Extreme Heat Belt

The counties marked in red are expected to experience temperatures of 125 °F = 51.67 °C at least one day a year, by 2053. This area is referred to by some as the Extreme Heat Belt. Screenshot of an Axios map, without the underlying data provided at the county level by the First Street Foundation.

The mission statement of the First Street Foundation reads: Make climate risk accessible, easy to understand and actionable for individuals, governments, and industry. A changing climate is impacting the risks facing American properties, communities, and businesses as perils like flood, fire, heat, and drought become more common, and more severe…. First Street Foundation is a non-profit research and technology group dedicated to quantifying and communicating those risks by incorporating world class modeling techniques and analysis with the most up to date science available in order to simply, and effectively, inform Americans of their risk today and into the future from all environmental changes.

Extreme heat refers to a maximum heat index greater than 125°F. This refers to a temperature reached at least one day a year. Currently (that is, in 2022) 8 million Americans are exposed to it. By 2030, some additional coastal areas in the Southeast and Mid-Atlantic may also experience a heat index at or above 125°F. By 2053, the number of people exposed to extreme temperatures, is expected to increase to 107 million people.

Dangerous days have a heat index greater than 100 °F = 37.78 °C. The Gulf Coast and Southeast will see the highest chances and longest duration of exposure to these. While many place experience more than 20 consecutive days with heat indices above 100°F, by 2053, these streaks could involve up to 74 consecutive days.

Local hot days are days that exceed the temperatures typically experienced for a particular area. The West will have the highest chance of long durations of these.

Future cooling-driven increases in carbon emissions could aggravate warming further. Texas, Florida, California, Ohio and Missouri are the top 5 states with the greatest cooling demand expected increase in CO2 emissions between 2022 and 2053.

As a missionary for SI, the international system of units, temperature always presents a quandary. In this official system, temperature is measured in kelvin, with symbol K. Both the kelvin and celsius systems use a 100 K/ °C difference between the freezing and boiling point of water, at a standard/ sea-level air pressure reading.

0 K is set to absolute zero, which is -273.15 °C, while 0 °C, in the celsius system, is set to the freezing point of water. In the Fahrenheit system, water freezes at 32 °F = 0 °C and boils at 212 °F = 100 °C, resulting in a 180 °F difference between these two points.. Thus, 125 °F = 324.8167 K.

SI clergy undoubtedly use many nights, sleeplessly pondering if the extreme heat value should be increased to 325 K = 125.33 °F, or if 50 °C = 122 °F, should be used. Those prioritizing as little change as possible will support the former. Those wanting to use rounder values, ending in 0, will opt for the latter. The reason for this proposal is that the world needs a mechanism to compare extreme heat locations, which will require heat to be expressed in degrees celsius. This is why, personally, 50 °C holds greater appeal, even if more locations in the world will fall into that category.

Those wishing to be further perplexed by this topic, are invited to read the Wikipedia article on thermodynamic temperature. In an imperfect world, every gram of improved understanding is worth the effort.

WBT

WBT = wet-bulb temperature. Yes, I appreciate short, cryptic post titles. That said, there is a serious point to this post, with life-saving potential, related to heatwaves.

A digital psychrometer (combined dry and wet-bulb thermometer).
The functions available with a modern psychrometer.

When a wet cloth/ wick covers the bulb of a thermometer, evaporation of the water cools the thermometer. This results in a WBT, which is equal to or below the dry temperature, measured on a thermometer without a wet cloth. The WBT reading reflects the humidity in the atmosphere. Humidity refers to the relative saturation of air with water. Low humidity means there is not much water in the air; high humidity means lots of water in the air. When the air can hold no more water, it is totally saturated. It is referred to as 100% relative humidity (RH). Air at a higher temperature is able to hold more water vapour, than air at a lower temperature.

A related concept is that of dew point = the temperature to which air must be cooled to become saturated with water vapor, at the current relative humidity. At, and below this temperature, water vapor condenses to form dew, a liquid state of water.

WBT is important because it can measure heat-stress conditions, that affect many people. In fact, a high WBT can kill them. This happened mainly from 2021-06-24 to 2021-07-01 in British Columbia. At 100% RH, the WBT will equal the dry temperature.

A combined dry and wet-bulb thermometer is referred to as a psychrometer. While analogue models are available, they require either calculations or the reading of graphs to determine values. One should not overestimate the ability of a person to perform even simple calculations, when they are potentially dying of heat stroke. Digital models can be purchased at relatively low cost that do all of the calculations automatically. The model illustrated above costs NOK 255 = US$ 26.38 = CA$ 33.72, including taxes and delivery charges to Norway (as of 2022-08-01). The quality of this particular model has not been evaluated.

At Cliff Cottage, we have recently received temperature and humidity sensors that will be part of our weather station, a subsystem of our home automation system. These components are considerably cheaper than the Habotest model, but require electrical and mechanical work, as well as programming, to implement as a system. Thus, the first iteration does not produce a cost effective system, may be frustrating to make, but will give satisfaction when completed.

From 2021-06-20 to 2021-07-29, the British Columbia Coroners Service, reported the following heat related deaths, in the table below. There are some who feel the number of deaths were under reported. Note that 445 of the 569 deaths (78%) occurred during the transition week, between June and July.

Age Group# of Deaths 
<40 2
40-49 13
50-59 42
60-69127
70-79160
80-89149
90+ 76
Total 569
Heat related deaths during the summer of 2021. Source: British Columbia Coroners Service.

British Columbia, was only one of many jurisdictions, that faced heat challenges in 2021. Temperature records are being broken regularly, throughout the world. In the United States, every state and territory had a maximum temperature that exceeded 37 °C. Of these 46 entities, only six had recorded maximum temperatures below 40 °C. Four states, had maximum temperatures at or exceeding 50 °C: New Mexico, 50 °C; Nevada, 52 °C; Arizona, 53 °C; and, the highest, California, 57 °C. In Canada, Lytton, British Columbia, distinguished itself with 49.6 °C, on 2021-06-29, the maximum ever recorded in the country. The next day, a wildfire destroyed most of the town. In Norway, the highest temperature recorded is 35.6 °C, at Nesbyen, on 1970-06-20.

The challenge with these high temperature values, is that they do not take into consideration humidity, which determines how people experience heat. Some locations on planet Earth may be approaching values that prevent human survivability. The countries most affected are Saudi Arabia and other Arabian Gulf states, Pakistan, India and Australia. What is not fully appreciated, is that indoor climates in temperate zones, can also create conditions that kill people during heat waves.

The difference between WBT and dry temperature, measures how effective people can cool themselves by sweating. Admittedly, this is a simplification because, in addition to humidity and temperature, solar radiation and wind speed are other factors that affect survivability. Yet, WBT is especially important in indoor environments, where deaths often occur in heatwaves.

Sweating above WBT will no longer cool down a person, but lead to a steady rise in body temperature. This is the limit of human adaptability to extreme heat. If a person cannot escape these conditions, their body’s core temperature will rise beyond the survivable range, and organs will start to fail.

