When I grew up, of course we were all in the Children’s Choir at church, and every school grade had its own choir every year to perform at the school Christmas concert. Its how I learned all my carols and Christmas songs
Of course its been years now since I was in a choir, but I do remember once, about 40 years ago, when I participated with hundreds of others in a Sing-Along Messiah at the McPherson Playhouse in Victoria —  what a great experience that was.
Now we are finding out that the recent COVID research says choirs are a prime mode of virus transmission:

It may be the single most famous outbreak in the U.S.: the Skagit County, Wash., choir practice.
Last week, the Centers for Disease Control and Prevention compiled the results of its contact tracing. The choir met every Tuesday evening until March 10. At that last meeting, 61 members were present and chairs were arranged close together in six rows of 20 with many empty chairs. They practiced for 40 minutes together, for 50 minutes separated into two smaller groups, and then for 45 minutes sang together again. There was a 15-minute break between the second and third session for oranges and cookies, but many didn’t eat.  No one reported physical contact between members and most everyone left immediately after practice. Hand sanitizer was distributed. But, in the end, 53 of the 61 contracted the coronavirus. Three were hospitalized, two died.
This seems to happen repeatedly. The Amsterdam Mixed Choir gave a performance March 8; 102 out of 130 singers tested positive. Fifty members of the Berlin Cathedral Choir tested positive as well.

I’ll bet it has something to do with the act of singing – maybe the forceful expelling of breath from deep in the lungs spreads the virus droplets further. Who knows? 
Whatever the reason, I think singing together in public is likely not going to be happening anymore, not until a vaccine is available.
So I guess there are going to be no more Choir!Choir!Choir! experiences:

This may be the way choirs will sing together now:

Even the Mormon Tabernacle Choir did an online Sing-Along Messiah this Easter.
But for one last time, here’s the real thing:

Angeline Bernadel, LPN at West River Healthcare in Milford, died of COVID19 on April 4th, 2020, may her memory be a blessing

Achal Prabhala and Ellen ‘t Hoen, in The Guardian, on our eventual COVID19 treatment and cure and its inevitable control by the pharmaceutical industry.

James Hamblin, in The Atlantic, on why some people with COVID19 get so much sicker than others. 

Ari Feldman, in The Forward, on how Orthodox Jews are flocking by the thousands to donate convalescent plasma in the fight against COVID19.

Tomas Pueyo, in Medium, on what the world has taught us the dance must look like if we want to open things up. 

Tomas Pueyo, in Medium, on the COVID19 dance steps that you yourself might be able to take.

Maryn McKenna, in Wired, on the risk that COVID19 will worsen the existing crisis of antibiotic resistance. 

Colleen Farrell, in The New York Times, on what to say and not say to those working COVID19’s frontlines.

       

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Joe Biden could stand in the middle of 5th Avenue and shoot Donald Trump and I would still vote for him

— doug wiser (@MyBigRedTruck) April 18, 2020

Dr. Huy-Hao Dao, 44,,who worked at Quebec’s Montérégie-Centre Integrated Health and Social Services Centre in Longueuil and sadly the first Canadian physician to die of COVID19, may his memory be a blessing.

Roxanne Khamsi, in Nature, on the incredible challenges we’ll face producing and distributing a SARS-CoV2 vaccine if/when we find one.

Michael Specter, in The New Yorker, with a profile of America’s real doctor – Anthony Fauci

Apoorva Mandavilli and Katie Thomas, in The New York Times, discuss what serology tests are, and whether they’ll help us all get back to work.

Ed Yong, in The Atlantic, on our pandemic summer and how the only way out is through.

Maggie Koerth, in FiveThirtyEight, on COVID’s destruction of our medical supply chains and how it’s not impossible the entire world’s supply of medical grade glass (used for vaccine vials for instance) has already been pre-purchased.

Terrie Laplante-Beauchamp, in the Globe and Mail, with her must-read 3 day diary of her experiences volunteering as an orderly in a Montreal based long-term care facility hit hard by COVID19.

       

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Denial. Anger. Bargaining. Depression. Acceptance.
These are the stages of grief and I’ve been through them all since the COVID19 lockdown began. I think everyone else has going through them too.

