COVID-19 and Wellness: Extra Credit

Welcome back (virtually) to class. We are certainly in unusual and unprecedented times due to the spread of COVID-19. Below you will find useful information for you to learn and engage with for your well-being during this challenging time. Read the content, watch the videos, and check out the additional information/resources that interest you via the provided links (wherever you see underlined blue font).

To learn more about the origins of the virus, watch the below video from the World Health Organization. Note that this video, though created recently, already contains some outdated information. What we know is changing regularly.

COVID-19 is no reason to panic. Though fear or anxiety about an illness outbreak is completely normal, we need to understand what we can do to minimize those fears and anxieties. It is a time to remain cautious, informed and conscientious. We need to understand the virus while also accepting there are many unknowns. The below graphic is an estimate, using epidemiological data, of the impact of the virus compared to other viral illnesses, like the flu, as of March 2020. What we know is changing from day-to-day.

COVID-19 Update NC Emerg Mgmt 3-24-20_Page_02.jpg

We need to understand our risks and how to prevent getting the virus (or any virus). We need to understand the risks of infecting others, even if we are asymptomatic or have mild symptoms. Though we do not need to panic, we need to be careful we are not indifferent too. Due to the unknowns, lack of treatment and not having a vaccine, we need to be cautious and abide by the directives of health professionals to minimize the impact of this virus on ourselves, others and our health care systems. We recognize there are many other challenges associated with this COVID-19 pandemic and we want to address those. We hope, despite the circumstances, we can all live as well as possible. Living well in these circumstances takes conscious effort. In this reading, we'll discuss the details of the virus and how to live safely and well in the midst of this pandemic.

COVID-19 and Wellness

Wellness is reciprocal, overlapping and interconnected. Therefore, an infectious disease pandemic, such as, COVID-19, impacts and is impacted by all aspects of our well-being. We want to equip you to understand this interconnectedness of wellness to help you protect your health and the health of others as much as possible.

As you have probably recognized, this pandemic is not just about contracting the virus and its potential impact on your physical health, although that is important. We have many other things to consider such as

Feeling lonely or isolated.

Feeling ill-equipped to handle a fully online course schedule.

Worrying treasured loves ones more at risk for severe illness may contract COVID-19.

Having restricted options for where we can go, preferred exercise or food.

Fearing financial uncertainty or insecurity.

Disappointment or anger over a school year or college experience far different from what we expected.

Grief over the lives lost or the burden carried by those on the front lines.

Wondering if we will be able to find needed supplies like toilet paper or when live sports will return.

Though those last ones may seem ridiculous, they can impact our well-being. This is evident by the supply panic some people are feeling causing them to hoard items, like toilet paper.

Our wellness is threatened by a unique, unprecedented problem that is impacting our entire globe. We hope we can equip you to handle it as well as possible. To aid our discussion, we will use Dr. John Travis' theory of the twelve dimensions of wellness. We will look at how our situation interacts with each of his 12 dimensions of wellness and what we can do to promote our wellness in each dimension. We can imagine, as pictured, putting COVID-19 in the center of Dr. John Travis' wellness wheel to visualize how this pandemic is touching every aspect of our well-being.

Self-Responsibility and Love

Dr. John Travis' first dimension of wellness is self-responsibility and love. Showing self-responsibility and love to yourself and others is the foundation of our wellness and what is most striking in this pandemic.

You have probably heard two prominent messages regarding COVID-19: practice good hygiene and engage in social distancing. We will address those and other important messages in this section.

How to Protect Yourself from COVID-19 (and other similar infectious diseases)

Below are recommendations from the Centers for Disease Control and Prevention on how to protect yourself from COVID-19. More details can be found here.

Know how the virus spreads

Currently no vaccine

Avoid exposure to the virus

No close contact (within 6 feet)

According to the World Health Organization (WHO), COVID-19 virus spreads primarily through droplets of saliva or discharge from the nose when an infected person coughs or sneezes. It is important that you also practice respiratory etiquette (for example, by coughing into a flexed elbow).

