African American Women in Iowa History

In light of March being Women in History Month (as well as Iowa History Month), I’d like to share some history stories about an African American librarian from Mason City, Iowa named Esther J. Walls. In 2020 during the Covid-19 pandemic, there was an essay about her, “Esther J. Walls: The Role of a Black Leader.” Her life story as a librarian, traveler, and educator is fascinating.

I looked through the list of women elected to the Iowa Women’s Hall of Fame and couldn’t find her name. However, I recognized Deborah Ann Turner’s name on the list. She was the first African American woman to be certified by the American Board of Obstetrics and Gynecology in gynecologic oncology. She was also from Mason City, Iowa. Her life story and list of accomplishments is also impressive.

I identify with both of them because they were born and raised in my hometown, Mason City, Iowa. Esther J. Walls was employed at the Mason City Public Library, my favorite haunt because my love of reading and writing began in early childhood.

An archived news item about Esther J. Walls entitled “A Mason City woman’s globe-trotting career” highlights her travels and her sense of humor.

Well, The Times They Are A’Changing at the CDC

We just found out that the CDC is, in fact, changing their recommendations on isolation precautions and other guidance for respiratory illness. It turns out the 5 day isolation rule for a positive Covid 19 test is going away. The Respiratory Virus Guidance page has changed as of today.

Sena found out about it from an article in the Wall Street Journal. The rules for health care personnel are not the same as they are for the public. I guess the times theye are a’changing.

CDC ACIP Meeting on the RSV Vaccine and Some Dad Jokes

We watched the section of the CDC ACIP meeting about RSV vaccines on February 29, 2024. There was a lot of discussion on the safety of the vaccine. It looks like it will still have a requirement that you have a shared clinical decision-making meeting with your physician. I think that still implies you’d need a prescription. However, there are only a handful of states which would require a prescription from your doctor. Iowa is one of them.

That made the comment by one of the committee participants thought provoking. I believe she got the RSV vaccine from a pharmacist, who asked no questions. There was no shared clinical decision-making discussion with that pharmacist.

But there was a discussion during the meeting with a pharmacist who was in the room. She made it clear that pharmacists had plenty of training (“20 hours” along with additional learning) and could handle the shared clinical decision-making piece with patients.

Sena and I have had all of our vaccines including the Covid-19 shots administered by pharmacy techs. I hardly know what the pharmacists look like because they are a blur, managing the drive-up window and all other customers. It’s clear that a large proportion of vaccines are available at most pharmacies and the techs give the shots. They are pleasant and happy to apply the Band-Aid.

You can’t even telephone the pharmacy and talk to a live person. Sometimes you’ll get a recording which replies to most of your questions with “Sorry, I didn’t get that. Did you say you want a vaccine or a cheeseburger with fries?” Scheduling vaccine appointments are generally done on line. Scheduling a visit with the pharmacist is probably not easier than scheduling one with your doctor, who might confuse you with “the colonoscopy” in room 5.

I’ve looked at the health care professional section on the CDC website pertaining to the age and medical conditions necessary to qualify for getting the RSV vaccine. I’m pretty sure I’m in the right age category, although I stopped keeping track after the evolution of asparagus. I don’t have any chronic medical conditions, unless you count dad jokes. I exercise, juggle, take only a multivitamin a day, meditate, and regularly leap tall buildings in a single bound. I’m pretty sure I don’t need the RSV vaccine, but what do I know? I’m a retired psychiatrist.

It looks like the risk of getting Guillain-Barre Syndrome (pronounced “GBS”) is not zero and may or may not be associated with the RSV vaccine. It’s pretty clear that 2 of the 3 major manufacturers of the vaccine who attended the meeting were pretty sensitive to any hints their product might have anything to do with GBS and might challenge you to a no holds barred thumb wrestling match if you say otherwise.

We think there’s a long way to go before everybody’s clear on who gets the RSV vaccine and when, and also where. But you can’t get it at the pharmacy drive up window.

