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Toni Morrison once said, “All water has a perfect memory and is forever trying to get back to where it was.” I thought about this as I stood over Dunbar Creek, craning my neck to take in the area and memorialize what I saw with my camera. My shutter clicked as I swatted mosquitoes from my face and attempted to distract myself from being inches away from cars driving by at full speed. One stumble in the wrong direction and I’d be flung into oncoming traffic — or down below into water so murky I couldn’t be sure of the depth.

I was terrified. But I desperately wanted to remember. I wanted to recall a space, place, and time that I had not known. And I was convinced this moment would connect me to something bigger. The water had something to teach me: about pain, the weight of forgetfulness, and existing in a space of liminality.

There is deep irony in places like St. Simons Island. Families and friends road-trip to this island, where they can feast on seafood and drink cheap beers in timeshares, or in second or third homes. This is their version of paradise and relaxation, leisure and ease they have earned. Leisure they feel a right to. But this leisure is decidedly white in its aims.

That weekend this summer, I didn’t see many Black people on St. Simons Island. They exist. They go there, too. But a coastal island in the marshlands of Georgia, St. Simons has a particular history that cannot be erased, because of its proximity to water and its connection to slavery. Places like these were prime real estate because of their ease of connection to precious cargo. Humans were shuttled like animals, chained and shackled, and sold. Sometimes they were held in slave depots until they could be sold or a sale was finalized — these were our earliest prisons.

Multiple truths, different versions of truth, can coexist. Concepts like leisure and rest shouldn’t fall into that category, and yet they do.

As in so many other places that are vacation and getaway central, Black leisure doesn’t exist here. Not when our pain is not validated and is instead erased. Not when Igbo Landing itself is largely inaccessible due to private land disputes.

My first few attempts to access Dunbar Creek via the bridge on Sea Island were dead-end, fruitless chases. Multiple times, I ended up on the other side of a wastewater plant, which has been there since the 1940s. The more direct route landed me tightrope-walking on that bridge — the closest I could get, since the area is on multiple acres of private property. That is why there is not even a commemorative marker.

The Saint Simons African American Heritage Coalition wanted to do something about that. In 2002, the group invited 75 people to pay homage to those who died at Igbo Landing and included some discussion on Igbo customs and traditions, in the hopes of giving the spirits lingering near the water some rest. Some of the coastal schools have also incorporated the story of Igbo Landing into their curricula. But there’s still so much to be done. Official marking would seal the history.

When I arrived back in Atlanta, where I live, the sand gathered underneath my feet on my car mat felt like a ceremonious parting gift. A trinket, a souvenir, a sentimental, heart-strung charm for the road, so that I never forgot what I saw, never forgot what it felt like to be there, breathing in that air, taking in that same view that my ancestors took in centuries ago. I felt connected because I had chosen to be a witness to their pain — and to their ultimate glory.

Nneka M. Okona is a contributing writer for the Counter and the author of “Self- Care for Grief.” She previously wrote about “heritage” tourism among African Americans for The Highlight.

This devaluation of domestic labor has been racialized from the start. The rhetoric of a “natural inclination” toward a certain type of work was used to justify slave labor while conveniently eliding the fact that the entire economy of the South would collapse without it. Instead of rebuilding a new economy after the Civil War, the South simply devalued the labor previously performed by enslaved people, whether in the fields or within the home. This standard was codified by law and held in place over the course of the early 20th century by Southern Democrats who insisted that agricultural and domestic workers be exempt from the otherwise sweeping labor protections of the New Deal era.

These two currents of labor devaluation — of women’s work and of racialized work — converge in caregiving. The systemic undervaluing of this labor affects those providing unpaid and paid care differently, but the impacts are interlocking. In Forced to Care: Coercion and Caregiving in America, Evelyn Nakano Glenn argues, “By virtue of its location in the home, caring work, whether paid or unpaid, is treated as though it is governed by the altruism and status obligations,” meaning the obligation to care for someone because of your relationship to them (daughter, son, sibling). “As a result,” Nakano Glenn continues, “paid domestic workers suffer various forms of exclusion from benefits and rights accorded other paid workers. Instead, like family members performing unpaid care, they are treated as dependents rather than true workers.”

