Science Says Sunday – Summer Safety

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This past week I was asked by Univision Noticias to give insight into what people should do as states begin to lift stay-at-home orders. Many people are interpreting this in two main ways:

  1. That everything is fine now and we’re good to go “back to normal”. While that would be amazing, in many states, we’re not quite there yet. In fact, some states in the US – Alabama included – are just now starting to surge, with an increase of cases seen daily. Here’s a good link where you can determine how your state is doing and determine what activities are safe to resume if you are still seeing a lot of COVID-19 activity in your state: https://coronavirus.jhu.edu/data/new-cases-50-states.
  2. That lifting the orders happened too soon and the state is not ready for a return to “normal”. This may be the case in states where there hasn’t yet been a decrease in case and death counts. This applies to Alabama. In this case, people want to know how they go grocery shopping, for example, safely, since a lot more people are out and about now.

Either way, you’re likely experiencing what many are calling “quarantine fatigue”. You haven’t seen your friends, your family, your coworkers, or your neighbors. You likely haven’t been to a restaurant or movie theater in months. Perhaps you, like me, have only been out of the house for essential items and the occasional takeout meal and then straight back to the safety of your family and/or home. With the lifting of stay-at-home orders, and honestly a completely disregard by some to follow public health recommendations, it is highly uncertain if we will ever get this virus under control, so we need to figure out ways to start to find some normalcy in our lives, while being SAFE. How do we do that?

Below are two great articles that describe the risk associated with a number of activities that you may consider this summer.

From Camping To Dining Out: Here’s How Experts Rate The Risks Of 14 Summer Activities

How to weigh the risk of going out in the coronavirus pandemic, in one chart (see below)

Table showing how different places present more risks during the coronavirus pandemic: Your home is the safest place. Outdoor environments present moderate and higher risk. Indoor spaces with people you don’t live with present the highest risk.

The bottomline is that you should try to avoid the three C’s:

COVID-19 Information and Resouces

Crowded places

Closed spaces

Close-contact settings

This means that outdoor activities can provide some much needed reprieve this summer. Go for a bike, a run, a hike, perhaps an not so crowded lake or body of water, to get some fun in the sun and some much needed activity. Here are some tips that have been adapted from the CDC, Seattle Children’s, and the NIH.

Sun Safety

  • Protect yourself and your children from getting too much sun. The sun’s rays are strongest between 10 a.m. and 4 p.m., so be extra careful during that time.
  • Use sunscreen with a sun protection factor (SPF) of 15 to 30 and apply 30 min before going outside or in the water. Reapply every two hours and after being in the water or sweating. This one is tough with littles, so be creative about this step. Often, this is a good time to go over pool/beach/lake rules.Choose one that protects against UVA and UVB rays.
  • Keep children under 1 out of the sun as much as you can. Dress babies in lightweight, light-colored clothing with long sleeves and long pants, and always cover their head.
  • Note that when it is 90° or above and humid, it is recommended that children should not play outside or exercise for more than 30 minutes at a time. This means you should…

Travel Safety

  • Always wear a seat belt and strap kids into an age/weight/height appropriate seat accordingly. You can always check with your pediatrician about what that seat may be, and stop by the fire department if you need help fitting one into your rear seats.
  • Never leave children alone in a car, even for a minute. Children left in cars are at risk for heat stroke, which can lead to death. Other risks are setting the car in motion and getting injured by playing with power controls.

Riding Safely

  • Wear a helmet! Make sure kids wear one as well.
  • Teach kids about road safety, especially those who will be allowed to ride around in the neighborhood this summer. Look both ways, look for cars…they may not see you!

Water Safety

  • Never leave children alone in or near the water, even for a minute. You have to watch kids, but also adults closely. The latter is especially important when drinking. Lots of horrible accidents happen on boats when people are drinking and having a good time on lakes/oceans, etc. Be diligent. Call 800-336-BOAT for additional information on boating safely.
  • Make life jackets a cool thing to wear! Even the most experienced swimmers can tire, so when in doubt, and when in groups, especially with kids, consider wearing a life jacket.

