COVID-19 Response Strategies

In these unprecedented times, as we continue to learn more about COVID-19, we must be vigilant in weeding out false information and seeking out credible resources to educate ourselves on the subject. These tactics are essential for easing anxiety and assuaging fears. Because the situation is constantly evolving, it can be difficult not to panic. While much of the information regarding this virus continues to develop, we can still take comfort in knowing that despite the increase in confirmed cases, the risk to the general public continues to be low. Many states have closed schools for multiple weeks, people are told to avoid heavily populated areas (many of which have been mandated to close), to work from home, and to cancel unnecessary travel. Dr. Rahal continues, “It is estimated that 40% to 70% of people will eventually get COVID-19, most will recover, and the virus will be mild. But we need to slow down the rate at which people are becoming infected so that our healthcare system can keep pace, and is not overburdened all at once by severe cases. We want to avoid the devastation that Italy is currently experiencing.” With schools closed for the foreseeable future and public establishments slowly following suit, people should heed expert advice and take the virus seriously. Still, it’s important that we not panic, educate ourselves from reliable sources, practice good hygiene, and learn ways to protect our loved ones. Cynthia Cervoni, PhD, clinical psychologist at Stony Brook University Hospital, says, “The combination of extensive media coverage and lack of official information appear to be creating an atmosphere of panic and worry. Be mindful of your sources. It is important to seek information from reputable, evidence-based resources, like the World Health Organization or the Centers for Disease Control.” Here is a recap of the coronavirus (COVID-19) and how we can take measures to protect ourselves and our families.

Symptoms

Like most infectious diseases, symptoms vary from person to person and can range from mild to severe. While the coronavirus has been compared to the flu, the symptoms appear to be different. The most common symptoms are:

FeverDry coughTirednessShortness of breath

Less common symptoms include:

Aches and painsRunny noseSore throatDiarrheaLoss of taste and smell

The World Health Organization states that more severe infections of the disease can lead to:

PneumoniaSevere acute respiratory syndromeKidney failureDeath

Symptoms can appear two to 14 days after exposure, which is one of the reasons the virus is so contagious. A small percentage of people can become infected and not develop any symptoms or feel sick, another reason why the virus spreads so quickly. The World Health Organization says about 80% of people recover from the disease without needing special treatment.

How Is It Transmitted?

COVID-19 is mostly transmitted from person to person via droplets. Droplets from a cough or sneeze can be transmitted from an infected person to another person and inhaled into your nose and mouth. This typically happens when people are in close contact with one another—less than six feet apart. The virus also can live on surfaces. According to the World Health Organization, the amount of time it can live depends on a variety of variables including, type of surface, temperature, and humidity. Worldwide school closures have been implemented to prevent the disease spread, particularly among children. Jonathan Jassey, DO, a pediatrician in New York, says that “a vast majority of illnesses in kids is viral, at least 75% of what we regularly see is viral.” Some experts suggest that children can pass along the virus to others without even knowing it because their symptoms are mild and appear to resemble a common cold. On the other hand, the Centers for Disease Control and Prevention (CDC) has said that people seem to be most contagious when they are the “sickest.” Community spread, or how the virus spreads within one’s community, is something that is still being investigated. Some parts of the United States are in the initiation phase, while others are in the acceleration phase. For more information on transmission see: How It Spreads at the CDC.

