The Law of Nature

On July 20, 2020July 20, 2020 By kateginsbachIn Alaska, Alvin, Global Health, Uncategorized2 Comments

In all my studies about pandemics I would always think about what one would look like today, we have made so many scientific advances since the 1918 flu but it’s now clear one thing hasn’t changed and that’s human behavior.

My dad talks about getting taken to the gymnasium when he was a kid to get his polio vaccine, and how grateful his mom was that there was one available. Polio killed but even more so it maimed in a ferocious way that children were put in iron lungs or if they were lucky only wheel chairs for the rest of their lives. The first big outbreak happened in 1916 in New York City, before that it had circulated but did not strike in the way it did that year. Until a vaccine was created in 1955, theaters and pools would shut down every “polio season” as they were often seen as hot spots in an attempt to prevent the spread. Those who could leave crowded cities often would escape to the country side in an attempt to avoid it and children often had to carry records showing that they were not infected with it. The March of Dimes came out of polio research and really spurred early philanthropy beyond the ultra wealthy. FDR took it upon himself to call on Americans to send dimes to help fund polio research (hence the name). Even when there were no known cures people would seek out remedies, FDR would escape to a bath house down in Georgia believing that the water helped with his rehabilitation (probably an early form of water therapy).

What was once a potential death sentence or a life filled with disability has been almost completely eradicated worldwide, there are less than 200 cases globally but without a vaccine it’s estimated that 17 million people who are otherwise healthy at this moment would be paralyzed. As of 2017, there were three individuals in the US who still depended on an iron lung to survive, which is one of the most inspiring and also heartbreaking medical devices we have. This article does a great job of painting the picture of those three lives. In the peak year of 1952, 60,000 cases of Polio happened in the US with 3,000 people dying, and an additional 21,000 paralyzed as a result. Polio gets into the body through the mouth then grows in the intestines, it can then travel into the blood stream reaching the nervous system where there it will attack the spinal cord or the brain, where it can cause paralysis. The death like most viral infections is not pretty, imagine a 6 year-old gasping for breath as their lungs become paralyzed and they essentially drown in their own secretions, parents only able to offer some comfort as they cradle their head as the rest of the body is in an iron lung working to force them to breath. Devastating. Jonas Salk started trials of a vaccine in 1953 (beginning with his own children) and by 1960s the reoccurring epidemics were 97% gone.

Why am I talking about polio, well with the current pandemic feel like I can finally spew out all this random knowledge about other diseases, and I still have a book due to the Notre Dame Library about it. But because I think a lot about polio right now with the discussion of schools opening up because polio mostly impacted younger children– but also if at it’s peak it killed 3,000/year by today’s measure we would have never focused on a remedy so maybe there is a lesson to learn about how society acted towards life during that time. There aren’t a lot of articles out there about movements during polio that contested the closure of areas; but I’m sure some mothers were exasperated when getting to the pool to realize it’s closed down and all the kids want to do is go for a swim. COVID-19 fortunately does not strike kids in the same way as adults and elders, or at least that is what current studies show but we’re still responding in real time to the virus so we still don’t know everything about it (the polio vaccine did a double blind study with 1.8 million school children). The most recent data shows that kids under 10 aren’t big spreaders of the virus, but with 1/3 of the cases in Florida being children that might change. A study that just came out of South Korea (n=65,000) shows that kids ages 10-19 are just as effective at spreading COVID-19 as adults (still limitations within the study). Those kids who are impacted tend to have preexisting conditions (much like adults) and symptoms are showing up differently with inflammation and rashes, and often triggering Kawasaki Disease (1/3 of kids who were diagnosed with this in NY had preexisting conditions).

Let’s take it back for all of you at home that stopped your science education in high school (and there is nothing wrong with that, that’s where my math career ended and always so grateful I have Heidi to message about math problems– and math is technically different than stats which I have painstakingly taken twice now for two different degrees….). A virus is a collection of genetic code (either DNA or RNA) surrounded by a protein coat that needs host cells to replicate itself, since it can’t replicate on its own. Viruses are different than bacteria–which are single celled organisms that can harm or help support life — think of gut bacteria vs. those that cause an infection. Viruses can’t be treated with antibiotics and instead need anti-viral medication or vaccines to eliminate them, non-pharmaceutical interventions are a way to reduce or mitigate the spread, think of hand washing.

Why does this information matter, well based on quite a few facebook posts I’m convinced that people don’t know how viruses function and behave. Because viruses can’t survive on their own, they need a host, and that host doesn’t necessarily have to be humans but most human infectious diseases are initially transmitted from animals. This is a great video that shows how host jumps happen. One more step that the virus has to take is going from just infecting humans to transmit the virus from human to human. H5N1 causes a severe respiratory disease in birds (avian flu) and human cases do occur with a 60% mortality rate but it’s very difficult to transmit humans to humans so the virus jumps from a bird to a human and there is no additional jump to another human– but if it jumped human-to-human and retained that mortality rate we’d have a problem.

Humans are hosts for COVID-19, it is transmissible from human-to-human which means each one of us is a potential host and potential spreader. How do we stop COVID, we make it hard for it to find a host. This is where all the non-pharmaceutical interventions come in that have been talked about; washing hands, wearing a mask, maintaining physical distance because we don’t have any antivirals or vaccines developed at the moment, and even if we did, a mass vaccine campaign is no small undertaking.

Right now the United States has 142,000 deaths from COVID–in the past two weeks alone cases are up 33%, hospitalizations are up 75%, and deaths are up 101% with 20 states being in the “red zone”. That’s a line of dead bodies that stretches 66 miles, or from my parent’s house to the nearest McDonald’s, pasture upon pasture filled with a person who was somebody to someone. So it’s been extremely frustrating and quite dismaying to see people’s response to this: “It’s not a problem here” “Masks are an infringement of my freedom” and “We just have to live with it” because we’re all potential hosts and we’re all potential spreaders. Even arguably those who have been previously infected because we don’t know how long immunity is lasting for, and it might not mean much if the virus keeps mutating beyond what immunity you had.

