High labor costs remain an ongoing problem threatening providers’ bottom lines, according to new data from Kaufman Hall. The research revealed that medical groups’ median investment in each employed physician has reached more than $300,000 for the first time.

The post High Labor Costs Continue to Plague Providers, Data Shows appeared first on MedCity News.

Metropolitan Joseph of the Antiochian Archdiocese of North America joins Fr. Andrew Stephen Damick to talk tough ministry questions amid the COVID-19 pandemic. How do a bishop and his clergy struggle to minister in these conditions? What about new technology? How do we relate to government? Also joined by Fr. Thomas Zain and Fr. Nicholas Belcher, His Eminence addresses head-on the pain and difficulty we're all facing, covering practical matters as well as bigger theological and spiritual questions, collected directly from concerned listeners. This in-depth interview wraps up with questions on his time with St. Paisios, communing the non-Orthodox, and the future of monasticism in his archdiocese.

The latest candidate for the post has withdrawn just days after the appointment was announced.

Plastic pollution hits Southeast Asia, Sub-Saharan Africa, and India hardest, with India leading in production.

Washington – State-run OSHA programs face staffing challenges in part because of budget cuts, and federal OSHA should provide better access to training and deadlines for taking over troubled state programs, concludes a new report from the Government Accountability Office.

Product recalls in bakery and snack categories have remained consistent over the years, with undeclared allergens the primary cause. These costly recalls are preventable!

Deepfakes threats advance, and technology is challenged to keep up.

Kids in California struggle with more cavities than kids in most states, despite Medi-Cal efforts to fix dental care administrative hurdles and focus on prevention.

What caused the Plague? And what methods did people use to combat the spread? Learn about its origins, past outbreaks (including the Black Death), and the long-lasting impact of its legacy today. --- For more videos from Smithsonian Magazine: https://www.smithsonianmag.com/videos/ Digital Editorial Director: Brian Wolly Supervising Producer & Scriptwriter: Michelle Mehrtens Producer: Nicki Marko Producer: Sierra Theobald Video Editor: Natalie Cline Graphic Designer: Kevin Schoenblum

Somalia is currently in the midst of a dire humanitarian crisis that threatens to destabilize the nation’s security. This crisis is a result of the Somali Civil War, which began in 1991. Altercations between clan-based operations have caused a host of issues over the years, including over 596 civilian casualties, according to the United Nations […]

DNA evidence from tombs in Sweden and Denmark suggests major plague outbreaks were responsible for the Neolithic decline in northern Europe

Title: Before Volcano Buried Pompeii, Toxic Water May Have Plagued Residents
Category: Health News
Created: 8/29/2017 12:00:00 AM
Last Editorial Review: 8/30/2017 12:00:00 AM

Title: Mental Health Issues Can Plague Families of Kids With Type 1 Diabetes
Category: Health News
Created: 8/5/2022 12:00:00 AM
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Toronto : Viking Canada ; New York, NY : Penguin Group (USA), 2006

His efforts to weaken pollution controls expected to endure

His efforts to weaken pollution controls expected to endure

ROBERT MUIR-WOOD: Containment - isolating those who are ill and infectious - is the oldest known response to mass infection, dating back thousands of years.

ROBERT MUIR-WOOD: Containment - isolating those who are ill and infectious - is the oldest known response to mass infection, dating back thousands of years.

Crayfish plague, spread by invasive North American crayfish, is currently devastating native European populations. However, while the disease is commonly diagnosed on the basis of diseased animals, free-living infective spores can contaminate water bodies. In the first study to test detection techniques for this disease in natural waterways, researchers found that invasive signal crayfish release low levels of plague spores, allowing it to spread undetected.

In Beijing, a city lousy with haunted spots, one historic mansion in need of some TLC just can't seem to catch a break due to its ghostly reputation.

The air at 85% of national parks is unhealthy at times, report finds, building on a study that said concentration of smog-forming ozone rivals that of cities.

It's no Jurassic Park, but a flea stuck in amber for 20 million years may still shed light on the Black Death.

White-nose syndrome is still spreading wildly, but a few bat colonies may be showing signs of resistance.

New research shows that urban green space largely benefits the wealthy and educated, not the underserved communities that need it most.

Plastic pollution similar to ocean 'garbage patches' has been found in the Great Lakes, especially microscopic beads used in many personal care products.

The locust plague already poses an 'unprecedented' threat to food security, and could still grow 500 times larger.

The Association of Certified Fraud Examiners (ACFE) recently released the 2014 Report to the Nations on Occupational Fraud and Abuse, and I noticed one overarching theme as I read through it: fraud has been and continues to be a costly… Read More

The post Occupational Fraud Continues to Plague Businesses appeared first on Anders CPAs.

Coconino County Public Health Services District and Grand Canyon National Park will begin monthly monitoring for plague. https://www.nps.gov/grca/learn/news/grand-canyon-and-coconino-county-to-monitor-for-plague.htm

He didn’t at first appreciate the scare and chose to stay in the crowded city. And he hadn’t at the start stockpiled food or self-isolated or realized the extent of the contagion. But he did come to acknowledge the horror and the “brutal courage” of those who tried to help. “He” was Daniel Defoe. The time was 1722. The occasion, the publication of “A Journal of the Plague Year,” three years after Robinson Crusoe. In the “Journal” Defoe is looking back 57 years to when The Great Plague hit London, one year before The Great Fire would destroy just about anything that was left. Ironically it was probably the fire that helped finally destroy the vermin carrying the infecting bacteria. Writer, merchant, at times spy, Daniel Defoe created in the “Journal” a chronological first-person narrative of the epidemic in the voice of a middle-class tradesman, a saddler. Defoe would have been 5 when The Plague broke out, so his gripping on-the-scene account, augmented by research, must be considered

As Christians we need to have both a practical and a biblical perspective on what is going on in the world. Most importantly, God does not want us to live in fear. We have an unprecedented opportunity to show people where to find peace and the Prince of Peace.

