A Field Hospital

The national news reports a field hospital in New York’s Central Park.

Battle conditions exist and we must be prepared to meet the invader, head-on.

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I look at health issues from a nursing point of view and often get frustrated when the health solutions I see aren’t occurring within the system I occupy.  When this happens I get aggravated.  This aggravation comes from working for 35 years within the nursing profession.

Control is an illusion, especially in a rapidly changing environment.  However, I see the empowerment of our frontline staff and first responders including the transformational leadership into an army of well-armed confrontational leaders.  These military-style health care, first-line providers have the power and ability to attack, counter-attack, surprise, and cyber-attack the COVID-19 coronavirus.

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As we mobilize, this virus finds itself without sufficient support to replicate, stretching its resources so far that there’s not enough space or material to provide for reproduction since its harsh environment is void of welcoming micromanagement – the virus will die.

The COVID-19 virus finds it difficult, if not impossible, to replicate in this hostile environment.  The virus depends on laden air droplets passed from an infected host to spread its continuous, unchecked empowerment of disease.  Traveling down roads of destruction is difficult, if not impossible, for COVID-19 when our empowered confrontational leaders lead the way and push back the invading force of combat.

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As we reflect on the field hospital in New York’s Central Park let’s examine the reason for its presence – COVID-19.  Someone, somewhere let their guard down when dealing with safe, conscientious health care. The world is paying the price.  We are at war with an enemy unseen by the naked eye.

However, we gathered our forces, supported our frontline staff and first responders.  Our leadership is transformed into an engaged, empowered sentinel network of combat generals commanding a ‘boots-on-the-ground’ force ready and able to defend us against this invader.

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We are combat-ready.  Our mission is to stay combat-ready.

 

 

 

 

 

 

Our Best

We are being challenged in all parts of our lives.

This is the time to show our best potential.

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Remember, a piece of coal under pressure produces a diamond.

We already know practices that keep us at our best – a healthy diet, exercising, financial awareness, enjoying the company of a family pet and physical mindfulness.

• When we breathe in, our diaphragm – the main muscle used for breathing – contracts and moves downward, allowing our lungs to expand into our chest. Meanwhile, the muscles between our ribs contract to pull our rib cage upward giving our chest cavity space. This allows oxygen we inhale to pass into our bloodstream. We feel relaxed.
• Eating a well-prepared, healthy diet in a mindful manner allows our digestive system the opportunity to absorb the nutrients it needs to fuel the exchanges to keep us healthy. Sitting at the table and eating a meal with our family is a good thing.
• People who cook at home at least six times a week take in fewer calories, less salt, and save about $100 a month compared to those who eat out that often.  According to the American Journal of Preventive Medicine.
• 36.5% of U.S. households own a dog while 30.4% own a cat. Owning a pet is important in terms of getting people out of bed in the morning and engaging in routines but also connecting them with others.  This is particularly important today when some people who are isolated may be prone to feelings of depression.
• Staring loving into our pooch’s eyes raises our body’s levels of oxytocin, a feel-good hormone that promotes mindfulness.  Sharing our home with a pet gives us comfort.

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• A study in Health Affairs found that 4 million Americans – 1 in 6 Americans – have past-due health care bills on their credit report, a debt totaling $81 billion. (18% of the GDP).  This study also concluded that when families routinely set aside a little over $250 they are less likely to miss these payments.  We are struggling but we do pay our bills.
• A WebMD article referring to an AHA study indicates that exercising can slow the aging process by up to 9 years.  1 in 4 adults meet the recommended exercise guidelines of 30 minutes a day of moderate aerobic activity five days a week. That’s up from less than 1 in 5 a decade ago. (CDC) Exercising daily inside our home is a great idea.

So, we’re doing things right; we’re working well under pressure – we’re on our way to being diamonds.

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We’ll get through this challenging time together. In the distance, I see a very large, brilliant, sparkling diamond glistening in the sun.

 

 

You Control the Soap

A powerful weapon against germs is in the palm of our hands when we use soap and water correctly to wash our hands.

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An article by WebMD (March 6, 2020) reminds us that we can’t necessarily control what we touch or who else touches it but we can look after our own hands.

Correct handwashing hits germs on two fronts: physically removing germs and viruses from our hands and then it bursts open any outer coating the agent may have.