“It’s not a problem here”– this is really interesting to me because I think of 9/11, the twin towers didn’t fall in rural South Dakota and yet my community was shell-shocked on the attack. 3,000+ Americans died and it was enough that people felt called into action from around the country. I also think of what our reaction would be now to 9/11, how many would be quick to believe it’s a conspiracy theory, an inside job, a way to control the citizens, how much misinformation would have gotten circulated on facebook. If COVID isn’t a problem at the moment for your community, be grateful, but also work to take steps to prevent it from becoming a problem. We continue to take our shoes off at the airport, even though dying in a terrorist attack is a much lower threat than COVID-19 right now. Viruses don’t respect borders, it doesn’t stop at state lines or county lines.

“Masks are an infringement of my freedom” I’m not sure how this became such a rally cry or such a partisan issue. Masks aren’t an infringement of your freedom. Individual liberty isn’t an absolute. “In every well ordered society charged with the duty of conserving the safety of its members the rights of the individual in respect of his liberty may at times, under the pressure of great dangers, be subjected to such restraint, to be enforced by reasonable regulations, as the safety of the general public may demand” and that “[r]eal liberty for all could not exist under the operation of a principle which recognizes the right of each individual person to use his own, whether in respect of his person or his property, regardless of the injury that may be done to others.” (Jacobson v. Mass, 197 U.S. 11 (1905)). Basically you’re arguing that everyone should have the freedom to unfettered rights and that rights come with no responsibility.

Cheney and I agreeing 100% on something–not the Patriot Act….

The mask argument just shows how unwilling we are at the moment to take care of one another. I get there was confusion early on with masks, I didn’t start wearing one until end of March when I went out. A lot of the mask data we have is from antecedent studies because it would be unethical to have a control group without masks exposed to COVID-19. We continue to learn new information about this disease, and we’re responding in real time. We know to be infected it’s time + exposure. Because I live in Alaska when I go to a trail I don’t wear a mask (I also don’t go to very busy trails), but will have a face covering around my neck that I can pull up like a bandana or buff. It doesn’t have to be this all or nothing, we know that inside, poor ventilated spaces are great for transmitting the virus, and that masks help if you can’t maintain distance (inside and outside). On a personal note, I would love to see the data of those who supported the Patriot Act passage and those who oppose mask mandates, my guess is that there is a large correlation but I would argue the Patriot Act was a larger infringement on your individual liberty.

“We just have to live with it” Nope, nope, nope. No other country is willing to live with it, if this is your view point, ask how many more Americans is it acceptable to die. I get frustrated because the amount of deaths we have are wholly unnecessary, and I’m quite ashamed of our response. I have spent the past three weeks in the weeds of other countries law and policies related to COVID and I can tell you almost every country is performing better on this test. Are we suppose to be okay that we’re doing better than early model projections, that we don’t have 500,000 Americans dead? What’s the threshold for you to take action? Washing hands, wearing masks, maintaining distance are what should also be part of broader testing and contact tracing. Look and see if you are able to get tested in your area without showing symptoms? It’s not happening in a lot of places and until it does we will be in this constant catch up game.

This past week I was in a pretty dark spot because I can’t believe that this our response and that people are okay with it. Do I think if I got the virus I would die, statistically no, but there are outliers, do I want to have prolonged lung damage or neurological damage, no. Do I think my parents are at a higher risk, absolutely. Do I want members of my community to die or have their lives impacted, no. This virus doesn’t just kill but wrecks havoc on one’s body in a brutal way (and in ways we won’t know for a while), and I know what you’re thinking, but Kate, asymptomatic people, you wouldn’t even know you had it, except that lung damage is shown in those who have shown no symptoms. Imagine going for a hike or a walk with 75% of your current lung capacity. Breathe through a straw if you want a full effect.

As schools talk about re-opening, we’re missing the part of the conversation that talks about what we can do in the next 6-weeks to make that more feasible. I don’t have kids so I’m not writing from a place of needing to get them out of the house so I can focus on my work, but I feel for those parents who are navigating this work space and childcare/school work at home. I think ignoring the disease is not a great approach– and think there are concrete steps we can be taking to ensure our schools are safe for when they do open up.

Viruses don’t care about our families, our work, we can’t negotiate with them. It’s the law of nature, not the law of man that we are battling with. Do you want to be part of the solution or part of the problem? Everybody is a potential host of this virus to replicate in. We don’t have to be in total lock down or completely open, it doesn’t have to be this divisive. We’re all battling the same enemy, we’re all on the same team. Until everyone realizes that the longer this is going to go on. The longer issues go on beyond COVID, immunizations are down, mental health issues, domestic violence. A lot of people had an idea of fissures happening within our society but this has exposed large ruptures in a way that we should no longer be willing to ignore. For me this is the longest I’ve gone without seeing my family. And everything just seems a little harder to deal with most days– as if I was going to graduate from therapy any time soon…

As for Alvin and I’s adventures, we have gone canoeing, hiking, backpacking–oh and he ran away from the boarder’s for two days and ended up 20 miles away, yikes. We just sent out a breed kit to find out what he is. If you haven’t placed your bet yet, you can here.

Congrats, if you made it this far, my next therapy session is about 3 weeks away and the turmoil in my mind was putting me in not a great place personally so welcome to my current therapy session. Happy to discuss anything further or provide references to anything that I have. Hope at least the pictures of Alvin helped you get through it. I’m sure if you’re reading this you’re probably on a similar page with the COVID response.

Keep Moving

On May 8, 2020May 8, 2020 By kateginsbachIn Alaska, Alvin, Global Health, Other Adventures, Uncategorized4 Comments

Alvin has taken to sleeping under the bed and even retreating there at moments during the day. After a quick google search it seems like dogs to do this to feel safe and to help them relax easier; after learning that I wondered if he had room for me under there.

The past two weekends I’ve been able to go camping. Which means life has simultaneously felt weird and normal. The Governor specifically addressed travel saying that you can go but cannot go into stores outside your community. The case count remains low here and with the physical distancing that took place early on gave the hospitals enough time to increase their bed capacity (and morgue capacity) so that if we do surge they are better equipped. As a result, some restrictions have been eased which I think we’ll know in about 2-3 weeks how that worked out.

The first weekend I found a friend to watch Alvin because apparently even the best trained dogs shred tents and not wanting to add a $300 tent to his running tab thought it was best to leave him home.

We headed down to Caines Head in Seward, I’m told it’s the trail that you take your out of state Alaska friends and also your girlfriend who doesn’t backpack. Perfect.

