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This Guardian report gives a discussion with Austin based Dr. Attia of Early Medical and ways to ensure healthspan- adopting healthy patterns of living including food and exercize, sleep, that start at an early age. The approach is that prevention should be the best way to tackle health issues that can develop later in life and the time for that is early, right now. Most of it is well established based on exercizing well, and weight exercize routine for strengthening muscle. It could just as easily include yoga or pilates, and sports. Nutrition plays an equally important part.

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The commissioner of the Food and Drug Administration 2017-2019 and the deputy medical director of its medical device center, give their thoughts on how to setup a sentinel surveillance system that would help tackle coronavirus and future epidemics. The idea is to track an outbreak in real time, with results sent to central labs so that outbreaks can be contained early and the surveillance operates to isolate affected areas for treatment and quarantine. High quality data from specific locations in real time and testing to isolate small pockets of infection, with rapid and reliable diagnostic tools are critical parts of this system.

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Some ideas on how to reopen the economy in Britain in phases starting with release of some activities in May, followed by mid-June, and early July. Medical precautions and new protocol for being out on the streets, in public transport and in offices would have to be observed.

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Reduce risk of dementia later in life by taking up exercise seriously says this report in The Times. Habits of exercise are learned early and help later in life is proven. As people grow older the following forms of exercise and activities can reduce risk of dementia is proven in medical journals. Exercise such as walking, cycling, running. Strength training with weights and exercise balls.Yoga and Tai-Chi, standing on one leg for balance, and meditation. Household chores such as ironing, washing, and cleaning. Gardening and outdoor activities. Running barefoot on grass also help the mental process and brain.

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The knowledge that the virus  caused human to human transmission and that it spreads to wide parts of the population very quickly were critical pieces of information that remained with Chinese epidemiologists, doctors and medical researchers, and were suppressed by local authorites in Wuhan.  Yet China's version of the U.S. CDC, China's Centre of Disease Control and Prevention, modeled on the U.S. control efforts worked effectively to identify the problem. Virologist Gao Fu, heads China's CDC. This report in Germany's Der Spiegel says Mr. Fu made it a habit to scan China's internet before bedtime for any signs of possible disease outbreaks. On the night of December 30 he came across rumors of an internal memo from the Wuhan Health Commission of an outbreak of a vaguely worded lung disease. When he called the Wuhan health authority he found their answers to be evasive which alarmed him. The next morning December 31 Mr. Fu sent the first of three teams to Wuhan which is how China was able to identify the problem, in the sense that Chinese authorites in Beijing were to rely on Dr Gao Fu to overcome the problem of Wuhan provincial authorites. He informed the World Health Organization Beijing office on that day. The Der Spiegel report says "shortly afterward," the Seattle Times in its report says this was about New Years Day 2020- Mr Fu made a call to Dr. Redfield, head of the U.S. Centre for Disease Control, who was on vacation. Redfield is deeply disturbed on hearing this from Fu and they have conversations over the next few days to the point that Dr. Gao Fu is in tears about what has happened. On January 1 Taiwanese public health authorites shared the information with WHO that the cornonavirus was a human to human transmission, would the Taiwanese authorites not have shared it with the U.S. the same week during calls from the U.S. CDC or other public health authorites alarmed about the situation. (The WHO was proving useless by Jan 14 when it contradicted Taiwan's more reliable assessment  on Jan 14 going by the letter from president Trump to WHO). On January 6 a few days later Dr Redfield and Dr. Azar head of Health and Human Services ask China for permission to send a team of CDC U.S. experts to China. This is cited in the U.S. letter to the World Health organization- the lack of human to human transmission information being given to the U.S. officially early by China. A risk that could have been a topic of conversation between the U.S. and China heads of CDC. That letter from president Trump also points out that the team of experts the U.S. planned to send was not accepted by China till Feb 16, one and half months after that series of conversations between Dr. Gao Fu of China CDC and Dr. Redfield of U.S. CDC in an alert message.  In effect removing one of the key defences for the U.S. and Europe in making their own defensive actions and plans, laying the basis of the worldwide coronavirus pandemic affecting millions of people. Dr Redfield is a AIDS researcher at the University of Maryland who spent most of his life trying to control spread of HIV and was appointed by president Trump to head CDC agency in 2018. He set a goal of eliminating AIDS by 2030 and is more comfortable with aids patients and research than the bureaucratic nature of agencies- CDC has about 11,000 employees. Once it was clear that a team of U.S. experts was not given permission to make its own assessment in Wuhan in the few days after January 6 offer to sent the team to China by Redfield of U.S. CDC and Dr. Azar, would it have alerted the U.S. that something was seriously heading the wrong way for a epidemic risk. That letter of president Trump cites how the head of WHO during the first SARS crisis in 2003, Dr. Harlem Brundtland acted when she faced China's lack of cooperation during that crisis by saying openly that this was a danger to world public health and millions. Could CDC in the U.S. and the other connected health authorites have taken the responsibility and filled Dr Brundtland's role in this crisis, that the WHO failed to perform?    ...

