10 Lifestyle Changes to Survive COVID-19

Niagara Falls, Ontario. (Dr. Noorali Bharwani)
Niagara Falls, Ontario. (Dr. Noorali Bharwani)

“The new realities of working from home, temporary unemployment, home-schooling of children, and lack of physical contact with other family members, friends and colleagues take time to get used to. Adapting to lifestyle changes such as these, and managing the fear of contracting the virus and worry about people close to us who are particularly vulnerable, are challenging for all of us. They can be particularly difficult for people with mental health conditions,” says World Health Organisation.

Fortunately, we can do a lot to look after our own mental and physical health and to help others who may need some extra support and care.

Here is a list of 10 things you can do to keep yourself and your family safe, healthy and happy:

1. Fear of COVID-19. It is normal to be afraid of COVID-19. But if you follow the rules laid down by the health officers then you do reduce your risk of contracting the illness. It also helps keep your family stay healthy.

2. Loneliness, anxiety and depression. Loneliness is the state of mind. You can be in a company or relationship and you may feel lonely. You may be alone and feel sorry for yourself. It’s a feeling of sadness or even anxiety that occurs when you want company. Humans are social animals. Our connection to others enables us to survive and thrive. So, stay connected with your family and friends. Talk to them frequently and laugh with them.

3. Fear of fake news. Follow trusted news channels, such as local and national TV and radio. WHO website is another place to check for facts.

4. Maintain your daily routine. Early to bed, early to rise and go for a walk, go to a gym or workout at home.

5. Control your desire to eat. That is the best way to control your weight. If you are spending more time at home due to the pandemic then organize your eating routine. Avoid snaking in between meal times. Remember, it is easy to put on weight but very difficult to get rid of it.

6. Dangers of alcohol and drugs. Do not start drinking alcohol if you have not drunk alcohol before. Avoid using alcohol and drugs as a way of dealing with fear, anxiety, boredom and social isolation.

7. Support your children. Your children need your attention with at-home learning and make sure time is set aside for play. Help children find positive ways to express feelings such as fear and sadness. Sometimes engaging in a creative activity, such as playing or drawing, can help you with this process.

8. One for all, all for one. Each individual should act for the benefit of the group, and the group should act for the benefit of each individual. Even if we cannot be close physically, we need to stay close emotionally and reach out if someone needs support.

9. Protect yourself and protect others. Wearing a face mask is becoming mandatory in many places. You must also consistently and strictly adhere to good hygiene and public health measures, including frequent hand washing and physical (social) distancing.

10. Finally, have a sense of purpose in life. Make the best use of the time you have due to the circumstances beyond your control. Be in charge of your dreams and wishes. Never lose hope. Never give up. Tough times never last but tough people do.

Take care. Be safe. We can win this battle together.

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Use of high-dose influenza vaccine for seniors.

Sunrise in San Francisco. (Dr. Noorali Bharwani)
Sunrise in San Francisco. (Dr. Noorali Bharwani)

Our immune system changes as we get older. And flu season takes its toll. Use of high-dose influenza vaccine for people 65-years of age and older can have some benefits.

Canada’s flu season typically starts in October, when temperatures drop and people are in closer contact with each other indoors. The time to get a flu shot is between now and November, before the virus is circulating widely, says the Public Health Agency of Canada (PHAC) on its website.

As Canada braces for another flu season alongside COVID-19, experts say it’s difficult to predict the severity of the virus and the effectiveness of the flu shot this year.

How many Canadians are affected by the flu each year?

An estimated 3,500 Canadians die of the flu each year and 12,200 are hospitalized, making it one of the 10 leading causes of death in this country, says PHAC.

According to the national Influenza Vaccine Coverage Survey, we know that only 42 per cent of Canadian adults reported getting the flu shot last season, though it’s up from 38 per cent in the 2017-18 season and 36 per cent in 2016-17.

“Despite the fact that the influenza vaccine is much better than nothing… a lot of people still think that they don’t want to get it because it’s not good enough,” says Dr. Allison McGeer, a physician and infectious diseases specialist at Mount Sinai Hospital in Toronto (Second Opinion CBC Oct 12, 2019).

