Common Questions and Worries

Today I want to address some common questions and worries.  There is a lot we don’t know right now, but I’ll try to give you the best information we have currently.

But first let’s talk about worrying (this doesn’t mean I’m minimizing the pandemic, just that worrying doesn’t help anyone):

  • Our ears make earwax, our mouth makes spit, our brain makes thoughts.  That doesn’t mean we need to analyze those thoughts and focus on them anymore than we analyze and focus on our spit or earwax.  If you have scary fears, you can just note them the same way you would a weird glob of earwax. “Huh, that’s a weird glob of earwax” or “Huh, that’s a scary thought.”  Thinking it doesn’t make it true anymore than your earwax is some fount of truth just because you pulled it out of your ear.
  • We all tend to suffer significantly more from worrying about things that never come to pass than from what actually happens.  Even if something scary does actually happen, worrying does not prepare you for it. People have often told me that worrying will make it less of a shock when it happens.  The opposite is true–people who choose to stop worrying are better prepared for whatever actually happens.
  • I used to be a world class worrier and I know from experience that it’s impossible to just stop worrying.  Worrying is almost like an addiction–it gives the worrier something of a high (a cortisol and adrenaline rush) that can be hard to walk away from. Normal life just isn’t as interesting! Learning to not worry is something you practice, like doing planks. It’s hard and it’s worth it. The first time you won’t last very long but over time you’ll get stronger and stronger.
  • Trying to completely dam up your thoughts is just as possible as damming up the mountain creeks–they just overflow.  But you also don’t need to chase the thought downstream–you’ll end up where you didn’t intend to be very quickly. Instead, just note the thoughts floating by and let them float away again.  If you find yourself fixating on your scary thoughts, just gently guide your mind back to where you want it to be.
  • Limit your exposure to the media–if something important happens, you’ll know.  You don’t need to be reading/watching every single thing as it comes out. Most of it is just generating something to catch your eyeballs so that  you’ll watch ads and they make money off of you. Don’t let them. Feeding that adrenaline/cortisol high with videos, articles, and podcasts feels exciting. But if you aren’t calling your officials and demanding change, that information overload isn’t helping anyone.  And you don’t need every detail to demand change.  Don’t passively consume scary stuff.
  • Fill your mind with something else.  I would highly recommend the podcast The One You Feed (click on link) . I listen with my kids because I want them to develop resilience through a deeper understanding of mental health and how to take care of themselves. I read a lot, and many of the books I’ve read and recommend have been covered on the podcast through interviews with the authors.  It’s not quite the same as reading the whole book, but you’ll get the main ideas and be able to decide if it’s worth getting the book.
  • If you are spiritual, now is the time to focus more on your practices. If your own place of worship is closed completely, there are many providing virtual services right now.  My family participated in our usual church on the sofa on Sunday. The kids chimed right along with the liturgy and we were all glad we’d participated. Regardless of your religion, there are virtual options right now.  Please avail yourself of them.

What do I do if I have cold and flu symptoms?

  • If you do not need medical care then please self-isolate (click on link for CDC guidance). Or if you prefer a more user friendly format, click on this link for a Vox article.
  • If you do need medical care (have concerning shortness of breath as described in yesterday’s email or are at higher risk from coronavirus and have worsening symptoms): go to the ER and tell them why you are there.  Try to cover your mouth and nose with a mask or scarf if it doesn’t make it too difficult to breathe.
  • If you aren’t sure whether you need medical care, give me a call and we’ll sort it out.  In general if you are under age 50 and low risk, make the decision in the same way you’d decide if you needed medical care for a cold or flu.  If you are miserable but breathing, take care of yourself at home. If you are having significant respiratory distress, go in.
  • Thankfully, children have relatively mild infections from coronavirus.  But it’s still RSV and croup season so don’t ignore concerning symptoms.  Your little one could still have one of the other common bugs.

Why can’t I get tested?

  • It is ironic that for a country that is typically all about getting tests done, more so than other countries, we currently can’t.
  • We have a severe shortage of tests, testing supplies and personal protective equipment right now so they are being saved primarily for people who are severely ill in the hospital and for healthcare workers.  Even though places like LabCorp are running the tests, doctors offices (including CSFM) don’t have the supplies necessary to collect the specimens.  Politicians keep saying that testing is available but the reality on the ground is that a lot of small practices don’t have what we need and the larger practices and hospitals have to ration the supplies for the most vulnerable.  It’s not an ideal situation.
  • The PCR test is actually very simple and can be run by many labs–the problem is getting permission to do so.  Hopefully these kinks will be worked out soon since it’s not a matter of coming up with a complicated new test, just getting everything up and running.  Remember, much smaller and poorer countries than us are able to run as many tests in a day as have been run total here. So it’s possible.
  • For most people, getting tested will just let you know whether you have it or not but won’t give us any information about what to do–we should all do the same thing.  Do the Five, isolate if you are feeling at all under the weather.  See above for what to do if you have symptoms of coronavirus.
  • My hope (based on what is possible, not on what’s happened so far) is that there will be multiple drive-through testing facilities set up in the coming days so that large numbers of people can be tested.  But that’s just a hope right now.

