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The Month of "Re"


Dear Everyone:


I would like to formally declare June The Month of Re


There are lots of Re words floating around out there right now


ReEntry

ReTurn

ReEngage

ReNew

ReBuild

ReFrame

ReImagine


All this Re-ing is very exciting: Family! Friends! Summer sports! Restaurants! Travel!


I’m also noticing a lot of folks – particularly those who were genuinely committed to keeping others safe over the last year – struggling a bit. In addition to excitement, Re is also conjuring some fear and uncertainty.


In fairness, it IS a bit whiplashy and disorienting. And it ReMinded (even money says I beat this idea to death) me that we're due a COVID update.


~~



...I think everyone will be wearing masks in the future.

In April 2020, I wrote a Princess Bride Q&A based on what we knew about the benefits of mask-wearing.


At the time, there was still tremendous uncertainty about the novel coronavirus, how infectious it might be, the vectors of transmission, and the associated morbidity and mortality. We had no effective treatment, cure, or vaccine. The medical community was scrambling, public health officials had just realized the U.S. no longer had a federal pandemic response team (it was dismantled in 2018), and state governments were in a cage fight with each other, scrapping to secure desperately needed PPE, ventilators, and equipment.


We shut down to protect each other. We masked up to protect each other. We closed schools and adjusted to remote work and school to protect each other.


And (much more slowly that laypeople would like, and much more quickly than scientists could have previously imagined) we gathered and disseminated data. The internet was a crowdsourcing and crowdsharing bonanza for physician groups, nurse groups, epidemiologists, public health professionals, and other health care frontliners. We became confident about transmission modality (no more wiping down groceries!) relative risk (outside is safe!) and identified higher risk populations. We got better with testing and treatment. We learned how to mitigate and balance risk.


Nine months later, my husband was getting his first dose of the Pfizer vaccine. A month after that, I received my first Moderna. And 15 months after the first cases of Covid19 were reported in the U.S., there are now THREE highly effective, extremely safe vaccines widely available in every state. A growing number of areas have surpassed the critical threshold for herd immunity, and in most places in the United States, anyone who wishes to be vaccinated has opportunity to do so.


Rising vaccination rates and availability coupled with a steady decline in new COVID cases in the U.S. (33,000/day as of this writing, down from 240,000 daily cases after the winter holidays) led the CDC to revise and update its masking guidelines.


Fully vaccinated individuals can now move confidently in and through most situations without a mask.


Science is amazing.


~~


If you’re going to hold liminal space, brace yourself for the primal scream.

H. Plett


Liminality is the ambiguity or disorientation that occurs in the middle stage of a rite of passage. It is a threshold; the point of transition away from what WAS, but not yet fully into what will be. This is the space we currently occupy.


I recently wrote a blog touching on three important ideas: 1) We have all just lived through a period of unrelenting toxic stress; 2) Trauma primes us for additional trauma reactions; 3) Not Everything Is A Face-Eating Bear.


We spent 15 months scrambling to protect ourselves, our families and each other from a virus that has, to date, killed nearly 600,000 Americans. Uncertainty drove ambiguity in public health messaging, and the entire pandemic was politicized in ways that further harmed everyone.


Because we knew that masking was the most effective way to reduce rates of transmission and protect each other, refusal to mask came to be viewed as threatening.


Small wonder, then, if it doesn’t feel safe to unmask.


And yes, if you’re fully vaccinated, it really is safe.


The new masking guidelines are based on 4 main findings:


  1. Covid rates have plummeted, nationally.

  2. Vaccinated people are not catching Covid very often, rarely end up hospitalized when they do, and almost never die.

  3. Vaccinated people are very low-risk for transmitting Covid.

  4. Unvaccinated kids are lower risk for serious illness, and don’t appear to transmit Covid as frequently or easily as originally thought.


AND, if fully-vaccinated-you still struggles with feeling safe, you are normal. This is expected. It will get better with time.


~~


The takeaway?


First, get vaccinated. These vaccines are safe, effective, and are out-performing our hopes in providing long-lasting immunity and transmission reduction. The Pfizer vaccine has now been approved for anyone 12y+, and approval for the younger crowd should come, soon (great news for those of us planning for fully reopened schools in the fall!)


Then, be patient with your process. Can you “know” that every unmasked person you encounter is also fully vaccinated? No. However, rates are currently so low that the odds of encountering someone who is unvaccinated AND infected is dropping every day.


Furthermore, if you are fully vaccinated, the odds of contracting COVID from an encounter with an unvaccinated, infected individual drop even further.


Finally, even if you DO happen to encounter, swap secretions with, and become one of the VERY few fully vaccinated individuals who becomes infected, rest assured the vaccine STILL protects you against significant illness, hospitalization, and death.


Vaccines have effectively transformed Face-Eating Bear into Cute Chipmunk.


Science says, “You’re welcome.”


~~


Look, it still may take a while for our threat detection systems to downregulate. Be patient with the process - and with each other, too. Risk-tolerance varies, as do our lived experiences.


It was an extraordinarily difficult year, and the very best thing we can do now is practice holding this liminal space with kindness and understanding. Curiosity is a superpower, and assumptions can be weapons.


We have opportunity for growth and healing beyond the harm. As we ReStore and ReBuild, we also have opportunity to ReImagine. If we’re willing to learn from each other, and to allow the conversion of our wounded places to sources of wisdom, we can build something better.

We can BE better.


~~


Summer is here and school is out.


Make space for Joy.


Take time for Rest.


Play. Laugh. Connect.


Listen.


Heal.


And, of course, Hydrate.


More soon,


Dr. K




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