Showing posts with label health. Show all posts
Showing posts with label health. Show all posts

Sunday, February 9, 2020

Nobody knows anything about coronavirus, and there are two reasons why

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Source: Facebook (I've seen it in several places, I have no idea who to credit for creating it)


I noted in my last post that "we know nothing" about coronavirus, and I want to expand on that a little and talk about why.


...the international media is taking government data as gospel, which people in China know right now not to do. We don’t know what the fatality rate is because nobody knows how many people died before being diagnosed because they couldn’t get care. China keeps reporting “2.1%”, a number I don’t think anyone in China believes. We have no idea how contagious it is, either. We know nothing.

Let me be clear when I say "we don't know anything" - we don't know the fatality rate, as I noted. We also don't know yet where it came from (though as SARS originated in a wet market, coronavirus probably did too). We don't know how contagious it is, because if we don't know how many people have it, and how many have died from it, how can we know how easy it is to get?

We probably know that it's transmitted through aerosolized body fluids - that is, droplets of saliva from normal breathing - and you can get it by getting it on your hands and touching sensitive membranes in your face. At least, we think we know - that information also comes from China, but it seems highly plausible, even likely. In fact, it's hardly groundbreaking, that's how most colds and flus spread. 


In fact, if you're going to be worried about anything, don't let it be coronavirus. If you are not in China, you probably will not catch it (even if you are in China, you might be fine). Be afraid that we don't know anything about anything, the people fighting it don't really know anything, and even if the CCP did know, they'd probably lie about it.

But why? We can blame two factors - the first is that the Chinese government and health care "system", such as it is, is completely overwhelmed and it's likely they themselves don't have a clue what these data actually are. The second is that the Chinese government thinks it can decide what is true, and attempts to push a political agenda even to their own detriment, as well as the world's. 


So there are two layers of unreliability: the CCP is lying about data it doesn't even know itself. 

The first reason isn't entirely China's fault. I mean, it is absolutely their fault that they covered up the initial outbreak, allowing it to get worse. If they've learned anything from SARS, it's manifested in a slightly faster path from "pretending this doesn't exist and punishing anyone who says otherwise" to "admitting we have a problem", not in eliminating the first stage altogether. It is also their fault that they've allowed the nation's lackluster health care - which is absolutely not "free" or even "public" as many Westerners believe - to fester for so long.

But it is not their fault that the virus broke out there; these things happen around the world. So it's not their fault that they are the epicenter, nor that they had to be the first to fight it, while the rest of the world got a heads-up and some time to prepare.

The second - their consistent lies and cover-ups when SARS should have been a lesson against such behavior - obviously is their fault. That should not need to be explained. The lying, yes, but also their consistent opposition to Taiwan's participation in the WHO and other international organizations (such as ICAO) where their expertise and superlative health care and responsiveness to the epidemic could be of great help in combating it.

With all that in mind, let me hazard a few speculations about these things we don't know. 


First: coronavirus probably is highly contagious - we just don't know to what extent. We don't have enough data to compare it to the common flu, so please stop doing that. But the flu exists in China, and hasn't created an epidemic like this in previous years. If people going out for hot pot can infect much of their family and it's possible to contract it just transiting through Hong Kong, that points to potentially high contagion rates. It's possible that China is overreacting by locking down entire cities, but I doubt they'd self-destruct their own economy - through two sources I know that even Shenzhen is in full-city quarantine, which would be economically devastating - if they didn't have reason to worry.

But - how much of that contagion is simply because it is highly contagious, compared to how much is potentially caused by overwhelmed health care systems in China and poor public hygiene in general? I contracted bronchial pneumonia twice in one year in China; this is almost certainly a contributing factor. How much of it is due to an inability to practice appropriate epidemic-fighting hygiene protocol because masks, sanitizer and alcohol cleaner are all impossible to get, in a contagion zone?

I have no idea, but the fact that the virus seems to be spreading slowly and is basically under control in most of the rest of the world means that it probably can be contained, and isn't necessarily going to be a global pandemic. You might want to keep people in China in your thoughts, however. They don't deserve this and with every Chinese system on overload, it's probably going to get worse.