COVID-19

  • Continue to wear a mask when going out of the house, wash your hands frequently, and continue to practice physical distancing from others.
  • Outdoor is best, and continue to limit interactions outside your household if possible. Some, done safely (refer to chart) may be possible, but stay vigilant.
  • Finally, we are all witnesses to the injustices faced by the African American community in the past weeks, months, years. This week you may have heard about many protests and you may be wondering, what about COVID-19? Hats off my to my friend and colleague who put together these recommendations for keeping safe while protesting:

Continue to be safe friends. We’re in for a long summer, but together, we will get through this. I close with a quote from Dr. Martin Luther King, Jr.:

The time is always right to do what is right.

And now, is the time, to do just that.

Science Says Sunday – R & R

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New unicorn floating to make R&R a little less boring!

Whether you’re zooming all day, back to working your regular job, and/or doubling as a butler/playmate/chef for your kids/family, there’s no doubt 1) you’re likely getting very little down time and 2) getting very little time to yourself. The latter is less important for some than it is for others, but the former is likely important for most. Prioritizing rest and relaxation, even in the busiest or stressful of times, is important to maintain sustained levels of productivity.

I personally fall in the zooming all day and catering to my kids’ needs simultaneously. As such, the lines between work and play are often blurred, especially during this pandemic, where I find myself working all hours of the day, whenever I can fit in some time to work, zoom, or check items off my to-do list.

As I struggled with what topic to address in today’s Science Says Sunday post, my good friend and colleague Dr. Amanda Willig reminded me that talking about the “science of the importance of rest for productivity” would be a great topic to cover. In fact, two articles were primed for sharing on this very topic. The first, published March 20, 2019 titled “Stanford professor: Working this many hours a week is basically pointless. Here’s how to get more done—by doing less” based on a discussion paper series article titled “The Productivity of Working Hours” suggests that:

“…productivity per hour declines sharply when a person works more than 50 hours a week. After 55 hours, productivity drops so much that putting in any more hours would be pointless. And, those who work up to 70 hours a week are only getting the same amount of work done as those who put in the 55 hours.”

Bottom line: working longer does not necessarily mean you’re working longer or better. Working smarter is the key to checking those things off your list. So how do we do that? Keep reading.

If you are back to working on campus, in the office, or your regular worksite away from home, keeping track of hours may not be difficult because being away from home enables a clear separation of work from home in most cases. However, if you’re working from home, keeping track of hours spent working might be a bit more difficult. More and more I hear from friends and colleagues that zooming is exhausting and there are more and more meetings scheduled than ever before. Some call it the “after COVID-19 email and zoom meeting avalanche”. To some extent, that’s because of the ease of communication enabled by Zoom, but also, of course, because figuring out how to move on with work-life required a lot of meetings about how best to work remotely while accomplishing everything that once required in person interactions.

I’ve always known that resting allows me to re-group, to re-energize, and provides a recharging period that pre-kids, was easy to carve out. With kids, and especially with them at home now with me, getting that time is harder, and carving it out is guilt-inducing. So what do we do? We prioritize.

Rest and relaxation should be something you prioritize in your day or week. This is easier said than done, trust me. Advice I need to remind myself to follow quite often. Also recognize though, that rest and relaxation does not look the same for all people. For some, relaxing means going for a long run; while for others, like me, it may mean alone time including some hours to binge watch some shows on Netflix. Nevertheless, carving out that time, per day or week, is essential, and will ensure that you’re able to take on the next day, the next week, or that next big project that awaits in the wings.

Here are some things I have done to ensure I get some R&R when needed:

