The freelance epi

This pod starts the moment I met Emily Burns for the first time after being mutual Twitter followers over the past two years. We set aside time after learning that we had each chosen to allow our torn ACLs to self heal (unthinkable to most). Emily and Alli talk about COVID-19 pandemic policies which failed to risk-stratify the population, what an empowered community can accomplish (Emily moved from Boston to Texas last year), raising curious minds who can shape their own tendencies to create vs consume content, podcasts to enjoy while traveling, and ACL self repair (vs surgery). A wide-ranging episode!

Follow Emily on Twitter @Emily_Burns_V and Alli @KrugAlli

Who else do you want to meet?

In this second conversation with clinical social worker Shawna Campbell, ACSW, we talk about her Frog Creek Adventure School and how children learn through play outdoors. The pandemic years have made parenting a fraught and anxious time, but kids still need a chance to be children, to be free to play without existential worries like climate change, war, or violence. Families are also looking for a sense of belonging and community, a place for their kids to gain social skills, conflict resolution, confidence and JOY. Shawna describes the importance of letting our microbiome "learn", too, through getting dirty! As kids get older, they need to build confidence, a sense of self, independence and yet be grounded by the love of their parents and community as they define their path. Having a connection to nature and to oneself, even when the going gets rough and we feel alone from time to time can build the resiliency necessary to weathering challenges. 

Find Frog Creek at: https://www.instagram.com/frogcreekadventureschool/?hl=en

Shawna also mentioned a book by Daniel Siegel MD -  Brainstorm: The Power and Purpose of the Teenage Brain

Welcome to the third in this series of conversations with teachers and other professionals working in schools. Today we hear from Joseph Jones, who is the lead for the non-profit organization Communities in Schools serving Norfolk and Chesapeake in Virginia. We’ll hear how students and educators are responding to the shift away from the mask mandates – welcoming the choice and better connections with each other, but also cognizant that this change brings with it concerns about how to keep families safe. We also hear from Joseph his first-hand observations about how students are different now than they were pre-pandemic, impacts on their motivation level, what challenges get in the way of them rising to the occasion and taking advantage of opportunities that education offers, and what kinds of changes in education might help.

Communities in Schools 

https://www.cisofhamptonroads.org/

The song clip at the end is "Love & Hate" by Michael Kiwanuka, a British musician. 

Courtesy Wikipedia: Michael Samuel Kiwanuka is a British singer-songwriter and record producer who is signed with Polydor Records. His 2012 debut album, Home Again, went gold in the United Kingdom and his second album, Love & Hate, debuted in 2016 at number one.

Thank you for listening! Would love to hear from you. Please drop a comment or question using the message feature on anchor.fm or connect with me on Twitter @KrugAlli.

Christina Kennedy is a first grade teacher in Oregon whose definition of equity is lived out every day in her classroom. She defines the notion of equity in education by placing the needs of all students front and center, whether it is finding a coat, a snack, salted sunflower seeds, delivering lunches, a tech who speaks Spanish to visit the home of a student unable to log in... It is time to place the needs of students at the center of all we do. That is equity - providing hope to students, erasing the question marks in their minds about the future, while addressing the concerns of our educators about the safety of the classroom. As an epidemiologist I believe the data says the classroom is the safest place to be for both students and teachers. The Urgency of Normal can be accomplished equitably. Christina's powerful stories about reaching her students will energize fellow educators and hopefully draw dedicated young people to the joys of the teaching profession at a time when we desperately need them. 

Recorded in an ice rink lobby, this episode brings you an experienced teacher's perspective on the pandemic classroom. My guest is a hockey mom and -- most relevant here -- a fourth grade teacher who has a Master's in Education and a doctoral degree in Innovative Educational Leadership. She has worked for 5 years in a school serving disadvantaged students, in the virtual environment last year, and is back in the classroom this year. The district moved to mask-optional a month ago, providing us a chance to touch base on how things are going. 

The conversation was loosely structured around equity and what that word means to a teacher today, major classroom challenges pre-pandemic and how the burden of teaching has changed during the pandemic. We also discuss the struggles teachers face every day trying to meet the needs of all students and the important (yet sometimes undervalued) role of parents as partners in education. Finally, we discuss checking biases at the door, doing some self-reflection regarding perceived risks and career paths, finding innovative professional pathways to retain teachers who have underlying health conditions while recruiting teachers to the classroom who are ready and willing to move on to pre-pandemic teaching. 