In both child and elder care, this “social organization of care,” as Nakano Glenn calls it, has remained unaddressed for decades, societally “tolerable” only because the people bearing the greatest burden have been women, particularly women of color. Even as more and more women have entered the workforce each decade, and more and more elders require more and more complex care, the governmental understanding of who should provide that care has remained stubbornly rooted in the ideology of family responsibility. In practice, that means continually undervaluing those who provide paid care, while also making it incredibly difficult for family members in most states to receive Medicaid payment or reimbursement for their labor as a part- or full-time caregiver.

The continued devaluation of caregiving means that turnover for paid caregivers is high. As soon as someone can find a job that pays better, offers medical benefits or worker’s comp, or puts less physical strain on the body, they quit. In many states, particularly those where care workers haven’t been able to unionize and bargain for protections and better pay, there’s an ongoing labor shortage that only gets worse every year.

This shortage has direct effects on the family members supervising that care. The lack of affordable or even available assistance means more “coerced” caregiving by family members who feel they have no other choice; according to the AARP, this accounted for 53 percent of caregivers in 2020. What’s more, finding replacement caregivers and then coordinating their hours is one of the most mentally taxing components of familial caregiving, a task that only gets harder when labor is in short supply. When you make a job a bad job, you create more labor for the people who rely on assistance from that job.

The result is caregiver burnout, poor care, and poor caregivers. As Kate Washington writes in Already Toast: Caregiving and Burnout in America, “Burnout kills empathy and makes worse caregivers of all of us who suffer from it.” For paid caregivers, burnout arrives for the same reasons it arrives in any low-paying, highly demanding field: They’re simply not paid enough. The combination of low, stagnant wages and inconsistent scheduling made for a median income of $27,080 as of May 2020, and that figure varies wildly from state to state. (In Houston, for example, the annual mean wage was $21,120; in Seattle, $33,770.)

This was exacerbated during the pandemic, when the narrative of “aging in place” at all costs became even more forceful. Paid caregivers in 21 states were offered some form of hazard pay or pay increase, but those workers were the exception, not the rule. Even as demand has skyrocketed, pay in most states has remained stubbornly low, and because home health workers weren’t designated as “essential,” they didn’t have the same access to regular testing, PPE, or vaccines as other health care employees.

For unpaid caregivers, the burnout comes from the combination of performing physically and mentally exhausting work, coordinating care and medications, managing their own jobs and families, and navigating the bureaucracies of care and finance. Compassion fatigue and secondary traumatic stress, with symptoms ranging from depression to insomnia to substance abuse, are widespread and largely undiagnosed. Just as with so many parents who operate without societal support, life becomes a matter of sheer endurance. But at some point, as care needs become even more acute, no amount of endurance or will or grit can make the situation tenable. There are no solutions and no real relief, other than eventual death, shaded with the peculiar mix of relief and regret.

Unpaid caregivers told me that part of their frustration and exhaustion stems from their sustained invisibility. Liz O’Donnell, author of Working Daughter: A Guide to Caring for Your Aging Parents While Making a Living, said that in the Facebook group she runs for unpaid caregivers, one recurrent frustration is that the press is filled with articles about how hard it is to parent during Covid-19 — which is important — but there is very, very little about the challenges of caring for adults in isolation, especially while trying to work. “I’m lucky that I have teens who can handle their own Zoom calls,” O’Donnell said. “But it was also really, really hard for people who have a parent with dementia who didn’t understand that you were on a Zoom call.”

We don’t know how to talk about the challenges of elder care with each other, especially at work. When O’Donnell was still trying to juggle care for her parents, who have since died, and a full-time job, she found there was no repertoire, no familiarity, no way for her coworkers to understand. You don’t just come into work one day and declare, “I provide elder care now!” Unlike with, say, the birth of a child, there’s no office- wide email, no celebration, nothing that visibly changes, no employee resource group — no resources, period.

Just incredible stress, and the feeling, particularly among women caregivers, that you have no other option but to keep juggling care and work responsibilities.

