The Wellness Collaborative (TWC) would like to extend support and offer some thoughts as we navigate current stressors due to concerns about the corona virus, specifically, the strain called Covid-19, which is causing the current pandemic.

The words used in infectious disease spread can be scary, but the underlying principles are basic, and always the same.  Most infections are spread from person to person, but via different routes. Here are some FAQ’s:

How does Corona Virus Spread?
This virus is spread by respiratory means, through saliva, coughing and sneezing.  It continues to live on surfaces for a variable amount of time and one can carry it on their hands as well. We transmit it to the face and mouth entry points when touching those areas. We know that Tuberculosis is also an infection that is spread by similar respiratory mechanisms, but viruses can be even easier to transmit.

What is a pandemic?
It is an infection that has spread through many countries, generally in a short amount of time. They are had to contain, but do eventually end at some point.

Why are events being cancelled?
When people are in close proximity to each other they can spread the virus via the air, particularly through “aerosolization” when they cough.  The tiny droplets spread out as far at 6 feet away. That is why authorities are recommending, “social distancing” of 6 feet from others, no kissing, no hugging, etc.  Instead, use an elbow tap or virtual hug. Many universities are now cancelling classes and moving them to online webinars to protect students and staff. Some schools are sanitizing whole buildings.  Italy told citizens to stay home for two weeks to try to stop the spread, which has been very heavy there, this is an extreme measure, and bumps up against civil rights we honor in the U.S. Nonetheless, people have to be both sensible and practical for themselves and others.

How do I prevent getting Corona Virus?
The same way you prevent getting or giving others the flu or the common cold, which 50% of the time is caused by rhinovirus.  People who have underlying health conditions, such as asthma, and other respiratory disorders, diabetes, lupus, and immune sensitivities, to name a few, are always at higher risk for complications should they become sick, be it from pneumonia, influenza or corona.  And those living in tight quarters, with many others, or were ventilation is a problem may have more risk of contact too. So keep these things in mind and seek medical attention if you develop fever, aches, and flu like symptoms.

The key to prevention is washing your hands frequently. Wash your hands with soap and water often, AND linger at the sink longer than you think – 20-30 seconds.  This is especially important when you need to put anything on/near your face and mouth.

If you don’t have access to water, use a hand sanitizer. For corona virus the only one certain to work is 70% ethyl alcohol…so read the label.  If it is 62% will it work? We don’t think that is strong enough to kill the virus on your hands or surfaces, but we can’t be sure.
Other types of sanitizers work for the flu, which is still much more common in the U.S. than Corona is as of today.

Don’t touch your face, nose, mouth, unless you first wash your hands right before doing so.
This is how the virus gets in to your body.

Is there a treatment for individuals infected with COVID-19, and how do I know the difference between Influenza ( FLU) and COVID-19?
 
There is no effective treatment for COVID-19, but most people will recover on their own.  
Flu is more common, and has similar risks.  There are treatments for flu but early intervention is critical.  So seek attention for any flu like symptoms. 

Should I cancel travel?
Current recommendations are that if you can postpone travel you should.  If not, then follow the recommendations for hand washing, and hand sanitizers. Purell, for example, makes small bottles of 70% ethyl alcohol gel. If you are over age 60, you should not go on a cruise at this time, so check with your cruise line to see if they will allow you cancel or issue a credit. If you are sick, yourself it is recommended that you not travel or expose others.  If you must leave your home to get medications or groceries, and cannot send a friend, wear a facemask to reduce the risk of exposing others.  It is not 100%, but it is a necessary effort.

What about children?
Pediatric implications
“Based on what we know, children have experienced a mild form of the disease and some have been hospitalized,” said Ann-Christine Nyquist, M.D., FAAP, a member of the AAP Committee on Infectious Diseases. With many questions remaining about the virus, she urged pediatricians and their patients to seek information only from trusted sources — the AAP, CDC and local and state health departments.
 
Dr. Nyquist offered the following guidance:
Keep children out of the health care system if it’s not necessary.
Parents can obtain succinct messages and guidance at this site. See the HealthyChildren.org article authored by H. Cody Meissner, M.D., FAAP, for examples. 
 
Advice for parents
Parents should follow the same protocols now as during the cold and flu season, Dr. Nyquist said. “If they have a runny nose, they have a runny nose. If they have difficult time breathing, they should seek care.

How do I find out more about prevention, treatment, and testing centers?
Recommendations are changing daily, and erroneous information may be circulating.
You can find more information from the most reliable sources on the home pages of: 

Mass.gov
CDC.gov
HealthyChildren.org

This is stressful, what can I do?
While it is understandable to feel nervous during moments of crisis, remaining in that state can adversely affect your physical, mental and emotional wellbeing. It is important to stay mindfully aware, centered and intentionally practice ways to decrease stress and increase serenity. 
 
Stay ‘Calm, Schooled and Connected’
 
Calm…Practice relaxation through helpful techniques – take regular slow deep breaths, move your body, name what your feeling and then reframe it, notice what you see, feel and hear in the moment and reflect on what makes you grateful.
 
Schooled…It is important to stay informed from reliable and vetted sources so that you have and maintain accurate useful information. Avoid constant viewing of news loops and circulating alarming stories without context. As you learn of new information be sure to check into it and keep others updated accordingly and responsibly.
 
Connected…We are wired to connect so staying socially engaged in positive relational networks helps us to maintain our physical and psychological wellbeing. Smiling at and acknowledging another person literally activates a relaxation response in our mind and body which counters stress and activates happiness. While we take recommended precautions to avoid overly dense public spaces be sure to call, video chat and check in with loved ones, neighbors and fellow community members during this time.

Written March 11, 2020 
by:
Robin Reed MD, Co-Founder President, Internist
Jeanette Callahan MD, Co-Founder Treasurer, Pediatrician
Karen Craddock PhD, Co-Founder Clerk, Applied Psychologist

The Wellness Collaborative, Inc.
Web: thewellnesscollaborative.org