What immunocompromised people want you to know

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While many people in the U.S. have abandoned COVID-19 mitigations like vaccines and masking, the virus remains dangerous for everyone, and some groups face higher risks than others. Immunocompromised people—whose immune systems don’t work as well as they should due to health conditions or medications—are more vulnerable to infection and severe symptoms from the virus. 

Public Good News spoke with three immunocompromised people about the steps they take to protect themselves and what they want others to know about caring for each other.

[Editor’s note: The contents of these interviews have been condensed for length.]

PGN: What measures have you been taking to protect yourself since the COVID-19 pandemic began?

Tatum Spears, Virginia

From less than a year old, I had serious, chronic infections and have missed huge chunks of my life. In 2020, I quit my public job, and I have not worked publicly since. 

I have a degree in vocal performance and have been singing my whole life, but I haven’t performed publicly since 2019. I feel like a bird without wings. I had to stop traveling. Since no one wears a mask anymore, I can’t go to the movies or social outings or any party.

All my friends live in my phone now. It’s a community of people—a lot of them are immunocompromised or disabled in some way. 

There are a good portion of them who just take COVID-19 seriously and want to protect their health, who feel the existential abandonment and the burden of all of this. It’s really isolating having to step back from any sort of social life. I have to assess my risk every single time I leave the house.

Gwendolyn Alyse Bishop, Washington 

I was hit by a car when I was very young. I woke up from surgery, and doctors told me I had lost almost all of my spleen. So, I was always the sickest kid in my school.

When COVID-19 hit, I started working from home. At first, I wore cloth masks. I didn’t really learn about KN95 masks until right around the time that COVID-19 disabled me. [Editor’s note: N95 and KN95 masks have been shown to be significantly more effective at preventing the transmission of viral particles than cloth masks.]

I actually don’t get out much anymore because I am disabled by long COVID now, but when I do leave, I wear a respirator in all shared air spaces. My roommate and I have HEPA filters going in every room.

And then we test. I have a Pluslife testing dock, and so we keep a weekly testing schedule with that and then test if there are any symptoms. I got reinfected [with COVID-19] last winter, and a Pluslife test helped me catch it early and get Paxlovid. [Editor’s note: Pluslife is a brand of an at-home COVID-19 nucleic acid amplification test, which has been shown to be significantly more effective at detecting COVID-19 than at-home antigen rapid tests.]

Abby Mahler, California

I have lupus, and in 2016, I started taking the drug hydroxychloroquine, which is an immunomodulator. I’m not as immunocompromised as some people, but I certainly don’t have a normal immune system, which has resulted in long-term infections like C. diff.

I started masking early. My roommates and I prioritize going outside. We don’t remove our masks inside in public places. 

We are in a pod with one other household, and the pod has agreements on the way that we interact with public space. So, we will only unmask with people who have tested ahead of time. We use Metrix, an at-home nucleic acid amplification test.

While it’s not easy and it’s not the life that we had prior to COVID-19’s existence, it is a life that has provided us quite a lot of freedom, in the sense that we are not sick all the time. We are conscientiously making decisions that allow us to have a nice time without a monkey on our backs, which is freeing.

PGN: What do you want people who are not immunocompromised to know?

T.S.: Don’t be afraid to be the only person in a room wearing a mask. Your own health is worth it. And you have to realize how callous [people who don’t wear a mask are] by existing in spaces and breathing [their] air [on immunocompromised people].

People think that vaccines are magic, but vaccines alone are not enough. I would encourage people to look at the Swiss cheese model of risk assessment. 

Each slice of Swiss cheese has holes in it in different places, and each layer represents a layer of virus mitigation. One layer is vaccines. Another layer is masks. Then there’s staying home when you’re sick and testing.

G.A.B.: I wish people were masking. I wish people understood how likely it is that they are also now immunocompromised and vulnerable because of the widespread immune dysregulation that COVID-19 is causing. [Editor’s note: Research shows that COVID-19 infections may cause long-term harm to the immune system in some people.]

I want people to be invested in being good community members, and part of that is understanding that COVID-19 hits the poorest the hardest—gig workers, underpaid employees, frontline service workers, people who were already disabled or immunocompromised. 

If people want to be good community members, they not only need to protect immunocompromised and disabled people by wearing a mask when they leave their homes, but they also need to actually start taking care of their community members and participating in mutual aid. [Editor’s note: Mutual aid is the exchange of resources and services within a community, such as people sharing extra N95 masks.]

