As Health Carer Workers (HCWs) we are anxious about spreading the infection to our families and the people we live with. On top of that, our friends & families are worried about us because we face an increased risk.
It is an important time to have conversations that explore the risks and share decision making.
Here are some tips to get you started.
Start the conversation.
- Be honest, and for kids be age-appropriate (they don’t need all the information adults need)
- Share factual information – not the exaggerated news and social media feeds
- Balance the risks with the good information – our hospitals are well prepared, the actual COVID illness is mostly mild for kids, and even for most adults.
- Ask for opinions, and try to achieve shared decision making
Factual information- Risk for HCWs
- The risk for COVID-19 is increased for health care workers, but we actively reduce those risks:
- Everyone is screened on entry
- Strict protocols to reduce transmission & use protective equipment
- Increased hospital cleaning protocols
- Rigorous contact tracing for HCWs
- Extra isolation measures – including potential alternative accommodation in hotels if the risk gets too high
- Extra testing availability
- The risk is also increased for people who live with HCWs but it is small and unlikely to be a significant driver of spread
There are things we can do to reduce risks at home
- Maximise isolation within the home if you can
- Separate rooms, separate spaces, regular cleaning of surfaces, video calls etc
- Minimise touch – fewer hugs, fewer kisses (save them up for after COVID)
- There is also this advice from the Australian Nursing and Midwifery Foundation for entering your home and minimising the risk of infection. Please note, this is not the Department of Health & Human Services' advice, and most hospitals do not have enough scrubs for all staff.
- Keep a box by the door to place your shoes
- Leave your bag, wallet, mobile, keys, etc in a box near the entry
- Change out of your clothes immediately and wash them. Use the hottest possible machine wash setting and dryer if you can.
- Clean items you’ve bought in and surfaces you’ve touched
- Remember to wash your hands regularly
- Wash your personal things like phone cases, glasses, keys, lanyard, etc (hot soapy water or disinfectant spray)
- Consider changing in and out of your uniform/scrubs at work
And remember: The main goal of social isolation is to slow the speed of spread (to flatten the curve) so we don’t overwhelm our hospitals. That way, when we get sick we get first-rate care. It is inevitable that some of us, whether HCWs or not, will get infected.
Apart from avoiding infection, the next best thing we can do to ensure we all recover is to ensure our health care system works and for that to work, we need to stand together – HCWs, our families, our communities
The risks are less if we stand together.
The majority of this article was written by the Centre for Disease Control & Prevention in the USA (CDC). Links and phone numbers have been adapted for Australia, and some information has been changed to adapt to Australian circumstances.
Stress and Coping
The outbreak of COronaVIrus Disease 2019 (COVID-19) will be stressful for most people. Fear and anxiety about the unknown, especially a new disease can be overwhelming and cause strong emotions in adults and children. Coping with stress will make you, the people you care about, and your community stronger.
Everyone reacts differently to stressful situations. How you respond to the outbreak can depend on your background, the things that make you different from other people, and the community you live in.
People who may respond more strongly to the stress of a crisis include
- Older people and people with chronic diseases who are at higher risk for COVID-19
- Children and teens
- People who are helping with the response to COVID-19, like doctors and other health care providers, or first responders
- People who have mental health conditions including problems with substance use
If you, or someone you care about, are feeling overwhelmed with emotions like sadness, depression, or anxiety, there are lots of options:
Stress during an infectious disease outbreak can include
- Fear and worry about your own health and the health of your loved ones
- Changes in sleep or eating patterns
- Difficulty sleeping or concentrating
- Worsening of chronic health problems
- Increased use of alcohol, tobacco, or other drugs
- New instances or escalation of family violence
People with pre-existing mental health conditions should continue with their treatment and be aware of new or worsening symptoms. Contact your GP or mental health clinician if you have questions.
Existing data indicates that we should expect an increase in family violence due to the pandemic. Family violence risk factors include confinement in the home, financial uncertainty and unemployment. Contact: Safe Steps 1800 015 188
Taking care of yourself, your friends, and your family can help you cope with stress. Helping others cope with their stress can also make your community stronger.
Things you can do to support yourself
- Take breaks from watching, reading, or listening to news stories, including social media. Hearing about the pandemic repeatedly can be upsetting.
- Take care of your body. Take deep breaths, stretch, or meditate. Try to eat healthy, well-balanced meals, exercise regularly, get plenty of sleep, and avoid alcohol and drugs.
- Make time to unwind. Try to do some other activities you enjoy.
- Learn the skills of relaxation. Try downloading a meditation app (like Smiling Mind), try online yoga through YouTube. Google slow breathing exercise.
- Connect with others. Talk with people you trust about your concerns and how you are feeling.
Call your healthcare provider if stress gets in the way of your daily activities for several days in a row.