The critical WBT value for humans was usually considered to be 35 °C, indicating a situation where a healthy person could survive for six hours. One representation of this is an air temperature of 40 °C, and a relative humidity of 75%. This value comes from a 2010 theoretical study. However, research by Vecellio et al., found that this value only applied to young healthy people. Real-world data indicates that the critical WBT value is closer to 31.5 °C.

This means that the numbers of people exposed to potentially deadly combinations of heat and humidity across the world would be vastly higher than previously thought. Many older and compromised people will experience dangerous conditions far below the threshold WBT.

In Canada, the humidex = humidity index has been used since 1965 to describe how hot the weather feels to the average person. It is a nominally dimensionless quantity, calculated from °C and the dew point. Values of: 20 to 29: little to no discomfort; 30 to 39: some discomfort; 40 to 45: great discomfort, avoid exertion; above 45: dangerous; heat stroke possible/ probable.

Humidex plot (Source: Morn, using Matplotlib code)

The American Heat Index (HI) was developed from the Humidex in 1979. It is calculated using °F or °C and relative humidity. It makes assumptions about: human body mass, height, clothing, level of physical activity, individual heat tolerance, sunlight exposure, ultraviolet radiation exposure, and wind speed. Significant deviations from these will result in heat index values which do not accurately reflect the perceived temperature.

Heat Index plot (Source: Morn, using Matplotlib code)

In many situations, building construction results in indoor temperatures exceeding outdoor temperatures. Construction methods may prohibit water saturated air from leaving a building. In climates with high humidity, such as along the Gulf of Mexico coast and even on the Atlantic coast of Florida, in the United States, it is often common to use a vapour barrier close to the outer wall, with negative consequences during heatwaves. Sometimes the best solution is to omit a vapour barrier. This is the opposite of the approach used in cold climates, such as Canada, Norway and northern United States where the vapour barrier is located on the inside of the outer wall.

Heatwave Precautions

Since many of the readers of this weblog are older, it is important for them to know what to do when temperatures rise.

A first step is to realize that an indoor environment can be particularly deadly, in part because there is no wind to increase evaporation rates, needed for effective sweating/ perspiration.

A second step is to track indoor temperatures. Even without a psychrometer or wet-bulb thermometer, one knows that the WBT will be below this dry temperature. This means that temperatures should probably not be allowed to rise above, say, 30 °C, without taking some action. Thus, moving to a shady, outdoor location, may reduce risk, compared with staying indoors.

Air conditioning units are another solution, but not everyone can afford them. Their acquisition typically has to be planned well in advance of a heatwave. Fans can be effective at increasing the quantity of air available for evaporation, but they usually should be used with an open window.

In some places, special shelters have been built/ commissioned, that people can visit without charge to find heat relief. While many people will search for information online about shelters located near them, there are other sources of information available. Public libraries are a great place to find this sort of information.

World Plumbing Day

Friday, 2022-03-11 is world plumbing day 2022! Starting today, I am using this day, once a year, to inspect the plumbing at Cliff Cottage. It was inspired by an event on Sunday, 2021-07-25 when wastewater from the washing machine started to back up over the bathroom floor. The piping leading from the washing machine was clogged. It had probably gone at least a decade since the piping was last checked.

After an hour’s work spread over two days, everything worked normally again. To prevent these sorts of emergencies in the future, I decided that the best way was to perform preventative maintenance once a year. I googled plumbing day, and discovered it was an event happening around the world, on this date that started in 2010.

There are several similar days throughout the year that I won’t be celebrating, in part because they are too similar: World Water Day = 03-22; World Cleanup Day = 09-15; Global Handwashing Day = 10-15; World Toilet Day = 11-19. Yes, on this weblog, International Standard ISO 8601 is used for dates, in the format YYYY-MM-DD. Here, only MM-DD appear.

It is very easy to avoid/ postpone preventative maintenance activities. Thus, a fixed date, once a year, helps people schedule activities. In Norway, 12-01 is set aside as Smoke Detector Day. Batteries on all of the smoke detectors in the house are replaced once a year on that date, with the older batteries recycled to power less critical operations, or given to the public library that has taken over the techno workshop.

Other days that could be useful for doing related maintenance and other work, include: Global Recycling Day = 03-18; World Gardening Day = 04-14; Naturalists may prefer Naked Gardening Day, which is the first Saturday in May, In 2022 that is 05-07.

Voluntary Assignment: Are there other days in the year that should be set aside/ used for various maintenance activities? If so, please share these as a comment.

Not just days, but years and decades

Since this is 2022, it is the International Year of Artisanal Fisheries and Aquaculture. Artisanal fishing consists of various small-scale, low-technology, low-capital, fishing practices undertaken by individual fishing households, often coastal or island ethnic groups that make short fishing trips close to the shore. In 2023, it will be the International year of Millets. Millets are highly variable small-seeded grasses, widely grown around the world as cereal crops or grains for fodder = animal feed, and human food. Millets are important crops in the semiarid tropics of Asia and Africa (especially in India, Mali, Nigeria, and Niger). 97% of millet production occurs in developing countries. The crop is favoured due to its productivity and short growing season under dry, high-temperature conditions.

The period from 2021 to 2030 is the United Nations Decade on Ecosystem Restoration. It would also be fun to hear from other people on how they are approaching this task.

World Water Day (03-22) was an event I managed at Leksvik senior secondary school. The municipality of Leksvik (now amalgamated with Rissa to form Indre-Fossen) is adjacent to Inderøy. It hosted numerous companies making water related products, everything from domestic faucets, long-length infrastructure piping and and valves for ship ballast systems, to containerized desalination equipment. Many of the companies producing these products have now sold off their product lines, or moved, either abroad or to other parts of Norway. The school received funding to start a project with a focus on energy and water. In 2008, I was hired as project manager. My focus was on building and using submersibles = remotely operated vehicles (ROVs). I also transformed the building housing the project into Nautilus, a virtual submarine. It took its name from the Jules Verne’s (1828 – 1905) fictional submarine featured in his novels Twenty Thousand Leagues Under the Sea (1870) and The Mysterious Island (1874). When I worked there, the school celebrated World Water Day from 2009 to 2015.

Note: When published it was claimed that World Water Day and World Goth Day shared the same date. They do not. World Water Day is 03-22, while World Goth Day is 05-22. Updated: 2022-03-23 at 19:30.

Nightscout

The Nightscout logo and motto/ hashtag.

Today’s weblog post focuses on Nightscout, a social movement for Type 1 diabetics, and their parents, that enables them to access and work with continuous glucose monitor (CGM) data and open-source tools, so they are better able to manage their condition. They describe themselves as CGM in the Clouds,

In healthy people the pancreas regulates blood sugar. It works continuously without intervention. Diabetics have to take control, and inject insulin using syringes, although in recent years it has become more common to use an insulin pump connected to the body and providing an even base dose. It is difficult for people to adjust insulin levels which have to continuously monitored and adjusted for the rest of the patient’s life.

There are three main types of diabetes mellitus (DM): 1) Type 1 results from the pancreas’s failure to produce enough insulin due to a loss of beta cells; 2) Type 2 begins with insulin resistance, a condition in which cells fail to respond to insulin properly, but may result in a lack of insulin, as the disease progresses; 3) Gestational diabetes occurs when pregnant women, without a previous history of diabetes, develop high blood sugar levels.

