” The report has a detailed economic analysis of the costs and benefits based on theoretical models.

US data on infant deaths is confusing.

Several different measures were used to try an estimate deaths due to blind cords. The first approach used anecdotal information “Based on newspaper clippings, consumer complaints, death certificates purchased from states, medical examiners’ reports, reports from hospital emergency department-treated injuries, and in-depth investigation reports, CPSC staff found a total of 209 reported fatal and near-miss strangulations on window covering cords that occurred among children <8 years old from January 2009 – December 2021.” This is 16 deaths/year(3). A second source estimated 8.1 deaths per year due to blind cords.(4)The CDC reported a rate of 25.5 deaths per 100,000 live births due to accidental suffocation and strangulation in bed using the ICD 10 codes in 2020. Figure 2 A fourth source was a peer reviewed article published in 2018 found 141 blind entanglements resulted in death over 16 years, for an annual death rate of 8.8 per year.(5) This was the most thorough analysis of data I found.

Figure 1(6)

I then went to the US Mortality Data base and the ICD Code W 75 to show trends over time which have been increasing Figure 2

Figure 2(7)

ICD W 75 is Accidental Suffocation and strangulation in bed.

The range of deaths from different sources range from 8 -25 per year depending on the methods and data sources. Most deaths using the ICD 10 code accidental strangulation W75 are in children under one year of age, male, Native American or Black or living in the southern US states. A fifth source of data is the US Emergency Dept database.(8) I explored the data base but the data on deaths was not published on line. This database included a field 683 Window Shades, Venetian Blinds, or Indoor Shutter but does not specify cords.

The manufacturers of blinds published a post in 2021 about the cost of re-tooling and the potential 4,900 job losses. This was not included the cost benefit analysis above.

So, what does all this tell us?

  • It is difficult to come up with a precise number of infants deaths due to strangulation by blind cords but there is a small number of infant deaths attributed to cords in blinds.
  • The cost benefit analysis is theoretical and the data is difficult to find and substantiate.
  • It will be impossible to say if the ban reduces unexpected infant deaths until there is an accurate way to report the deaths.
  • There will be a time lag until new types blinds can be produced and existing blinds replaced.
  • People may give up on blinds and go back to drapes to help mitigate loss of heat.
  • There is going to be a lot of customer feedback on the changes that will have to be born by retailers.
  • With todays level of technical capacity, manufactures should be able to come up with an alternative to corded blinds that open from the top. So why I haven’t they found anything that does the job?
  • In this time of deaths from COVID, guns and drugs, the amount of time and effort put into the banning of blinds exceeds the benefits that could be derived by banning guns and controlling substance use.
  • WordPress does not enable importing of footnotes.

Notes

The WHO has added new codes to the ICD 11 in 2022  PB00 Unintentional threat to breathing by suffocation from object covering mouth or nose.  Object or substance producing injury E92A Roller or venetian blind or indoor shutter.

[1] https://laws-lois.justice.gc.ca/eng/regulations/SOR-2019-97/FullText.html

[2] https://canadagazette.gc.ca/rp-pr/p1/2017/2017-06-17/html/reg7-eng.html

[3] https://www.federalregister.gov/documents/2022/11/28/2022-25041/safety-standard-for-operating-cords-on-custom-window-coverings

[4]  N. Marcy, G. Rutherford. “Strangulations Involving Children Under 5 Years Old.” U.S. Consumer Product Safety Commission, December 2002. was widely cited in the reports but the document was not found on the WWW.

[5] Bridget Onders, Eun Hye Kim, Thitphalak Chounthirath, Nichole L. Hodges, Gary A. Smith; Pediatric Injuries Related to Window Blinds, Shades, and Cords. Pediatrics January 2018; 141 (1): e20172359. 10.1542/peds.2017-2359

[6] https://www.cdc.gov/sids/data.htm#:~:text=We%20defined%20cause%20of%20death,%2C%20(799.9%3B%20R99).

[7] https://wonder.cdc.gov/controller/datarequest/D76;jsessionid=E2A5C8A8389056FA2E5F2DA9A781

[8] https://www.cpsc.gov/cgibin/NEISSQuery/UserCriteria.aspx?UserAff=XNTlUuA3gVTx5UjCJb8RMA%3d%3d&UserAffOther=ACCDbi4Soz8YSJIYHY0l%2fA%3d%3d

Books We Love : NPR

Here are 400+ great reads from 2022 handpicked just for you by NPR staff and trusted critics.
— Read on apps.npr.org/best-books/

This book list has the ability to open a link to your local library and you can borrow or put a book on hold including Ebooks. Or there are links to AMAZON. This is the book list I have been waiting for. Now they just need a link to Goodreads.

Northern Populism. Ever heard of it?

www.policyschool.ca/wp-content/uploads/2020/06/Northern-Populism-Graves-Smith.pdf

A very long read. Published in June 2020 it follows on the early post I published on the ethical conflicts during COVID. This post is from a Canadian Think tank and polling company. It is helpful to understand the forces driving things like the Ottawa convoy and see international trends in public emotional responses to perceived and real events.