I spend pretty much all of my time working on LongCOVIDAidBot, which promotes mutual aid for people who have been harmed by COVID-19.

A.M.: An important thing to think about when you’re not disabled is that it becomes a state of being for all people, if they’re lucky. You will become disabled, or you will die. 

It is a privilege, in my opinion, to become disabled because I can learn different ways of living my life. And being able to see yourself as a body that changes over time, I hope, opens up a way of looking at your body as the porous reality that it is. 

Some people think of themselves as being willing to make concessions or change their behavior when immunocompromised people are around, but you don’t always know when someone is immunocompromised. 

So, if you’re not willing to change the way that you think about yourself as a person who is susceptible [to illness], then you should change the way that you consider other people around you. Wearing a mask—at the very least in public indoor spaces—means considering the unknown realities of all the people who are interacting with that space.

This article first appeared on Public Good News and is republished here under a Creative Commons license.

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  • To Nap Or Not To Nap; That Is The Question

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    It’s Q&A Day at 10almonds!

    Have a question or a request? We love to hear from you!

    In cases where we’ve already covered something, we might link to what we wrote before, but will always be happy to revisit any of our topics again in the future too—there’s always more to say!

    As ever: if the question/request can be answered briefly, we’ll do it here in our Q&A Thursday edition. If not, we’ll make a main feature of it shortly afterwards!

    So, no question/request too big or small

    ❝Is it good to nap in the afternoon, or better to get the famous 7 to 9 hours at night and leave it at that? I’m worried that daytime napping to make up for a shorter night’s sleep will just perpetuate and worsen it in the long run, is there a categorical answer here?❞

    Short version: generally considered best is indeed the 7–9 hours at night (yes, including at older ages):

    Why You Probably Need More Sleep

    …and sleep efficiency does matter too:

    Why 7 Hours Sleep Is Not Enough

    …which in turn, is influenced by factors other than just length and depth:

    The 6 Dimensions Of Sleep (And Why They Matter)

    However! Knowing what is best in theory does not help at all if it’s unattainable in practice. So, if you’re not getting a good night’s sleep (and we’ll assume you’re already practising good sleep hygiene; fresh bedding, lights-off by a certain time, no alcohol or caffeine before bed, that kind of thing), then a first port-of-call may be sleep remedies:

    Safe Effective Sleep Aids For Seniors

    If even those don’t work, then napping is now likely your best back-up option. But, napping done incorrectly can indeed cause as many problems as it solves. There’s a difference between:

    • “I napped and now I have energy again” and you continue with your day
    • Darkness took me, and I strayed out of thought and time. Stars wheeled overhead, and every day was as long as the life age of the earth—but it was not the end.” and now you’re not sure whether it’s day or night, whose house you’re in, or whether you’ve been drugged.

    These two very common napping experiences are influenced by factors that we can control:

    How To Nap Like A Pro (No More “Sleep Hangovers”!)

    If you still prefer to not risk napping but do need at least some kind of refreshment that’s actually a refreshment and not just taking stimulants, then you might consider this practice (from yoga nidra) that gives some of the same benefits of sleep, without actually sleeping:

    Non-Sleep Deep Rest: A Neurobiologist’s Insights

    Take care!

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  • Astaxanthin: Super-Antioxidant & Neuroprotectant

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    Think Pink For Brain Health!

    Astaxanthin is a carotenoid that’s found in:

    • certain marine microalgae
    • tiny crustaceans that eat the algae
    • fish (and flamingos!) that eat the crustaceans

    Yes, it’s the one that makes things pink.

    But it does a lot more than that…

    Super-antioxidant

    Move over, green tea! Astaxanthin has higher antioxidant activity than most carotenoids. For example, it is 2–5 times more effective than alpha-carotene, lutein, beta-carotene, and lycopene:

    Antioxidant activities of astaxanthin and related carotenoids

    We can’t claim credit for naming it a super-antioxidant though, because:

    Astaxanthin: A super antioxidant from microalgae and its therapeutic potential

    Grow new brain cells

    Axtaxanthin is a neuroprotectant, but that’s to be expected from something with such a powerful antioxidant ability.

    What’s more special to astaxanthin is that it assists continued adult neurogenesis (creation of new brain cells):

    ❝The unique chemical structure of astaxanthin enables it to cross the blood-brain barrier and easily reach the brain, where it may positively influence adult neurogenesis.

    Furthermore, astaxanthin appears to modulate neuroinflammation by suppressing the NF-κB pathway, reducing the production of pro-inflammatory cytokines, and limiting neuroinflammation associated with aging and chronic microglial activation.

