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Ask Dr. Halverson: COVID-19: Facts, challenges, coping ideas

web 5 29 Halverson photo
By Dr. Jim Halverson
COVID-19 has had a profound impact. Not only has there been significant mortality due to the disease, but ongoing physical and psychological challenges can be very difficult. Consider the following.
Mortality
To date, more than 110,000 people in the United States (and more than 400,000 worldwide) have died with COVID-19. U.S. deaths continue to increase by nearly 1,000 per day. How does that number compare to all causes of death in the United States for this year? Here are the leading causes of death in the U.S. for 2018, the latest year that data is available. These top 10 have changed very little in recent years in ranking or in total numbers.
1. Heart Disease: 655,381 deaths
2. Cancer: 599,274 deaths
3. Accidents (unintentional injuries): 167,127 deaths
4. Chronic Lung Diseases: 159,486 deaths
5. Stroke (cerebrovascular diseases): 147,810 deaths
6. Alzheimer’s Disease: 122,019 deaths
7. Diabetes: 84,946 deaths
8. Influenza and Pneumonia: 59,120 deaths
9. Chronic kidney diseases: 51,386 deaths
10. Intentional self-harm (suicide): 48,344 deaths
Current projections estimate more than 140,000 deaths from COVID-19 by year’s end. This will place it near the top five for deaths in 2020.
Morbidity
Much less talked about are the significant physical effects on people who have been seriously ill but eventually recovered from COVID-19. Strokes, permanent lung damage, heart failure, kidney failure and other conditions can continue to affect survivors. Much like polio, which killed more than 50,000 Americans between 1916 and 1955 and left more than 500,000 with permanent neuromuscular damage, the impact on COVID-19 survivors may last for the rest of their lives.
Psychological issues
Millions of us are affected by anxiety, grief, overuse of alcohol or drugs, insomnia or depression by this pandemic. Whether it is due to the effects of COVID-19 directly on us, our family or friends OR the effects of social distancing, job loss, financial concerns or other life changes, the struggle is very real.
Not only are we dealing with what has happened thus far, we are also dealing with the fear of what could happen. This anticipatory stress is new to many of us. We are anxious about possible serious illness or death from the disease, about our job, our children’s education, how long the disease may last, and many other concerns that we were not facing four months ago.
Techniques to help deal with anticipatory stress and make it less intense
    1) FIND BALANCE IN THE THINGS YOU ARE THINKING
Our minds begin to show us images of the future. We often see the worst scenarios. Our loved ones getting sick. Being separated from our family or friends for a long time. That’s our mind being protective. Our goal is not to ignore these images or make them go away — your mind won’t let you do that and it can be painful to try to force it.  If you feel the worst image taking shape, make yourself think of the best image. We all get a little sick and the world continues. We are able to get together again with family and friends. Not everyone I love dies. Maybe no one I love dies because we are all taking the right steps.
    2) COME INTO THE PRESENT
This will be familiar advice to anyone who has meditated or practiced mindfulness. Name five things in the room you are in right now. Relax your breathing. Realize that in the present moment, nothing you have anticipated has happened. In this moment, you’re okay. You have food. You are not sick.  This really will work to dampen some of the psychological pain.
    3) LET GO OF WHAT YOU CAN’T CONTROL
One of my favorite daily thoughts is “Go with the flow. Let go of fear and the need to control.” What our neighbor is doing is out of our control. What the government is doing is out of our control. What others are feeling about this pandemic is out of our control. What is in our control is staying 6 feet away from others. Washing our hands. Taking good care of ourselves with a healthy diet, physical activity and adequate rest. Meditating. Finding meaning and purpose in our lives every day.
    4) STOCK UP ON COMPASSION
Everyone will have different levels of fear and grief and it manifests in different ways. A patient got very snippy with me the other day in the office and I thought, “That’s not like this person; that’s how they’re dealing with this. I’m seeing their fear and anxiety.” So be patient. Think about who someone usually is and not who they seem to be in the moment.
    5) TAKE POSITIVE ACTION
Keep trying. Every day will bring new challenges and new accomplishments.  It’s okay to feel grief. Feel it and then go on to the next feeling. This is a time to be overly protective but not overly reactive. This is survivable. We will survive.
Stay hopeful, stay safe and stay well.

 

— Dr. Jim Halverson is an Ojai physician who writes a weekly column on COVID-19 for the Ojai Valley News.

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