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To PCR or Antigen Test?-that is the question
With many people relying on at home rapid antigen tests to be able to safely gather with family members and attend events, it’s important to know just how far these tests go at helping us assess risk. There is a range of variability in the sensitivities of these rapid home tests especially when it comes to the omicron variant. Sensitivity refers to the ability of a test to accurately give a positive result in someone who is infected with the virus. Numbers for these rapid antigen tests have ranged with some studies showing sensitivity as low as 44% in asymptomatic individuals and an overall sensitivity of 65% and others showing sensitivity of roughly 92% in symptomatic individuals and 78% in asymptomatic individuals. The accuracy of these tests as discussed in the studies does depend on whether one is symptomatic or not (with symptomatic being more accurate) and of course at what point in the course of the illness one is being tested. That being said, there is some utility to rapid antigen tests.
A rapid antigen test detects a protein on one of the spikes of the coronavirus and is less sensitive overall than a PCR test because it takes more viral particles for it to reveal a positive result. A rapid antigen test may be best used if one is trying to determine if still infectious and a risk to others. It is unclear at this point how much viral load one needs to carry in order to be considered infectious, but if the rapid antigen test is positive, the result should be trusted. The timing of when to take the test is important though since you may not have a high enough amount of virus to be detected if you test too early after exposure (which is why PCR would be better early on) so if asymptomatic after a known exposure, testing with a rapid antigen test around day 3-5 and again at day 5-7 since exposure would be more accurate.
A PCR test also known as a reverse transcription-polymerase chain reaction test can pick up small amounts of viral genetic material. The test then amplifies the genetic material, making it a very sensitive test. However, because it reveals positivity even when there’s a small amount of virus, it can actually stay positive for many weeks after one is infected even if one may no longer be “infectious.” An appropriate time to take a PCR test is when one has had a known exposure to someone with COVID-19 or is experiencing symptoms. Since initial studies suggested that the 1-2 days before symptom onset and 2-3 days after symptom onset may be when one is the most infectious, it is important to opt for a PCR test because it may detect the virus earlier than a rapid antigen test, which is not as sensitive. That being said, a recent Japanese study found that viral loads for omicron were highest at days 3-6 after symptom onset, which also calls into question the shortened quarantine guidelines put out by the CDC.
Of course, it’s important to recognize that access to affordable testing is a major obstacle for many. This is why we need to ensure that everyone has access to free testing and delivery of these tests is equitable. For more information about specific rapid tests and their sensitivity, refer to the links below.
https://pubmed.ncbi.nlm.nih.gov/34242764/
https://www.cdc.gov/mmwr/volumes/70/wr/mm7003e3.htm
https://www.nytimes.com/article/at-home-covid-tests-accuracy.html?ref=oembed
https://www.health.harvard.edu/diseases-and-conditions/if-youve-been-exposed-to-the-coronavirus
https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2783099
https://www.niid.go.jp/niid/en/2019-ncov-e/10884-covid19-66-en.html
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Austin outdoors: the top hiking trails to visit
Since moving to Dallas, I’ve been to Austin several times and each time it feels like I’m visiting a completely different city. Either Austin seems to transform its image quickly or I’m always discovering novel sights and activities. The restaurant scene, the live music, the shopping, the overall feel of the city and the many Austin outdoor adventures that await are endless. I could go on about all the things I love about Austin, but I’ll save that for future blog posts.
On our last trip, we chose to focus on exploring some of the surrounding Austin-area hikes and get a better feel for the Austin outdoors. Having stayed in the city many times before, we chose this time to stay somewhat on the outskirts at a lake house on Lake Austin. We picked the location because it was easier to get to a few of the hiking areas I had scoped out online, but also easy to get to the center of the city for other outings.
We planned to visit Lady Bird Lake Trail, McKinney Falls, Hamilton Greenbelt Trail and Hamilton Pool Preserve. Now I use the term “hiking” loosely as we had a baby in tow and there’s only so much terrain we can cover (or rather my husband can handle when carrying him in a hiking backpack). Some of these spots allow for leisurely strolls and all of them have the option of taking easier trails.
Lady Bird Lake Running Trail
Of course Lady Bird Lake Running Trail is probably the most popular trail in Austin as it’s in the heart of the city and encompasses a range of recreational activities, merging nature and urban life. There are a lot of different entry points to this trail (also called the Ann and Roy Butler Hike and Bike Trail) and each time I’ve visited I’ve taken a different path. Some people use the dirt path, some use the boardwalk and others do a combination. This is where you will see tons of paddleboarders and kayaks especially on the weekends. They also offer pilates classes on top of paddleboards! Lady Bird Lake Running Trail is one of my favorite Austin outdoor spots to visit.