"We really need teachers who care, and want, and really believe that no matter where a child comes from, no matter how much money their family has that this child can learn and change the trajectory of their life. Those opportunities should be there for everyone. But sometimes there are so many obstacles that a teacher has to overcome, they just feel like ‘I don’t have time for this today.’ This is where we need partnerships – therapists, counselors – to help children overcome trauma and learning disabilities."

"Students really need their teachers. We as a society cannot continue to pause education because of COVID."

"We teach our kids to think with the end in mind. Are we thinking with the end in mind? It’s time to go back to pre-pandemic."

Today's conversation picks up where Dr. Rohan and I left off - the catastrophizing of the pandemic, rhetoric and the response to the pandemic, words which convey little of value because we define them differently (eg, novel, flatten the curve, the new normal), and being outliers (educators who think we may have over-reacted).   

Guests:

Lelia Glass Ph.D. Coordinator of Linguistics Program, Assistant Professor of Linguistics, Georgia Tech 

Dr. Lelia Glass is an Assistant Professor of Linguistics in the School of Modern Languages.  She earned her Ph.D. from Stanford University in 2018, where she won the Walter J. Gores Award for Excellence in Teaching, and held a dissertation fellowship from the Andrew W. Mellon Foundation and the American Council for Learned Societies. Lelia works on lexical semantics (word meaning), compositional semantics (sentence meaning), pragmatics (inferences drawn in context), and sociolinguistics (how people use language in their social identity), from an empirically rich perspective, with a particular interest in how our knowledge of the (physical, social) world affects our interpretation of language. Education: Ph.D. in Linguistics, Stanford University (2018) M.A. in Linguistics, Stanford University (2014), B.A. in Linguistics, University of Chicago (2012), with honors  

Liz Rohan Ph.D. Professor of Composition and Rhetoric, University of Michigan-Dearborn 

With Gesa Kirsch, Dr. Rohan edited Beyond the Archives: Research as Lived Process (Southern Illinois Press, 2008). Her research, which reflects her ongoing interests in pedagogy, feminist research methods and America’s progressive era, has appeared in journals such as Rhetoric Review, Composition Studies, Pedagogy, JAEPL, Reflections, Composition Forum, Peitho, and also in several book chapters. She edited the diaries of a historical college student, John Price, that is published online in cooperation with Denison University and the Five Colleges of Ohio Digital Depository.  Education: B.A. in American Culture, University of Michigan-Ann Arbor, M.A. in Writing, Depaul University-Chicago Ph.D. in English, with a concentration in Writing Studies, University of Illinois-Urbana-Champaign

This was recorded in early November but chaos intervened -- for weeks -- and a sense of futility set in. These recordings are a message in a bottle to my future self, and for those of you who have discovered them it is lovely to know I'm not alone. Sometimes it's just too hard to connect in person, to reach out and engage. I tend to go inward but I'm thinking of others who are struggling and wish I could do more. That is what is feels so futile -- I'm just one person. But collectively, we're more than that, and we're everywhere -- as the analytics show. Thank you for being you, and for finding this and listening. 

Topics covered:

- gas station conversation with Betty about why she got vaccinated, thoughts on boosters

- parking lot conversation with Timmy about why he didn't get vaccinated, yet

- malted milk balls in Spotsylvania 

- commentary by Ben about risks - ones you can modify and ones you just have to manage through

- strategy for quick engagements with people - think about one dose? 

- Dietrick's blessing on the way home

Leave me questions or topic suggestions below or at akrug@abcmedicalwriting.com.

Thank you!

We talk about how the semester is proceeding, how being in person and singing together again has made an impact on the overall academic experience. Nicola notes that for some students, being able to sing together again made coming back to campus a priority. Alli talks about the challenges of starting a hockey season during Delta with two groups - vaccinated and unvaccinated - sharing the same rink space. Good communication and collaboration allow for trust and individual responsibility to replace protocols. Enjoy! We'll meet up with Nicola again next month to hear how her Wed performance went :)

A report from the rink our first month into the hockey season and the COVID homie system, how this informs our transition to a post COVID world, immunity via vaccine vs natural immunity, the question of vaccine induced myocarditis (ie young men matter), and scaring people at Food Lion with my open ended street epi questions...

