How did the pandemic change our habits?

S1: It's time for Midday Edition on KPBS. Today , we're talking about how the pandemic has changed culture. I'm Jade Hindman. Here's to conversations that keep you informed , inspired and make you think. The culture around personal space , workplace etiquette and even tipping has changed.

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S1: Plus , we'll look at how in many cases , the pandemic helped create more inclusive workplaces and how it changed the way we look at illness. That's ahead on Midday Edition. The World Health Organization has ended the global health emergency for COVID. And later this week , the US health emergency for COVID will expire. Still , health officials say while the emergencies are over , the pandemic isn't. That leaves many of us in a gray area , especially since so much change during the pandemic. For example , what's the appropriate thing to do when you're sick with a cold or any other respiratory illness ? Are the days of going to school or into the office sick over ? And what about tipping now that it seems everyone expects one ? What's the proper amount and what's proper etiquette ? Well , Jules Hurst is an expert in etiquette. She graciously joins us. Jules , welcome to Midday Edition.

S2: Thank you. Thank you so much for having me.

S1: Glad to have you. All right.

S2: Right. And we really relied on the delivery people putting the groceries in the back of our trunk. I mean , we really relied on them so heavily that we felt compelled to , like , just tip them right. And we we were tipping them above and beyond more so than what we would have any other time. And that just kind of stayed. And especially like before , when you would go to a fast food or to a non Sit-Down meal and you would see a little tip jar there and we would put our change in there or a dollar bill in there and and we wouldn't really think anything of it. Well away went the tip jar. And because everything is pretty much on that little iPad now or that or that pad. So they turn it around and and there's a , you know , the tip options there for you and you know and because before remember we were just putting our change or that dollar in that little tip jar. Now we're faced with , you know , 18% , 25% , 30% , you know , just these numbers. And we're like , what are we supposed to do ? You know , they're looking at you , people behind you or waiting. So so right now. So tip right now is really a hot topic because because we're seeing it more and more and more. So people are scratching their heads. So , yes , much , much to unpack here.

S1: And also , like since the pandemic , I , like a lot of people , started using DoorDash , Instacart , you know , all of the food and grocery delivery apps.

S2: So that's not the same as tipping. So let's , you know , make sure we understand that because sometimes people will say , oh , well , it's it's probably already in there. So that's number one. So it's generally going to be between 3 to $10. And here's how you want to think of it. When somebody goes above and beyond , that's when we you know , that's when we tip , right for somebody who goes above and beyond. So if they are delivering your food , you know , it could be $3. But if if they're picking up your stuff and and they're delivering it to you , then that would be more towards the $10. So again , it's just what it is that they are doing for you at that time. The service they are providing.

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S2: So , again , you may want to give a little bit more to that person who has to take multiple trips up the stairs to the back of the of the complex in the rain versus somebody who's literally just picking up bags from the counter to their car , from the car to your front door. They see there's a little bit of a difference between the two. That's how one should tip.

S1: You touched on this earlier , but one way tipping has changed in recent years has to do with technology. Many tip jars have been replaced by tablets. So as soon as you swipe your card at the checkout counter , the question pops up with a suggested amount in big , bold letters. Would you like to tip ? And you feel like everyone can see it and everyone's judging you , especially the cashier , with all of the pressure , you know , whether real or perceived , you just hit ? Yes. For 21% tip on a pack of bubble gum you just purchased. You don't even know for certain if that frontline worker will get the tip or if the corporation takes a percentage. What's proper etiquette for digital tipping and how does it really work ? Yeah.

S2: Okay. So number one , we should never feel pressured , you know ? But I get it , you know , because I do too , is like he or she is looking at you and they're just looking. You get you. And they're smiling. And you. So again , just with the tip know if you're ordering something and it's complicated or you're ordering , let's say coffee for the whole the whole office , your whole department , you know , whether it be coffee or food , you know , then , of course , you know , you would tip accordingly If it's an establishment that you frequent often and it's the same barista or the same sandwich maker or the same , you know , then of course , you're because you've built a rapport , you would tip in that case as well.

S1: Also , one other way that I think technology has changed things is that , you know , you assume that you can leave a tip on a card or something , but there's still a lot of places where you can't do that , where it's cash only. The sky cap , for example , at the airport , right.

