September 2020
S M T W T F S
30
31
01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
01
02
03
Site Pages
 
Links
Home Page Download Files
Photo Albums
 
Club Information

Welcome to the Rotary Club of Homer-Kachemak Bay - Celebrating Over 34 Years Serving Homer and the World

Homer-Kachemak Bay

Four Way Test: True, Fair, Goodwill & Beneficial to All

We meet In Person
Thursdays at 12:00 PM
Best Western Bidarka Inn
575 Sterling Hwy
PO Box 377
Homer, AK 99603
United States of America
District Site
Venue Map
Reporting COVID Deaths

Behind every one of these statistics is an individual. We're saddened by every death and our hearts go out to the family and loved ones of these individuals who died. 

DHSS is aware that the topic of how COVID-19 deaths are counted generates a great deal of interest. This webpage should answer some of your questions.

Current process

There are two avenues for the public reporting of COVID-19 deaths in Alaska.

 

By health care facilities

The first is from reporting by health care facilities. Because COVID-19 is a reportable infectious condition, hospitals report cases of COVID-19 directly to the Division of Public Health’s Section of Epidemiology. Later, if those hospitalized patients pass away, those deaths are also reported. 

The benefit of this method is real time reporting. The state has the ability to report the death within days of the death occurring. However, this method may not capture deaths because of the time lag associated with COVID patients who may remain hospitalized for a longer period of time, have a more complex disease and death process, or died outside of Alaska. Further, this more real-time method means that deaths have not yet undergone review by CDC.

Through death certificates

The second process is through death certificates and their review by CDC. Every death in the state, and of out of state Alaska residents, results in the production of a death record. A death record contains the who, what, when, and where of a death. The cause of death section of a death record provides the ‘why’. A death record is registered by the Division of Public Health’s section of Health Analytics and Vital Records (HAVRS). The cause of death language is de-identified and forwarded to CDC’s National Center for Health Statistics (NCHS). There the cause of death language is coded by nosologists (professional trained to classify disease) using the International Statistical Classification of Diseases and Related Health Problems (ICD-10) medical classification. Once coded, the data are sent back to HAVRS. These data essentially serve as the final cause of death description.

The benefit of reporting deaths that moved though the NCHS process is these data represent the most accurate death counts. The cause of death statements have undergone review and have been coded - coded as U07.1. However, a death certificate takes an average of 9 days from the death to be registered by the state. This is before the NCHS review. The disadvantage is a delay of one to three weeks for data review and return to the state. The data lag means NCHS provisional death counts may not reflect all deaths reported by the State during a given time period, especially for more recent periods.

Data corrections

Finally, data corrections may change death counts. On occasion a death record needs a correction that may change the death counts. An example might be the original death record had an incorrect state of residence. Generally, upon discovery, corrections are handled by a state’s vital records office and the updated data are provided to NCHS if necessary.

The Death Certificate process

The federal government has worked with states to collect and standardize death reporting since the early 1900s. Cause of death and a decedent’s demographics are first recorded onto a death record. Death records are administered by the vital records program in the state where the death occurred. A death record is first filled out by a funeral director; the cause of death section is provided by a medical professional; and final registration is completed by a state’s vital records office.

CDC considers “Cause of Death” to be a best medical opinion. CDC wants the cause of death to come from medical professionals.

People can die from more than one cause. CDC reporting conventions allow a death certificates to capture the many conditions that contribute to a person’s death. The Cause of Death section on a death certificate has two parts:

  • Part I is the chain of events –the diseases, injuries, or conditions that directly cause the death. There are four lines available, ‘a’ through ‘d’.

    • Line ‘a’ is reserved for the immediate cause of death. The immediate cause of death is the final disease or condition that resulted in death. 

    • Line ‘b’ (and ‘c’ if necessary) are reserved for intermediate causes of death. The medical professional outlines the logical sequence of causes, or etiology that leads from the underlying cause of death to the immediate cause of death. Sometimes, there is no intermediate cause of death.

    • The last line available is reserved for the underlying cause of death. This is the disease or injury that initiates the chain of events leading to the immediate cause of death.

  • Part II is where a medical professional may enter any medical conditions that contributed or exacerbated, but did not cause, the death.

Note that for a death by a virus, if the symptomology and circumstances are compelling, and the medical professional is convinced a specific virus caused the death, NCHS will accept a cause of death certification without laboratory confirmation. Again, CDC is looking for a medical opinion. CDC does, however, encourage confirmation of viral deaths with testing.

After a death record has been certified, the cause of death section is forwarded to CDC’s NCHS. NCHS nosologists review the data, determines its accuracy, electronically and manually code the deaths using ICD-10 classification, and report back the final and coded cause of death to the states. Nosology is a branch of medicine that deals with classification of disease. To become competent takes many years of training. This process has in place since the 1980s for all causes of death.

Dying from a condition versus dying with a condition

In the semantics of health researchers, dying from something means a condition is the underlying or contributing cause.

Consider the case in the example above. The immediate cause of death is a rupture of the myocardium, preceded by an intermediate cause acute myocardial infarction, preceded by an intermediate cause of coronary artery thrombosis, preceded by an underlying cause of atherosclerotic coronary artery disease. If a researcher were asked the cause of death for this individual, they would be correct to say either a rupture of the myocardium, a heart attack, a blocked artery, or hardening and narrowing of the arteries. If a researcher were performing a study on heart disease, this case would be counted. If a researcher were making an annual count of deaths from hardening and narrowing of the arteries in general, again this case would be included. On the other hand, if the researcher was developing a year-end report of leading causes of death, they would just report the underlying cause.

If a decedent had listed an immediate cause of death of stroke, that was a complication from an intermediate cause of blunt force trauma to the head, which had the underlying cause of a vehicle crash; a researcher would be correct in saying this individual died from a stroke, a head injury, or a car crash. Stroke and the head injury would be considered contributing causes associated with the underlying cause of a car crash.

On the other hand, if an individual died in a car crash also happen to test positive for COVID-19, COVID-19 would not be listed on the death certificate and the death would not be considered a COVID-19 death. This would be a case of dying with a disease. In this case, the death certificate would only list the sequence of conditions associated with the vehicle crash.

All reported Alaska resident COVID-19 deaths have the virus listed as a condition in Part I or Part II. A death where COVID-19 is listed in Part II might be considered as a contributing cause depending on how CDC nosologists interpret the cause of death provided by the medical professional. Most Alaskan deaths have listed COVID-19 somewhere in the lethal chain of conditions within Part I. However, if Alaska receives the coding of a COVID-19 death from CDC, even from Part II, we will report it.

Epidemiological significance of reporting COVID deaths

Whether COVID-19 shortened a life by 15 years or 15 minutes; whether COVID-19 is an underlying or contributing condition, the virus was in circulation, infected an Alaskan, and hastened their death. This must be reported.

Despite Alaska’s COVID-19 deaths, we should note that Alaska’s per capita death rate from COVID continues to be lower than almost every other state. Alaska’s overall mortality rate is also lower than most other states. According to JAMA, Alaska has had no estimated level of excess deaths during the COVID time period of March 1 2020 to May 30 2020.  This conclusion is echoed in Alaska’s own look at excess mortality. So far, researchers have not found any unexpected increase in death counts or rates relative to recent years.

Where can I find COVID Death Data?

You can find counts of COVID-19 deaths on the Alaska Coronavirus Response Hub: data.coronavirus.alaska.gov.  On the COVID-19 Cases Dashboard, you can find the count of death that can be shown for Alaska residents (including AK residents diagnosed and isolated OOS), non-residents, or for both residents and non-residents diagnosed and isolated in Alaska.  The “Cumulative Deaths” graph on the COVID-19 Cases Dashboard reflects the date when a death was confirmed by the State, not when the death occurred.  “Table 1. Cases by Report Date” of the summary tables also shows a count of deaths; however, this table reflects deaths by the date when the case was confirmed COVID-19 positive, not by the date that the case was reported dead.

