SOUTHWEST UTAH PUBLIC HEALTH FOUNDATION | WINTER 2021 HOLIDAY FOOD SAFETY
COVID Q&A
HOME PREPAREDNESS
PG. 18
PG. 8
PG. 26
FROM THE HEALTH OFFICER Welcome to the 24th issue of HEALTH Magazine, a publication dedicated to providing public health information and education to the residents of Washington, Iron, Kane, Beaver, & Garfield counties. Like our Fall 2020 issue, many of the articles here will focus on the COVID-19 pandemic. We have all been watching cases increase worldwide, and this update should help you understand what we’ve learned and what you can do about it. This is the time to take responsibility for your own health and those around you. People over the age of 65 and those with certain underlying health conditions are at the highest risk for hospitalization and death from COVID-19. If you are high-risk, you might not be able to do things others feel like they can do for a while. Even if you are not highrisk, watch out for others around you who might be. Wear a mask and keep your distance when around others outside of your household. Wash your hands often and please stay home when you are sick. Many in our community have suffered hurt, stress, and loss from various causes, so rise above any blame or contention and find opportunities to help those in need. While there is much we have yet to learn about COVID-19, our understanding has increased. This is a disease of close contact, which is defined as being within 6 feet for more than 15 minutes. Most spread happens in families or social groups, about 85% of the time an infected person is able to identify who gave it to them. 80% of the spread of this disease originates from 10% of the cases. The following risk factors make you more likely to have severe COVID-19 disease: age, obesity, diabetes, hypertension, chronic kidney disease, chronic lung disease (not to include mild or moderate asthma), being immunocompromised, and substance abuse.
Medical interventions to treat COVID-19 have advanced rapidly. Hospitalization stays have shortened, and we are grateful for healthcare providers who have been diligent in keeping up-to-date on the latest COVID-19 therapies and for their dedication in treating those afflicted with this virus. Having said that, I think they would all agree that they would rather not have you need their services. The Utah Department of Health and our Governor have issued guidance to limit the spread of COVID-19, but personal responsibility will make the difference. Although highrisk individuals bear the greatest burden of serious illness and death from COVID-19, anyone can get and spread this disease - so please carefully consider what you will do to protect those you love and others in your community.
Wear a mask and keep your distance. Wash your hands often and please stay home when you are sick.
Much of our current testing capacity has been focused on efforts to identify cases in high school and colleges that might otherwise spread the disease undetected. My hope is that in-home rapid testing will soon be available, easily allowing each of us to test before entering a situation where we might expose someone at risk.
Progress toward a vaccine has been rapid. The first doses will arrive in Utah by the end of December and healthcare workers and long-term care facilities will be highest priority. We will provide updates at swuhealth.org to let you know when and where vaccines will be available to the public. These are highly effective, safe vaccines and I will get mine as soon as it’s available to me. Again, because this is a disease that spreads primarily through close contact with infectious people, basic public health measures like wearing masks, keeping at least six feet of social distance, washing your hands, and staying home when sick can make a significant impact in keeping COVID-19 at bay. If we can keep our efforts up through the next few months as vaccinations arrive we will soon see the beginning of the end of this pandemic. Sincerely,
David W. Blodgett, MD, MPH Southwest Utah Public Health Department (SWUPHD) Director & Health Officer
SWUPHD LOCATIONS (Southwest Utah Public Health Department)
B E AV E R 75 W 1175 N Beaver, Utah 84713 435-438-2482
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IRON 260 E DL Sargent DR. Cedar City, Utah 84721 435-586-2437
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ON THE COVER INSIDE PROTECT 6. A DOCTOR GOES VIRAL
ZDogg MD
8. COVID Q&A 10. COVID Q&A CONT. 12. HANDWASHING By William Clayton Petty, MD
PROMOTE
Many have ventured to the national parks this year. As southern Utah residents we could not be luckier than to have multiple state and national parks in our health district. Depicted on the cover are the snow capped hoodoos of Bryce National Park. Winter is a wonderful season to experience all our local parks. Get some fresh air, avoid the crowds, and enjoy a little nature therapy.
The information and guidelines regarding COVID-19 contained in this issue of HEALTH Magazine are current at the time of publication but are subject to change as new developments occur.
14. PANDMIC OF 1918 By Victor R. Worth, DO
HEALTH MAGAZINE
16. 100 YEARS LATER 18. HOLIDAY FOOD SAFETY 20. WALKING THROUGH THE AGES
DIRECTOR/HEALTH OFFICER:
By David Heaton
PREVENT
David W. Blodgett MD, MPH
22. COVID VS. FLU VS. COLD 24. HOSPITAL CAPACITY
PUBLISHING DIRECTOR: Jeff Shumway
By Terri Draper
EDITOR:
26. HOME PREPAREDNESS
By Emily Davis
David Heaton
28. NATURE: CHEAPER THAN THERAPY
DESIGN & ARTWORK:
By David Heaton
31. PERSPECTIVE
Kindal Ridd
QUESTIONS OR COMMENTS INFO@SWUHEALTH.ORG
The entire contents of this publication are Copyright ©2021 HEALTH (the magazine of the Southwest Utah Public Health Foundation) with all rights reserved and shall not be reproduced or transmitted in any manner, either in whole or in part, without prior written permission of the publisher. Health magazine hereby disclaims all liability and is not responsible for any damage suffered as the result of claims or representations made in this publication. Printed by Hudson Printing Company / Salt Lake City, Utah / hudsonprinting.com
A DOCTOR GOES
DR. ZUBIN DAMANIA, MD ZDoggMD is actually the alter-ego of Dr. Zubin Damania, a real MD. After completing a residency as an internist at Stanford University School of Medicine, Dr. Damania spent ten years as a hospitalist at the Palo Alto Medical Foundation while he honed his talents as a teacher, speaker, and entertainer. His ZDoggMD persona gained immediate success on YouTube and other social media platforms, hitting home with health professionals and general viewers alike. In the past year, Zubin Damania (in his true form) has produced a steady stream of engaging, enlightening, and humorous videos that intelligently navigate the controversies surrounding the COVID-19 pandemic. With his permission, we present a few excerpts from some of Dr. Z’s recent videos.
POLITICS AND RISK PERCEPTION
Are we too cautious or too careless when it comes to coronavirus? Well, the answer is both. Because Americans are extraordinarily bad at under-
standing risk. And this is of crucial importance because if we overestimate the risk of coronavirus, we destroy the economy and our social fabric. If we underestimate the risk of coronavirus, we lose lives.
