Doc’s Corner

How to Curb Your Anxiety about Covid 19

Despite the obvious seriousness of the situation that the Covid 19 virus presents, it is important to keep the threat in perspective. During the 2009-10 H1N1 swine flu pandemic an estimated 60 million people in the US became ill and about 17,000 died. It was especially severe in young people with 1800 children dying but less than 2000 elderly (over age 65). The first case was identified in California and spread quickly. It was declared a pandemic by WHO within 15 days of the first reported case. Fortunately it was much less contagious in the older, more vulnerable population, in contrast to the opposite which is happening with Covid 19. In a “normal” flu season the CDC estimates about 200,000 people are hospitalized, 90% are age 65 and older. An average of about 36,000 die with complications of influenza, usually those having co-morbid risk factors. It should be noted, that these numbers represent estimates based on “models”, extracting data taken from small groups intensely studied, since relatively few people are actually tested. The statistics regarding Covid 19 are still evolving.

The novel Covid 19 pandemic sweeping the world is highly contagious and likely much more lethal than influenza and H1N1. The SARS epidemic was much more lethal but less contagious. With all of this said, Covid 19 is currently spreading rapidly with its ultimate lethality and fate largely not yet determined. The vast majority of those infected with Covid 19 are most likely to suffer minimal or mild symptoms. Unfortunately it is attacking the elderly that tend to be most vulnerable. We currently have no proven antiviral remedy or vaccine available (although much hope is in the pipeline) and supportive ICU care, including ventilators is limited.

We have plenty to be concerned about, but worry is health negative and actually makes us more vulnerable to illness. Some people tend to panic related to acute intense uncertainty. The healthy approach is to focus on what is known, not on all that is unknown. It is good to be aware of the unknown, but then focus on the known as that is the only component we can actually do anything about. We only fear the unknown. Fear is reduced and panic resolved when we focus on the known. Another contributor to stress is frustration that comes from trying to control the uncontrollable. Most of us do not control what we could control, because we are so distracted by all that we cannot control.

Uncertainty and disrupted behavior patterns can contribute to feeling tense and anxious, resulting in poor sleep patterns. During stressful times, many stop their regular exercise routines and eat less nutritious food on an irregular schedule. At times of stress it is helpful to share our concerns with others and be around other people we care about. The mandated physical distancing recommended related to Covid 19, has us feeling socially distant and lonely. Look for creative ways to stay socially connected while staying physically distanced.

As with most persistent health issues, life-style is an important component to enhance wellness and mitigate against dysfunction and illness. Although it is often very difficult to change feelings, each of us has volition over our behavior. Feelings should be acknowledged and accepted as they are, without effort to change them. When we wish our feelings were different, we can make changes in our focus and in our behavior that in time will affect our feelings. A priority is to place emphasis on bringing order into our life to replace chaos. Establishing a schedule or routine tends to help calm anxiety. Although it may seem trivial, the simple routine of making your bed each morning can help start your day with something that is very “controllable” with little effort. Start to incorporate other routines into your daily life that contribute to a sense of “order”.

Resumption of a regular physical exercise routine is very important. Get outdoors and enjoy some sunlight daily if possible. Eating nutritious food at regular intervals and going to bed about the same time each evening enhances our sense of wellbeing. These acts reduce worry (focusing on the unknown) and in turn help to lower general anxiety. What we think about and focus on is a major contributor to anxiety. If you find yourself watching cable news or on line reports throughout the day, consider receiving a status update perhaps once a day to keep informed, but allow yourself to focus on other issues.

Rather than feeling overwhelmed by a complex problematic situation that seems unsolvable, break it up into smaller components and then identify which of those you can manage (control) and do not spend much effort on the parts that cannot be controlled. Example: None of us can control another individual, but if we focus on controlling ourselves (personal responsibility), we can influence others. Most of us do not control what we could control to the extent we could control it because we are so distracted by all that we cannot control. When possible, prioritize taking care of yourself first so that you can then be more helpful to others. Neglecting your own needs to help others in need, other than in acute circumstances, will compromise your ability to meet those needs and result in frustration that contributes to anxiety. Sometimes when our thoughts cause us to worry or even feel a bit of panic, pause, take a deep breath for a “reality check”, evaluate what our worrisome thought is based on prior to proceeding with a measured response. During these

uncertain times, make an effort to take personal responsibility very seriously. It will make your efforts more effective and enhance your health.

As far as Covid 19 goes, each of us can do much to minimize the risks to ourselves as well as others, especially for those most vulnerable. Follow the guidelines and the “spirit of the guidelines”, using careful forethought and applying creativity and encouragement. So many are suffering. Most of us are the fortunate ones. Expressions of gratitude are a powerful force in fighting elements of depression and sadness.

Execute what we know for certain will reduce our risk of illness, always practice good hygiene:

Wash your hands frequently and when possible your face, preferably with soap and warm water or use hand sanitizers. Perhaps most importantly, avoid touching your face, the most likely site of entry of the virus into your system through your eyes, nose or mouth. Sneeze or cough into a tissue (discard) or the inside of your elbow. Disinfect frequently used items and surfaces as much as possible. Keep a distance of at least 6 feet from others except for immediate family members sharing a household.

Practice physical distancing but find creative ways to keep socially together. Find a balance between your online and offline life.

Remember we are all in this together and will get through it sooner as we all do our part.

Welcome questions and comments

Paul R. Block, MD, FACP, FCC

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