As Christians we need to have both a practical and a biblical perspective on what is going on in the world. Most importantly, God does not want us to live in fear. We have an unprecedented opportunity to show people where to find peace and the Prince of Peace.

"... There shall be famines, and pestilences, and earthquakes in divers places," and so it is... but is the coronavirus one of the seven last plagues ? and is taking precautions against its spread displaying a lack of faith ? Study with the pastors as they speak on this topic in this episode of Bible Answers Live, and you'll learn also of life and family once we all get to Heaven, and what the role of grace is as we strive for a perfect character, before eternity in Heaven.

Coronavirus isn't the first pandemic to sweep the world. Typhoid and flu killed millions. But history's really big killer was the bubonic plague. Three historians discuss what we can learn from the history of plagues of the past.

In the fourteenth century, the plague killed about half the population of Europe and Asia, making it one of the most devastating pandemics in human history - and it's a disease that persists to this day.

Hundreds of thousands of schoolchildren visit the national capital each year to study history and democracy — except, of course, this year.

When photos of the wrong destination appear in tourism ads, is it humorous or a ploy? Esperance in WA has become Hawaii and Melbourne the Gold Coast, but false advertising is being exposed.

LONDON (AP) - From resounding applause to ostracization and isolation. That's essentially the journey Lt. Cmdr. Robert Embleton, who served 34 years in Britain's Royal Navy...

I'm counting 16 March as day 0, being when the government actually started getting serious about reducing the rate of infection spreading.

Will cut all these entries and tag Covid, so feel free to block or ignore or filter if that's best for you.

Day -2 (Saturday): After much dithering decided I did want to enjoy my last planned excursion before cancelling everything. Travelled to London with ghoti_mhic_uait, attended a Pop-up Painting event in a fairly crowded room under a pub, and then went out for dinner in a half-empty, very nice South Bank restaurant. I suspect if that was a mistake I'll never know. Mainly I feel glad that I got three really nice dates with my three partners in the last semi-normal week. One of them involved staying in being coupley, but two of them involved trips to London probably later than was wise.

Anyway the pop-up painting was cool. They set you up with a canvas, brushes, acrylic paints, and an apron, and there's a reference image to copy. In our case it was loosely based on this Banksy, but an interpretation of it, not exactly that picture. The first hour or so, they let the participants just play around with paints, doing whatever we liked to fill in the background. I pretty much just copied the reference image's sunset sky, because I wanted to get comfortable with using the paints, mixing colours and creating textures, more than I wanted to try to exercise creativity. Then there was a break with wine, then in the last 40 minutes the facilitators talked through copying the silhouette of the girl, in a fair amount of detail, like, make a C shape here, this line should be at a 45 degree angle, etc. You were still allowed to paint something else if you wanted to, but again, I found following directions quite helpful. The audience were relatively diverse; mostly young-ish but seemed to be a good cross-section of the London public.

At the moment ghoti_mhic_uait can eat basically only protein and needs a lot of meat anyway, and I'm vegetarian and tend to get most of my calories from carbs. Ghoti miraculously managed to find a place that could feed both of us, this rather lovely Eastern European place. I had creamed mushrooms with some latke-ish things, and a sort of lentil pie with cucumber salad and a lot of capers, and Ghoti had some really impressive-looking pickled herring, and some roast duck with apples and red cabbage. It was very exciting, and goodness knows if we'd ever get a table for a normal weekend. They're also very into their vodka and cocktails, which we didn't sample but I might be interested to try a more alcohol-focused event another time.

London was quiet but not completely a ghost town. Almost everybody who booked showed up for the painting, but it was the last one the organization ran, they're cancelling going forward.

Day -1 (Sunday): The synagogue ran Sunday school as normal, on the grounds that schools are still open. But two of the teachers (who are related to each other) didn't show, so I had to take two classes. And in fact, of my expected 10 children across two classes, only three showed up, and we had only 14 of our roster of 50 overall. So most likely we're not going to bother running the last two classes before Pesach, but it's not definitely cancelled yet. In the afternoon OSOs and their children came over for roleplaying, which again had been planned for a while and didn't seem dangerous enough to cancel.

Day zero (Monday): We had known since Friday that we'd been given a week to close the whole campus where I work (bar "essential" staff, mostly those working directly on Covid responses in the lab), and send everybody to work from home for an indefinite period, probably minimum several months. My team had a meeting about how we would handle the transition, and agreed that there was really no reason for most of us to return to the site after yesterday. My lovely line manager has been handling all the disaster response for the last several weeks, basically cancelling everything we do because nearly everything we do is... run international conferences. She was somewhat hysterical by yesterday, but just about holding things together. She very kindly offered to give me a lift home so I could take my computer equipment. We're allowed to take our ergonomic chairs and even our desks, or there's budget to set up home offices, though I was fine with just my laptop and a decent sized screen. Shit is serious.

We detoured via a lost property office to retrieve my wallet which had fallen out of my bag on the coach to work; the coach company tracked me down via a dental appointment card which led to the local council who called me before I cancelled the cards and before I got trapped on the other side of a quarantine barrier from my account access tokens. On the journey she put the radio on and we heard the government announcement.

I am technically in the high risk category as I have chronic asthma. I don't think my asthma is particularly "severe" but it probably would be if I got pneumonia. I haven't really fully processed thinking of myself as one of the "vulnerable" people rather than one of the healthy people who need to act to protect others. Since I'm working from home anyway, I don't have a whole lot of reason to need to go out for the next several weeks. But realistically it's gonna be months, isn't it? I had a bit of a feeling of being sent home to die when we were packing up the office. I have about the degree of death-fear that I get when my period is late; it's not that likely that I actually have Covid-19, it's not that likely that if I do get it I will get complications, and even if I do get complications I might still survive it. I'm a little scared of social collapse, but only a little, I can't really picture, like, mass starvation or something.

Day 1 (Tuesday): I worked from home. I talked to jack a lot (he's very tolerant of my extrovert need to talk things through when it's emotionally scary). We took a car trip to his (deserted) office to pick up computer equipment for him to also work from home for the duration, and didn't interact with any other humans.

