‘Science Says’ Sunday – Covid-19 and Mental Health

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Last week, I chopped four inches off my hair. It isn’t something I would have never done under “normal” circumstances, say for example, in the absence of a pandemic.

Two-three weeks ago, I was working around the clock trying to adjust to my new normal. I was maybe sleeping 4-5 hours a day.

Three weeks ago, when I started working from home, I was on the verge of tears anytime I spoke with someone outside my home, but especially when talking to family and colleagues.

Experience in academia has taught me several things about how I handle stress, but most importantly, it has taught me that I internalize it so well, that I only realize I’m stressed once the stress has physically manifested and I feel unwell.

Once again, I had no idea I was feeling stressed. Actually, I was feeling panicked. Everyone says, “worry only about the things you can control”. Well, as an epidemiologist and science communicator, I felt like I had been sounding the alarm since January, maybe February! I felt and feel, like that is one part of this pandemic response that I am in control of. Yet, often, feel like I’m speaking to a select few only, and for something, speaking into a void.

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Still, I’ve persisted in my pursuit of science communication and continue to update anyone who will listen about scientific evidence arising about covid-19 and the virus that causes it. I post on Facebook, Twitter, Instagram, send via text…you name it. Give me a platform, and I will attempt to educate. Not to mention, regaining a semblance of normalcy as I work to continue my own scientific pursuits for work.

Still, not gonna lie, it’s exhausting. Especially when you see that people still don’t get it and/or simply fail to comply with #socialdistancing, for example.

Starting to realize that I was spiraling into a physical manifestation of stress/panic, I attempted to take a step back and reflect. Coincidentally, I read two things that put a lot into perspective:

  1. Guidelines for working during this pandemic” from the Association for Behavioral and Cognitive Therapies, shared by good friend and colleague Dr. Dori Pekmezi. 

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The first point was SO EYE OPENING. YES. I was, in fact, not just working from home. I was IN FACT, at home, during a crisis, trying to work. WOW.

Also, why was I on the verge of tears every time I joined a zoom call?? This tweet summarized the reason why:

Finally, as a natural introvert, I expected to transition into remote-work and social distancing pretty easily. But what I found myself experiencing was more profound than that. I found myself grieving. Then I read this article and it made made so much more sense:

People are feeling any number of things right now. Is it right to call some of what they’re feeling grief?

Kessler: Yes, and we’re feeling a number of different griefs. We feel the world has changed, and it has. We know this is temporary, but it doesn’t feel that way, and we realize things will be different. Just as going to the airport is forever different from how it was before 9/11, things will change and this is the point at which they changed. The loss of normalcy; the fear of economic toll; the loss of connection. This is hitting us and we’re grieving. Collectively. We are not used to this kind of collective grief in the air.

You said we’re feeling more than one kind of grief?

Yes, we’re also feeling anticipatory grief. Anticipatory grief is that feeling we get about what the future holds when we’re uncertain. Usually it centers on death. We feel it when someone gets a dire diagnosis or when we have the normal thought that we’ll lose a parent someday. Anticipatory grief is also more broadly imagined futures. There is a storm coming. There’s something bad out there. With a virus, this kind of grief is so confusing for people. Our primitive mind knows something bad is happening, but you can’t see it. This breaks our sense of safety. We’re feeling that loss of safety. I don’t think we’ve collectively lost our sense of general safety like this. Individually or as smaller groups, people have felt this. But all together, this is new. We are grieving on a micro and a macro level.

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Article linked, here.

Eventually, I left myself breakdown. Several times. I broke down in tears, all by myself, and let it all out. Sometimes, you have to break down in order to build yourself up again.

So what does this all mean and what am I to do??

So, if anything you have read in this post rings a bell, or if you identify with it in any way, you may be asking, well, how do I fix it. I started to wonder the same thing, and refer to the third section of the HBR article, which says:

Understanding the stages of grief is a start. But whenever I talk about the stages of grief, I have to remind people that the stages aren’t linear and may not happen in this order. It’s not a map but it provides some scaffolding for this unknown world. There’s denial, which we say a lot of early on: This virus won’t affect us. There’s anger: You’re making me stay home and taking away my activities. There’s bargaining: Okay, if I social distance for two weeks everything will be better, right? There’s sadness: I don’t know when this will end. And finally there’s acceptance. This is happening; I have to figure out how to proceed.