According to the IDF Diabetes Atlas, 9th edition, an estimated 463 million people had DM worldwide (8.8% of the adult population), in 2019, with type 2 making up about 90% of the cases.

Legacy medical equipment companies, much like legacy automotive companies, perpetuate their market share by making it intolerably expensive for new companies to become established. In the automotive world, this is in part because of the extreme cost of setting up manufacturing facilities. With medical equipment, it is the cost of gaining approval in assorted jurisdictions. In the USA, for example, the Food and Drug Administration (FDA) regulates the sale of medical device products. Manufacturers (or their sales agents) must present evidence that the device is reasonably safe and effective for a particular use.

The high cost of market participation, means that legacy manufacturers can avoid/ discourage innovation, which helps improve profit margins, but denies patients access to improved technology. This is what nerds, patients and relatives have now managed to solve with Nightscout, for diabetics. It is a do-it-yourself DM tech community. It first developed data-sharing tools. More recently, an open-source closed loop artificial pancreas system has been developed.

Wikipedia says that Nightscout began in 2013-02 , when the parents of a 4-year-old boy newly diagnosed with type 1 diabetes began using a CGM system. When the child was at school there was way to access this data in real time. The boy’s father, John Costik, a software engineer, developed software to access and transfer CGM data to cloud computing infrastructure. Lane Desborough and Ross Naylor added a blood glucose chart display. A community of developers emerged to make the software generally accessible. Because this software amounted to an unlicensed medical device, it was not released immediately as open source code to address legal concerns. After this was done, the combined code was released in 2014 as the Nightscout Project.

In another part of cyberspace, Loop started off as an Apple-only framework and algorithm that runs on an iPhone, worked with older Medtronic insulin pumps and requires a small box, the RileyLink, to communicate between the pump and smartphone. It was created in large part by Pete Schwamb. An unknown number of people use this technology.

OpenAPS

The Open Artificial Pancreas System project (OpenAPS) is an open and transparent effort to make safe and effective basic artificial pancreas system technology widely available. It began in 2013, when Dana M. Lewis and Scott Leibrand became aware of the software created by John Costik. The OpenAPS software can run on a single-board computer, such as a Raspberry Pi.

Lewis, who has a DM Type 1 condition, was dissatisfied with her commercial device, because its hypoglycemic status alarm was too quiet to wake her. To address this, Lewis and Leibrand extended the CGM-in-the-cloud software to create a custom high volume alarm. They then used the same CGM-in-the-cloud software to create Do-It-Yourself Pancreas System (DIYPS) software, which provided a decision assist system for insulin delivery. This become a closed loop system using open-source decoding-carelink software created by Ben West to communicate with Medtronic insulin pumps, enabling data retrieval and issuance of insulin-dosing commands to pumps that support it. With this update, the DIYPS system became OpenAPS.

Its stated aim of OpenAPS is “to more quickly improve and save as many lives as possible and reduce the burden of Type 1 diabetes.” Their website states that “community efforts will be open source and free for use for other people, open source projects, researchers, and non-profits to use, and available on an open and non-discriminatory basis for all commercial manufacturers to use in proprietary products if desired.”

OpenAPS differs from other APS currently in clinical trials in two significant ways: 1, it is designed to use existing approved medical devices, commodity hardware, and open source software, and 2. it is designed primarily for safety, understandability, and interoperability with existing treatment approaches and existing devices. Those concerned about safety issues are encouraged to read this statement of principles.

An aside: In researching this post, one article in particular highlighted the need for professionalism in the production of code. In this case, the anonymous coder was unable to understand contextual issues. Obviously, many of the projects mentioned here have been professionally run. However, it is very common to encounter code written by amateurs, that is unsuitable for real-world use. The advantage of using people with a medical condition is that they have internalized much of the contextual information needed to produce appropriate code, even if they are amateurs.

Closed loop artificial pancreas systems integrate a glucose monitor with an insulin pump, using connecting controller software (such as assorted varieties of Loop). The system’s purpose is to keep blood glucose levels within a specified desired range for as long as possible. This can reduce damage to kidneys, retinas and nerves.

Since Nightscout is Do-It-Yourself (DIY), the onus is on the user to provide and deploy any and all resources needed, such as the MongoDB database, a web host and other software. This can result in many barriers, that prevent potential users from enjoying Nightscout’s benefits.

Recently, on 2020-11-20, Medical Data Systems LLC met with and formally petitioned the FDA for clearance of the service product “T1Pal.com.” T1Pal.com is a hosted Nightscout platform that runs copies of the latest Nightscout software on its servers for the benefit of individual subscribers.T1Pal is a hosted Nightscout platform running the latest version of Nightscout on its servers. It provides subscribers with Nightscout as a Service. This means that Medical Data Systems LLC takes responsibility for maintaining and updating the site. T1Pal was designed by Ben West, a member of the original CGM in the Cloud team and lead core developer for the Nightscout Project. A subscription costs US$ 12/ month and upwards, depending on the services provided.

Tidepool

Originally, this post had intended to focus on Tidepool, a Palo Alto, California based nonprofit company founded by Howard Look in 2013. The company works with medical equipment manufacturers, such as Dexcom and Medtronic, to create interoperable automated insulin pump systems, communicating with iPhone and Android apps.

Tidepool wanted to build a database where people with insulin-dependent diabetes could store and analyse data about their condition. Its iOS and Android apps and web system, allow users to add and view CGM related data to gain better insights into their condition. This data can be shared with health personell.

As stated in the previous weblog post on telemedicine, some equipment and software providers assume they own patient data. These companies have very disturbing privacy policies. Tidepool encouraged equipment manufacturers to develop systems that would work with Tidepool software. They elminated some of the friction, by setting up a (not-for-profit) foundation to administrate collected data.

Tidepool Loop will be its next big step, What I have been unable to discover is wny users would prefer yet another open-source closed loop artificial pancrease system, where the openAPS already seems to feature one, not to mention the RileyLook.

Developing open-source software can be messy. Sometimes, work is duplicated, and at other times, nobody is doing the work at all. The people who have a vested interest in mitigating a health condition, or in the case of Type 1 diabetes, their parents, will develop breakthrough improvements that manufacturers seldom prioritize. Software is cheap to produce, especially if development time is freely given. My expectation is that additional improvements in hardware will also come in the future, as open-hardware, as increasing numbers of people invest in CNC hardware, that can build precise equipment inexpensively.

Some sources:

Off topic: Wyze Watch

This blogger has pre-ordered two Wyze smart watches using a facilitator in the United States, for delivery in 2020-03. This pre-order opportunity is restricted to addresses in USA, and is ending a week after the planned publication of this weblog post, on 2020-12-22. The unit price is about US$ 20, excluding taxes, shipping, non-black watch strap and who knows what else. These two watches will be used initially for experimental purposes.

Telemedicine

The Psion Organizer II (1986) was one of the first hand-held devices, later referred to as a personal digital assistant (PDA) when Apple launched the Apple Newton (1992). Other important devices that led to today’s ubiquitous smartphone, include the Nokia 9000 Communicator (1996) and the Palm Pilot (1997) . Throughout this time frame many companies and organizations developed medical content to support the use of these devices in medical situations, including physicians’ offices and hospital wards.