CARES Act Funding Used to Support Mental Health and Suicide Prevention Efforts
Alaska DHSS signup page

DHSS Press Release: CARES Act funding used to support mental health and suicide prevention efforts

Alaska DHSS sent this bulletin at 09/10/2020 02:44 PM AKDT

FOR IMMEDIATE RELEASE

Contact:  Clinton Bennett, DHSS, 907-269-4996, clinton.bennett@alaska.gov

CARES Act funding used to support mental health and suicide prevention efforts

Sept. 10, 2020 ANCHORAGE — The Alaska Department of Health and Social Services (DHSS) will distribute $750,000 of federal Coronavirus Aid, Relief, and Economic Security (CARES) Act funding to mitigate the impacts of COVID-19 on mental health and address associated risk factors for suicide. The funds will provide direct support to Alaska’s communities and behavioral health providers as they respond to increased mental health needs that have arisen due to the COVID-19 pandemic.

“We have not seen a significant increase in suicide rates so far this year, but we know that suicide is a leading cause of death for young people in Alaska and our annual suicide rate continues to be much higher than the national rate,” said DHSS Commissioner Adam Crum. “I thank Governor Dunleavy for his support in approving our use of CARES Act funding to help address risk factors for suicide so that Alaska families won’t have to bear the burden of the loss of their loved ones.”

Through the end of this year, the following strategies will be implemented in response to the mental health challenges Alaskans are facing as a result of the pandemic:

  • Providing funding in each region of the state to prevent suicide, substance misuse and mental health stigma associated with the impact of the COVID-19 pandemic. This will support local strategies, assuring familiarity with the needs unique to each region.
  • Expanding access to the statewide crisis call center which will include targeted efforts to engage youth and young adults, and connect them with local resources.
  • Training behavioral health providers on evidence-based, culturally relevant approaches to treating individuals at risk for suicide.
  • Facilitating postvention community planning and training to support healing after a suicide and prevent further suicides in the affected community. This strategy focuses on developing a community response plan with people from a variety of disciplines – such as police officers, teachers, tribes, journalists, social workers, faith communities and behavioral health providers – using best practices so no one inadvertently increases the likelihood of someone else taking their life. Each community develops a plan that is specific to the needs and resources within their own communities or regions.

“We recognized the need for more support to individuals and communities given Alaska’s long-standing struggle with high rates of suicide, which is being compounded by additional stressors from the pandemic,” said Division of Behavioral Health Director Gennifer Moreau said. “But we also know Alaskans are resilient and that if we support one another, these strategies can provide the help we all need to get through this together.”

The week of Sept. 6-12, 2020 is National Suicide Prevention Week which occurs each year during National Suicide Prevention Month. All year long, including the month of September, DHSS and Governor Dunleavy are committed to taking actions to improve the lives of Alaskans during these difficult times.

# # #

Peope of Action Around the Globe

United States

The Rotary Club of Yakima Sunrise, Washington, has installed nine pianos in public spots where anyone can sit down and tickle the ivories — and the community. Sites include brewpubs, a shopping mall, and a coffee shop, and more installations are planned soon. The Painted Piano Project also provided stipends of $300 to artists who decorated the donated instruments.

A Heintzman & Co. piano made of crystal was sold at auction for $3.2 million.

“People stop to listen to the music or take a moment to examine the beautiful artwork,” says Nathan Hull, the club’s immediate past president. “The pianists play everything from Mozart to Van Halen, and that has been a lot of fun.”

United Kingdom

To raise funds for End Polio Now, the Rotary Club of Narberth & Whitland is selling Rotary-themed scarves designed by fashion and textiles student Mia Hewitson-Jones with help from graphics student Sam Stables, both enrolled at Pembrokeshire College. The scarves went on sale in 2019 after the club garnered approval from Rotary International for use of the logo. By April of this year, nearly 100 scarves had been sold and another shipment was on the way, says club member John Hughes. “We have sold a few in America and Canada,” adds Hughes. The idea of selling specially designed scarves was conceived by Mary Adams when she was president-elect of the club in 2016.

Romania

Faced with the coronavirus pandemic, the Rotaract Club of Cluj-Napoca “SAMVS” adapted an online mental health campaign on the club’s social media accounts, encouraging people to engage in satisfying activities, such as art. The social media campaign focused on “how to make the best of your #stayhome experience,” says club member Loana Vultur. More than 3,000 people have viewed the club’s posts on Facebook and Instagram. “No money was necessary,” Vultur says. “Our resources were our minds, creativity, and the will to help. In Romania we have the expression, ‘Make heaven from what you have.’”

Image courtesy of Namaste Direct

Guatemala

More than 100 Guatemalan women have been helped financially by the Interact Club of Hillsdale High School in San Mateo, California; its sponsoring Rotary Club of San Mateo; and the nonprofit group Namaste Direct. Over the years, about 100 Hillsdale Interactors have joined chaperone Rotarians and teachers on trips to Antigua, a city in Guatemala’s central highlands, to meet the women who have received grants funded through student-led fundraising events including “penny war” collections and taco dinners.

Nearly half of all Guatemalans live on less than $5.50 a day.

The site visits are eye-openers for the students, who see how microloans, financial literacy workshops, and mentorship have empowered the women, says Namaste Direct’s founder and chief executive, Robert Graham. He cites Namaste’s policy of charging lower interest rates than many other nongovernmental organizations (loans range from a few hundred dollars to $4,000), its adherence to Western consulting methodologies, and Rotary involvement as major reasons for the program’s success. “Many women have corner convenience stores, while others purchase clothing and household goods in bulk for resale at the local market,” Graham says. Other beneficiaries include a nut vendor, a chicken butcher, and a chocolatier.

India

In the Rotary Club of Vapi’s first 20 years, club members oversaw the establishment of a school, a hospital, and a college. “Our club created an entire town worth residing in,” says Ketan Patel. In 2011, seeking a way to honor the RI presidency of club member Kalyan Banerjee, the Rotarians embarked on a project to provide free kidney dialysis that continues to this day. Nearly 3,800 patients have received more than 32,000 procedures. “The entire treatment is free of charge,” says Patel. The cost of the dialysis project is covered by Rotarian and community contributions, along with club fundraising.

— BRAD WEBBER

• This story originally appeared in the August 2020 issue of The Rotarian magazine.


The Rotarian Conversation: Vivek Murthy
 
Loneliness — the absence of human connection — is twice as prevalent as diabetes in the United States. A former surgeon general tells us what we can do about it
 
Vivek Murthy grew up helping out in his parents’ medical practice, filing charts and cleaning the office as he watched the way they built connections with their patients by taking the time to listen to what they had to say.
 
When he became America’s top doctor — the 19th U.S. surgeon general, a position he held from 2014 to 2017 — he went on a listening tour himself. Some of the problems people told him about were things he anticipated: opioids and obesity, diabetes and heart disease. He also talked to Elmo of Sesame Street about vaccines and called for addiction to be recognized as the health problem it is rather than a moral failing.
But one unexpected topic became a recurring theme: loneliness, which “ran like a dark thread through many of the more obvious issues that people brought to my attention,” Murthy writes in his new book, Together: The Healing Power of Human Connection in a Sometimes Lonely World.
 
A 2018 Kaiser Family Foundation report found that 22 percent of American adults say they often or always feel lonely — that’s 55 million people, twice the number that are diagnosed with diabetes. Australia pegs its problems with loneliness at around 25 percent of its adult population. The United Kingdom has a similar figure. And other countries in Europe and Asia are struggling with double-digit percentages. “My guess is that most of these survey numbers are underestimated, because most people still don’t feel comfortable admitting that they are lonely — whether that’s to an anonymous person administering a survey or even to themselves,” Murthy said in an interview with The Rotarian.
 
Before becoming one of the country’s youngest surgeons general at age 37, overseeing 6,600 public health officers in more than 800 locations, Murthy partnered with Rotary clubs and other service organizations in India to set up community events for an HIV/AIDS education program that he co-founded with his sister, Rashmi. He also co-founded the nonprofit Doctors for America and the software technology company TrialNetworks.
 