Take steps to protect yourself

Clean your hands often

Wash your hands with soap and water for at least 20 seconds, especially after being in public, blowing your nose, coughing or sneezing

If soap and water are not readily available, use hand sanitizer (at least 60% alcohol)

Avoid touching your face

Avoid close contact

Avoid any contact with sick people or people that have been exposed to sick people

Stay home

When you cannot stay home, always practice social distancing: Keep distance (at least 6 feet) between yourself and other people, even if they aren't sick

Take steps to protect others

Stay home if you are sick, except to get medical care, if needed.

Cover your mouth and nose

Use a tissue that you throw away after or inside of elbow

Throw used tissues in trash immediately

Immediately wash your hands (20 seconds) after coughing or sneezing

Wear a face mask

Originally the CDC advised only the sick to wear face masks/coverings. As of early April, the CDC is now advising all to wear face coverings in public to slow the spread of COVID-19. The recommendations from the CDC for wearing face-coverings and information about how to make a face-covering are provided here. If you do wear a face mask or cover, social distancing and good hygiene are still important. If you are sick, stay home. Do not be tempted to get out even if you have a face mask. If you absolutely must get out (ex: to go to the doctor), wear a mask, keep your distance, wash your hands, etc.

Clean and disinfect

Clean and disinfect surfaces that are touched frequently. See EPA-registered household disinfectants. This includes your cell phone, light switches, handles, counters, faucets, doorknobs, etc.

Watch for symptoms (information from the CDC):

Reported illnesses have ranged from mild symptoms to severe illness and death for confirmed coronavirus disease 2019 (COVID-19) cases.

These symptoms may appear 2-14 days after exposure.

Fever

Cough

Shortness of breath

If you have mild symptoms you can try the Coronavirus Self-Checker from the CDC

When to Seek Medical Attention

If you develop emergency warning signs for COVID-19 get medical attention immediately. Emergency warning signs include*:

Trouble breathing

Persistent pain or pressure in the chest

New confusion or inability to arouse

Bluish lips or face

*This list is not all-inclusive. Please consult your medical provider for any other symptoms that are severe or concerning.

What to do if you are sick (information from the CDC):

Here you can find information from the CDC about if you should get tested and how.

Stay home except to get medical care

Stay home: Most people with COVID-19 have mild illness and are able to recover at home without medical care. Do not leave your home, except to get medical care. Do not visit public areas.

Stay in touch with your doctor. Call before you get medical care. Be sure to get care if you have trouble breathing, or have any other emergency warning signs, or if you think it is an emergency. Know your risk. You can find information about high-risk populations here.

Avoid public transportation: Avoid using public transportation, ride-sharing, or taxis.

The North Carolina Department of Health and Human Services is asking for those with mild symptoms to self-isolate immediately. Due to shortages in tests and safety supplies for medical professionals they do not want everyone to get tested. Call your doctor to tell them about your symptoms and to see if you do need to get tested. This document from NCDHHS explains these recommendations.

Separate yourself from other people in your home, this is known as home isolation

Stay away from others: As much as possible, stay away from others. You should stay in a specific “sick room” if possible, and away from other people in your home. Use a separate bathroom, if available.

Call ahead before visiting your doctor

Call ahead: Many medical visits for routine care are being postponed or done by phone or telemedicine.

If you have a medical appointment that cannot be postponed, call your doctor’s office, and tell them you have or may have COVID-19. This will help the office protect themselves and other patients.

If you are sick wear a facemask, if available.

This link provides information about when and how to wear a mask.

Cover your coughs and sneezes

Clean your hands often

See above information about covering coughs and sneezes and handwashing

Avoid sharing personal household items

Do not share dishes, drinking glasses, cups, eating utensils, towels, or bedding with other people in your home.

Wash thoroughly after use

Clean all “high-touch” surfaces every day

Clean high-touch surfaces in your isolation area (“sick room” and bathroom) every day; let a caregiver clean and disinfect high-touch surfaces in other areas of the home.

High-touch surfaces include phones, remote controls, counters, tabletops, doorknobs, bathroom fixtures, toilets, keyboards, tablets, and bedside tables.

Be sure to follow the instructions on the label to ensure safe and effective use of the product. Many products recommend keeping the surface wet for several minutes to ensure germs are killed.
Most EPA-registered household disinfectants should be effective. A full list of disinfectants can be found here.