S2: We still tip at the hotel , the doorman , the bellhop , our housekeeper , concierge. So we need dollars for them because as you mentioned , there is no credit card transaction , right ? Because they're providing a service. And until we see their Venmo QR code , there is no other way to tip them , which is this is something if they provide a service , we tip we need to tip them in cash.

S1: You mentioned tipping hotel employees. What about housekeeping ? Sure.

S2: So housekeepers , it would be 2 to $5 per night. And that would be because a lot of hotels are no longer cleaning on a on a daily basis. You know , they'll clean every I think I've seen some that say like every second day or every third day. But , you know , please do let us know if you need towels , etcetera. So if you are going to request extra towels , you would give them , again , $3 , $2 , $3 every time , you know , they bring you something. But if they are going to make up your room every single day , then you want to make sure to leave the tip each day because , you know , the housekeeper changes or can change from day to day. So you want to make sure that the person who is actually cleaning up your room that day is actually getting that tip , that 2 to $5 tip. And if you feel compelled to leave a little bit more than go , there is no no one's ever going to say , oh , no , $5. You already gave me $5. You don't need to give me anymore.

S1: This is Midday Edition. I'm Jade Hindman. I'm speaking with etiquette expert Jules Hurst about tipping. I mean , you know , with with tipping seeming to have been expanded , the expectation for a tip , I mean , when ultimately when is tipping expected and when is it not ? Okay.

S2: So absolutely. Under no circumstances should we ever stiffed somebody at a sit down restaurant that is , you know , that that that one is there. And also , with that being said , the national average for tipping at a down restaurant is 18 to 20%. I think with like 19 or 20% being like the the amount every single time. So when you're thinking about can , you know , is this restaurant in my budget , you have to think about the tip as well. It's not oh , do we order another round of drinks or do we or do we give the whole 20% on tip ? You know , that's not the question. You know , so the tip has to be part of that overall budget. So that is something that we don't want to skip out on. The same thing with our nail salon , with our dog groomer , Those and anybody who provides a service like like that to any kind of beauty. Your dog , sit down. We don't skip the tip. Hm.

S1: You mentioned the salon. And and from what I remember , before the pandemic , the rule was always to tip the hairdresser , for example. But the owner of the salon doesn't get a tip. Correct. So but a lot of that has changed now , right ? Because oftentimes there's not there's not even a salon to go into. Everybody has their own studio in a solo salons or something. Yes. And but still , your beautician is asking for a tip , but they technically kind of run their own business.

S2: They're still there , still providing all the same service with the same overhead. And we all know how expensive everything is getting. So I factor that in as part of my when I'm going to go get my hair done , I know how much that's going to cost and I know how much I have to tip again because everything is so expensive. A lot of us are just trying to make it.

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S2: So a lot of your smaller restaurants that like for lunches and your food trucks , they all have their QR codes so that you could tip them. So a lot of anybody who's providing some type of meal is asking for a tip , whereas before it wasn't like that.

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S2: It's pre tax. Okay.

S1: Okay. All right. Good to know. Good to know. Yeah.

S2: Yeah. You don't want to you don't want to tip on tax.

S1: All right. You even see like even in those apps I think it's it's including the tax in there when it gives you a suggested amount I don't know yeah.

S2: And so one more thing on on the apps and on that the screen so let's go back to that coffee house that the non Sit-Down establishment you know you can't hit the other so let's say you know this person and you didn't really you ordered just a regular black coffee nothing fancy and you want to leave something but you don't want to leave , you know , the 15 to 20 the options given there is that other option that you can also click and put your own amount.

S1: I mean , you know , at the end of the day , you know , everyone sure , everyone is deserving of a tip.

S2: Yes. You know , why is it on us to have to bridge the gap on their , you know , in their wages ? So so that but that is the argument. I would say pay them more and maybe we can still tip them a little bit , but at least we wouldn't feel the pressure. Right. Right. Because I yeah , because I feel right now like we as consumers are feeling pressured to bridge that gap.