“Influenza vaccines are about 50 or 60 per cent effective in protecting you from hospitalization due to influenza. How good are seat belts at protecting you from dying in a car accident? About 50 per cent. How good are smoke detectors at reducing your risk of death in a house fire? About 35 per cent. So, we have this weird double standard that goes on with vaccines,” says Dr. McGeer.

There are two types of flu vaccines. The high-dose vaccines contain four times as much flu virus antigen – the part of the vaccine that stimulates the immune system – as regular Fluzone and other standard flu vaccines.

High-dose vaccines are meant for seniors. This can give older people a higher immune system response against the flu. Fluzone High-Dose is approved for use in Canada for adults 65 years of age and older. It costs about $75 and needs to be ordered in advance compared to regular Fluzone vaccine. There is no charge for the regular vaccine.

Fluzone High-Dose is given by injection. Like other flu vaccines, Fluzone High-Dose is made up of the three flu strains most likely to cause the flu during the upcoming flu season. A new vaccine called Fluzone High-Dose Quadrivalent that is made up of four flu strains has also been approved for people age 65 and older.

People age 65 and older have the highest risks of flu complications. Protecting this group from the flu is especially important.

Some older adults may have weaker immune systems, which can lead them to be less protected after a regular flu vaccine. In response to a regular flu shot, older people produce 50 per cent to 75 per cent fewer antibodies, which protect against the vaccine antigens, than do younger adults.

Studies have found higher antibody levels in older adults who received high-dose flu vaccines than in those who received standard flu vaccines.

In addition, one study found almost 25 per cent fewer cases of influenza in adults age 65 and older who took the high-dose vaccine compared with those who took the standard-dose vaccine.

In a large study comparing high-dose and standard-dose flu vaccines, those who received the high-dose vaccine were more likely to develop side effects during the week after getting the vaccine. Side effects included a fever and soreness at the injection site.

Canada’s National Advisory Committee on Immunization (NACI) concluded that Fluzone High-Dose vaccine for older adults should provide superior protection compared with our standard dose vaccine. It is 24.2 per cent more effective than regular Fluzone vaccine.

We are going to face many challenges this winter. So, make sure you get your flu shot as soon as it is available. Take care. Be safe. Protect yourself and protect others.

Start reading the preview of my book A Doctor's Journey for free on Amazon. Available on Kindle for $2.99!

Uncontrolled hypertension is a major risk factor for severe illness from COVID-19

Guitar shaped pool in Memphis, Tennessee. (Dr. Noorali Bharwani)
Guitar shaped pool in Memphis, Tennessee. (Dr. Noorali Bharwani)

Hypertension is often called the “silent killer.” Keeping that in mind, when was the last time you had your blood pressure checked?

It is important to have your blood pressure checked on a regular basis. Because of COVID-19 fears, many people are avoiding hospitals and doctors’ offices. Some recent research shows people with uncontrolled high blood pressure are at a high risk of severe illness from COVID-19.

What causes high blood pressure?

Common factors that can lead to high blood pressure include: a diet high in salt, fat, and/or cholesterol. Chronic conditions such as kidney and hormone problems, diabetes, and high cholesterol level can lead to high blood pressure. A family history, especially if your parents or other close relatives have high blood pressure. This can affect you.

Blood pressure above 130/80 mm Hg is considered high blood pressure.

Most of the time, high blood pressure has no obvious symptoms. But left untreated, it can damage the blood vessels. This damage can lead to a range of health problems, including: heart attack, stroke, kidney disease and many others.

More than 100 million North Americans have high blood pressure. At least 30 per cent of these people are not aware they have high blood pressure. Uncontrolled hypertension is very dangerous. It’s even more dangerous because when a patient has uncontrolled high blood pressure, COVID-19 is more likely to be fatal or lead to hospitalisation and serious complications.

The Centers for Disease Control and Prevention (CDC) estimates that people with hypertension are three times more likely to be hospitalized if they are infected with the coronavirus, compared to those who don’t have high blood pressure. People of any age with certain underlying medical conditions are at increased risk for severe illness from COVID-19.

We are learning more about COVID-19 every day.