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Your likelihood of dying of coronavirus if you’re under the age of 24 and don’t have a ton of medical problems is infinitesimally small (making automobile accidents 36 times more deadly), and yet we overestimate it. If you wear a mask and take reasonable precautions, you’re pretty safe. The elderly seem to think they’re not at high risk for this by a factor of two. They underestimate how deadly it is. COVID-19 is 14 times more deadly for elderly people than automobile accidents. That’s a big difference. So what does that mean for the world? It means protect people at risk. People who are at high risk should take extra precautions, staying home if they don’t have to go out and shop, definitely wear masks, wash hands, social distance. Be careful around young people who can be asymptomatic spreaders. Now, what does politics have to do with all of this? Well, it turns out, it’s probably more the case that groups are triggering each other than actually responding to the science and the actual risk. So here’s the call to action. Let’s have a nuanced discussion about risk and benefit; if we get beyond the politics and all the misunderstanding, we will do much, much better simply by understanding risk. Not too careless. Not too cautious. Just right. It’s like a Goldilocks thing.¹
A FINISH LINE IS IN SIGHT
If you get hospitalized with coronavirus now your chances of dying are vastly less than they were in the beginning, and that’s why our death rate is still rather subdued. I’m hoping that it’s not going to rise to the levels we saw in the beginning. We know that our early lockdowns were done because we didn’t know what we were doing. We used a blunt instrument to shut everything down, and then we found out we
broke the economy, caused mental health issues, substance abuse, domestic abuse, and our children weren’t getting educated. Now we know. You want to target protection where you need it. You want to not overwhelm the hospitals. That’s really it. So how do you do that? Target your efforts and then let the rest of us get to work, doing another thing which we’ve learned, which is masking. Look, I get it, Americans hate masks. I hate them too. From the very beginning I thought “Cloth masks are dumb, this is the stupidest thing I’ve ever heard. Why would it work in public when you’re putting a diaper on your face?” Well, it turns out there’s more data that says masks not only protect others from your droplets, they protect you by lowering the amount of virus you inhale at any given time. It’s not zero, but it’s less, which means you can mount an effective immune response, develop maybe even immunity without getting so sick that you’re hospitalized or dying. That’s huge. And it’s a tiny price to pay for getting to the finish line without economic devastation. The finish line is another thing that’s starting to emerge, which is the vaccine. Early on I was skeptical. Now we have emerging data of 90% efficacy. Even if we get 60% efficacy, that’s going to be a game changer which means there’s a finish line. So what do we need to do? A - stop panicking, B - probably stop watching the news, C - don’t go to big crowded events and don’t have a ton of people over to your house. Wear a mask when you can’t socially distance, wash your hands, get on with your life, get your kids in school as safe as they can be with structures in place. Is it going to get ugly this winter? Maybe. Can we prevent our hospitals from being overwhelmed? Yes. And we’ll get to that finish line. ²
¹ Condensed from 2 Careless or 2 Cautious? Coronavirus Risk, Explained (ZDoggMD, 9-20-20, YouTube) ² Condensed from The Winter COVID Surge | A Doctor Explains (ZDoggMD, 11-13-20, YouTube)
SWUHEALTH.ORG | PAGE 7
KNOWLEDGE O V E RC O M E S F E A R
WHAT IS COVID-19?
COVID-19 (short for Coronavirus Disease 2019) is an illness caused by the SARS-CoV-2 virus, a new coronavirus that is related to SARS-CoV (2003 pandemic) and the MERS-CoV (emerged in 2012). Coronaviruses get their name from the appearance of a surrounding halo, or corona, under an electron microscope.
WHERE DID IT COME FROM?
COVID-19 appears to have originated in China. The first confirmed case in the United States was announced on January 21, 2020, but recent findings suggest COVID-19 was present on the west coast in December 2019 and may have been spreading internationally earlier than we thought.
WHAT MAKES THIS A PANDEMIC?
A pandemic is defined as the worldwide spread of a contagious new disease that affects large groups of people, making COVID-19 the 9th pandemic in the last 100 years.
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HOW IS IT SPREAD?
Mostly through close person-to-person contact by respiratory droplets produced when an infected person coughs, sneezes, talks, or sings. Droplets can be propelled a short distance (usually about 6 feet) through the air and deposited on the mucous membranes of the mouth, nose, or eyes of persons who are nearby. The longer or more frequently you’re within 6 feet of someone with contagious COVID-19, the more likely you are to get infected. It’s not known exactly how long viral particles can linger in the air after being expelled. The virus can also spread when a person touches a surface contaminated with infectious droplets and then touches his or her mouth, nose, or eyes, although this is less likely than person-to-person. There is no evidence of infection from water, food, pets, or mailed packages.
WHAT ARE THE SYMPTOMS?
They include fever, body aches, fatigue, cough, sore throat, headache, shortness of breath, and loss of taste or smell. You should get tested if you experience any of these. You should seek medical care if you have trouble breathing, persistent pain or pressure in the chest, or bluish lips or face.
HOW LONG BEFORE AN INFECTED PERSON SHOWS SYMPTOMS?
Usually 5-6 days after they were exposed to the virus, although it can be up to 12 days. A person is contagious for about 2-3 days before and for up to 10 days after starting symptoms. Most infected people who don’t get sick by day 10 will not get symptoms (known as asymptomatic).
WHAT DOES IT MEAN TO BE EXPOSED?
You are considered exposed (possibly infected) to COVID-19 if you were in close contact with someone who was contagious and tested positive for the disease. Close contact means within 6 feet for 15 minutes or longer or a cumulative 15 minutes in a 24 hour period.
You should quarantine for at least 10 days after your last contact to make sure you don’t develop symptoms. You can end quarantine if you get tested on day 7 and get a negative result.
HOW DANGEROUS IS THIS DISEASE FOR ME?
Of those who test positive for COVID-19, 28% of those over age 85 will require hospitalization. 21% of those aged 65-84 will require hospitalization, 7% of those aged 4565 will require hospitalization, 3% of those 25-45 and less than 1% of those under 25 will require hospitalization. Risk factors include age (being over 65), obesity, diabetes, hypertension, chronic kidney disease, chronic lung disease, being immunocompromised, and substance abuse.
WHAT IS THE MORTALITY RATE?
94% of those who have passed away from this disease were known to be either in one of the older age groups, have an underlying disease risk factor, or both. Overall, the risk of death from COVID-19 infection in Utah is .4%, but it is 18% for those over age 85 and 5% for those 70-84; it is .6% for those 50-70, and below that it drops to less than .01%.
HOW ARE COVID-19 DEATHS DETERMINED?
If the death certificate lists COVID-19 as a cause or significant contributor to death with no alternative causes noted by the Medical Examiner, OR there was a confirmed (positive PCR) test and no alternative causes of death noted, OR there were COVID-19 symptoms and close contact with a confirmed case and no alternative causes noted.