Risk

Because this virus is new, we do not have the antibodies to fight it off; therefore, we are all at the same risk of getting it, becoming ill, and spreading it. However, the personal risk to the virus continues to be low and varies depending on where you live, if you have traveled to a high risk area, and if there is community spread. It’s important not to underestimate your healthy habits. If you are a person with an underlying health condition but have healthy behaviors, such as eating a nutritious diet, getting adequate sleep, and exercising, you must be prepared, but should not panic. Dr. Rahal says: “Know that your healthy habits matter and can aid in your immune response and recovery.” It is important for people with these types of conditions to stay in close contact with their medical team for support and advice. Try not to let your condition make you feel disempowered and continue to practice your healthy habits, which include your regular disease prevention strategies. Based on the most readily available evidence, adults make up the most cases and children seem to be spared to a degree. Some doctors suggest that children are more likely to get the flu, which many kids and parents have experienced in the past. Confirmed cases of COVID-19 in children seem to have mild symptoms. Dr. Jassey says, “There are many hypotheticals as to why this is happening, one of which is that as we age our immune systems weaken." Although we don’t know exactly why children are being spared, the fact that we don’t see many children getting sick from this virus is certainly welcome news.

Coping With Pre-Existing Conditions

That said, parents of children with pre-existing conditions need to be prepared. In children with Type 1 diabetes, for instance, Tina Cheng, DO, pediatric endocrinologist at NYC Health and Hospitals/Elmhurst Hospital Center says, “According to the American Diabetes Association and the Juvenile Diabetes Research Foundation, there should be no reason to think that COVID-19 will pose different risk between the different types of diabetes mellitus. The risks may vary depending on age, complications, and how well they’ve been managing their diabetes.” Dr. Cheng recommends staying in as much as possible, especially if you are in a place experiencing community spread. Additionally, it is important for parents to be aware of the following:

Know the contact information of your doctors and health care team, pharmacy, and insurance provider.Make sure you have enough diabetes supplies—medications, insulin, alcohol swabs, test strips, ketone strips, needles, syringes, and pump supplies.Most importantly, review sick day management guidelines.

In addition to personal risk and community risk, physicians continue to be most concerned about systemic risk and the ability of the health care system to keep up with the overload of anticipated cases. Hence, the reason why many areas of the country are asked to stay home until we can get control over the situation.

Things Outside of Your Control

It is not easy being told that you need to distance yourself from loved ones, cancel trips, parties, and celebrations, keep your kids home from school while you work from home, close your business, or scramble to find home essentials and groceries. Unfortunately, these changes are outside of our control. This situation is unlike anything we’ve ever had to endure. But we must temporarily surrender to our local advisories. We need to work collectively in our communities to protect each other. It’s not going to be easy, but once we accept it, hopefully we can move forward and persevere. We also cannot control other people’s actions, fears, and thoughts.

Prevention

As parents, we want to protect our family and make them feel safe. Even during this very uncertain time, we can still do that. We can opt to engage in healthy behaviors that will keep our minds and bodies alert, healthy, and strong. We can aim to eat nutritious meals, get adequate sleep, exercise, laugh, play, and practice mindfulness.

Practice Proper Hand-Washing and Hygienic Behavior

You may not be able to prevent your toddler from mouthing toys all the time, but you can do your best to make sure your children are washing their hands properly (for at least 20 seconds with warm water and soap) after they appear dirty, after bathroom use, and before meals. Explain to them that it is important not to touch their mouths, noses, or faces after touching surfaces, too. It’s a hard concept for children to understand and they may forget at times. When they do, don’t panic. It’s worse to create phobias. Simply correct them and tell them they’ll do better next time.

Disinfect Surfaces and Avoid People Who Are Sick

Cleaning and disinfecting (with wipes or alcohol that has at least 60% concentration) frequently touched surfaces such as iPads, iPhones, computers, keyboards, doorknobs, light switches, and chairs can help to kill germs. Dr. Jassey also recommends “laundering items using the warmest appropriate wash cycle. For example, plush toys can be a vector of transmission of germs.” It is also a good idea to launder sheets, blankets, and clothing more often. Avoid people who are sick and stay home as much as possible, especially if your area is being heavily affected.