“You see a lot of statistics about the 65 percent of caregivers who make some change at work, or the $300,000 in total lost wages and benefits for women, or people who take time off or switch to a less demanding job or quit altogether,” O’Donnell said. “But there’s also a lot of just hanging on. Women know how dangerous it is to leave the workforce, and we know it’s not something that many of us can afford. The average family caregiver is a woman in her late 40s and early 50s. If that woman takes her foot off the gas pedal in her career, does she ever get back in?” The care itself is exhausting, O’Donnell said, but the additional anguish over what the care has taken from your life and from your future? That’s debilitating.

If you haven’t faced figuring out care for yourself or a loved one, you might think this isn’t your problem. It likely will be at some point, but even if it isn’t, it still matters. When one pillar of society is broken, the rest of the pillars are asked to bear even more weight. Some calculations are hard to parse, but some are straightforward: If your mom stops working to take care of her parents and drains her savings to do so, that will affect you when she needs care. The promise of automation won’t fix the labor shortfall. Increasing immigration quotas might help, but the job itself is still a bad one with high turnover. Everyone’s miserable, and nothing’s even close to optimal — not for elders, and certainly not for the ones providing care.

The current situation is a prime example of what political scientist Jacob Hacker calls “policy drift,” where the needs of a society have changed dramatically but the social policy created to address those needs remains mired in a previous reality. In this case, a reality decades in the past, when far less of the population was aging, when the care needs were far less complex, and when far fewer women worked outside the home. That’s not to say that the situation was optimal in that previous reality, but now it’s falling on the shoulders of millions of paid and unpaid caregivers. 

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So how do we correct that drift? The tech industry has recently realized that the family caregiver market is massive and hugely underserved, and various startups are trying to make certain aspects of caregiving less unnecessarily burdensome. Carefull, headed by former consultant Todd Rovak, aims to alleviate the massive stress of elder financial management. “Right now, people are essentially becoming the CFO for their parents,” Rovak told me. “They don’t have the skills for it, and the system fights them all the way. It’s not built for them to do it with any efficiency.”

Most caregivers get their parents’ passwords to help with smaller tech issues such as paying a bill online, only to find themselves dealing with repeated commemorative coin purchases, fraud, identity theft, and political donations that unwittingly turned into recurring ones. Carefull is sort of like a smarter Mint.com, with alerts for behaviors that are common among aging adults: double-paid bills, missed payments, orders to a company in the middle of Canada they’ve never purchased from before. (Erratic or odd bank account behaviors can signal cognitive decline years before an official diagnosis.)

This sort of tool is useful when elders still live autonomously, and in other ways when they need a full-on financial caregiver; it also makes it far easier to distribute the labor among multiple family members. Lessening one component of the psychological and time burden of care is important, as is protecting against the cascading financial effects of fraud on credit scores within the family (one family member attempts to correct another’s debt, then finds themselves deeper in debt or late on payments, and so on). Tools like Carefull create a system where there was none and then make it easier to navigate, ultimately clarifying an unnecessarily convoluted corner of care labor.

A handful of employers are trying to fill gaps, too, drafting policies that acknowledge and accommodate elder care responsibilities. The tech company Hyperscience, for example, recently implemented a new elder care benefit that provides up to $36,000 a year per dependent for elder care, plus access to a “concierge” service to help coordinate care. It’s a great perk — for the 300 or so people who work at Hyperscience. It doesn’t actually address the larger quagmire, and no app or private benefit will. The primary intervention has to happen at the state and federal level.

The most straightforward fix, according to Caroline Pearson, the elder care expert from NORC, is to invest federal dollars in creating an actually useful program for those navigating elder care, including far more robust websites with discernible care options for each state, as well as increased funding and footprint for local Area Agencies on Aging. That’s the stuff that’s easy to wedge into any federal budget. Much harder — but more important, and what we should start advocating for — is a comprehensive program for long-term care, which starts with making long-term care insurance universal, mandatory, and at least partially funded through a payroll tax. (At this point, there are funds earmarked for elder care in the budget reconciliation bill, but the breakdown of those funds is incredibly unclear.)

