1

Mitigation and COVID-19

When I was a child visiting my grandparent’s Iowa farm, I would often hear stories of how my mom and her eight brothers and sisters lived during the war efforts of the 1940’s. My grandma described a common purpose—that sense of pride that the family rationed and repurposed. Their singular focus was that the good of the individual was less important than the whole of the country, even the world.

Watching the coronavirus make its way across the world and rapidly grow in the United States, I can’t help but think of those stories. As the shelves of Costco and Sam’s Club stores emptied this weekend, and school closures were announced community by community, it made me realize that our time to step up is now. Our singular, collective focus needs to be mitigation and in order to be successful, mitigation efforts need to be embraced and enacted on by us as individuals.

What is Mitigation?

Mitigation is a strategy to reduce the seriousness or impact of a natural disaster, such as a pandemic. The goals of mitigation include minimizing morbidity and associated mortality, avoiding an epidemic peak that overwhelms healthcare services, keeping the effects on the economy within manageable levels, flattening the epidemic curve to wait for vaccine development and manufacturing to reach populations, and actively pursuing the development of antiviral drug therapies. Practically, mitigation relies on social distancing—measures that are taken to restrict when and where people can gather to stop or slow the spread of infectious diseases such as the coronavirus.  Social distancing measures include limiting large group gatherings, closing buildings and canceling events. However, for mitigation to be successful, individuals, even those who are asymptomatic, must be willing to self-isolate.

Self-Isolation Challenges

In a society as mobile as ours, and where high degrees of social contact is the norm, self-isolation is challenging. For instance, if one has become accustomed to eating meals outside the home, the transition to grocery buying and cooking may seem formidable. If one is used to getting together with friends to play cards, go running, have a beer after work, the loss of those types of activities will create holes in one’s social network.

We are fortunate to have an infrastructure in which many people can work from home and education can be delivered virtually. Workers who cannot isolate because the nature of their work cannot be done virtually, must take precautions. While in the workplace, distancing at least six feet, maintaining high levels of handwashing and the use of hand sanitizers is a must.   When returning home, it is best to avoid being in the presence of those most vulnerable to coronavirus—elders and persons with underlying comorbidities. It is also important to acknowledge that one may feel anxious and may not have all the answers that our members or clients are seeking. Maintain lines of communication with co-workers and supervisors. For those who are new to work at home, talk to coworkers for whom this has been the norm to get some advice on structuring the workplace and the day. And don’t forget that you can use technology to connect with friends. Facetime, Skype and other video conference capabilities are a great way foster your relationships during social isolation.

Mitigation is a critically important strategy to quell the spread of the virus. It has been beneficial in China as new cases are now falling. In areas where community spread is mild, targeted isolation of high-risk people, or those who may have come in contact with the virus, can be implemented. Even inside households, those with symptoms should keep distance from the healthy. And, even if you are asymptomatic, but have been in a high-risk area or where there is growing or wide community spread, it is important to maintain social distancing and self-isolation.

Social distancing and isolation are not easy—but I am trying to look at them as the Victory Gardens of my mother’s childhood. I hope that 50 years from now, my grandchildren will hear stories of how the United States and the world beat back the coronavirus, and I hope that my children who are on this journey with me now will reflect and recognize the importance of a global community, productively working together for the common good.




Addressing anxiety about the coronavirus (COVID-19): Healthcare workers

The novel coronavirus (COVID-19) outbreak in the United States continues to evolve, with more cases and quarantines popping up on news feeds everywhere. The closer it gets to their homes, the more people are worrying. In our last post, “Addressing anxiety about the coronavirus,” we talked about the things people can do to help feel less anxious and more in control. But what about the people on the front lines? Nurses, doctors, healthcare workers and other medical professionals who are testing for and treating patients with COVID-19 are at a higher risk of contracting it than the general public. What can they do to take care of themselves, physically and emotionally?

As Kushal, Gupta and Mehta stated in Study of Stress among Health Care Professionals: A Systemic Review, “Work related stress is a potential cause of concern in healthcare workers and is associated with decreased job satisfaction, days off work, anxiety, depression, sleeplessness , medical errors and near misses.” Long shifts and working with sick people—some of whom are gravely ill—can lead to burnout and anxiety from their normal jobs. These already-struggling healthcare workers are now faced with COVID-19 unknowns and demands, including taking care of people with confirmed cases of the virus.

While some people may feel they are at the whims of the virus, there are things healthcare workers can do to take some control over their work environment and manage their fear or anxiety.

  • Know what your organization’s plans are. Read the business continuity plan and know your role. Talk to your team members about cross-training and covering for each other if one of you gets sick. In addition, ensure you are following proper protocols for cleaning and preventing spread. Visit cdc.gov for helpful information. This is particularly important for behavioral health providers who may not always think about universal precautions.
  • Surround yourself with green. If your facility permits, bring in a few plants to liven up your surroundings. Being around plants has a calming effect on people. Employees who work in offices with plants tend to feel better about their jobs, worry less and take fewer sick days.1 If you can’t have plants in your space, take time to look out the window and find some green. You may find that is enough for a quick mental break and perspective.
  • Use small tools to create a calming environment. A small water feature, a sand garden or hourglass, stress balls and other items can provide a quick way to refresh your mind. Or just step back, take deep breaths, stretch and/or meditate.
  • Find someone to talk to. Some hospitals have on-site or on-call chaplains; take advantage of them. Don’t be afraid to talk to your coworkers about how you are feeling. Chances are, they are feeling the same way and would welcome a discussion. Many medical settings offer a form of rounds that addresses the emotional impact of caring for a particular patient or theme. Similar semi-structured discussion groups with peers can be very helpful in handling stress and preventing the development of PTSD.2
  • Get professional help. Be open to contacting your organization’s EAP, if you have one, or reach out to a therapist if you find yourself developing “compassion fatigue,” where your desire to help others erodes.
  • Limit exposure to media. Media outlets have a tendency to sensationalize stories, so it’s important to consume news thoughtfully and with a critical eye.

In addition, do all the normal things to take care of yourself: try to eat healthy, well-balanced meals, exercise regularly, get plenty of sleep, and avoid alcohol and drugs. Doing these things can have a positive impact on your mental health and help you manage anxiety.

For more information and tips, visit MagellanHealthcare.com/COVID-19. We wholeheartedly thank you for all you are doing to combat this outbreak.

1: https://www.webmd.com/a-to-z-guides/ss/slideshow-health-benefits-houseplants.

2: See Schwartz rounds.

Disclaimer: The content in this blog article is not a substitute for professional medical advice. For questions regarding any medical condition or if you need medical advice, please contact your healthcare provider.




Public Health Spotlight – Coronavirus

On January 31, 2020, the United States (US) issued a public health emergency for 2019 novel coronavirus (2019-nCoV), a new virus first identified in Wuhan City, Hubei Province, China. This comes on the heels of the World Health Organization (WHO) declaring the coronavirus outbreak an international public health emergency. The disease now called coronavirus disease 2019 (COVID-19), which is a new type of coronavirus without a vaccine or medications to prevent or treat it, has resulted in thousands of confirmed cases and hundreds of deaths in China. This human respiratory illness is moving quickly with cases reported in a number of other countries and continents. In the US, while the number of confirmed cases are currently low, safety measures are being enacted to keep the risk of transmission low. As ongoing investigations seek to learn more about this infection, US public health agencies have dedicated coronavirus sites. They actively update these sites as new information becomes available and communicate up-to-date guidance. 

 

Disclaimer: The content in this blog article is not a substitute for professional medical advice. For questions regarding any medical condition or if you need medical advice, please contact your healthcare provider.