Typically after completing a lap around the Lady Bird Lake Running Trail, we head to one of our favorite brunch spots such as the Well ATX! Make sure to check out Zilker Park and Barton Springs Pool while in the area as well! Barton Springs is fed from a natural spring and open all year round to swimmers.
Hamilton Greenbelt Trail
After spending the first day in the city, we drove to our airbnb on Lake Austin. Lake Austin is about a 30 minute drive from Austin and of course we had to stop to grab a latte from summer moon, a Texas Hill Country original. Well known for their special sweet cream called “moon milk” and their delicious coffee, summer moon has multiple drive-thru locations throughout hill country. We stayed at a beautiful home with lakeside views (views pictured below). The next morning, we drove about 30 minutes to Hamilton Greenbelt Trail to set out on a hike. The Hamilton Greenbelt Trail incorporates a diverse terrain with multiple paths and waterfalls one can chase. There are a lot of oak trees that shade the way if you don’t want to be in the sun. There is also a more “primitive trail,” which is a little rocky, but not very difficult.
After completing the Hamilton Greenbelt trail, we headed to lunch at the Oasis, a restaurant known as “the sunset capital of Texas.” The views here really are spectacular and worth taking in.
We spent the afternoon in Austin doing some shopping. We like to put out names down at one of our favorite Austin patio’s Perla’s while we shop around as there is often a long wait to get in. This seafood and oyster bar is an absolute must when visiting not only for the food, but the atmosphere and vibe.
McKinney Falls
The next morning, we drove to McKinney Falls. McKinney Falls is best known for its waterfalls and cypress trees. It surrounds Onion Creek and Williamson creek and people can be seen fishing or swimming in the creeks. Our visit here was short as we only walked to the McKinney Falls lower falls as it is a short walk from the parking lot. There is also a McKinney Falls upper falls path, but based on my reading it was more rugged and not as easily accessible.
Austin is only about a 20 minute drive from McKinney Falls so we spent the rest of the day walking around Austin with a stop at Mozart’s coffee, a coffee shop on Lake Austin. Something I just love about Austin is the plethora of places that boast lakeside views. For dinner we ventured to another favorite Austin patio, Aba restaurant. They have great quality mediterranean food and an eclectic drink menu, but the ambiance and scene is really the main draw of this place.
Hamilton Pool Preserve
On our last day, we planned to visit Hamilton Pool Preserve, the furthest drive we did from our airbnb at about 45 minutes. This was probably my favorite hike of the trip and the only hike that required reservations in advance. Hamilton Pool Preserve reservations can be made here. We were able to make Hamilton Pool Preserve reservations for a 9 AM slot the day before, but it was also a week day so reservations may be required earlier for a weekend. The Hamilton Pool Preserve contains a historic swimming hole where people can swim, but I would also check in advance if you’re looking to swim as there are dates when swimming is not allowed (determined by water temperature and bacteria level in the water). The hike to the pool is about 30 minutes from the parking lot and can be a little rugged at times, but overall feasible. It is a really pretty hike and the pool preserve itself is beautiful too.
After our visit to Hamilton Pool Preserve, we drove back to Dallas. On our drive back to Dallas, we stopped at Bidermen’s deli, a delicious Jewish-inspired deli for some bagels. As a New Yorker, I am always searching for the best bagels. I have yet to find a NY equivalent bagel in Texas, but this place is pretty good.
Austin has something for everyone, but the Austin outdoors are Texas Hill Country’s best kept secret. It is truly a magnificent place with so many outdoor adventures that await!
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Coffee chat: which masks are best?