Fuel Your Body With Good Nutrition

Adequate nutrition is important for health throughout the lifespan. Healthy eating can also help people manage chronic diseases. A variety of fruits, vegetables, fiber, healthy fats, and lean protein can keep energy levels high and provide the body with the antioxidants, vitamins, and minerals it needs to keep the immune system strong. It’s never too late to start eating better. Now that we are home, we can enjoy family meals and start cooking more. Every nutrient functions differently and, while there is no one super immune boosting food (or vitamin), certain nutrients play a larger role in immune function. Protein is especially important for healing and recovery. Vitamins A, C, and E are also important in immune function as they stimulate antibodies, act as antioxidants, and protect against infections by keeping skin and tissues in the mouth, stomach, intestines and respiratory system healthy. Foods rich in these nutrients include sweet potatoes, pumpkin, butternut squash, carrots, citrus fruit (orange, lemon, lime), berries, melon, peppers, tomatoes, almonds, and fortified cereals.

Get Enough Sleep

Sleep is often underrated and underutilized. Now that parents have their kids home, they may be working more at night to make up for time during the day. But keep in mind that getting adequate sleep is important in disease prevention and treatment. Dr. Jassey says, “Studies show that people who don’t get enough sleep are at increased risk of getting sick. During sleep, your immune system produces cytokines and certain cytokines are needed to help to fight infection. In addition, disease fighting antibodies are reduced if you don’t sleep enough.” The amount of sleep you should get depends on your age and sleep is important for all ages. Sleep recommendations based on age from the National Sleep Foundation are as follows:

Newborns (0-3 months): 14-17 hours (total per 24 hours)Infants (4-11 months): 12-15 hoursToddlers (1-2 years): 11-14 hoursPreschoolers (3-5): 10-13 hoursSchool-age children (6-13): 9-11 hoursTeenagers (14-17): 8-10 hoursYounger adults (18-25): 7-9 hoursAdults (26-64): 7-9 hoursOlder adults (65+): 7-8 hours

Exercise

The CDC reports that people in good health are less likely to contract the virus and less likely to experience additional complications, such as secondary infections, from COVID-19. Exercise is a healthy habit that contributes to the health of yourself and your children. Now that most gyms have been forced to close, you may be wondering how you’ll get your workout in. There are plenty of ways to do this. If you have equipment at home you can stream videos from YouTube or other entities, like Beachbody on Demand. Many gyms that have closed are now offering online sessions—check those out. Engage in family activities—go for a hike, wash the car, have a dance party, walk the dog, ride bikes, play in the backyard—any type of exercise is better than none.

Maintain a Schedule

Maintaining a schedule can reduce stress and anxiety in the home. Dr. Cervoni says, “The impact of stress on our immune systems is well known.” She suggests that families “create a schedule for yourself and your children. It does not have to be rigid or tightly packed, but try to keep up with a consistent wake up time and mealtimes throughout the day." “Schedule time for work and school activities and leave room for some extra play if possible,” Dr. Cervoni says. “You can keep the schedule posted in a communal space, so everyone knows the expectations.” You can also have your children help you make the schedule. They can choose activities they’d like to do for “specials” or help make their favorite lunch that they don’t get to eat in school.

Take a Break From Media

It can feel impossible to avoid the news, mostly because it changes daily and we want to stay current, “Everyone can benefit from limiting exposure to news and media coverage, especially children,” Dr. Cervoni says. “Though limiting children’s media exposure, do make sure you are having conversations with your children about the coronavirus. Use language they can understand, dispel any misinformation, and quell excessive worries they may have.”

Unify With Your Community

This is our time to be part of something larger than ourselves. Offer support to elderly neighbors or those that live alone and ask for help when needed. Share information, helpful tips, and at-home activities with neighbors and parent friends. As difficult as this situation is, we are in this together. We must act as a unified front.

Keep a Journal

Write down your feelings. Express your fears, your worries and your joys. In these unprecedented times, you’ll have a narrative of what you went through and what you’ve overcome. Journaling can not only provide nostalgia but can reduce stress and be therapeutic.

