Novel Coronavirus (COVID-19): Lessons Learned

Posted Posted in Brain Science, Continuing Education, Homestudy, Psychology

We are living in historic times.  A century from now, medical personnel, civil authorities, small business owners, corporate leaders, average investors, and everyday citizens will study the lessons learned from this pandemic.  Here are just a few of the ones we’ve learned already:

  • We should all plan and prepare for crisis, disaster, or catastrophe — especially in good, stable times.  Every family and business needs to build an emergency fund of 3-6 months minimum.
  • It’s important to listen to knowledgeable, wise people (not conspiracy theorists and people on social media).  However, even the most brilliant experts can be wrong.  Predictive models are not crystal balls.  There are unrecognized variables in nearly every situation.
  • Panic never solves problems.  If it did, we wouldn’t have any problems left.  The antidote to fear and panic is perspective.  Every day in the U.S., approximately 8,000 people die from multiple causes.  Each year, we lose between 30-40 thousand people from complications of the flu.  We do not shut down the nation.
  • Bureaucracies often do more harm than good.  Their function is largely based on outdated, territorial group-think, and they cannot change or adapt quickly.  Control freaks almost always create more problems than they solve.
  • All decisions have unintended consequences.Some of them can be disastrous. “Either/or” thinking is often a false choice.  Health, both physical and mental, is heavily dependent on financial stability.  The notion that we must choose between public health or a stable economy is a false choice.  They are mutually dependent.
  • Tunnel vision is usually a mistake.  Rigid adherence to long-held principles of epidemiology can crash an economy and engender other, less obvious medical problems like cardiac events, severe depression, anxiety, sexual abuse, physical abuse, emotional abuse, child abuse, drug abuse, alcohol abuse, suicide, violent crime, and eventually societal breakdown.   It takes discipline and wisdom to see the big picture.
  • “Better safe than sorry” is not always the right choice.It’s understandable in a crisis, but it rarely addresses the root of a problem.   We can protect our most vulnerable people with selective isolation and quarantine and still move forward with life.   Sometimes we must take reasonable risks.
  • Saving a buck by reducing housekeeping staff and standards of cleanliness, especially in public places, can be horribly costly in the long run.  Many hospitals, nursing homes, and medical offices are nowhere near as clean as they were 40 years ago.  Better personal and public hygiene will turn out to be a very good thing in the years to come.
  • Living and working in overcrowded, congested areas has been a problem throughout history.   Smallpox, plague, cholera, yellow fever, malaria, and tuberculosis have taken the lives of millions over the centuries.  Flu pandemics, in many cases, have been even worse.   Perhaps this pandemic will teach us all to be more respectful of everyone’s personal space.
  • We have more everyday heroes than we realize.Celebrities are not heroes.   Nurses, doctors, respiratory therapists, pharmacists, social workers, cafeteria workers, cooks, cleaning people, truck drivers, police officers, firefighters, EMTs, grocery-store clerks, bank tellers, delivery people, postal carriers, farmers, utility crews, and millions of everyday people doing their jobs and looking after others are heroes.  They need to be honored.
  • Politicians should not control the number of hospitals, ICU beds, ventilators, or CT scanners.   Hospitals cannot be run as if they were merely ugly hotels, focused almost solely on occupancy rates.  Surge capacity in beds, staffing, and equipment is essential.   Since 1976, we have seen a 16% decline in the number of ICU beds in our country.  Prudence matters.   It always has.   It always will.

This crisis will end.  We will learn more than we can possibly imagine.  For now, be calm, be kind, be patient.  Your actions may be more heroic than you realize.

homestudy

Mindfulness and Social Connections Soothe Anxiety and Boost Immunity

Posted Posted in Brain Science, Continuing Education, Elder Care, Psychology, Seminars

By Andrea D’Asaro, MBSR

It is normal to be scared and even paralyzed in the midst of so much uncertainty around the Coronavirus (COVID-19). That’s where simple mindfulness practices can help us stay grounded and connected despite recommendations for social distancing and work at home for many Americans. Deep breathing can slow anxiety, depression and keep our nervous system stable. Reaching out to others can boost our sense of connection, increase oxytocin (the love hormone), and maintain our immunity, which can fall when stress rises.

1. Come back to the moment with five mindful breaths

It’s easy to immerse oneself in the constant stream of on-line and often conflicting information. This can also increase our anxiety. With stress, the rational part of our brain can spin out of control into survival mode or fight, flight and freeze.

Whenever you notice yourself ruminating, worrying or feeling overwhelmed, try 5 mindful breaths:

Sit in a comfortable seat with your feet on the ground (lying down or standing are also options) breathe slowly in through the nose and out through the mouth to slow the nervous system, count five breaths with in and out, counting as one. Pause at the end and check your body and mind to see if anything is different. Continue to 10 or 20 breaths, as you wish. You may want to count your five breaths on your fingers, tracing each digit while taking one breath as an additional grounding with the body.