For further information from Beyondblue
Reduce stress in yourself and others
Sharing the facts about COVID-19 and understanding the actual risk to yourself and people you care about can make an outbreak less stressful. Check out these basic facts about COVID.
When you share accurate information about COVID-19 you can help make people feel less stressed and allow you to connect with them.
For parents
Children and teens react, in part, on what they see from the adults around them. When parents and caregivers deal with the COVID-19 calmly and confidently, they can provide the best support for their children. Parents can be more reassuring to others around them, especially children, if they are better prepared.
Not all children and teens respond to stress in the same way. Some common changes to watch for include
- Excessive crying or irritation in younger children
- Returning to behaviours they have outgrown (for example, toileting accidents or bedwetting)
- Excessive worry or sadness
- Unhealthy eating or sleeping habits
- Irritability and “acting out” behaviours in teens
- Poor school performance or avoiding school
- Difficulty with attention and concentration
- Avoidance of activities enjoyed in the past
- Unexplained headaches or body pain
- Use of alcohol, tobacco, or other drugs
There are many things you can do to support your child
- Take time to talk with your child or teen about the COVID-19 outbreak. Answer questions about COVID-19 in a way that your child or teen can understand.
- Reassure your child or teen that they are safe. Let them know it is ok if they feel upset. Share with them how you deal with your own stress so that they can learn how to cope from you.
- Limit your family’s exposure to news coverage of the event, including social media. Children may misinterpret what they hear and can be frightened about something they do not understand.
- Try to keep up with regular routines. If schools are closed, create a schedule for learning activities and relaxing or fun activities.
- Be a role model. Take breaks, get plenty of sleep, exercise, and eat well. Connect with your friends and family members.
Learn more about talking to kids about COVID-19 from the Royal Children's Hospital
For responders
Responding to COVID-19 can take an emotional toll on you. There are things you can do to reduce secondary traumatic stress (STS) reactions:
- Acknowledge that STS can impact anyone helping families after a traumatic event.
- Learn the symptoms including physical (fatigue, illness) and mental (fear, withdrawal, guilt).
- Allow time for you and your family to recover from responding to the pandemic.
- Create a menu of personal self-care activities that you enjoy, such as spending time with friends and family, exercising, or reading a book.
- Take a break from media coverage of COVID-19.
- Ask for help if you feel overwhelmed or concerned that COVID-19 is affecting your ability to care for your family and patients as you did before the outbreak.
Learn more tips for taking care of yourself during emergency response (note, this is a US site, & whilst the support advice is excellent, the phone numbers are not relevant for Australians. When we have an Australian equivalent, we will update this information).
For people who have been released from quarantine & self-isolation
Being separated from others if a healthcare provider thinks you may have been exposed to COVID-19 can be stressful, even if you do not get sick. Everyone feels differently after coming out of quarantine. Some feelings include:
- Mixed emotions, including relief after quarantine
- Fear and worry about your own health and the health of your loved ones
- Stress from the experience of monitoring yourself or being monitored by others for signs and symptoms of COVID-19
- Sadness, anger, or frustration because friends or loved ones have unfounded fears of contracting the disease from contact with you, even though you have been determined not to be contagious
- Guilt about not being able to perform normal work or parenting duties during quarantine
- Other emotional or mental health changes
Tips to deal with the stress of self-isolation
Self-isolation heightens loneliness and can cause stress, fear, and worry.
Here are some quick tips to cope:
- Use social media & the telephone to connect with loved ones – start a small group and touch base each day – think about groups for family, friends and close neighbours.
- Use the time wisely – do things you love. Take an online class, read that pile of books on your bedside table, watch all of those TV shows you missed. Repaint the bathroom!
- Stay healthy – eat well, exercise, sleep well. All can be done in your home. Take the time to cook, do online yoga or aerobics, meditate, and focus on good sleep habits.
- Dodge the panic – there are thousands of armchair experts spreading doom and gloom right now. Try to limit your media and online exposure. Listen to the advice from true experts via the government and universities, and not all day long. Take a break.
- Online help – if you are finding you are struggling, ring one of our many helplines, or search ‘online psychologists’ – many doctors, psychologist and psychiatrists work online (called telehealth) and lots of it is covered by Medicare.
If you feel at any point that your emotional well-being is a risk, remember:
Or any of the national helplines – all available here
This is a quick guide to the essential health info you need for preventing, preparing for, and having COVID-19. There are many resources online, especially at the Australian Health Department Coronavirus info page. Below is a quick & basic summary. Prepare yourself
- Stay fit – eat, sleep, exercise
- Give up or cut back on smoking now (get nicotine replacement from the pharmacy)
- Prepare mentally – find ways to relax like meditation apps & slow breathing
- GET the flu shot (available April).