Denial – how can this be happening? WTF is this? Isn’t there some easier way?
Anger – don’t they realize what they are doing to us and to the economy? Its so terrible for so many people.
Bargaining – well, maybe it won’t last too long if everybody acts the right way.
Depression – how awful this is, and its going on FOREVER!!!
Acceptance – it is what it is. Nothing we can do except to get through it.

Though I must admit, I still feel anger:

What shocks me about #COVID19 is the economic disaster. I never realized we might have no way to control a disease except to close everything down, worldwide, and keep it closed for weeks or months. People starving, businesses bankrupt, economies ruined, lives devastated.

— Cathie from Canada 🇨🇦 (@CathieCanada) April 14, 2020

The economic hit from this is going to be so hard, and last so long, and hurt so many innocent blameless people.
But every time I start to feel sorry for myself and for all of us, I remember that whatever I am going through, it is nothing, absolutely nothing, compared to what others are dealing with.
I don’t think our society will ever be able to repay doctors and nurses for what they are doing for all of us, risking death every day to save as many as they can.
There was one tweet in particular, from a pediatric surgical fellow and single mother in New York, that made me just cry.

My babies are too young to read this now. And they’d barely recognize me in my gear. But if they lose me to COVID I want them to know Mommy tried really hard to do her job. #GetMePPE #NYC pic.twitter.com/OMew5G7mjK

— Cornelia Griggs (@CorneliaLG) March 29, 2020

I hope she will be OK.
I hope someday her children will be able to honour her for what she is doing.

Dr. Doug Bass, may his memory be a blessing, the first physician in NYC to die from COVID9

Sorry to those who enjoy these reads, but by accident, deleted the lot of them save one

Dhruv Khullar, in The New Yorker, on his work as a physician in NYC during the time of COVID19, and adrenaline, duty and fear.

       

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Here’s the tweet of the week month:

Arlene Reid, 51, mother of 5 and PSW in Ontario working in LTC, died from COVID19 on April 27th. May her memory be a blessing.

Gid MK, in Medium, with his meta-analysis of reported infection fatality rates for COVID19

Jeanne Lenzer and Shannon Brownlee, in Inside, on the out of control “science” of this pandemic.

Joss Fong, in Vox, with a great explainer on how to understand that graph of all the countries’ COVID cases you keep seeing. 

Ed Yong, in The Atlantic, with a spectacular guide on how to make sense of the all over the place that is COVID19.

Caitlin Flanagan, in The Atlantic, with the 2020 commencement speech you’re never hear (but you should so read).

       

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Are you an Ontario resident recently diagnosed with either type 2 diabetes or pre-diabetes where COVID19 has prevented you from receiving comprehensive support to help manage and understand your new condition? If so, my new venture may can help, and better still, for FREE. Built initially to support weight management, Constant Health, our new digital behavioural intervention, is being re-positioned to help people with newly diagnosed diabetes and pre-diabetes who in turn have been left stranded by COVID19.

Constant Health’s iOS app (note, this opportunity is currently only available for those with iPhones or iPads as the Android app is still in development), will provide you with 12 weeks of private and secure (PHIPA compliant) access to both a Mayo clinic certified health coach as well as a registered dietitian who together, by way of text messaging and video chats, will work collaboratively with you on your diet and lifestyle to help improve your blood sugar control and teach you about your new condition.

Constant Health’s technology includes a robust, open-ended collaborative goal setting engine, a built-in food diary, a searchable and filterable database of millions of the web’s most popular recipe sites, along with a proprietary real-time dashboard which will allow our team to applaud and encourage your success as well as to help troubleshoot your struggles.

As with my office’s practice (the Bariatric Medical Institute), Constant Health’s services aren’t limited to any particular dietary strategy, but instead work with you on whatever approach you feel would best suit your life and preferences. From low-fat, to keto, to vegan and everything in between Constant Health can help.

Rest assured, there are no strings whatsoever. Currently, thanks to an unrestricted grant from Novo Nordisk, we have a limited number of spots available to freely offer and plainly, we are not currently accepting paid patients. However due to provincial medical licensing regulations for both MDs and RDs, and the need for physician screening, we can currently only extend this offer to Ontarians.