Telemedicine? Telehealth? eHealth? Different people and organizations use different terms to describe the same subject. The World Health Organization (WHO) uses telemedicine to describe all aspects of remote health care including preventive care. In Europe, the more general term is eHealth, which is more than just Internet medicine, but almost everything related to computers and medicine. There is a branch of this referred to as mHealth, with a focus on hand-held devices (smartphones aka – in Europe – mobile phones = cell phones). In USA, the operative term is telehealth which also includes non-clinical services. There, telemedicine refers to remote clinical services. Here, the WHO definition is used.

The purpose of this post is to encourage people to engage in a dialogue about telemedicine, generally, but especially with the appropriate authorities where they live. They should let the world know what telemedicine services they need and want … along with additional insights and information, incorporated in the usual questions: Where? When? Why? and How?

Unfortunately, most people do not know very much about telemedicine. Thus as a first step it may be useful to read the Wikipedia article on it.

The pandemic has shown that many things need to be done differently, including health care. No prospective patients should have to travel to a (crowded?) doctor’s office to have a prescription renewed, or blood pressure measured. The first, could just involve a simple e-mail request, the second – an example of remote monitoring – could involve a patient attaching the cuff of a blood pressure monitor to their upper arm at home, in such a way that the device can measure systolic and diastolic pressure, keep track of the results in a home medical journal, and send them onwards to the appropriate health centre, especially if there is an apparent need to adjust medications or discuss lifestyle changes. In general, the advantages of telemedicine are: greater patient satisfaction and cost-effectiveness, with comparable health outcomes.

At the time of writing, Trøndelag county has the lowest incidence of COVID-19 in Europe, with less than 20 infected people per 100 000. Why? First, there are very few immigrants and other foreigners, which means that almost the entire population understands the relevant rules. There have been problems in other areas of Norway because the Norwegian government has insisted in communicating unilingually in Norwegian, and – until recently – has not made provision for translations. This means that immigrants have not been given information, in a language they understand. Second, and more importantly, people have followed the rules. They may not like them. They may complain. Yet, they follow them. Because they are followed, and the COVID-19 infection rates are reduced, there is a lighter touch in terms of regulations, than in many other areas of the world.

Update: 2020-12-08 11:34 (Less than half an hour before this is scheduled to be published). There has been a new COVID-19 outbreak in Trondheim. Maybe our county is no longer best in Europe, I don’t know. However, the outbreak seems to affect many Eritrean immigrants, and the government specifically asked them to get tested. So, even governments are learning how to do things differently.

Why is USA so different from Trøndelag? The answer may lie with Maggy Thatcher, and her good buddy, Ronny Reagan. “There is no such thing as society: there are individual men and women, and there are families,” Margaret Thatcher (1925 – 2013) said, as reported in Woman’s Own, 1987-10-31. Libertarians such as Thatcher, Ronald Reagan (1911 – 2004), Donald Trump (1946 – ), Boris Johnson (1964 – ) and more, don’t seem to believe in society, social norms, or in following rules. When people fail to follow rules in the middle of a pandemic, bad things happen.

Another problem in the US is that so much of the health care is provided by for-profit businesses, that have their own vested interests and approaches to the pandemic. They are not so much interested in reducing/ eliminating the pandemic, as they are in maximizing their profit, or at least reducing their loses. Even in Norway, there has been privitization in the health sector, that has had negative consequences.

For twenty years, or so, I had B12 injections, every three months. For the first twelve years or so, it was possible to make an appointment for an injection. Thus, I would visit the medical centre, wait perhaps five minutes, receive an injection, then leave. Then, suddenly, about the time the municipal run health service became a privately owned one, appointments for injections were no longer possible. Patients just had to take a chance and meet up. Personally, I didn’t appreciate this new system because the time spent waiting increased significantly. The health service no longer valued my time. Then, one August, I discovered that I had failed to receive an injection in May. I had met up, but the nurse was so overworked that I was asked to come back another day. Unfortunately, I quickly forgot about that, and my calendar showed a B12 shot being given. There had been no follow up from the medical centre alerting me to the missed injection. There is no reason for this lack of follow-up. It is very easy to implement in a data system. In fact, I had worked on this very type of problem earlier.

Back in the late 1980s I had worked with HUNT (Helseundersøkelse i Nord-Trøndelag. Now known in English as the Trøndelag Health Study, after the merger of Nord- and Sør-Trøndelag in 2020) and had made a mock hypertext version of their standard procedures for hypertension (high blood pressure) and diabetes. This demonstrated how data-mining of a patient journal could be used to collect data about these two conditions, and alert the patient’s doctor (and ultimately, the patient) when anomalies emerged. In 1991, one of my former students received a grant to start a company InfoTech AS, to make a real-world version of this. The major problem was that the privately-owned providers of patient journals regarded patient data as their own personal property, and would not co-operate. This was, in part, because the Norwegian government had not taken privacy concerns about patient data seriously.

Now, in 2020 in the middle of a pandemic, nobody is allowed to just meet up at a medical centre, for an injection, or anything else. Appointments have to be made for everything. When I had my annual check up with my GP, he looked at my chart, and could see immediately my one and only medication. With a new national change in policy away from B12 injections to B12 tablets, he asked me if I wanted to take B12 pills, instead of an injection? There was no doubt in my mind that I would prefer them, and so it was arranged.

What is irritating about this situation is that there should be absolutely no problem alerting everyone with a B12 deficiency problem (or any other medical situation) about tablets being allowed to substitute for injections, or any other improvement. It is simply that the medical profession is living in the past, and is not aware of the potential offered by data-mining, and similar computing techniques.

It is important for people to keep abreast of new developments, and to reflect over their own needs. They also need to contact politicians and others to make changes that will improve society. Health is important.

World Goth Day #12

Ophilia (1851) by John Everett Millais (1829 – 1896).

Today (2020-05-22) is Goth Day #12. World Goth Day originated at the British Broadcasting Corporation (BBC) in 2009, when Radio 6 was looking at a number of music subcultures including Goth music. Goth DJs Cruel Britannia and Martin Oldgoth decided that May 22 would be the day each year to celebrate it.

Unfortunately, being an active Goth has a number of negative consequences. Researchers Robert Young, Helen Sweeting and Patrick West write: “identification as belonging to the Goth subculture [at some point in their lives] was the best predictor of self harm and attempted suicide [among young teens]”, and that it was most possibly due to a selection mechanism (persons that wanted to harm themselves later identified as goths, thus raising the percentage of those persons who identify as goths).”

Thus, the decision to publish this weblog post has less to do with the celebration of World Goth Day in 2020, and more to do with helping susceptible people cope with life in this challenging period of time when we all face the COVID-19 pandemic. Let us reach out with friendship and inclusion (virtually or in real-life) to those who no longer feel part of society, including those who self-identify as Goths.

In order to talk with a Goth, it might be useful to know something about Gothism!

Of course there is an official World Goth Day website complete with a list of world events. I appreciate that one of the three goths decorating this page is following COVID-19 procedures, and is equipped with a face mask.