Acceptance, as you might imagine, is where the power lies. We find control in acceptance. I can wash my hands. I can keep a safe distance. I can learn how to work virtually.

 

But also, this article which spoke to one of the things I was worried about the most…my productivity.

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Linked here

Among the tips, the suggestion to “embrace a new normal”. In my mentoring, I always speak to the ability to be flexible, and how flexibility is many time, the key to success. Worrying about what was going to happen next, in the presence of uncertainty was wasted energy for me. Rather, focusing on what I knew what certain for at least another month (ie remote working), and findings ways to thrive and adapt, would be how I would move forward.

Thanks to friends, I quickly found ways to reconnect with friends and family I was no longer seeing on a regular basis. The House Party app and Facetime have been great ways to reconnect. We, as a family, take more bike rides than ever before. We make an effort to play outdoors at least an hour a day. Those are things we keep within our control. I’ve also reminded friends that social distancing DOES NOT MEAN SOCIAL ISOLATION. Make it a point to stay connected. Fellow epidemiologist and twitter colleague posted this recently, and provides suggestions for staying in touch with people.

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Everyone says, “worry only about what you can control”. Well, that has certainly been harder for me to do than people expect it to be. I am a worrier by nature. I worry about all the things, all the time. So what is working for me, is coping. The articles mentioned above, are things that are shifting my mindset and helping me cope.

Remember that stress is not good for your health. I know this well. If you are struggling with this, I highly encourage you to talk to someone about it. Here are some tips provided by my institution. I hope they are helpful for you:

“Despite the outbreak, it’s important to remember that life still goes on and that there are a number of strategies people can use to cope with this type of stress, said Laura Dreer, Ph.D., a clinical psychologist in the University of Alabama at Birmingham Department of Ophthalmology and Vision Sciences. “We know that people have a tremendous ability to flourish in light of what one might consider life-altering situations.”

 

 

 

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Article linked here

 

As I mentioned before, we are likely in this for at least a month longer, if not more. That means, at all costs, try to preserve your sanity, take care of yourself and your family first, in whatever ways that is possible. I know that many of my family and friends are considered essential workers, and for them, social distancing is not possible. I can’t imagine the stress that must be causing. For those who are affected financially by the covid-19 crisis, this HAS to be extremely stress and panic-inducing. If this applies to you, here’s a good article I found with resources that I hope can provide some answers.

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Article linked here

I end with a poem that is relevant to the topic of infectiousness, and something you can do from a distance. 🙂

Pin on Quotes to live by

‘Science Says’ Sunday – 5 facts about COVID-19 communication

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Last week, I shared a short Instagram TV video where I pleaded with my viewers/readers to please continue social distancing. In that time, I have given media interviews, participated on video podcasts like Communal Expressions, all with the same message: We must continue to practice social distancing to help flatten the curve.

A colleague of mine shared a Twitter thread by Vivek Murthy, titled “Five tried and true principles for communication during a public health crisis (these literally save lives). In it, he shared five principles that are crucial to communication during public health crises and they include:

  1. Be transparent and truthful
  2. Be consistent
  3. Over communicate
  4. Lead with scientists and science
  5. Be compassionate

In my communication on Chic in Academia, I have attempted to share messages about COVID-19, keeping all of the above in mind. What is disheartening is, hearing people continue to call this all a hoax; saying that flattening the curve and social distancing is an over reaction; discrediting the fact that scientists, physicians, health care workers, and so many others are working tirelessly to try and get this pandemic under control.

Last week, I shared information with articles providing evidence that :

While I recognize that not everyone I know reads my blog, or that everyone you know reads this blog, I do know that this messaging is not unique, and mirrors what a lot of experts are saying.

For what it’s worth, until we have (not listed in any particular order),:

1) COVID-19 tests for everyone

2) ventilators and beds for all critical ill patients

3) personal protective equipment for our friends on the front line (physicians/healthcare workers)

4) antibody tests

5) an effective drug treatment

6) a vaccine

7) accurate data (we still don’t know exactly what our denominator is!!)