  1. Come up with a plan. Everything I do, goes on the calendar. If it’s not on the calendar, it’s not happening. Lately, that means that I add in the time the kids will need to eat, do homework, play, etc. I have been breaking up my day such that I concentrate on work in the morning. Take a “break” around 1-2pm, and dedicate the afternoon to the kids and all their needs. On occasion I do have meetings or work that overlaps with this afternoon kid time, but for the past two months, this schedule has worked well. After dinner, the kids get to do their own thing (eg play xbox, watch tv, play catch outside, ride bikes) while I catch up on a bit more work. We all do bedtime together, and I carve out some me-time after they go to bed.
  2. Communicate. Sharing my need to have “quiet time”, to “sleep in”, or to do whatever I need to do, requires communication with both my kids and husband. I can’t expect them to read my mind and have them know exactly when I am in need of time to recharge, especially since we all need such different amounts of recharge time and/or “me time”. My kids are older now, so they can be left alone for an hour or so in another room in the house, long enough for me to shut the door and take a cat nap or have a moment of much needed quiet. When they were younger, my hubs and I would take turns sleeping in on the weekends, or alternate who would put the kids to bed. Lately, we also do this when we want to get a workout in early or late in the day. Communication is key to ensuring you are able to get what you need.
  3. Figure out your zen. Identify what recharges you and what rest and relaxation means TO YOU. For me, sleep is a big part of it. I need at least 8 hours of sleep to feel normal. Cleaning, organizing, keeping busy also sometimes re-energizes me. It depends on the day. Other days, it means absolute quiet, no phone, and Netflix binging or a good book.
  4. Figure out what distracts you. Part of the reason I sometimes work long hours is because I entertain distractions. Social media, staring off into space, you name it. Sometimes, if the task I need to accomplish doesn’t align with my current state of mind, it will not happen efficiently. Working efficiently means you identify when you work best for what tasks. For example, I write best in the afternoon and evenings. Mornings are great too, but they are best for me to execute small tasks like email and checking small things off my list. The feeling of accomplishment propels me into a more focused state later in the day/evening. Combined with the right setting, efficient work can happen if you identify your work style and plan for that according to what you have on your to-do list.
  5. Set limits. I’ve had to learn this the hard way over the years, but there are a few things that have helped me find some balance. A clear separation between the work week and weekends has been crucial. I do still work weekends on occasion, but they are less frequent than they used to be. This provides me a true opportunity to get some rest and relaxation in on the weekends. Evenings are similar. With kids and their extracurricular activities or other needs, working evenings becomes nearly impossible anyway, but it has taught me that working efficiently during the day is essential and that I’m able to get just as much done during the day and just as quickly, as I used to before I had kids and had hard stops. This can be tough when you have littles, especially now that many of us are working at home. Finding a way to balance the unpredictability of life with babies/toddlers and work is key to being able to set limits when able. Sometimes, though, this means that you simply acknowledge that during this time, you simply will have to accomplish less than you are used to. Being realistic about what can be accomplished, under promising and over delivering at work is likely the way to go, all to ensure that you don’t burn out and that you’re able to be physically and mentally present for those babies.

The National Institutes of Health recommends sleep and rest for your overall well-being. In fact studies show that sleep/rest may be important for:

While additional research is needed on the the effects of rest alone on health, much research (linked above) suggests that sleep is super restorative and that lack of sleep has been associated with poor health outcomes. Nevertheless, rest is necessary above and beyond sleeping (says the PhD, anecdotally, but trust me nonethless?? :D), so make sure to get it in as best as possible.

On this Memorial Day weekend, you may have to do things that don’t enable you to rest and relax. Perhaps because you have to work, or because you have littles to take care of, or an elderly parent to watch after…whatever the reason, if not this weekend, make sure to figure out a way to carve out time for some R&R. Your body and brain will thank you for it. Personally, if you’re looking for me this weekend, you’ll find me floating around in our pool or sitting in front of a TV ingesting brain candy. 😉

 

‘Science Says’ Sunday – COVID-19…what happens now

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This was meant to be a weekend – perhaps month – of graduation ceremonies and parties. Facebook reminded me that on this weekend, eight years ago, I graduated with my doctorate degree in Epidemiology. First generation graduate, first in the family to graduate from high school, college, and two graduate schools. Big deal, no doubt. Therefore, I empathize with those unable to experience graduations in person, for whom this too would be a big deal. Although, looking back, I’m certain that it would not have changed the impact of the moment, or everything that I accomplished which led up to that moment. I’m certain my parents would be as proud as they are/were, my friends/family would be as well, and although we wouldn’t have been able to celebrate in the moment, we most certainly have celebrated eventually. If you’re reading this and you were supposed to graduate this spring, I leave you with these thoughts:

 

…and this quote:

“Kid, you’ll move mountains! Today is your day! Your mountain is waiting. So get on your way!”