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The Indian state of Kerala has experience tackling virus situations. Most recently with a Nipah brain damaging virus in 2018. For cases to double Kerala has 72 days, compared to a national average of 8 days. With total 437 cases and 3 deaths Kerala has shown "the importance of early tracking, screening, home quarantine, strict isolation and public participation," says Dr. B Iqbal, chairman of the Kerala state expert committee on coronavirus in an interview with DW. com. The first case was a medical student arriving from Wuhan on Jan. 24, diagnosed 6 days later. During the Nipah virus crisis Kerala limited deaths to 17. Kerala is an example of the importance of a well funded and well established and organized health care system. The Indian state of Chhatisgarh has taken a proactive approach color zoning districts. Of 28 districts 23 are free of coronavirus. Less cases and zero deaths.The key state health minister says was early preparations and then luck playing a part. Most cases today are concentrated in India in the Mumbai area, state of Maharashtra. ...

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With staff shortages and the spread of omicron variant some German states are no longer doing contact tracing. Contact tracing is not happening in Berlin or Hamburg says this report in DW.com. The chair of the Federal Association of Doctors, Dr. Teichert, in an interview with RND says "comprehensive followup is almost no longer taking place at the moment." He also said there is a "massive fluctuation" in staffing levels for nearly two years. Experts even say that because of staff leaves and office closures infection rates will not be really known till later, a "sink into ignorance" says a medical statistician.

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This WSJ report looks at the efforts of sugarly cola companies such as Pepsico under a new CEO to push their cola products aggressively with advertising, and modern logistics. It cites Barry Popkin, nutrition professor at the University of North Carolin School of Public Health that they are making products that are killing us more slowly. With less sugar than before but still at a time of dangerously high obesity levels in the world just as dangerous or more dangerous to humans, because they are not as healthy as previous generations. The pandemic proved the danger of higher obesity levels. The numbers say it all-1% of children 5-19 years obese in 1975 going up by 8% to 9% in 2020, and doubling to 19% in 2035, says the WSJ. That is doubling by 2035 to 19%-  simply astounding. Popkin says the fact that Americans are living more years with disabilities, and fewer disability free years, is very much linked to the food intake. On The Guardian's pages was an article about a surgeon who has a startup in Austin, Dr. Attia of Early Medical, that promotes "healthspan." It focuses on getting healthy living habits  through better nutrition, exercize, to start at an early age as being critical for a healthy life span. It is not the same starting at an early age with good food and exercize habits vs starting later in life as this means fewer disability free years when starting later in life.  ...

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Weak and poorly equipped public health systems, densely crowded conditions, make coronavirus spread extremely serious in South Asian and African countries. India imposed a complete lockdown of the entire country. South Africa imposed a 21 day lockdown enforced by the military. Decisive and strong action is needed early. Pakistan acted early to quarantine pilgrims entering the country from Iran. Pakistan's government has announced a $20 monthly wage subsidy for poorer households. The average in Africa is 20, according to the UN, and South Asian populations are also very young. Generally hotter climates may offer some offsetting factors to makeup for the lack of strong public health systems. India made major strides in direct deposit to bank accounts of 1.3 billion citizens by the government for many social safety net schemes in the last 5 years. It has also computer records of all citizens under a plan underway for a decade. The nationwide rollout of 4G mobile technologies has connected every citizen including remote areas. This should assist in the identification and isolation of affected areas and people. Other factors that mitigate the spread will be access to medicine when medicine and vaccine is developed for the virus. India has a large pharmaceutical industry, scientific labs and other medical resources similar to South Korea, which should help limit the affected areas and people. ...