I am still undecided about whether I really will isolate myself completely, though the guidelines include me in the category of people who should. I will quit teaching Sunday school and attending services, which is likely to be academic anyway as I'm fairly certain the synagogue will close within the next few days. For now I intend to keep seeing my OSOs; they are ten minutes walk away and our lives are so intermingled that we probably all have the same infection status.

Personal status: feels like the beginning of a mild cold.
Social circle tally: one case, two acquaintances with suspicious symptoms. Nobody I've been in physical contact with within a month though.

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Day 3 (Wednesday): successful social distancing, yay. I worked from home, I came into contact with no humans except jack.

Work tried to establish ways to keep in touch, socially as well as for specific work concerns. We have just moved to a new system, Cisco Webex, for conference calls, and it's really not holding up to the volume of everybody suddenly moving to WFH. So we had a slightly hilarious team coffee chat, when half the participants had no audio and we ended up playing charades.

Mood-wise, I felt slightly manic all day. Every time I had to communicate with someone at work I used way too many words, and I got plenty done but everything felt like it was in a massive rush and slightly out of control.

I also successfully persuaded my mother, and my Stoke community, not to hold big Passover seders with crowds of vulnerable people travelling from all over to gather in a small room and share meals. It is going to be really awful to miss a big seder with my family of origin for the first time in my 41 years of life. But better than infecting my over-70 parents or my paralysed brother. And the Stoke community are breaking a streak of even more decades, and they grumped that I (along with the Chief Rabbi of their movement, the United Synagogue) am overreacting, but they're not risking the health of their various elderly and frail members, so that's good.

Today I mostly worked from home, but I had to go out for, of all things, dental surgery. I'd assumed it just wouldn't happen in the middle of a pandemic, but a tooth extraction is sufficiently urgent that it went ahead. The poor receptionist was absolutely frantically sanitizing every surface continuously.

I had never had a tooth taken out before today. Really rubbish first, I must say! The dentist was super lovely, kind without being patronizing, but I found myself very close to panic. The actual operation lasted only a couple of minutes and the local anaesthetic was the (not very bad) worst part of it, but anyway. I decided to walk home in order to calm myself down, though jack did offer me a lift. Then I met up with ghoti_mhic_uait and we went for another walk together, which did a lot for my general mood and happiness.

Town was quieter than usual, but not completely dead; there were enough walkers, cyclists and joggers out and about that it wasn't entirely easy to maintain the prescribed 2 metre separation from everybody. Also businesses, including pubs and other social gathering spots, are still open (because the government are trying to make individual businesses rather than insurers or the state assume the risk of telling individuals not to go to bars, but not telling bars to actually close), and were quiet but had some customers.

Personal status: If I had the beginning of a mild cold before, I now feel I have the end of a mild cold. Sore throat which I can't tell if it's an infection or a reaction to having my mouth poked about.
Social circle tally: One case, four with suspicious symptoms. All online acquaintances so far.

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Well, as they say, that escalated quickly.

Day 5 (Friday): Stayed home all day with jack. We ordered takeaway for our date night while we still can. The delivery guy wore a proper facemask.

Day 6 (Saturday): Woke up feeling kind of grim. Decided, on consultation with my partners, that I was fairly sure it was just a cold, so we agreed I would go ahead with my planned evening with cjwatson and the children.

In the morning I virtually 'attended' a livestreamed service, which is a really really new thing for my community who normally ban telecoms and electronics on the Sabbath. It was weird, but I felt good for praying with the community even if I wasn't actually interacting with them directly. In the afternoon I did a virtual play readthrough over Zoom, organized by the lovely wildeabandon. It was really really fun, and I got to see the faces of friends I haven't seen for ages, as well as a couple of internet acquaintances I had no mental image of previously. The play was Loves labours lost and I played a couple of small but fun roles, Lady Katharine, a slightly bitchy court woman, and Sir Nathaniel, a pompous curate.

And then I walked to my partners' house, and it was sunny and seemed basically normal. Plus I was feeling completely better by mid afternoon. I took a winding route to stay most of 2m away from any other pedestrians. We played Labyrinth and watched TV and I stayed the night.

In the morning (Sunday) there was more TV and another game, Robot turtles, a sort of cut-down, child-friendly version of Robo Rally, which the children have got much better at since we last played. And we walked part way together to metamour's house where there was mother's day planned, which I didn't join in with, I went home to jack. We went out to the local shop, I walked with him to enjoy the spring weather and he did the actual shopping, as I'm in theory more vulnerable than him.

Sunday evening I did my chevruta (traditional paired Jewish text study), which has always been online because my partner is in New York, and we had a long and pleasant video call with some old friends of jack's I don't see often enough.

Today, day 8, well, jack and I stayed home, mostly working. And anxiously watching the news of how most of the country treated the weekend as a bonus bank holiday and flocked to tourist spots and crowded into parks and gardens. It was kind of obvious the restrictions would have to get stricter, if that was how people were interpreting more gentle restrictions.

Then they cancelled the daily "briefing" (I haven't really been listening to them as it's mostly just our incompetent prime minister waffling with no substance) for a COBRA meeting. I carried out my intended plan of collecting Judith from OSOs' for a Hebrew lesson, and am I ever glad I did. Because as of an hour ago, and starting from tonight, we're no longer allowed out at all except for "essential" purposes. And we're explicitly no longer allowed to meet friends and family. So I don't know how long it will be before I get to hug my partners again.

In a way, lockdown isn't very different from how we were already behaving, with one vulnerable person in each of our three houses (me and metamour have asthma, girlfriend is pregnant). We were already going out only once a day for exercise, we were already only visiting shops to buy, like, food. But what it has taken away from us is that we can no longer bounce between the three houses, treating the polycule as a closed pod. I think our behaviour for the past week has been safe. If I walk a kilometre to my partners' house, that's no different from walking a kilometre in a random direction to get exercise. But the problem is everybody thinks they're an exception, (and multi-household poly relationships are never thought of in official rulings), so now it's forbidden.