Many attribute the start of Gothism to English author Horace Walpole (1717 – 1797) who started it off by writing The Castle of Otranto (1764). Other readers may prefer to read Ann Radcliffe’s (1764 – 1823), The Mysteries of Udolpho (1794). Washington Irving (1783 – 1859) also contributed to the genre with The Legend of Sleepy Hollow (1820), also available in its Disney animated adaption, The Adventures of Ichabod and Mr. Toad (1949). Then again there are classics such as Bram Stoker’s (1847 -1912) Dracula (1897), and Anne Rice’s (1941 – ) The Vampire Chronicles (1976).

The first mention of Gothic Rock is by music critic John Stickney to describe a meeting in a wine-cellar with Jim Morrison, described as “the perfect room to honor the Gothic rock of the Doors“. While some musicians may favour The Velvet Underground as the ultimate Gothic rock group, my own preference is for Siouxsie [Sioux aka Susan Janet Ballion (1957 – )] and the Banshees, and their track Spellbound (1981). In Norway, the Stavanger band, Theatre of Tragedy, contributed to the Gothic metal genre with its beauty and the beast aesthetic that combined harsh male with clean female vocals. Other Goth oriented bands include: Bauhaus, The Chameleons, The Cure and Sisters of Mercy.

In terms of film, the 2019 South Korean black comedy thriller, Parasite, is outstanding, and should appeal to many Goths. Another film with Gothic elements is The Rocky Horror Picture Show (1975). Because of its black humour and general lack of seriousness, it may offer a suitable dose of escapism to help people struggling to cope with a pandemic. Other relevant films in chronological order include: The Hunger (1983), Beetlejuice (1988), The Nightmare Before Christmas (1993), The Crow (1994) and The Craft (1996).

There are also computer/ console based Goth games. The Gothic role-playing game series was developed by Piranha Bytes GmbH, in Essen, Germany. It consists of three versions Gothic (2001), Gothic II (2002) and Gothic 3 (2006). There is also a fourth version, Arcania: Gothic 4 (2007), developed by Spellbound Entertainment AG, from Offenburg, Germany. This company has reorganized as Black Forest Games GmbH.

Fashionistas are undoubtedly irritated about the late reference to clothing in this weblog post. Cintra Wilson (1967 – ), writing You Just Can’t Kill It, in the New York Times 2008-09-17, notes: “The goth subculture, however, for those who live it, is more than the sum of its chicken bones, vampire clichés and existential pants. It remains a visual shortcut through which young persons of a certain damp emotional climate can broadcast to the other members of their tribe who they are. Goth is a look that simultaneously expresses and cures its own sense of alienation.”

My own approach to the Gothic was not through literature, music, film, games or fashion, but art, especially that found in the works of the Pre-Raphaelite Brotherhood. Ophelia (1851) by John Everett Millais (1829 – 1896) is one such inspiring work. In addition, John Ruskin (1819 – 1900) was particularly attracted to the Gothic in architecture, which he commented at length upon in, The Seven Lamps of Architecture (1849).

COVID-19

COVID-19 is the name of a coronovirus disease first identified 2019-12-31, of an animal to human zoonotic event that occurred at the Huanan Seafood Wholesale Market in China. According to Wikipedia, zoonosis is an infectious disease caused by bacteria, viruses, or parasites that spread from non-human animals (usually vertebrates) to humans.

This event did not affect me personally for 56 days, until my arrival at AMS, Amsterdam Airport Schiphol, on 2020-02-25 at 9:00. It was then that I was asked if I had visited China, or had any of the known symptoms. While our flight OSL – AMS did not include anyone wearing face masks, there were at least four passengers on our AMS – SFO flight.

Since then, events have intensified.

On 2020-03-17, NRK, the Norwegian Broadcasting Corporation, was reporting that Norwegian (the airline) was refusing to transport non-Norwegian-citizen residents back to Norway. One day later, two members of my family and I did not have this problem with Delta/ KLM. Everything went smoothly. We had gone to Detroit after San Francisco. At DTW, Brock had to present his residency card in order to get a boarding card to fly from AMS to TRD. Trish and Alasdair had no problems with their Irish passports.

On arrival at TRD, a representative of the authorities boarded the plane, and read out the rules. This included 1) no tourists would be allowed to land, but would be transported back to AMS, 2) that passengers must remain quarantined for 14 days, and 3) that people with corona symptoms would not be allowed on public transport, but would have to use private vehicles. After that Norwegian citizens were allowed off the plane. Once they were off, the rest of the passengers were allowed off. That could have been about 8 people, including us. We then had to present our passports at the immigration desk. They checked our status, and allowed us in. Then we had to be inspected by the health authorities dressed in hazmat outfits. Again, we were allowed to proceed. We picked up our luggage, and ran to the train, arriving on the train platform with a minute to spare.

Alasdair used his Vy (the train company) app to buy the train tickets. There were very few people on board the train. Alasdair had to “inspect” the tickets for the conductor who, before Corona, would normally be handed the telephone and press the ticket inspection button him/her-self. We then contacted our personal food shoppers by SMS. Trish had days earlier sent them a shopping list, and now paid them using our “Vipps” (bank) app.

At Røra station, we found our car – almost without any snow on it. We then drove about 7 km to Straumen, where we picked up our groceries, from the back of the shoppers’ vehicle, and transferred them into the back of our vehicle. We talked to the shoppers who had come to the door of their house, thanking them, but keeping a distance of at least three meters. Then we drove 13 km home to Cliff Cottage.

As this is being written, there are now 6 people dead from Corona virus in Norway. The average age is 89! Our local area has opened a special emergency clinic for people with respiratory problems.

The Norwegian krone has never been so cheap (or the American dollar so expensive). Today, it was 10.50 to the dollar.

On our arrival home, we began our 14 day quarantine. Because we are symptom free, we can walk in the woods and work outside, but have to avoid people.

Covid-19 World Cup/ Superbowl

The Covid-19 World Cup/ Superbowl will be taking place on 2021-01-01. This will allow cities/ counties/ states/ countries/ regions/ continents in the world to compare themselves with all the other players. There will be winners and losers in all categories. At the very least, everyone will be comparing themselves against China.

As Oliver Milman reported: The US is on course to be severely ravaged by the coronavirus outbreak due to a delayed and dysfunctional testing regime and misleading messaging from the Trump administration, public health experts have warned. (2020-03-15 02:54) Unfortunately, this early tactic of denial will probably put USA towards the bottom of developed countries.

Milman also cited an editorial by Herbert Holden Thorp (1964 – ), a chemist, inventor and entrepreneur as well as the editor-in-chief of Science:

For the past 4 years, President Trump’s budgets have made deep cuts to science, including cuts to funding for the Centers for Disease Control and Prevention and the NIH. With this administration’s disregard for science of the Environmental Protection Agency and the National Oceanic and Atmospheric Administration, and the stalled naming of a director for the Office of Science and Technology Policy – all to support political goals – the nation has had nearly 4 years of harming and ignoring science.