The trail beckoned us into the forest with lush tree coverage and dark, rich soil. We had an early start in order to make sure that we were able to cross a section while the tide was low and had plenty of time to spare. We topped off our water at a waterfall and headed to a fort that was used during WW2 to eat lunch but only after having to walk through the fort and hope that no bears were hibernating.

After that we headed to South Beach, which I kept calling North Beach and set up camp. Unlike winter camping it was insanely easy, no digging a hole, no shuffling around on skis, no having to eat a snack before hand; tent set up and ready to go in less than 3 minutes.

Having so much time we wandered around the beach, watched some sea kayakers, filled up our water bottles for dinner, made dinner, walked around the beach some more, found a dead otter somewhat near our tent. In my mind I was like oh great, that will attract the bears not us, which the next morning I was told that it could make the bears aggressive and they could come for us–ignorance is bliss.

In the morning I crawled out of the tent, with just about as many layers on as for winter camping but without a -20 degree sleeping bag. Again, the break down of camp proved much faster than winter camping and we were on our way.

As we hiked up we lost track of the trail covered up in snow and in a few places had to post-hole our way through. As communities begin to open up I felt a similar feeling to apprehensively moving forward on top of the snow: is it safe, will it hold me, and then occasionally finding my leg plunging through the crust and only being stopped by my hip on the surface. I had no idea that the snow remained that deep in places (deeper than a whole “Kate Leg”) and feel like with COVID cases we are in some ways only on the surface (again, call your congressional delegates about mass testing +contact tracing). We got down from the snow coverage and back onto the beach were we (I) haphazardly looked for animals in the water. We got back to the car and had just enough snacks to hold us over for the drive back but did put a to-go order in to a place in Anchorage to pick up on our arrival.

Last week I had a roller of emotions. It didn’t help that I was also about to start my period (not to add stuff to stereotypes but should be noted). I took a new job, well actually I took it a while ago but it’s in Washington DC so was waiting for more information on when I would physically need to be there. Initially thinking June 1 but then maybe end of June and finally got word that it would be mid-late fall. Which means working remote starting June 1 until we can be in the same space, but with the caveat of having to work east coast hours (for those of you at home, Alaska is in a separate time zone) meaning 5am-1pm in Alaska time. At first I was really excited about getting to stay in Alaska, I felt like I was just hitting my stride and settling in, getting friends, a community, have a boyfriend, have an Alaskan dog, starting to do more activities, have a sweet work remote gig, the dream.

But at some point the reality of me having to get to DC with the logistics of a pandemic began to cast a shadow over this ideal situation, besides having to go to bed at 8pm every night for a 4am start to the day. I initially thought of staying till the end of my lease, through July. Part of me was like yeah, do that, getting to DC is a problem for future Kate to deal with. But that would mean either moving end of July and in all likelihood flying (which I was adverse to all the germs on planes to begin with so no thank you at the moment) or staying here until I could get to DC which realistically might not happen until after fall. I have time now to drive, and it’s not ideal because even though it’s essential travel I can’t stop anywhere except for gas in Canada. Thinking of going to South Dakota and hunkering down with my parents Tenzen and Alvin (still not sure which one would end up sleeping in my bed) until I needed to head to DC (a 20 hour drive from SD vs. 70 hour from AK). I’ve consulted with all my friends in public health and my therapist about what to do. I think with things opening up in about 2-3 weeks we’ll see how it’ll play out and the last day I can make a run for home would be May 25 in order to get there and start work on June 1. Right now I’m leaning towards going home but I feel like I’m leaving this safe cocoon in Alaska for a hot zone/inferno in South Dakota. It could be a game time decision.

Me telling Alvin to not embarrass me camping

Maybe some of this coupled with it being Alvin’s first overnight camp trip was on my mind when I had Alvin hooked around my waist and hiking up Point Hope. He’s been really good (mostly for maybe having no training in his life) but does pull sometimes. I was seated on the ground digging something out of my pack when he saw a puppy approach and he lunged for it. The belt had slid up above my hips and onto my stomach and so when he lunged, he performed the heimlich maneuver on me, which felt like getting the wind knocked out of me. And then just for good measure he did it two more times. And then I started crying, and it’s never about what you’re crying about–like when I bought the wrong size bed, it wasn’t about the bed it was about having a brain injury and dealing with that. It’s like all this uncertainty hit me and I couldn’t see how I was going to move forward.

Luckily Kevin un-clipped Alvin from me and took him to give me some space. Kind of reminded me of when your mom is on the verge of an emotional breakdown (as portrayed in TV shows) and your dad is like “okay kids, let’s go get some ice cream”. We made it to the summit without any other incidents and then Alvin took a nap.

Going down he was much better, probably from getting tired going up. We would alternate between jogging and hiking down with him.

We got back to camp and met our friends who also have a rescue husky. Talking to them made me feel a bit better as the owner told me she cried multiple times the first 6 months of having hers and now they take her biking, hiking, and running. Because the other dog was off-leash eventually we decided Alvin could go off too. In the moment of unclipping him from his tether saw the rest of my evening spent looking for him on the hillside. Fortunately, that did not manifest and he stuck close to us, the other dog, and the campsite. It was actually really fun to watch him play with the other dog and at some points it’s like he realized he was a dog. The other dog started digging a hole and then Alvin realized he too could dig a hole. Then came the moment of truth. Bedtime. Was Alvin going to hear a noise in the night and shred our newly acquired $25 craigslist tent (in case he did shred the shit out of it, would only be out $25….).

He was a champ and I’m not sure he moved positions the whole night, no holes in the tent, no holes in our sleeping pads. Here’s hoping I can train him to sleep more on my feet and keep them warm.

We packed up the next morning and shuttled Kevin for a pack rafting adventure. I walked around a bit with Alvin but mostly sat on the beach reading a book that had been on my list since September only pausing once to briefly entertain what my life would look like without the pandemic– no Alvin, more bike riding, I’d probably already be on my way to DC for the June 1 start so I could stop and ride my bike and see friends along the way. And yet, sitting on that beach felt completely normal.

We’re going backpacking again this weekend but combining the two last weekends into one: Backpacking with Alvin. Last weekend we just car camped with him, but will continue to haul that beef-cake of a tent around in the backpack just in case though.