Here are the protocols we are currently using in our hockey rink:

Vaccinated person – exposed to COVID:

• Needs to self-monitor for symptoms for 14 days.
• Does NOT need to quarantine but get tested 3-5 days after exposure. If positive, isolate for 10 days.
• Wear a mask in public places indoors until negative test* obtained.
• Can continue coming to practice and games if ASYMPTOMATIC.
• *Rapid test is fine! Rapid is 96% sensitive and 99% specific within 7 days of exposure.

UNvaccinated person – exposed to COVID:

• Wear a mask and get tested right away. Begin 14 day quarantine.
• Early test-to-release from quarantine on day 7 if no symptoms develop and negative test between days 5-7.

Cold symptoms – no known COVID exposure, any vaccination status:

• Wear a mask and get tested (rapid test) within 3-5 days of symptoms starting.
• If negative, retest in 36 hours.
• If 2 negatives, all clear.

If you have changes/suggestions, please drop me a line akrug@abcmedicalwriting.com. 

Thank you! 

Choral singing and hockey - the two highest risk activities in a respiratory pandemic. We found each other on Twitter and instantly realized we had much in common. Prof Dedmon has been seeking to harmonize pandemic precautions with student needs to continue engaging in one of the most beautiful of human art forms: choral singing. Listen to her thoughts about trying to assimilate an avalanche of guidance, learning to love science, and making new friends in the process. Nicola is an absolute delight, a highly intuitive and intelligent being who treads forward carefully and compassionately, yet with the courage and conviction to interpret science and help her students navigate through this tail phase of the pandemic. Enjoy this conversation...and hopefully next time we'll get to hear some choral singing, too!

Let's talk about something beautiful - Meet Prof of Choral Studies Nicola Bertoni Dedmon for an unscripted chat about resuming activities which bring people and their passions together while preventing unnecessary risks.

Choral singing and hockey - the two highest risk activities in a respiratory pandemic. We found each other on Twitter and instantly realized we had much in common. Prof Dedmon has been seeking to harmonize pandemic precautions with student needs to continue engaging in one of the most beautiful of human art forms: choral singing. Listen to her thoughts about trying to assimilate an avalanche of guidance, learning to love science, and making new friends in the process. Nicola is an absolute delight, a highly intuitive and intelligent being who treads forward carefully and compassionately, yet with the courage and conviction to interpret science and help her students navigate through this tail phase of the pandemic. Enjoy this conversation...and hopefully next time we'll get to hear some choral singing, too!

In this conversation with our 16 year old, we explore how to communicate with teenagers about annoying covid protocols (he agrees that dealing with teens is a lot like managing chickens), my minor rant about double-masking, and how to choose good sources of information. 

Last week, we modified our intensive protocols for the rain and cold weather, allowing the skaters to put their skates on in the rink, spreading out in locker rooms and the lobby. Usually the protocol is to enter the rink fully dressed, including skates, and proceed directly to the ice. During bad weather, we allow the kids to tie skates inside. Last week, the high schoolers interpreted the rain protocol to mean dress entirely in the rink, and one team ended up with about 6 kids in the small party room, with no masks on. The time period was relatively brief (10-15 minutes) but they were too close in an unventilated room. This conversation explores the challenge of dealing with this sort of situation, and the importance of keeping the big picture in mind while preserving relationships. 

Thank you for listening to this journal as I reflect on the privileges and challenges of serving as a volunteer in a community effort to keep hockey alive for kids. Find me at www.abcmedicalwriting.com for developmental editing, writing, data analysis or other medical communications projects.  Thank you! 

This episode looks at the calculation for Moderna's mRNA vaccine efficacy, building on what we did with the Pfizer vaccine trial data. We also consider a question about preservatives, comparability of the two clinical trials, and more. 