8) accurate and consistent messaging about what we need to do to get a handle of this pandemic

we will continue to see known case and mortality numbers increase, especially if we don’t continue social distancing. Ensuring #1-8 above will help reduce the need for social distancing. At minimum, #1-6 would help provide answers for #7 and #8.

I have shared all the information we have to date. What we need now is some degree of ‘lever adjustment’ to move forward. In the short term, a high degree of social distancing is important because we need the other levers to rise or increase in order to reduce the lever or need for social distancing:

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Once we have a effective treatment, antibody tests to determine who has been sick and recovered, comprehensive testing, and everything our hospitals need to treat everyone who gets sick, then we can begin to scale back on significantly on social distancing efforts.

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NOTE: If you’re reading this and can help me make these figures interactive, please email me! bhidalgo@uab.edu

In the news this week, you may have heard that more masks are coming, that additional ventilators are being shipped to states, and that companies are developing tests to determine whether you are positive or have been previously infected. I’m excited to see what awaits us, but for now, social distancing is a must.

Because I haven’t been able to upload my own IGTV video, here’s one that Communal Expressions shared this week on their Facebook page where I answer a number of questions about what we do and don’t know about COVID-19:

Finally and most importantly, many of you continue to ask questions about the following topics, so here are some short answers:

  1. Can I continue to take Ibuprofen? YES. Here’s an article that tells you why you should not be quick to abandon current treatment you may be on.
  2. Can I wear a mask if I have one? If you have surgical or N95 masks at home, you should donate them to your local hospital because many hospitals DO NOT HAVE ANY. If you are making homemade masks, please also donate those to your local hospital until they can obtain more surgical and N95 masks. When are hospitals are fully stocked, then you can wear masks if you want to. If you are sick, you should be at home, and you can wear a mask to keep droplets from falling all over your house and infecting other people in your home.
  3. Can I pick up takeout, curbside meals, or get food delivered? Yes! Read about why it’s safe here.
  4. Can I self-treat if I think I have or have been diagnosed with COVID? NO. Read why here.
  5. Can I get re-infected with COVID-19 if I’ve already had it? Evidence suggests no. Good article describing why, here.
  6. Is the virus mutating? Yes, but here’s why it doesn’t appear to be a big problem.
  7. Should I worry about my risk for COVID-19 if I have a specific blood type? NO. Here’s why.
  8. I’m interested in COVID-19 projections for my state. Where can I find that information? Here’s a good resource!
  9. Is the virus that causes COVID-19 airborne?! No. World Health Organization fact check, here. Note that aerosols ARE an issue in hospital settings during intubations, for example, so medical professionals do need to worry about the virus becoming aerosolized and need appropriate personal protection like face masks to prevent getting infected.Image
  10. Can I infect other people even if I am not symptomatic? YES. The evidence we have so far suggests that there is some asymptomatic transmission/infections happening. Here’s a figure that shows what the current evidence suggests:

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In short, whether you only get a little sick or super sick, the fact remains: YOU CAN MAKE OTHERS SICK during the period when you have ZERO TO NO symptoms. Until we can test everyone, and adjust the levers on the graphic shown above, please #stayhome and keep #socialdistancing to help #flattenthecurve.

‘Science Says’ Sunday – COVID-19 What we know as of 3/22/2020

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Those of us following the COVID-19 pandemic feel very much like we’re drinking water of out a fire hose. Everyday, there is a massive influx of information. New studies out of China and other countries are being published at an unprecedented speed, mirroring what we are seeing in terms of the spread and manifestation of the disease in different populations.

I do want to remind you, however, that as we share news of reports, studies, or findings, please recognize that what we know about COVID-19 is very much evolving on a daily basis. Not to mention the fact that because this is all so new, much of what is being published are correlations, associations, observations. Very few studies have published information that suggests causality between two things.
So, bear with us – scientists – as we navigate these uncharted waters. I know it’s hard to be patient in a time when so much is frenzied, but without good interpretations, we risk making inaccurate recommendations as we forge this war against COVID-19.