Still trying to get that Patagonia sponsorship…

Creatures of Comfort

On April 25, 2020April 25, 2020 By kateginsbachIn Alaska, Global Health, Uncategorized2 Comments

Did you know that without any social distancing, one infected individual with COVID-19 can infect more than 400 people over the course of 30 days. With social distancing that amount can drop to only 15 people over the same amount of days. Going forward even after the initial peaks I think as one person put it, we will be in a “hammer and dance” situation where there is an ebb and flow of restrictions put in place as the virus continues to circulate, at least until we have an effective vaccine, prophylactic, or anti-viral therapy. Not to make this start super depressing but the fastest vaccine brought to market took 4 years, which was for mumps. I don’t think we will be in this hammer and dance situation for 4 years because so much money is in the pipeline for research and development at the moment but yeah…

Fashion and function–thanks Kathi Deane!

This week proved to be a little harder as our society’s response towards social distancing measures has become more divisive, which I will just leave it at that instead of going down a rabbit hole of rights vs. responsibilities of productive members of society, not to mention court cases that support strong public health measures. Might I suggest listening to the Hysteria podcast for those who want to think more about this.

Alaska still has a low case count and the Governor has started talking about a reopening plan. He has, however, seemed to defer much of the response to our Chief Medical Officer who I have now started calling, Patron Saint Zink of the COVID Response. It seems that the response will be science and case incident driven, as I saw the other day, “I would rather have to wait a few weeks to get my hair done at a barber shop, than have the mortician do it.” And yeah, there is no way the mortician would know my dye numbers so for the record my roots are a 5R and the rest is a 6R, and not too many people who can tame this mane soo…. let’s all keep our space for the sake of our future dye jobs so they don’t become die jobs. Be glad you aren’t in my head all the time…

My family keeps shaming my hair but nowhere to go soooo

It’s been interesting to see how time has slowed down and even though the days seem to blur together I feel like I have more time because it’s more intentional. Or at least that’s the narrative I’m telling myself, as this article points out, “we can’t control the virus, we can’t control the government, we can’t even control whether our faraway family members and friends stay safe and inside. But we can control our own individual existences by making them that much less complicated than an outside world that weren’t not even allowed to live in anymore.”

Instead of spending 90 minutes in the morning getting ready and driving to work, I wake up, drink some coffee, take Alvin for a leisurely 30-40 minute walk while catching up on podcasts.

Then I walk to the bedroom next door with my desk to begin my work day. I settle into a makeshift work routine. Most of my client’s have multiple risk factors for COVID-19 so navigating that space has been challenging, both in terms of getting them access to programs they are entitled to while also having zero in person contact with anyone. In a lot of ways Alaska was primed for a situation like this, because they are so rural most court systems have operated with telephonic and remote hearings for a while, even for us in Anchorage. Some challenges have been worked through like having video conferencing for will signings, while others remain like getting notaries for power of attorneys. But time remains an illusion and simultaneously it all seems like an emergency and it doesn’t. Some days I finish what needs to be done by 2 other days its past 5 but in a world where nowhere to rush off to, it seems so arbitrary.

Quarantine has certainly brought a lot of challenges and I’m grateful every day this lockdown did not happen in January. It’s also brought more time and space to communicate with one another. Reflecting on the past year I thought a lot about death, more specifically seeing death all the time made me think about if I had a choice how I would like to go. I’d want something that would give me time with my family and friends and left my mental capacity in tact. And I don’t want to make light of the people dying right now because it seems absolutely horrific; one of the most impactful moments of my life was being there when someone died and I can’t imagine those who are having to make the transition by themselves.

In a lot of ways it seems like quarantine is creating that space for more time. I now have a standing weekly FaceTime appointment with my immediate family, the kids, my college friends, and am in almost constant communication with my Notre Dame friends and high school friends. Before with the time zones was often difficult to find a time that worked for everyone. I’ve talked more to my aunts and uncles in this time than maybe the entire year before this happened. I know not everyone is this fortunate but in a lot ways it’s like time is being created to have more meaningful contact and communication (even though I realize very limited in-person contact is happening).

And with people having more time on their hands it’s almost like we’ve all had more time to reflect and reach out. Like my first boyfriend from high school sent me this really funny message about when he tried to walk me to my door but slipped on the ice– legit thought he was messaging me about wanting legal advice haha–don’t worry got his permission before posting:

“Hey Kate, Hope you’re doing well! Congratulations on your progressing your career! This is rather random but I wanna know if you remember a story that has been told by Eamin every chance he’s gotten since it happened back in 2006. That story being the time we were “going out” and I dropped you off at your house. I said I would walk you to your door and you told me that I didn’t need to. I disregarded your request, got out of my car, and tried to hurry around to catch up to you. Mind you the shoes I was wearing were completely bald, zero tread. Also it was winter. Anyway I plant my hand on the front corner of my grandma car (pretty sure thats what I was driving at the time? might have been the Intrepid) and am completely betrayed by the snow and my traction-less shoes. I fell so fast, I’m pretty sure I was on the ground before my hand actually made contact with the car. By the time I recover, you’re already at your door. I basically said, “welp see you later.” And drove off. Possibly the most defeated/embarrassed I’ve been in my entire life lol of course I told Eamin immediately. This comes up at least twice a year and puts us into fits of giggles.” So naturally I laughed super hard at this and then went down the rabbit hole with him of assessing our awkward interaction as 16 year-olds new to the dating scene.

I’ve had other messages pop up with friends about times in college, events that happened after, or even weird dreams people are experiencing. Even a friend dropping by and talking to them from the porch while they stood on the street seemed like such a treat.

And the feeling of isolation remains but only in a physical restriction and I keep going back to Marina Keegan’s writings, “It’s not quite love and it’s not quite community; it’s just this feeling that there are people, an abundance of people, who are in this together. Who are on your team.” How we emerge from this is still unknown but I remain optimistic that we will sculpt our future in a way that is more just and equitable for everyone– we should not be satisfied with the systems returning to normal, we should demand more. “You’re probably not spending the evening hours putting the final touches on embroidered pillow-covering when you’re worried about feeding your family, and you can’t curl up by the fire with a dusty old book when you don’t have a house, let alone a fireplace. You definitely can’t do it if you’re on a ventilator.” Molly Roberts.