If you’re interested, live in Ontario, and have an iPhone, simply fill out this quick survey and if eligible, our office will contact you to book a consultation with me so that I can explore your medical history and have a peek at your lab results for us to mutually determine if the program is for you.

        

“We don’t know what the food-service sector will look like,” said Jaime Chamberlain, a fresh-produce importer based in Nogales, Arizona. When the pandemic largely shut down the US in mid-March, “I lost about 96 percent of my food-service contracts from one day to the next. That is an incredible hit to my business.”
Now, Chamberlain asks, “Are people going to go back to cruise lines? Will they go to a restaurant that seats 100 people? Will that restaurant be able to operate with the same amount of seating? Maybe there’ll be no more conventions for 1,000 people… I think people are going to be very reluctant.”
Burkett, speaking by phone from his Mississippi farm, shares those and other worries, and not just on his own account.“As a farmer, the dilemma I’ve got right now, is we don’t have a market. I’ve got crops going to be there to harvest, and I don’t know if we’ll have someone to sell to or not.” In a few weeks, Burkett said he will have more than 120,000 ears of sweet corn to harvest — all meant to go to restaurants that may or may not need them. “My biggest fear is the fear of how long this is going to last. I have to decide now what I’m going to plant in the fall. I’ve got to order seeds, get the ground ready,” Burkett said. He’s decided, for example, to go ahead and plant seedless watermelons, so they’ll be ready to sell this fall to the New Orleans school system — and he’ll have to hope the schools are open.

Canada is going to be having similar problems, because nobody knows what is going to happen.

Here are Obama’s two addresses tonight to the HBCU and high school 2020 graduating classes. 

Mary Agyeiwaa Agyapong, UK RN, 28 years old, died from COVID April 12th. May her memory be a blessing.

Peter Piot, one of the scientists who discovered Ebola, in Science, with his thoughts on COVID, both as an expert and as a survivor.

       

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Well, I think we have all realized now there is not going to be any “normal” anymore. 

Dr. Bredy Pierre-Louis, Family Physician, Brooklyn, Died From COVID19. May his memory be a blessing

Caitlin Flanagan, in The Atlantic, on having stage IV colon cancer during the time of COVID19 (if you only read one piece this week, make it this one)

Orac, in Respectful Insolence, discusses Plandemic.

Tomas Pueyo, in Medium, on testing and contact tracing.

Ed Yong, in The Atlantic, covers whether or not we should be currently worried about coronavirus mutations

       

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People in the United States are realizing that Trump and his administration have spent the last two months tweeting and twiddling their thumbs.

I wonder if John Lennon ever realized how prophetic his words would be:Nobody told me there’d be days like theseStrange days indeed.I never understood how a pandemic would destroy the world economy.  Millions of people out of work. Millions w…

You can follow Dr. Griggs on Twitter

Italian novelist, Francesca Melandri, in The Guardian, writes you a letter to you from Italy explaining what you’re about to be facing.

Stuart Richie, in Unherd, on why you might not want to trust psychologists on matters coronavirus

Ed Yong, in The Atlantic, with a characteristically great deep dive on whether or not we should all be wearing masks.

Harlan Krumholz, in The New York Times, needs you to know there are many false negative #COVID19 tests and why if you have symptoms, you should assume that’s what you’ve got.

J. Kenji López-Alt, in Serious Eats, with the definitive guide to food safety and the coronavirus (a must read if you watched that long, scary, YouTube video about same)

Mary Chris Jaklevic, in HealthNewsReview, explains why you need to consider stories detailing #COVID19 scientific studies with caution.

       

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The COVID-19 news is so depressing, beaten only by the economic news, which is absolutely awful. So here’s something a little more lighter-hearted, on a cold Friday. 

I was driving with my 13 year old daughter on Saturday and we were just chatting. I asked her what was trending these days on her TikTok stream (in the past she’d been served up antisemitism)? Apparently it’s fat shaming Lizzo.

I asked her to share some videos with me.

She sent over 10 in less than a minute.

Some representative examples to follow, but all this to say, TikTok, while hugely entertaining, is a cesspool of hate and bullying, and if your children use it, probably worth asking them every once in a while what’s trending on their streams so that you can take the time at least to talk about it.