Now, the president suddenly needs science. But the centuries spent elucidating fundamental principles that govern the natural world—evolution, gravity, quantum mechanics—involved laying the groundwork for knowing what we can and cannot do. The ways that scientists accumulate and analyze evidence, apply inductive reasoning, and subject findings to scrutiny by peers have been proven over the years to give rise to robust knowledge. These processes are being applied to the COVID-19 crisis through international collaboration at breakneck, unprecedented speed; Science published two new papers earlier this month on SARS-CoV-2, and more are on the way. But the same concepts that are used to describe nature are used to create new tools. So, asking for a vaccine and distorting the science at the same time are shockingly dissonant. (End quote)

The fantastic thing about this championship is that there are any number of metrics that can be used to describe winners in contrasts to losers. Of course, politicians are not really interested in this at all. They have a vested interest in explaining why their area is fantastic, and other areas are not. Even then, not all countries/ states will be playing fairly. Some metrics can be found today. The first metric is population, along with an estimate of the percentage of people aged over 60/ 65/ 70, if this is available. Another metric available immediately, is the number of intensive care unit (ICU) beds. Figures from 2012, show this to be 8.0 per 100 000 people in Norway. More recent figures show figures for the world in the following graph.

The dates of test kit availability, and their first testing indicates how prepared the country/ state was. Indeed, the legitimacy of other metrics are, in part, dependent on the availability of these kits. At the end of the year, it will be important to know: how many people were tested; the number of positive test results, which with sufficient numbers of tests, could be an indication of the breadth of infection; the number of associated deaths. In order to compare players, data must be expressed as a percentage, or more usefully, absolute numbers per 100 000 people.

South Korea will undoubtedly emerge as the winner of the world cup/ superbowl, teaching the world how to approach similar epidemics. Given its population of 50 million, 74 new cases emerged on 2020-03-17 in contrast to 909 at its peak on 2020-02-29. Later, Reuters reported that South Korea kept new infections around a low 100 or less each day.

Numbers may yet resurge. Behind Korea’s success so far has been the most expansive and well-organized testing program in the world. This has been combined with extensive efforts to isolate infected people and trace and quarantine their contacts. South Korea has tested more than 270 000 people, (5 200 tests per million inhabitants). In contrast, USA has tested 74 per million inhabitants, according to the CDC.

“Diagnostic capacity at scale is key to epidemic control,” says Raina MacIntyre, Professor of Global Biosecurity at the University of New South Wales, Sydney. “Contact tracing is also very influential in epidemic control, as is case isolation.”

Legislation enacted in South Korea in 2015 gave the government authority to collect mobile phone, credit card, and other data from those who test positive to reconstruct their recent whereabouts. That information, stripped of personal identifiers, is shared on social media apps that allow others to determine whether they may have crossed paths with an infected person. In addition, South Korea established 43 drive-through testing stations, and in the first week of 2020-03 their Ministry of the Interior rolled out a smartphone app that can track quarantined people and collect data on symptoms.

In contrast to South Korea, and even China, USA is the developed country that I expect to come in last place. This will demonstrate that private insurance (and health care) have no place in the modern world. It may indeed indicate an end of USA’s (and capitalisms) dominance in the world, especially with respect to the economy, and innovation. In the short term, I expect a brain drain of intelligent people, and others with the opportunity to leave, from USA for places with better health care, and welfare. Canada, New Zealand and Europe will be sought after destinations. Australia and Asia, not so much. In Europe, and Italy especially, Cuba and Russia have received praise for their aid and assistance during this crisis. Perhaps these two countries will also be sought after destinations for disillusioned Americans.

In Scandinavia, there will be a regional competition between three groups of countries: Finland, Sweden and Norway/ Denmark. Finland looks as if it will be the winner.

Bjørgulv K. Bjåen writing behind a paywall in the Norwegian newspaper Vårt Land, states that Finland is in a special position. While other Nordic countries have reduced their emergency preparedness stores, the Finns have chosen to have large emergency stocks – buffers – especially with respect to drugs. In the current situation, it looks like the Finnish government will stop sales and exports of these from Finland.

Because of its Second World War experiences, Finland became a borderland between the East (The Soviet Union/ today’s Russia) and the West (Western Europe/ today’s European Union). For a decade after 1945, it had to pay major war reparations to the Soviet Union. In the process they learned to make things that they had never made before, such as icebreakers.

The contingency idea has massive support in Finland. After 1991, the Soviet Union was disbanded and four decades of a hot Cold War cooled. Sweden and Norway downsized emergency stocks, in contrast to Finland’s continued crisis thinking that embedded the principle of being prepared for surprise.

The Finnish Medicines Agency (Fimea) currently has a list of 1 400 drug types that are stored in so-called turnover stocks: One should at all times have enough for six to ten months of consumption. Manufacturers, wholesalers and hospitals rotate stock, as a matter of principle. Normal consumption is calculated from last year’s consumption.

Norway has chosen another solution. Until the EEA regulations became Norwegian law, Norway had large emergency storage facilities organized by the state medical Norwegian Medical Depot (NMD). However, after the EEA Agreement entered into force in 1994, the wholesale company changed its character; from state, to semi-state, to privatized. The Norwegian parliament (Storting) decided that the state monopoly had to be disbanded because it was in breach of EEA law. No one had told Norway to disband it.

This has resulted in the down sizing of emergency stocks, and the have been scaled down, and responsibility has spread to many players. In a report from last year, National Drug Preparedness, the Directorate of Health acknowledges major shortcomings:

“Many actors with different responsibilities for drug preparedness in Norway make the landscape unclear.”

“Only a marginal proportion of medicines consumed in Norway are produced in Norway.”

“Contingency stocks in Norway are largely concentrated in the central Eastland area, and also have inadequate content”.

“The specialist health care procurement systems are not robust in terms of drug preparedness.”

“Many municipalities have not secured emergency supplies of medicines for the health services they provide.”

“There is low awareness among the population about the importance of having a supply of necessary medicines at home.”

Sweden also recognizes that emergency storage has been replaced by the idea that most can buy something when it is needed. Last year, the Swedish Defence Research Institute analysed Sweden’s supply readiness. Finland copied Sweden’s earlier model for total defence planning and developed it further, while Sweden reduced it. There is now a shortage of drug readiness stocks.

In Sweden, emergency preparedness changed dramatically after it joined the EU in 1995.

Finland also has large emergency stocks with other important crisis products, fuels, groceries, seed, grain, metal and agricultural spare parts. Fuel stores are to secure up to five months of consumption. Grain stocks will last for six months.

In Norway, emergency grain storage facilities were closed in 2003. Today, grain storage is sufficient for only three weeks. In 2014, the Norwegian Institute for Agricultural Economics Research presented a report that said grain stocks were low.

When the right-leaning Solberg government presented the state budget for 2020, it was stated by the political parties supporting the government, that national emergency stocks for grain are not needed, because Norway can buy grain from abroad. That the supply lines are completely blocked off “for some time will not be seen as realistic”, Minister of Agriculture and Food Olaug Bollestad reported in the budget document.

Marcus Carlsson, a mathematician at Lund University, discusses two approaches to pandemics in a video, mitigation and suppression. The upper model in the video shows mitigation. This is the strategy Donald Trump appears to favour 2020-03-25, and the one implemented in Sweden. It is the same one used by South Korea, but with one major difference. To be successful, it requires extensive testing and tracking of cases, from the beginning. Until now, USA has lacked the ability to test. Yet, Trump is afraid the economy might tank without this approach. Others believe that mitigation might cost an extra million, or more, lives in USA, and take at least two years to complete. Not only that, the economy will probably still tank.

