covidbmc

COVID-19: Bodies Mentals Chicken

Many people are asking for understandable information and advice to follow during this novel coronavirus outbreak, or COVID-19. Our federal government has produced a mountain of misinformation and continues to dispense lies about the likely prevalence of coronavirus, grossly underreporting local transmission rates amidst a shortage of test kits. During times of crises, leadership can come from unexpected sources. In suspending all NBA games, Adam Silver delivered a powerful message to the public that this outbreak must be taken seriously. In a single announcement on March 11, Silver enforced more effective public health policy than the White House has for this pandemic. Soon, all other major sports leagues followed. The NBA’s decisive action was critical in setting off these dominos.

Recall Marshawn Lynch’s post-game interview in January, after what was conceivably his last game in the NFL: take care of your bodies, your mentals, and your chicken. It’s solid advice to young players in the league and a simple set of guidelines for dealing with this outbreak.

Your bodies
Reducing transmission so that each case gives rise to less than one new case is the only way to stop an outbreak. Despite the fact that many COVID-19 cases are mild, to prevent severe cases we have to reduce all transmission. Though not exclusively, we've seen many severe cases in the elderly and patients with prior respiratory conditions. In the absence of behavioral interventions, the number of severe cases requiring hospitalizations will exceed the capacity of the US healthcare system and lead to preventable deaths. We need to reduce transmission among everyone to protect the most vulnerable members of our communities and keep the healthcare system functioning.

With this virus, there are no pharmaceutical interventions (vaccines, anti-virals) yet so we’re reducing transmission with basic public health measures and behavioral interventions. These have been well-covered in the media lately. These non-pharmaceutical interventions are extremely effective against infectious diseases and successfully ended all Ebola epidemics before 2014. The usual common sense about hand washing, not touching your face, and limiting your exposure to other individuals is highly effective for taking care of your bodies. Update your greetings with new guidelines that involve no physical contact. You can also significantly limit your exposure to the virus by limiting your physical proximity to others (give yourself about 6 feet of space), avoiding crowds, and reducing non-essential travel. You might hear this referred to as ‘social distancing’ but it just means creating physical space between yourself from others and avoiding crowds. It’s good advice and it’s effective. Finally, if you think you might be getting sick or if you already are sick, stay home and don’t have contact with others. Self-quarantine is a good idea anytime you think you have an infectious disease. The decisions you make during this outbreak regarding your own risk and exposure affect you, the people around you, and the people around them. Make unselfish choices.

Your mentals
Social distancing is physical distancing, NOT social isolation. Another important issue during this outbreak is mental health. Mental health is vulnerable during times of crisis and social support improves mental health, which then bolsters physical health. It’s all connected. It’s difficult to eliminate physical human contact and keep your mental health in check. It’s even more important than usual to keep up with your social networks and check in on each other. Someone you know will likely end up in self-quarantine or isolation, either due to suspected or confirmed coronavirus infection. Fourteen days of physical isolation will be psychologically challenging.

Fortunately, while practicing effective ‘social distancing’ and simultaneously maintaining social contacts would have been difficult in previous decades, now there are many options to do this safely. Stuck in your apartment in self-quarantine? Videochat a friend. Attending class via Zoom or telecommuting to work? Catch up with classmates and co-workers via texts. Make a conscious effort to have social interactions when you’re physically distanced or isolated. If a friend or family member is in quarantine, create a schedule that allows someone different to check in with them at least daily. Everyone’s busy and everyone’s trying to adjust, so don’t try to take on too much yourself. Delegate properly and everyone will benefit. Note that social media can actually have negative effects on mental health and feelings of loneliness so don’t assume there are enough Instagram puppies to keep a quarantined friend company.

Even if you’re lucky enough to avoid quarantine, you will miss travel or crowded events that you’ve been looking forward to. The disappointment will take a toll on your mental health. You might also be feeling overwhelmed by the endless stream of rapidly changing information and misinformation. Without leadership from the federal government, we have no large-scale management plan or timeline for moving forward. Take a moment to acknowledge any resulting feelings of insecurity. A lack of guidance and reassurance can cause anxiety and stress so don't face it alone. Everyone who isn’t sick can get outside, enjoy some time with pets, finally find time to read, or delve into old or new hobbies.

Your chicken
Finally, the meaty part of all this. First of all, don’t blow your paycheck stockpiling months of food and supplies. Don’t panic and buy every possible over-the-counter drug. You can’t stay safe if you’re the only one in town with soap so buy what you need and leave the rest for others. Hoarding toilet paper is not going to solve anything. It’s a good idea to check your supply of prescription medication and make sure you have at least two to four weeks-worth on hand. Assess the shelf-stable foods that have been sitting in your cupboard for a while now. You may already have enough un-expired food to get you through several days. Reduce your grocery shopping frequency going forward and use each trip to get what you need for a week or two at a time but adjust this around your budget and storage capacity.

The bigger problem is our American health care system. Even those of us who are lucky enough to have insurance are constantly surprised by the many expensive, seemingly vital, routine services that aren’t covered. Worse, the federal government has fumbled preparedness and response through this entire outbreak. It was local government officials who set important precedents to eliminate costs for testing and treatment. New York, Washington, and California led the way, providing free testing for everyone.

On March 12, the director of the CDC finally delivered a long overdue “guarantee” of free coronavirus testing for every American. While we don’t yet know how this will roll out operationally, the importance of free testing cannot be overstated. People will not get tested or seek treatment if they’re worried about high associated costs. Unreported cases lead to transmission levels that are nearly impossible to stop. In addition to free testing, employers need to encourage and reward responsible self-quarantining behavior. Paid sick leave for everyone would vastly improve compliance with self-quarantine measures. A system where sick days translate to days without pay promotes a lot of avoidable virus transmission. A mild infection in one person who feels well enough to report for work can cause a severe case in another person. Ultimately, it will be very difficult to manage this outbreak if Americans pay a personal financial cost for being responsible members of society. This is doubly important in service, education, sanitation, and hospitality industries as well as any jobs that require contact with many people per shift.

This outbreak will continue to change our daily lives. We will not go back to ‘normal’ in a few weeks or months, we need to adjust to a new normal. To protect the most vulnerable members of our communities, the less vulnerable have to make responsible, unselfish choices. Constantly consider how your personal behavior is going to impact everyone around you and everyone around them. The government hasn’t delivered clear communication about the current situation, detailed a plan moving forward, or prioritized protecting the health of our communities. Instead, local governments and professional sports and athletes have lead the way, making unprecedented, sometimes unpopular, decisions to guide us through the necessary interventions to manage this outbreak. Marshawn Lynch wisely instructed us to protect our bodies, our mentals, and our chicken. It’s our responsibility to extend that to protecting each other.

Nita Bharti, March 9 2020, updated March 12.