We are able to give up comforts only if we have those comforts to begin with. This statement isn’t meant to shame anyone for doing things that they are now doing or not doing– and how they are dealing with the pandemic. More of an observation, like if my biggest inconvenience at the moment is only going to the grocery store 1-2 times every two weeks, then after this is over I hope we all work to ensure everyone has those same levels of comfort and security moving forward. After the 2008 economic recession it seemed the people turned inwards out of a fear based response that their securities were no longer secure, understandably so. Right now there is a lot of fear and uncertainty and hopefully moving forward we will not forget that we are all on the same team.

In case you clicked on this after seeing the imagine thinking it would be more photos of Alvin, sorry to disappoint. I’m going camping this weekend so at least will have something else to talk about next time.

Weird Times

On April 17, 2020 By kateginsbachIn Alaska, Global Health, skiing, Uncategorized, XC SkiingLeave a comment

I’m not even sure how to start this post– honestly most days being in Alaska feels like I’m perched somewhere just watching the world burn. I’m grateful for the response that Anchorage’s Mayor took early on and Alaska as a state, our case increase has been a slow uptick, still under 300 and only a handful of deaths.

But we only have 880,000 people….cool, cool, cool.

Meanwhile, my parents in South Dakota still have no lockdown orders mandated state-wide. Some cities and counties are doing their part but most were slow to react and not everyone has an order. I’m proud of my parents for taking it seriously, finally got my dad to stop going to the jail (I wrote a motion on why inmate’s should be released– proud prosecutor’s daughter ha). Unfortunately, I also wrote a paper last year that focused on contrasting my community with another community which means I know there are 3,570 residents, 290 people (before COVID and people losing their jobs) without health insurance; 847 individuals have one or more disability and just over 1,000 individuals are over the age of 65. I know that our hospital has 25 beds and 2 ventilators. And I’m well over 3,000 miles away but even if I was closer, I know that if someone I love goes into the hospital I can’t go with them. And it’s terrifying because it’s like a ticking time bomb and we won’t know the extent of the damage for months to come.

Love the community that raised us– and yes after this is over I might be blonde again…

Beyond my family I think about the community that raised me, growing up in a small town (the same one as my mother) means that everyone knows everyone, so I think of my teachers, most of who are retired now, I think of my friends who work in the hospital, I think of the restaurateurs, the grocers, the ranchers, the funeral director, those in the assisted living facilities who became like second-grandmas.

Dug through some photos so needed to post more than one

I think of this virus and the response and I’m not sure I will ever forgive those in power who passively have let the virus wash over our communities. With recent cases, Sioux Falls just surged ahead of Chicago and Seattle with a higher per capita infection rate at 182.25 per 100,000 people [When I started this draft, SD had just over 600 cases, it’s now over 1,300 in the 2 days since…]. But I also know not every worse case scenario that is portrayed in the news is going to come true– but hard sometimes for my mind not to go there.

Did I need to find something to take my mind off of all of this, oh you betcha. Usually around this time I start training for the upcoming season but with COVID and most races getting pushed back haven’t felt the need to really jump into training–fortunately I planned on this year being most developmental and focusing on the Maah Daah Hey but now not wanting to suppress my immune system (check out this article my Godfather sent me about training loads during this time) and/or train for things that might not materialize means I’m actually in a pretty good mental state around bike racing right now (heyyyo, shout out to my law school therapist).

With physical activity focused less on gaining fitness and more on mental clarity, I decided to start cross-stitching again, it’s repetitive and I have to focus somewhat otherwise I tend to stab myself, perfect. I collected all my things and was engaged in a ‘this color or that color’ when my phone rang. “Hi, we have a dog that we think would be perfect for you.” As like most things in life until that moment I had forgotten that I put in an application for a foster dog. “He’s 6, we just got him in, he’s real sweet.” “Ummm, okay when do you need me to pick him up by.” “Can you get him before 3 today.” They texted me a few pictures and I confirmed with my roommates that they were okay with having a dog in the space. Alright, let’s do this.

I put an application in when I started working from home figuring it would be a good idea to take my mind off of everything– they said that they didn’t have any dogs at the moment so I mostly forgot about it until they called. I picked the dog up, he didn’t have a name, and they handed everything over to me, leash, food, poop bags, crate, and blankets. I got him home and unloaded all his things and took him for a walk. I had planned to go cross-country skiing with a friend later and one of my roommates said she would watch him so I could leave him out while I was gone. Perfect. I grabbed my gear and opened the door to leave when he squeezed by my legs–it took me a minute to realize what was happening, with Tenzen he’s allowed in the front yard because he stays there, when I realized this dog was not Tenzen I tried to grab him but he eluded my clutches and took off. I threw my ski boots down and took off sprinting behind him. I didn’t even have a name for him so couldn’t even yell anything. This dog is going to be gone and I’m going to have to tell these people, I’ve already failed. I kept sprinting with my heart rate not getting that high since cross nationals. Luckily the street he had turned down had a large fence at the end of the lane. He ran there and then kind of jogged around. I slowly approached without trying to spook him. Luckily, like most days, I had some jelly beans in my pocket so dug a few out and stuck them out to entice him to get close enough to grab his collar. Well my plan worked; in the 5 minutes I was sprinting after him I didn’t think once about the virus.

I had been mulling over a few names, I’ve had a few dog names in my mind for a while but only fostering him didn’t want to give him one of those. Upon catching him and bringing him back settled on the name Alvin. After Alvin McDonald, an early cave explorer in the Black Hills.

Since then we’ve settled into a routine of 3-4 walks during the day, which means I’ve reduced my running because I don’t want to leave him but have gained leisurely paced strolls with the occasional abrupt jerk when he pulls. It’s given me a reason to finally catch up on those podcast recommendations or call my family. After a week of feeding him several large heaps of dog food a day to get his weight up figured we were ready to try a short run. Run is a loosely applied term for what we did. It started off promising but with him being more interested in smelling things and I realizing he only has one speed (a bit too fast for walking sometimes, a bit too slow for running). We settled into some weird shuffle of 2.5 miles in 40 minutes.