@noahswitzer98

Everyone please ##stop making ##lizzo memes ##fyp

♬ original sound – noahswitzer98

@nickring4

When you lose Lizzo while your whale watching 😂 ##greenscreen ##lizzo ##meme ##xyzbca ##xyzcba ##joke ##fyp ##memes ##tiktokmemes ##comedy ##comedicgenius

♬ ITs ANIT new girlfriend of your ex – its_anit

@yaboyg35

##greenscreenvideo ##lizzo ##meme ##tacticalnuke ##mw2

♬ original sound – yaboyg35

       

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Elie Mysal, in The Nation, with the depressing truth behind why Elizabeth Warren won’t be America’s next president. 

Sharon Otterman, in The New York Times, with an absolutely shocking story of enabled antisemitism from New Jersey (and I don’t shock easily)

Derek Murphy, in Wired, on marathon cheaters and their investigators

[And if you don’t follow me on Twitter or Facebook, here’s the segment I did yesterday on CTV’s The Social where we chatted about many things COVID19 (if geoblocked outside of a Canada, a VPN spoofing a Canadian server ought to work]

       

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Waiting for any industry to self-regulate itself is just plain dumb. Honestly, industry’s job is to protect and promote sales, and that’s of course true for the food industry as well.

Self-regulation tends to crop up not out of altruism or doing the right thing, but rather as a means to forestall legislative regulatory efforts which in turn would prove to be more damaging to sales.

Take this recent initiative out of Australia which will see the food industry not advertising their junk to kids within 150m (500ft) of schools. 150 whole metres! While certainly not likely to do anything at all, it’ll be especially useless perhaps in that the school buses themselves will be exempt, as of course will be the bus stops’ shelters.

Oh, and as toothless as it is, it’s also voluntary.

Really the only thing this initiative will do is provide the food industry with ammunition if and when facing calls for legislated regulation (something we’re hearing more and more calls for) and to pretend that they care about anything other than profits.

It’s always best to remember, as I’ve written before, the food industry is neither friend, nor foe, nor partner.

       

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James Hamblin, in The Atlantic, on how yes, you’re probably going to get the coronavirus.

Peter Daszak, in The New York Times, welcomes you to the age of pandemics.

Vivian Wang, in The New York Times, with the bad good news that most coronavirus cases are likely to be mild.

Zeynep Tufekci, in Scientific American, on what you can do to prepare for when the coronavirus spreads to your country.

       

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The latest of many systematic reviews and meta-analyses of herbal supplements for weight loss plainly makes the case that there is no justification for their sale.

They. Don’t. Work.

None of them.

None. Of. Them.

So why does Health Canada license and allow the sale of 1,128 natural products whose listed purported use is for weight management? Or of the 671 products that purport they’ll improve sexual enhancement? Or of pretty much any of them?

Maybe the answer lies somewhere in the taxation of the $1.8 billion annual Canadian sales of vitamins and supplements?

Maybe it lies in well-intentioned hope?

Maybe it lies is political contributions and lobbying?

But the one place where it doesn’t lie is in science. Shouldn’t that be the only place that matters?

       

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Ethan Weiss, in STAT, with a personal essay about his daughter, albinism, CRISPR and ethics.

Jonathan Freedland, in The Guardian, with the last desperate warnings of Auschwitz’ few remaining survivors.

Olga Khazan, in The Atlantic, on what abortion will look like if it once again becomes illegal.

       

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Short post to say that watching people aggressively argue about their preferred diets of choice, and seeing reputable people willing to prop up the most shameless of medical hucksters if they happen to share a nutritional belief, and the endless debates about physiology, and meal timing, and breakfast, and fasting, and macronutrients, and lipids, and anti-science shilling, and multi-level marketing, and so much more, is so very tiresome.

As a clinician I know that what actually matters is how to help the person sitting in front of me, remembering that science, meal patterns, macronutrients, and physiology, may not always matter the way some study says they could or should in the face of an individual’s life and personal preferences. Ultimately, and regardless of what I think is “right” on paper or right for me, my job is to help patients make sustainable changes that in turn lead them towards the healthiest life that they can actually enjoy.