Is it going to be like Italy here?

  • It all depends on how quickly and thoroughly the current CDC recommendations are enacted.  The good news is that the measures we’re living with now (staying home from school and work, cancelling weddings, Doing the Five, etc) are probably being done much earlier in the course of the spread here than they were in Italy.  Both the U.S. and Italy started these restrictions when we were at around 3000 cases. But Italy has a population of 60.5 million and we have a population of 327.2 million.  While we don’t have as much testing so aren’t entirely sure, the death rates give similar information and those are much more accurate.
  • We should look at Seattle to have a better idea of what it might look like here. As of this writing, more than half the deaths in Seattle have been from one nursing home.  This is definitely turning out to be more deadly than influenza (probably 10 times more deadly). And at the same time, it’s the huge number of people flooding the healthcare system combined with the number of healthcare providers incapacitated by illness that is the biggest problem.  We have time to make plans and changes.  
  • If it does turn out to be as bad across the country as Seattle or Italy, most people will still be fine in the end so panicking now will not help.  I know that the majority of my patients have been through very difficult experiences in their lives and you are all resilient people who will do what needs to be done and get through this too.  Our lives may not be the same but we will adjust to a new normal.  
  • When something horrible happens, a lot of good always comes of it too.  The schools being closed mean that there won’t be any school shootings. The bars being closed and having nowhere to go should hopefully cut down on drunk driving deaths.  Most people I know are discovering that more time quietly with their families is causing them to rethink their values and previous pace of life. We can be grateful for the good even as we mourn for those who are suffering.

I’ve heard coronavirus is really contagious so why aren’t healthcare workers wearing the full body suits and goggles like I’ve seen on the news in other countries?

  • The doctors and nurses caring for people with known coronavirus are wearing full protective equipment.  The bigger concern right now is that in other countries where their numbers are coming down, they are also completely separating people who COULD have coronavirus from everyone else, sending them to separate hospitals, never to the usual ERs and primary care offices.  And caring for them in everything from hotels to gymnasiums so that they aren’t spreading the illness.
  • In place of these measures, our country is trying to move as much medical care virtual as possible and keep potential cases tucked up at home.  It’s imperfect but it’s better than having everyone coming in and out of a doctor’s office spreading disease. The goal is to keep everyone (healthy or sick) at home unless they need emergent medical care.
  • Coronavirus is very easy to transmit. That is why social distancing is so important.  Our bodies and body fluids and anything coming off our bodies need to not be in the same space with other people.  The virus can stay alive on surfaces for hours to days (they aren’t quite sure how long). But normal household cleaners work, so sanitize frequently.
  • Doctors are connected through online groups and are spreading information quickly.  Please trust that doctors know more than the media and are working behind the scenes to be ready.  Politicians don’t stop healthcare workers from coming up with solutions. These are real people working in hospitals and medical offices who don’t want it to be like Italy either.
  • Any also, social distancing.  Read my previous emails about it.  Please practice it.
  • It’s now pretty clear that you are contagious TWO DAYS BEFORE having symptoms as well as 14 days after.  Those two days are a great reason for everyone to just stay home. None of us want to find out we have coronavirus and have been spreading it without knowing.

What do I do for someone who is high risk?

  • Keep that person in a bubble–no going out in public and every person around them should be conscientious about Doing the Five
  • Don’t visit them if you don’t live with them.  The fewer people they come in contact with the better.  We now know that coronavirus is probably contagious for about 2 days before symptoms appear.  You don’t want to share. My sister has offered to set up my mom to Duo with the rest of the family so we can all spend time face to face without sharing germs.  (My mom also receives these emails…Hi Mom!)
  • Monitor your high risk loved one carefully and have a lower threshold for going to the ER.  People who are high risk can get dramatically worse over the course of just a few hours. So if they are getting worse rather than better, take them in for medical care right away.

We can all do our part to prevent the spread of the virus.  If we can flatten the curve, we can significantly improve outcomes.  Stay home if you don’t need emergency medical care and try to make the most of this forced quiet time.  

If you have any questions or thoughts feel free to reach out at any time.

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