– Dr. Seuss

COVID-19 has undoubtedly turned our worlds upside down. My first post on COVID-19 was published late January, during a time when we were all very much just learning about the virus and disease. In that time – four short, yet absolutely long-feeling months – science has moved at WARP speed. SO FAST. Faster than I’ve ever seen science advance in my life. Nevertheless, what we know remains rather limited, particularly in light of the most important question everyone is asking now: “What happens now?” So, let’s address the top 5 questions I’ve been asked recently, and what the science says.

My state is reopening. What can or should I do or not do?

This is an interesting question with no straightforward answer. In some cases, states are reopening where we are starting to see a decrease in rates of infection. In other cases, states are reopening and case and death counts continue to increase. See how your state is doing here. Whatever the case may be for your state, it is important for you to consider the following:

Until we have 1) widespread testing, 2) contact tracing, and 3) isolation of individuals who are sick, we may likely have to continue to live life with some form of precaution.

Remember this graphic?? The COVID-19 response is multifactorial and warrants several things to be in place before we can go back to ‘normal’. 

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An increase in testing among other things, should allow that social distancing lever to come down a bit. However, if we don’t have widespread testing, contact tracing, etc in place, social distancing remains an important component of slowing down the spread of COVID-19. There are some great articles detailing where the idea of social distancing comes from and when it was used previously (ie The Black Plague and the 1918 flu). You can read a few of those here, here, and here. This isn’t our first rodeo, y’all.  If you’re also wondering what contract tracing and isolation means, read this article I provided definitions for to help clarify.

So…am I saying you have to continue to stay home?? Well, a reopening of your state may mean that you cannot stay home because you have to go to work, take your kids to daycare, continue to grocery shop, etc. Therefore, precautions should include,

  • avoid large crowds or group settings,
  • practice good hygiene,
  • don’t touch your face (virus enters through your mouth, nose, eyes),
  • maintain physical distance between you and others (at least 6 feet if possible)
  • wear a mask when in public*

*Wearing a mask protects others from you. How? It helps limit the amount of particles of virus coming out of your nose/mouth from spreading. Surgical masks are best if supplies are abundant, but otherwise, cotton masks with filters or masks with multiple layers are also recommended. Remember that wearing a mask does not mean you should stop engaging in the risky behaviors listed above. It is simply an added layer of disease prevention, so when you wear a mask you should continue to maintain your distance from others, wash your hands, and don’t touch your face. Others should do the same around you.

Science says that the virus appears to transmit most frequently in enclosed spaces, where people are in close proximity. Does that mean that the virus does not transmit well in outdoor spaces? Evidence so far suggests probably not if your outdoor encounters are short and you are not close to other people. Being outdoors in close proximity, as is done in sports, concerts, parties, is still a big question. Here’s a nice Twitter thread citing the three which have explored transmission of COVID-19 in three indoor settings:

Bottomline: Continue to proceed with caution, continue to maintain a physical distance from anyone outside your household for the time being. Wash your hands, wear a mask when out and about, and avoid large crowds or group gatherings/settings. Remember that family/friend gatherings fall in this category of caution as well.

Summer is coming. What about summer camps, daycares, and pools? Are they safe?

Lotsa questions here, so let’s start with summer camps and daycares. First and foremost, let’s recognize that many of you may have to return to work soon, if not already had to,  and childcare is a significant need. Some childcare centers are reopening, with several sanitary and physical distancing precautions in place. The same holds true for some summer camps, although I’m seeing summer camps more willing to open if they typically host outdoor activities/camps. I am hopeful that the protocols put in place at daycares and summer camps will be sufficient to reduce spread in those encloses spaces with multiple people in one building/classroom. In general, kids do tend to do better with COVID-19, but that does not mean that they do not get infected.  It also doesn’t mean they don’t get super sick. It does mean they tend to get super sick in numbers that are fewer than adults, for example, but nevertheless, important to keep in mind as you make decisions about how to move forward with care. Be especially careful if you are sending your kids to daycare/camp, and they are coming back to a home where older individuals or anyone who is considered high risk, lives.