Carlsson is not an epidemiologist. He is an amateur. However, he is concerned that there is no evidence of a “herd immunity” approach controlling a virus outbreak anywhere in the world, without extensive testing. He described the Swedish government’s approach as “a mad experiment with 10 million people”.

A second approach, the lower model in Carlsson’s video, is suppression. This is the approach being used in Norway and Denmark, and in most other European countries, including two that have recently given up on the first approach – Britain and the Netherlands. According to Carlsson, this is the preferred approach, especially if there is a lack of testing. In the video he reads from a paper supporting it.

In an article in the Guardian newspaper, that describes Carlson, and comments on the 18m mark of the video, Carlson calls Sweden’s chief epidemiologist, Anders Tegnell, deceptive.

The Directorate of Health (Hdir) and the Norwegian Institute of Public Health (FHI) recommended different strategies to the government. They chose to follow Hdir and suppression, rather than FHI and mitigation. If suppression fails, then mitigation will be used.

Interestingly, Hdir has been given an overview of how much contamination equipment, including personal protective equipment (PPE), is available, but it is secret. They believe the figures will create fear, uncertainty and weaken Norway’s position in the international market if it becomes public knowledge.

FHI’s fourth risk assessment for covid-19 was published 2020-03-24. This assessment is translated into English immediately below.

In the risk assessment, FHI presents the first estimates of the number of infected in Norway with projections of the number of infected, the need for hospitalization and intensive care for the next three weeks.

  • FHI recommends that the choice of strategy for the further course is postponed one to three weeks. During this period, among other things, a better basis for decision can be obtained, in particular knowledge of the effect of the measures from March 12, says Director of Public Health Institute Camilla Stoltenberg.

In the coming weeks, it is crucial to win time and fight the epidemic with measures that can significantly reduce the spread.

  • A clear goal for the strategy is important. A key premise is that there is only high enough population immunity that can provide lasting protection against new, large outbreaks – this is achieved by getting many people infected or by vaccine, says Stoltenberg.
  • The choice of strategy and measures is made under great uncertainty, and there is a need to obtain more and better knowledge quickly and continuously, she continues.
    Prerequisites for the risk assessment

The Institute of Public Health is working to understand the situation and provide forecasts for the epidemic’s development in Norway. For this, a mathematical simulation is used together with real-world data, especially on hospital admissions.

The Institute today presents the first estimates of the number of infected persons in Norway with projections of the number of infected persons, the need for hospitalization and intensive care for the next three weeks. Thus we also have the first estimates for the dark figures in Norway.

There are still major uncertainties, and forecasts may change next week. As the epidemic progresses, FHI will have better data that can be built into the model, and the institute will adjust the model. The assumptions used in this assessment are:

  • Overall mortality among infected persons below 1% (lethality).
  • Severe age-related mortality; 90% of deaths in the group > 70 years.
  • About 1% of all infected people will need hospitalization and ¼ of these will need mechanical breathing assistance.
  • The measures should be adapted so that you get RE (the number of infections, ie how many an infected person is infected) down towards and maybe below 1.
  • Depending on the strategy choice and the effect of measures, we can expect that around 5% – 50% of the population will be infected during the epidemic.

FHI’s recommended strategy

It is clear that measures to reduce the number of infections are necessary. The choice of strategy and measures is difficult and must be done under great uncertainty. There are no simple solutions, and all strategies are experiments. Decisions with potentially major ripple effects must be made under uncertainty, regardless of who takes them.

FHI recommends that the choice of strategy for the future course be postponed one to three weeks. During this period, a better basis for decision can be obtained, in particular knowledge of the effect of the measures from 12 March.

Furthermore, the institute will develop new tools to optimize testing, isolation, infection detection and quarantine. This work is in full swing and moving forward at high speed. During such a period, the burden of measures can also be analyzed, ie the negative effects of the measures on societies, businesses, groups of sick and individuals, including consequences for life and health, and build better capacity in the health service. (End of Assessment)

In Norway, we get a daily status report from FHI. A summary of this status report for 2020-03-25 follows.

A total of 2,916 infected persons have been reported. This represents 54.3 cases per 100 000 in population. Of these, 264 of the infected were reported in the last 24 hours. 00:00 to 24:00. Highlights from the day:

  • 12 deaths have been notified to the Norwegian Institute of Public Health (2020-03-24 at 08.00). The average age of the dead is 84 years.
  • The average age of those infected is 47.7 years, 46.8 percent are women and 53.2 percent are men.
  • 1 437 people have been infected in Norway. 1 043 have been infected abroad and for 350 the infection site is being clarified. Of those infected in Norway, 724 have been close contacts of a known infected case and 671 have no known path of infection, 42 are being clarified.
  • In Norway, 73 089 have been reported tested for coronavirus (SARS-CoV2) (as of 2020-03-25 at 12.00).
  • 237 patients admitted to hospitals with proven covid-19 (figures from the Directorate of Health as of 2020-03-25 at 12.15). The number of admissions per day is increasing.
  • There are a total of 74 persons who have been or are in intensive care with certified SARS-CoV-2, of which 51 are hospitalized (figures from the Norwegian Intensive Care Register). The average age of those admitted to intensive care is 60 years. Of these, 77% are men. (End of status report)

Politico asked 34 opinion makers how they expected COVID-19 to change the world. They comments are interesting and warrant attention. Unfortunately, Politico did not reach out to anyone at Cliff Cottage. Brock’s expectation is that this epidemic, will lead to increased ruralization. That is, the urbanization trend will be stopped, and there will be a new back to the land movement, reminiscent of the early 1970s. Activities where random people congregate will decline. These will include visits to stores, bars, cafes and restaurants, theatres and cinemas, amusement parks, casinos and sports stadiums. The concert era has ended. The cruise ship era has ended. Instead, people will focus on small-scale growing of their own crops, and entertain themselves at home, producing their own music and art.

Tim Lang, is concerned about food supply, and fragile supply chains. For several years now, I have been talking (but not doing anything practical) about the use of 15 m2 (150 square foot) geodesic domes as hydroponic greenhouses to grow foodstuffs. People without gardens can grow food on balconies. People without balconies can grow food indoors. I did buy some LED lights optimized for plant growth. However, everyone should be considering how they can grow their own supply of food.

For several years now, I have suggested purchasing an abandoned motel and setting it up as a commune. There would be a common kitchen, dining hall, and socialization area. Half of the units would be used for accommodation, half as workshops.

In terms of location, I have often wondered about – then dismissed – Ocean Falls, British Columbia. This has had an important place in my wife Patricia’s family history. Her uncle, Mort Heaps, was mill manager. Her sister, Aileen, was a nurse at the hospital. This video provides an overview of its current state.

Other locations that I have considered are located in the southern interior of British Columbia, or Vancouver Island/ Gulf Islands/ San Juan Islands/ the rain shadow of the Olympic Peninsula.