At the same time, we need to make home health care a “good American job,” with the corresponding ability to unionize and bargain for worker’s comp, health benefits, and higher pay — which will then attract more workers, reduce turnover, and reduce subsequent stress on family caregivers. For people who do still want to provide familial care, more states should remove the restrictions on who can be compensated for it, thus preventing caregivers from draining their own savings entirely in the process. Finally, there are ways to make care outside the home an actually affordable option. It doesn’t mean reducing the quality of care but requires reimagining what nursing home care looks like, particularly in terms of size, and addressing longstanding staffing shortages by making those jobs desirable as well.

Does this sound expensive? Like a cost you’d rather not pay via your individual taxes? Or something that will never benefit you personally because you’ll figure out how to take care of your parents and your kids will figure out how to take care of you? Like you can just go get a job at a place like Hyperscience and start using an app like Carefull and have everything figured out just fine?

First off, you’re almost certainly wrong, and second, that attitude of personal responsibility is what led us here in the first place. This isn’t a problem we age out of in the way we age out of being the parent of a small child. In our lifetimes, at least, it’s a problem that’s just going to get worse and worse, much like the health of the people who need care. You might remember how, a few branches back in your family tree, people moved in with their family members in their later years and everything worked out fine. Or, more recently, a relative survived on their pension until the last year of their lives, was able to cover private at-home care, and hardly even touched their savings. Today, those stories are effectively fairy tales — stories we tell ourselves to avoid confronting reality. Your grandparents’ reality, your great-grandparents’ reality, it is not your reality.

As a society, we are living so much longer, and the diseases and conditions we live with require so much more: more care, more medicine, more vigilance, more maintenance. Which is why piecemeal solutions are laughably insufficient. We need to actually create a viable system, one that doesn’t ask people to be unspeakably wealthy, furtively siphon off their assets, or wait for years for affordable care. Then we need to make the people working within that system visible and their labor, in turn, valuable.

That requires legislative buy-in and, perhaps even more difficult, an ideological shift in our conception of what makes labor essential and a rejection of the belief that we don’t need social safety nets in this country because we have women. None of that work can start if we pretend our loved ones won’t fall off a cliff and suddenly need our whole selves to cushion the fall, if they haven’t already.

Talking to dozens of adult caregivers, I heard variations on the same theme over and over again: It’s brutal, it’s tearing my family apart, it makes me resent everyone, including the people for whom I’m providing care. The suffering is not new. The crisis has just further expanded within the middle class and the population at large, gradually making it less and less ignorable. “We can’t have a strong economy if we have millions of people working as full-time caregivers and making so little that they are still living in poverty,” Secretary of Commerce Gina Raimondo recently told the New York Times. “We can’t have a strong economy when we have millions of other people dropping out of the work force to take care of elderly loved ones.”

Right now, several experts told me, the public alarm around the state of elder care is about where it was with child care 10, 15 years ago. We didn’t act on the alarm bells when it came to child care, and now the system is in a pandemic-accelerated crisis, with rippling effects across the economy. The question, then, is whether we want to wait the 10, 15 years for that implosion, right as even more Gen X-ers, millennials, and older Gen Z-ers age into caregiving roles and, shortly thereafter, need their own care. Or do we want to address the problem now, before it risks collapsing us, and our families, entirely?

If you’d like to share with The Goods your experience as part of the hollow middle class, email annehelenpetersen@vox.com or fill out this form.

This isn’t to say that case counts are totally irrelevant. First, cases can turn into long Covid in a minority of people; the disability sometimes associated with that condition isn’t discussed as often as hospitalizations and deaths, but it matters.

Second, delta is much more transmissible than the original version of the virus, with an R0 now estimated at between 6 and 7, so it can spread all too easily in areas with low vaccination rates. “Certainly R0 is important when you’re looking at largely unvaccinated populations — a state like Missouri or some counties in Mississippi,” Adalja acknowledged.

But by and large, he said, “We have to move away from focusing solely on cases and really look at hospital stress. It’s not just, ‘Did hospitalizations go up?’ It’s: ‘What are hospitalizations as a percentage of capacity in the ICU? Are hospitals reporting stress scenarios?’ That’s what’s important.”

