Love in the Time of COVID

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It feels like so long and yet somehow also no time at all. As we think about navigating social connections—like dating—this new landscape, I want to share a little about some conversations I had with my new friend Missy Modell—the genius behind such internet classics as that Dr. Fauci song love song.

Last week, Missy had made a comment in an instagram story about wanting to continue wearing her mask and I shared that I’m still wearing mine too. As we kept chatting, I drew a parallel between establishing boundaries during sex and establishing boundaries with meeting up during COVID. Missy loved the idea and suggested we have an instagram live to talk about it more. If you’re interested, you can watch it here. We cover a lot of ground, including this similarity between healthy communication while Normal Human Dating and healthy communication navigating social connections in a pandemic.

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We Live in Each Other’s Shadow: Social Distancing is Our Social Responsibility

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As you may know, a new coronavirus called SARS-CoV-2 has been spreading, causing a disease that epidemiologists have named COVID-19. The disease is new (so the majority of people aren’t immune), spreads easily from person-to-person, and can cause severe illness in the elderly and medically fragile. The spread of the disease to so many people in so many places has led the World Health Organisation to declare the spread COVID-19 a pandemic.

The situation is very, very serious, but there are lots of steps you can be taking to keep yourself healthy. At this stage, Public Health is also needing us to keep our communities healthy through actions we call “social distancing.”

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MNÁwesome: What Happens When We Legalise Abortion?

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If you follow me (or probably any other Irish person) (or read Irish news) (or are passingly aware of when Ireland makes foreign headlines), you probably heard that the Republic of Ireland voted last month to repeal the 8th Amendment of the Irish Constitution (Bunreacht na hÉireann). It was a massive, multiyear campaign that took off running after the tragic—and completely preventable—death of Irish dentist Savita Halappanavar.

I know that this topic is hard for many people and that there are a lot of very strong emotions. As a devout Roman Catholic, I’m familiar with both sides of the issue. I’m not going to dig into the intricacies of the philosophy on when life begins, but I will say this: I desperately wish that I lived in a world without abortion. I wish that I lived in a world in which every pregnancy was planned and healthy and no one ever had to make the decision whether to terminate their pregnancy. I wish I lived in that world, but it doesn’t exist. It is not my place to tell someone else what they need to do with their body and in no other instance do we insist that it is.

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Sitting with our Grief: Mental Health Matters

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My grandfather died yesterday. He was quite elderly and was battling an aggressive case of cancer, so his death was not unexpected, but it is painful all the same. We had known the end was near for several days and every time my father called I had expected it to be with the sad news. As a consequence, I have found myself feeling as though my grief were already all poured out and that I'm drowning under the weight of my guilt for being so stopped up. It reminds me a bit of the emotional equivalent of when I had appendicitis and, after days of agony, finally crawled to my bathroom consumed with the thought that I would feel better if I could just vomit. I don't expect that vomiting would do me much good this time, but I can't help think that I would feel so much better if I could just have a good cry. 

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We Carry Them With Us: How the Health of our Great-Grandparents Shapes Our Own

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Last week was both Columbus Day and Indigenous People’s Day in the United States. Thanksgiving is right around the corner. These days remind me of the stories I heard in school as a child about the “discovery” of America and the “first people” to come here. As an immigrant family, the stories of these holidays weren’t a part of our home life, but they certainly appeared at school each autumn. I remember being told to memorise a poem about Columbus in first grade and the narrative of the first thanksgiving appearing in each US history course I took. 

While having time off from school and work is nice (I certainly enjoy that part of civil service), these days are also wonderful opportunities to talk about the health disparities we see between Native American/Alaska Native (AIAN) and other groups in the US. Native writers have spoken and written and researched this far better than I will here, but it’s important for all public health practitioners to discuss the ways that the health of the people who grew us and raised us shapes our own health. 

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Medicines and Vaccines Part 3: Is it the Water or the Vaccines?