The announcement says three weeks, but I think what's actually going to happen is that people will again not take the restrictions seriously and it will have to be extended.

Personal status: I thought I was doing ok, and the tighter restrictions are almost certainly necessary and not really a surprise. But it hurts.
Social circle tally: three cases, including one person I see face to face (though not for at least a month). 8 mostly online acquaintances with suspicious symptoms.

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Adapting to the new normal.

Day 9 (Tuesday): Worked from home. Did my daily exercise by walking past the house where OSOs are quarantined so we could wave to each other from a distance. We actually ended up having a conversation, them on their doorstep, me several metres away. Which is perhaps stretching the no gathering thing a little but I think the risk is low and the psychological benefit is enormous. I have vastly more cope knowing I can still see and talk to my partners.

Day 10: (Wednesday): Worked from home. Failed to secure online delivery for now. Called my parents who reported that they were doing fine and that my doctor cousin had completely randomly, for no reason at all, told them they need to isolate from my brother within the household. I said that sounded over the top. But then I spoke to my brother and it turned out parents left out an extremely salient fact, namely that they had been in recent contact with someone symptomatic. Called my parents again, and talked them through sensible in-house isolation precautions. Part of the reason my brother is quarantining with them is because they have a big house with multiple kitchens and bathrooms, so hopefully this is doable. But I've been kind of tearing my hear out over all this.

Day 11: (Thursday): Another exercise walk and distanced chat with OSOs. Again, felt much better for that. I noticed that the local corner shop is observing proper social distancing, with only a few people allowed in the shop at a time, and everybody else queuing outside actually at 2m separation.

Took part in a rehearsal for running Saturday's service purely over Zoom. (Unlike last week, nobody is going to the synagogue building at all, so we will need to coordinate between people in different locations.) There are lots of probably more exciting options for livestreamed shabbat services, but if you would like to virtually join ours on Saturday (and hear / see me fake-read the Torah), PM me for the Zoom link. I'm not putting it on the public internet because scumbags have been hacking Zoom-based services in order to harass Jews :-(

Day 12 (today): Pleasantly boring day. jack did some shopping in a locally owned shop, which was quieter than Tesco.

Personal status: In spite of being worried about my family of origin, I am getting used to this situation and basically feel ok. Also I still / again have mild cold symptoms. Tracking makes me paranoid, but also makes me realize just how unreasonably susceptible I am to mild respiratory stuff. I've pretty much constantly had a mild cough, with occasional chest soreness or shortness of breath ever since I started paying attention. I'm pretty sure it's chronic asthma with rhinitis and unreasonable sensitivity to normal endemic viruses, rather than acute Covid, but 'pretty sure' isn't ideal with the stakes this high.

Social circle tally: five cases. Twelve people with suspicious symptoms. Now including some people I see in person, but none recently.

Does anyone have any recommendations for decent online bridge setups? Free as in beer would be good, free as in speech is always a bonus. We can probably download software if needed, but ideally we want to work across multiple different tech eg phones, tablets, laptops with various OSes, so probably web-based is easiest. Also it needs to be at least vaguely usable by people who are not completely computer savvy, though not completely clueless either.

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Small milestones.

A couple of significant milestones just now: it's been a full week since I went within 2m of anyone other than jack. He's not been as fully isolated as I have, since he has no underlying conditions and has been doing our household shopping. Of course making an effort to avoid getting too close to people, but still.

And I've passed the magic 14 days since I last took public transport and intentionally went to venue with a crowd of people. I don't yet feel confident I definitely haven't caught the virus, particularly since I've spent most of the intervening time with very mild almost-certainly-a-cold-but-who-knows symptoms. But the feeling of impending doom is somewhat lessened, knowing that I've been in a two person almost closed pod for most of the significant infectious period.

Anyway, Day 12, Friday, was almost a normal day. I often work from home Fridays in normal life anyway, and I was very absorbed in putting the finishing touches to my online course. And then after 5 I had date night with jack, like we always do, and we cooked together and played a successful episode of Gloomhaven.

Day 13, Saturday, I did online synagogue service again. This time I had a small role in the service, reading something from Leviticus in place of a full Torah reading. And this time it was entirely on Zoom, with nobody physically in the synagogue. It went pretty well and it was nice to see people's faces all over the screen. And another lovely readthrough with wildeabandon and co, the radio play of Gaiman's Stardust, where I had the delightful role of the chief evil witch Morwanneg, and was congratulated on my evilness. And a Zoom party in the evening hosted by ptc24. Finally a phonecall with cjwatson before we both retired. So yeah, basically a very full day of virtual socializing!

Day 14, Sunday, wasn't much quieter. I virtually attended OSOs' church service, since they'd showed up to mine and it seems nice to support each other. It's much more isolated than ours: they literally just have a camera feed of their priest in an empty church, with no interaction with the rest of the congregation. I could hear the Communion wafer snap, which is a weird experience; I've been told it's basically like matzah but I didn't know that it sounds like matzah.

We just about had time for lunch between church and setting up for an online game of bridge, with my brother and parents in one location, and me and Jack in one location, and OSOs and metamour in a third location. Thank you to silveradept for recommending us a nice simple card playing site, Trickster Cards. It's not completely perfect but it's a lot less fiddly than some of the more serious sites we found. We had hoped to use Jitsi for video chat but couldn't get it to work on everybody's assorted devices, so we fell back to Zoom and just put up with redialling every 40 minutes. And I had to leave the gaming table fairly promptly for my online chevruta.

Today, day 15 since the somewhat arbitrary date I started counting, I attended communal weekday prayers, which I basically haven't done since I lived in Sweden in the mid 2000s. Broadcast Zoom service from the movement rabbinic seminary, which was delightful. Not only could I see people's faces on screen, I could see the smattering of fellow Reform Jews who, like me, lay tefillin every day. It's always been a bit lonely knowing that the very great majority of people who lay tefillin don't approve of women, and anyway with normal life commuting I can't usually get to communal prayers on weekdays.