In 2020, we didn’t have vaccines to prevent cases or make them less severe, and transmission was high enough that the pandemic was expanding. “The only way to alter that was to find interventions to bring the R0 down below 1,” Kates said. “Everything was focused on that. That’s why we had lockdowns, social distancing, masking. All those activities were designed to buy time for the health care system and to buy time for countries to figure out if we can find vaccines.”

Now that we have such highly effective vaccines, our new mission is clear, but distinct from last year’s. “The goal is to vaccinate as many people as possible,” Kates said. “Why is that the goal? Because that single thing will drive deaths and hospitalizations very low.”

Instead of trying to eliminate risk, aim to reduce it

When it comes to HIV and various sexually transmitted diseases, many public health experts have come to embrace an approach called harm reduction. They’ve realized that pushing an abstinence-only approach (avoiding all activities that involve any risk) doesn’t work; people need to have pleasure in their lives, so the best thing to do is explain how to make an activity safer — how to reduce harm — rather than just expecting people to avoid it altogether.

“I think what happened in the early pandemic is that many public health experts … went back to an abstinence-only approach,” Adalja told me. “That approach basically told people: don’t do anything, none of it is safe, there is no acceptable level of risk. It didn’t allow people to think about graded risk — outdoors versus indoors, masked versus not masked. It also stunted the ability of the average person to be able to make risk calculations.”

To be fair, this “abstinence” approach was an understandable reaction at the beginning of the pandemic, when we were seeing hospitals go into crisis in places like New York City and we still knew relatively little about the novel coronavirus. That kind of crisis encourages short-term thinking: Use a blunt tool now, like telling people to mask everywhere and stay at home whenever possible, to get things under control, and sort out the pros and cons later.

But as the months passed, some experts expressed concerns that the cons of an abstinence-only approach were serious. “What are the negative consequences in terms of decreased childhood vaccinations or psychiatric illnesses or substance abuse or [decreased] cancer screenings? You couldn’t even say that. If you said that, you were actually considered like a Covid denier,” Adalja told me. “I’ve been advocating harm reduction from the very beginning, and I was criticized, ostracized, yelled at …. It was considered completely heretical.”

Some experts kept pushing for harm reduction, and their views became accepted to some degree. But the zero-tolerance approach to risk we inherited from the pandemic’s early days has been, for some, very hard to shake. Again, this mindset is entirely understandable given the trauma we’ve all been through. Yet it’s clear that we’ll likely always have some level of Covid-19 circulating, and we have to learn to accept some risk.

Are kids less vulnerable or more vulnerable than adults?

Although early 2020 was a scary time, one comforting message we kept getting was: The kids are all right. Children, we were told, are far less likely to get seriously ill from Covid-19. The main danger is to older and immunocompromised adults.

It’s still true that kids are at relatively low risk of getting seriously ill. But two things have changed.

First, adults are eligible to be vaccinated, while children under 12 — who number around 50 million in the US — are not. So while we adults got used to thinking of ourselves as more vulnerable than kids last year, those who are vaccinated are now the ones who’ve got a protective coat of armor kids lack.

Second, the delta surge is landing more kids in the hospital than at any previous point in the pandemic. As the Atlantic’s Katherine J. Wu reports, “Across the country, pediatric cases of COVID-19 are skyrocketing alongside cases among unimmunized adults; child hospitalizations have now reached an all- time pandemic high. In the last week of July, nearly 72,000 new coronavirus cases were reported in kids.”

All this makes it very difficult for parents to reason through what they should and shouldn’t let their kids do. And it’s no wonder they’re confused. Although the experts agree on many things — it’s a bad idea to send a child to school without a mask, for example — their approaches diverge in some ways.

“When you look at other respiratory viruses that we deal with in children — influenza and RSV [respiratory syncytial virus] — they exact a bigger morbidity and mortality toll than Covid does,” Adalja told me.

“So I often say, ‘Would you do this for the flu? Would you do this for RSV?’ Many people have incorporated flu and RSV into their daily lives and how they think about their children. And I think that’s what you have to think about,” he added. (The exception, he said, is if you have a child who’s immunocompromised or has asthma or other medical conditions; then more caution is merited.)