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This WSJ Exclusive report shows 1.89 million breakthrough infection cases in the US and at least 72,000 hospitalizations, 20,000 deaths among fully vaccinated people in the US this year. The WSJ reviewed medical record data for 21 million fully vaccinated people, and an array of state reports to put together this analysis. It shows people with weaker immune systems and elderly are more susceptible for breakthrough infection and hospitalization. It also shows that vigilance is necessary in following covid protocols for social distancing, masks, hand washing, as the figures show smaller but yet significant percentage of people at ages younger than the elderly are getting breakthrough infections and getting hospitalized. 3.35% of people 35-49 years who were fully vaccinated but with waning immunity from taking the shots early on and lacking booster shots to build immunity back up again, and who are breakthrough infections, are hospitalized in this WSJ analysis of EPIC's Health data. For people 50-64 years this is 7.45%. The importance of getting the booster shots has never been greater. ...

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This WSJ report looks at the research practices at Theranos. Some researchers say there was a lack of technical rigor in the research and the lack of a patient effort necessary in advancing medical science. Carreyrou cites instances which show the lack of rigorous medical background for management in the company, and premature introduction of products. The blood testing technology Theranos says it is inventing is still at an early and uncertain stage, according to experts. Pfizer says it has done only pilot projects with Theranos at an early exploratory level, and has no projects currently with the company.

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A labor shutdown that nearly shut down the US economy says the Washington Post is a result of policies set by the BSNF management for attendance on freight trains by engineers and other workers. It resulted in a tragedy. Hiles, 51, suffered a heart attack on June 16. He missed a doctor's appointment because he was called back to work. Not showing up could have invited penalties under strict attendance policies of BSNF, one of the largest rail carriers in the US. Aaron Hiles told his wife he felt different, then he made an appointment to see a doctor. On June 16 the locomotive engineer suffered a heart attack and died in an engine room on a BSNF freight train somewhere between Kansas City and Fort Madison, Iowa. President Biden has stepped in and arranged an agreement that includes time off when needed for medical reasons and a 24% increase in pay by 2024.

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Every day lost in the struggle with coronavirus is a big thing, which is why Itay's most affluent northern region has gone from being well equipped with resources of healthcare to seeing the health system overburdened to the point of disaster. This WSJ report shows why this has a lesson and an early warning for how the U.S. and other countries should design their response. It is also why the White House team that includes President Trump in the U.S. emphasized the plan for just the first 15 Days in the news conference at the Brady Room in the White House on March 16. It is saying the first 15 days are critical, not a day to lose.  It does not matter if you are an advanced economy with state of the art hospitals. Social behaviours must change, old rules rewritten and implemented throughout nations, quickly in days. Here WSJ shows lessons learned by Dr. Cereda at the Hospital of the University of Pennsylvania who trained in Milan and was in constant contact with colleagues in Milan and elsewhere. Many of the lessons relate to not overburdening hospitals and health systems and protecting health systems. This means mild to moderate cases are managed from home and not in the hospital, through massive deployment of outreach services and telemedicine. It means therapies can be delivered at home or through mobile clinics. The second major lesson from Italy is to protect healthcare workers and doctors. The entire White House team with Dr Faucci of CDC and Dr Brx, head of Infectious Diseases in the U.S. news conference of president Trump March 16, focused on the goal of protecting healthcare workers, doctors and hospitals, so they remained strong to take on the crisis. The second goal of the White House team is to protect the elderly with medical conditions. To do this only the most serious patients are treated in hospitals the rest for mild to moderate at home.  Studying the conditions in Bergamo and other parts of Lombardy and northern Italy, is helping U.S. medical leaders to prepare for the current nationwide effort, the 15 days plan announced by the White House. The lessons from the Papa Giovanni Hospital in Bergamo are important say U.S. medical leaders, including Dr. Brendan Carr, head of emergency medicine at Mount Sinai Health System in New York.  He says build capacity in hospital beds before we need it. Clear out hospital space and add new hospital beds.  ...

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About 60% of Americans think the testing for coronavirus and getting medical supplies to health care workers is too slow, in a poll by Wall Street Journal/NBC News. About 6 in 10 Americans in a new survey say they are concerned that the U.S. would move too fast to loosen coronavirus restrictions to slow the spread, and only 3 in 10 say they are concerned that it is not moving fast enough. About twice as many Americans thinking the risks were higher that public authorites and governors would reopen states too soon. About 75% of respondents in the survey say they are very or somewhat worried about themselves or a family member getting the virus. Mr. Trump's approval rating  remains unchanged from March with 46% approving. Most people place their faith in the governor of their state- 66%, and Mr. Fauci, Director National Institute of Infectious Diseases- 60%, than anyone else. On the economy president Trump is seen as being better at handling the economy 47% to 36% than Democratic nominee Biden, even though Biden has a nine point lead. This confirms the widespread dissatisfaction at the way medical supplies shortages are felt at hospitals, and the way testing for coronavirus is happening with not enough testing. President Trump perceived by business and the public as better at handling the economy is also confirmed in this survey. The dissatisfaction with the president for supplies shortages and testing lagging behind may also be tempered by a sense that the public has not taken aggressive action in supporting an early lockdown with many governors and people not supporting or following strict distancing rules till late March. By contrast the president acted quickly to stop all flights from China. ...