Murthy spoke with senior staff writer Diana Schoberg by phone in April from Miami, where he was staying during the COVID-19 pandemic.
THE ROTARIAN: Hypothetically speaking, is a Tibetan monk in seclusion lonely?
 
VIVEK MURTHY: Loneliness is a subjective state — it’s not determined by the number of people around you, but by how you feel about the connections in your life. People who are surrounded by hundreds of others, whether they are students on a college campus or workers in a busy office, may be lonely if they don’t feel those are people with whom they can fully be themselves. Others who may have only a few people around them may not feel lonely at all if they feel good about those relationships and good about themselves.
 
For a monk to exist in complete isolation and not feel lonely, he would have developed a very deep spiritual practice and built a strong connection to God and the divine. 
 
“Service shifts our attention from ourselves to other people.”
 
TR: In your book, you describe someone who found his purpose and connection in the military. How can we find that sort of team environment?
 
MURTHY: People who have served in the Peace Corps together can often experience similar bonds. People also have that deep shared experience in times of natural disasters — not just the shared pain and trauma of a disaster, but also the shared joy and inspiration of the response to that trauma. People who have been a part of an organization where they have a deep sense of mission and where they’ve sacrificed together for the cause can also experience the bond. 
 
How do we create more opportunities for experiences like that? Part of that has to do with how we prioritize social connections as we get older. To many people, it seems almost like an indulgence to prioritize their relationships. They have responsibilities to their families, their kids, and their work, and it’s a question of where relationships fit in.
 
TR: What role can Rotary play?
 
MURTHY: What is powerful about organizations like Rotary is that they are rooted in service. Service shifts our attention from ourselves, where it increasingly is focused when we feel lonely, to other people and in the context of a positive interaction. Service reaffirms that we have value to add to the world. One of the consequences of loneliness when it’s long-lasting is that it can chip away at our self-esteem and lead us to start believing that the reason we’re lonely is that we’re somehow not likable. Service short-circuits that. 
 
Right now, people want to help. What they don’t know is where to go to actually do something meaningful. Organizations can provide those opportunities. That can be extraordinarily powerful. When I started doing community work, one of the principles I was taught is that people come to the table for the mission, but they stay at the table for the people. It’s hard to sustain even the worthiest mission without building a strong sense of connection between the people who are participating. 
 
TR: What can we build into our clubs to foster that sense of belonging?
 
MURTHY: Shared experience, shared mission, and the opportunity to understand each other more deeply create deeper connections. We’ve touched a little bit on the shared experience and shared mission part. But the opportunity to understand each other more deeply is something you can facilitate with a little bit of structure. 
 
When I was the surgeon general, we did an exercise called “Inside Scoop.” That turned out to be far more effective than the happy hours and group picnics that we had been doing before. At each weekly staff meeting, one person would show pictures to share something about their lives. It was so useful because it didn’t take much time at all — five minutes during a meeting. But it created an atmosphere where it was OK to share and it was OK to bring some part of yourself that was not work-related to the table. And that ended up being the key to helping people understand each other and learn about each other.
 
TR: How can technology help us connect in a healthy way? 
 
MURTHY: Despite all of the tools we have for staying in touch with each other, technology is a double-edged sword. Just as it can be used for strengthening our connections, it can contribute to their deterioration.
When you use technology to strengthen social connections, it can happen in a few ways. For example, you can connect with people you might otherwise not be able to connect with. When I was younger, the only affordable way we had to connect with my grandparents or cousins in India was to write them a letter, which took two weeks to get there, and a response would take two weeks to come back. Now, we can talk much more frequently because we can videoconference with them at next to no charge. That is a great example of how to use technology for the better.
Another example would be when we use online platforms as a bridge to offline connections. So if I’m coming to Milwaukee for a talk, I can post that on Facebook. And if that helps my friends get in touch with me and meet up, that’s a great way to facilitate in-person connection.
 
“Loneliness is a natural signal that our body gives us when we’re lacking something that we need for survival.”
 
TR: Is there anything we’re learning because of COVID-19 about communication that will help us as we go back to being in-person communicators?
 
MURTHY: For many of us, the absence of physical contact with other people has made it all the more clear how essential in-person interaction is. And how there really isn’t a full substitute for it. We can get close with things like videoconferencing, but it’s just not the same. 
Also, it’s become more apparent that it’s not just your family and friends that make a difference as to how connected you feel; it’s the interactions that you have with neighbors and community members and strangers. There’s something powerful in receiving a smile from someone. Those moments have a significant effect on lifting our mood.
 
TR: Is loneliness something that can be diagnosed? Is it medically recognized?
 
MURTHY: Loneliness can be assessed; the UCLA Loneliness Scale is one example. But it’s not the kind of condition that we currently would diagnose as an illness, per se. Loneliness is a universal condition that people experience for varying periods in their life. It’s a natural signal that our body gives us when we’re lacking something that we need for survival, which is social connection. In that sense, it’s very similar to hunger or thirst. Our social connections are just as vital to our survival as food or water. If we feel lonely in the absence of adequate social connections for a short time, we can use that signal to reach out and spend more time with a friend. But when loneliness lasts a long time, we start to run into trouble with it affecting our mood and having a long-term effect on our physical health. 
 
Doctors and nurses should be aware of loneliness, because it’s likely present in the lives of many of the patients that they care for and likely having an impact on the health outcomes that they’re trying to address. But we should be cautious about making people think that loneliness is an illness. There is already a fair amount of stigma about loneliness that makes people feel that if they’re lonely, they’re socially deficient in some way. Not everyone who is lonely is broken. Nor do we need a new medication or medical device to solve the problem of loneliness. I think what we need is to re-center ourselves and refocus our lives on relationships. 
 
TR: Because of the coronavirus, people are staying home for the good of all people — not necessarily for themselves, but so they don’t pass the virus to vulnerable populations. Why doesn’t that message translate for vaccines?
 
MURTHY: It’s a fascinating and disturbing phenomenon. There were times when people were more accepting of the need to vaccinate in order to protect not only their own kids, but also other kids. What has happened over time is that misinformation has proliferated. Some of it has been based on erroneous studies. Some of it has capitalized on fears that parents had about their children developing conditions like autism around the same time they were getting vaccines, even though the two aren’t related. It is emotionally charged — we’re talking about people’s children here. 
When a threat is new, people tend to come together because there is an immediate danger and they’ve got to figure out how to save themselves. But the longer that threat continues, the more likely you are to get misinformation, especially if the effort to contain the threat is painful. And in the case of COVID-19, it is painful.
 
While the response to COVID-19 and the resistance to vaccines feel very different, there are similar risks. All of us want this to end as quickly as possible, and if a source that we trust starts to tell us that this is a hoax or there’s an easy way out, some people are going to believe that. Not because they’re bad people or uneducated, but because in the face of continued pain, all of our minds will look for a way out. 
 
TR: What are the best responses to someone who refuses to vaccinate their children?
 
MURTHY: We have to understand what’s driving people’s concerns. Is it because of a personal experience? Is it because someone that they trust had a bad experience? One of the worst ways you can deal with misinformation is to shut other people down and to make them feel that they’re ill-informed or that you don’t respect them.
 
The second thing that’s important is to be vulnerable and open to sharing your own story. If you have a child and struggled with a similar decision, or if you felt the pain of seeing your child being poked with a needle, it’s important to share that. It’s easier for two people who share a human experience to talk about a complicated issue than for two strangers to do that. 
 
Beyond vaccines, I’m thinking about political polarization in our country and in the world. We have lost so much of the power of our connection with each other. We’ve allowed our relationships to be edged out and deprioritized — not just with family and friends, but also with our neighbors and community members. As a result, it’s become harder for us to talk about difficult issues like health care, climate change, or any number of big issues that we’re facing as a society. If we can’t engage in healthy dialogue, we can’t solve big problems.
 
• Rotary Action Groups connect Rotary members and friends who want to work together toward a shared mission such as water or the environment. Find out more at rotary.org/actiongroups.
 