    By modulating these pathways, along with its potent antioxidant properties, astaxanthin may contribute to the restoration of a healthy neurogenic microenvironment, thereby preserving the activity of neurogenic niches during both normal and pathological aging. ❞

    Source: Dietary Astaxanthin: A Promising Antioxidant and Anti-Inflammatory Agent for Brain Aging and Adult Neurogenesis

    That first part is very important, by the way! There are so many things that our brain needs, and we can eat, but the molecules are unable to pass the blood-brain barrier, meaning they either get wasted, or used elsewhere, or dismantled for their constituent parts. In this case, it zips straight into the brain instead.

    See also:

    How To Grow New Brain Cells (At Any Age)

    (Probably) good for the joints, too

    First, astaxanthin got a glowing report in a study we knew not to trust blindly:

    A Multicenter, Randomized, Double-Blinded, Placebo-Controlled Clinical Trial to Evaluate the Efficacy and Safety of a Krill Oil, Astaxanthin, and Oral Hyaluronic Acid Complex on Joint Health in People with Mild Osteoarthritis

    …and breathe. What a title that was! But, did you catch why it’s not to be trusted blindly? It was down at the bottom…

    ❝Conflict of interest statement

    NOVAREX Co., Ltd. funded the study. Valensa International provided the FlexPro MD® ingredients, and NOVAREX Co., Ltd. encapsulated the test products (e.g., both FlexPro MD® and placebo)❞

    Studies where a supplement company funded the study are not necessarily corrupt, but they can certainly sway publication bias, i.e. the company funds a bunch of studies and then pulls funding from the ones that aren’t going the way it wants.

    So instead let’s look at:

    Astaxanthin attenuates joint inflammation induced by monosodium urate crystals

    and

    Astaxanthin ameliorates cartilage damage in experimental osteoarthritis

    …which had no such conflicts of interest.

    They agree that astaxanthin indeed does the things (attenuates joint inflammation & ameliorates cartilage damage).

    However, they are animal studies (rats), so we’d like to see studies with humans to be able to say for sure how much it helps these things.

    Summary of benefits

    Based on the available research, astaxanthin…

    • is indeed a super-antioxidant
    • is a neuroprotective agent
    • also assists adult neurogenesis
    • is probablygood for joints too

    How much do I take, and is it safe?

    A 2019 safety review concluded:

    ❝Recommended or approved doses varied in different countries and ranged between 2 and 24 mg.

    We reviewed 87 human studies, none of which found safety concerns with natural astaxanthin supplementation, 35 with doses ≥12 mg/day.❞

    Source: Astaxanthin: How much is too much? A safety review

    In short: for most people, it’s very safe and well-tolerated. If you consume it to an extreme, you will likely turn pink, much as you would turn orange if you did the same thing with carrots. But aside from that, the risks appear to be minimal.

    However! If you have a seafood allergy, please take care to get a supplement that’s made from microalgae, not one that’s made from krill or other crustaceans, or from other creatures that eat those.

    Where can I get it?

    We don’t sell it, but here’s an example product on Amazon, for your convenience

    Enjoy!

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  • Reasons to Stay Alive – by Matt Haig

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    We’ve previously reviewed Matt Haig’s (excellent) The Comfort Book, and now it’s time for his more famous book: Reasons To Stay Alive. So, what’s this one, beyond the obvious?

    It narrates the experience of anxiety, depression, and suicidality, and discovering how to find beauty and joy in the world despite it all. It’s not that the author found a magical cure—he still experiences depression and anxiety (cannot speak for suicidality) but he knows now how to manage it, and live his life.

    You may be wondering: is this book instructional; is it reproducible, or is it just an autobiography? It’s centered around his own experience and learnings, but it gives a huge sense of not feeling alone, of having hope, and it gives a template for making sense of one’s own experience, even if every person will of course have some points of differences, the commonalities are nonetheless of immense value.

    The writing style is similar to The Comfort Book; it’s lots of small chapters, and all very easy-reading. Well, the subject matter is sometimes rather heavy, but the language is easy-reading! In other words, just the thing for when one is feeling easily overwhelmed, or not feeling up to reading a lot.

    Bottom line: whether or not you suffer with anxiety and/or depression, whether or not you sometimes feel suicidal, the contents of this book are important, valuable insights for everyone.

    Click here to check out Reasons To Stay Alive, and see through the highs and lows of life.

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  • Are Waist Trainers Just A Waste, And Are Posture Fixers A Quick Fix?