I did some work, though mostly got very distracted by the dashboard of my new course, showing lots of people signing up from just about every corner of the globe. Look, it's an actual real thing out in the world, with 1500 people actually learning from materials I put together! And this evening I have my online Hebrew class as usual, and jack is doing some online roleplaying.

No new symptoms showing up among my immediate social circle in the last few days. However I'm starting to hear of deaths of people I'm connected to at second degree. Two people from partners' church. One of our movement rabbis. The father and grandfather of one of the cleaners at work. I am sad about these people I don't know (I think I might have met R' Kraft once or twice, may his memory be a blessing), but also afraid. Afraid that somehow, I'll run out of sadness and not be able to respond appropriately when someone I know is bereaved. Or that I won't, and I'll just drown in endless grief. Like a lot of these things there's no point buying trouble by worrying about it.

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As of some time last night, I have novel respiratory symptoms. I'm basically fine but it feels safest to act as if I am infected.

My lungs hurt, and it's not the tightness I associate with mild asthma symptoms, or the tired muscle ache / burn I associate with a bad cough (whether asthma or viral). Not badly, but pretty much continuously. I'm coughing a bit but not severely, and I don't feel feverish. I have a slight headache and sore throat, but that could be just about anything including stress. I am somewhat distracted but I've been able to get on with useful work today.

I'm probably being over-cautious, but I feel like the balance of probabilities points towards suspected case. So this morning jack and I activated our self-isolation plan. We've divided up the house so that I "live" upstairs and he stays downstairs apart from using the bathroom. We have separate towels and we're cleaning metal bathroom surfaces constantly. jack has taken on food prep for both of us and he's leaving me plates of food and cups of tea and retreating to the bottom of the stairs.

And we're preparing to avoid leaving the house at all until it's more likely that we're not infectious than that we still are. We have plenty of supplies, and we managed to get an online supermarket delivery order in by virtue of going on the website just after midnight last night, which was fortuitous timing. It's going to suck, more so if my symptoms progress beyond the almost ignorable level, but since we can do this I think it's the right thing.

The most likely (and in some ways comforting) narrative I can come up with is that I picked this up when I had to attend a dental appointment two weeks ago. I had very mild symptoms (including a tell-tale sore throat) within a few days of that surgery, which in retrospect I can imagine might have been the first phase. And now, 12 days after the first symptoms, I have potential lower respiratory tract symptoms, so hopefully this is the second phase. That's comforting because it suggests my source of infection is a necessary medical appointment rather than either something frivolous I did, or just being unlucky even though I've stayed at home except for exercise for ten days now, and jack has been doing minimal necessary shopping with careful social distancing. And if I picked it up at the dentist it's unlikely I infected the dentist or any of his staff or patients. Also, if my guess is right I'm probably approaching the end of the infectious phase.

We are really not sure how long we should maintain full isolation at home. UK guidelines say 7 days from start of symptoms (me, today), or 14 days from contact with a symptomatic person (Jack). But I suspect this is not entirely adequate especially as it's much less restrictive than the WHO advice. If my symptoms don't get any worse than this and jack doesn't get sick at all, which is definitely the brnach of the timeline I'm hoping for, I won't know whether I've actually had Covid. Currently we're thinking that if nothing changes we'll start interacting with eachother again after 7 days, but not go outside until we're more confident the incubation period has passed; I think the safest is 14 days from the end of symptoms but we might not be able to sustain that.

Send hugs and support to jack, please? He's doing amazingly in a somewhat scary situation.

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I'm doing basically fine but continuing to be careful.

I still have the same single worrying symptom I had on Thursday, sore lungs. I don't otherwise feel ill, feverish, tired or anything else, so I'm really second guessing myself over whether isolation was the right choice.

The last few days have been mostly pleasant though stressful for jack who's handling everything on his own and worrying about me getting seriously ill or possibly infecting him.

Friday was 19 days since the government started taking action. I worked in my new upstairs den (previously jack's den.) We had a weird date where jack brought me up a tray with the Shabbat ritual things, I made kiddush sitting at the top of the stairs and he sat at the bottom, and we ate dinner in parallel but at a distance. And then we played Potion explosion over Steam, which worked pretty well.

The weekend was ridiculously lovely, and we were both good and only sunbathed and exercised in our own garden. Saturday, day 20, I went to virtual shul, which on only the second iteration starts to feel almost normal. Bigger than usual congregation, including some of the people who are usually strict about not using electronic technology on Shabbat. And in the afternoon I attended the second half of wildeabandon's Stardust readthrough which was generally satisfying and companionable. And I had a long phonecall with ghoti_mhic_uait.

Sunday, day 21, had slightly fewer online social commitments. We had a lot of time in the sunshine in the garden, remaining carefully distanced. cjwatson came by to wave to me from the street while I looked out of an upstairs window like some ridiculous fairy tale princess. We video chatted to jack's university friends; it's been a long time since the original trio got together since one of them lives in Croatia and has two small children. And I did my online chevruta just like the previous week, slightly sheepishly admitting I was Skyping from bed because I was isolating for basically no reason. And I had a long conversation with cjwatson in the evening.

Since today is day 22, and two weeks of lockdown, it's now been a whole two weeks since I last interacted directly with anyone other than jack. jack has also not left the house or allowed delivery people to come close to him since I got the weird symptoms on Thursday, so five days so far.

I now know eight people who have pretty clearly been through a bout of coronavirus, and 21 who like me are being careful because they have suspicious symptoms.

Thanks to everyone who made nice comments on my last post, I really appreciate all of you.

comments

Still basically fine, but this one is a bit whiny.

I'm losing track of everything I'm trying to count. This is:

Less frequent posts since time hardly exists any more.

5 weeks of pandemic life (yesterday).
4 weeks of lockdown and since I last interacted with anyone except jack.
19 days since I thought I maybe had symptoms.
13 days since I ended internal isolation with jack. He hasn't had any symptoms at all.
5 days since I last had symptoms I was significantly worried about.
3 days since I returned to occasionally leaving the house for exercise.
Also, day 12 of the Omer.