I’ve worked him up to accepting treats, and now we’re starting to broach commands [although my Dad has pointed out, he has me trained], although I’m not even sure he even recognizes his name at this point. The first weekend I had him I left him at home for the adventures, still unsure of his capabilities. One day I did a very mellow alpine touring ski which required some stream crossing and bush whacking, only to get within range of the summit and have it disappear.

Not wanting to loose ourselves in the abyss we turned around and followed our tracks down where the clouds dissipated and the sun seemed like it had always been there. Going down felt euphoric, as my skis seemed to float underneath me.

To avoid the stream crossing we did earlier we ended up skinning up and thought we had found a good place to cross the gully but after getting to the other side realized it wasn’t a good exit. We ended up skinning a bit up in the terrain trap, which just means that if an avalanche were to happen that’s where it would likely go. Obviously we assessed the risk, extremely low, but if something did get triggered it would be less than ideal. Basically we were kind of like sitting ducks and at mercy of others actions– and again thought about the virus because feel to some extent we’re all just sitting ducks waiting, feeling trapped at what might be headed towards us but unlike the current pandemic we were able to get out of the gully and to the other side quite quickly.

We then pitched our angle uphill a bit more so we could then gain enough speed to make it back to the car without having to put our skins on. I felt so bad about leaving Alvin at home for a few hours that I think I took him on close to a 90 minute walk that night.

I’m sure he must just stare out the window like this when I leave him.

The next day I did a shorter cross-country ski but again left Alvin at home. We ended up on the other side of the valley but the snow was a little more crusty.

We had less of a finish in mind and more of a let’s see where this takes us approach. We skied for a bit, took our skis off, and hiked for a bit, and then had some lunch, deciding it was a good spot to turn around.

I’m not sure how much was the crust and how much was the champagne (I mean life is short, right) I drank for lunch that resulted in more than a few face plants. We skied down and stayed off the main trail to avoid as many people as possible.

The second week with Alvin I settled more into a routine, recognizing his favorite spots to poop and when he’s most likely to go. He started sleeping out of the crate and after the first night gave him multiple pillows off my bed to accommodate him. Was grateful when a friend offered one of her dog beds up– now those floor pillows have just become his second bed….

He hasn’t had any real accidents in the house, other than peeing on my bike attached to the trainer. He wasn’t a fan of it to start with but then really showed his feelings during that moment. I was yelling at him to stop and he didn’t even flinch, didn’t break eye contact just kept going. He’s more tolerating of my trainer rides now but not sure I’ll ever get him close enough to a bike to be a proper trail dog.

This past weekend I took him on his first hike, but not before heading out on my own the day before. I headed up Wolverine Peak, which was 9 miles and definitely not one for the dog at the moment. It was pretty steep uphill with some icy spots that made me grateful I bought shoes with spikes in them last fall even though I thought it would be an overkill (lover of treadmills and trainers). The trail head had the most people which again for Alaska I guess is crowded but compared to most other places it was like 6-10 people and we were mostly able to avoid people and pull our masks over our faces. The trail traffic was a minimum and the view from the top was well worth taking in.

On the way down we stepped off the trail to give distance to older guys who jokingly covered their faces and said they had the virus yesterday and were better now. I responded a bit snarky to some effect saying, “you think this is a joke but people are dying.” I really wanted to follow-up with and ‘you’re more likely to die than I am’ but left it at that and instead of getting back on the main trail, bush whacked a bit to get down into a gully that would avoid more people. Everyone else seemed conscious of maintaining distance and trying to minimize any potential spread.

For Easter planned on doing an early morning hike (kind of like a sunrise service) with Alvin to see how he would do but upon waking couldn’t see the mountains so opted for a later departure date and a trail closer to the water and out of the mountains. Alvin is pretty great on the leash and just likes to stop and smell and mark most things–at least on the way out. We hiked about 2 miles out to a vantage point to take pictures of the good boy before turning around.

On the way back he was less interested in smelling things and oscillated between wanting to sprint and dilly-dallying down the trail. He did quite well, given my history with Tenzen was more than prepared to have to carry him for some of it. He also did well around other dogs, he seems to be mostly curious and not aggressive in anyway. I’m not sure he’ll ever be an off the dog leash, for one he still does not recognize his name, and two I’m not sure he would ever come back.

I’m now on my fifth week of work from home, which means I finally gave in and assembled my desk and office chair. At this point my contract ends mid-September and honestly not sure I will be back in the hospital before then. Mentally preparing for a marathon but hoping for a sprint….

I remain grateful that my life continues to have some semblance of normalcy (definitely recognize the privilege that comes with all of that) as my heart aches for all of those who have had massive shifts in their lives and livelihoods as a result. Again, if you are thinking we need to open up the economy and don’t understand why we aren’t, call your representatives and demand massive testing for COVID and for the anti-bodies. Testing and contact tracing is our best bet at the moment (until there is a vaccine) while continuing to socially isolate. Just because our government is incompetent doesn’t mean you need to be (looking at you, South Dakota).

The Abyss

On March 28, 2020March 28, 2020 By kateginsbachIn Alaska, Global Health, skiingLeave a comment

Last weekend seemed like an indulgent, illicit activity and now a lifetime away. Many people are finding themselves in spaces that don’t allow for them to escape for empty trails (looking at you, CO) and fresh air all while being able to maintain 6 feet of distance apart. I was finding myself with feelings of isolation in Alaska this winter and have found that this might be as good of place as any to weather out the impending storm. As COVID-19 cases have slowly uptick in Anchorage I’m now trying to consciously recreate in a way that would reduce the need for me to access healthcare services or require a backcountry rescue so will in all likelihood find myself on the local trails for the impending future–but fortunate enough to squeak one more weekend in.

We headed out to another glacier, this one was 20 miles one way–the plan being we’d ski out, set up camp, ski back the next day. I did 20 miles total the weekend before but my biggest fault when it comes to mileage is I still operate in cycling miles, 20 miles, psh ain’t no thang. Little different when cross-country skiing and having 30-40 pounds on your back (realistically probably 20 since I didn’t pack my industrial strength hairdryer this time– and if you don’t get that reference guess we know what you’ll be doing in quarantine).