A recent study published in April in Journal of the American Medical Association (JAMA) found that hypertension was one of the biggest predictors of severe illness and death from COVID-19, along with diabetes and obesity. Controlling hypertension, diabetes and obesity is very important.

We eat too much and we do not exercise enough. Our blood vessels become harder and less compliant with age. When the blood is pumped out of the heart into less compliant blood vessels, the blood pressure goes up. So, the heart has to work harder and eventually it becomes tired, weak and fails. It silently causes damage to our vital organs and eventually results in heart attack, congestive heart failure, stroke, kidney failure and blindness.

Research has shown that 50 per cent of the patients with high blood pressure discontinue their antihypertensive medications by the first year. This is no good.

Four steps to lowering your blood pressure:

  1. Exercise most days of the week.
  2. Consume a low-sodium diet.
  3. Limit alcohol intake to no more than one to two drinks per day.
  4. Make stress reduction a priority.

Take care. Be patient. Be safe. Protect yourself and protect others.

Start reading the preview of my book A Doctor's Journey for free on Amazon. Available on Kindle for $2.99!

Temperature screening to detect COVID

Mausoleum of Aga Khan III, Sir Sultan Muhammed Shah, located along the Nile of Egypt. (Dr. Noorali Bharwani)
Mausoleum of Aga Khan III, Sir Sultan Muhammed Shah, located along the Nile of Egypt. (Dr. Noorali Bharwani)

Symptoms of COVID-19 can vary from person to person. Symptoms may also vary in different age groups. In severe cases, infection can lead to death.

Symptoms may take up to 14 days to appear after exposure to the virus. One of the primary symptoms with COVID-19 is an elevated body temperature of above 38˚C (100.4˚F). The normal human body temperature remains around 36.5°C to 37°C, regardless of the external temperature or weather.

Some workplaces have started screening their employees using touchless temperature scanners in order to determine whether they may enter the employer’s workplace.

As Canada continues to reopen, some grocery stores, salons and other businesses have implemented temperature screening in an attempt to prevent the spread of the virus.

The process was made mandatory for all air travellers in Canada in mid-June. Any passenger who shows a fever on two measurements, taken 10 minutes apart, will be asked to rebook after 14 days.

However, some experts wonder whether the step is effective given a person can shed the COVID-19 virus without having a fever or any change in body temperature. The tool often used to measure temperature has also been shown to be unreliable.

A person may have elevated temperature because of certain pre-existing conditions, weather and what the person was doing immediately prior to having temperature checked.

A person may be infected with the virus but may not have symptoms like fever. They are capable of shedding and transmitting the virus. In the pre-symptomatic phase, a temperature check won’t help. If you have fever then we know what we are dealing with.

For those reasons, temperature screening has not been recommended by Canada’s chief public health officer. But temperature checks remain part of COVID-19 detection though not all cases present with fever.

According to World Health Organisation (WHO), temperature screening alone, at exit or entry at the airport, is not an effective way to stop international spread, since infected individuals may be in incubation period, may not express apparent symptoms early on in the course of the disease, or may suppress fever by taking medications.

Temperature screening measures require substantial investments for what may bear little benefits. It is more effective to provide prevention recommendation messages to travellers and to collect health declarations at arrival, with travellers’ contact details, to allow for a proper risk assessment and a possible contact tracing of incoming travellers, says WHO.

Temperature screening should be considered just one layer in a screening process. It is within the rights of a business to deny you service on the grounds of a high temperature. You can be denied service if you refuse to wear a mask or refuse to have your temperature taken. This is because employers and employees have the right to a safe working environment.

Employers are responsible for the safety of their employees.

The most effective way to protect yourself against the new coronavirus is by frequently cleaning your hands with alcohol-based hand rub or washing them with soap and water. Cough into your sleeve. Maintain social distancing. Wear a mask in public places. Maintain adequate ventilation and adequate environmental cleaning.

In situations where you cannot keep a safe distance from others, public health officials recommend the use of a non-medical face mask or covering to prevent spreading the respiratory droplets that can carry the virus.

Take care. Be patient. Be safe. Protect yourself and protect others.

Start reading the preview of my book A Doctor's Journey for free on Amazon. Available on Kindle for $2.99!