What about swimming pools? Evidence from the SARS epidemic in 2002/2003 suggests that the chlorine in swimming pools should be able to kill the virus that causes COVID-19. The biggest concern with pools, is close interactions with people outside and inside the pool. In the pool, you should continue to try to maintain a physical distance from others; for example, swim with one lane between you and other person in the pool. Outside the pool, and especially important for parents with kids, is to keep physical distance and avoid touching surfaces. Hand hygiene continues to be important. Here’s a good article to read for those who are avid swimmers or considering returning to a pool this summer.

Bottomline: A lot will depend on what safety measures are put into effect in the pools you plan to visit this summer. Open water sources similarly. Most important is to maintain a physical distance from others if you decide to visit your local pool or go to the beach/lake.

I’m seeing a lot of posts about Vitamin D deficiency and COVID-19. Does that mean I should start taking Vitamin D??

This is a tricky question, because we have seen a disproportionate number of deaths in 1) individuals who are older and 2) African Americans. Scientific studies suggest that these two population have a higher probability of vitamin D deficiency. Does that mean that vitamin D deficiency is CAUSING worse COVID-19 disease? Not necessarily.

When studies find an association between two things (eg, low vitamin d and COVID-19 disease severity), that does not automatically mean that low vitamin D causes more severe COVID-19 disease.

Remember, correlation does not imply causation!

Bottomline: There are a number of other factors that may play a role in disease severity. Most importantly, consult with your physician before taking vitamins to determine 1) if you need them (you can have a blood test to determine your level) and/or 2) to determine what dose you need, if any. Do not attempt to self-dose on Vitamin D without physician guidance.

Antibody tests are advertised everywhere these days. Should I go pay $100 to get one?

Let me say this: I have seen a number of local businesses and medical practices advertising antibody tests and all I can say is that scientific studies suggest that the utility of these tests is pretty low. Why? Many of them aren’t specific or sensitive enough to detect past infection. Not to mention the fact that we still don’t know 1) if you have been infected with COVID-19 in the past, whether you are still able to infect others, 2) whether you can be infected again, 3) how long the immunity – if any – will last.

Bottomline: Scientists are still actively working to answer questions about immunity, so hang tight and save those $100 for a rainy day, or until a fully vetted antibody test is on the market.

What in the world is happening in kids and what is Multisystem Inflammatory Syndrome in Children (MIS-C)??

Let me start by saying that experts do believe this is still a rare occurrence in children. While we don’t yet have a denominator for disease incidence and prevalence for the magnitude of spread of COVID-19 in kids ages 19 and younger, a health warning from the Centers for Disease Control and a scientific brief from the World Health Organization give some information on the topic.

Bottomline: Information for MIS-C is still limited, so as we have more information, I will be sure to include it in future Science Says Sunday posts. In the meantime, here are some symptoms to be on the lookout for, in case your child or a child you know should have them. If they do, make sure to consult with a pediatrician.

 

 

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Finally, let me finish by saying that I recognize that all of this is so very new, so very overwhelming, and that it can be hard to figure out what information is correct. I wish I could say that science speaks for itself, but when people take science and manipulate findings to prove their own biases or points, that’s when – for me – being in science, becomes ultra frustrating. We don’t know a lot about COVID-19 right now. Just because experts/scientists/physicians change their mind, does not mean they are wrong. It simply means that they are taking new evidence into account and adjusting recommendations accordingly. COVID-19 has only been around for a few months, and science is working as quickly as possible to get answers so we can decide what steps to take next. Don’t know someone with COVID-19 or didn’t see a hospital surge in your city or state? Please don’t let that alone be the indicator for severity of disease. COVID-19 is something we need to get a handle of and so far, we know that 1) social and physical distancing works, 2) COVID-19 can be deadly, 3) it spreads efficiently, 4) kids are not immune to it. I hope we will know more in the months to come, but for now, stay healthy, be careful for you and others, and for those who continue to adhere to public health recommendations…THANK YOU!