While we escaped from the constant news updates and feelings of impending doom it was hard to completely turn my mind off from the virus. I would float in and out of scenarios and do comparative analyses to past pandemics and outbreaks (fun fact my favorite pandemic to study is the 1918 flu (you never forget your first) but my favorite disease is tuberculosis). I worried about being out of service for 48 hours and the potential notifications that might be awaiting my arrival. I also thought about if we should even be out there– there is a lot of discussion right now about if people should be partaking in these activities (yes, no, responsibly…I’ll default to my favorite lawyer answer, “it depends” (not legal advice).

The first day called for cooler temps than last weekend and snow. Okay going to get my winter camping badge for real this weekend. We drove 2 hours out of Anchorage and pulled off on the side of the road. I know the saying, “be bold, start cold” but I’m always convinced I will stay cold and never get warm so I bundled on layers with the thought I would take them off as needed. I was told that it was a river bed of flatness out to a glacier so was slightly surprised when we started on a slight downhill, followed by a pretty steep uphill, some more downhill, and some fresh tracks. Stopping to go pee I mused that I’d probably just leave my skis on so I don’t sink in the snow to which there was thunderous chorus that exclaimed of course I should keep my skis on just try not to pee on the bindings (still so much to learn). We descended down for about four more miles before the reaching the river bed.

With the clouds still surrounding us we just began skiing towards this white abyss. And in a lot of ways the physical landscaped matched my internal feelings about the pandemic. Right now we can’t see what we’re working towards (all these measures social distancing, quarantine, isolation against an invisible enemy) we have projections of what will happen if it works and if it doesn’t work but we’re in this abyss right now where we have pushed off from one side and have yet to see a safe landing. And yet we kept moving, I would repeat the mantra in my head, “kick, glide, feel the rhythm, feel the ride” (and if you don’t get that reference also prime quarantine opportunity). We would stop and change layers as needed–adding, removing, snacking. Talking about what the view would have given us without the clouds. On an exposed section the wind had picked up and the soft, fleeting snow had turned into fierce pieces of ice striking my face, it reminded me of acupuncture needles and just imagined I was getting a free facial –one guy talked about doing 100 mile ski race (yeah, read that again) and how it was like this the whole way and at one point he remembered thinking he just wished the snow would stop hitting him in the face. We only dealt with it for maybe 15-20 minutes but imagine I would have different thoughts if it was 100 miles…

After skiing for 19 miles with about 6 hours of moving time we talked about setting up camp, we were within range of the glacier (maybe depending on route beta) but could still be 2-3 miles away, it was getting late and dark and still a lot of things that need to be done to set up camp. We found a spot perched out of the riverbed and got to work. I dug out a hole to put the tent in, which at least helped to warm me up, while one of the other guys started the stove to melt snow and boil water for our bottles and dinner.

We got it accomplished and set up without too many mishaps– and even dug out some more snow for cooking and eating.

Even adding on another area for a firepit (as one of the guys packed firewood and we stacked it on shovel to get it going). It was nice to warm up next to and abate my shivering if only for intermittent moments.

After we had gone through all the wood we headed to bed. At this point I took off my damp ski boots, put on wool socks and down slippers, and got into dry clothes which helped to really warm me up (the -20 degree bag also does wonders). I still slept with a puffy vest, jacket and a hat on. I even figured out how to work the sleeping bag this time and only woke up once with a cold face.

Before going to sleep one of the guys thought about checking the weather for the morning, I lamented, that it doesn’t matter what the weather is going to be we have to face whatever shows up so we can just not check and pretend it will be nice. Which again took me back to the pandemic as we don’t know what tomorrow will bring but we’re in it and regardless will have to wake up and face whatever shows up overnight. Luckily, the morning did not disappoint. I stepped out of the tent and was greeted by calm skies and the sun starting to creep over the horizon releasing a nice alpenglow that quickly bathed the valley in sunlight.

We made breakfast, packed up camp, leaving our bags and gear to ski over to the glacier. It was alluring but in a more subdued enchantment than the previous weekend. It wasn’t piercing blue but rather dingy with intricate crystal lattices where water had frozen onto the surface.

We skied around for a bit, I learned that you should just follow in the previous tracks and not put in your own tracks on a glacier–not because anything bad happened, it was just pointed out to me as I was frolicking around.

Here’s me in multiple puffy layers…frolicking

We headed back to our camp spot to pick up our things and I took off about three layers on the top and bottom. We started making our way back along the trail we came in on. The views were pretty spectacular so occasionally I would just stop to turn and take it in.

Skiing out was pretty uneventful, minus the view. I found myself more hungry than the day before and slowly made my way through all my snacks (and a few emergency ones-which made me a little nervous but never got to my emergency, emergency sour patch kid provisions so).

All those downhills became uphills in the later part of our day but saw it as an opportunity to try to get better at going uphill (spoiler alert, I did not) but at least it gave my legs a different position to be in for a while. We crested the last hill and could see the road off in the distance but there remained a false flat to get up to the car. I started on the slight incline that would lead up to the car but had no concept of how long or the distance it would be so pulled out another emergency provision when I saw the snow pile the car was situated behind and put the morsel back in my jacket for another time (because I had left a bag of Hippeas in the car as a post-ski snack, also learned that trick the week before).

We got to the car and my boots were frozen to my bindings so took the whole contraption off. Then got in and ate a bunch of Hippeas.

Putting the fun between the legs (mostly a cycling joke)

The whole time I kept making comparisons to being in the backcountry with the pandemic– feel free to keep reading but stop if this will contribute to your anxiety. I’ll also put some good websites that I follow you can check out at the end.

