March 30, 2020: Universal Mask Policy; Coping With Lockdown

Good morning,

The start of another week. The US coronavirus situation is probably going to look pretty gnarly this week, so best of luck getting heads down to WFH.

On to the update.

Universal Mask Policy

When I tried to buy groceries a few days ago I encountered this sign at the Asian supermarket. It more or less says that using masks protects other shoppers and employees. And at the end, it says “如无口罩，不允进入”, which means “If you don’t have a mask, you’re not permitted to enter”. I continue to see roughly 90% of people wearing masks in the Asian parts of SF, while only 30% wearing masks in other parts of SF.

Why is this important? Because of asymptomatic cases:

Even if those masks are ineffective protection for healthy people, they could still be extremely effective at preventing an asymptomatic carrier from spreading. Coughs stay in the mask, runny noses aren’t wiped with hands, you get the picture. And a 50% reduction in viral spread is a really big deal.

A few days later, UCSF followed suit:

In an effort to further reduce the risk of spread of COVID-19 among our workforce, patients, and community, UCSF Health will institute a more comprehensive universal surgical mask policy beginning 3/29/20 at 5:30 AM

All Staff, Faculty, Trainees and Visitors, will complete the screening procedure and then obtain a surgical mask.

Surgical mask should be worn ALL DAY when inside a clinical care building.

Coping With Lockdown

If you’re curious how long your shelter-in-place might last, check out these projections on hospital resource use. My guess is that the absolute earliest any shelter-in-place might be lifted is when hospital resource use is back down to 10% of peak. For California, that means June 5.

If 2 more months of lockdown sounds daunting, you’re not alone. This is a great twitter thread to read from someone who experienced a lockdown in Beijing earlier this year. I’m quoting it in full.

Peter Martin @PeterMartin_PCM

So you're going crazy under lockdown? I know the feeling. I've been in Beijing for the last two months. My housemate is away and I'm thousands of miles from my family. I have some thoughts on how to make lockdown better. These won't apply to everyone, but they ring true for me:

Peter Martin @PeterMartin_PCM

1) Know things will get better. The first few weeks felt pretty oppressive, but now I'm kind of used to it. Even if the lockdown goes on longer than expected, you'll get used to your new environment and likely grow more comfortable with your own company.

Peter Martin @PeterMartin_PCM

2) Have a routine. Fill it with stuff that makes you feel good. It might be home workouts, cooking, or learning something new. It might be a TV show that calms you (I've rewatched The Office and Parks and Rec). You'll get your work done, but don't let that become your only focus

Peter Martin @PeterMartin_PCM

3) Be careful with technology. Seeing pictures of and doing video calls with loved ones has made this whole experience much easier to deal with. Don’t underestimate the difference between hearing someone say they're doing ok and seeing it with your own eyes. On the other hand…

Peter Martin @PeterMartin_PCM

… my social media feeds are full of anxiety-inducing outrage and doom-mongering. I need social media for my work, but I've started logging out of Twitter when I'm done with my workday and I'm limiting my time on Facebook. It helps.

Peter Martin @PeterMartin_PCM

4) Appreciate little changes that improve your life. In my part of Beijing, so few people have been on the streets that strangers now nod as they pass each other. It’s a small thing, but it's kind of beautiful and it reminds me of the small town in England where I grew up.

Peter Martin @PeterMartin_PCM

5) Don't hate yourself for not being constantly productive We trick ourselves into thinking all time at the office is well-spent. It’s not. Your day at home will include idle moments and that's ok. Even if it takes you to parts of YouTube that make you question your self-respect

Peter Martin @PeterMartin_PCM

6) Accept that you're stressed. You're worried about yourself. Your family. Your friends. The world. And there's a sense of fear in the air. Don't try to talk yourself out of it. Tell your friends. Write it down. Meditate. Exercise. Do whatever you need to do to deal with it.

Peter Martin @PeterMartin_PCM

7) Talking of stress, don't feel guilty that you're consumed with your own feelings when others (doctors, the elderly, the socially isolated) have it harder. Your stress is real too. And unless you deal with it properly, you won't be able to support others.

Peter Martin @PeterMartin_PCM

8) You're going to have off-days when you just feel really crappy and sorry for yourself. That's ok. It would be kind of strange if you didn't. Take some time off. Do nothing. Relax. Write a line under the bad day when you're done and start a new one tomorrow.

Peter Martin @PeterMartin_PCM

9) Write to people you don't contact often enough and ask how they're doing. I was really touched when people did this for me. Others will appreciate it when you reach out. The social contact and sense of solidarity will probably make you feel good too.

I wish you luck with your own shelter-in-place and WFH.

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Have a good day and see you tomorrow!

Andrew