Monitor your symptoms

Common symptoms of COVID-19 include fever and cough. Trouble breathing is a more serious symptom that means you should get medical attention.

According to the CDC, if you have a fever or cough, you might have COVID-19. However, most people have mild illness and are able to recover at home.

If you are having trouble breathing, seek medical attention, but call first. Call your doctor or emergency room before going in and tell them your symptoms. They will tell you what to do.

See this handout from the CDC for more details

The CDC and North Carolina Department of Health and Human Services recommends these 10 things to manage the illness at home.

Seven tips to prevent the spread of the virus from the WHO

We all need to do our part to take care of our own health and minimize the spread of this coronavirus. We all play a part in this and this is not a time to take risks since there are so many unknowns such as being asymptomatic but carrying the virus, not knowing the severity of the virus in individuals, the virus living on surfaces days after exposure, etc. The White House, CDC and FEMA are urging us all to take appropriate precautions and stay at home as much as we can. Minimize trips to the grocery store or pharmacy to only go when absolutely necessary.

Breathing

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The circumstances of this pandemic can cause a wide array of reactions in each of us. Check-in with your breathing throughout the day. Take some time to take quality deep breaths. The below video by Jess Hartmann may help you develop a breathing practice. When we practice effective breathing we promote optimal oxygen inhalation and waste (carbon dioxide) exhalation. It can help to energize, calm and center us. You can find specific times or cues during the day to remind you to check-in to see how you are breathing and then take some time for deep breaths.

You can find an additional mindful breathing practice here.

Taking care of our respiratory health

COVID-19 is a respiratory illness. Therefore, this pandemic is a great time for us to be more aware of our breathing and practice behaviors that strengthen the effectiveness of our breathing. Public Health Officials are urging those that smoke and use electronic cigarettes to try to quit now. E-cigarettes are already thought to be associated with lung illness and injury and some research suggests that COVID-19 is worse for smokers and vapers. If you do smoke or vape, take extra steps to protect yourself from contracting COVID-19 like those in the at-risk populations. If you feel now is a good time to quit, the CDC provides resources.

Sensing

Now more than ever we may be aware of our sense of touch. We are living in a world where "social distancing" with those outside of our homes is essential to the health of ourselves and the health of communities. Nearly every aspect of our day is impacted by social distancing, from contact with our friends or family to precautionary steps we take like cleaning our hands and surfaces as well as avoiding touching our face. And, we must maintain at least a 6 feet distance from others due to the spread of respiratory particles. Honoring and practicing social distancing can help slow the spread of COVID-19 to lessen the burden on our health care systems. We can see the tragedy that ensues when these systems are overwhelmed. We all need to do our part to prevent this by staying at home and practicing social distancing.

Though we may be uber aware of touch right now, we may take for granted overall sensing and the ability to overload our senses with new, frightening, or uncertain stimuli. Consider the following to keep your sensing more balanced while we battle this pandemic.

Media Overload

We can easily get sucked into news and media regarding current COVID-19 statistics, projections and information. This can be an overload and assault to our senses which can elicit a panic or stress response. We can limit the amount of news and media to which we expose ourselves and be intentional about how we consume the news. Turn off the news and disconnect from social media at times during the day. We can also engage in mindfulness practices that use and calm the senses. Below is an example of a sensing grounding practice.

Find a comfortable seat and bring attention to your breath, then consider and reflect on the following in your immediate surroundings

5 things you can see

4 things you can feel or touch

3 things you can hear

2 things you can smell

1 thing you can taste

How others impact sensing

Being around others, particularly in such concentrated amounts, can have an impact on our emotions. The behaviors of others can create sensing overload as well. Due to stay at home orders, you may find yourself struggling with this. Perhaps your parents talk about the news and their fear constantly. Maybe your siblings raise their voices when they are upset or angry. Maybe your home is kept dark or cold. Perhaps you feel you have to eat quarantine foods that are not your preference and you cannot enjoy their taste. These can all stress our senses depending on how we choose to respond. Be aware of how the behaviors of others can impact your sensing dimension and determine healthy coping strategies. It is important to give ourselves and those immediately around us as much grace and patience as we can at this time. Find ways to voice your needs and be willing to listen to the needs of those around you.