So, healthwise: I had about 5 days, 2nd April to 7th April, when my lungs hurt. Just continuously, not affected by taking deep breaths or posture or anything much else. I didn't have any other symptoms whatsoever. After that I had like a week of thinking I was better, except that the soreness returned intermittently. So I really wasn't sure when I could start counting to the end of isolation; the UK guidelines say 7 days from symptoms appearing, but everywhere else counts from the end of symptoms, and the symptoms were so minor and tailed off so gradually that I don't know where I'd place the 'end'.

On 16th April I had a weird episode of dizziness, much worse than I'd ever experienced before. I pretty much had to lie down for a couple of hours. I had no other symptoms, no tiredness, no fever, just plain vertigo. I looked it up on the internet as you do, and articles from before Covid-19 suggested that sometimes people get post-viral labyrinthitis, whereas more up-to-date information suggested dizziness might be a Covid-19 symptom. I don't know. If my lung soreness was in fact Covid-19 then I got the dizziness two weeks after symptoms appeared, which seems implausibly long.

We decided we could start going out from Sunday 19th. We're still staying away from shops and avoiding other people. It's a bit arbitrary but it is over two weeks since I first worried, and 5 days since I had even the vaguest trace of symptoms (except the dizziness which might or might not be relevant).

So, the rest of the bank holiday weekend when I was sad that I didn't get to do Easter family time with OSOs. I did in fact enjoy some restful time with jack. We played Gloomhaven and unwound a bit from work and Pesach. And we managed to get in some remote Stellaris with cjwatson; it pretty much Just Worked even though we last played most of a year ago and had a really old version of the game. We used Discord for voice chat and it was pleasant and companionable.

Two and a half days back at work, then I had to take an afternoon off to be dizzy, but I was fine by Friday. The lovely Reform Movement started up broadcasting again after a break for the festival, and I attended a couple of seminars (but haven't yet got back into the habit of attending communal morning prayer).

This recent weekend I had deliberately not made too many social plans. I had a nice date with jack on Friday evening. OSOs virtually joined me for the Saturday morning service, and I listened in to their church service on Sunday. The latter feels much less like being together because it's just a broadcast, whereas our service has a Zoom congregation and is a bit more interactive, but I still wanted to support my partners. We also managed a couple of nearly spontaneous games of online bridge using the Trickster Cards site, a matter of just sending a text saying, do you feel like playing and pretty much starting a game with minimal faff. The first was with my mother and brother who are quarantined together, and the second was with OSOs. And I've had a couple of phonecall dates with each of my non-domestic partners.

Going out for the first time after self-isolation was weird. We decided that we could justify going for a short drive to reach a place more pleasant and less crowded than Cambridge city. We went to Waterbeach in order to look at the river, but decided against walking along it because the path is too narrow. It was the most amazingly gorgeous day, just perfect spring weather. And during the three weeks I stayed at home the world has become gloriously green. There were a few people about enjoying the weather but it was far from crowded. We walked in a little nature reserve and it was really lovely.

But I found it emotionally hard. I was anxious about getting too close to people, I was anxious about getting in trouble for having fun and not moving fast enough. And I was really struggling with feeling sad about this perfect spring that we're mostly going to miss, and not knowing how many more seasons will just flow past while we're all stuck indoors, and the people who won't make it through quarantine to enjoy the outdoors again.

Today was a bit better, I returned to my pre-symptoms habit of walking across very quiet north Cambridge suburbs to OSOs' house. And we chatted with them on their doorstep and me more than 2m away in the street, and that made me feel better. I was a lot less angsty about going out of the house the second time than the first.

Last few days I've had fairly obvious hayfever but otherwise feel fine. There are 7 people known to me personally who have had pretty clear cases of Covid-19, and 26 including me who have had suspicious symptoms.

comments

Keeping on keeping on.

7 weeks and change of pandemic life. That's a lot of weeks.
43 days lockdown, and no significant interactions except with my husband. Though 26 days since I gave up internal isolation and I have been interacting normally with him within the house for those 3 1/2 weeks.
18 days since I decided that any novel symptoms I had were mostly gone. I've had very occasional returns of the lung soreness, but very briefly and mildly to the point I'm not sure I'm not just deluding myself. During these 18 days I've been going out occasionally for exercise and fresh air, and jack has visited actual shops a couple of times to pick up things we needed faster than internet delivery could manage.
And day 27 of the Omer. I'm still not expecting plague lifting by day 33, though I know some countries are starting to relax some restrictions.

New lockdown activities: sfred and djm4's extremely moving partnership ceremony over Zoom on 25 April. It was exceptionally well coordinated, with a congregation of around 200 people. And even though the couple had initially told us the socializing part would be postponed until after the Reconnection, actually after the ceremony we just unmuted everybody and there was this amazing buzz of congratulations and people being pleased to see each other and little kids shrieking, just like at a real wedding.

Collaborative crossword solving with seekingferret. That was really fun, despite silght technical issues with Discord. I am not at all experienced with American-style crosswords (and sometimes was thrown by specifically American clues), but I contributed only a little less than my fair share.

Teaching three different Hebrew school classes over Zoom. The new ones, for my actual local cheder where I am formally employed as a teacher, are going less well than the established one with two boys from Stoke plus my partners' daughter. Some of the children are struggling because they've suddenly switched from "screens are evil and rot your brains" to "your entire education is now on screens (so good luck working out how to operate a smart phone!)". Others are just too young for online teaching to work well; my youngest class is Yr 4 which means some of them are not quite 9 and still need direct personal interaction from a trusted adult to hold their attention. I feel even more sorry than previously for people who are trying to teach infant school or even kindergarten online. And the most tech savvy kid is also the worst behaved; right now the set-up is such that I don't have moderator privs and it took her about 10 minutes to work out that she could grab the screen from me, and scribble rude drawings over my worksheets, and there's not a whole lot I can do about it technically.