Call Friends and Family

Having conversations won’t prevent you from contracting the virus, but it will keep you connected to humanity and remind of you the importance of relationships. Consider having your child or children request one family or friend to reach out to daily. You’ll be surprised at how much these interactions can help.

Treatment

If you or your child has been exposed to someone with COVID-19, don’t panic. Continue to stay home and wait 14 days. You may or may not get the virus. If you are symptomatic, most physician offices are recommending all people with symptoms call the office and be screened before coming to the office. No walk-ins are permitted, and many are offices are offering telehealth via video or phone consults. If you suspect you have gotten the virus and have not been tested, the CDC recommends continuing to wash your hands often with soap and water or an alcohol-based sanitizer that contains at least 60% alcohol. As much as possible, stay in a specific room and away from other people in your home. Also, you should use a separate bathroom, if available. If you need to be around other people in or outside of the home, wear a face mask. If you are sick, avoid sharing personal items such as dishes, towels, and bedding. Fluids, rest, cool mist humidifier, and fever-reducing medications are recommended. Keep in mind that children and teenagers should not use medications that include aspirin due to their risk of Reye syndrome. If your symptoms or your child’s are not getting better in three or four days or are getting worse, call your doctor’s office for advice. In these instances, supportive care, such as hospitalization, oxygen, and fluids may be necessary while your body fights off the infection. If you or your child have a medical emergency, call 911 and notify the dispatch personnel that you have or may have COVID-19. Will a mask help me? The World Health Organization says the following about masks:

If you are healthy, you only need to wear a mask if you are taking care of a person with suspected 2019-nCoV infection.Wear a mask if you are coughing or sneezing.Masks are most effective when used in combination with frequent hand-cleaning with alcohol-based hand rub or soap and water.If you wear a mask, then you must know how to use it and dispose of it properly.

Should families cancel all travel? At the rate we are going, it is likely that we won’t have a choice in this matter. Most experts would agree that it is not advisable to travel and that in efforts to slow down the spread of this disease, we should reschedule all travel that is non-essential. Should children keep their regularly scheduled appointments, such as well visits? Currently, many physician offices are encouraging children to keep their well visits. Because this situation is constantly evolving, this could change. Dr. Jassey says, “Annual visits, especially for younger infants and toddlers, are important for vaccines.” You are likely to continue to receive communication from your physician offices about their updated policies and procedures. Can offices begin testing? Depending on where you live, your physician offices may or may not have testing abilities. This continues to develop. If you are concerned about your health or the health of a loved one, your primary care doctor or pediatrician should be able to advise you on next steps. Do we know if this is seasonal? Currently, we do not know this answer, and Dr. Jassey says, “There is no idea how to predict. When the swine flu swept through the United States, we saw a ton of flu cases in June and July. It’s just too soon to know.” According to the WHO, from the evidence so far, the COVID-19 virus can be transmitted in all areas, including areas with hot and humid weather. There is no reason to believe that cold weather can kill the new coronavirus or other diseases.

A Word From Verywell

The COVID-19 pandemic is causing major chaos and distress in our lives and the lives of our children. As parents, it’s our job to keep our kids safe, answer their questions, and ease their fears. Although there is a lot to learn about this novel virus, for most people, particularly children if they contract the disease, symptoms will most likely be mild and they will fully recover. Doctors, experts, and health organizations have urged us to stay vigilant and do our part to slow down the spread of this disease. Although much of these circumstances are out of our control, we can take part in keeping our families healthy and safe. Doing your duty can help to save lives of people you’ve never even met. As this situation continues to evolve, make sure you are checking in on your mental health, taking deep breaths, reducing media exposure, moving your body, eating nutritious food, and turning to reliable sources for information and advice. The information in this article is current as of the date listed, which means newer information may be available when you read this. For the most recent updates on COVID-19, visit our coronavirus news page. What Pregnant Women Need to Know About Coronavirus How to Control Your Temper While in Quarantine