How much of the unknown fatality rate is caused by those same factors - an overwhelmed system, shortages of necessary hygiene supplies and poor general public hygiene, as well as paranoid quarantine policies that put people in non-virus-related danger and have resulted in at least one death?

It's impossible to say, but the fact that a lot of people are dying from coronavirus in China (though we don't actually know how many) and very few have died abroad shows that the environment and poor government response in China are factors. 


That brings me to my final points - first, I don't even know how much to blame China for actions which seem malicious. That charter flight meant to bring at-risk Taiwanese back to Taiwan, that ended up being full of wives and children of evacuees (who also deserve to be flown out, but not at the expense of at-risk people)? You know, the one which ended up containing at least one confirmed coronavirus carrier? Some have accused China of purposely putting infected people on that plane as an attack on Taiwan, but I honestly think, in conditions that have been described as "wartime", that it's far more likely that they didn't have the wherewithal to intentionally put a carrier on that plane, and just let a person who'd bribed their way into a seat take what they'd paid for.

Second, if you are not in China, please stop freaking out. Taiwan's response has been exemplary - this is what open information and quick responses can accomplish. Japan has done a good job as well; Singapore is pretty good at this sort of thing. In fact, it seems that even if this coronavirus is highly infectious and highly fatal, that a strong public health response can keep it in check. Again, it's not China's fault that it was the epicenter - only that it spread in a government-imposed information vacuum.

That the rest of Asia has done a brilliant job of organizing a strong response before it could spread further is good news for the world.

This is probably not the last epidemic virus that will originate in China - the huge population, generally poor public health care, poor public hygiene (think bad plumbing, undrinkable tap water, rarely-cleaned public toilets, public spitting - though that has decreased markedly in the last decade) and prevalence of wet markets almost guarantee it. I certainly hope for the people of China that coronavirus is brought under control, though I also hope that they can overthrow that useless CCP and create a government more capable of responding to such outbreaks.

In other words, sunlight is in fact the best disinfectant. Open information, strong public health and quick action seem to be pretty effective in combating coronavirus, and they are protecting entire populations. I can only hope China figures out those three coronavirus 'vaccines' sooner rather than later. 


But the ability of much of the rest of Asia to coordinate a containment response and share what information they have freely is good news for the rest of the world. Forget the "first island chain" and South Korea in terms of traditional defense - warships, airstrips, bases and whatnot. This is the front line when major epidemics originate in Asia, and rather than excluding a key node in that defensive chain from organizations like the WHO, maybe the world should stop pretending the CCP is a true ally, and start realizing that the rest of Asia - including Taiwan - should get more credit. 

Wednesday, May 22, 2019

Gym Recommendation: The Key

Over the past few months I've been gearing up to write my dissertation, and was feeling a bit blue about having lots of reading to do because I didn't want to sit like a slug on the couch doing it. A friend recommended The Key, them my husband joined and liked it, and I thought: there are surely exercise machines I could use while reading, even if it's just a bit of light elliptical or stationary bike.

I knew I could do this at the local municipal gym (which is not far from my house), but never seemed to make it down there - in part because the one in my district is in an odd location that isn't too close to anything else I need or want to do. Before The Key, none of the paid gyms really appealed to me either: either they always seemed crowded, or they were too heavily skewed toward weight training, or they were too expensive and only had annual memberships available (I travel often so don't necessarily want to pay for a month when I won't be around.)

Or, in one memorable instance, I had already heard some concerning things about the management at another gym and they way they treated people and interacted with the expat community - only to have those concerns abundantly validated recently. I didn't want to give money to a place that wasn't welcoming to everyone.

So, I joined The Key. From their Facebook page:


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It currently costs NT$1500/month (renewable monthly so you cancel if you won't be in town and then return), is conveniently located near other places I often go (just north of Zhongxiao Dunhua) and at the nexus of useful transport hubs, has a big-enough room of cardio exercise machines (not just a preponderance of weight training equipment, which isn't useful to me while I'm trying to get reading done) and has a decent cafe on-site - with discounts for members - as well as a comfortable rooftop relaxing space accessible to members.