S1: Now I want to dive into what we should be thinking about when we are sick. I mean , the rules for what is acceptable when it comes to being sick have changed. If you sneeze out in public , you're likely to get a mean side eye rather than a bless you now , you know. But before COVID , there was an emphasis on toughing it out , going to work , kids going to school , even if they're sick , with a cold and a bad cough and sneezing.

S2: But yes , you know , they are expecting you to go and just to to tough it out. But like any other time , if you have a fever , stay home. If you're if you're coughing and coughing and coughing , stay home. If it's if you're getting over it , if you have a little bit of a sniffles , you know , that would be okay to go. But if you're coughing so much that you're not even really paying attention , then why are you there ? And like you said , you know , one little sneeze and everybody's looking at you like , give oh , my gosh. Right. And they're get away from me. So you really have to use your best judgment. And if you don't feel well , again , you shouldn't have to go if you have a fever. Yeah.

S1: Yeah. It feels like the social norms and culture around that have certainly shifted.

S2: They certainly have , especially because you can't even though a lot of organizations are frowning upon this. But you can still work from home. So they'll say , well , you can stay home , but can you still do X , Y , Z ? Well , okay , well then I'm not really calling out sick. I'm just working from home. So that's where you have to make it clear , you know , am I calling out sick , meaning no work or am I just working from home because I got a fever and I don't really want to go in to the office ? Right.

S1: You know ? And what about social distancing and personal space ? Before the pandemic , it was common to give hugs and handshakes for greetings. Now , when you reach out for a handshake , you're likely to get a fist bump instead. And , you know , and some people are really anxious about their personal space being violated by a hug.

S2: If our body language in this case plays a lot into it. So if somebody comes up close to you and they come up really close uncomfortably , you know , just take a step back. So if you're with someone and they do that , that doesn't mean that , you know , they want you to take a step back with them. They're just trying to get , you know , some more space between the two of you. So if you are in a , let's say , in a situation , whether it be business or just you're seeing someone and you know that the handshake is coming and you are not fine with that , then you can simply either just put your hands together just by your chest area , kind of like grasping them and , you know , just with a head nod. Good to see you. Kind of a , you know , like a gesture and. That should tell the other person. Just by doing that , I'm not shaking your hand because my hands are here by my chest. If you're going to do a fist bump , then as you're putting up your hand , instead of putting it up to give a handshake , automatically create that fist bump. So that way the person that you're going to be exchanging this with knows what is acceptable behavior for that interaction.

S1: You have to set your boundaries.

S2: Set your boundaries absolutely correct. And you cannot be offended. Some people get so bent. Well , they don't want like , you know , it has nothing to do with you. Or maybe it does , but for the most part , it does not. It's not always about you. It's that other person's comfort level. And there's nothing wrong. It's we don't know what goes on behind. If she goes home , he or she goes home to somebody who's immune compromised or they themselves or I mean , it's none of our business. We saw what they're what they're allowing. So go with it.

S1: All right. Some great advice , Jules. I so appreciate it. And I'm sure a lot of other people do as well.

S2: Oh , thank you so much. Thank you for allowing me to help everyone out there. Be gracious and courteous.

S1: Jules Hurst is a Los Angeles based etiquette expert. And of course , Jules , thanks again.

S2: Thank you so much.

S1: We'd love to hear your thoughts on etiquette when it comes to tipping and personal space. Give us a call at (619) 452-0228. Leave a message or you can email us at midday at pbs.org. Coming up , we continue the conversation with how the pandemic changed remote work.

S3: It doesn't have to be either or. And that's that has been the conversation for decades. Hybrid is best in every survey. It turns out that hybrid produces the best results.

S1: You're listening to KPBS Midday Edition. You're listening to KPBS Midday Edition. I'm Jade Hindman. If you're listening to this , then chances are the pandemic has had a major impact on the way you work and the way you think about working in the first place. Whether you've gone fully remote or back in the workplace or you're trying out a hybrid schedule , one thing is clear the American workplace looks a lot different than it did three years ago , and the entire culture of working has undergone some major changes. Joining me now with more on what's changed since COVID upended the workplace is Kate Lister , president of Global Workplace Analytics , based in Carlsbad. And Kate , welcome back to the program.

S3: Well , thank you. It's great to be here.

S1: Great to have you. So remote versus in-person work remains one of the most highly debated topics in the workplace.