HOW DOES THE HEALTH DEPARTMENT COUNT A CASE AS “RECOVERED”?
The SWUPHD considers COVID-19 cases as recovered if the person is not hospitalized or deceased after 21 days of testing positive.
SWUHEALTH.ORG | PAGE 9
WHAT ARE COVID “LONG-HAULERS”?
It is estimated that up to 20% of symptomatic COVID-19 cases may have lingering health problems for months following their initial infection, including shortness of breath, cough, fatigue, pain, loss of taste and smell, and mental health issues. Long-haulers and many healthcare providers are concerned that these conditions may last long after the pandemic ends.
WHAT ARE THE TESTS FOR COVID-19?
PCR TESTS: Very accurate test that detects SARS-CoV-2 viral genetic material to diagnose
active infections. A healthcare worker uses a nasal swab to collect a sample from the back of the nose, or takes a saliva sample. Can take 2-5 days to get results. ANTIGEN TESTS: Rapid diagnostic tests (15 minute) that detect specific fragments of the virus to indicate if a person is positive and infectious. Uses a swab sample taken from the nose.
ANTIBODY TESTS: Or serological tests, detect the presence of antibodies through a blood sample. They can indicate if you’ve had COVID-19 in the past. Has the potential for inaccuracy.
WHAT’S THE DEAL WITH MASKS?
Face masks add a layer of protection that helps stop respiratory droplets from traveling in the air onto other people. They may also offer a smaller degree of protection to the wearer. Masks, combined with social distancing, hand washing, and staying home if you’re sick, can reduce the spread of COVID-19 and other respiratory illnesses significantly. For the time being they should be used at least when within 6 feet of others outside your household and people who are at high-risk of severe illness. Children under two or anyone who has a hard time breathing should not wear a mask.
WHAT KINDS OF MASKS ARE BEST?
• N-95 (unvented, professionally fitted): Superior protection for wearer and those in contact with the wearer. Recommended for front line healthcare workers doing direct care, can be uncomfortable and stifling if worn for long periods. • Surgical (inexpensive, disposable, rectangular, pleated, blue on one side/white on the other): Great for public use when widely available. • Cloth (at least 2-layer, pleated surgical style or shaped for face, can be washed): a close second. • Bandana (worn as 1 layer): not effective. • Neck gaiter: not effective, may actually increase dispersal of smaller droplets.
WHEN IS THIS PANDEMIC PROJECTED TO END?
What goes up must come down, although we don’t know when. While we do the best we can to protect our most high-risk community members, there are reasons for hope; on the near horizon are promising treatments, possible inexpensive at-home testing, and an effective vaccine.
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WHAT DO WE KNOW ABOUT THE VACCINE?
SHOULD I GET VACCINATED IF I ALREADY HAD COVID-19?
Several vaccines for COVID-19 are now either approved or soon will be by the FDA as safe and effective (in the 95%+ range). Like other vaccines, common side effects that can occur (as the body reacts to build immunity) include soreness at the injection site, headache, fever, and fatigue. As COVID-19 vaccinations recently began in England, two people with a history of anaphylaxis had an allergic reaction to the shot. They were treated and recovered, but it’s now recommended that you consult your doctor if you have a similar history before getting vaccinated.
WHEN CAN I GET VACCINATED?
As soon as healthcare providers are vaccinated, followed by care center staff and residents, school employees, and possibly other prioritized groups, COVID-19 vaccines should be available to the public by early spring of 2021, likely at low or no cost. The SWUPHD will alert the community with updates as we go forward.
Since we don’t yet know how strong immunity is after recovering or how long it lasts, vaccination will still be recommended.
WHERE CAN I GET INFORMATION ON: • My county’s disease transmission level and the guidelines/mandates that go with it? • Keeping my business and customers safe? • Planning an organized event with precautions in place? • Getting tested? • What to do if I test positive or was exposed to someone who was? • COVID-19 vaccine updates? • Local daily data on case numbers, hospitalizations, deaths, and recoveries?
VISIT SWUHEALTH.ORG/COVID
STAY INFORMED WITH PUBLIC HEALTH IN SOUTHWEST UTAH BY JOINING OUR TEXT LIST! TEXT SWUHEALTH TO (435) 252-2010 FOR GENERAL HEALTH DEPARTMENT INFORMATION AND DISTRICT UPDATES. YOU CAN ALSO JOIN A SPECIFIC LIST FOR UPDATES IN YOUR COUNTY: BEAVER COUNTY - TEXT BVR TO (435) 252-2010 GARFIELD COUNTY - TEXT PNG TO (435) 252-2010
IRON COUNTY - TEXT CDR TO (435) 252-2010 KANE COUNTY - TEXT KNB TO (435) 252-2010 WASHINGTON COUNTY - TEXT STG TO (435) 252-2010
SWUHEALTH.ORG | PAGE 11
T H E H I S T O RY O F H A N D
Written by William Clayton Petty, MD Southwest Utah Board of Health Member
H
umans have always washed their hands when covered with mud, dirt, or other undesirable solids. But it was not until 1847 that the link between handwashing and disease was documented. In 1199, the renowned Arabic physician, Moses ben Maimon, wrote that one should “never forget to wash your hands after touching a sick person.” There was no scientific evidence for his recommendation, but this did not deter him from teaching that cleanliness was the physician’s best friend. In his own practice he even went one step further: “I dismount from my animal, wash my hands, then go forth to my patients.” The link proving that hand washing could deter disease begins with the story of “childbed”, or puerperal fever, a bacterial infection contracted by wom-
en during childbirth. The first known documented evidence of childbed fever was reported in Paris in 1646. Hospitals throughout Europe and America in those days were reporting between 20 to 25% death rates among women giving birth in hospitals. Occasionally there were fatality reports of up to 100%! Dr. Alexander Gordon of Scotland said in 1785, “I myself was the means of carrying the infection to a great number of women.” Fevers were thought to be the result of an “infectious process,” even though bacteria had not yet been discovered. Some physicians of the era felt that childbed fever might be associated with contagion and poor hygiene. In 1822, a French pharmacist demonstrated that solutions containing chlorides of lime or soda could eradicate the odors of human corpses. He postulated
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that physicians attending patients with contagious dis- any time by the midwives, the medical students, or eases would benefit by using a liquid chlorinated solu- the attending physicians. Dr. Semmelweis postulated tion on their hands. that “cadaverous particles” were being transmitted on the hands of the medical students from the autopsied In London, Dr. Thomas Watson recommended that corpses to the mothers. After experimenting with varipractitioners who attended birthings should wash their ous solutions to cleanse the hands, he required medical hands with a chlorine solution and require obstetrical students wash their hands with chlorine water/chloriattendants to change clothes. One year later, in 1843, nated lime solution before starting ward work and beDr. Oliver Wendell Holmes of Boston concluded that fore each vaginal examination. childbed fever was carried from patient to patient by physicians and nurses. He suggested that doctors The first month after hand washing was instigated, the should avoid performing autopsies before attending mortality rate in the medical student ward dropped