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In this last part of our medicines and vaccines series, we’re going to talk about how vaccines work and how we know they do. I know that vaccines are a contentious topic and I want to start by acknowledging that sometimes delaying or forgoing a vaccine is the evidence-based decision. If someone is pregnant, they shouldn’t have the varicella (chickenpox) vaccine. A child with leukemia probably shouldn’t get the measles, mumps, and rubella (MMR) vaccine. Those conditions which make vaccines temporarily or permanently unsafe for an individual are, thankfully, very, very rare. For most humans, following the CDC vaccine schedule is safe and will provide both them and their contacts with protection against those diseases.

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Medicines and Vaccines Part 2: Bringing Essential Medicines to Market

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In our last piece, we talked about the pharmaceutical development pipeline and how some drugs are repurposed from other medicines, rather than being discovered as a new medicine completely. In this post I’ll talk about what that pipeline looks like for antibiotics and vaccines, two of the most important types of medicines that we have. 

Vaccines and antibiotics, like all medications, are very expensive to produce (as we discussed in Part 1), but they can’t be sold for the same high prices as nonessential (think Viagra) medications. This creates a problem for the development pipeline: how can companies afford to take risks on new development for products that won’t cover the cost of producing them? The answer was surprising for me when I first started studying public health. 

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Medicines and Vaccines Part 1: The Pharmaceutical Pipeline

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I often hear people express concern that pharmaceutical companies (Big Pharma) are making a killing on medications and vaccines and fear that we can’t trust them because of it. I also feel a lot of discomfort with pharmaceutical companies skyrocketing the prices for products like daraprim and epi pens. Drugs are really, really, really expensive to make and somebody has to foot the cost for developing them, but we also have people dying because they can’t afford the basic medications they need to live. There has to be a better way, but it’s hard to know what to think when the process is so mysterious. This piece is the first in a 3 part series on how medicines and vaccines are made and what they do. We won’t be able to cover every aspect of it because 1. that’s the stuff of dissertations and 2. I honestly don’t know all of it, but we’ll go through an overview of how the very basics.

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A Tale of Two Cities: What's Happening in Cascadia?

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I've always been fascinated how the United States, despite being so advanced and spending so much on healthcare, can still rank so lowly in health outcomes. When I talk to friends and family in the UK, Canada, or Ireland about our healthcare, they're often baffled at how our system runs. "You send the ambulance away? But why?" "Because it costs $500 and I can drive myself for much less." My son's birth was uncomplicated and I delivered him myself in the hospital's bathroom, but received a $35,000 bill for the trouble. One of my cousins delivered her baby a couple of weeks later in Northern Ireland, received excellent care, and never saw a bill for the process because healthcare there doesn't have a fee-at-point-of-service model. She didn't have to get "pre-authorization" to birth her baby because that isn't a thing. Her health insurance company didn't say her unborn child couldn't be insured because he didn't have a birthday yet because that is absolutely ludicrous. 

We know that health and healthcare are different (though related) things, but what are the outcomes of such different social policy landscapes on the health of the people that live there? Do government social policies really make for better health? Let's discuss! 

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Vaccine Hesitancy: A Case for Compassion

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The purpose of writing this isn’t to shame parents who are vaccine hesitant or vaccine resistant or even to convince you with data. The purpose isn't to make anyone feel like they don't love their children enough or somehow aren't smart enough to be parents. Or, honestly, to make you think that I think those things. The point of writing this is to speak to the parents who are frustrated and frightened by the declining immunisation rates in places like Vashon Island in Washington State, who are worried when they see a notice come home that there’s been an outbreak of a vaccine-preventable disease in their child’s school. It’s scary for parents whose children are potentially exposed and school exclusions, while effective, can cause frustration in affected communities. 

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Health: More than Healthcare

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Exploring the ways that our social connections, the community we live in, and economics influence our health

When we think of our health, our first thought is usually of going to see a physician (or other medical provider) and having tests like an MRI done, but access to medical care only makes up a small proportion of our overall health. Our health is shaped much more by the social determinants around us–the air we breathe; the water we drink; the amount of education we have; the safety and accessibility of our housing, nutrition, and public transportation. Together those factors build a framework that we call “The Social Determinants of Health.”

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