Positive sensing behaviors

There are many things you can try out to positively impact your sensing dimension and in turn, your well-being, during this pandemic. Below are some ideas.

Music therapy - make a "feel good" playlist.

Be mindful of what you are "consuming". Consider the sights, sounds and tastes you are "consuming"--the quantities, quality and types. Try to develop an awareness of your reaction to those and avoid or cope with those that are negatively impacting you.

Be mindful when you eat to really "taste" and appreciate your food. With the pressure or desire to panic buy our food, mindful and intuitive eating may be even more challenging. We might be distracted by feelings of guilt that we have more than enough or fear we do not or will not have enough. When you eat you can savor the food and think of the people that went into getting the food to your plate. Be grateful for the farmers and factory employees working through this pandemic. Be grateful for the grocery employees working long hours with the heavy responsibility of extra cleaning and stocking and fears of contracting the virus themselves.

Water therapy: try playing in the water like when you were a kid (sprinkler/hose/throwing water balloons), take a hot bath or shower and enjoy how the water feels, or soak your feet.

Enjoy comfort foods: prepare or purchase a meal or food you find comforting. Eat it very slowly and truly taste, savor and enjoy each bite.

Find some humor: Watch funny videos, shows or movies or listen to funny podcasts

Get creative: Try to create a new recipe using available ingredients, make some art, do a crafting project, make a tiktok dance video

Get outside: go outdoors and enjoy all it has to offer. Really listen, look and feel.

A note about getting outdoors. Some of you may feel the only thing in your world that has stayed the same is...nature. Therefore, getting outdoors can provide some comfort and peace. Find ways and times to get outside. Listen to the birds. Touch the dirt. Walk barefoot in the grass. Smell the flowers. Sense!

Be mindful of negative coping strategies we may engage our senses in like binge-eating and using drugs or alcohol. Though these can sometimes make us feel better at the moment, engaging in these behaviors does not actually help our well-being. There are psychological and physiological consequences of engaging in these behaviors. If you feel you cannot refrain from using drugs or alcohol please reach out for help. If you need help with binge-eating contact your Campus Dietitian. If you choose to drink alcohol, understand how to do so safely and avoid drinking as a coping mechanism since it will not be effective. Rely on productive behaviors like those already mentioned and others you will find throughout this chapter.

When we are dealing with tough situations, stressors or overload, we can sometimes dismiss coping strategies completely and instead engage in avoidance behaviors to try to cope. However, just avoiding challenges can be negative and unproductive. Perhaps you feel so overwhelmed you just check out--doing nothing. Not feeling motivated to address your challenges, you avoid them completely and instead binge on Netflix or over-sleep. Maybe you feel confused about a new fully online course schedule so you just avoid getting on Canvas to check or do any of your schoolwork. Or maybe you are stressed about being stuck at home with your family so instead of addressing concerns with them, you lock yourself in your room and are cold to them, avoiding as many interactions as you can. These are just some examples. Avoidance behaviors can amplify the problems in the future and cause a ripple of other problems. Though temporarily stepping away to practice some self-care is healthy, doing nothing to address our challenges is not. Practice good coping strategies early and often. Engage in preventative behaviors like good stress and time management and taking intentional time apart so you can mitigate a desire to engage in negative avoidance. It is understandable to want to avoid our problems so each day we want to try to choose to positively cope over avoiding. Even if you just take one little step today, it can help you move forward.

Eating

Eating well, as we all know, is important for our well-being at all times. During this pandemic, it has become even more important to eat well to keep our physical and psychological health strong and resilient.

Eat nutritiously

We each have different circumstances that impact how we eat during this outbreak. When possible, choose to eat an abundance of fruits and vegetables. Practice the ten principles of intuitive eating.

The United States Department of Agriculture provides several resources for healthy eating. They encourage meals with plenty of fruits and vegetables that are proportioned like below (Choose My Plate). Eating a nutrient-dense diet can strengthen our immune system, help us manage stress, provide necessary energy and benefit our psychological well-being.

