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Oh hai, so you want to know about social distancing? Cancer parents are here to help.

You know what’s odd? To write a sentence like, “Being a leukemia family is a really big advantage right now.”

We started our self-quarantine on Monday afternoon and learned on Thursday that pretty much all of the greater Bay Area will be joining us now with school and nearly all events cancelled. We feel weirdly lucky to go into these weeks knowing mostly what to expect, armed with practice and the knowledge that we know we can do this. We’ve had over a year of training on germ hygiene and indoor activity planning. So, for once, here we are to share not just a family update (don’t worry, scroll to bottom for that), but some pro-tips that none of you ever wanted to need. But first, a word about WHY YOU MUST TAKE THIS SERIOUSLY STARTING NOW.

We’re not going to take the time to post all of the #flattenthecurve science but some of you, like Jeff, have either opted-out of social media or never got caught by that pandemic in the first place. Social media has given us early visibility into 1) the best evidence and 2) the remaining pockets of well-meaning downplay sentiment. We’re past the “we’re probably crazy” embarrassment of a month ago and are ready to risk being a little preachy to our family, who we love. To our SF and scientist friends, this might be an echo chamber of your feeds.

Here’s a simulator that’s fun to play with to see why social distancing works.

Real social distancing is the only viable strategy right now, not hoping for a vaccine. You KNOW it’s coming to your city/town sooner or later. But maybe, maybe some of you are still thinking, is this really necessary? A month ago we were saying to ourselves, “The death rate is low” or, “this is mild for many people”. In our opinion, massive amounts of evidence from this and past pandemics should be enough, but in case it isn’t, let’s get personal.

Setting aside for a moment the scary possibility of contracting COVID19 (where 99% of deaths in Italy have occurred in people over 60), let’s just think about your personal medical needs, or Thea’s, in a world like what’s happening in Italy right now. When our hospital beds become overcrowded with COVID19 patients, and they will, where will you go if you have a bad fall, get the flu, have a heart attack, or need your regularly scheduled IV drug infusion? Will you be able to get your prescription medications when supply chains degrade further? What will happen if Thea’s children's hospital is forced to become an adult triage center? How will she get her next spinal chemo or IV chemo? What will we do if the daily oral chemo meds she needs to maintain remission are no longer accessible?

Social distancing is not a snow day. Do not have dinner parties, play at playgrounds, or schedule playdates. Here’s one dialogue with experts that was helpful to us. The better we are at this, the less people will needlessly die. No matter what we do, it seems that 35-70% of the US population will get COVID19. Our vigilance in self-quarantining will determine when those people will get it: all at once, or spread out over the next year.

The fatality rate was 5.8% in Wuhan, compared with 0.7% in the rest of China. It’s not that people near the epicenter of the first outbreak got somehow sicker (and we are going to pass over some factors in contextualizing mortality rates). The reason the first place infected has the highest death rate is that it didn’t know to act quickly enough to socially-distance, and thus too many people got it in too short a timeframe and that overwhelmed their healthcare system.

Yes, we have one of the highest rates of critical care beds per capita, but one of the lowest overall hospital bed capacity, and it’s over 60% utilized already. We will run out. Case counts are growing faster than the estimate in the “let’s talk math” twitter thread from a week ago, doubling every 2-3 days instead of every 6. Imagine no beds, people in hallways, and exasperated healthcare workers making decisions to allocate the free ICU beds and ventilators to the youngest, healthiest patients.

PLEASE. There are no hard and fast rules about social distancing but please be conservative.

Okay, now that you are really ready to try staying away from others, here are some thoughts that have gotten us through our “hermetically sealed” days in the past. None are novel or brilliant, but all have been tested.

  1. Do you like lists? Now you like lists. Make lists. Oh look, we’re making a list here. A list of safe outdoor games and activities, a list of toys and materials hiding in all sorts of spaces in your house that you’ve forgotten about. Lists of what food and medicine and cleaning supplies you have. Lists of ideas for activities. Just, all the lists. We print them on actual paper and post them up so we can run over and add or “grab” an idea when needed. The internet is spinning with so many great ideas right now so if you’re out of fresh ones, google it.

  2. Young kids? For the weekdays at least, make a schedule chart with post-its. Each post-it is a different 30-45 min activity. Make up the schedule every morning together with the kids. Grown-ups have some of it filled in already and kids get to pick some of it themselves. Keep the schedule visible at all times. When things don’t go according to plan, make a big show of going over to the schedule and making adjustments (rather than abandoning or ignoring it). Ours pictured here is a pocket chart but post-its work just as well.

  3. Include a (safe) outdoor activity once in the morning and once in the afternoon. Be strict about this one. Our girls whine about making the effort to go outside and then become calm, zen-children once we finally get there. They could be literally smacking eachother inside and the moment we’re outside they’re all “let’s be scientists and do a nature science diagram” like little pod children.