Similarly, as a public health advocate, I know that if there were any amount of education, or a brilliantly crafted public health message, that in turn would effectively drive societal behaviour change we’d have all already changed all of our behaviours. I can also tell you that energies spent on initiatives relegated to personal responsibility, including but not restricted to those promoting one person’s diet tribe, pale in importance to energies spent on initiatives relevant to changing the food environment. And there’s no shortage of targets that span all dietary dogmas – from advertising to kids, front-of-package health claim reforms, junk food fundraising, the provision of free cooking skills to kids and adults, national school food programs and improvements, tax incentives and disincentives, and more.

All this to say, it’s my opinion that these two flawed foci, that there’s one best or right way and that personal responsibility will be our salvation, are the two main reasons why we can’t have nice things in nutrition and nutrition related public health.

        

I have been away from the blogger writing for quite a time. I have been busy working to get well and after two years without being able to walk I am finally making progress. I was encouraged during the past couple of years to receive many contacts from…

This evening at the local Metro  I saw something resembling “panic buying”.  Not quite at that point. Nobody got violent.  More like the kind of lineups you see before the Superbowl or a long-weekend.  Except everyone, everyone, was…

I keep saving COVID-19 tweets and then before I can post anything, it all gets worse.  

Jennifer Yang, in The Toronto Star, speaks with 3 of Toronto’s health care heroes.

Adam Rogers, in Wired, explains what convalescent plasma is and how it might help treat COVID19.

Ed Yong, in The Atlantic, being Ed Yong and writing an incredible piece on how this pandemic might end.

David Enrich, Rachel Abrams and Steven Kurutz, in The New York Time, on the sewing army rising up to help.

Helen Branswell, in STAT, summarizing all the we’ve learned to date about the SARS-CoV2 virus.

Daniela J. Lamas, in The New York Times, writing as a critical care physician in Boston on the unfathomable reality she’s facing there.

Siddhartha Mukherjee, in The New Yorker, on how the coronavirus behaves inside of our bodies.

       

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Gretchen Reynolds, in The New York Times, answers questions as to the safety of exercising in the face of COVID-19

Cornelia Griggs, in The New York Times,  a critical care physician in New York, explains why she needs you to know that the sky is falling.

Yascha Mounk, in The Atlantic, tries to explain why people aren’t staying home despite incredible risks and ramifications of not doing so.

Ashleigh Tuite and David Fisman, in The Globe and Mail, both infectious disease epidemiologists, with their thoughts on how we might slow the burn of the COVID-19 forest fire.

Aaron E. Carroll and Ashish Jha, in The Atlantic, with their thoughts on how we can beat this coronavirus.

Pam Belluck, in The New York Times, needs you to know that though children uniformly have much milder cases of COVID-19 than adults, some will become seriously ill.

Manny Fernandez, in The New York Times, with a sobering read on how the coronavirus will impact the already impoverished.

       

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The year 2000 sure has been a wonderful this year. Whatever riled her up we will never know but  the daily events have been nothing less than specular. Record low temperatures and record high temperatures. Record snowfalls and record everything. I…

Things are awful and they’re going to get worse – the economy is going to tank, maybe worse than it did in 2008, and hundreds of thousands of people are going to lose their jobs. 

One’s a pandemic disaster, the other’s Iambic pentameter

— folb (@SleepingAnnual) March 14, 2020

7 views on why social distancing is so important right now and why we have to “cancel everything“. If you think that #COVID19 isn’t a big deal, do take the time to read these pieces to learn why you’re wrong (ordered solely by way of the order I happened to read them in).

Eliza Barclay and Dylan Scott, in Vox.

Tomas Pueyo in Medium

Yascha Monk, in The Atlantic

Helen Branswell, in STAT

André Picard, in The Globe and Mail

Sharon Kirkey in The National Post

Kaitlyn Tiffany in The Atlantic

Also, here’s Wency Leung, in The Globe and Mail, on what you should do if you think you have COVID19, and here is the Toronto Star’s infographic on what self-isolation should look like if it’s determined that you’ve contracted the virus.

Siouxsie Wiles and Toby Morris / CC BY-SA

       

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Visited The Elsy (LCBO) today.  I notice that while they’re knifing each other over toilet paper at the Walmart across the parking lot, here everything is calm.  People believe that Water and wipes are essential, booze some kind of peripheral…