The USDA also gives the below 10 tips for building a healthy eating style that is sustainable. Additionally, they have tips for food planning during the Coronavirus outbreak. Now can be a good time to strengthen our eating habits.

Harvard Medical School and the Harvard T.H. Chan School of Public Health have published a revised version of the USDA plate that does not include dairy and makes more room for plant-based diets. You may find this recommendation works better for your preferences. It still includes fruits and vegetables as half of the plate but encourages limiting dairy and processed meats. It is pictured below.

Remember that eating nutritiously is not about having a "perfect" diet (there is no such thing) or being rigid about the way we eat. Those pursuits can actually be health prohibiting. Practice flexibility and self-compassion when it comes to eating, now and always. Recognize that the stress associated with this situation may change your dietary needs. Try to be in tune with your body and remember that eating some fruits and vegetables is better than none. If you have questions or concerns you can reach out to your campus dietitian or a community dietitian that may be offering virtual nutrition counseling.

What if you do not have enough food?

Some people may find themselves in a situation in which they are worried about getting food or being able to have enough food as the pandemic continues. Additional resources are below. If you have more than enough food during this time, please consider donating to a food pantry close to you.

Other resources for getting the food we need:

Good and Cheap Cookbook

Other resources for eating on a budget:

Feeding a family healthfully on a low-income budget

Budget-friendly tips

Shop healthy on a budget

Money-saving grocery shopping tips

Be a savvy farmer's market shopper

Know how to keep your food safe

If you are concerned about getting the virus from food or food packaging the Food and Drug Administration addresses that concern at this link. There is also useful information about food safety , ordering take out food, shopping at the grocery store, and disinfecting reusable grocery bags from North Carolina State University.

Moving

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During these times, you may find yourself sitting more than usual. Being confined to our homes can drastically reduce the amount of lifestyle physical activity we do and can impact our exercise time as well. Consider strategies you can implement to move throughout the day. It could be setting a timer to remind you to get up every 90 minutes to move around for a few minutes. It could be jogging in place, doing some jumping jacks or doing a few sun salutations every time you take a bathroom break. Find something that works for you. When possible, try to break up bouts of sitting with movement that works for you. Keep it simple, practical and achievable.

We hope you are also finding the time and resources for daily exercise. As you have likely realized, what you do for exercise may have to change given our circumstances. If you enjoyed weight lifting, you can try out bodyweight training. If you enjoyed cardio machines, you can try out the wide variety of free aerobic exercise classes online. This is a great time to try out something new or get a little creative. To stick with your exercise routine, make an appointment with yourself and keep it. Determine an exercise time that works with your schedule and stick to it like you would any other appointment. If you have others in your home with you, consider including them. You can even engage in a virtual workout with friends. And...practice self-compassion. If you miss a day of exercise or do not move much one day--let it go. It is just one day and there is tomorrow to try again. Check-in with yourself to see if you need to adjust your expectations of yourself to be more realistic.

This link provides information from the American College of Sports Medicine (ACSM) on staying active during the COVID-19 Pandemic. Additionally, you can find some free exercise resources below.

Resources

American Council on Exercise No Equipment Exercise Library

ACSM past Health and Fitness Summit workout videos

Planet Fitness Work-ins

Free Apps

Nike Training Club App: Interval training, resistance training, mobility, yoga, etc.

Map My Run: GPS app, allows people to track their course, distance, pace, etc.

Charity Miles: allows users to have money donated based on mileage.

Couch to 5K: Training protocol to be able to do 5K

Sworkit: a variety of fitness options

Stava: jogging/walking, can create teams

Zombie run: running app with Zombie storyline

Down dog

Seven - 7 Minute Workout

30 Day Fitness Challenge Pro

Fiton

Walk the Distance

Walkr

Hops - Journey of Tree Spirit

The Walk - Fitness Tracker Game

YouTube

Yoga with Adrienne

Yoga with Kassandra

The Body Coach

Blogilates

Heather Robertson

OneGirlBreathing Yoga and Fitness

As always, be a critical consumer when using resources. Be in tune with your body and do not follow the directive of the teacher if it causes pain or feels like it is not appropriate.