• Illustration by Viktor Miller Gausa
 
• This story originally appeared in the August 2020 issue of The Rotarian magazine.
Healthy Alaskans 2030

Healthy Alaskans

FOR IMMEDIATE RELEASE, August 12, 2020

Contact:

Shirley Young, Alaska Native Tribal Health Consortium, (907) 268-1014

Clinton Bennett, Alaska Department of Health and Social Services, (907) 269-4996

 

Comments and personal action needed on Alaska's draft health improvement plan, Healthy Alaskans 2030

The State of Alaska Department of Health and Social Services (DHSS) and the Alaska Native Tribal Health Consortium (ANTHC) are pleased to announce that the draft state health improvement plan, Healthy Alaskans 2030, is now open for public comment on the State of Alaska Public Notice website at http://notice.alaska.gov/199049 until Sept. 2, 2020, at 5 p.m. 

 

Healthy Alaskans is a long-standing partnership and joint effort of DHSS and ANTHC to provide data-driven objectives for ambitious — yet achievable — goals for improving the health of all Alaskans. The Healthy Alaskans 2030 plan is composed of 15 priority health topics containing 30 health objectives. Each objective has an established target to reach by 2030.


We need action from every Alaskan in order to reach these goals.


“What helps this plan succeed is engagement and commitment from as many Alaskans as possible,” said Alaska’s Chief Medical Officer Dr. Anne Zink. “Whether you’re an individual, a community leader, a business owner or in the health care field – no matter what your role – we encourage you to read this plan, make comments and take steps to improve your own health and the health of our communities.”


Within each plan objective, there are specific evidence-based strategies and actions that are recommended to move the state closer to achieving the target. HA2030 provides a framework for partners and stakeholders who are actively engaged in improving the health of Alaskans. This collaborative planning process is intended to encourage shared ownership and responsibility for the plan’s implementation, the framework of which has been grounded in a review of national models such as Healthy People and County Health Rankings, completion of a statewide health assessment, the prioritization of health topics, objectives, and targets, and the identification of strategies and actions to reach those targets.

 

“We strongly encourage Alaskans across the state to select two to three individual goals that they can target within their own households and spheres of influence,” said Kirsten Kolb, Chief Administrative Officer for ANTHC and member of the Healthy Alaskans Advisory Team. “Especially during these changing times, attainable areas of focus such as limiting the sugary drinks in our homes, increasing the amount of exercise we get per day and evaluating the ways we relieve stress are some of the ways these strategies can be put into action in everyone’s day-to-day lives.”

Another way to help on an individual and corporate level is to ensure that the state health improvement plan is a complete, effective and thoroughly vetted plan by reviewing it, responding to the guiding questions and submitting your comments and any questions per the instructions in the public comment announcement.

To learn more about Healthy Alaskans or to participate in Healthy Alaskans efforts, go to: www.healthyalaskans.org 

###

 

Anti-Covid-19 Toolkits for Businesses (and Homes)
 
Here are the links to the two different business toolkits – the first from CDC, the second Alaska specific support.
 
Information from the CDC
 
Loads of Alaska materials
 
These toolkits are the ones Derotha told us about at last week's meeting.  As far as I can see, all of the information is appropriate for businesses, and some are even appropriate for some homes.
 
The Alaska specific toolkits are especially appropriate for Alaska, and do cover some Alaska specific items.  They both worth looking at.
 
Here is just one example of the Posters available for download.
 
Covid-19 and Households Living in Close Quarters
How to Protect Those That Are Most Vulnerable
 
This guidance is intended for people living together in close quarters, such as people who share a small apartment, or for people who live in the same household with large or extended families.
Older adults (65 and older) and people of any age who have serious underlying medical conditions are at higher risk for severe illness from coronavirus disease 2019 (COVID-19). The following information is aimed to help you protect those who are most vulnerable in your household.
Everyone should limit risks
If your household includes one or more vulnerable individuals then all family members should act as if they, themselves, are at higher risk. More information on steps and actions to take if at higher risk.
Limit errands
Family members should leave only when absolutely necessary. Essential errands include going to the grocery store, pharmacy, or medical appointments that cannot be delayed (e.g., infants or individuals with serious health conditions in need of aid).
If you must leave the house, please do the following:
  • Choose one or two family members who are not at a higher risk to run the essential errands.
  • Wear a cloth face covering, avoid crowds, practice social distancing, and follow these recommended tips for running errands.
  • Limit use of public transportation, such as the train or bus, during this period if possible.
    If you must use public transportation:
    • Maintain a 6-foot distance from other passengers as much as possible.
    • Avoid touching high-touch surfaces such as handrails, and wash hands or use hand sanitizers as soon as possible after leaving.
    • More information on how to protect yourself when using public transportation
  • Don’t ride in a car with members of different households. If that’s not possible:
    • Limit close contact and create space between others in the vehicle.
    • Improve air flow in the car by opening the window or placing air conditioning on non-recirculation mode.
  • Wash your hands immediately after you return home.
  • Maintain as much physical distance as possible with those at higher risk in the home. For example, avoid hugging, kissing, or sharing food or drinks.
Vulnerable members should avoid caring for children and those who are sick
Adults 65 years and older and people who have serious medical conditions should avoid caring for the children in their household, if possible. If people at higher risk must care for the children in their household, the children in their care should not have contact with individuals outside the household. Members of the household who are at high risk should also avoid taking care of sick people of any age who are sick.
Separate a household member who is sick
Provide a separate bedroom and bathroom for the person who is sick, if possible. If you cannot provide a separate room and bathroom, try to separate them from other household members as much as possible. Keep people at higher risk separated from anyone who is sick.
  • If possible, have only one person in the household take care of the person who is sick. This caregiver should be someone who is not at higher risk for severe illness and should minimize contact with other people in the household.
    • Identify a different caregiver for other members of the household who require help with cleaning, bathing, or other daily tasks.
  • If possible, maintain 6 feet between the person who is sick and other family or household members.
  • If you need to share a bedroom with someone who is sick, make sure the room has good air flow.
    • Open the window and turn on a fan to bring in and circulate fresh air if possible.
    • Maintain at least 6 feet between beds if possible.
    • Sleep head to toe.
    • Put a curtain around or place other physical divider (e.g., shower curtain, room screen divider, large cardboard poster board, quilt, or large bedspread) to separate the ill person’s bed.
  • If you need to share a bathroom with someone who is sick, the person who is sick should clean and disinfect the frequently touched surfaces in the bathroom after each use. If this is not possible, the person who does the cleaning should:
    • Open outside doors and windows before entering and use ventilating fans to increase air circulation in the area.
    • Wait as long as possible before entering the room to clean and disinfect or to use the bathroom.
  • If you are sick, do not help prepare food. Also, eat separately from the family.
Visualizing Speech-Generated Oral Fluid Droplets with Laser Light Scattering
To the Editor:
Video
 
Digital Object Thumbnail
 
Aerosols and droplets generated during speech have been implicated in the person-to-person transmission of viruses,1,2 and there is current interest in understanding the mechanisms responsible for the spread of Covid-19 by these means. The act of speaking generates oral fluid droplets that vary widely in size,1 and these droplets can harbor infectious virus particles. Whereas large droplets fall quickly to the ground, small droplets can dehydrate and linger as “droplet nuclei” in the air, where they behave like an aerosol and thereby expand the spatial extent of emitted infectious particles.2 We report the results of a laser light-scattering experiment in which speech-generated droplets and their trajectories were visualized.
 
The output from a 532-nm green laser operating at 2.5-W optical power was transformed into a light sheet that was approximately 1 mm thick and 150 mm tall. We directed this light sheet through slits on the sides of a cardboard box measuring 53×46×62 cm. The interior of the box was painted black. The enclosure was positioned under a high-efficiency particulate air (HEPA) filter to eliminate dust.
 
When a person spoke through the open end of the box, droplets generated during speech traversed approximately 50 to 75 mm before they encountered the light sheet. An iPhone 11 Pro video camera aimed at the light sheet through a hole (7 cm in diameter) on the opposite side of the box recorded sound and video of the light-scattering events at a rate of 60 frames per second. The size of the droplets was estimated from ultrahigh-resolution recordings. Video clips of the events while the person was speaking, with and without a face mask, are available with the full text of this letter at NEJM.org
.
 