Prepare your house
- Have enough food and drink for about a week
- Buy basic medical supplies – paracetamol (about 100 tablets per person will be plenty), a thermometer, and some face masks if available
- Have enough cleaning supplies – soap and water, detergents, household disinfectant
- BUY an alcohol-based hand sanitiser with over 60 percent alcohol.
Prevent infection – reduce your risk
- WASH hands often with soap and running water, for at least 20 seconds. DRY with paper towels or hand dryer
- TRY not to touch your eyes, nose or mouth
- COVER your nose and mouth with a tissue when you cough or sneeze. If you don’t have a tissue cough or sneeze into your upper sleeve or elbow
- You DON’T wear a face mask if you are well.
What to do if you get sick
- Isolate yourself, and if you need to be in the company of other people then wear a face mask.
- Cover your face when you cough, use tissues, dispose of the tissues.
- Clean your hands often to avoid infecting others from touching shared surfaces.
- Call a doctor – don’t go directly. They will instruct you on how to get tested and what you can do to relieve symptoms.
- Common symptoms: fever, cough, sore throat, runny nose.
- Less common: shortness of breath, fatigue, aches & pains, headache.
- Supportive care at home – just like the flu or a cold, use paracetamol for pain and fever and keep drinking enough fluids. Otherwise, rest.
- The usual course of illness: time from getting infected to showing symptoms (called incubation time) is about 5 days (range 2 to 14 days), duration of illness is about 2 weeks for mild cases and about 3 to 6 weeks for more severe cases.
- Likely severity: Mild symptoms (no or mild pneumonia) 80 – 90% people; severe disease requiring hospital 10 - 20% of people (rough estimates)
Manage your anxiety The news has been frightening, and you may feel anxious and panicky. Here are some things to remember:
- The news has not been completely reliable. Whilst government sources are stressing the importance of trying to reduce the spread of the virus, they have also been trying to stress that in most people the illness is NOT severe and NOT life-threatening. Many people have it without symptoms. Of those who get sick at least 80% do NOT need hospital care.
- Cut back on news & social media; get your information from reliable government websites like https://www.dhhs.vic.gov.au/coronavirus
- Anxiety passes. It is temporary.
- Try things to relax: download a meditation app like Smiling Mind or google slow breathing techniques and watch them on YouTube. Here is an example of slow breathing on YouTube
- Remember the usual supports:
When should you go to a hospital?
- Difficulty breathing or shortness of breath
- Persistent pain or pressure in the chest
- New confusion or inability to wake up
- Bluish lips or face
Things to take to the hospital Super useful:
- Medicare card &/or private insurance, DVA card
- Your GPs details
- Medications – bring a list or just bring the packets
- Any health aids - hearing aids, dentures etc
- Pyjamas, warm clothes, underwear, non-slip footwear
- Toiletries - including toothbrush, toothpaste, soap, shampoo, deodorant, etc
- Phone & charger
Useful:
- Sleeping mask and ear plugs
- Headphones, computer, charger
- Money – not too much, for snacks and newspapers
When can you break isolation? Follow medical advice, as the DHHS guidelines are updated frequently but as a rough guide this is from the latest version (sourced 25/3/2020):
- The patient has been afebrile for the previous 72 hours, and
- At least ten days have elapsed after the onset of the acute illness, and
- There has been a noted improvement in symptoms, and
- A risk assessment has been conducted by the department and deemed no further criteria are needed.
- Testing is no longer required to meet clearance criteria
Are you immune to COVID-19 after you've been infected once? There is not enough information about the immune response to SARS-CoV-2 virus yet to know for sure, but experts think that you probably are immune, but that the immunity might not last forever. Here is a good summary of the information so far in New Scientist. What should you do if you live with other people who are unwell or isolated?
- Maintain good isolation (social distancing) and wear a mask when that is not possible
- Clean all surfaces in your isolation area daily
- Get a caregiver to clean all surfaces in other areas daily
- Use soap and water or another detergent if the area is dirty. Then a household disinfectant afterward.
- Do not share household items
What to do if your kids have symptoms
- Kids appear less likely to get sick
- Kids appear less likely to transmit the virus
- Seek medical advice for testing and symptoms relief
- Treat them as you would if they had a cold or the flu
- Pay close attention to your cleaning, hand washing, and mask use to avoid becoming infected yourself.
- Reassure them and communicate clearly that you expect them to get better quickly (they will have been hearing the exaggerated doom and gloom on the news too)
Frequently Asked Questions What's the difference between COVID-19 and SARS-CoV-2? COVID-19 is short for Coronavirus Disease 2019 meaning it is the illness (disease) caused by the virus. SARS-CoV-2 is the name of the virus that causes the disease, and it is short for Severe Acute Respiratory Syndrome Coronavirus 2. The first, SARS-CoV caused an epidemic in 2002 & 2003 in China, Canada, Hong Kong, Chinese Taipei, Singapore, and Hanoi in Viet Nam. It didn't spread enough to be considered a pandemic.