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    Are Waist Trainers Just A Waste, And Are Posture Fixers A Quick Fix?

    Yesterday, we asked you for your opinions on waist trainers and posture-fixing harnesses, and got the above-depicted, below-described set of results:

    • The most popular response was “Waist trainers are purely cosmetic, so useless. Posture-fixers have merit”, with a little over a quarter of the votes.
    • The least popular response was “Both are great tools to help us to optimal waist size and posture, respectively!
    • The other three answers each got a little under a quarter of the vote. In terms of discrete data, these were all 7±1, so basically, there was nothing in it.

    The sample size was smaller than usual—perhaps the cluster of American holiday dates yesterday and today kept people busy! But, pressing on…

    What does the science say?

    Waist trainers are purely cosmetic, so, useless. True or False?

    True, simply. Honestly, they’re not even that great for cosmetic purposes. They will indeed cinch in your middle, and this shape will be retained for a (very) short while after uncinching, because your organs have been squished inwards and may take a short while to get back to where they are supposed to be.

    The American Board of Cosmetic Surgery may not be an unbiased source, but we’re struggling to find scientists who will even touch one of these, so, let’s see what these doctors have to say:

    • Waist training can damage vital organs
    • You will be slowly suffocating yourself
    • Waist training simply doesn’t work
    • You cannot drastically change your body shape with a piece of fabric*

    Read: ABCS | 4 Reasons to Throw Your Waist Trainer in the Trash

    *”But what about foot-binding?”—feet have many bones, whose growth can be physically restricted. Your waist has:

    • organs: necessary! (long-term damage possible, but they’re not going away)
    • muscles: slightly restrictable! (temporary restriction; no permanent change)
    • fat: very squeezable! (temporary muffin; no permanent change)

    Posture correctors have merit: True or False?

    True—probably, and as a stepping-stone measure only.

    The Ergonomics Health Association (a workplace health & safety organization) says:

    ❝Looking at the clinical evidence of posture correctors, we can say without a doubt that they do work, just not for everyone and not in the same way for all patients.❞

    Source: Do Posture Correctors Work? Here’s What Our Experts Think

    That’s not very compelling, so we looked for studies, and found… Not much, actually. However, what we did find supported the idea that “they probably do help, but we seriously need better studies with less bias”:

    The use of posture-correcting shirts for managing musculoskeletal pain is not supported by current evidence

    That is also not a compelling title, but here is where it pays to look at the studies and not just the titles. Basically, they found that the results were favorable to the posture-correctors—the science itself was just trash:

    ❝ The overall findings were that posture-correcting shirts change posture and subjectively have a positive effect on discomfort, energy levels and productivity.

    The quality of the included literature was poor to fair with only one study being of good quality. The risk of bias was serious or critical for the included studies. Overall, this resulted in very low confidence in available evidence.❞

    ~ Palsson et al.

    Since the benefit of posture correctors like this one is due to reminding the wearer to keep good posture, there is a lot more (good quality!) science for wearable biofeedback tech devices, such as this one:

    Spine Cop: Posture Correction Monitor and Assistant

    Take care!

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  • Parent Effectiveness Training – by Dr. Thomas Gordon

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    Do you want your home (or workplace, for that matter) to be a place of peace? This book literally got the author nominated for a Nobel Peace Prize. Can’t really get much higher praise than that.

    The title is “Parent Effectiveness Training”, but in reality, the advice in the book is applicable to all manner of relationships, including:

    • romantic relationships
    • friends
    • colleagues
    • …and really any human interaction.

    It covers some of the same topics we did today (and more) in much more detail than we ever could in a newsletter. It lays out formulae to use, gives plenty of examples, and/but is free from undue padding.

    • Pros: this isn’t one of those “should have been an article” books. It has so much valuable content.
    • Cons: It is from the 1970s* so examples may feel “dated” now.

    In addition to going into much more detail on some of the topics covered in today’s issue of 10almonds, Dr. Gordon also talks in-depth about the concept of “problem-ownership”.

    In a nutshell, that means: whose problem is a given thing? Who “has” what problem? Everyone needs to be on the same page about everyone else’s problems in the situation… as well as their own, which is not always a given!

    Dr. Gordon presents, in short, tools not just to resolve conflict, but also to pre-empt it entirely. With these techniques, we can identify and deal with problems (together!) well before they arise.

    Everybody wins.

    Get your copy of “Parent Effectiveness Training” from Amazon today!