2. Reach out to friends and boost oxytocin

Social distancing is not emotional distancing! We can increase our happiness when we make real-time connections with others and bring ourselves a spurt of oxytocin, “the bonding hormone.” Try calling distant relatives, friends and others who may feel isolated at this time, using an old-school technology–the phone! When we take the step to converse with relatives or friends, we are boosting our own mood with activation of serotonin, according to research from Stanford University School of Medicine. Such social support is associated with a decreased risk of infection and reduced stress hormones, according to research from Carnegie Mellon University.

Many senior living communities are limiting visitors and keeping elders apart from each other to avoid spread of the virus. Older people, who may not use email or social media, are already at greater risk for depression or anxiety. We know that loneliness is deadly too. Real- time phone calls allow us to hear emotion in another voice and exchange concerns and pleasantries; it’s much more engaging than texting, according to research from the University of Wisconsin.

In this time of the elbow bump, we are advised to avoid hugging. No worries, the self-hug can also enhance the oxytocin, also called the “bonding hormone”.

Try the self-hug: Open your arms wide as you take a breath in, then cross them over your chest and you breathe out. Gently grasp your upper arm with the opposite hands and give yourself some kind squeezes. If it’s comfortable for you, close your eyes and bring to mind your personal “circle of caring.” Imagine the faces of those people or pets who care deeply for you (living or decreased) around you, smiling tenderly. Or envision your favorite happy place like a fireplace or a cozy bedroom. Remember to hold your hug for 20 seconds or more for the best benefits.

3. Strengthen self-care with mindfulness

Mindfulness is all about paying attention on purpose. This means observing how you feel, what your body and mind is craving and how you may best care for yourself. Instead of reaching for social media, a new video, or a less nutritious treat, consider the best way to nurture yourself–what you might recommend to a good friend.

During these anxiety-provoking times, remember the tried-and-true stress reduction strategies. Do you best to get adequate sleep, exercise regularly, spend time in nature and employ relaxation techniques on a daily basis.

Meeting a friend for a brisk walk in nature while bringing your attention back to the moment can bring multiple benefits. You might also consider slow mindful walking where you bring attention to each foot as it touches the ground. It’s helpful to say, “heel, ball, toe” as you notice the movement of the foot against the ground. Enjoy your slow walking and remember, there’s wrong way to bring yourself mindfulness.

Prioritizing these behaviors during the coronavirus crisis can go a long way toward bolstering your immune system and increasing your psychological well-being. Caring yourself in these ways may be a new habit to build over time, so start with one practice at a time and add on as you go, with kindness. Giving yourself kindness allows you to extend it to others who are struggling at this time.

Coronavirus (COVID-19): Reason, Prudence and Common Sense

Posted Posted in Continuing Education, Elder Care, Homestudy, Nutrition, Seminars, Webinars

By Mary O’Brien, M.D.

A pattern is emerging.  Clinical and laboratory experience in several countries reveals that there are two strains of coronavirus (COVID-19).  The virus is comprised of an unstable single strand of RNA that is mutating.  This is known as antigenic drift and it is expected.  Researchers have identified an “L” strain and an “S” strain.  At present, the “L” strain appears to be associated with more severe symptoms and a higher mortality rate.  More widespread and accessible testing (which is now underway) will help us discern which strain is prevalent in various regions.

The vast majority of deaths have occurred in elderly people with significant underlying illness.  The cluster of patients in a nursing home in Kirkland, Washington, underscores the fragility of sick, elderly patients in enclosed settings.  Outbreaks on cruise ships reflect a similar pattern of transmission.  A large percentage of cruise passengers are over 50.  People don’t like to think of 50 as older, but physiologically, it is.

Clinically, patients with more serious illness have a high fever (over 101°F), a deeper-sounding cough (not a tickle in the throat), and shortness of breath.  The mortality rate in countries with good health care is around one percent.  China and Iran are impossible to assess, but mortality rates there appear to be around 3.4 percent.  Older men in China have very high rates of smoking, which is a crucial factor in both morbidity and mortality.

For now, several additional practices make sense:

  • Minimize or restrict visitors to patients in hospitals and nursing homes. Sick, elderly people need to be protected.
  • Frequent, thorough hand-washing with soap and hot water for 20‒30 seconds is best; hand sanitizers are second best. Keep your hands moisturized to avoid cracked skin.
  • Don’t eat with your fingers; don’t lick your fingers.
  • Keep your hands away from your face, eyes, nose, and mouth.
  • Sanitize your phone everyday. It’s the filthiest thing you touch.
  • Facial hair on men is a veritable Petri dish for microorganisms — especially among the nose, mouth, and chin. Now would be a good time to shave.
  • Change your pillow cases everyday.
  • Don’t waste your face masks. Surgical masks protect other people from your coughs and sneezes.  They don’t protect you from others.  Besides, many viruses penetrate our immune defenses through our eyes.
  • Toss your toothbrush at least every month, and whenever you are feeling ill.
  • Increase oral care with antiseptic mouthwash several times a day.
  • Stay well-hydrated to optimize the integrity of mucous membranes.
  • Let yourself and your patients get more sleep. Sleep is immensely important for multiple aspects of immune function.

The virus will evolve, and we will adapt.  At some point, it will resolve.  Right now, many people, especially those in the media, are overreacting.  That is always a mistake.  There has never been a substitute for reason, prudence, and common sense.  Steady as she goes.  How often can you say it?