It has become increasingly important to upgrade our masks given how contagious the omciron variant is and the recent data suggesting the need to switch to high filtration masks, but which masks are worth investing in? The two most important features we look at our mask quality and mask fit. Studies have shown that the risk of infection increases within minutes for someone who is wearing a cloth or surgical mask compared to someone wearing a well fitted, high filtration mask where exposure would take hours before it became a threat. Of course, fit-tested National Institute for Occupational Safety and Health (NIOSH) approved N95 masks often used by healthcare workers offer the best protection overall, but even non-fit tested N95 masks offer more protection than any other mask. In a study by Lindsley et al. 2021, % outward and inward leakage was evaluated and time to infectious dose for an uninfected person was assessed with different types of masks. It was demonstrated that the N95 is superior to surgical masks, cloth masks and wearing no mask at all. Brosseau et al. 2020 assessed non-fit tested N95s and also arrived at favorable conclusions. For those who may not have access to N95s, KN95s and KF94s offer excellent protection. For specific mask recommendations, check out the mask nerd, Aaron Collins. As an engineer and expert in aerosol science, he does his own experiments looking at filtration efficiency (FE) of various masks and has great videos on youtube with detailed reviews (keep in mind experiments are done on his own face). I took a look at these and put together his top rated masks:
Bluna FaceFit Large KF94 with 99.1% FE
Mask Lab KF Style FFP2 with 98.3% FE
CleanTop Evergreen KF94 with 99.8% FE
LG Airwasher KF94 with 99.1% FE
For smaller faces, mask nerd recommends the BOTN Medium KF94 with 99.7% FE and Dr.Puri Medium KF94 with 98.7% FE
Powecom Black KN95 with 96.8%-98.9% FE
Arun External Nose Clip KN95 with 99.8% FE
With children going back to in person learning all over the country, many parents are wondering what masks are best to help keep their kids safe. @masknerd has a great youtube video that provides some guidance, but I would also add that the best mask for your children is the one they can keep on the longest. Here are the ones recommended by @masknerd:
Blue Tiger Kids KF94 with 99.4% FE
Bluna Kids KF94 with 98.8% FE
BOTN Kids KF94 with 99.3% FE
HappyLife Goodsay Youth KF94 with 99.3% FE
Now that we have established what kinds of masks are necessary to keep us well-protected, we should expect the government to increase production of these masks, make them widely available and free for all! #maskup #maskswork ##maskmandates #covid19 #doctorsofinstagram #physiciansofinstagram
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Why I started this blog
Hi! My name is Jessica and I’m a native New Yorker, currently living in Dallas, Texas where I work as a practicing neurologist. While I have many interests outside medicine including writing, reading, traveling and discovering new restaurants and coffee shops, the main impetus for starting this blog was to have a place to express my passion (and sometimes frustration) about social, political and health issues. When George Floyd was murdered and many people were expressing their outrage and showing solidarity with #Blacklivesmatter, I noticed that some influencers and those in the public sphere stayed silent or made half-hearted statements that did not add anything of value to the movement or the conversation. That irked me. Similarly, the COVID pandemic has affected us all yet, you wouldn’t know that looking at the social media accounts of some public figures. As someone in healthcare who has witnessed firsthand how COVID has affected patients and uprooted our hospital systems and also experienced the personal struggles of raising a baby and keeping my family safe, I felt it was important to be in the conversation. I decided to be more intentional about who I follow on social media and cleansed my social media of accounts that did not use their platform to advocate for social issues. I follow many accounts that are focused on food, fashion, travel, beauty etc. because those things are all parts of life, but I think we are all multi-faceted and can discuss where to get the best latte while also discussing topics like voter suppression. This may not be everyone’s cup of tea (or coffee) and that’s okay, but I hope we can move towards a space where more influencers and those in the public domain utilize social media to create change on deeper levels.
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Spain in Summer: A Wondrous Visit
In July 2019, during a major heat wave that overtook most of Europe including Spain, I set out on an 8-day Spanish excursion with my mom. It was the first international trip we took-just the two of us and the decision to go was somewhat impulsive. Summer may not be the most ideal time to visit Spain especially when walking is the major mode of transportation, but alas, I soon realized that Spain is always a good idea. We started out in Madrid where we planned to stay a total of 4 nights. We would venture to Seville via train from Madrid on one of those days. The trip would end in Barcelona where we’d stay 3 nights. Madrid, Seville, Barcelona-three very different regions that would provide a well rounded overview of Spain culture and life.
Madrid: A city as chic as its people
The energy of Madrid reminds me of that of cities like New York and Paris (my two favorite cities in the world) so it was no surprise I fell hard for Spain pretty quickly. We stayed in the Salamanca neighborhood, known as the ritziest neighborhood in Madrid at the Hospes Puerta Alcala Hotel. This is a beautiful hotel situated in a prime area that is walkable to many tourist attractions including Retiro Park, El Prado Museum and Plaza Mayor. We spent the first day walking around the Salamanca area where there are a lot of restaurants and shopping. Madrid is a very fashionable city and most people look runway ready; the voguish shopping experience certainly reflects this as well. We had dinner at El Paraguas and sat in their beautiful outdoor space; the service and food here were impeccable.