S3: That's how long we've been following this trend. Typically , before the pandemic , 75 to 85% of employees said they'd like to work from home , at least some of the time in the pandemic. 80% to 85% said that they would like to work at home some of the time. The difference now is they have the opportunity to ask for it. They're in a position to ask for it , and they are more galvanized in their resolve , having experienced it for the last three years.

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S3: I mean , number one reason is the commute. And in fact , they give back 50% of time that they would have otherwise spent playing in traffic and they spend that time working. And that's also been consistent before the pandemic. So that's the first thing. The second thing is work life balance. Just being able to throw in a load of laundry in the middle of the day , not having to that that tension of fighting , the traffic , of getting there on time , of having to leave earlier and earlier to make sure that you get to that meeting on time. It turns out that flex time is just as actually more important than flexible location , and that's been true for a long time also. So 95% of people would like to flex their time and 85 to 90% would like to flex their place. And it's about control , I think. You know , we just we want some control over our lives.

S1: You know , I imagine employers have a different perspective , too , when we're talking about the biggest reasons people do want to work a hybrid schedule or just work remotely altogether.

S3: At the beginning , employees and employers were very far apart and prior to the pandemic , only 5% of employees worked from home half time or more. During the pandemic , it was like 60%. So big , big , big change. And where they've come together is around that hybrid time. There are more employees that want to work fully from home. About 30 to 35% want to work fully from home. Managers want only about 25% or 20% of managers want them to be fully remote. About 15 to 20% want to be fully in the office. So maybe they don't have a place to work at home. And that has been a problem during the pandemic. Maybe they like to go to the office to get away from whatever it is at home. And then the balance is in that middle hybrid that employers are pushing for in the office 3 to 4 days a week. Employees are pushing for home 3 to 4 days a week. And historically , it's been for people that have work from home , it's the average has been two and a half days a week. So the tension is there. But but we're getting there. The problem is they're asking people to come to the office and people aren't coming. I think that's probably the biggest reason. I'm getting phone calls from companies today.

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S3: You know why ? And I get typically it's we feel like productivity is going down. We feel like it's hurting our company culture. We feel like it will impede aviation , it will reduce employee engagement. And so I say , okay , and how have you measured that ? And I've never had any any company leader that has shown me the measurement. They don't measure it. It's a feeling. And so , you know , you've got these leaders who want to lead , who want to have their people around them , and they're just grasping at. At straws for why there's good reason to have them come in. But there's evidence there's there's a long history of evidence in each of one of those categories that shows it's just not true. People are more productive , culture has not suffered. Engagement is actually better at home. All of those factors. Oh , innovation. That innovation actually is a two part process. You're most creative when you're alone , right in the shower where you have your great ideas in the car and you're most innovative , bringing those creative ideas together and turning them into something viable in groups. Yeah. So , you know , it doesn't have to be either or. And that's that. That has been the conversation for decades. Hybrid is best in every survey. It turns out that hybrid produces the best results.

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S3: I think The first is trust. They don't trust their employees to work untethered , in spite of the fact that 80% of managers say that people were as productive or more productive during the pandemic. There's that worry. There's that doubt. You know , are they sitting on the sofa eating bonbons ? Well , who cares if they are if they're actually producing the results that they're supposed to produce ? In a lot of ways , the pandemic didn't create management problems. It revealed them. And one of the things that it primarily revealed was that managers don't know how to manage. They're not managing by results. They're managing by butts in seats , backs of heads , which doesn't tell them anything about a person's productivity. I mean , the highest time online shopping is during work hours before the pandemic. So what does that tell you about whether or not they're they're actually fully working when they're in the office ? The second thing I think is sort of the the the typical leader is probably on the extrovert scale , probably has a pretty high self opinion. You know , we saw this with I won't mention the name , but a very large company that came out early in the pandemic and said no good will ever come. A remote work was actually interviewing his director of h.R. The next morning and said , hey , am i allowed to ask you questions about this ? Because that really created quite a stir. And she said yeah. She said he just didn't know. He didn't understand. He thought everybody was like him and they wanted to be in the office and they had to show him polls and surveys and all kinds of things that said , no , it's just not true.