Figure 1. Emission of Droplets While a Person Said “Stay Healthy.”
 
We found that when the person said “stay healthy,” numerous droplets ranging from 20 to 500 μm were generated. These droplets produced flashes as they passed through the light sheet (Figure 1). The brightness of the flashes reflected the size of the particles and the fraction of time they were present in a single 16.7-msec frame of the video. The number of flashes in a single frame of the video was highest when the “th” sound in the word “healthy” was pronounced (Figure 1A). Repetition of the same phrase three times, with short pauses in between the phrases, produced a similar pattern of generated particles, with peak numbers of flashes as high as 347 with the loudest speech and as low as 227 when the loudness was slightly decreased over the three trials (see the top trace in Figure 1A). When the same phrase was uttered three times through a slightly damp washcloth over the speaker’s mouth, the flash count remained close to the background level (mean, 0.1 flashes); this showed a decrease in the number of forward-moving droplets (see the bottom trace in Figure 1A).
 
We found that the number of flashes increased with the loudness of speech; this finding was consistent with previous observations by other investigators.3 In one study, droplets emitted during speech were smaller than those emitted during coughing or sneezing. Some studies have shown that the number of droplets produced by speaking is similar to the number produced by coughing.4
 
We did not assess the relative roles of droplets generated during speech, droplet nuclei,2 and aerosols in the transmission of viruses. Our aim was to provide visual evidence of speech-generated droplets and to qualitatively describe the effect of a damp cloth cover over the mouth to curb the emission of droplets.
 
Philip Anfinrud, Ph.D.
Valentyn Stadnytskyi, Ph.D.
National Institutes of Health, Bethesda, MD
 
Christina E. Bax, B.A.
Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA
 
Adriaan Bax, Ph.D.
National Institutes of Health, Bethesda, MD
 
Disclosure forms. opens in new tab provided by the authors are available with the full text of this letter at NEJM.org.
 
This letter was published on April 15, 2020, at NEJM.org.
6 Mild Symptoms of Coronavirus You Shouldn’t Ignore, According to Doctors
Korin Miller
4 days ago
 
The Centers for Disease Control and Prevention (CDC) has made the symptoms of COVID-19 crystal clear: fever, cough, and shortness of breath. But as more and more people develop the respiratory illness caused by the novel coronavirus, experts are seeing a wide range of symptoms in patients—and they tend to overlap with the common cold, flu, and even allergies.
a person lying on a bed: The signs of COVID-19 can go beyond a fever, cough, and shortness of breath. Here, doctors explain the mild symptoms of novel coronavirus you shouldn’t ignore.© Westend61 - Getty Images The signs of COVID-19 can go beyond a fever, cough, and shortness of breath. Here, doctors explain the mild symptoms of novel coronavirus you shouldn’t ignore.
 
The CDC maintains those big three are the symptoms of novel coronavirus, but the World Health Organization (WHO) has a more extensive list that includes 14 different symptoms detected in people with mild cases of COVID-19. That’s a big deal, since “most people infected with the COVID-19 virus have mild disease and recover,” per a February report of a joint World Health Organization-China mission. In fact, that report found that 80% of confirmed patients had mild to moderate disease.
 
So, which coronavirus symptoms should you be paying closer attention to—and what should you do if you think you may be infected? Here’s what doctors want you to know.
 
Back up: Why does the CDC only list three novel coronavirus symptoms?
 
“It’s because these are the most common symptoms in the U.S.,” says Richard Watkins, M.D., infectious disease physician and professor of internal medicine at Northeast Ohio Medical University.
  • Fever: This is by far the most common sign of COVID-19, and is defined by having a temperature of 100.4° F or higher.
  • Cough: Experts say patients typically develop a dry cough, meaning you’re coughing but nothing is coming up, like phlegm or mucus.
  • Shortness of breath: This symptom often presents in more advanced cases and can range in severity. Some people simply feel winded by otherwise normal activities, while others end up having trouble breathing on their own. “It feels like you’re not getting enough air,” says David Cutler, M.D., a family medicine physician at Providence Saint John’s Health Center in Santa Monica, Calif.
That said, several studies have shown a solid number of people infected with COVID-19 have no symptoms. “We are likely missing many cases here in the U.S.,” Dr. Watkins says.
 
What are the mild symptoms of novel coronavirus?
 
In the WHO report, the organization analyzes nearly 56,000 cases of COVID-19 in China and breaks down a wide range of “typical” symptoms, as well as how often people with the virus experienced them:
  • Fever (87.9%)
  • Dry cough (67.7%)
  • Fatigue (38.1%)
  • Sputum production (33.4%)
  • Shortness of breath (18.6%)
  • Sore throat (13.9%)
  • Headache (13.6%)
  • Muscle aches and pains (14.8%)
  • Chills (11.4%)
  • Nausea or vomiting (5.0%)
  • Nasal congestion (4.8%)
  • Diarrhea (3.7%)
  • Coughing up blood (0.9%)
  • Red eyes (0.8%)
A lost sense of smell wasn’t on the WHO’s list, but several organizations—including the British Rhinological Society, British Association of Otorhinolaryngology, and American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS), say it’s a possible symptom, too.
 
Below, what you need to know about the mild symptoms that didn’t make the CDC’s list:
 
1. Lost sense of smell
This “has been seen in patients ultimately testing positive for the coronavirus with no other symptoms,” the AAO-HNS said in a statement. “It could potentially be used as a screening tool to help identify otherwise asymptomatic patients, who could then be better instructed on self-isolation.” According to a joint statement from the British Rhinological Society and British Association of Otorhinolaryngology, two out of every three people with confirmed cases of COVID-19 in Germany had a lost sense of smell, and 30% of patients in South Korea who tested positive experienced the same thing.
 
“Viruses are a common cause of changes to the sense of smell or taste that can occur with an upper respiratory infection,” says Rachel Kaye, M.D., assistant professor of laryngology-voice, airway, and swallowing disorders at Rutgers University. “Viral infection can result in both inflammation and swelling of the nasal cavity lining, leading to nasal congestion, which in turn causes a change in smell. Furthermore, there is also some evidence that viral infection can lead to neurologic damage in the smell receptors.”
 
2. Fatigue
It’s not shocking that a viral infection would cause people to feel completely wiped out, says Susan Besser, M.D., a primary care physician at Mercy Medical Center in Baltimore. “Your body is working hard to fight the virus, and that requires a lot of energy,” she says. “It doesn’t leave much energy left over for you.”
 
3. Sputum production
Sputum production, a.k.a. excess mucus that you may cough up, isn’t super common with COVID-19, but it’s common enough that more than a third of patients have experienced it. Dr. Cutler points out that sputum production is common with plenty of other respiratory conditions, like the common cold and allergies, so you shouldn’t rush to assume you have coronavirus if you’re experiencing this.
 
4. Sore throat
Because COVID-19 is a respiratory virus, you may have postnasal drip (where excess mucus drips down the back of your nose and throat) and that can cause irritation in your throat, Dr. Besser says. Also, constantly coughing can be tough on your throat in general.
 
5. Aches, pains, and headaches
These are common symptoms with viruses, Dr. Cutler says. “When you get a viral infection, often you get a fever and that fever response can cause the body to feel achy all over,” he explains. “We see that with the flu and other infections as well.”
 
6. Diarrhea, nausea, and vomiting
There’s no clear reason to explain why this is happening in some people, Dr. Besser says, but she has some theories. “It’s possibly due to increased drainage from postnasal drip into the stomach—that can cause issues,” she says. It could also just be the way the virus itself behaves in some people, she says.
 
New research in the American Journal of Gastroenterology, which has not yet been peer-reviewed, found that a “unique sub-group” of COVID-19 patients develop digestive symptoms. “In some cases, the digestive symptoms, particularly diarrhea, can be the initial presentation of COVID-19, and may only later or never present with respiratory symptoms or fever,” the researchers wrote.
 
