public health

Soon, the masks come off

/ Rudy Owens / Leave a comment

Masks are coming off soon, when previously many jurisdictions had required them in many indoor settings to prevent the spread of COVID-19. Many want this. Many who also know about the term “endemicity” would also like to believe we have “immunity” and can get back to “normal.”

In Portland, Oregon’s Sellwood neighborhood, the masks are coming off already, indoors and outdoors, at most eating establishments.

Hey, as a person who yearns for social contact like millions of others, I would like to go back to that now-crowded, maskless wine bar in Sellwood near my home too. Personally, I won’t do that any time soon.

The reason is, the underlying SARS-CoV-2 virus and its mutations will remain prevalent and potentially a real public health concern, based on what current science tell us. But I’m not saying this. Professor Aris Katzourakis, of the Department of Zoology, at Oxford University in the United Kingdom, made this point in the Jan. 24, 2022 issue of Nature.

Rudy Owens, wearing two masks, on a flight in June 2021 from Seattle to St. Louis.

In his essay, “COVID-19: endemic doesn’t mean harmless,” published just before the Omicron surge began to fall in many countries, Katzourakis wrote: “There is a widespread, rosy misconception that viruses evolve over time to become more benign. This is not the case: there is no predestined evolutionary outcome for a virus to become more benign, especially ones, such as SARS-CoV-2, in which most transmission happens before the virus causes severe disease.”

Katzourakis, and other public health and scientific experts, are not rooting for one outcome or the other. They are just using science to provide an informed opinion, hopefully to keep people healthy. And if some people keep wearing masks, that is fine with me. I will likely be one of them. That is a decision we all will still be able to make, for reasons that make good scientific and health sense.

Global health icon Dr. Paul Farmer touched a generation of public health practitioners

/ Rudy Owens / Leave a comment
Dr. Paul Farmer speaks at the University of Washington School of Public Health in 2018. Photo is courtesy of the University of Washington; story here.

World-renown global health advocate, Dr. Paul Farmer, died in his sleep in Rwanda, leading to an outpouring of both sadness and praise from many health and public health practitioners in the United States and around the world. At the time of his sudden death, Farmer was working in the central African nation at the medical school he co-founded with the Rwanda’s former minister of health, Dr. Agnes Binagwaho.

Farmer, a medical doctor and anthropologist with advanced degrees from Harvard, co-founded of the Boston-based Partners in Health (PIH). The group confirmed his death on Twitter today, Feb. 21, 2022. ABC News reported PIH had confirmed Farmer died from an acute cardiac event that happened during his sleep.

Despite his prestigious graduate pedigree and also having attended Duke University as an undergraduate, he eschewed the path of traditional power and influence that his elite training afforded him. He had his eyes set on the world, where many lacked access to basic health care. According to Duke University, Farmer sought to “strengthen public health systems in order to provide quality health care in some of the world’s most vulnerable communities.” By the time of his untimely death, he had established a wide following after having spent decades of his life working on addressing global health inequities, in Haiti, Africa, Eastern Europe, and Latin America. 

It is fair to say Farmer influenced nearly a generation of health and public health practitioners in the United States who have an interest in global health and health inequities. Those singing his praises today range from policy hawks like Samantha Power, to Hollywood celebrities, to former President Bill Clinton, as well as scores of public-health minded doctors who shared comments on Twitter, expressing sadness at the news of Farmer’s passing.

Farmer left a mark with his peers and colleagues globally who shared his passion to fix the same root issues driving and underlying global health inequities. The day after Farmer’s death is filled with diversity of persons who work in those fields sharing personal comments explaining why Farmer mattered in this collective effort. One former colleague, Dr. Sriram Shamasunder, met Farmer as a university student and was inspired to join in the work Farmer was doing. “He conveyed with his words, the irresistibility of social medicine, where health workers aim to address the root causes of disease in its social and economic context,” wrote Shamasunder in an essay published by National Public Radio just after Farmer’s demise. “This work is where necessity, urgency, and joy become bound together.”

Nearly every graduate student I met at the University of Washington School of Public Health (UW SPH) when I got my degree there (2010-‘12, as an older student) shared tales describing that their interest in working in international health was influenced by Farmer’s thinking and writing. He also visited my alma matter to speak about his work. That praise felt very close to hagiography, which can also hide any famous person’s flaws and blind spots. Those who know better of making saints from mere mortals can easily describe this type of myth-making as “white saviorism.” That is real too, regardless of Farmer’s accomplishments.