In today’s post, I’m sharing a little about what we know with certainty; and let me tell you, it is not a whole lot. However, putting the things that we know will work (like social distancing) into practice, will absolutely make a difference, so PLEASE, please help us all by staying home, practicing social distancing, and helping to flatten the curve.

What do we know?

  • COVID-19 is caused by the SARS-CoV-2 virus.

    “Shown are a schematic of 2019-nCoV (Panel A) and full-length phylogenetic analysis of 2019-nCoV and other betacoronavirus genomes in the Orthocoronavirinae subfamily (Panel B).”

  • SARS-CoV-2 is part of the coronaviruses family. The coronaviruses family includes viruses that cause the common cold, the flu, MERS, and SARS.

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  • SARS-CoV-2 is made up of a small set of genes, surrounded by fatty lipid molecules. This fatty covering can be dissolved by soap/detergents. That means, hand-washing with soap and water for 20 seconds is highly recommended. Ethanol also breaks the virus apart, so hand sanitizers with at least 60% ethanol are effective, in the absence of water. Finally, for cleaning, Windex, bleach water, and soap and water are effective for cleaning surfaces.

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  • SARS-CoV-2 can be spread during the pre-symptomatic and/or mild symptoms phase. That’s partly what is making it so hard to prevent the spread. People may think they are not sick, and inadvertently spread disease during that time. The more people get sick all at once, the more likely we are to overwhelm our hospitals. This also means we risk getting our healthcare workers and physicians sick, which decreases the chances that of all people who need care will get the care they need.

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  • SARS-CoV-2 lives on surfaces for a while. How long? In laboratory settings, up to 3 hours aerosolized, up to 4 hours on copper, up to 24 hours on cardboard, and up to 2-3 days on plastic and stainless steel. These times were determined in a laboratory setting, so in actuality, the virus may live less time in the air/on these surfaces, but nevertheless speaks to the importance of social distancing to avoid coming into contact with surfaces where others may have coughed/sneezed/touched. https://www.nejm.org/doi/full/10.1056/NEJMc2004973

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  • Social distancing works!! We have seen how well social distancing efforts have helped to slow the spread of COVID-19 in China and South Korea for example. Let me remind you, though, that both countries put social distancing measures in place that were a lot more stringent than the ones many of our states have put in place. The Stay Home orders that California and New York have enacted are a good start, but we truly need stronger regulations/requirements for staying home and social distancing in order to make a difference and flatten the curve. I know something longer term and stronger requirements than what we have in place in some states seems harsh, maybe even scary. But, if we are to truly tackle this virus and prevent more infections, hospitalizations, and deaths, it’s what we need to do.

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  • Social distancing means, social distancing! In order for us to truly slow the spread of infection, we need to socially distance ourselves as much as possible. Here’s a guide that can help you figure out what the do’s and don’ts of social distancing are.

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  • This is not going to be easy. It is going to be hard. It is hard to work from home and homeschool and try to pay the rent while not getting paid and and and and…the list is endless. My boys and I have been at home since Friday, March 13th. We haven’t left the house except to go on bike rides or play outside. WHY. Because we don’t want to risk getting sick AND we don’t want to risk getting others sick. The data is still very new in terms of who is at risk in the US. The risk for COVID-19 is bound to be different by country simply because we have different age structures, different potential co-morbidities, different healthcare systems, different governmental structures. The virus alone cannot determine the epidemiology of a disease. The epidemiology of a disease is multi-factorial, and while we can certainly learn a lot about how to stop the spread and how to prevent and treat it, ultimately, we must adapt those lessons to our own environments and populations to find the best fit solution. This, my friends, is going to take time. Could it take months? Maybe. Adhering to social distancing is the only way we will be able to determine how soon we can return to “normal”. Not adhering to social distancing is likely to prolong it all. We have the power to make a change, and to slow the spread. Please, please, stay home if you can.

In case you haven’t already noticed, there is a hub on this website with COVID-19 information. It is being updated regularly with information about some of your most frequently asked questions. I am also taking questions on Instagram and Facebook if you have any that aren’t covered there. Please visit the page when you have a moment. I’m vetting all the information included and hope to continue to update it as we learn more about COVID-19 and all that’s to come.

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So, practice social distancing, and flatten the curve.

Friends, we got this.