However, a 2013 study using trained observers watched 3,700 people wash their hands and found:

• 5% washed their hands correctly
• 1 in 4 did the ‘splash and dash.’
• 10% didn’t wash at all
• 5% spent more than 15 seconds washing, rubbing, and rinsing

Dr. Elizabeth Scott, Ph.D. who co-directs the Center for Hygiene and Health in Home and Community at Simmons University in Boston says that those efforts aren’t enough if we’re trying to keep from getting sick.

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Scrubbing our hands with soap is a vital step to good hand washing.  The coronavirus, which has left 100,000 worldwide infected with COVID-19, – is encased in a lipid envelope — basically, a layer of fat.  Soap breaks that fat apart and makes the virus unable to infect us.  Together, friction, water, and soap can rinse these infective agents away.

We already know that washing our hands under running water for at least 20 seconds as we sing a cute song is a scientifically accepted process.  So, adding friction and soap to the process gives us the triad that we need to help combat the COVID-19 virus.

We need to pay attention to places on your hands that we normally don’t consider.

• lower palms
• around our fingernails
• around our nail bed
• the back of our hands

Dr. Donald Schaffner, Ph.D. at Rutgers University in New Brunswick, NJ who studies predictive food microbiology, hand-washing, and cross-contamination states that using paper towels is an effective tool beyond just simple hand washing because paper towels remove even more germs than just washing alone. Dry hands are also less likely to spread contamination than wet hands.

Here are some interesting statistics about contamination and cleanliness.

• 67% of public toilet users don’t wash their hands at all
• 6 seconds is the average time a person washes their hands after using a toilet
• 92% of phones are contaminated with bacteria such as staphylococci and E. coli.
• 100% reduction in bacteria after cleaning a keyboard with an antibacterial wipe

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Teaching people about handwashing helps them and their communities stay healthy.  Handwashing education in the community reduces:

• the number of people who get sick with diarrhea by 23-40%
• diarrheal illness with weakened immune systems by 58%
• respiratory illnesses, like colds, in the general population by 16-21%
• absenteeism due to gastrointestinal illness in schoolchildren by 29-57%

“We touch a lot of different surfaces that hundreds of others might be touching,” according to Kelly Reynolds MSPH, Ph.D. a professor and environmental microbiologist and the University of Arizona. Germs spread quickly.

You Control the Soap.

 

 

 

 

Decisions

This is a period of decision making not only for the world and our country but each of us, personally.

Often our decisions are subjective – based on how we feel.

Sometimes our decisions are objective – based on proved scientific research.

Usually, it’s a combination of both feelings and facts.

So, as we are embroiled in a pandemic world of coronavirus COVID-19, opportunities present for all of us to reflect on personal choices.  Information is available to keep us safe from potential exposure to illness if we chose to avail ourselves of the guidelines.

I was pondering this situation as my daughter sent me this picture.

People are powerful decision-makers; all people, men, and women, and children.

Whatever your political belief or constitutional conviction we are presented with a situation that brings us together in a unique way.

So, as people in power make decisions for others and as adults make decisions for children, let’s decide to make good, healthy decisions that promote wellness for all of us.

 

Viruses, Epigenetics, Methylation

According to health organizations, emerging viral infections are a major threat to global public health.

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COVID-19, which appeared in December in Wuhan, China and spread quickly around the world, is actually a type of coronavirus (CoV) – one that is similar to SARS-CoV and MERS-CoV, all which attack the respiratory system and derive from animal origin. (A Look Into the Epigenetice of a Coronavirus Infection – March 10, 2020).

Since these new viruses are able to mutate quickly in humans and are constantly changing, it’s up to the host’s immune system to ‘clear’ the infection.  Epigenetics may offer some clues into this viral puzzle.

Epigenetics is the scientific study of both genetic and non-genetic factors that determine a cell’s specialization.

Methylation is a chemical tag interwoven on the DNA that influences the expression or silencing of the cells’ basic DNA without rearranging the structure.

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Viruses from the family of coronaviruses are not able to change genetic sequences.  However, they can alter the expression, allowing them to defeat a host’s immune response and successfully spread infection.  This process is not yet fully understood but it’s clear that viruses antagonize the immune system.