CDC ACIP Meeting on Covid 19 Vaccine Additional Dose

The CDC ACIP meeting on February 28, 2024 on the proposal of a Spring booster of the Covid 19 vaccine was interesting and confusing. Initially right after the morning presentations, we were a little confused about whether the committee was targeting only those who got the vaccine booster last fall or everybody. That didn’t make much sense given the concern about low overall uptake of the vaccine.

The presenters also mentioned that getting the Spring Covid booster would be part of a shared clinical decision-making discussion with your doctor, similar to that recommended for the RSV vaccine. That was bewildering because we think that’s part of the reason some people might skip the RSV vaccine, given the news reports last year pointing out you had to have a prescription from a medical provider in some states to get it.

I was pretty interested in learning more about T-cell immunity given the concern about waning which of immunity from vaccines over a few months, which I think was based on neutralizing antibodies from B cells. I thought the CDC web site link to an article about the T-cell immune response suggested that cell mediated immune responses might mean that our immunity might not be waning that quickly. However, one of the presentations, “Evidence to Recommendation” showed a slide indicating that your T-cell immunity gets weaker with age (ref. de Candia P, Prattichizzo F, Garavelli S, Matarese G. T Cells: Warriors of SARS-CoV-2 Infection. Trends Immunol. 2021 Jan;42(1):18-30. doi: 10.1016/j.it.2020.11.002. Epub 2020 Nov 13. PMID: 33277181; PMCID: PMC7664351.)

I’ve read other articles, one of them on the CDC website, which says you may have more durable immunity provided by T-cells, but if I read it carefully, the authors hedge and say that T-cell adaptive immunity may not be as strong when you’re older. (Moss, P. The T cell immune response against SARS-CoV-2. Nat Immunol 23, 186–193 (2022). https://doi.org/10.1038/s41590-021-01122-w).

Later in the afternoon, the committee voted that those who are 65 years old and older should get the spring dose. There was no further discussion of limiting it to only those who got the Covid vaccine in the fall of 2023. There was also no discussion of the shared clinical decision-making detail. The committee upvoted the resolution with a majority.

And yet, the voting question did say: ACIP recommends that persons greater than or equal to 65 years of age “should” (which was changed from “may”) receive an additional dose of 2023-2024 Formula COVID-19 vaccine. The “additional dose” means in addition to the vaccine (monovalent XBB.1.5) given last fall. That’s a relatively select group, when you take the subset of those who are 65 and older.

However, the slides in the “Evidence to Recommendation” had recommended there should be shared clinical decision-making, meaning that you should discuss getting the vaccine with your doctor. However, according to the STAT NEWS article summary of this meeting, substituting the word “should” for “may” would make the conversation with a doctor unnecessary.

Finally, there was no discussion at all of changing the 5-day isolation precaution for those testing positive for Covid-19. If the committee were planning to drop that, as many news agencies recently reported, I would think they’d have discussed it at length at the meeting.

The CDC Director will have to sign off on the additional Covid-19 shot before it’s official.

2/29/2024 Update: CDC Director endorsed the additional dose yesterday.

Flight of Ideas on Junior Bald Eagles

A couple of days ago the temperature was in the mid-seventies, which is pretty balmy for February. We took the opportunity to get out for a walk on the Terry Trueblood Trail. It’s coincidental, but we did the same thing on the exact same date last February. It’s under the same condition for the most part—escaping from the bad news on the web. The difference was the temperature; it was only in the fifties last year.

The remarkable thing last February was that another trail walker claimed to have seen 16 bald eagles. I’ll have to say that we doubted it, at first. But shortly after that, we caught sight of half a dozen. There were also the quilted hearts we saw, connected to the “I Found a Quilted Heart” project, the goal of which is to make you happy.

This time, although we didn’t find any quilted hearts, we saw a young bald eagle in flight. It was a little hard to tell what it was at first. Bald eagles don’t look bald when they’re in the juvenile stage. I had to look it up. Juveniles look pretty mottled. I wondered if its parents were the bald eagle pair, which we saw at Trueblood in December of 2023. Probably not, given that nesting begins in January, incubation lasts over a month and the eaglets take their first flight over two months later, according to the Iowa Dept of Natural Resources. But it’s fun to think about.