Have a good leader: Going into the backcountry requires you to be putting your life in others’ hands if something happens. Our trip leader sent out a map, route guidance, and information on what to anticipate and expect. Right now I feel that most administrations are operating out of fear/unknown/uncertainty/poor planning and actively triaging while not doing anything to assuage the public’s anxiety about what we’re facing (don’t believe me, remember the 2009 pandemic, how long were you stuck in your house for that one?).
Only take what you need: skiing 20 miles with a pack means making the conscious effort to really decide if you need an article of clothing or piece of gear. This is also relevant now with people buying insane amounts of toilet paper and hand sanitizer (pro tip: hand soap is better).
But be prepared: It means I carried 4 pairs of socks, extra food, and multiple different layers to meet the potential challenges. Social distancing means reducing your interactions so be prepared to last a week between grocery store runs.
Don’t be a dick: You’re in the backcountry with a long ski out, if you’re attitude goes south it’s going to impact everyone. Again, turn you speakers off at 11:30pm when ya know your next door neighbor has a small child and is also stuck at home all day.
Communicate effectively: Talking about when to eat lunch, letting them know if you’re stopping to change layers or to take a rest. Giving others in the group time to anticipate (I usually announce that I’ll be peeing in 20-30 minutes to get everyone on the same page). Right now we don’t have one unified voice giving us direct messages (thank you federalism for reserving public health powers to the states; apparently the founding fathers did not know how viruses work and that they don’t respect boundaries). During Ebola the US had a Czar (what an amazing job title) right now you have the President saying one thing, State Governors enacting various orders, and Dr. Fauci trying to get a clear and accurate message out, but not one unified message telling you that this is going to be a long haul– are we up to the challenge yes, because we are responding by taking x,y,z steps and this is what the next few weeks/months are going to look like.
Look out for one another: Checking in to make sure everyone is still feeling okay, do we need a break, how about some candy, how are people’s feet. When you’re in the backcountry you’re only as strong as your weakest member (i.e., me– also thank you to all my high school coaches who loved that saying and would occasionally linger their gaze a little too long on me when I had a lackluster performance.) For a pandemic, we’re only as strong as our most vulnerable, our most uninsured, our most elderly. Which means being willing to step up and take care of each other now- the cost of treatment of COVID-19 is estimated to be ~$34,000. Imagine not having insurance, are you going to go to the hospital unless it gets really bad and how many potential people will you be in contact with before it gets to that point. Our institutions are being challenged, health isn’t just the absence of disease but all the social determinants that make it up (access to food, water, housing…) all these things that provide stability so people can seek healthcare. I also don’t think it should take a pandemic for us to realize how broke some of our systems are but that’s a whole another blog post/paper.
Don’t operate out of fear: Things can go wrong but staying calm and making decisions using logic will help you go a long way. My go to mantra for most things is: Facts over fear. The hysteria around contagious diseases is somewhat understandable; and only supports stronger legal regulations so that politicians cannot capitalize on this fear and uncertainty to gain political points. By enacting robust legal framework that safeguard civil liberties while taking into account an unprecedented necessity for quarantine we can avoid the mistakes of the past and abrogate the uncertainty of the future (lolz, this was a section from my conclusion on my paper on quarantine last year where I mostly argued that quarantine should only be used a tool of last resort because we have so many other provisions we can use to safeguard the health of the public– didn’t really factor into my analysis a 2 month lackluster response from the government for a contagious disease outbreak–jokes on me).

I remain angry at the situation because I don’t believe it needed to get to this point. China as the source of outbreak spent a lot of their time triaging and just trying to get ahead of it. They put other countries on notice and I believe our response is criminal because we had plenty of time to prepare and we squandered it away (it’s like getting a 30-day eviction notice and waiting till day 31 to take action). Lives will be lost because of the passive response our government (cutting funding to the CDC, designing their own test, not adequately providing healthworkers with protective equipment) has taken. I remain hopeful that communities are up to the challenge, we are up to the challenge, and just like the storm moving out and the blue sky shinning the next day, we will emerge from this cloud. Research actually shows that when disasters strike people become more pro-social, they cooperate and support each other, they’re better than ever. This storm isn’t going to blow over overnight and we won’t get through it quickly (Easter is highly aspirational– and without more tests to know what we’re really up against, highly unlikely) it definitely won’t be today, not this week, unlikely this month, maybe May we’ll take a breath and reassess. What I’m saying is it’s going to be a long haul at this point and things will probably get worse before they get better but we need to stay strong and do our part– oh yeah and call your congressional reps and demand mandatory testing and while you’re at it suggest that they commandeer private companies to start making PPE, ventilators, and getting respiratory therapists trained (grateful to the companies that have shifted their focus already–but the government should respond like a war effort, this is a war we are waging). Yah know, I love a good government overreach. But really if you think the free market will save us now, there has been a post circulating showing that Tuberculosis remains the number one killer in the world as if that means we should not be taking action with COVID-19. This actually shows why we need a strong government response. Antibiotics have existed for TB for nearly 70 years and yet it remains endemic in parts of the US (no, really, think about the last person you knew with TB in the US and now realize it’s still around circulating in communities– not your community? Maybe ask yourself why that is–happy to pass along a paper). Oh yeah and also tell them that the vaccine and treatment should be covered by federal funding. As much as it’s easy to get consumed with the negative I remain optimistic that this will shift our societal norms for the better. That doesn’t mean I don’t fluctuate between wondering if the tightness in my chest is anxiety or the virus–daily temperature checks and yoga to help assuage my fears. If you feel like this paragraph sounds exasperated with tones of eternally optimistic well welcome to the inside of my brain at the moment.

Unlike the 1918 Flu, I hope that when this is over we will not look backward and inward with fear and shame of our response. COVID-19 has exposed massive fault lines in domestic and global institutions but I remain hopeful that we will come out on the other side willing and ready to work towards a more perfect world. But as my brother would say, ‘hope springs eternal‘ with me.

I feel like I should apologize for how sassy this comes off as but I’m not going to because I don’t like having to counsel young parents who are in high risk categories of what documentation should be in place for their children because they have been informed by their physicians if they catch COVID they will likely die.

For your reading pleasure:

Duck of Minerva– Mostly focused on global politics but all the articles as of recent are focused on COVID-19 responses.

The Washington Post Monkey Cage– Also another political science based platform but mostly for domestic politics.

New England Journal of Medicine: Mostly focused on COVID-19 related science, stats.

And if you’ve made it this far here are some things I’ve combat my anxiety:

Down Dog: Free yoga!

These articles sent by my friend, Vega: The Science of Well-Being and one on the grief you’re feeling. She also shared a host of wellness tips, I won’t put them all here but my favorite was: Remind yourself daily that this is temporary. It seems while we are in the thick of it, it will never end. It is unsettling to think of the road stretching ahead of us. Just remember we will return to feeling free, safe, busy, and connected in the months ahead. You can find more of her stuff, here.

If you’ve made it this far, congratulations, take a breath and remember those blue skies will be back.

Kate Ginsbach

Tag: Pandemic

The Law of Nature

Keep Moving

The Abyss