  4. Unless you are already a homeschool parent (and if you are, I want your tips. all the tips give them to me now i beg of you), and especially if you need to get work done each day, loosen your screen time rules. If you want to make yourself feel better about that and have the patience, organize the more academic apps into a folder for each kiddo. They pick apps from the first folder for a certain amount of time you set and then they can pick from any of them. Make your own google doc or site with links to the shows you approve of so they don’t have the painful experience of seeing ALL the netflix options only to have you say no to most of them. Don’t even count facetime as screen time! Schedule facetime playdates galore. We’re really enjoying an app called Marco Polo for this, which is kind of like video voicemail made fun.

  5. Parents, give each other breaks. We are particularly bad at remembering this one. We know we need to but the day slips by if you don’t schedule them precisely in advance. It feels weird to do that, but do it. Recently we started making a list (lists!) for things that relax us inside our home. Amazingly, neither of us put “breaking up nonstop petty bickering” on ours.

  6. There’s a better way to wash your hands than you’ve probably been doing.

When I read our old blog posts, I notice each one talks about amazing, special memories we made while cooped up inside. Make some memories, gifts, family dance videos, journal, and write a letter to your kids to send when they’re older.

That’s what we’ve got. It’s nothing magical but maybe helpful to some. And now, for a quick update on life in the Vyduna household.

To put it mildly, it’s been a rough cold and flu season for us. Our careful hygiene and frequent quarantine last year meant we had no colds, pretty much that whole year. So maybe we were overdue and needed to rebuild immunity to things. But wow. Thea has had three ear infections, Flu A, many colds and coughs and two separate trips to the ER for fever (thankfully never admitted). Siggy, Jeff and I have also been sick quite a bit (I don’t remember the last time I didn’t have a stuffy nose). It’s been hard on everyone, especially Thea who in all her maturity has clearly stated, “I don’t like it when things don’t happen the way they’re supposed to.” Sing it, sister. Plans have been changed or canceled so frequently over the past months that we’ve stopped telling her about upcoming things to spare her the disappointment. Thea’s current immunity levels are low and bordering on needing a special type of blood transfusion. We’ll find out next week about that but suffice it to say, it does not make us feel good going into this coronavirus storm.

Despite all the illness, Thea has continued to love school and excel at it. We can’t say enough about her magical teacher, who clearly adores her and all of the students and makes special effort to make Thea feel included even when we’re not there. Last week, for example, Thea facetimed into “centers” every single morning and was carried around to each table to complete the tasks. She hates missing school and asked for a school playkit at home so she can be the teacher. Before all this she’d been taking piano lessons and swimming which has built her confidence a lot.

Siggy continues to love her school and boss everyone around in the cutest way possible. Her biggest struggle is and probably always will be her little sister complex. She is furious she can’t do everything Thea can do and absolutely under no circumstances should you ever call her cute, which apparently means “little”.

Thea still goes to the hospital for twice monthly blood draws, takes her oral chemo every day and visits the OR for a lumbar puncture followed by IV chemo & steroids every three months. We just finished one of these “pulses” so she won’t need to go back again until May.

We started assessing our emergency supplies three weeks ago and spent two full weekends getting things organized. We felt crazy at the time because most people weren’t there with us yet, but are glad now that we didn’t have to shop in the insane mobs that have become the new normal this past week. So, to those readers in other parts of the country, it’s good to feel like you’re overreacting. Don’t let that stop you. In the end we’re actually shooting for that. If one day we can all say, man that was an overreaction, then actually it wasn't, it worked.

P.S. If you can’t stay inside and must make urgent errands etc, consider some of the automatic hygiene habits we’ve developed over time. If you are questioning any one of them, we built them for a reason. Ping us and ask and we will tell you stories.

  1. Sanitize immediately when entering and exiting the car, no matter what.

  2. 1)Sanitize immediately when entering the house, then 2) go straight to the bathroom and wash with soap. Why both? I’ve noticed we get distracted from step 2 sometimes.

  3. Bribe like hell to wash hands well. We use fun musical timers and chocolate chips (Yes, they get one every time they wash well. Don’t worry, their uncle is an orthodontist.)

  4. Wash hands before and after any food prep or consumption, wash hands after blowing noses.

  5. Put cleaning wipes in every bathroom, kitchen and entryway. Build nightly habit to wipe down handles, flushers, faucets, knobs, drawer pulls, light switches etc. Siggy loves this job.

  6. Remove cloth hand towels and replace with paper towels.

  7. Keep toothbrushes separate from one another.

  8. Keep wipes in car and sanitize door handles, steering wheel, etc.

  9. Change clothes when coming in from outside. Jeff stopped riding public transit.

  10. As Siggy says, sanitize the hanitizer :)

And finally, perhaps most importantly, our hearts swell and eyes get teary thinking of all of the healthcare workers and service workers that will be on the frontlines fighting this and keeping basic services open. From the tops of our heads to the tips of our toes, thank you, thank you, thank you, thank you.


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