to births and that all medical staff should wear clean less than 3% and remained there for the next seven clothing. months. Yet Dr. Semmelweis received only criticism from his colleagues for his efforts. The contention beAuthor Richard Gordon Great Medical Disasters de- came so intense that he left for Pest, Hungary in 1850 scribes conventional physician hygiene at the time: where he accepted the Chair of Obstetrics at the St. Ro“Cleanliness was next to prudishness...there was no chus Hospital. The death rate in the obstetrical wards object in being clean...indeed, cleanliness was out of he oversaw dropped to 0.82%. In 1861 he wrote a clasplace. It was considered to be finicking and affect- sic paper entitled The Etiology, the Concept and the ed. An executioner might as well manicure his nails Prophylaxis of Childbed Fever. before chopping off a head.” Surgeons “operated in blood-stiffened frock coats - the stiffer the coat, the Dr. Semmelweis’ adamant and outspoken defense of prouder the busy surgeon.” proper handwashing in preventing childbed fever may have played a role in his death. He became outraged Dr. Holmes was a crusader for his beliefs and asserted at the indifference of his fellow physicians and began that if a physician had two cases of childbed fever in writing letters to prominent European obstetricians, his practice within a short time he should remove him- denouncing some as irresponsible murderers. In 1865 self from obstetrical duty his wife and contemporarfor a month. Such outraTHE FIRST MONTH AFTER HAND WASHING ies felt he was losing his geous recommendations mind and admitted him to WAS INSTIGATED, THE were not accepted by his an insane asylum where MORTALITY RATE IN THE MEDICAL peers. Without scientifhe died 14 days later from ic studies to back up his STUDENT WARD DROPPED TO either being severely beatviews, he suffered vicious LESS THAN 3% AND REMAINED THERE FOR en by hospital personnel criticism and mockery by or from a wound to his THE NEXT SEVEN MONTHS. other doctors. hand. Dr. Semmelweis The link between handwashing (now referred to as has since become known as the “Savior of Mothers.” hand hygiene) and disease was finally provided by the Although bacteria, originally called “animalcules”, work of Dr. Ignaz Philipp Semmelweis. In 1847, while were discovered in 1683, these microorganisms had Dr. Semmelweis was working as the Assistant Chair- not yet been linked to disease. In 1880, Louis Pasteur, man of Obstetrics at the Vienna General Hospital, his a French microbiologist and chemist, reported his obgood friend Professor Jakob Kolleschka cut himself servations on a series of mothers who had died from while doing an autopsy. After he died, his autopsy childbed fever. He took blood and pus samples from showed the same changes as victims of childbed fever. the deceased and cultured them. He then observed Dr. Semmelweis linked this observation to the differ- the cultures under a microscope and noted that “parence he noted in the death rates of mothers in the two asites…in long chains…appear as little tangled packets like tangled strings of pearls.” These “long chains” obstetrical wards of the hospital. were bacteria, later called streptococcus. In one ward, the mothers were delivered and attended to by student midwives, while in the other ward the The link between bacteria and disease had been esmothers were delivered and attended to by medical stu- tablished. Pasteur and his German contemporary, Dr. dents. The death rate in the midwife ward was 2.85% Robert Koch, are regarded as the fathers of germ thebut on the medical student ward it was a dismal 11.25%. ory and bacteriology. Evidence was now available to doctors and nurses that they were responsible The medical students were performing autopsies in the convince transmitting streptococcus from patient to patient early morning and then going to the obstetrical ward; for delivering babies and doing vaginal examinations on in the hospital. post-delivery mothers. No hand washing was done at The solution? Simple, routine hand washing.
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T H E PA N DE M I C O F
Written by Victor R. Worth, DO Guest Columnist When the “Spanish Flu” swept the nation in 1918, males weren’t as conscientious about personal hygiene and thought masks were too feminine, so public health advertisements and cartoons primarily depicted men and boys in an effort to rebrand hygiene as manly and patriotic.
the fall of 1918, World War I, Iwasnknown then as the “Great War”, drawing to a close. But the world
would face an even deadlier tragedy that winter – influenza. At least 50 million people around the globe would lose their lives to this illness. Nearly 700,000 people died in the United States. The disruption of normal life caused by this pandemic is hard to imagine today. Here in Utah,
schools, churches, theaters, and other public gathering places were closed down. Stricken homes had to display large quarantine signs. Rules required face masks in public, forbade spitting on sidewalks, and limited the number of passengers on streetcars. The city of Ogden even required a certificate of good health issued by a physician within the last twenty-four hours for anyone wanting to enter town. Funer-
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als were limited to 15 minutes and no more than three cars could follow a hearse to the graveyard. Unsurprisingly, hundreds of additional policemen had to be hired to enforce these public safety orders. Despite these measures, the pandemic accelerated. Desperate families tried a variety of ineffective tonics and herbal remedies. Even alcohol was touted as being able to prevent the infection, and though Utah was a dry state, health officials allowed doctors to administer it. But in an age when influenza was poorly understood, there was little more that physicians and families could do besides try to alleviate the symptoms, maintain nutrition and hydration, and let the patient rest. By the end of the pandemic, at least 2,500 Utahns had lost their lives.
FIGHTING THE FLU
Other influenza pandemics would appear over the next hundred years, but none even nearly as severe. Perhaps that’s why awareness of the flu’s deadly potential seems to have slipped to the back of our collective consciousness. Yet influenza remains a real threat. Every year, between 20,000 and 60,000 Americans die from the flu and its complications. Compare that, for example, to 11,000 reported fatalities in the entire world from the Ebola virus over the last full decade. The threat of an exotic illness grabs headlines and provokes fear, while year after year, influenza takes its deadly toll. My own experience as a physician sadly includes such cases: lives claimed, and bodies – even young ones - forever crippled by the flu. Yet much of this suffering could be prevented. How?
1918, and immunization has become our most powerful weapon against influenza. The fact is that flu shots work. They decrease the chances of getting the flu and can reduce the severity of illness in those who still get sick despite being vaccinated. Interestingly, flu shots decrease the chances of being hospitalized and dying not just from the flu, but from heart disease, stroke, and other problems that the flu can aggravate.
has been shown that even someone living in the same home as a person with the flu can prevent transmission with careful handwashing and the use of a mask if they start early enough. Cleaning of frequently touched surfaces and objects can also help. If you do get sick, stay home from work and keep sick children home from school. Cover your cough, wash your hands frequently, and avoid sharing personal items.