They believe these symptoms may occur because the virus enters your system through “a receptor found in both the upper and lower gastrointestinal tract where it is expressed at nearly 100-fold higher levels than in respiratory organs.”
 
What should you do if you think you have novel coronavirus symptoms?
If you’re experiencing multiple symptoms of COVID-19, get your doctor on the phone. You should not go to the hospital, because you could potentially spread the virus if you do have it or pick it up if you actually don’t. Once you discuss your symptoms, your doctor will be able to determine if you qualify for a COVID-19 test and go from there.
 
However, there is no specific cure for novel coronavirus and most people are being advised to treat mild symptoms with over-the-counter remedies while isolating at home for at least 14 days, Dr. Watkins says. “Many people have symptoms for two weeks—some longer and others a shorter duration,” he adds.
 
For a fever, aches, and pains, have acetaminophen (Tylenol) on hand and follow the label’s dosage instructions. Turn to cough medicine or tea with honey to relieve your cough or sore throat. Plenty of rest and fluids are also recommended. If you notice your symptoms getting worse, though, call your doctor again about next steps. And if the following occur, the CDC says it’s your cue to head to the hospital: 
  • Trouble breathing
  • Persistent pain or pressure in the chest
  • New confusion or inability to arouse
  • Bluish lips or face
  • Other severe or concerning symptoms (like a fever that won’t die down)
When can you leave your home after experiencing novel coronavirus symptoms?
 
The CDC has guidelines that depend on whether you have access to a COVID-19 test.
 
If you will not have a test, the CDC says you can leave home after these three things happen:
  • You don’t have a fever for at least 72 hours without the use of fever-reducing medication.
  • Your symptoms have improved.
  • At least seven days have passed since you first had symptoms.
If you will have a test, you can leave home after the following:
  • You no longer have a fever without the use of fever-reducing medication.
  • Your symptoms have improved.
  • You received two negative tests in a row, 24 hours apart.
When in doubt, call your doctor to be on the safe side.
 
From PREVENTION
 
 
 
THE CORONAVIRUS CRISIS:  Should We All Be Wearing Masks In Public?
Health Experts Revisit The Question
CARMEL WROTH
Even without symptoms, you might have the virus and be able to spread it when out in public, say researchers who now are reconsidering the use of surgical masks.
Elijah Nouvelage/Bloomberg via Getty Images
 
Updated March 31, 8:25 p.m. ET
 
A few months ago, it may have seemed silly to wear a face mask during a trip to the grocery store. And in fact, the mainline public health message in the U.S. from the Centers for Disease Control and Prevention has been that most people don't need to wear masks.
 
But as cases of the coronavirus have skyrocketed, there's new thinking about the benefits that masks could offer in slowing the spread. The CDC says it is now reviewing its policy and may be considering a recommendation to encourage broader use.
 
At the moment, the CDC website says the only people who need to wear a face mask are those who are sick or are caring for someone who is sick and unable to wear a mask.
 
But in an interview with NPR on Monday, CDC Director Robert Redfield said that the agency is taking another look at the data around mask use by the general public.
 
"I can tell you that the data and this issue of whether it's going to contribute [to prevention] is being aggressively reviewed as we speak," Redfield told NPR.
 
And Tuesday, President Trump weighed in suggesting people may want to wear scarves. "I would say do it," he said, noting that masks are needed for health care works. "You can use scarves, you can use something else," he said.
 
On Tuesday Dr. Deborah Birx, who serves as the White House's coronavirus response coordinator, said the task force is still discussing whether to change to the recommendation on masks.
 
Other prominent public health experts have been raising this issue in recent days. Wearing a mask is "an additional layer of protection for those who have to go out," former FDA Commissioner Scott Gottlieb told NPR in an interview. It's a step you can take — on top of washing your hands and avoiding gatherings.
 
In a paper outlining a road map to reopen the country, Gottlieb argues that the public should be encouraged to wear masks during this current period of social distancing, for the common good.
 
"Face masks will be most effective at slowing the spread of SARS-CoV-2 if they are widely used, because they may help prevent people who are asymptomatically infected from transmitting the disease unknowingly," Gottlieb wrote. Gottlieb points to South Korea and Hong Kong — two places that were shown to manage their outbreaks successfully and where face masks are used widely.
 
A prominent public health leader in China also argues for widespread use of masks in public. The director general of the Chinese Center for Disease Control and Prevention, George Gao, told Science that the U.S. and Europe are making a "big mistake" with people not wearing masks during this pandemic. Specifically, he said, mask use helps tamp down the risk presented by people who may be infected but aren't yet showing symptoms.
 
If those people wear masks, "it can prevent droplets that carry the virus from escaping and infecting others," Gao told Science.
 
The argument for broadening the use of face masks is based on what scientists have learned about asymptomatic spread during this pandemic.
 
It turns out that many people who are infected with the virus have no symptoms — or only mild symptoms.
 
What this means is that there's no good way to know who's infected. If you're trying to be responsible when you go out in public, you may not even know that you're sick and may be inadvertently shedding the virus every time you talk with someone, such as a grocery store clerk.
 
"If these asymptomatic people could wear face masks, then it could be helpful to reduce the transmission in the community," says Elaine Shuo Feng, an infectious disease epidemiology researcher at the Oxford Vaccine Group at the University of Oxford.
 
Given the reality of asymptomatic spread, masks may be a good socially responsible insurance policy, Gottlieb argues. "[Wearing masks] protects other people from getting sick from you," he says.
 
But there is still a big concern about mask shortages in the United States. A survey released Friday from the U.S. Conference of Mayors finds that about 92% of 213 cities did not have an adequate supply of face masks for first responders and medical personnel.
 
At this point, experts emphasize that the general public needs to leave the supply of N95 medical masks to health care workers who are at risk every day when they go to work.
 
And supplies are also tight for surgical masks, the masks used everywhere from dentists' offices to nail salons and that are even handcrafted.
 
"We need to be very mindful that the supply chain for masks is extremely limited right now," Gottlieb says. "So you really don't want to pull any kind of medical masks out of the system."
 
Given current shortages, it may be too soon to tell the general public to start wearing surgical masks right now. "We certainly don't have enough masks in health care," says William Schaffner, an infectious disease expert at Vanderbilt University. "I wouldn't want people to go out and buy them now, because we don't want to siphon them off from health care."
 
Where does that leave us? Some research has shown that cotton T-shirt material and tea towels might help block respiratory droplets emitting from sick people, even if the effect is minimal.
 
"Homemade masks, shawls, scarves and anything that you can conjure up at home might well be a good idea," says Schaffner. "It's not clear that it's going to give a lot of protection, but every little bit of protection would help."
 
But experts say homemade masks may not be effective if not constructed and handled properly.
 
That's why Gottlieb says the CDC should issue guidelines advising people on how to construct their own cotton masks. "Cotton masks constructed in a proper way should provide a reasonable degree of protection from people being able to transmit the virus," he told NPR.
 
There's no definitive evidence from published research that wearing masks in public will protect the person wearing the mask from contracting diseases. In fact, randomized controlled trials — considered the gold standard for testing the effectiveness of an intervention — are limited, and the results from those trials were inconclusive, says Feng.
 
But Feng points out that randomized clinical trials have not shown significant effects for hand hygiene either. "But for mechanistic reasons, we believe hygiene can be a good way to kill pathogens, and WHO still recommends hand hygiene," she says.
 
And those randomized studies were looking at how the face mask could protect the wearer, but what experts are arguing is that face masks may prevent infected but asymptomatic people from transmitting the virus to others. It's hard to come by data on this point. One meta-analysis reviewing mask use during the SARS epidemic found that wearing masks — in addition to other efforts to block transmission, including hand-washing — was beneficial. Another meta-analysis of mask use to prevent influenza transmission was not conclusive but showed masks possibly help.
 
The research may not be conclusive, but researchers we interviewed agreed that mask use is better than nothing. "There are some modest data that it will provide some modest protection," Schaffner says. "And we can use all the protection we can get."
 
