Knowing Your Circle of Control

Julie McMurry starts her new Online COVID Family Update with a joke.

“An epidemiologist, an ICU doctor, and a scientist all walk into a bar (or cafe or family gathering or get on a plane). I’m just kidding, they know better.” That joke may not get her on the Jimmy Kimmel show as a hot new standup, although it has a certain undeniable Andy Kaufman charm, but it’s Ms McMurry’s way of acknowledging how hard it is to see people having fun at cafes, seeing friends gathering without the proper precautions. Like it or not, inadvertently or otherwise, she adds, those people we see in these gatherings are proving what is safe and what is not safe to do, frequently at their own peril.

Her COVID Family Update is a plea to her family to be vigilant and not let their guard down as we see some people doing and to have a long view of the pandemic and only take calculated risks where they bring joy.

In coronavirus time every week, every day, can feel like a year. Looking back to March seems like a lifetime ago. In those beginning days of awareness, Julie McMurry was one of the earliest sources of reliable information on the coronavirus. From her home in Santa Barbara she wrote the manifesto, which became flattenthecurve.com. It was the Google Doc that broke Google Drive. It remains an invaluable source of information on the virus, which despite all of our wishes otherwise, continues to evolve and develop around us and throughout the world.

Beyond the Curve

Meanwhile Julie has moved on from “flattened,” continuing her work at TISLab – the Translational and Integrative Sciences Laboratory, a part of the Oregon State University College of Public Health, where “an interdisciplinary team focuses on data interoperability to expedite translational research.” You got that? Actually, it’s simply a lab designed to develop techniques for scientists in every discipline to effectively share information and comb through vast qualities of data to enable new discoveries, which of course is not so simple. In her job she reviews an enormous amount of diverse data and is always processing new information.

In a sense we’ve all moved on from flattening the curve whether we like it or not to what is practical and possible as the virus, the economy, the heat wave, and now massive wildfires have engulfed us. Clusterapocalypse is a term that comes to mind, a term that encapsulates how unimaginable it is to have so many crises all happening at once. Navigating what is practical and what remains in our “Circle of Control” is crucial for everyone, even a public health advocate and activist, like Julie McMurry.

Know Your Circle of Control

“I have been endeavoring to focus ruthlessly on the circle of my control,” Julie states resolutely. “I feel it’s important to have physical boundaries in terms of not taking on infection risk, but there are also significant psychological risks associated with assuming more responsibility and assuming more power then is rightfully any one person’s.”

As the pandemic has taken over the headlines in new ways, anxiety can become overwhelming. It’s crucial to learn how to take a step back to relieve our anxiety over what we cannot control. This is especially true as children and parents begin dealing with schools reopening. Nothing could be a bigger hot button issue for parents than putting their children at risk in schools insufficiently prepared for COVID. It’s one thing do something momentarily risky for yourself, but risks for your children are a bright red line issue for most people.

Julie touts teaching support expert Brandy Thompson’s version of the “Circle of Control” for teachers and kids. Brandy Thompson creates teaching aids for students and teachers featuring Social and Emotional Learning (SEL) for students and self-care for teachers and counselors. Her website, TheCounselingTeacher.com, offers a wealth of ancillary support in these days of Zoom-fatigue and doom-scrolling for the Coronial Generation.

Julie has applied the Circle of Control concept to evaluate her own efforts to warn about the unfolding dangers of the pandemic.

“There was such a need in those early times for solid information. It’s a lot easier to find now, but at the time we whipped that thing together,” she remarks referring to the flattenthecurve.com website. “The outcome has been disappointing to be sure, but on balance I am glad I acted in the way that I did and that so many others acted in the way that they did. It could have been so much worse. It could have been that nobody listened.”

As she focuses on new messages and other ways to deliver them, her Twitter @figgyjam has become a hub for information, spinning out articles and new developments. It’s actually quite entertaining, and the quickest way to get a clear sense what she is finding on the horizon, featuring posts and stories about COVID sniffing dogs, the best face masks on the market from the UK, a scientist’s geeked-out version of John Lennon’s “Imagine” about “no proliferating identifiers and data sharing,” and the latest from TISLabs.

Catching up with Julie in her house on Zoom included frequent interruptions from her son, Marcus, who was in Zoom Video Camp, and her husband, who was on another video conference in the next room. Such is life these days.

“I was thinking about dogs; eight dogs were trained for one week in this well-designed study and the dogs achieved an overall average COVID detection rate of 94 percent, which is impressive,” she says. Her interest in testing developments has spread to fast home testing, the testing of sewage systems and other “prevalence” testing which would create faster, better, more practical markers for calibrating community viral risk. 

“Unless you need to be hospitalized right now, test results are almost worthless,” she explains. “The next big thing that will be a game changer is rapid home tests. If they can scale up, it would provide a reasonable way for people to move on with their lives, without relying on the presence of a vaccine. If you’re having a wedding for a hundred people and it’s outdoors, you could get a hundred rapid tests and test people before they come in the door and be able to at least have something resembling normal. Is it going to get every single person that’s positive? No, but it’s nevertheless a way to reestablish some normal routine.”

The goal of prevalence testing is to understand what the presence of the disease is in a particular place at any given time, then once it reaches a certain threshold, action can be taken.

“Sewage testing is important. We need to have low cost, minimally invasive ways to monitor community transmission,” she says. “So testing is high on my list, including pooled testing as well.”

She has been less than pleased with what the City of Santa Barbara has provided online and regularly contacts them and calls out their lack of meaningful information.

“Even now the City’s homepage has a carousel of six prevention tips,” she says. “All of which focus on washing and cleaning, and none mentioned any possibility of aerosol or airborne transmission. It’s a bit of denialism. Oh, and by the way, I got a jury summons yesterday.”

What Was Correct, What Was Less So

She doesn’t hesitate to evaluate the effectiveness of her own work on flattenthecurve.com with the same critical eye.

“Here are the things that were correct: the infection fatality rate was within the range originally predicted,” she says. “It looks to be closer to 0.5 to 1.0, which varies a lot depending on the circumstances. It was correct that the virus is highly transmissible person to person and can be spread asymptomatically or symptomatically. It was correct that it has a very wide range of manifestations involving all kinds of body systems. The complexities are going to take years to untangle. And lastly, infection control really makes a big difference.”

Flattenthecurve.com advocated masks, staying outdoors, and distancing early on, but she readily admits fomite transmission concerns were misleading.

“Knowing what I know now, I would have done more to deemphasize the surface-based concerns,” she admits.

What comes up again and again in her thinking are the practical straightforward remedies. Those seem, at least from Julie’s perspective, the effective strategies at this point: the unfailing ritual of sanitizers, mask-wearing, distancing, and understanding the circle of your control.

Being Practical Within Your Circle of Control

“We have to acknowledge, accept where we are. We could bitch and moan all day about how our government failed us, and they did, but it’s better to just be clear-eyed about where we are now,” Julie says, describing what she considers our landscape at this moment.

“What we need to do is have a laser focus on our Circle of Control, our Circle of Influence. We need to do what we can right now to mitigate the spread. It boils down to – don’t take dumb risks, take the risks that bring you joy and nothing else. So, don’t go to that party you didn’t want to go to in the first place, don’t invite someone in your home that you don’t even like, because how awful would you feel if you either infected someone else or got infected over an interaction that was just perfunctory, right?”