IMMUNITY
TREATMENT
Everyone over six months of age should get a flu shot. People over 65 and those with lung, heart, kidney, and other medical problems, are at especially high risk of severe complications of the flu. So are pregnant women. Family members can help protect people at higher risk by getting vaccinated themselves. Health care workers should get a flu shot annually. Every year, the CDC’s recommendation for which strains of flu to include in the annual vaccine changes based on what strains seem likely to reach us in the fall and winter. Since it takes about six months to produce a vaccine, those predictions are not always spot-on, and the flu vaccine can vary in effectiveness from year to year. Even so, it is unwise to simply pick and choose which year to get a flu shot. One study, for example, showed that a single flu shot reduced the risk of death by about 10%, while the practice of getting annual flu shots reduced the risk by an impressive 75%. Researchers are also working hard to develop a universal flu vaccine that would protect against all flu strains and not have to be modified every year.
If you have typical signs of the flu (fever, chills, body aches, cough, sore throat, headache, fatigue, and sometimes vomiting and diarrhea), or if you know that you have been exposed to someone with influenza, consult your doctor. Besides over-the-counter and home treatment, antiviral medications may be appropriate. They can shorten the length of the illness and significantly reduce its severity. However, these medications don’t seem to work well unless they are started within 48 hours after the onset of symptoms.
FLU AND COVID-19
The COVID-19 pandemic involves a new coronavirus, but the same prevention measures work against influenza, which may explain why influenza activity seems lower than usual as we enter the 2020-21 flu season. However, one of the best things we as individuals and families can do is to stay vigilant and get vaccinated against the flu since many hospitals have already been strained from treating COVID-19 patients.
Dr. Victor Worth practices family medicine at the Intermountain Fortunately, we know a great Preventing the spread of influenza Canyon View Clinic in Parowan, deal more today than we did in begins with simple measures. It Utah
HYGIENE
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L AT E R
n page 8 we defined a pandemic as the worldwide spread of a contaO gious new disease that affects large groups of people. None of those we’ve experienced in the past one-hundred years has come close to the Great Influenza of 1918, which remains the worst pandemic in recent history. The worst known pandemic of all time was the “Black Death” bubonic plague which, after several waves beginning in 1347, killed up to 200,000,000 people.
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While the plague was caused by a bacterial infection, all of the pandemics shown here were virus-caused, and mostly influenza. They also typically lasted roughly a year with the exception of AIDS and MERS, which have persisted since 1981 and 2012, respectively. The chart below shows the death tolls of each pandemic as a percentage of the population that year (or the highest mortality year for AIDS) to show a more accurate
representation of the impact the disease had on the world at that time. Our methods of detection, surveillance, and response to disease outbreaks have seen improvement, but the unpredictability of the emergence and behavior of pandemics remains a challenge that will require the best efforts of science, medicine, and nations now and in the future.
PA N DE M I C S S I N C E 1 9 1 8 Figures are based on standardization to 2020 population per 100,000
SPANISH FLU
(INFLUENZA H1N1) 40-50 MILLION DEATHS
SWINE FLU
(INFLUENZA H1N1) 200,000 DEATHS
HONG KONG FLU (INFLUENZA H3N2) 1 MILLION DEATHS
EBOLA
(EBOLA VIRUS) 11,000 DEATHS
ASIAN FLU
(INFLUENZA H2N2) 1.1 MILLION DEATHS
SARS
(SARS-COV-1) 800 DEATHS
AIDS
(HIV) 4 MILLION DEATHS
COVID-19
(SARS-COV-2) 1.6 MILLION DEATHS
(1981, HIGHEST FATALITY YEAR)
MERS
(MERS-COV) 400 DEATHS (2014, HIGHEST FATALITY YEAR)
Data Source: National Center for Biotechnology Information (www.ncbi.nlm.nih.gov/pmc/articles/PMC7426550) Visualization Source: Southwest Utah Public Health Department
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FOOD SAFETY
(165° is for cooking poultry, casseroles & leftovers) (160° is for cooking ground meats) (145° is for cooking roasts, ham, steaks, chops, pork) (≥140° is for keeping food warm) (≤40° is for refrigeration)
“Then the Whos, young and old, would sit down to a feast. And they’d feast! And they’d feast! And they’d FEAST! FEAST! FEAST! FEAST!” Holiday season has arrived! As families, loved-ones, friends, and neighbors gather to celebrate these special events, food will likely play a major role. There is also an increased risk of catching a foodborne illness, which could leave you feeling “Grinchy”. So, whether you “feast on Who-pudding” or “rare Who-roast beast”, the following suggestions will help keep the upcoming holidays memorable for all the right reasons.
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PROMOTE
“Their mouths will hang open a moment or two…”
Many diseases can be spread through the foods we eat. Every year, it is estimated that over 37 million Americans get sick with a foodborne illness, often causing fever, nausea, vomiting, or diarrhea. Keep meats and eggs separate from other food, from the shopping cart to the fridge to preparation. Wash fresh produce thoroughly before preparation. Always wash your hands thoroughly before eating and preparing foods, and after handling raw meat. Do not handle or prepare food if you are sick!
“He slunk to the icebox…”
Germs can reproduce rapidly when foods are left at room temperature. Foods should be kept either hot (at least 140°) or cold (40° or below). Avoid keeping perishable food out on tables or counters for “grazing” for longer than two hours. Store it in the refrigerator or freezer at that point.
“...the last thing he took was the log for their fire!”
Generally, bacteria in food can be killed by adequate cooking. Roasts, hams, steaks, shops, and whole pork should be cooked to a temperature of 145°. Ground meats, especially beef, should be cooked to 160°. Turkey, chicken, casseroles, and leftovers should be cooked to 165°. Using an accurate meat thermometer is the only way to ensure these foods have been cooked to the safe minimum internal temperature! Insert the thermometer into the center of the meat to get a reading, and clean between uses.
“...and he, HE HIMSELF, the Grinch, carved the roast beast.”
If you buy a frozen turkey for your holiday feast, remember that it will need to thaw. The safest way is in the refrigerator: 24 hours for every 5 pounds, up to six days before cooking, so plan ahead! The alternative is to submerge in cold water 30 minutes for every pound, changing the water every half hour. Keep all utensils and surfaces used to prepare raw foods washed and separate from other food. Use these tips to help keep you, your family, and guests safe and healthy at your next holiday gathering. Happy feasting! Adapted from an article published in the Winter 2015 issue of HEALTH Magazine (“Don’t Feel Grinchy”). Quotes and images from “How the Grinch Stole Christmas” by Theodor “Dr. Seuss” Geisel, ™ & © Dr. Seuss Enterprises. Used with permission.