This junior bald eagle looked a little clumsy, both in the air and near the water’s edge. It looked like it might have caught a little fish. It seemed like it was trying to learn how things work in the world and how it’s supposed to fit in.

Instinct takes care of most of that for a bald eagle. Humans have a lot of figuring out to do. We ran into somebody on the trail who told us a great deal about local history. Over time, a lot of things have changed in Iowa City. That goes for the world, too. Much of the time, the changes don’t always seem to make life better, at least according to older people who talk about them.

But the seasons come and go. Bald eagles lay eggs. Eaglets fledge. They don’t gaze up at the moon. Humans do look up at the moon, and occasionally fly there. It’s hard to know why.

There are plenty of earthly mysteries. We saw small black handprints on the Trueblood sidewalk, not far from the shelter. I can’t figure out why they would be there, and what’s more, I can’t find out anything on the internet that explains it. So much for the internet. I supposed I could take a chance and ask Artificial Intelligence (AI) about it, but I’m not confident it wouldn’t just make something up.

We also found a little badge on the ground. It was labeled National Museum USAF Junior Flight Crew. This time, when I checked the internet, I found out there is a lot of information about it on the internet—but none of it helped me understand why it would be on the ground along the Terry Trueblood Trail. You can find a very long article on the internet about how items from the National Museum USAF might not have been handled the way they should have been. You can buy one for about $20 or so on eBay, if you’re interested.

I think it’s more interesting to see how the junior bald eagles learn their way around the world. They earn their wings the old-fashioned way.

Rubber Snake Trick for Pesky Birds So Far

So far, the rubber snakes are not scaring off the birds. We have the telltale evidence for their continued visits to our porch.

It’s only a couple of days. We moved them around to see if that fools the birds into thinking the snakes are real.

Hot Mic in the NASA Control Room

By now, everybody probably knows about the Intuitive Machine lunar landing of the Odysseus space craft recently, broadcast from NASA. I happened to have a direct audio hookup to the control room during the hot mic episode which somehow didn’t get broadcast last week.

Sam: OK, how’s Odysseus doing?

Doug: Uh, we slightly overshot the planned landing.

Sam: What? How did that happen?

Doug: Not sure, but I heard a crunching noise.

Sam: Crunching? There’s no crunching allowed on this mission!

Doug: It’s OK, we can hit the gas and put it down in a different spot a little further away.

Sam: How far?

Doug: Not much, about 1,000 miles give or take. Almost there; applying disc brakes—now.

Sam: What is Odysseus’ position now?

Doug: Well, it looks like it sort of fell over on its side. But it’s transmitting images.

Sam: Great! What’s coming across?

Doug: Kind of fuzzy. Wait a sec, just need to adjust the rabbit ears here. What’s that?

Sam: Hard to make it out.

Doug: OK, there. It’s yellow, whatever it is. Stand by. Wait, are those wheels?

Sam: Adjust the focus.

Doug: Whatever this yellow thing or vehicle whatever on wheels is—it’s coming closer. Hey, there’s somebody inside!

Sam: Oh my god; a life form! On the moon! Quick, what’s it doing?

Doug: Wow. It just gave me the finger. Since when are taxicabs on the moon?

Sam: Dammit! Are you telling me that Odysseus didn’t even leave Earth?

Doug: No sir! But that moon rock sort of looks like a manhole cover.

Sam: You’re fired, Doug.

Doug: Does that mean the Odysseus Landing Gala and Orgy is off? I don’t think I can return the Counting Kites THC Magnum Cocktails.

Sam: I guess now we’ll have to refund the 118 million dollars from NASA—minus the cocktail charge.

Thoughts on Upcoming CDC ACIP Meeting

Sena and I are talking about the upcoming CDC meeting on February 28th-29th next week. The agenda looks like they’ll be talking about an “additional dose” of the Covid-19 vaccine.