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During question time in the US Congress US Senator Rand Paul stated that the US money was used to fund research at the Wuhan Institute of Virology. A ban on gain of function research on virus was lifted by the US in 2018. Following the lifting of this ban which was strongly opposed by scientists at Cambridge, Massachusetts, research was conducted that many of these scientists considered dangerous and risky. This report in the BBC shows Dr. Anthony Fauci. director of the NIAID, the Institute for Allergy and Infectious Diseases responding to Dr. Rand Paul, Senator from Kentucky. Much of the discussion goes into definition of "gain of function research" and misses the broader implications. Scientists in Cambridge had warned early of the danger of doing research because of earlier mishaps such as the one involving anthrax research from accidents that are always a risk. Epidemiologist Marc Lipsitch of the Harvard Chan School of Public Health warned of just such an "accidental pandemic" in Three Questions, Three Answers in the January 2018 issue of the Harvard Chan School of Public Health journal. He stated that an "accidental pandemic" could result from the lifting of a ban on a risky kind of research favored by some virologist professionals. Most of the medical and scientific community in Cambridge fiercely opposed the lifting of the ban on what they saw as risky research with little benefit in 2018.    ...

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France was exceptionally well prepared says France 24, citing a report in Le Monde, for the SARS crisis in 2002 and the H1N1 influenza in 2009. A billion masks were stockpiled by 2009. Following the H1N1 influenza not appearing in any significant way the media, political parties and the public shifted their attention away from public health crises preparation. For H1N1 the government spent 1 billion dollars some of it going to pharmaceutical labs. The eurozone financial crisis that followed the global financial crisis shifted policy to austerity measures. The entire preparation effort for influenza type health crises was abandoned as too costly.  The same pattern repeated in Britain which was also well prepared before 2010. Austerity budgets after 2010 had little room for public health investment.  One could say a similar pattern was seen in the U.S. Today the worst hit countries are U.S., Britain, France and other European countries. France which had 1 billion masks in 2009 to tackle a possible H1N1 epidemic finds itself with 150 million masks in March 2020 and scrambling to find masks. Some masks which were usable were even destroyed as expired, ministers and experts who had built up the prevention effort in 2009 were even demoted and forgotten, as was much of the preparation in these years. It wasn't just medical supplies pubic awareness had practically disappeared. In the U.S., in Europe, the same situation of a lack of public awareness so that experts, government, and the public could work together quickly, was clear to see. In countries such as Taiwan the preparation led to speedy response at all levels, making contact tracing, isolation of clusters effective. In the U.S. and Europe this early, early, period was lost leading to makeup mitigation measures and the growing sense of a loss of control over the virus. ...

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The deputy chief medical officer, Dr. Jenny Harries, asks people in Britain to limit themselves to what is sensible and not what is possible, to use common sense, so that reopening works. The Housing Secretary, Mr. Jenrick says the room for maneouvre is limited with the reproduction R ratio for Britain at somewhere between 0.7 and 0.9. There is also a lag period for data making it so that the current situation is not known. Germany's after reopening is now estimated by Robert Koch Institute at 1.14 so that there is some shift to be expected as the opening happens, the idea being to limit this to around the 1.0 figure. Britain reopens cautiously and in  in a patchy way with primary schools reopened, and people from different households allowed to meet in groups of six as long as they stay 2 metres apart. Outdoor markets and car showrooms are also reopening. Also stated is the need to be sensitive to geography as areas such as London which were hit early and with severity are now better off than areas in the north of England. ...