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WA L K I NG T H ROUG H T H E
Written by David Heaton Managing Editor
abies get lots of attention when B they take their first steps, which are celebrated with applause, cheers,
er, whether it's across the room or across a continent. We walk around without a second thought, it's autoand Facebook posts. The skill of matic. But when is the last time you walking is an important one and walked "on purpose"? humans have employed it out of instinct and necessity throughout his- Walking for good health is currently tory to get from one point to anoth- highly recommended; it's low-im-
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PROMOTE
pact, free, and beneficial for the Health is the first requisite after moheart, lungs, joints, and mind. You're rality." exposed to nature, fresh air, and sunshine. Depression and anxiety are Many great authors, artists, musiand thinkers made walking reduced, healthy weight is achieved cians, part of their routines. Mason Curand maintained, and sleep is im- ry, in his book Daily Ritual, found proved. Done with family, friends, many examples in his research. and pets, walking can even strength- Beethoven took two-hour long vigen relationships. orous walks with Fitness guru Jack pencil and music "ONE STEP AT A TIME LaLanne said, paper stuffed in IS GOOD WALKING." "Walking is a big his pocket in case CHINESE PROVERB part of my life. If inspiration struck. you walk vigorSigmund Freud ously, it's just as took daily one-hour walks around Vigood for you as running." Author enna at "terrific speed". John Milton Rebecca Solnit adds, "Walking ar- spent up to four hours a day walking ticulates both physical and mental up and down his garden. Jane Ausfreedom." ten took part in frequent walks with company, a custom often portrayed The virtues of walking have been in her novels. Victor Hugo chose the known since ancient times. Hip- beach for his daily two-hour walks. pocrates proclaimed, "Walking is For years, Charles Dickens had man's best medicine." Diogenes three-hour walks through London or coined the Latin phrase solvitur the countryside. Darwin beat Dickambulando - "it is solved by walk- ens by half-an-hour in his schedule. ing". A Bulgarian proverb reads, Tchaikovsky walked for thirty min"From walking-something, from utes in the morning, then two hours sitting-nothing." It turns out sitting later in the day. Louisa May Alcott is worse than nothing, it's actually walked with her family, who were linked to early death, especially for ahead of their time in advocating those with sitting jobs. healthy lifestyles. Thomas Jefferson, who took daily long walks throughout his life, was concerned that "the Europeans value themselves on having subdued the horse to the uses of man. But I doubt whether we have not lost more than we have gained by the use of this animal (replace 'horse' with 'motor vehicle' for our day)." Jefferson also wrote, "I repeat my advice to take a great deal of exercise, and on foot.
Who knows what you will contribute to the world? Why not follow in the footsteps of the great minds of the past and add a daily walk to your schedule? Thomas Jefferson encourages, "No one knows till he (or she) tries how easily the habit of walking is acquired." How easy? Just follow the advice of this Chinese proverb: "One step at a time is good walking."
"NO ONE KNOWS TILL HE (OR SHE) TRIES HOW EASILY THE HABIT OF WALKING IS ACQUIRED." THOMAS JEFFERSON
SWUHEALTH.ORG | PAGE 21
lthough you can catch a vari- to cause more severe symptoms and A ety of contagious illnesses year- is especially dangerous to vulnerable round, we have a designated “cold & populations.
flu season” that runs from fall to early spring and coincides with school, When we say we have the “stomach cold weather, and more indoor gath- flu” (nausea, vomiting, and diarerings. rhea), it’s probably a gastrointestinal illness caused by bacteria, parasites, A cold refers to an upper respirato- or other virus besides the flu. Often ry illness, often caused by common it's a case of food poisoning which coronaviruses, that is usually a nui- is more frequent during the holidays sance but harmless. when people gather to eat. The flu, a respiratory illness which can also involve the lungs, refers to the family of influenza viruses which show up on a seasonal basis and tend to mix and mutate. Influenza tends
COVID-19 has joined cold & flu season as a new coronavirus that has surpassed the seasonal flu in cases, hospitalizations, and deaths this year.
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COLD VS FLU VS COVID SYMPTOMS
COLD
FLU
COVID
GRADUAL ONSET OF SYMPTOMS
ABRUPT ONSET OF SYMPTOMS
SYMPTOMS RANGE FROM MILD TO SEVERE
FEVER
RARE
OFTEN
OFTEN
FATIGUE
SOMETIMES
SOMETIMES
SOMETIMES
COUGH
MILD
OFTEN (USUALLY DRY)
OFTEN (USUALLY DRY)
SNEEZING
OFTEN
NO
NO
ACHES & PAINS
OFTEN
OFTEN
SOMETIMES
RUNNY OR STUFFY NOSE
OFTEN
SOMETIMES
RARE
SORE THROAT
OFTEN
SOMETIMES
SOMETIMES
DIARRHEA
NO
SOMETIMES IN CHILDREN
RARE
HEADACHES
RARE
OFTEN
SOMETIMES
SHORTNESS OF BREATH/ DIFFICULTY BREATHING
RARE
RARE
OFTEN
LOSS OF TASTE AND SMELL
RARE
RARE
OFTEN Data Source: Intermountain Healthcare
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C A PAC I T Y By Terri Draper, Guest Columnist Dixie Regional Medical Center Communications Director
A
Working Together to Protect and Care for Those at High Risk
lthough what is known and what has been done about the COVID-19 novel coronavirus pandemic has changed over the past year, one core objective has remained constant: to protect high-risk people and guard our hospital resources. Intermountain Dixie Regional Medical Center, one of Utah's five trauma centers, has been at the forefront of Southwest Utah's battle with COVID-19. Along with accepting critical patients from the district's other hospitals, Dixie Regional is also the medical referral center for the rest of south-
ern Utah, northwestern Arizona, and southeastern Nevada. “We are so grateful for the many physicians, nurses, respiratory therapists, and other caregivers across our community who are doing so much to care for our patients,” said Patrick Carroll, MD, MPH and Medical Director of Dixie Regional. “We are also grateful for the Southwest Utah Public Health Department and the many other agencies and individuals who are partnering with us in this effort. Together, we will find a way to care for every patient who comes to us in need.”