Plaza Mayor The next morning we walked around El Retiro Park and then headed towards the El Prado Museum. After exploring the museum, we went to Plaza Mayor and walked around Sol Gran Via (the city center). In the evening, we made our way back to our hotel and took a cab to La Latina neighborhood for dinner and a Flamenco show. I had looked up several restaurants and Flamenco experiences in the La Latina area and a tapas place, Juana La Loca came up a few times in my search. In general, it is recommended that you make a reservation in advance as it’s a very popular spot, but we were lucky and when we walked in, the manager was kind enough to find us a spot for a quick dinner before our show. After dinner, we went to Corral de la Moreria to see the Flamenco show, which started at 9:30 PM. I highly recommend seeing a Flamenco show while in Madrid-such a unique and culturally enriching experience!
La Latina neighborhood La Latina neighborhood A Day Trip to Seville
The next morning, we took the train from Atocha station in Madrid to Santa Justa station in Seville. When we arrived, we headed to a nearby brunch spot called Torch Coffee Roasters. We had booked a tour through the Tiqets app for the Cathedral de Seville cathedral and Alcazar Palace at 2:30 PM. The Cathedral de Seville is the largest cathedral in the world and the third largest church! It is a work of perfection that incorporates both Muslim and Christian architecture as it’s built around a mosque. The Alcazar Palace is the oldest royal palace in Europe that’s still used today. This palace is famous for its mudejar architecture and remnants of Renaissance, Moorish, Baroque and Gothic elements. We finished both tours around 5 pm and then made it to our 7:15 PM train back to Madrid.
Cathedral de Seville Seville Alcazar Palace Alcazar Palace We spent our last day in Madrid walking along Madrid’s most famous street, Gran Via and doing more shopping. We visited the Templo debod, which is an outdoor display of Egyptian sculptures best visualized in the evenings. The next morning, we took an 11 am train to Barcelona and arrived at 1:30 PM. We stayed at Hotel 1898 located off La Rambla, which is the main street in Barcelona near the gothic quarter. I knew immediately this was where we were meant to stay as the lobby had a Magnolia’s, the NYC bakery.
Templo debod Madrid A Gaudi (but definitely not gaudy) experience
We spent our first day in Barcelona exploring the Gothic quarter. Often referred to as a medieval city, the Gothic quarter is a coalescence of old Roman architecture and modern buildings, merging both old and new. Charming shops, cobblestone roads, narrow alleys and tall, looming buildings all add to the unique vibe of Barcelona. After exploring the area and taking in some of the street culture, we walked down La Rambla avenue to find a restaurant for dinner. With so many options and an eclectic range of cuisine, we decided on a delicious tapas restaurant called Ciudad Condal, located near the Obama bar.
The next morning we had brunch at Caravelle near our hotel and did some shopping along Passeige de Gràcia, one of the main shopping and business areas in Barcelona (also the most expensive street). I had purchased la Sagrada Familia tickets for the guided tour through the Tiqets app, which we took at 2 pm. This Antoni Gaudi masterpiece and UNESCO World Heritage Site remains unfinished, but is still a must-see! Along with the tour, you have the option of purchasing an additional ticket to go up in one of the Sagrada Familia towers, the Nativity Tower and the Passion Tower, which overlook the city. I had read that the Nativity Tower offered more picturesque views so I opted to do that one.
I had also gotten Casa Battlò tickets ahead of time so we went there next. This is another one of Gaudi’s masterpieces and probably my favorite structure that we visited. It’s really difficult to capture just how unique and original this building is so highly recommend visiting. For dinner, we went to Oasis Natural Cooking, which I had picked out beforehand when looking for a healthy spot. We spent our last full day in Spain visiting Park Güell. We purchased Park Güell tickets through the Tiqets app ahead of time and did the guided tour. I do think the Park Güell guided tour was worth it as the stories behind the architecture are just as captivating as the architecture itself. We then explored the Gothic quarter on our last night. The next morning we flew home from the Barcelona international airport.
Spain in a summer heat wave can be a daunting proposition and we spent A LOT of the time walking in the hot sun with temps as high as 110 F, but the heat did not take away from how magical Spain is. Spain is such an incredible country with rich history and architecture that visiting once is just not enough. I look forward to returning and trying out all the seasons of Spain in the future.
COVID-related information
With over 80% of its residents fully vaccinated and almost 90% with at least one dose of the COVID vaccine, it is clear that people in Spain trust their public health experts. Spain also has an indoor mask mandate that is strictly followed and until very recently, had an outdoor mask mandate.