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Lufthansa's CEO announced in the early days following the crash that pilot Lubitz was "100 percent" fit to fly. Kulish and Clark point to the denial at Lufthansa and some other airlines about the need for airlines to have a clear understanding about the psychological condition of pilots. This exceptional report with contributions by a team of NYT reporters tells the story of Lubitz and the airline industry's lack of effective screening. The lack of systematic screening of pilots for psychological issues was raised by the UN's Civil Aviation Organization in 2012, and by the European Commission's Aviation Safety Agency focussing on strict data protection rules with Germany in November 2014. A culture of privacy in Germany following the experience of pervasive intrusions into privacy by the Nazis and the Soviet backed GDR government in East Germany, and strict data protection rules, create a special situation in Germany of being reluctant to pass on information or delve into personal records. The head of Lufthansa's department of aviation psychology, says he would not have accepted the pilot Lubitz if he had known about his medical problems of depression before or during the training period....

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Americans Save Early and set aside for savings 10% of your pre-tax income, is the advice to ensure a safe and healthy savings retirement. This is absolutely critical. What the government can do is to ensure that incomes keep uo with inflation with fair wages in industry. It also can and should protect Americans from unexpected medical costs by ensuring that all Americans are covered by health care and for catastrophic situations. Then it is the task of Americans to build a culture of careful saving that their ancestors had and considered a essential part of virtue. For this to help build savings for retirement the government and the Federal Reserve together- as Biden and Powell have shown one with capital investments to build a strong economy and the other by protecting savings and cost of living action- must ensure that no financial crises take interest rates to zero or 1-2%. At interest rates of 5-6% for returns this helps build savings for retirement. For this to happen banks have to go back to their traditional work in the economy and no speculation risk, and Silicon Valley go back to inventing and not a culture of capturing capital allocation in capital markets and paying little in taxes. A new culture would put government in its right place to ensure that it plays a significant role in building manufacturing and science and technology in the US as president Biden has done through government investing in infrastructure and renewable energy, chips and science, and in education, healthcare.  ...

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This NYT report cites safety experts saying that Norfolk Southern's excessive focus on profits may be partly to blame for derailments and accidents like the one in Ohio. Norfolk Southern made $3 billion in 2022, invested $2 billion in its railways and operations, up a third from 2021. But says the NYT Norfolk invested only half of the $18 billion it put into stock buybacks and dividends for its railways and  operations over a five year period. One environmental group says the railways have fought all kinds of basic safety regulations- modern braking systems, stronger tank cars for explosive, even information on what's on trains from passing to communities. Senator Maria Cantwell of Washington now leads an investigation from the Senate Commerce Committee. She said- Over the past five years the 7 railroads "have cut their workforce by nearly one third, shuttered rail yards where rail cars are traditionally inspected, and are running longer and heavier trains." Concerns about staffing shortages and rail road scheduling policies led to workers not being able to take medical leave leading to workers deciding to go on strike. This was averted by president Biden on December 2, 2022 by imposing a contract for pay raises and better terms for workers on the railroad companies only about 3 months before this train disaster. ...

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Of 161 million people employed in 2024 about 40-50 million in vulnerable groups living from paycheck to paycheck and without savings to support them in a medical emergency is a real problem in the US economy. It is why even as unemployment looks good at 4% and inflation down to 3% there is a lot of angst for Americans for cost of living. Fifteen million baby boomers who will turn 65 years for retirement between now 2024 and 2030 face a situation where they have less than 250,000 in savings. Many who were born between 1945 and 1962 called baby boomers are in this group with diminished savings. In the prime of their careers they were hit by the 2009 financial crisis caused by bank speculation risk taking. They also were hit by the pandemic in the peak years of income growth. Other such vulnerable groups are young people with high student who are being helped by president Biden. There are also the low income groups that have been hit by medical costs and a family emergency that were pushed into poverty. Other groups in the millions are the people at the low income levels who are working paycheck to paycheck because of housing costs. About one fourth or 25% of apartment renters are people whose households budget shows 50% or more going to housing costs which have increased 20% in the last 2-3 years, which includes the pandemic years 2022 and 2023. President Biden seeks to limit apartment rent price increases to 5% and Kamala Harris has proposed help for families for the portion above 30% of household income going to rent. The jump in cost of living from automobiles, automobile repair and housing, cost of groceries have affected other groups with large credit card debt. This is a result of the supply chain concentration in China which comes from American business overconcentrating production in China and previous administrations doing little about this. Biden's answer is to bring jobs and manufacturing knowhow and investment back to America. During the pandemic some people resisted getting vaccinated and lost their jobs, a million people lost their lives, others took early retirement seeing the stress ful lives during the pandemic, others including women quit to take care of children. This has reduced the labor supply to business leading to tight supply higher prices.The result is that there are about 5 such vulnerable groups each with about 5-10 million people for a total of about 40-50 million people at risk. For these people the cost of living presents huge challenges, including childcare. It includes young people and retirees, single women and families on low income hourly wages that have not kept up with inflation.  ...