This scourge will end! For every activity that is eliminated, a new one will emerge or more likely re-emerge. There could be changes. Online shopping will predominate, while physical stores will decline. Some shopping centres may be re-purposed, but many will have to be bulldozed. Hopefully, their area (including parking lots) can be used for other purposes, including housing, recreation and urban agriculture. People will grow and process more of their own food. Hopefully, it will be healthier and more organic.

Stavanger Airport Parking Garage Fire: A tidbit

Thermite RS1-T4 (photo: Howe & Howe Technologies)

On 2020-01-10 a fire broke out in a parking building at Norway’s Stavanger Airport. There were no injuries to people. However, much of the structure collapsed, including ramps to upper stories, because of structural damage caused by intense heat. Fire trucks could not enter the structure because of its low ceiling height. Because of its open walls, it was not, and was not required to be, equipped with a sprinkler system. An estimated 200 – 300 vehicles were destroyed in the fire, but about 1 300 vehicles were trapped in the building. It was initially reported the fire started in an electric vehicle. However, the fire started in a recalled diesel-powered 2005 Opel Zafira. The car was recalled after a similar fire in Cork, Ireland 2019-08-31, damaging about 60 cars in another parking structure.

Fake news, has resulted in some places in Norway banning electric cars from parking in their structures, although this is being contested by The Norwegian Electric Vehicle Association. It has sent out letters about this situation, the latest on 2020-01-21. The Norwegian Directorate for Social Security and Preparedness (DSB) states that electric cars rarely burn, but when that happens, the fire has a different course than fire in a gasoline or diesel-powered car. The fire energy is smaller and develops more slowly, but the extinguishing work must be done in a different way and may take longer.

Nils-Erik Haagenrud, Fire and Rescue Chief in Rogaland, the county where Stavanger is located, wants the county to invest in a robot that can be put into extinguishing work, when crews have to stay away from a fire, physically. Rogaland has the longest subsea tunnels in Europe, with exactly the same problems as in the parking facilities. Oslo and Romerike use robots.

Max Whirlpool: A tidbit

Max Whirlpool (16) shown immediately after being unplugged, and waiting to be escorted outside of the kitchen, for smoking.

Max Whirlpool (16) has been expelled from the kitchen for smoking. A representative from the kitchen, who wishes to remain anonymous because he is unauthorized to speak on behalf of management, stated: “We practice tough love. There is no discrimination. Any electrical appliance caught smoking will be treated exactly the same way as Whirlpool. It will be removed from service. ” He added that Whirlpool has worked in the kitchen since 2003.

Our next microwave oven will not be a Whirlpool. That is not because of any dissatisfaction with Max, until the smoking incident. It is more related to Whirlpool as a corporation. It does not appear to take the health and safety of consumers seriously. In fact, even when one of its products was clearly to blame for a massive loss of life, 72 people, it attempted to blame others.

Recently, the Guardian reported that the Grenfell fire report “… went further than many expected, as did Moore-Bick’s dismissal of attempts by corporate groups to delay or prevent findings that might count against them, such as the “fanciful” claim by Whirlpool – the manufacturer of the Hotpoint fridge-freezer – that the fire could have been started by a cigarette.”

Earlier, the Guardian had reported on another fire, where MP Andy Slaughter said “… the government should learn from a serious fire in his constituency in 2016, when a faulty Indesit tumble dryer started a blaze in the Shepherds Court tower block in Shepherd’s Bush, west London. Residents escaped with minor injuries. Twenty fire engines and 120 firefighters attended the scene.

The same article cited a letter to UK business secretary Larry Clark, where Slaughter stated “that Whirlpool – which owns both Hotpoint and Indesit brands – had “a poor history of fire safety”.

Wikipedia, in a section titled UK Dryer Fire Risk, in its article about Whirlpool Corporation, writes: “Safety warnings about tumble dryers published on the Indesit and Hotpoint websites in 2015 advised customers that “In some rare cases, excess fluff can come into contact with the heating element and present a risk of fire.” Condensers and vented tumble dryers sold under the brands Hotpoint, Indesit, Creda, Swan and Proline and manufactured over an 11-year period between April 2004 and September 2015 present a fire risk. An estimated 5.3 million tumble dryers were bought in the UK over the time period. Originally, and even after several fires were confirmed as being caused by faulty devices, Whirlpool advised customers that using such devices was safe provided they were not left unattended but would not issue a product recall. Whirlpool offered to fix faulty machines or replace tumble dryers at a cost of £99 – an offer met with derision with consumer groups and in the press. Parliament discussed widespread difficulties with getting faulty machines fixed or replaced, including long wait times and poor service.”

Max’s replacement Sam, a Samsung MS23K3515AW purchased for NOK 900, has arrived in Inderøy. We have spent some time learning how to operate Sam. We are looking forward to working with him to serve our modest microwaving needs in the coming years: reheating food/ beverages and defrosting. Sam is originally from Malaysia.

Optotypes

Originally written: 2018.01.01 20:46;Updated 2019.05.03 15:00

20/20 vision is just so 19th century. In many locations it is referred to as 6/6, in Europe as 1.0. Vision acuity tests originate with their invention in 1843 by ophthalmologist Heinrich Kuechler (1811–1873), in Darmstadt, Germany.

500px-Snellen_chart.svg
Snellen Chart (Artwork: Jeff Dahl, based on public domain document)

In 1862, Dutch ophthalmologist Herman Snellen (1834 – 1908) developed an optotype to estimate visual acuity. Optotype? Most people call it by its synonym, eye chart. In full size, the E at the top will be 88.7 mm (3.5 inches) tall. The other letters are proportionately smaller. When viewed at a distance of 20 feet = 6096 mm, normally rounded down to six meters, acuity can be estimated based on the smallest line a person can read.

In 1888, Swiss born/ Paris resident Edmund Landolt (1846-1926) improved upon this with the Landolt C, a broken ring that uses the Snellen letter C. Both the stroke width and the gap are 1/5 of the diameter. The gap can be oriented in various positions. Normally, there are eight different alignments, each 45° apart. The person being examined must decide where the gap is. The size of the ring is reduced until a specified error rate is exceeded. The Landolt C is the standard chart used for acuity measurement in most European countries. It is specified in ISO standard 8596.

A Landolt C optotype. Not easy to find on the Internet, because many charts only show four positions, rather than the official eight.

In the first paragraph, 20/20 vision (and two equivalents) were referred to. 20/20 is just an American reference value for visual acuity. In the rest of the world this norm was called 6/6 vision. In Europe, they actually perform division on the numbers and end up with 1.0 to describe a condition where, at 6 meters distance, a human eye is able to separate contours that are approximately 1.75 mm apart. Vision of 20/40, 6/12 or 0.5 corresponds to lower, vision of 20/10, 6/3 or 2.0 to better performance.

Normal individuals have an acuity of, or better than, 20/13.3, 6/4 or 1.5, but it is dependent on age and many other factors. 20/20, 6/6 or 1.0 vision is not perfect or even particularly good acuity. It is simply good enough. To drive smaller commercial vehicles in Norway, 20/25, 6/7.5 or 0.8 acuity is required. For passenger vehicles the requirement is 20/40, 6/12 or 0.5.