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Dr. Carroll explained that over the years the hospital, while coordinating with other agencies, has developed surge plans to help prepare for disasters and events, including pandemics. “In a pandemic, there are three phases of care. Conventional care is the phase we are accustomed to when there is not a pandemic. It’s how we would all like to provide, and receive, care – within circumstances that allow for the highest level of quality.” The next phase is contingency care. “We entered the contingency care phase earlier this year, when the number of patients needing care in our intensive care unit exceeded the number of beds we had there to provide care,” said Dr. Carroll. “At that time, we activated our surge plan, temporarily equipping rooms beyond the ICU with ventilators and other supplies so we can provide intensive care within them. It is not ideal, but we are working through it.” “Within the healthcare industry a hospital is considered full when you fill 80 percent of your licensed beds,” Dr. Carroll said. “Think of it this way: We can’t put a newborn in an adult bed, or a cancer patient in an orthopedic unit. Different kinds of care require different needs, so by the time we get to 80 percent occupancy, we feel full. We plan operationally to that level and although we may exceed this periodically, we don’t exceed it in a sustained way.” During December, however, the number of COVID patients at Dixie surged to as many as 65, accounting for as much as 23 percent of the hospital’s overall licensed beds (284) being used for COVID care on multiple occasions. Dr. Carroll said hospital leadership had to obtain a waiver from the state to allow greater numbers because of the pandemic’s emergency classification.
“We also deployed the Blu-Med tent earlier this year, which can add as many as 25 beds if we were to escalate to the third phase of care, or crisis care,” said Dr. Carroll. “We hope we don’t have to use it, but if we do, I’m grateful to have it.” When considering surge planning, space needs commonly come to mind first. “In addition to space needs, surges in patients can significantly increase demand for supplies and staffing,” said Dr. Carroll. “Right now, the largest concern is staffing.” ICU nurses at Dixie normally care for one or two patients each due to the critical nature of their injuries or illness. Because of the high ICU patient volumes which have exceeded 150% of our normal ICU capacity on multiple days, Dr. Carroll said nurses there are now caring for two or three patients each, stretching staff availability very thin. “I’m grateful to be part of the Intermountain Healthcare system that has helped by bringing nurses and respiratory therapists in from other hospitals, including traveler nurses,” he said. “But it is not enough. Our caregivers are exhausted.” “We need your help. In order for our hospital to provide the highest quality care, we need your help to reverse the trend of increasing cases. We need your help by limiting interactions with those outside your household as much as possible. We need your help by wearing a mask anytime you are closer than six feet to others not part of your household. We need your help by testing and isolating yourself right away if you start to experience any symptoms of COVID. We need your help not because someone is compelling you to do this, but because it is the right thing to do. Thank you.”
R E I N F O RC E M E N T S As Utah braced for the inevitable arrival of COVID-19 cases, Coral Desert Rehabilitation in St. George was preparing their facility to become one of the state’s four transitional units, capable of handling coronavirus patients who need skilled healthcare at a level higher than home care but might not necessarily need to take a hospital bed. Coral Desert now has 33 dedicated COVID-19 beds and has worked closely with Dixie Regional and other care providers to relieve some of the burden of resources. They have a highly trained team of 30 staff and strict testing and precaution protocols in place to assure safety for patients and employees.
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E VA LUAT I NG YOU R H O M E
I
Written by Emily Davis Healthcare Preparedness Program Coordinator
t may seem like a long time ago, but how prepared were you at the beginning of the COVID-19 pandemic? Did you have enough toilet paper or did you use those spare socks instead? Did you wish you were more prepared, and if so, what have you done about it?
WHY SHOULD I BE PREPARED NOW?
Benjamin Franklin once said “By failing to prepare, you are preparing to fail.” We cannot always rely on the government or even our community to meet our personal needs. Government services quickly become overwhelmed with responding to large emergencies and disasters.
caused by a lack of preparedness. We witnessed that as the pandemic approached, when thousands of people rushed out to buy toilet paper, bottled water, cleaning supplies, and baking products. But it wasn’t just that. Large quantities of daily necessities and medications became limited or unavailable. This meant that vulnerable individuals were prevented from accessing what they needed. The disruption of national supply chains exacerbated stockout situations and resulted in an increased shortage of consumer products. Sooner or later, shortages and panic buying could happen again.
WHAT IS HOME PREPAREDNESS?
Led by emotions and social influenc- 72 or 96-hour kits have been a common es, panic buying is often a result of fear recommendation when it comes to home
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preparedness. However, in a pandemic where a two-week quarantine after being exposed is not uncommon, a 96-hour kit will only last four days. The current recommendation is a minimum two-week supply of necessities. This is a shelter-in-place situation versus an evacuation scenario, so your items don’t have to be in a portable bag or even all in one place. You just need to know where they are.
Can you imagine the blessing of having six months of finances saved? Millions of Americans have lost their jobs during this COVID-19 pandemic. Those who were prepared were able to take a vacation, collect unemployment as a bonus, and still have money to live off of!
With a quick Google search, you can find lists specific to your needs of recommended items to have on hand. Besides the basic necessities of food, water, shelter (and chocolate for some of us), a few other things to consider would be:
When it comes to emotional preparedness, it is important to learn and start practicing good mental health. You’ll be able to use those developed skills to help you cope better during disasters. Some basic steps include:
• Pet supplies • Toilet paper (to last at least 2 weeks, not 2 years!) • Feminine hygiene products • Baby needs (diapers, wipes, formula) • Extra medications • Games or other activities to fill the time This is obviously not a complete list. The following websites have additional emergency preparedness checklists and ideas: • BeReadyUtah.Gov • CDC.gov/childrenindisasters/checklists • Ready.gov/plan The best thing about home preparedness is that YOU get to decide what you need and how prepared you want to be, whether it’s for two weeks or two months, or longer!
PREPAREDNESS ISN’T ALWAYS PHYSICAL
There are two other areas of preparedness that are important: financial and emotional. Looking at the first three financial “baby steps” from money guru Dave Ramsey is a good place to start: 1. Save $1,000 for a starter emergency fund
2. Pay off all debt (except the house) 3. Save 3-6 months of living expenses
• Practicing stress reducing activities like yoga, meditation, and walking. • Developing an attitude of gratitude by sharing a positive thought or something you’re grateful for each day. • Stopping unhealthy coping behaviors such as smoking, drinking, binge eating, etc. • Making time for yourself to enjoy the things you like to do.
COVID-19 WON’T BE THE ONLY DISASTER
It’s no mystery that much of the world is in chaos. We’ve seen an increase of earthquakes, tsunamis, wars, and civil unrest around the globe. COVID-19 is not the only disaster that has occurred this year. We are not immune from other disasters just because we are currently in the middle of one. Maybe it won’t be a 5.7 magnitude earthquake like Salt Lake City experienced in March, but what if you lose your job, have major flooding in your home, or experience a zombie invasion. (Just joking on that one). Whatever the case, we can use this pandemic to evaluate our personal preparedness and take the necessary steps to be more resilient for when the next disaster strikes.
