Health Pearls In the Time of COVID

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March 29, 2020

For the past decade our Lady Docs community has met in person and on-line for intellectual discussion, physical challenge and emotional support. Over the past month, as the COVID-19 pandemic overtook our community, we have had to maintain physical distancing, but our intellectual and emotional connections are even more robust. These discussions have become more urgent, as we try to find ways to sustain the physical, emotional, and financial health of our community, our patients, our families, and ourselves.

Today, we willshare some personal thoughts from Drs. Seidelman, Yau and Nathan with the community, with more to follow. Please feel free to share these with anyone who might find them helpful.  

CHOOSE YOUR FAMILY

(Marsha Seidelman MD – Pulmonary Medicine)

 For the past few weeks, many of us have been attending webinars on COVID-19 – including those hosted by the Maryland Department of Health, CDC and Dr. Rebecca Katz, the Director of Global Health Sciences and Security at Georgetown.

A common theme is the frustration health professionals feel when even the best-educated and most intelligent people are NOT practicing the simplest, most effective means of infection control: PHYSICAL distancing – which can be done while maintaining social connections virtually (phone, Zoom, and other platforms).

The recommendation is to ‘choose your family’ – the smallest circle possible – and stick with it. Having dinner with close friends is NOT okay.  They may be nice, they may be clean, but they may have been exposed to coronavirus.  And although they are well, they can be shedding the virus in their secretions.  People are most contagious even before they show symptoms themselves – THAT is why this virus is spreading at unprecedented rates. 

Physicians and other health workers are working untold hours under unsafe conditions, with safety regulations being relaxed to keep pace with the lack of personal protective gear.  Colleagues are dying because the disease keeps spreading. My neighborhood list serve keeps posting sightings of students scaling the fence surrounding the track and fields, teens driving around in groups and congregating at ice cream stores. If one of the many kids who scaled the fence to get together at a local high school track was a carrier,  the virus could spread to a dozen or more families and all of their subsequent contacts.  Think of what that would do to our local ERs and ICUs. We already know we don’t have enough masks, shields, gowns, or ventilators as this outbreak escalates.  Kids shouldn’t think they’re immune – reports out of Seattle show that young people between 20 and 40 are developing  cardiac complications with heart failure and sudden death.

I hear story after story of health care workers who are young parents dying who are scared to return home to their young children.  Retired physicians have returned to work to help out in this shortage and have succumbed to the virus. Many health care workers are very giving, willing to run toward the fire, not away from it.  

Physical distancing rules aren’t going to be relaxed until we see a significant downward trend in the curve, which will only happen when everyone observes the rules. Go for walks alone. Get your sleep.  Eat well. Talk to your friends and shop for your elderly neighbors.  Remain socially connected at a physical distance.  This is how Singapore bent the curve early.

This is difficult for everyone.  A few people may have extenuating circumstances that require more extensive social contact. But the rest of us need to use distancing – this powerful tool – for the good of our local and greater communities. 

UNIVERSAL PRECAUTIONS

(Dr. Linda Yau – Internal Medicine)

In the mid 1990’s when HIV/AIDS was a death sentence, I was in training as an Internal Medicine resident at the Johns Hopkins Hospital.  We knew that it was transmitted through blood and body fluids, so we were instructed in universal precautions, treating all patient samples as suspect. Any procedure involving blood or fluids like blood draws, surgeries, spinal taps, or sputum collections could be potentially infectious.  We wore goggles, face shields, and used gloves. With the new COVID-19 pandemic, we should again use our scientific knowledge to decrease spread and protect everyone from serious illness by remembering universal precautions. 

Faced with a more insidious and more easily transmitted virus this time, we at Lady Docs want to emphasize the importance of droplet precautions and physical distancing from each other.  This virus is very infectious even when the infected person is asymptomatic.  Every person is a possible carrier of COVID.  We must be very careful to minimize physical contact with other people.  COVID is spread via droplets from the respiratory system.  You can get it if an infectious person coughs or sneezes on you, if you share cups or utensils or if you touch a surface where those droplets landed.  Everyone should avoid touching their faces with unwashed hands.  The virus is thought to be transmissible if an infected person touches their mouth or nose and then touches a doorknob, and then you touch the same doorknob and then touch your face.  For this reason, the CDC is telling everyone to wipe down high touch surfaces like doorknobs, countertops, computers, and phones daily.

Decide who is going to be your ‘family’ group – those who you will interact with more freely and then treat all others as potentially having COVID-19.  Postpone social events, even small dinner parties and any gathering where you would be within 6 feet of one another.  Don’t play sports where the virus could be passed from one person to the next.  Even with parks, try to walk 6 feet away from others.  The important thing to remember is that universal precautions means being cautious and careful with everyone.  This does not mean that we are any less kind or polite to each other, or in the case of health care workers, any less compassionate with our care.  We are trying to decrease the spread of disease so that the healthcare system is not overwhelmed and that anyone who is seriously ill with this disease can get the intensive care that they need.  As recent social media posts by physicians have said:  I Stay at Work For You, Please Stay At Home For Us. Â 

SOCIAL DISTANCING WHILE STAYING EMOTIONALLY CONNECTED

(Aruna Nathan MD – Internal Medicine and Lifestyle Medicine)

While maintaining a good 6 foot distance, you can still accomplish many tasks to stay socially connected and engage with your neighbors and community. Making intentional eye contact helps our brains to feel connected – make eye contact with as many people as possible, even from 6 feet away.

Check in on your older and more vulnerable neighbors, offer to run to the grocery store or pick up their prescriptions. When I talk to my patients who are in their 80s, many of them still have to get groceries and pick up medications themselves.  Many older people are also very anxious at this time and may fall short of caring for themselves.  A few days of improper nutrition can affect their immunity and make them even more susceptible to viral infections like COVID-19. We can ask our older neighbors if we can help by delivering healthy foods like soup to show we care.

If we can work from a grassroots level and help the vulnerable population stay at home, it will make a big difference in reducing the stress on the health care system, workers and limit the burden of illness.

Over the coming week, we will share health tips ‘in the time of COVID’ from our colleagues.  Stay well! 

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