    *Note: There is an updated edition on the market, and that’s what you’ll find upon following the above link. This reviewer (hi!) has a battered old paperback from the 1970s and cannot speak for what was changed in the new edition. However: if the 70s one is worth more than its weight in gold (and it is), the new edition is surely just as good, if not better!

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  • Get Better Sleep: Beyond The Basics

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    First though, for the sake of being methodical, let’s quickly note the basics:

    • Aim for 7–9 hours per night
    • Set a regular bedtime and (equally important!) regular getting-up time
    • Have a 2-hour wind-down period before bed, to decompress from any stresses of the day
    • Minimal device/screen usage before bed
    • Abstain from stimulants for as long before bed as reasonably possible (caffeine elimination halflife is 4–8 hours depending on your genes, call it 6 hours average to eliminate half (not the whole lot), and you’ll see it’s probably best to put a cap on it earlier rather than later).
    • Abstain from alcohol, ideally entirely, but allow at least 1hr/unit before bed. So for example, 1hr for a 1oz single shot of spirits, or 2–3 hours for a glass of wine (depending on size), or 3–4 hours for a martini (depending on recipe). Not that that is not the elimination time, nor even the elimination halflife of alcohol, it’s just a “give your body a chance at least” calculation. If you like to have a drink to relax before bed, then well, only you can decide what you like more: that or actually getting restorative sleep.
    • Consider a warm bath/shower before bed, if that suits your schedule.
    • Wash and change your bedsheets more often than seems necessary. Or if that’s too onerous, at least change the pillowcases more often, which makes quite a difference already.
    • Lower the temperature of your bedroom shortly before bedtime; this will help cue the body to produce melatonin
    • Make your bedroom as dark as reasonably possible. Invest in blackout blinds/curtains, and remove any pesky electronics, or at least cover their little LEDs if it’s something that reasonably needs to remain on.

    Ok, now, onwards…

    Those 7–9 hours? Yes, it goes for you too.

    A lot of people mistake getting 6 hours sleep per night for only needing 6 hours sleep per night. Sure, you may still be alive after regularly getting 6 hours, but (unless you have a rare mutation of the ADRB1 gene) it will be causing harm, and yes, that includes later in life; we don’t stop needing so much sleep, even stop getting it:

    Why You Probably Need More Sleep

    With this in mind, it becomes important to…

    Prioritize your sleep—which means planning for it!

    When does your bedtime routine start? According to sleep scientist Dr. Lisa Matricciani, it starts before breakfast. This is because the things we do earlier in the day can greatly affect the amount (and quality) of sleep we get later. For example, a morning moderate-to-intense exercise session greatly improves sleep at night:

    Planning Ahead For Better Sleep

    As for quality, that is as important as quantity, and it’s not just about “soundness” of sleep:

    The 6 Dimensions Of Sleep (And Why They Matter)

    “What gets measured, gets done” goes for sleep too

    Sleep-deprived people usually underestimate how sleep-deprived they are. This is for the same reason as why drunk people usually underestimate how drunk they are—to put it in words that go for both situations: a cognitively impaired person lacks the cognitive function to realize how cognitively impaired they are.

    Here’s the science on that, by the way:

    How Sleep-Deprived Are You, Really?

    For that reason, we recommend using sleep-tracking software (there are many apps for that) on your phone or, ideally, a wearable device (such as a smartwatch or similar).

    A benefit of doing so is that we don’t think “well, I slept from 10pm to 6am, so that’s 8 hours”, if our device tells us we slept between 10:43pm and 5:56 am with 74% sleep efficiency because we woke up many times.

    As an aside, sleep efficiency should be about 85%, by the way. Why not 100%, you ask? It’s because if your body is truly out like a light for the entire night, something is wrong (either you were very sleep-deprived, or you have been drugged, that kind of thing). See also:

    An unbroken night’s sleep is a myth. Here’s what good sleep looks like.

    So waking up during the night is normal, and nothing to worry about per se. If you do find trouble getting back to sleep, though:

    How to Fall Back Asleep After Waking Up in the Middle of the Night

    Be careful about how you try to supplement sleep

    This goes both for taking substances of various kinds, and napping. Some sleep aids can help, but many are harmful and/or do not really work as such; here’s a rundown of examples of those:

    Safe Effective Sleep Aids For Seniors?

    And when it comes to napping, timing is everything:

    How To Nap Like A Pro (No More “Sleep Hangovers”!)

    Want to know a lot more?

    This is the book on sleep:

    Why We Sleep – by Dr. Matthew Walker

    Enjoy!

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