Kates said she’s not yet ready to consider Covid-19 in the same light as the flu because we’re still seeing a big increase in cases — it’s not yet endemic. Some of this is subjective, she explained: We consider a virus endemic when we as a society are okay with accepting the level of impact it has, but people will differ as to what constitutes an acceptable level.

For her part, “because there’s still so much spread, I think that’s a risky proposition at this point,” she said. “Kids can spread this virus. So part of what we’re also trying to do — because they cannot get vaccinated yet — is reduce their risk of exposure, not just for them, but for everybody else.” Roughly half the US is still not fully vaccinated.

Jeenah Moon/Bloomberg via Getty Images
The New York City Health Department has begun a “Vax To School” campaign in preparation for upcoming school reopenings.

This doesn’t mean parents should keep their kids home all the time; as mentioned above, the zero-risk approach will have to give way to harm reduction. Kates is still planning to send her child, who’s too young to be vaccinated, to school. She’s relying on mitigation strategies like masks and ventilation, noting that “schools have figured out a lot of things” in the last year.

In general, she added, the best thing parents can do is be fully vaccinated themselves and encourage other people to get fully vaccinated. She also recommends that fully vaccinated parents wear a mask indoors in public places even if their city or state does not require it, so as to lower the risk that they could get infected and bring that infection home.

“Until we are able to get beyond where we are right now with delta, that is another layer of protection that you can put between yourself and this virus, and therefore protect your child,” she said.

The pandemic was always global. Why are so many health strategies still local?

Our focus for most of 2020 was on stamping out the virus in our own cities, our own countries. We used masks and social distancing to avoid overwhelming our local hospital systems. We tried to support and protect our neighbors, whether through mutual aid groups or more informal means.

Toward the end of 2020, Americans began to hear that scary mutations originally detected in the UK and South Africa were showing up in the US. The appearance of variants should have driven home the fact that the pandemic always was, and remains, global: When a problem pops up in one country, it’s in all nations’ interest to take notice and help.

And yet, when vaccines became available in the US, America soon accumulated a staggering surplus of doses — and hoarded them. This May, as the virus ravaged populations from India to Brazil, several experts told me the US was clearly engaged in “vaccine nationalism,” where every nation just looks out for itself, prioritizing its citizens without regard to what happens to the citizens of other countries, especially lower-income countries that can’t afford to buy doses. (The Biden administration did eventually donate more than 110 million doses and send other supplies abroad, though many experts still say it should do more.)

Indranil Mukherjee/AFP via Getty Images
A Covid-19 vaccination site in Mumbai, India, on August 23.

But it’s now become blatantly obvious that caring only for our local community or our country is counterproductive: The more we allow the virus to spread unchecked in other parts of the world, the more chances we give it to mutate into dangerous variants like delta.

To the Medical University of South Carolina’s Kuppalli, that’s a strong argument for working toward global vaccine equity rather than rushing for booster shots in countries with high vaccine availability, like the US. “Let’s give everybody their first shot before we’re giving people their third shot. If we’re going to get this pandemic under control, we need to get the global rates of infection down,” she said. Otherwise, “we’re going to continue to get variants. Unfortunately, we live in a very individualistic society where people have a really hard time understanding that.”

This phase of the pandemic requires a shift away from the individualist or nationalist mindset. Everyone needs to conceive of the fight against Covid-19 as a truly global fight — because it is.

From The Hindu: Sports

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From Ars Technica

From Jokes Subreddit

  • A couple wants to have sex but their son is in the house. -

    The only way to pull off a Sunday afternoon “quickie” with their 8-year-old son in the apartment was to send him out on the balcony with a Popsicle and tell him to report on all the neighborhood activities…

    “There’s a car being towed from the parking lot,” he shouted.He began his commentary as his parents put their plan into operation.

    “An ambulance just drove by!”

    “Looks like the Andersons have company,” he called out.

    “Matt’s riding a new bike!”

    “Looks like the Sanders are moving!”

    “Jason is on his skate board!”

    After a few moments he announced… "The Coopers are having sex. Startled, his mother and dad shot up in bed.

    Dad cautiously called out…“How do you know they’re having sex?” “Jimmy Cooper is standing on his balcony with a Popsicle.”

    submitted by /u/JosephineAlberts
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