I certainly recommend it for everyone, but especially for women. Most importantly, I've never once felt judged or unwelcome as a...um, plump woman who isn't even necessarily there to lose weight the way I have at gyms in the past. Management is friendly and always accessible if you have questions or issues and they make a real attempt to remember their clients' names and faces. Overall it's just a place where I think women can feel comfortable. It's hard to put that sense of 'comfort' into words, but it's there.

The space is nicer and more inviting than the municipal gyms (though I'm happy those exist), with big windows looking out over leafy Dunhua Road. The actual gym portion of the space is above the cafe starting on the 2nd floor, so nobody on the street can see you huffing and puffing away but you can look out at the scenery. There's good wifi and free water. There are lockers (bring your own lock) including ones you can rent longer-term as well as changing rooms and showers which are clean and well-maintained.

Most of the cardio machines come with televisions and USB plugs, so you can watch TV or Netflix while you work out if you're not a hardcore nerd like me. The displays can be set to a number of languages, including English, and are fairly easy to use. They have classes where you can learn how to use the weight-training equipment (and other classes too, as well as personal training, but I'm there to work out as I read so I haven't explored those yet). There are English speakers on staff.

The space is tall and narrow as it's designed to fit into the building it occupies, but they make the most of it with an elevator so changing floors isn't too much of a pain.

So yay, The Key! If you're looking for a place where you can work out without feeling judged or potentially discriminated against or just want a place that's more conveniently-located, this is the place for you.

Note: I was not asked or paid to write this post. The opinions expressed in this review are my own.

Wednesday, November 22, 2017

Let's talk about sex education in Taiwan

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It's a popular expat pastime to point out ways that Taiwan is different from one's home country - you know, the typical "back home we have churches but here we have temples" type of narrative. I do it myself sometimes. There's nothing wrong with that type of story - vive la difference and all - but it's interesting sometimes to look at ways in which countries on two different ends of the world are more alike than they are different - for better or worse. And sometimes both.

This is one of those "both" times - an interesting article appeared on NPR pointing out Taiwan's forward thinking sex education curriculum (although implementation is far from perfect, as teachers incorporate it into other subjects as they see fit) as well as opposition to it. Both good (the modern, pragmatic curriculum content) and bad (anti-gay groups saying the same-sex relationship education is 'improper') are quite similar to the debate over this issue that goes on in my own country.

I've long been critical of sex education in the USA - as the article points out, what is taught (if anything) is state rather than federally mandated, so American children in different states might graduate with wildly different knowledge about sex and reproduction. More age-appropriate knowledge is always better in this regard (with "age appropriate" meaning "a strong knowledge base before a young person becomes sexually active, and whatever knowledge they are curious about regardless of age"), so it is never a good thing for a student in one state to have less knowledge than a student in another. When sex ed is taught, as it was in my school, I wonder about the content. I learned about sexually transmitted diseases and reproduction, but did not learn much about female anatomy - I had to inquire on my own to learn that one can pee with a tampon in, for example, and that's just unfortunate as it should have been taught - and nothing at all about physically and emotionally healthy sexual relationships (with the emotional part especially ignored). I learned that from a combination of talking with my mother, reading a book she'd given me, and honestly, learning on my own.

Imagine if I hadn't had a good upbringing or open-minded mother. Imagine what I might not have known about healthy sexuality simply because I was born into a more conservative family or state. Imagine how much of a problem that might have been for me as an adult - even with a pretty good education in these matters from home, I still made (relatively minor) mistakes. What sorts of bigger mistakes might I have made without this healthy upbringing?