Talking of people for whom tech is a barrier, I've also been involved in the community welfare programme, trying to help someone who really has no idea how to access the internet short of buying a computer and full broadband subscription. Not someone particularly ancient either, and never thought they would be the kind of person who receives welfare. But at least open to the idea that pandemic life will be better with an internet connection.

Zoom crafting, hosted by pseudomonas. He has a very good theory that it's nice to gently hang out with people, but while doing something rather than having the whole social event focused on chat. Definitely less exhausting than purely conversational Zoom parties, but still feeds my extrovert energies. I have added a few rows to my rather long-abandoned Möbius scarf project.

IRC. Slack is ok, Discord is ok, even Twitter is bearable if you curate your feed carefully. But it turns out that working with a flow of text based conversation in a window is just really soothing to my emotional state. I don't have to reply to or even read everything, but just knowing my people are there, and if I do want to join in the conversation, I can do so on a full-sized keyboard, is just brilliant.

Our veg box person, Cambridge Fruit Co. has now teamed up with a cake shop (and a butcher's, if you like that kind of thing), so we now get a random selection of cake with our random selection of fruit and veg. This week: avocados, a swede and a mango. Also new to our online shopping rotation: v expensive bread flour from former hipster café Stir. It's leading to perceptibly better breadmaker bread, and cheap bread flour isn't very available anyway, so for the moment it's worth the extra money.

Today I feel kind of physically miserable. I think it's mostly menstruation-related and not outside the range of normal for me. But emotionally mostly ok, I'm doing better at finding a balance between getting enough connection, and getting drained by too many video calls, or worse, arguing with people who are Wrong on the Internet because I'm starved of social connection.

comments

(in-package #:cl-pestilence)

;;   This is _not_ a simulation. It's just a game. And any resemblance
;; to any world, real or imaginary, is entirely coincidental.

;;   You can copy/paste this post in its entirety into a Common Lisp
;; REPL and play around with it if you like. I'm documenting it where
;; possible, but it's just a small toy to poke at for the moment.

;;   I've been thinking a lot about asymmetric multiplayer games and
;; <gestures wildly to world at large> all this.
;; I'm not actively _trying_ to model it accurately, but it's probably
;; obvious what's been consuming my thoughts lately.

;;   Let's get right into this. I'll explain as I go, and tie a few things
;; together neatly at the end. I hope. Regardless, there will absolutely
;; be a repo sometime fairly soon.

;; A place can be tagged arbitrarily, and can contain occupants.
;; They also collect points.

(defclass place ()
  ((tags :initarg :tags :initform nil :accessor tags)
   (occupants :initarg :occupants :initform nil :accessor occupants)
   (points :initform 0 :accessor points)))

(defun place? (thing)
  (eq (find-class 'place) (class-of thing)))

(defun place (&key tags occupants)
  (make-instance 'place :tags tags :occupants occupants))

(defun gen-place ()
  (let ((tag (pick '(:apartment-building :house :cottage
		     :office-building :factory :store
		     :cafe :lounge :theater))))
    (place :tags (list tag))))

(defmethod details ((place place))
  (format nil "====================~%~a {~{~a~}}~%~{  ~a~^~%~}~%"
	  (first (tags place))
	  (rest (tags place))
	  (mapcar #'details (occupants place))))

(defmethod show ((place place))
  (format nil "~20@a ~5a [~{~a~}]~%"
	  (first (tags place)) (points place)
	  (mapcar #'show (occupants place))))

;; A peep goes places.
;; They have
;;  - their daily routine (a list of places to visit)
;;  - their todo (the part of their routine they still need to do;
;;                they are currently at the first place in this list)
;;  - their health (a number from 0 to 100)
;;  - a list of plagues
;; Finally, they _also_ collect points.

(defclass peep ()
  ((routine :initarg :routine :initform (list) :accessor routine)
   (todo :initarg :todo :initform nil :accessor todo)
   (health :initarg :health :initform 100 :accessor health)
   (plagues :initform nil :accessor plagues)
   (points :initform 0 :accessor points)))

(defun peep? (thing)
  (eq (find-class 'peep) (class-of thing)))

(defun peep (&key places)
  (make-instance 'peep :routine places :todo places))

(defun health->string (health)
  (cond ((>= health 90) "@")
	((>= health 80) "0")
	((>= health 70) "O")
	((>= health 50) "o")
	((>= health 30) ":")
	((>= health 1)  ".")
	(t "☠")))

(defmethod details ((peep peep))
  (format nil "[~a ~3d [~{ ~a~^ ->~}]]"
	  (health->string (health peep)) (health peep)
	  (mapcar
	   (lambda (place) (first (tags place)))
	   (routine peep))))

(defmethod show ((peep peep)) (health->string (health peep)))

;; A world is a list of places, occupied by peeps. The world we start
;; peeps in also determines their routine.

(defun gen-world (&key (num-places 20) (num-peeps 100))
  (let ((places (loop repeat num-places collect (gen-place))))
    (loop repeat num-peeps
       do (let* ((routine (loop repeat 5 collect (pick places)))
		 (peep (peep :places routine)))
	    (push peep (occupants (first routine)))))
    places))

(defmethod details ((world list))
  (format nil "~%~{~a~}~%" (mapcar #'details world)))

(defmethod show ((world list))
  (format nil "~%~{~a~}~%" (mapcar #'show world)))

(defmethod all-peeps ((world list))
  (loop for place in world append (all-peeps place)))

(defmethod all-peeps ((place place))
  (loop for o in (occupants place) if (peep? o) collect o))

;; `tick!`ing a world means moving every peep through their routine once.
;;   We `tick!` each peep, then `tick!` each place until all the peeps are
;; done. Then we reset their routines.
;; You can think of this as a turn in the game.