Concern over presymptomatic spread in the community has also led some hospitals to change their policies and extend the use of masks to nonclinical employees and visitors. Last week, Massachusetts General Hospital in Boston took the unusual step of giving surgical or procedural face masks to all employees who go into the hospital to work, even if they don't provide care to patients, the hospital's Infection Control Unit associate chief, Erica Shenoy, told NPR.
 
"This runs very contrary to what we normally do in infection control," she says. "But we felt that with the unprecedented nature of the pandemic, this is the right decision at this time." She says if an employee were to get sick while at work, "the face masks would serve to contain the virus particles and reduce the risk of patients and others working at our facilities."
 
On March 29, the University of California, San Francisco, also started giving surgical masks to all staff, faculty, trainees and visitors before they enter any clinical care building within the UCSF system.
 
Feng cautions that if people do start wearing face masks regularly in public, it is important to wear them properly. She notes that the World Health Organization has a video on how to practice correct hygiene when putting on or taking off a mask.
 
Saskia Popescu, an infectious disease researcher and biodefense consultant, is skeptical that healthy members of the public need to start wearing masks regularly — she says people should follow current CDC guidelines. But she emphasizes that if you are going to wear a mask, "you have to wear it appropriately." That means, she says, "you have to discard it when it gets damp or moist. You want to stop touching the front of it. Don't reach under to scratch your nose or mouth."
 
Otherwise, she warns, wearing masks could give "a false sense of security."
Why to Use a Face Mask, and How to Make One
 
The China Red Cross delegation to Italy was appalled that social isolation was so weak, because it was obvious that everyone was not required to use a face mask.  Doctors say that masks are needed for sick people to prevent droplet spread when talking, clearing a throat, or respiratory action. We now know that there are many non-symptomatic infected people spreading the virus, who have no knowledge that they are infected.  The only way to have almost 100% of droplet spread stopped is to have 100% of all people using masks when in public. That also gets rid of any 'you’re sick' stigma. Droplet spread from less than 6 feet is the most prevalent form of transmission, followed by droplet contamination of surfaces. These transmission methods both can be greatly reduced with community use of masks, including homemade cloth masks. Community use of sewn cloth masks also reserves medical grade masks for the health care system.
 
The news videos of each country that has 'controlled' the Coronavirus pandemic show 100% mask usage when people are outdoors or in public.  In a time of mask shortage, we are trying to give you a way to get a useable mask.  These are not normally as good as an N95 mask, and are NOT recommended for those who are actually known to have the coronavirus, but are FAR better than nothing.  This has been proven, and is recommended by the CDC.
 
In order to make it more likely that people can get a useable and useful mask, we are including some patterns for you on the < homerrotary.org > website.  Some are very easy to make, and most will work well for everyone. The biggest thing is to get a good seal, so that you are actually breathing THROUGH the cloth.  Using 1/8” elastic seems to be the most comfortable to use for holding the masks in place, but make them so that people will actually use them.  If useable elastic is not available, ribbons that will tie around your head will work.  Please remember, the masks are for preventing the spread of disease, not to stigmatize anyone.  If we are all wearing masks, we are all less likely to get a disease.
 
People can get many patterns to sew their own or for their community. Many use double layers of cloth, but they may be so thick they do not pass air well. If you, or your child, cannot breathe through the mask, find something easier to breathe through. A single layer of flannel passes air but absorbs or stops passage of droplets created when talking, coughing, or sneezing. Remember, CDC says washing with soap and water will kill the virus, so these are reusable for the non-medical community after soap and water washing. An individual may need two or three for a day, but all can be washed, dried, and be ready for reuse overnight. People should save the used masks for washing in a plastic bag, and to treat them as contaminated until washing.  Of course, wash your hands with soap and water for at least 20 seconds after handling droplet laden used masks. 100% cotton cloth (no synthetic or synthetic blends) works best.
 
 We have lots of people sitting at home across the area wanting to know how to help. This could be a great local Rotary project, similar to the prevention project of Polio Plus.
 
Paul
How to Make a Simple Particle Mask.
This is a homemade particle mask as made by Tina Seaton.  It is pretty simple, and works very well.  The "pipe cleaner" used as a stiffener is something that makes this mask work very well by allowing you to form the mask around the nose.  Apparently the large diameter pipe cleaners cut in half work out very well. Dimensions can be adjusted to better fit smaller or larger people. there are many other designs available on the internet.
 
Several studies have been done on the best cloth to use.  Tea towels or dish towels appear to provide the best filtration, with two layers providing up to 97% filtration, but being almost impossible to breathe through.  The flannel here works very well, and is normally fairly comfortable. Normally, new cloth is washed prior to making the masks. then washed again afterwards. Using soap and as hot water as is available works the best.  This decreases the likelihood of contamination, also.
 
Large Size7"x 11"
 
Fold Over and Sew End Seams
 
 
Half a Pipe Cleaner Sewn Into Upper Seam.  1/8" Elastic, 7" Long On Each End.
 
Fold Up and Sew Bottom, Catching Elasticat Corners.  Reinforce Stich on Elastic
 
Three Tucks On Each End (Folded the Same Way).  Sew on Each End.

A View of One End of the Mask Illustrating the Folds
 
And Here Is Paul Modeling the Mask.
IMPORTANT!  Fire Extinguisher Recall
This is some very important information, and very timely. Recently one of the subject fire extinguishers discharged itself, and spread a white powder into the owner's house.  The powder MUST be vacuumed up, as it can be quite corrosive, and definitely shortens the life of moving parts as it is also very abrasive.  The extinguishers can self-discharge or not discharge at all!  Please check. Please note that there are several different brand names included in this recall.
 
Kidde Recalls Fire Extinguishers with Plastic Handles Due to Failure to Discharge and Nozzle Detachment: One Death Reported
 
·  https://www.cpsc.gov/s3fs-public/styles/thumbnail/public/110%20and%20Excel%20FX%20Identification%20Guide.jpg?4UuTu3RhWgLocT6MZ9J57XE39R76Kr50&itok=l_sHwRUR
·  https://www.cpsc.gov/s3fs-public/styles/thumbnail/public/Pindicator%20ID%20Guide.jpg?YBUwMb.UZSgcriCoDi0cWeQu4orHym_X&itok=Ayu1icKv
Name of product:
Kidde fire extinguishers with plastic handles
Hazard:
The fire extinguishers can become clogged or require excessive force to discharge and can fail to activate during a fire emergency. In addition, the nozzle can detach with enough force to pose an impact hazard.
Remedy:
Replace
Recall date:
November 2, 2017
Recall number:
18-022
Consumer Contact:
Kidde toll-free at 855-271-0773 from 8:30 a.m. to 5 p.m. ET Monday through Friday, 9 a.m. to 3 p.m. ET Saturday and Sunday, or online at www.kidde.com and click on “Product Safety Recall” for more information.
Recall Details
In Conjunction With:
Description:
This recall involves two styles of Kidde fire extinguishers: plastic handle fire extinguishers and push-button Pindicator fire extinguishers.
Plastic handle fire extinguishers: The recall involves 134 models of Kidde fire extinguishers manufactured between January 1, 1973 and August 15, 2017, including models that were previously recalled in March 2009 and February 2015. The extinguishers were sold in red, white and silver, and are either ABC- or BC-rated. The model number is printed on the fire extinguisher label. For units produced in 2007 and beyond, the date of manufacture is a 10-digit date code printed on the side of the cylinder, near the bottom.  Digits five through nine represent the day and year of manufacture in DDDYY format. Date codes for recalled models manufactured from January 2, 2012 through August 15, 2017 are 00212 through 22717.  For units produced before 2007, a date code is not printed on the fire extinguisher.
 
