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Updates on Coronavirus/COVID-19 in Massachusetts

Updates on Coronavirus/COVID-19 in Massachusetts

As you’re all likely aware, the MA state of emergency measures are in effect until May 4, 2020, pending further updates.

And you’re also likely aware that we are in the thick of it now in Massachusetts. We are preparing for our surge of COVID-19, and while hoping it won’t be as bad as predicted, we all need to prepare and support our hospitals and frontline healthcare staff as they face the increase in cases.

To help with that support, here is the latest recommendations for what each of us can do to help “flatten the curve” and support these heroic frontline healthcare and emergency workers (as well as the grocery store workers, pharmacy staff, and other essential workers!).

What you can do

  • Social Distancing: never more important! Now is the time we need to continue to make a difference in how quickly this virus spreads.
    • Avoid going out if you don’t need to; it’s ok to take a walk/run as long as you stay a good distance (at least 6-10 feet) from others and wear your facial covering.
    • Only go to stores when absolutely necessary, and be directed when shopping (know what you need, don’t browse).
    • If possible, order online. Most pharmacies are doing at-home delivery services. However, be aware that grocery deliveries can be quite backed up, especially in the city.
  • Use facial coverings when you go out
    • The truth is that there are very few studies about this and how effective it is. That being said, one just came out showing it can have some effect. And at this point, it is being recommended given we need to do everything that is possible to slow this infection.
    • These facial coverings are thought primarily to prevent you from spreading it to others; so this is our chance to help our neighbors and community, and set an example so others will, in turn, do the same for us.
    • Here is a Boston Globe article on the change in this recommendation.
    • Here is a link from the CDC on how to use and make a facial covering.
    • Reminders:
      • Facial coverings do not take the place of social distancing
      • You have to remember not to touch your face even while wearing a mask
      • Be careful in removing your mask that you minimize how much you touch it
      • Have more than one so you can wash them frequently
      • Wash your hands thoroughly after removing your mask
    • *If you have any N95 or surgical masks, splash shields, or medical gowns at home, please consider donating them to local hospitals, ERs, or medical professionals.
  • Continue thorough, frequent hand-washing & surface-cleaning
    •  Instructions for proper handwashing from the CDC here.
    • General guidelines for prevention of COVID-19 here.
    • Additionally, avoid touching your eyes, mouth, nose, and face.

What to do if you are having symptoms of COVID-19

  • Know the symptoms of COVID-19.
  • Call (don’t physically go to) your doctor if you have a concern about COVID-19; please don’t flood the Emergency Department unless it is warranted.
  • IF you are having severe symptoms such as severe difficulty breathing, chest pain, etc., then call 911.
  • Thankfully, the vast majority of people can stay home while they recover from COVID-19, under supervision of their doctor.
  • There are numerous symptom checkers which can help with decision-making, including whether or not to get testing, in conjunction with your doctor:

Testing

We are still short of ample testing, sadly, as well as the protective gear to keep healthcare professionals safe while they are doing the testing.

That being said, there is more availability and the decision aids above in conjunction with conversation with your doctor can help decide if you should get tested.

While a positive test is considered a reliable result, a negative test does not necessarily rule it out. If you have a significant exposure or symptoms consistent with COVID-19 and test negative, self-isolation protocols would still be applied.

Stress and Supports

It is important to acknowledge that this is an incredibly stressful time. We’re facing an unprecedented situation with a tremendous amount of unknowns, and complete disruption of life as we know it. Some are facing severe financial crisis, poor access to food and medicines, personal health crisis, and grief from worry for and loss of loved ones. Anxiety is at a high.

In the face of this, I’m encouraging everyone to take a deep breath. We can only control our own thoughts, emotions, and actions. We are all in this together. We do know that the measures above can help, so focus on the part you can play.