(defmethod tick! ((world list))
  (let ((peeps (all-peeps world)))
    (loop while peeps
       do (setf peeps
		(loop for p = (pop peeps) while p
		   for res = (tick! p)
		   if res collect res))
       do (mapc #'tick! world)
       do (format t "~a" (show world)))
    (loop for p in (all-peeps world)
       do (setf (todo p) (routine p))))
  world)

;; Don't worry about the details of how to `tick!` peeps or places yet.

;;   Ok, here's where it gets a bit darker. Although we _did_
;; foreshadow this in the definition of `peep`. And also in the title
;; of the accompanying blog post.

;; A plague is another living thing.
;; It has
;;  - a host (a peep that it's infecting)
;;  - a signature (a token representing its lineage and strain)
;;  - health (how well it's doing inside its host)
;;  - virulence (how likely it is to spread to another host)
;;  - efficiency (how efficient they are at feeding)
;;  - reproduce (a function that returns a new instance to push into a new host)
;;  - and a strategy (a function, possibly closed, that takes
;;    itself and its host peep and mutates)

;; Plagues do not collect points; they score differently.

(defclass plague ()
  ((host :initarg :host :initform nil :accessor host)
   (signature :initarg :host :initform "SIG" :accessor signature)
   (health :initarg :health :initform 10 :accessor health)
   (virulence :initarg :virulence :initform 10 :accessor virulence)
   (efficiency :initarg :efficiency :initform 0.2 :accessor efficiency)
   (reproduce
    :initarg :reproduce
    :initform
    #'plague
    :reader reproduce)
   (strategy
    :initarg :strategy
    :initform
    (lambda (plague peep)
      (feed! plague peep 30))
    :reader strategy)))

(defun plague ()
  (make-instance 'plague))

;; Plagues can `feed!` on peeps or plagues. To feed means to
;; take away some of the targets' health and add some to your own.

(defmethod feed! ((self plague) (peep peep) (amount integer))
  (decf (health peep) amount)
  (incf (health self) (* (efficiency self) amount)))

(defmethod feed! ((self plague) (plague plague) (amount integer))
  (decf (health plague) amount)
  (incf (health self) (* (efficiency self) amount)))

;; Plagues can also `infect!` peeps by `reproduce`ing into them.

(defmethod infect! ((self plague) (peep peep))
  (unless (infected-by? self peep)
    (let ((child (funcall (reproduce self))))
      (setf (host child) peep)
      (push child (plagues peep)))))

(defmethod infected-by? ((self plague) (peep peep))
  (member (signature self) (mapcar #'signature (plagues peep))
	  :test #'string=))

;;  `tick!`ing a plague causes it to weaken and also carry out its strategy.
;; This models the background effect of the immune system of its host.

(defmethod tick! ((plague plague))
  (decf (health plague) 1)
  (funcall (strategy plague) plague (host plague))
  plague)

;;  `tick!`ing a peep means moving them to their next place, and also
;; `tick!`ing any plagues they may have contracted. Also, peeps are
;; resilient; they heal a small amount each time they tick (to a
;; maximum of 100).
;;  If a peep dies, they no longer move. And their plagues probably
;; won't do well. Peeps like to go places. They score points for each
;; place they go to.

(defun dead? (thing) (>= 0 (health thing)))

(defmethod tick! ((peep peep))
  (unless (dead? peep)
    (let ((location (pop (todo peep))))
      (incf (points peep))
      (setf (occupants location) (remove peep (occupants location)))
      (push peep (occupants (or (first (todo peep)) (first (routine peep)))))
      (setf (health peep) (min 100 (+ 5 (health peep))))
      (mapc #'tick! (plagues peep))
      (unless (empty? (todo peep))
	peep))))

;; `tick!`ing a place causes it to score for each `peep` present. And it causes
;; any `plague`s on present `peep`s to try to `infect!` other nearby peeps.
;; Places also lose points for each dead peep they contain.

(defmethod tick! ((place place))
  (incf (points place) (length (occupants place)))
  (loop for peep in (all-peeps place)
     if (dead? peep)
     do (decf (points place) 2)
     else do (loop for plague in (plagues peep)
		do (loop for victim in (remove peep (all-peeps place))
		      if (>= (virulence plague) (random 100))
		      do (infect! plague victim))))
  place)

;;  So, now we've got the basic framework of the game in place. There are three
;; players in this game: places, peeps and plagues.
;;   A plague player automatically loses if they are completely cured, and
;; automatically wins if they manage to kill everyone. That's fairly simple.
;;   A place player wins if they manage to cure the plague. They automatically
;; lose if all the peeps die. Also, fairly simple.
;;   A peep player is trying to survive. If they manage to make it some numer
;; of turns before dying, then we have to score the game instead of declaring
;; an outright winner regardless of game state.

;;   A peep player's score is the total number of points plus remaining health
;; on all of their peeps, minus the number of active plagues on said peeps.
;;   A plague player's score is the total number of health of their plagues,
;; with a multiplier equal to the number of places fully infected by
;; their plague.
;;   A place player's score is the total number of points in their places.

(defun score (world)
  (list :peep (let ((score 0))
		(loop for p in (all-peeps world)
		   unless (dead? p)
		     do (incf score (+ (health p) (points p)))
		   do (decf score (length (plagues p))))
		score)
	:place (let ((score 0))
		 (loop for p in world
		    do (incf score (points p)))
		 score)
	:plague (let ((score 0))
		  (loop for victim in (all-peeps world)
		     do (loop for p in (plaguesvictim)
			   do (incf score (max 0 (health p)))))
		  (loop for target in world
		     if (every
			 (lambda (victim)
			   (not (empty? (plagues victim))))
			 (all-peeps target))
		     do (setf score (* 2  score)))
		  score)))

;;   I think that's all I've got for now. This is definitely an idea I want
;; to run with. At the moment, it's just a tiny, in-repl proof-of-concept,
;; and not particularly fun, but I'm going to try developing it further with an
;; eye towards turning it into an actual web game playable from this site.

;; As always, I'll let you know how it goes.

(defun pick (lst)
  (nth (random (length lst)) lst))

(defun empty? (lst)
  (null lst))