Plastic-handle models produced between January 1, 1973 and October 25, 2015
2A40BC
Gillette TPS-1 1A10BC
Sams SM 340
6 RAP
Home 10BC
Sanford 1A10BC
6 TAP
Home 1A10BC
Sanford 2A40BC
Ademco 720 1A10BC
Home 2A40BC
Sanford TPS-1 1A10BC
Ademco 722 2A40BC
Home H-10 10BC
Sanford TPS-1 2A40BC
ADT 3A40BC
Home H-110 1A10BC
Sears 2RPS   5BC
All Purpose 2A40BC
Home H-240 2A-40BC
Sears 58033 10BC
Bicentenial RPS-2  10BC
Honeywell 1A10BC
Sears 58043 1A10BC
Bicentenial TPS-2  1A-10BC
Honeywell TPS-1 1A10BC
Sears 5805  2A40BC
Costco 340
J.L. 2A40BC
Sears 958034
FA 340HD
J.L. TPS-1 2A40BC
Sears 958044
FA240HD
Kadet 2RPS-1   5BC
Sears 958054
FC 340Z
Kidde 10BC
Sears 958075
FC Super
Kidde 1A10BC
Sears RPS-1 10BC
FC210R-C8S
Kidde 2A40BC
Sears TPS-1  1A10BC
Fire Away 10BC Spanish
Kidde 40BC
Sears TPS-1 2A40BC
Fire Away 1A10BC Spanish
Kidde RPS-1 10BC
Traveler 10BC
Fire Away 2A40BC Spanish
Kidde RPS-1 40BC
Traveler 1A10BC
Fireaway 10 (F-10)
Kidde TPS-1 1A10BC
Traveler 2A40BC
Fireaway 10BC
Kidde TPS-1 2A40BC
Traveler T-10 10BC
Fireaway 110 (F-110)
KX 2-1/2 TCZ
Traveler T-110 1A10BC
Fireaway 1A10BC
Mariner 10BC
Traveler T-240 2A40BC
Fireaway 240 (F-240)
Mariner 1A10BC
Volunteer 1A10BC
Fireaway 2A40BC
Mariner 2A40BC
Volunteer TPS-V 1A10BC
Force 9 2A40BC
Mariner M-10  10BC
XL 2.5 TCZ
FS 340Z
Mariner M-110 1A10BC
XL 2.5 TCZ-3
Fuller 420  1A10BC
Mariner M-240 2A40BC
XL 2.5 TCZ-4
Fuller Brush 420 1A10BC
Master Protection 2A40BC
XL 2.75 RZ
FX210
Montgomery Ward 10BC
XL 2.75 RZ-3
FX210R
Montgomery Ward 1A-10BC
XL 2-3/4 RZ
FX210W
Montgomery Ward 8627 1A10BC
XL 340HD
FX340GW
Montgomery Ward 8637  10BC
XL 4 TXZ
FX340GW-2
Quell 10BC
XL 5 PK
FX340H
Quell 1A10BC
XL 5 TCZ
FX340SC
Quell RPS-1 10BC
XL 5 TCZ-1
FX340SC-2
Quell TPS-1 1A10BC
XL5 MR
Gillette 1A10BC
Quell ZRPS  5BC
XL 6 RZ
 
Plastic-handle models with date codes between January 2, 2012 and August 15, 2017
AUTO FX5 II-1
FC5
M10G
FA10G
FS10
M10GM
FA10T
FS110
M110G
FA110G
FS5
M110GM
FA5-1
FX10K
M5G
FA5G
FX5 II
M5GM
FC10
H110G
RESSP
FC110
H5G
 
 
Push-button Pindicator fire extinguishers: The recall involves eight models of Kidde Pindicator fire extinguishers manufactured between August 11, 1995 and September 22, 2017. The no-gauge push-button extinguishers were sold in red and white, and with a red or black nozzle. These models were sold primarily for kitchen and personal watercraft applications.
 
Push Button Pindicator Models manufactured between  August 11, 1995 and September 22, 2017
KK2
M5PM
100D
AUTO 5FX
210D
AUTO 5FX-1
M5P
FF 210D-1
 
Remedy:
Consumers should immediately contact Kidde to request a free replacement fire extinguisher and for instructions on returning the recalled unit, as it may not work properly in a fire emergency.
 
Note: This recall includes fire extinguisher models that were previously recalled in March 2009 and February 2015. Kidde branded fire extinguishers included in these previously announced recalls should also be replaced. All affected model numbers are listed in the charts above.
Recall information for fire extinguishers used in RVs and motor vehicles can be found on NHTSA’s website.
Incidents/Injuries:
The firm is aware of a 2014 death involving a car fire following a crash. Emergency responders could not get the recalled Kidde fire extinguishers to work. There have been approximately 391 reports of failed or limited activation or nozzle detachment, including the fatality, approximately 16 injuries, including smoke inhalation and minor burns, and approximately 91 reports of property damage.
Sold At:
Menards, Montgomery Ward, Sears, The Home Depot, Walmart and other department, home and hardware stores nationwide, and online at Amazon.com, ShopKidde.com and other online retailers for between $12 and $50 and for about $200 for model XL 5MR. These fire extinguishers were also sold with commercial trucks, recreational vehicles, personal watercraft and boats.
Importer(s):
Walter Kidde Portable Equipment Company Inc., of Mebane, N.C.
Manufactured In:
United States and Mexico
Units:
About 37.8 million (in addition, 2.7 million in Canada and 6,730 in Mexico)
 
 
The U.S. Consumer Product Safety Commission is charged with protecting the public from unreasonable risks of injury or death associated with the use of thousands of types of consumer products under the agency’s jurisdiction. Deaths, injuries, and property damage from consumer product incidents cost the nation more than $1 trillion annually. CPSC is committed to protecting consumers and families from products that pose a fire, electrical, chemical or mechanical hazard. CPSC's work to help ensure the safety of consumer products - such as toys, cribs, power tools, cigarette lighters and household chemicals -– contributed to a decline in the rate of deaths and injuries associated with consumer products over the past 40 years.
Federal law bars any person from selling products subject to a publicly-announced voluntary recall by a manufacturer or a mandatory recall ordered by the Commission.
 
To report a dangerous product or a product-related injury go online to www.SaferProducts.gov or call CPSC's Hotline at 800-638-2772 or teletypewriter at 301-595-7054 for the hearing impaired. Consumers can obtain news release and recall information at www.cpsc.gov, on Twitter @USCPSC or by subscribing to CPSC's free e-mail newsletters.
Speakers
Paul Seaton
Sep 24, 2020 12:00 PM
Alaska's Fair Share
Derotha Ferraro, SPH
Oct 01, 2020 12:00 PM
Community Assessment
Susan Bunting
Oct 08, 2020 12:00 PM
Hearing
District Governor Joe Kashi
Oct 15, 2020 12:00 PM
District Governor's Visit--Rotary
?????
Oct 22, 2020 12:00 PM
Hospice of Homer Update
Tim Dillon
Oct 29, 2020 12:00 PM
How if the Kenai Peninsula Faring Economically During the Pandemic?
Henry ???? CACS
Nov 05, 2020 12:00 PM
Coastwalk
Bob Stark, Bob Hickman
Nov 12, 2020 12:00 PM
About 907Vets
Vivian Finlay
Nov 19, 2020 12:00 PM
Rotary Foundation News
No Meeting
Nov 26, 2020
Happy Thanksgiving
No Meeting
Dec 24, 2020
Merry Christmas!!
No Meeting
Dec 31, 2020
Happy New Year!!
View entire list...
RSS
The Conversation: Jeanne Gang

The Conversation:Jeanne GangA renowned Rotary alum affirms her commitment to environmentally sustainable architectureGrowing up in Belvidere, Illinois, a city 70 miles

Small scholarships help Illinois adults build their careers

Small scholarships help adults return to school and trade a job for a career - In a seemingly affluent Chicago suburb, poverty stops many adult students from affording classes to advance their skillsets. Local Rotary clubs are helping pay for school.

Nature &amp; Nurture

With help from a Rotary Foundation global grant, a group of women in rural Costa Rica are using ecotourism to enrich their families' futures.

The world stopped. They didn’t

These 10 workers put service above self when it counted most

African region declared free of wild poliovirus

Rotary and its GPEI partners celebrate a monumental achievement, say global eradication of wild polio is possible with the continued dedication and persistence of Rotarians