Vaccination Variables

 It's time for me to weigh in on vaccination hesitancy.  

First disclaimers....   I have been researching risks and rewards of vaccination only recently and I am clearly not an epidemiologist  or  vaccination expert. I have a bias related to Jenna's diagnosis of Type 1 Diabetes (Jan 2019) directly after a bad reaction to a required flu shot (all nurses were encouraged/required to get a flu shot) in addition to the fact I have never had a flu shot myself. Also I tend to be the equivalent of a Christian Scientist that minimizes all drugs and chemicals in my body.  However I tend to have a philosophy of utilitarianism in evaluating cost/benefits in moral behavior.  I have had COVID-19 (a mild case 12/7/2020) and survived with proof of the antibodies in my blood.  I have not had any direct family members who have died as a result of COVID-19 (although you could say my Dad's passing might be indirectly related). I'm a rusty statistician and have strong opinions about proper statistical analysis, terms and protocol.  I have not received the vaccination and have purposely deferred the decision with the expectation (maybe misguided) that my antibodies give me the necessary protection short tern against reinfection with the variants.  

Now to the point -  I believe the "herd effect" promotion of vaccination is driving momentum to rush to judgement about it's efficacy.   The general population (including the media) misunderstanding of efficacy and effectiveness (along with the fear both serious illness and/or death) has driven the herd to rapidly jump to vaccination as the defacto solution to the pandemic.  Finally - as a rusty statistician - I am appalled by the data not being collected; the lack of control groups; and the rush to judgement on non peer reviewed, small sample size, laboratory based theories, that are being revealed as science proven population truths.  There are long term risks that we can't predict - unknown costs that only time will reveal. 

Weighing this viewpoint against the altruistic "duty" to others becomes the central emotional variable that divides the vaccinated from the unvaccinated (in addition to each individual's self fear of getting the virus).  It is that moral dilemma  that I have studied rigorously for the past 10 years.  My best recommendation is to read  "Justice - What's the Right Thing to Do" or listen to Sandel's Harvard Lectures.  

The press, government (CDC), and vaccinated group would aspire to the practical viewpoint that the few casualties associated with the vaccine over-ride the benefits for the entire population (while justifying that -as and example- the blood clots are not any more than what is experienced in the pre vaccination world).  This says a few deaths are worth "saving" the many.  Yet this same logic could be applied in the macro view - 570K deaths for the 330M affected by non medical interventions (economic shutdown; educational casualties; etc. etc.).  Using numbers (particularly percentages) and elapsed time are the fundamental ways to erroneously argue the philosophy. 

But numbers don't count in the emotional world of individual decision making.  Reason and logic will never trump the spirit and soul inside.  It takes a higher order of philosophy to determine the truth.  It takes looking into the heart to understand motive and action.   

"Inside the envelope of patience there are many letters of forgiveness."   Time is the currency of patience.  COVID has been with us well over 500 days and will likely be with us permanently.  There is much we don't know but we do not have to fear the unknown. 

  

 

Heaven Board #17 - Grandparent Club

Susan and I were just inducted into the Grandparent club.  God's gift to Jenna and Paul occurred at 6:28am EDT as Theodore Lee Robinson (8lbs 7oz and 21 inches) entered this world.  We are blessed that Jenna (with Paul) managed her T1D in such a successful pregnancy.   

The Rookie Grandparents are prevented from holding Theodore because of Hospital COVID-19 restrictions and we will await the discharge of Jenna and Theodore accompanied by driver and proud new father Paul.  

All the nests are prepared - nursery at two locations - parents and grandparents.   What a year of change with two Heaven Board entries!   

Plenty of room for more :)

Volatility in my Blood

For less than a month, I have been testing my blood glucose levels.  As an experiment to understand, in a small way, the intrusion of mandatory activities that a Type 1 Diabetic must perform, I decided to buy a glucose monitor (Accu Chek Aviva Plus) and the necessary strips, lancets, and control solution.  

Today's rude awakening of the cost of test strips occurred when I ran out this morning and drove immediately to Walgreens to buy another set of 50. I was not using any insurance card for this purchase.

The pharmacist rang up the ticket - $109.99.   I nearly fell over (my blood sugar must have dropped suddenly)  since I had spent only  $22.95 for my first set of 50 test strips from Amazon.com.  And I had another 50 test strips on order for $15.00    How could there be a variation of over 7 times the cost?