Coronaviruses are common in humans and animals and can cause forms of upper-respiratory infections such as a cold, or bronchitis and pneumonia according to the CDC (Center for Disease Control and Prevention).  Yet, it is rare for an animal coronavirus to infect people and then spread from person to person.  However, this has happened with SARS-CoV, MERS-CoV, Avian Influenza (H5N1), Swine/Variant Influenza (H1N1) and now COVID-19.

In a study published in 2018 in the  Proceedings of the National Academy of Sciences, scientists identified that the epigenetics process of methylation was the primary suspect in suppressing the production of antigen presentation molecules in diseases.  As well, methylation was involved in lessening the immune response.

In other scientific studies, it’s obvious that viruses can delay or offset pathogen recognition as well as interferon-stimulated gene (ISG) expression levels by encoding proteins that prevent immune signaling response.  The immune systems can be inhibited into believing that no threat exists because the virus produces a protein that blocks the antiviral gene function.

Right now, we’re in the midst of fighting one of the most prolific viral outbreaks of the 21st century, it’s an emerging epidemic-prone disease and it’s efficient at spreading.

Any information gained from scientific studies should be made public across political and international boundaries.  Having information in a rigorous, peer-reviewed manner will increase the utility and leverage of already existing data systems, which may be vital in developing both vaccines and therapeutic treatments. (Natalie Crowley, A Look Into the Epigenetics of a Coronavirus Infection March 10, 2020)

The Center for Disease Control and Prevention (CDC), as well as most other medical experts, have determined that the Novel Coronavirus (nCOVID-19) poses a high risk for older adults and people who have severe chronic medical conditions like heart, lung or kidney diseases, etc… It’s vital to maintain some basic infection-control measures.

PRECAUTIONS

Avoid close contact with people who are sick

Clean your hands frequently

Wash your hands often with soap and water for at least 20 seconds, especially after being out in public, blowing your nose, coughing, or sneezing.

If soap and water aren’t available, use a hand sanitizer that contains at least 60 % alcohol.

To the extent possible, avoid touching ‘high-touch’ surfaces in public places, like elevator buttons, door handles, handrails and handshaking with people.  Use a tissue or your sleeve to cover your hand or finger if you must touch something.

Avoid touching your face, nose, and eyes.

Clean and disinfect your home to remove germs: Practice routine cleaning of frequently touched surfaces – tables, doorknobs, light switches, handles, desks, toilets, faucets, sinks, and cell phones.

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EXTRA CAUTION

Avoid crowds, especially in poorly ventilated spaces.  Your risk of exposure to respiratory viruses like COVID-19 may increase in crowded, closed-in settings with little air circulation if there are people in the crowd who are sick.

The CDC recommends that you defer ALL cruise ship travel worldwide, particularly if you also have underlying health issues.

You should avoid non-essential travel such as LONG PLANE TRIPS, and especially avoiding embarking on cruise ships.

Be sure that you have plenty of over-the-counter medicines and medical supplies (tissues) to treat fever and other symptoms.  Most people will be able to recover from COVID-19 at home.

Have enough groceries and household items on hand so that you’ll be prepared to stay at home for an extended period of time.

Medicare:

•  Covers lab tests for COVID-19
• Covers medically COVID-19-necessary hospitalizations
• Covers COVID-19 vaccine when one becomes available (covered – Medicare Part D)
• Advantage Plan may waive cost-sharing for COVID-19 telehealth benefits
• Covers “virtual” check-ins – ‘brief’, if it isn’t related to a medical visit within 7 days
• Patient needs to consent ‘verbally’ for ‘Virtual’ visit – doctor must document consent
• The COVID-19 patient may have the usual coinsurance/deductible waived
• Covers ‘telehealth’ cost if the patient initiates communication
• In a ‘rural area’ – you can have a ‘full visit’ in telehealth designated area
• Medicare is developing ‘New Billing Codes’ for COVID-19 services
• Instructs ‘State Survey Agencies’ on COVID-19 infection prevention
• Instructs nursing homes/hospitals to review COVID-19 infection control procedures
• Issues nursing home guidelines for treating patients with COVID-19

General Signs and Symptoms of a COVID-19 infection may include.

Cough

Difficulty breathing

Fever

Chest in your chest

Bluish color in your face or lips

These are general symptoms of a potential infection.  If you suspect that you or someone you know is infected call your local medical provider.

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COVID-19 is an emerging, global-health emergency that needs to have our highest priority.