S1: You're listening to KPBS Midday Edition , and I'm talking with Kate Lister from Global Workplace Analytics about the changes we've seen in the workplace since the pandemic.

S3: And this has always been a problem with remote work. And what it means is adopting new practices and processes. One of the things that I feel has happened over the last three years is that we've been in triage mode. We're going to go back , we're going to go back , we're going to go back. And so companies have not really changed the practices and the processes to the to support the way people are working equated to having a cell phone , but only using it at home. You know , when we first got cell phones or a smartphone and only using it to make phone calls , one of those practices and processes is how to set those boundaries. Only 30% of companies have offered training to their employees about how to be effective when they're remote. And one of the important things is to set team norms so , you know , have it written down. This is I'm available to you until this time you can call me before this. I have at the bottom of my email If you're reading this after hours , don't respond. Go do whatever. Go have some fun to sort of set the pace that if I'm maybe I want to work at three in the morning , but that doesn't mean that my people do. And so it's really about having those those conversations and the understanding of what's fair. On the other hand , you know , I don't really agree with some countries like France who has put in forget what they call it , but essentially they block the VPN after working hours so that employees can't work. Well , it doesn't make sense to me either , because one of the benefits of working remotely is that you can shift your time. And as I said , a lot of people want to do that. And some of us are night owls , not me , by the way , you know , want to work at 11 or 12 or one in the morning or maybe because of their family situation , that's when they have to. So it really comes down to individual choice. And there is there just is no one size fits all in in this game. It's different like country. It's different by region. New York is different than Texas , than San Diego. It's different by personality type. It's different by lifestyle. All kinds of things. And so what a company really needs to understand is what can we support best with the office ? What are the activities that are going to be done there and how do we best support them ? Because , quite frankly , I think one of the reasons people don't want to go back to the office is because they made them so bloody miserable for the last ten years.

S1: What I'm thinking , what comes to mind is that being able to be flexible and sort of work with everyone's needs within the company is really kind of a part of being inclusive , right ? Absolutely.

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S3: And the one of the things that I really hope we can take forward that we learned from the pandemic , that we were not inclusive when we were working with people at a distance. Those people were ignored , basically. And early in the pandemic , those people sort of started saying , hey , wow , I really feel like I'm more part of it because we're all this egalitarian square on the screen. It also allows people to hire from different areas. That allows them to bring in people of of different cultures and race the disabled. We actually the the Bureau of Labor Statistics showed that the disabled are more highly employed now than they were before the pandemic. Mean , isn't that great ? Yeah.

S5: Do you think the pandemic really. Encouraged.

S1: Encouraged.

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S3: Microsoft did a big study of 10,000 people or so and showed that there's been a total shift in what people value. And over 50% of people said that they now value their their work life balance over the their job. They've put themselves first.

S1: I've been speaking with Kate Lister , president of Global Workplace Analytics based in Carlsbad. Kate , thank you so much for talking with us today.

S3: Great to talk to you.

S1: When we come back , we'll talk about how we should be thinking about illness.

S6: I would never just be light about having COVID because it still has this unpredictable aspect that someday hopefully will will triumph over it.

S1: That's ahead. You're listening to KPBS Midday Edition. You're listening to KPBS Midday Edition. I'm Jade Hindman. The pandemic changed so much about how we look after our own health and well-being. But how has the era of COVID 19 impacted what we do to safeguard our health and what we know about illness in the first place ? Joining us now with more on how COVID has changed our perceptions of sickness and health overall is Dr. Eric Topol , director of the Scripps Research Translational Institute in La Jolla. Dr. Topol , welcome back to the show.

S6: Thanks , J. Great to be with you as always. Likewise.

S1: Likewise. Okay. So I think most people listening have had at least a COVID scare at least one time wondering if the cough or itchy throat is COVID or a cold or just allergies.

S6: I don't think there's any question of that. For those who are health conscious , when you get symptoms that could be COVID , knowing that this virus has more far reaching adverse potential. It's natural to be concerned. And of course , because it can simulate now with people having been vaccinated and prior infections and combinations , oftentimes it is in COVID , thankfully. And I would never just be light about having COVID because it still has this unpredictable aspect that someday hopefully will will triumph over.

