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As the pandemic continues to drag on and we move into the winter months, a number of things have stuck out to me as a practitioner in the United States. There continues to be a great deal of confusion over the best practices for safety in our personal lives, as well as confusion over what does it mean to have a vaccine on the horizon. I’d like to tackle the things that I’ve noted in my clinical practice related to pandemic fatigue, confusion over conflicting news sources, and general confusion. I’ll tackle this in a three part series.

First of all, kudos if you continue to read. I completely understand being exhausted by the idea of another article on COVID19. The exhaustion is real. Every one of my patients speaks to it, I feel it, and all of my healthcare provider friends feel it too. We are in the middle of what will be a collective trauma that our generations are experiencing together.

However with that exhaustion, I’ve noticed a temptation to relax on important safety practices of personal hygiene and daily habits that increases the risk of contracting COVID19. It is important to not let the mental fatigue of living through a pandemic allow us to become either callous or lax towards the protocols that will keep the majority of us safe and healthy. It is natural to want to give up, but the reality is that everyday practices will help to reduce transmission of COVID19.

I’ll address these safety protocols first, and then I’ll address the confusion that I’ve seen in my patient body regarding who should stay home, and when someone should reschedule appointments or plan to stay home from everything in a post tomorrow. There is A LOT of confusion that I am encountering on this topic, so please if you don’t want to read about hand washing, stay tuned for tomorrow’s blog post “When To Stay Home Clearly Defined.” It will help all your healthcare professionals out.

Things to recommit to doing this winter:

Wash your hands for 20 seconds of sudsing up before rinsing off. Sing ‘Happy Birthday” 2x, or find another 10 second refrain to sing twice. Get into all the nooks and crannies between your fingers, make sure to scrub your thumb as that is so often overlooked while scrubbing your hands.

Wear a mask properly – that means over both your nose and mouth– when outside of your home. This includes making sure that your mask fits properly. You need to have a mask that will stay in place while you talk, fit snugly against your face without large gaps, and covers both your nose and mouth while you talk. If your mask slides down below your nose repeatedly while you talk, or there is always a large gap with the mask sagging away from your face– either at your chin or your nose, your mask does not fit correctly and is not providing any safety to those around you. Finally, masks with valves in them do not protect others from respiratory droplets. Please do not wear masks with a valve in them. Learn why here. Mask cages can help a mask fit better and create space for breathing room, but again, your mask must fit securely over and completely cover the cage. A number of patients that have had anxiety and sensations of claustrophobia from wearing masks were able to alleviate these feelings by using a mask cage.

Finally have hand sanitizer on your person when out and about, and use it whenever you touch your mask. Consider the outside of your mask as contaminated— whenever you touch it, you need to sanitize or wash your hands.

Maintain social distance even when wearing a mask. Many people think it is an either or situation, when in fact we need both masks and to socially distance. You can read more about masks and all the confusion here and in the above link for types of masks.

Change your mask daily if you work outside of the home, or more frequently. It is a good idea to wash your mask after running errands. Make sure to have enough clean masks to make it through the week, so that you can limit laundry to once a week on your masks.

Avoid in person gatherings for the winter, and commit to outside gatherings in the spring with fewer than five people if vaccine use is not widely occuring. If you do have to have someone in your home (ie- a pipe bursts and you need a plumber….we have had a couple such situations this year. Home maintenance loves to pick the worst time to have say, a furnace break down for good….), then crack a window and consider putting some water on the stove to steam. New information suggests that more humid air helps break down the airborne COVID19 particles faster, as well as having an influx of fresh air, or combine humidity plus a slightly higher indoor air temp for a few hours after the individuals in your home left. Read the details about humidity and indoor temperatures as they relate to COVID19 here.

Vaccine Notes: we will have to continue to wear a mask, social distance, wash our hands thoroughly until roughly 75-80% of the population have received the vaccine. Learn Dr. Fauci’s timeline here. There is so much that we currently do not know regarding the vaccine, but the most important unknown is whether or not the vaccine actually prevents infection from COVID19. It is likely that the vaccine prevents a series infection with COVID19, but you may still get a light infection and be able to spread it to others. This is why we need to continue with mask wearing, social distancing, and good hand hygiene until we know more about the vaccines available. To get answers to many of the commonly asked COVID19 vaccine questions, please check out this NPR article here. Make sure to continue to look for current sources of news on the vaccine, as like with COVID19 itself, new information is rapidly coming to light each day.

If exposed as much as possible stay in a specific room and away from other people in your household, also referred to as self-isolating. If possible, please use a separate bathroom from your household. Wear a mask whenever you have to leave your designated room and move about the house, and sanitize frequently touched surfaces after you move about the house. Please avoid sharing any personal items like dishes, towels, and bedding until you have a reliable negative test or 14 days from exposure has passed without symptoms developing. Tomorrow I will go over how accurate different tests are.

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