Additionally, this is a good time to work on self-care to stay healthy, manage chronic medical conditions, and help manage the stress:

  • Stay informed with reliable sources but LIMIT how much social media and news you watch pertaining to the pandemic.
  • Find a way to exercise, preferably on a daily basis. There are a lot of online opportunities for this!
  • Eat mindfully. Try to make healthy choices while acknowledging that there may be difficulty obtaining certain foods, and that we may all find some relief in some comfort foods.
  • Meditate, practice relaxation, deep breathing. There are a lot of apps and online programs that can assist with this.
  • Stay socially connected, virtually. Reach out to family and friends. Utilize facetime, zoom, and other apps to connect face-to-face.
  • Sleep: shoot for 7-9 hours. Stay on a schedule.
  • Stay hydrated.
  • Limit caffeinated beverages, especially if you are feeling anxious.
  • Limit alcohol use. Alcohol can further mess with your mood and disrupt your sleep.
  • Stimulate your brain. Reading, puzzles, projects, conversations. Join an online forum on a topic that interests you. Find things to stimulate your thinking.
  • Be creative. Expressions of creativity can help manage stress as well as are good for the soul.
  • Laugh! Find a funny movie, read some jokes – laughter helps lift the mood and relieves stress!
  • Give back. Find ways to do things for others (virtually). If you know how to sew, make facial coverings for neighbors. As the saying goes, “perform random acts of kindness.” Donate, if you can. Send food or gift certificates to your local hospitals (check to see their preferences). Consider donating blood if you are not in a high-risk group.

The CDC has some recommendations along with a hotline if you are feeling in crisis: CDC Stress and Coping

There are a lot of meditation apps that can be helpful; Ten Percent Happier has done a podcast addressing “How to Handle Coronavirus Anxiety” – worth taking a listen.

It’s important to take good care of yourself. We are in a 100-yard dash right now, to flatten the curve; but we still have a marathon in front of us . . . so it’s a good time to establish good habits that can help preserve your health and well-being!

COVID-19 In the News

Medications for COVID-19

There has been a lot of questions regarding use of medications for both treatment and prevention of COVID-19. Hydroxychloroquine (Plaquenil) has gotten the most press, being heavily promoted by the President himself. While we are all hopeful that there will be effective and preventive treatments, the research is not yet there. Initial studies that sparked the interest were frankly not well-designed; plainly stated, their results could not rule out coincidence or chance or some unidentified factor.

There are numerous studies in progress, to evaluate Plaquenil as well as many other potential medications. The most recent randomized, controlled trials for Plaquenil or Plaquenil/Azithromycin have not been positive (although they were very small studies). Hospitals in Boston are involved in numerous trials of different medications.

Meanwhile, I do not recommend using these medications as they do have potential serious side effects and drug interactions. For every medication we use, we need to balance the benefit and the risk – and right now, there is no clear benefit. They are being used in hospitals for more severe disease on a case-by-case basis.

Additionally, there are people who need these medications to manage chronic conditions (such as Lupus and other rheumatologic diseases). Sadly, due to this premature promotion of the drug, the people who need it are having a difficult time getting it.

So my approach is that we need to practice patience and allow time for the medical researchers to evaluate these medications, as anxious as we are for a cure.

Blood Type and Coronavirus

There was a paper released from China that indicated some data suggesting a relationship between severe COVID-19 symptoms and blood type. I don’t put a lot of stock in those results. The type of data was not thoroughly vetted which means confounding variables, such as other genetic markers or other social-economic-health status determinants, may explain the results as well as just plain coincidence or chance. So I’m wary of this assertion and wouldn’t put much stock in it.

Ibuprofen/NSAIDs and Coronavirus

There were some early reports suggesting that ibuprofen and other anti-inflammatory drugs could worsen COVID-19. However, as this was investigated more, the evidence is lacking. The World Health Organization has since retracted it’s original advice. Factcheck.org summarizes it well. Currently, the recommendation is don’t stop taking NSAIDs if you are already using one for a chronic condition. Out of an abundance of caution, however, many are recommending that if you have a new ache, pain, or fever, try acetaminophen (Tylenol), as long as you don’t have a contraindication. Again, best to discuss with your physician.

Let me know if you have other questions or concerns!

Resources With Up-To-Date Information

Please seek out reliable sources of information. There is a lot out there that is not! Doublecheck things before promoting. Ask questions. It is important to be critical consumers of internet and news information!

Please be safe and take good care!