Tracy Kidder’s famous book about him, Mountains Beyond Mountains: The Quest of Dr. Paul Farmer, a Man Who Would Cure the World,  is the one book that came up in many conversations among UW SPH grad students. Here are some works by Farmer that provide some insights to his influential thinking, which are not uniquely his and also are shared by many doing similar work. I have not read it, but clearly the book has what can best be called a “dedicated following.” One cannot deny that Farmer was tireless in communicating the change he worked on, in the mud and in the field.

A good profile of him can be found in a New Yorker piece from 2000 that is circulating among those in global health who are lamenting this loss. The myth-making portrait by Kidder in her book about Farmer is based on a Haitian proverb: the Haitian proverb “Beyond mountains there are mountains”—as you solve one problem, another problem presents itself, and you go on and try to solve that too. That is a good metaphor to living life, ready to engage and never losing your purpose why you do what you do.

So are you talking to me, asked the man of the beautiful woman

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In the past month, I have been left speechless in the presence of pure genetic beauty. I say genetic, because human beauty does have a component derived from one’s ancestors, how they looked, how they cared for themselves, and how they selected their mates.

Athleta, the product line that captures the "beautiful athelete" look in its products makes me think of the women, and also men, I am seeing with great frequency in and around Portland.

Athleta, the product line that captures the “beautiful athlete” look in its products, makes me think of the women, and also men, I am seeing with great frequency in and around Portland.

There is also just sheer randomness in the assigning of physical features to a person, and the utterly incalculable fate that placed someone in an upper-middle-class neighborhood in the Bay Area and another in some godforsaken neighborhood in Detroit, where there are few resources, poor food choices, high crime, and economic despair. (That’s my public health nerd speaking here.)

Those gifted with good fortune can also take additional steps. They can eat good food, exercise daily, become religious, build social networks, adopt a positive outlook, and own a dog. All of these actions can also improve a person’s health, and thus one’s exterior appearance to their world.

So when I see beauty, I never think it is just one thing, though I know genetics matter. I think it is a combination of factors. I know that those with good fortune being born into the right class and group may have a higher probability of good looks.

I think about beauty often now in Portland, mainly because I see a lot of it. It seems Portland has become a popular spot for successful people, including people who have talent, connections, and an upper middle-class upbringing that promotes good luck, opportunity, and a higher chance at being good-looking. (In this country, the poorer you are, the higher your chances are at being overweight and obese, which creates many health and physical appearance issues.)

I have no magic quotient what a high proportion of beautiful people is to a low proportion. I just sense it when I am startled by it on a growing frequency. Portland, since I moved back here in 2014, has a very high percentage of attractive people. They look fit. They look confident. They appear to have a level of wealth—even some of the younger ones, who likely should be saddled in enormous debt given their age. That is unless they were wealthy to start.

Oddly, I stumbled on two incredibly beautiful women in the last month, both on biking excursions. One I met biking with friends. She was the co-owner of a winery, and she was a gracious host to my party. I could not get comfortable with this perfectly dressed, perfectly coiffed, perfectly mannered woman in her early 40s asking me for my order. I felt the Monster character in Young Frankenstein, who was confused when the Doctor said, “Hello handsome.” Was she talking to me? Yes, she was that perfect of a person in how she presented herself to the world.

Hello Handsome. That's what it feels like some times when you encounter Portland's class of beautiful people.

Hello, handsome. That’s what it feels like some times when you encounter Portland’s class of beautiful people.

Despite her nearly perfect everything, she was still a nice soul and a gracious business woman. I told my colleagues as we biked away, she was the girl who would never give me the time of day in high school. Yet, she was proving me wrong just minutes earlier.

Yesterday, again while biking, I saw yet another apparition of physical perfection. This time it was a blonde cyclist—and I normally am not someone who favors blonde hair and the Nordic look. She had on very stylish and colorful bike clothes—meaning expensive. She straddled a bike that was clearly in a price bracket above mine and stroked her machine confidently. We passed on my normal hill climb. She was descending. I was ascending. She gave me a friendly biker “hello,” smiled, and was soon gone, leaving me looking at her colorful figure fade into the distance. She seemed like some dream from a movie.

I would not think too much about this, were it not for other sitings of pretty women and handsome men in this city and in the surrounding area. Portland has changed. We have now become the beacon for the beautiful. It is not just for Southern California anymore.

All of this is highly unscientific, but often one must trust one’s intuition and test one’s hypothesis. I think the hypothesis I have confirmed is that I likely find myself in a pool with the prize catches, and perhaps I am not the king salmon. I still do not know where all of these large numbers of pretty people of Portland are coming from, but make no mistake, they definitely are coming here.