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The full text of the letter is given here. In this letter the U.S. sets out some important facts about events that happened during the coronavirus crisis during the crucial 4 month period from December 2019 to March 2020. Every week lost in this time due to reasons of a lack of transparency, openness meant hundreds of thousands of people more infected and tens of thousands of deaths worldwide. There are questions of transparency, of openness and this raises questions about the manner in which the World Health Assembly operates with hundreds of small countries in Africa and Asia having votes equal to that of the U.S., India, Brazil, Mexico with votes taken of over 200 countries. The entire election process can now be seen as questionable, when over a billion people in one country alone such as India or hundreds of millions in Brazil and Mexico would have to bear the consequences of poor decisions made by small countries that can be swayed in one direction or another based on political bias and other considerations that have nothing to do with global health.  At the conclusion of the letter by the U.S. to the current WHO shaped by a controversial election in 2017 the following is stated about the standards set by Gro Harlem Brundtland and which helped the world prevent the SARS crisis which originated in China in 2003 from spreading to the large countries of the world India, Brazil, Mexico, and other such countries in Asia and Africa, Latin America, and the U.S. European Union. "In 2003, in response to the outbreak of the Severe Acute Respiratory Syndrome (SARS) in China, Director-General Harlem Brundtland boldly declared the World Health Organization’s first emergency travel advisory in 55 years, recommending against travel to and from the disease epicenter in southern China. She also did not hesitate to criticize China for endangering global health by attempting to cover up the outbreak through its usual playbook of arresting whistleblowers and censoring media. Many lives could have been saved had you followed Dr. Brundtland’s example." Even this does not come to grips with the flawed way in which the election of WHO head is done. It can no longer be relied on when there is the danger that lack of transparency can emerge in the WHO leadership itself because of a flawed process. It risks endangering the lives and livelihoods of hundreds of millions in countries such as India, Brazil, Mexico, as well as in the relatively small countries of Africa and Latin America where even basic water supplies are at risk but which could tilt elections at the World Health Assembly. Consider that a cyclone just hit the Indian state of West Bengal and Bangladesh on May 20 just as the coronavirus pandemic is spreading. That this region of 1.5 billion people had just 2 votes out of over 200 cast at the World Health Assembly in 2017 shocking. And even these votes cast based on old geopolitical considerations not how good the candidate is, and how good the country he is coming from is in terms of its record  on public health. The irony here is that private foundations in the advanced countries in the U.S. and Europe some of whom are major donors to WHO did not think that more experienced candidates in their own countries with a better record of public health such as in France or Germany are better qualified, in a flawed NGO support mentality left from the Clinton years. Basically the people in these large countries such as India, Brazil, Mexico were disenfranchised, when the austerity policies were consuming the European Union, and the U.S. had just elected a new administration itself groping for ways to reverse years of neglect of public services and infrastructure priorities. They would trust good leaders no matter where they come from, who have a record of transparency, leadership, and all the values we cherish together no matter where we come from. ...

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The inspiring story of Joan Poh, only the second rower to compete for Singapore in an Olympics. She rises at 5 am to workout as she also works as a nurse in a 10 hour shift at Tan Tock Seng Hospital. She has missed meals as she does her training in the midst of work as a nurse. She returned to working in nursing after a call from Singapore government for frontline medical workers in April of 2020. She sees sport as a dream, a luxury that one has to work for. Puts in 100% as a nurse and when rowing 100% as a rower.  At 5 foot 5 inches, 30 years old,  she is much smaller than other rowers, and uses her technique and training to compete. She is the oldest of 3 children who grew up in a 1 room apartment in Singapore. Without resources she learned to row on a long boat by joining a dragon boat rowing team when she was 17, then learned to scull in 2015 at age 25. In 2019 she took extended leave from her hospital to train for the Olympics in Australia. A Canadian who won Olympic Bronze in 1996 and 2000 coaches her free from Vancouver Island in Canada, using videos and workout programs, and went to Singapore when Poh qualified for the Olympics to train her in person. She looks at competing not just as medal winning, and sees this as one step in building a team in the right direction. She sees creating opportunities for others, and overcoming her childhood situation growing up struggling for resources. She says early on it was for her not wanting her lack of resources to decide what she could do. As she puts it - to always aim for a strong start even though one started with not such a good start. ...