And, frankly, I think it's just stupid to pretend sex - and how to enjoy it in a healthy way - is somehow a shameful topic that we must avoid talking about to children or even in (some) polite company. Everyone is either doin' it, will do it, or wants to do it. It makes about as much sense to pretend it doesn't exist as not building public bathrooms (we all excrete, too) or not eating in public or even talking about eating or admitting we eat. I also think it's stupid to consider basic health education, including how to have healthy relationships in general, as inappropriate for children. If you're old enough to notice that you have sex organs, you are old enough to know what they're for. If you're old enough to know how and why you poop, you are old enough to know how babies are made. If you're old enough to know that your parents (hopefully) have sex, you're old enough to know the good things and dangers of doing it yourself.

And if you're old enough to ask, you're old enough to deserve an answer.

So, yeah, not too happy with my own country on this front. If we could stop being so terrified of a basic (and fun!) biological function, maybe we could have a happier and healthier population as a whole. If we could do that, maybe we could understand this biology in a more evidence-based way, which would lead to less misogyny and gender discrimination and less homophobia and anti-gay fearmongering.

As for Taiwan, frankly, I'm not sure what to make of sex ed here. I know a curriculum exists, and I have seen with my own eyes attempts at public service campaigns on the topic: I once had a culture shock moment in the MRT as I watched a safe sex commercial play on the televisions that announce the time of the next train. And yet, I'm  surprised by how often I come across straight-up head-scratcher beliefs. For example:

- That you cannot or should not use a tampon if you are a virgin
- That if you merely sleep in the same bed as a person of the opposite sex, you might get pregnant
- That if you drink cold drinks on your period, the menstrual lining will "harden" and stop flowing out (I know this one comes from older Chinese beliefs, but to me, hearing it is akin to hearing a Westerner talk about the healing properties of leeches)
- That homosexuality leads to AIDS epidemics
- That the percentage of LGBT people would decrease if we'd only raise children a certain way
- That it is "not normal" to be gay (often backed up with painfully flawed historical or demographic arguments)
- That criminalizing sex work will stop it
- That teaching abstinence or withholding education will stop young people from having sex
- That men "always" want to have sex but women "usually don't"
- That sex is a female "duty" to her husband


...so, basically, aside from the whole no-cold-drinks-on-yer-period thing it's more or less just like the US. As I don't think the US's sex education programs are particularly praiseworthy, I also have to wonder if Taiwan's national program is effective as so many of the same myths and misconceptions persist. It's even the same people - those anti-gay, usually religious types who are a few conspiracy theories shy of thinking the Earth is flat, who want to impose their ridiculous and frankly made-up morality on the rest of us - causing trouble and spreading lies.

A little slice of America in the Far East. In the worst possible way.

It's a shame, because unlike the US where a Puritanical past coupled with (pun intended) waves of immigrants who, while they bring diversity to the US, might not exactly bring a cutting-edge understanding of sexuality, this never had to be the outcome in Taiwan. Taiwanese culture is often dismissed as "conservative" and "repressed" by foreigners who don't know better, but the reality is a lot more complicated than that, and is not necessarily always conservative by Western standards. There is room in Taiwanese culture to be open about these things.


And then there's hilarity like this:


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This brochure is outdated now, but I still think it proves a point. I had originally thought of it as a good thing: an attempt to educate, albeit a flawed one. Now, I'm not so sure. Why is it in English? I don't remember seeing a similar on in Chinese (although one might exist). Do they think foreigners need to be educated to avoid "seductions in cities"? Are we seen as the problem? That's a problem in itself, but the childish presentation and straight-up hilarious English - why on Earth did they think that "工欲善其事,必先利其器" was a good idiom to use? This alone renders it useless and ineffective for even this misguided goal.

What's more, instead of all the useful information they could have put on the back, they chose "avoid seductions", "flowers with dazzling beauty can take your life" and...sharpening tools?

Despite all that talk of a progressive national sex education curriculum, is this really what it boils down to?

I don't know, as I don't work in a public school, I don't research this issue and although I've had friends tell me they had very little or no sex education in school, they are all old enough that their observations would not necessarily reflect today's reality.

So I'm not sure what to think, but I do know that Taiwan can, and should, improve in this area. It is entirely in keeping with local culture that it do so.