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S6: But otherwise , You know , I think we went through three years when people largely for forgo their would forgo their testing , you know , like screening tests and checkups because they just didn't want to deal with going to a clinic and a medical facility. So there's a lot of catchup going on right now. But on the other hand , there's not as much that there should be. Right. So , you know , people learn to to kind of not do this stuff and not be as health conscious. And obviously , there was a lot of problems with being able to have normal life and go to gyms and , you know , do things that were more in the health lifestyle positive. We're getting back to that now. We're still in this kind of endemic state where the virus is circulating. But overall , hopefully we're going to get a reboot that people's health , consciousness and lifestyles will be not only fully restored , but even go beyond where it was at baseline.

S1: But is it safe to get back out there to go to the gym ? I mean , it's still an enclosed area. I know for myself , it does create a little anxiety.

S6: Yes , there is a risk. It's small , though. The level of circulating virus is low. We're at the lowest wastewater , lowest hospitalizations , fatalities of COVID since the beginning of the pandemic. I don't think the risk of being in a gym is appreciable. It's there. I think there's more of a risk when you're in a room with a large number of people indoors , especially when there's not adequate ventilation most of the time. Now , as you know , Jade , people aren't wearing masks. So when you're in that kind of setting , that should be a time to rethink about wearing a mask. And as you also know , just wearing a mask when people aren't in their vicinity is not as good as everybody masking up. But we already saw recently a CDC conference that was held with 2000 people and they didn't wear masks. And the conference , ironically , was about the progress that's being made in COVID with COVID. And then there was a significant outbreak. So it can still happen. And that was recent. So we can't just let down. And I understand the concerns about the gym , particularly because people , you know , heavy breathing , putting stuff out in the air. So obviously you'd be better in a gym where there were a few people or nobody else exercising if you could pick your time. But also the risk is getting low. And , you know , a lot of people say you're just going to move on with your life. And also an important point is if you did get COVID , now the chance if you're vaccinated with boosters and if you had prior COVID added on to that chance of getting ill , especially if you're low age , 65 is low. And there's things like paxlovid and there's metformin and there's things that we didn't have before. So the worry factor shouldn't be nearly as high as it used to.

S1: Be in terms of keeping our guard up. I mean , you know , people really took to hand. Hand washing , using hand sanitizer and other daily health precautions.

S6: You know , overall , it's good hygiene and there are a lot of other pathogens out there besides this virus. So overall , it's a good practice. I think when you overdo it , then you start getting into this whole hygiene hypothesis about things that we are more sensitized to pathogens. And and this goes back to the whole peanut allergy and children. And , you know , I think the concern here is if you if it's overdone unnecessarily , is that not good for your immune system ? That is , you know , some exposure may actually be re helpful. So everything is good in moderation. Jane , think this fits into that umbrella as well.

S1: And more to that point , a lot has changed in terms of taking precautions. For example , before the pandemic , it was common practice to just power through it power through a cold , rather , and show up to the workplace or school regardless.

S6: So , you know , that's why even though we moved to this non emergency phase , as defined by the government , there still should be the concern , get tested , be sure that you're not unwittingly potentially harming others. So we that's something that will be with us for for some time going forward. Yeah. I mean I think before people would , you know , kids would go to school and they might be be sick , but , you know , not to the point where it's really affecting their energy and health otherwise. But now we just got to be a little more cautious because , you know , there still could be outbreaks , these so-called wavelets and who wants to be part of it no less , to be the one that is the patient zero that's , you know , responsible. So , you know , that's the sort of thing that , you know , it's just being a good Samaritan to not be a vector of of an outbreak.

S1: You're listening to KPBS Midday Edition. I'm speaking with Dr. Eric Topol , director of the Scripps Research Translational Institute. Dr. Topol , I want to move now to a topic you covered in your latest Substack article. It's an evolving discussion of the risk of disease after getting COVID.