That led me to an internet search to understand Why Test Strips Cost so Much -  $2.20 a strip.  Should I be upset with "Big Pharma", insurance subsidies, or the drug retailers?   The marginal manufacturing cost is less than $0.15.  But the technology needed (R&D) and the quality necessary (and different by vendor) is evident in testing the various Pharmaceutical companies.  In fact, this research raised my awareness that not all strips read accurately, there is significant potential user misuse (wrong strips, expired strips, etc.) and recalibrating and checking your monitor and batch of strips is a necessary part of the process.  Even the need for  a backup monitor is a good idea.

Now that Jenna has a CGM (Continuous Glucose Monitor) from DexCom, we have found several times where it's accuracy does not match her stick glucose monitor.  As a Statistician this has heightened my awareness of the whole subject of false positive readings and variations.   When your monitor reads 100 -  that really means 80 - 120.  The FDA requires more precision at the lower level but: " For results below 75 mg/dl: 95% of test results must be within plus or minus 15 points of the actual blood glucose level. So a reading of 70 means 55 to 85."

So - there is much to learn in this world of Type 1 Diabetes - physical, emotional, and ----  financial.
I guess volatility occurs in all the areas - glucose readings, confusion about data, and cash register/pocket book impact.


PS -  Why Test Strips Cost so Much - Part 2

Kinfolks Always Welcome

Jenna and I had an hour long discussion with my oldest Cousin, K.W., who has had Type 1 Diabetes for over 30 .  K.W. like his dad (my only Uncle) is funny, direct, and open.  Just what we both needed.  He provided the good, the bad, and the ugly stories of his own journey spiced with tips and encouragement about the worst is in the rear view mirror.

A conversation like this shows the power of sharing your vulnerabilities with others - a gift of therapy, compassion, and service.  We are made to help each other and it is when we isolate ourselves under the guise of independence that our souls decay.  A gift that is the mystery of love - transactional because it requires someone in need (a gift requiring courage to ask for help) and someone to help (the gift of providing service to someone requesting help).

In some cases it becomes a trinity - with an intermediary connecting the two.  In philanthropy it is called the Artful Asker (see 3/3/2010 "Artful Asker") - grateful recipient, joyful giver, and Artful Asker.

At the end of the conversation, I told K.W. that for the near future, I would be traveling to Florida on likely a regular basis and would likely show up at his door at anytime requesting and delivering a hug.   His response - Kinfolks always welcome!

Diabetes Downer

It has been quite a week of emotional challenges for the family.  Jenna now faces Type1 Diabetes and the family now enters a new journey of learning and support for this chronic condition.  Like first learning a new vocabulary word, buying a new model car, or any other newly learned (or acquired) item, suddenly the incidence of occurrence all around you seems greater than ever before.  Almost as common as every other part of your life.

For Diabetes the numbers are large but still a small percent of the population - 422 Million (2016) or 8.5% of adults. 90% of those have Type 2 so those with Type 1 are more rare  (1.25 Million in the USA).  Even with so small a number, as people we know have compassionately reached out to us, we have found numerous friends and their families with Type 1 Diabetes (8 and counting). Even though Type 1 is usually diagnosed at an early age (Juvenile), our connections were all diagnosed in their 30's.

Causes of Type 1 are unknown, but they have found some genes (HLA genotypes)  that influence the risk.  Other theories include environmental factors - possible viral infection or diet (gliaden a protein present in gluten).  But there is no real evidence for any of these yet.

As I told Jenna, knowing the cause (without any cure - preventative or post) does the person with the condition no good. Any anger associated with it just becomes self defeating and an unproductive use of time. Better to move as quickly from this emotion and from grief (which will occur)  to an emotional equilibrium with this new condition and hope for achieving the best future possible.

Easy to say (especially from a person that doesn't have the condition), but in reality everyone of us has some condition or weakness (inherited or created) that we must live with, cope with, and use to the best of our ability to achieve the purpose we were created for by God.  We maybe equal in the eyes of God, but we are all unequal in our own eyes. Only when we look at others, are we tempted to judge our own circumstances.  We can either let envy flood our thoughts or compassion redirect our attention into service and humility for our blessings.