Given the extent of vaccine fatigue going on, I tried to find a layperson-friendly article on the web about vaccine immunity with details about how long it lasts.

There’s review article from 2022 that helps a little bit. The author says that boosting every few months may not be practical as a long-term strategy. It leads to vaccine fatigue in the population. We all know how low the Covid-19 vaccine uptake has been. The author says that boosters should be offered annually or even less often. There is more to immunity than neutralizing antibodies.

The suggestion of some experts is to offer Covid-19 boosters to whoever wants it. I feel like I’m getting mixed and circular messages when I read that my immunity is “waning,” and I need another one. We’ve gotten every Covid-19 shot since the vaccine campaign began. Experts even differ on whether to call Covid-19 a “seasonal” respiratory virus. That would suggest you could get one shot annually during the respiratory virus season-like the flu shot. Obviously, it’s not that simple if the CDC recommends another Covid-19 vaccine this spring.

And the CDC respiratory virus channel snapshot from February 16, 2024 is a little concerning. A couple of days ago there was a news report that schools in Forest City, Iowa would have to move to remote learning because of outbreaks of influenza, strep throat, and even stomach flu. According to the CDC, respiratory virus activity levels are high all over Iowa, which surprised me this late in the season.

The Rubber Snake Trick to Scare Pesky Birds

Our porch is a favorite roosting spot for little birds. But they don’t just roost there. They leave certain things behind.

So, Sena bought some rubber snakes. I think we’ll know quickly whether they work. On the other hand, experts say that you need to move them around every so often so birds don’t figure out they’re not real.

I figure they’re worth a try, as long as extraterrestrials don’t abduct them. We could always kick it up a notch if they don’t work.

High as a Kite!

We heard about the marketing of a new cannabis product in Iowa. A company called Climbing Kites makes a beverage that contains low concentration THC and it’s legal to buy it as long as the percentage of Delta 9 THC is not above 0.3%. Their website says funny things like “Fly High:  All Buzz, No Booze.” However, it’s not legal to make it in Iowa. So, you just have to make believe you’re drinking it. Just kidding, sort of.

No, seriously, while it’s true it has to be made in Minnesota and shipped back to Iowa, you can buy it in Iowa legally as long as you’re over 21 years old and don’t mind going to prison for 20 years if you’re caught with an open container of the beverage while driving. Relax, that’s a joke. Have another drink! There’s a FAQ web page on the Climbing Kites web site. It’s Iowa’s first THC drink.

That doesn’t mean recreational marijuana is legal in Iowa, at least not yet. Several surrounding states are, though, including Missouri, Illinois, and Minnesota. There’s an interesting article on the future for marijuana legalization in Iowa.

Marijuana is still not legal at the federal level, though. It’s still classified as a Schedule I drug under the Controlled Substances Act. While there is some conflict between the states that legalize recreational marijuana and the federal government, the federal government is not hustling to prosecute in those states.

It’s been a while since I tried marijuana, which really only caused me to think I could feel every blade of grass (the kind you mow) under my feet. It was before the evolution of the paramecium and, as luck would have it, before the invention of matches. This meant I had to chew the marijuana, leading to a gas attack which attracted a pack of dinosaurs. Of course, my gas attack is what led to the first mass extinction of the large reptiles resulting in the formation of the first mammals, who traded the marijuana for cell phones with the Extraterrestrials. It’s hard to know who got over on that deal because mammals came down with the zombie scrolling fixation while the ETs got a case of the stucks, suddenly becoming unable to remember how to drive their spaceships or make basic decisions about abducting cattle or mutilating soybeans. As you know, that led to all the UFO crashes on the planet, eventually making it necessary to hire the Bigfoot clan to re-educate them about how to traverse multiple dimensions in space-time enabling the collection of massive amounts of beef jerky supplies. History tells us this didn’t work out well for the ETs because their mouths are way too small to eat beef jerky.

There are many ways to get high as a kite; the substance high, the runner’s high, the writer’s high, and more. Weighing the good and the bad about them is a difficult task.