FDA Briefing Document for Pfizer:  https://www.fda.gov/media/144245/download

FDA Briefing Document for Moderna: https://www.fda.gov/media/144434/download 

Note - I compute the efficacy using a solution that produced the 94.5% I found in the briefing document, but the actual formula uses the Hazard Ratio (HR). Here it is: 

            1-HR (Hazard Ratio) * 100 = 5 cases of symptomatic COVID / 90 cases of symptomatic COVID = 1 - 0.055 = 94.5%

In tonight’s episode, we check the pulse of youth ice hockey in Virginia Beach as the season continues to evolve. We loosely organized our conversation around the three periods of a game – the first period being the outset of the season and the protocols put in place by hockey director Rich Appleby . Although the rink already had in place all the federal, state, and local guidelines place, we found that we needed to step up our game even more.  After a two-week pause at the beginning of November, the program reopened with new more intensive protocols.  We just paused for the holidays after a second 6-week period of play closed without further transmission within the program. Families were thankful for the transparency and excellent communication throughout. Hockey director Rich is joined by high school head coach Bob Pizzini, who describes the on-ice role of coaches in keeping kids playing safely as we embark on this third period of play through March. We hope you enjoy the unfiltered conversation and surprise guests at the end.

1. Specific intensive protocols currently in place:

a. Gear up at home or in the parking lot at two outdoor ("fresh-air") changing areas, one set up for in-bound players and one for out-bound players

b. No locker rooms, no gathering in the lobby – get in, get out immediately before and after practice. 

c. Establish contingency plans for rain

d. Put mats out so kids can wear skates from car directly to rink

e. Coaches enforce rules so that everyone is accountable; leaving it up to parents invited too much variation depending on who was there, what mood the child was in, how much parent could push back and get masks on, etc. Coaches understand it’s an extra burden this year to push kids out of the rink when practice is over. Modifications were made for coaches with multiple kids having to stay around the rink between sibling practices.

f. Masks at all times except on the ice – experimenting with different gear, anti-fog sprays, dish detergent for those with glasses, double-layer gaiters (not single). 

g. Transition time lengthened between practices and games (practice is 45 min, with 15 min between practice sessions; games are 65 instead of 75 minutes with 17-minute running clock).

h. Switch to 17 minute running clock to reduce number of people on clock/scoresheet/PB and increase time cushion between games

i. Establish COVID liaison for the rink, and COVID point of contact for each team (effectively the team manager, but could be a designate)

j. Communicate the symptoms we are most likely to see in our population – no shortness of breath, no fever (generally 99.5F, not typically 100.4 or higher), often presents like a cold with a runny nose, headache, sore throat, muscle pain, fatigue, maybe diarrhea or nausea. Keep symptoms at home. If players become close contacts, the teams are quarantined and games have to get cancelled. Players must maintain strict distancing to keep the teams in play.

k. One parent in the rink for practice and games – alternate during the game between periods, or have one parent volunteer on score/clock and the other watch

This episode reflects on the systems engineering challenge of reducing risk of virus transmission - the human factors. Inspired by conversations with two great mentors today, one an epidemiologist, former professor and friend, and the other an aerospace engineer and friend who (actually!) enjoys endless conversations about COVID and how we can be better managers and communicators. Recorded while running (what?!), and thinking about running this endurance race against (with?) the indefatigable virus. Thank you for listening, and I hope you enjoy!

In this longer audible bio, I share how I got started as an epidemiologist and medical writer. It's Thanksgiving weekend, and a great opportunity to thank my mentors and managers who believed in me as a young person fresh out of grad school. I've known them for 20 years, and still turn to them when I need a confidence boost or fresh direction. 

My career has been very diverse. I was one of the few public health professionals who wanted to work for a non-profit HMO instead of going directly into a public health agency. After managing preventive health programs and publishing an original research article, I moved into vaccine sales and saw the frontlines of healthcare delivery in the Northeast. When I married a Navy Officer and started moving from coast to coast, then Hawaii and overseas to Japan, I needed a portable career. We just moved to Virginia Beach with our two teen boys after spending four incredible years in Japan.

Being a medical writer has offered me a professional path and connections with people doing important public health work around the world. In this episode, I describe how I use my training in epidemiology as a writing and research consultant, how I invest myself on the front lines as a volunteer epidemiologist, and some of the ideas I'm wrestling with from the policy sidelines. Thanks for taking a listen to this first episode!

Alli Krug is an epidemiologist and medical writer with 15 years' experience as a developmental editor for 400 published research manuscripts. I'm fast, fun to work with, and scholarly. This brief audible bio is for the manic multi-taskers among us. A good developmental editor or health copywriter can move your project through to publication.  Contact me today to book your project for 2021.