S6: I interestingly met with one of the leaders at NIH this morning about it , and the recovery trial is working on that. But of course , I think much too slowly because we really need effective treatments that are with compelling evidence rather than just anecdotes. But the exciting thing about long COVID is it's prevention , not just with vaccines , not just likely with Paxlovid early treatment , but metformin , which is a very commonly used drug for people with type two diabetes , but now has been shown in a really good randomized trial that had significant reduction of developing long COVID. If you get if you get COVID. So something to think about it , it's widely available with a prescription from a physician , very inexpensive. That's a that's progress on preventing long COVID. But we're still stuck on the treatment side. I hope we'll see some things soon. But it's frustrating because the US put $1 billion into this program called Recover , and we haven't seen any trials of treatments , which is what we desperately need.

S1: You know , in this latest article , it really deals with the elevated risk that people face in contracting a number of diseases after getting COVID.

S6: The first is developing diabetes. So type two diabetes , 12 different reports , the most , you know , very large , very impressive that the risk of diabetes is significantly increased. Well well , after the time of having COVID , even with mild COVID. So this is beyond 30 days. So that's one of those things in the earlier. Part of our discussion that , you know , you should be screened for if you're not feeling well and you're possibly your blood sugar is fasting or high , that that could be connected. The dots between what's going on there. So there is an increase. It's still low , but it's significantly higher than if you haven't had COVID. And that's one big body of data that's , you know , not it's incontrovertible. Now , as far as I can see , the other thing which is very concerning is that there's three studies , all of which are concordant for the increased risk of autoimmune diseases , things like rheumatoid arthritis , lupus , Sjogren's syndrome , systemic sclerosis , the whole grouping of autoimmune diseases have been increased , not as big a margin as with diabetes. It's about 2,530% increase , but still an increase That is , it appears that COVID , you know , weeks , months after getting COVID , some people have triggering of their immune system to go into this self directed antibodies or self directed t cell problem and develop a condition for both these the autoimmune and diabetes. It's possible that there will be recovery. We don't have a long enough follow up , but and there have been some for diabetes but this is one of the unknowns is will this be transient ? We'll only last for a matter of months. Will people's immune system start to revert to baseline ? That's that's an unknown at this point.

S1: And of course , you know , children and how they respond to diseases are a big part of this discussion.

S6: So remember , you look at long COVID , it's two different compartments. One of the symptoms and the other are these adverse effects like the diabetes and the autoimmune and the heart attacks and strokes. So children , the younger they are , the less chance of any of this stuff. But as they get older and more into adolescence , they start to get the risks that approach that of adults. Now , fortunately , children usually don't have severe COVID. They usually don't wind up in the hospital. And we do know , of course , all these complications we're talking about are more apt to occur with severe COVID. So overall , it's less of an issue with children , but they're not exempt by any means. Even , you know , young children , infants. Still , it can happen. It's just not as frequent.

S1: And finally , I want to end on something a little different. Recently , the surgeon general identified loneliness as the latest public health epidemic. And I'm sure some of that can be attributed to the pandemic and the need to isolate. But what are your thoughts on this and how can people connect and get back out there safely ? Right.

S7:

S6: Our our surgeon general , Vivek Murthy , who's a good friend of mine , wrote a book about this on loneliness. And he is certainly an authority. And he's pointing out that this is a serious concern. Obviously , in the early time of the pandemic with forms of lockdown , this was taken to a level that was unprecedented. But there's lots of residual loneliness. So many people , you know , work at home and hardly leave their cave. But even those who are essential workers , you know , the the the human to human interactions and bonds aren't still what they were pre-pandemic. So and even then there was obviously a huge issue with this so many people living alone. So what I think is great is that our surgeon general is on it and there will be efforts to try to provide improvements , but it is something we should acknowledge. It's it's something that is very tightly intertwined with mental health. And we are our species is one that relies on human human bonds and interactions , friends and family and all the things that are essential for our mental health. So hopefully we'll see work to be done to to titrate the problem because it's a significant one.

S1: I've been speaking with Dr. Eric Topol , director of the Scripps Research Translational Institute. Dr. Topol , as always , thank you so much for your insight.

S6: Oh , thanks for your great questions. Always enjoy it.

S1: We'd love to hear your.

S5: Thoughts on today's show. Give us a. Call.

S1: Call. (619) 452-0228. Leave a message or you can email us at midday at pbs.org. And if you ever miss a midday show , you can find our podcast on all platforms. I'm Jade Hindman. Thanks for listening.