As of February 1st, 2022, United States citizens can travel to Spain for non-essential travel if they are full vaccinated and the last dose of the COVID vaccine was given more than 14 days before travel and no more than 9 months prior to travel. If more than 9 months have passed since the last dose, visitors are required to get a booster shot as well. The booster should also be done at least 14 days before landing in Spain. A negative test is not required to enter the country, but there is a health screening process in the airport. Visitors from the US must also get a QR code from the Spain Travel Health Portal. For more information, visit the embassy site.
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Greece Travel Itinerary
I visited Greece in May 2018, about two months after I got engaged (having thought all along that my then boyfriend/now husband would propose during this trip to a beautiful oasis, but he surprised me and proposed earlier). I put together a Greece travel itinerary and planned a visit to Athens, Crete, Santorini and Mykonos. We flew into Athens from NYC (JFK) to spend the first two nights of our trip exploring some of the history. We stayed at King George, a luxury hotel in Constitution Square that is within walking distance to many of the main attractions in Athens. The hotel is beautiful and has a restaurant on the 7th floor with stunning views of the Acropolis and the city. We were able to walk over to the the Acropolis, Hadrian’s Library, the Temple of Zeus, the old city (Plaka). We spent two nights in Athens and then took a flight to Crete.
Crete is a large island and it’s hard to see it all in a few nights. We stayed in Heraklion, the capital of Crete for two nights. Heraklion is a beautiful port city and is close to the Palace of Knossos ruins, which is referred to as “Europe’s oldest city.” We visited the Palace of Knossos ruins on our second day and then stopped by Agapi Beach for some beach time after a morning of exploring archaeologic relics.
Palace of Nossos Ruins Agapi Beach We took a high speed ferry from Crete to Santorini, which I think is the most convenient way to travel the remainder of the islands we visited. It was about a 2 hour ferry ride and there are some beautiful views en route. There are 3 main areas in Santorini where one can stay-Oia, Fira and Imerovigli. I did my research on the different areas when putting together this Greece travel itinerary. I determined that Oai was where I wanted to be as it embodies a lot of that picturesque white and blue dome-like architecture one typically sees when coming across images of Greece. We stayed at Mystique, a luxury hotel situated within the Caldera Cliffs, offering panoramic views of the Aegean Sea.
Mystique It is of utmost importance that you catch a Santorini sunset in all its splendor when visiting the island so our next task after exploring the surrounding area and enjoying some pool time was finding a dinner spot where we could have an ideal sunset view. I think we accomplished that feat! Sadly, I don’t remember the name of the place we dined at, but there are tons of restaurants in the area that boast a great sunset view: Sunsets restaurant, Kastro Oia, Meze Meze.
Next on the Greece travel itinerary was Mykonos! Once again, we traveled by high speed ferry. This trip took about 2.5 hours. We made reservations at a brand new hotel (like literally opened the week we were there) Bill & Coo Coast and it was an unreal experience. There was a little bit of confusion because there are actually two hotels with the same name in Mykonos and we originally went to the older one (Bill & Coo Suites). The staff at Bill & Coo Suites was kind enough to transport us to Bill & Coo Coast. There was a limited number of guests staying here given it was opening week for the hotel, which gave it a very exclusive feel. The room we were given was incredible and even had its own private pool. The service was even more incredible. The hotel actually gave us a cordless phone to carry with us when we went out so we could call them and they would pick us up from wherever we are. This definitely came in handy because there weren’t really any ubers in Mykonos or anything similar that would enable us to get between the hotel and the town efficiently.
Bill & Coo Suites The aesthetics of Mykonos Town were my favorite-vibrant colors on all white backdrops and flowers lining all the streets and entryways. The vibe of Mykonos is also different than the other islands we visited as it’s more of a “scene.” Lots of high end restaurants, bars and lounges with an upbeat feel. After spending 3 nights in Mykonos, we headed back to Athens via ferry and flew back to NYC from there.
The total trip for this Greece Travel itinerary was about 9-10 days taking into account the time change and flight time. We spent the perfect amount of time on each island with the exception of Crete, which I think requires more than 2 nights if you’re expecting to cover more ground. Greece is a romantic haven brimming with culture and history with exquisite views at every turn. I didn’t get engaged there, but I can see why so many do!
*As of December 19, 2021 anyone over age 5 traveling to Greece is required to present a negative COVID-19 PCR test taken within 72 hours or a rapid antigen test taken within 24 hours of arrival to Greece regardless of vaccination status or prior infection. Also, proof of vaccination or proof of recovery from COVID is required to enter most public spaces such as museums, restaurants, athletic facilities etc. For more information, check out the US Embassy in Greece website.