SWUHEALTH.ORG | PAGE 27
NATURE: CHEAPER THAN
Written by David Heaton Managing Editor "Look deep into nature and then you will understand everything better." -Albert Einstein
here is a growing body of research T suggesting that spending time in natural settings is beneficial to the
body and brain. For many of us, it’s instinctive - which helps explain the idea of biophilia, or the human tendency to be drawn to nature and it’s many life-forms. Are we hardwired to spend time in the outdoors, and has that drive been subdued by the demands of modern living?
nature interactions have been “made possible by the construction of enclosed and relatively sterile spaces, from homes to workplaces to cars, in which modern humans were sheltered from the elements of nature and in which many, particularly people living in more-developed countries, now spend the majority of their time.”
Richard Louv, author of Last Child The Encyclopaedia Britannica, in a in the Woods, asserts that urbandiscussion on the biophilia hypoth- ized children with too much screen esis, notes that changes in human/ time suffer from what he terms “na-
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ture-deficit disorder”. He argues that time spent in nature is essential for the overall health of people of all ages.
• Improved mood • Increased ability to focus, even in children with ADHD • Accelerated healing from surgery or illness • Increased energy level • Improved sleep • Improved self-awareness and positive body image • Improved cognitive functioning • Boosted results of exercise
A study published in the 2004 American Journal of Public Health found that children diagnosed with Attention-Deficit Hyperactivity Disorder (ADHD) had their symptoms significantly lowered when put into natural settings. After being taken on 20 minute nature walks, these children were able to behave just like their non-ADHD peers for the rest of the day. In the 1980s, the Japanese government became so convinced that time spent in nature was benePsychologists Rachel and Stephen Kaplan came ficial that it implemented a practice called “Shinup with the “Attention Restoration” theory in rin-yoku”, meaning “forest bathing”. According to the 1980s, which has influenced environmental shinrin-yoku.org, “the idea is simple: if a person landscapers and designers ever since. They ob- simply visits a natural area and walks in a relaxed served that people living in city environments are way there are calming, rejuvenating and restorso constantly stimulated that their attention be- ative benefits to be achieved...there have been comes exhausted. This can lead to mental fatigue, many scientific studies that are demonstrating the stress, and depression. Exposure to nature, on the mechanisms behind the healing effects of simply other hand, captures our attention with no effort being in wild and natural areas.” The practice is on our part. Being fascinated with the pleasant now integrated into Japan’s healthcare system and sights, sounds, and smells of natural settings gives is covered by insurance. Shinrin-yoku has spread our brain a break and restores our attention lev- to the United States, where Certified Forest Therel. There is something about being in the natural apy Guides can be hired to lead participants on world that opens our senses to something larger mindful walks through natural settings. than ourselves. It amazes and delights humans from all cultures. While professional mental health therapy is essential in certain circumstances, you don’t need a John Muir, known as “Father of the National therapist to guide you through a meaningful expeParks”, said that “Thousands of tired, nerve-shak- rience in the outdoors. Whether we call it biophilen, over-civilized people are beginning to find out ia, instinct, or a spiritual yearning, all you have to that going to the mountains is going home. Wil- do is show up and nature will take care of the rest. derness is a necessity.” There are many benefits of Enter the woods, follow a trail or stream, or climb spending time in nature, some more obvious than a mountainside. Inhale the scent of a pine forest. others. They include: Listen to the sound of water lapping a lakeshore or bubbling down a creek. Take in the inspiring • Enhanced immune system functioning views of red sandstone cliffs and deep canyons. • Reduced blood pressure • Decreased risk of cardiovascular disease Become familiar with your area’s natural places. • Reduced stress Choose some favorites and invite others. Go often, • Reduced anxiety you won’t get a bill!
The best remedy for those who are afraid, lonely, or unhappy is to go outside, somewhere where they can be quiet, alone with the heavens, nature and God. Because only then does one feel that all is as it should be. - Anne Frank
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A PANDEMIC
The COVID-19 pandemic has dominated the media and minds of the world in 2020, leaving some of us with an ongoing sense of fear and uncertainty. While we should all take the necessary precautions to protect ourselves and others, this is not the first time humanity has dealt with angst on a large scale. These words from C.S. Lewis, written 72 years ago, may bring some perspective and courage (replace “atomic bomb” with “coronavirus"): In one way we think a great deal too much of the atomic bomb. “How are we to live in an atomic age?” I am tempted to reply: “Why, as you would have lived in the sixteenth century when the plague visited London almost every year, or as you would have lived in a Viking age when raiders from Scandinavia might land and cut your throat any night; or indeed, as you are already living in an age of cancer, an age of syphilis, an age of paralysis, an age of air raids, an age of railway accidents, an age of motor accidents.” In other words, do not let us begin by exaggerating the novelty of our situation. Believe me, dear sir or madam, you and all whom you love were already sentenced to death before the atomic bomb was invented: and quite a high percentage of us were going to die in unpleasant ways. We had, indeed, one very great advantage over our
ancestors—anesthetics; but we have that still. It is perfectly ridiculous to go about whimpering and drawing long faces because the scientists have added one more chance of painful and premature death to a world which already bristled with such chances and in which death itself was not a chance at all, but a certainty. This is the first point to be made: and the first action to be taken is to pull ourselves together. If we are all going to be destroyed by an atomic bomb, let that bomb when it comes find us doing sensible and human things—praying, working, teaching, reading, listening to music, bathing the children, playing tennis, chatting to our friends over a pint and a game of darts—not huddled together like frightened sheep and thinking about bombs. They may break our bodies (a microbe can do that) but they need not dominate our minds.
From “Present Concerns” by C.S. Lewis (copyright ©C.S. Lewis Ptc. Ltd. 1986. Extract reprinted with permission)
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PREVENT
FIND WAYS TO SERVE "The best way to find yourself is to lose yourself in the service of others." Mahatma Gandhi
Deliver hot cocoa supplies to a nursing home Sing or share talent through the windows Color uplifting posters or donate flowers Call your grandparents Ask someone if you can get their groceries
Post a kind note about someone specific on social media Send a postcard to those who don’t live nearby Call or write a gratitude letter to parents Say one nice thing about each person around the dinner table Respond with a kind comment on a social media post
Make a charitable donation Post an uplifting message to social media Pay for someone’s drink or meal behind you at a drivethrough Donate a meal to a food charity Acknowledge healthcare workers, teachers, or those you admire through social media
Chalk an uplifting message on your driveway Decorate a neighbor’s door with positive notes Post a positive Google or Yelp review to a local business Get on a local Facebook group page and offer something from your home you don’t need anymore to someone who could use it Roll your neighbors trash bin to the street for them
WHAT IDEAS DO YOU HAVE? SWUHEALTH.ORG | PAGE 31
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