And, when you can, get outdoors! Get some fresh air, sunlight and listen to the sounds of nature. Go for a walk, run, play some golf--anything you enjoy that allows for social distancing.

Feeling and Thinking

"According to the CDC, the outbreak of coronavirus disease 2019 (COVID-19) may be stressful for people. Fear and anxiety about a 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, your environment, your circumstances and the community you live in. If you, or someone you care about, are feeling overwhelmed with emotions like sadness, depression, or anxiety, or feel like you want to harm yourself or others, call 911. Additional resources are provided at the end of this section.

If you notice any of the following in yourself or others, it could be a sign you are experiencing stress due to the infectious disease outbreak: fear and worry about your own health and the health of your loved ones, feelings of grief, changes in sleep or eating patterns, difficulty sleeping or concentrating, worsening of chronic health problems, increased use of alcohol, tobacco, or other drugs. Take steps to care for your mental health, such as the suggestions in this chapter and get help immediately if your feelings seem persistent, uncontrollable or intense.

Taking care of our Mental Health

Taking care of yourself, your friends, and your family can help you cope with stress. Helping others cope with their stress, using appropriate boundaries, can also make your community stronger. Below are recommendations from the CDC. More details can be found here and recommendations from the American Psychological Association can be found here.

Take breaks from the news, 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 while also not over-sleeping, and avoid alcohol and not prescribed or illegal drugs.

Make time to unwind.

Do activities you enjoy that allow for social distancing or get creative and modify activities to allow for social distancing (ex: virtual dinner party).

Connect with others.

Find ways to have meaningful communications with others. If you have concerns, talk with people you trust about your concerns and how you are feeling. More details to come.

Call your healthcare provider...

If stress gets in the way of your daily activities for several days in a row or you feel overly overwhelmed anxious or experience any alarming symptoms call your healthcare provider or licensed counselor.

Are we experiencing grief?

In addition to stress, anxiety and depression we can also experience grief during this time. According to David Kessler, a leading expert and author on grief, we are feeling a number of griefs because our world is changing. We realize things will be different from this point forward. We have lost normalcy, we fear economic toll, we are uncertain about what the future holds and have a loss of connection. We grieve the lives lost and the burdens carried. This is causing collective grief, something we are not used to. Kessler says we are grieving on a micro and macro level.

According to Kessler, understanding the stages of grief can be a good starting point for helping us manage this grief. "There’s denial, which we see a lot of early on: This virus won’t affect us. There’s anger: You’re making me stay home and taking away my activities. There’s bargaining: Okay, if I social distance for two weeks everything will be better, right? There’s sadness: I don’t know when this will end. And finally there’s acceptance. This is happening; I have to figure out how to proceed. Acceptance...is where the power lies. We find control in acceptance. I can wash my hands. I can keep a safe distance. I can learn how to work virtually".

Additionally, we can let go of what is called "anticipatory grief", grief and anxiety about the unknown future. This type of grief can turn on our imaginations to the worst-case scenarios like images of someone getting very sick or us being confined to our homes for several months. Kessler suggests balancing these thoughts with realistic positive thoughts. See the flip side. Such as, we have all been at least a little sick at some point and done okay.

Instead of allowing your mind to wander into the future and seeing the worst, try to focus your mind on the present. There are many resources available to help us practice mindfulness and being present in the moment. Kessler gives an example, similar to a previously mentioned option:

"Name five things in the room.

Breathe.

Realize that in the present moment, nothing you’ve anticipated has happened. At this moment, you’re okay.

Use your senses and think about what they feel. The desk is hard. The blanket is soft. I can feel the breath coming into my nose.

This can work to dampen some of that pain." Kessler also encourages letting go of that which you cannot control. We cannot control how much our neighbors manage COVID-19 but we can control how much we social distance and wash our hands. We cannot control how long this pandemic impacts us but we can control our mindset and how much we allow it to impact us. Keep the focus on what you can control...you.

Lastly, be patient and compassionate with yourself and others. We are all navigating something new and unknown. We need to understand people, including ourselves, may not be themselves. We will all process and deal with these circumstances differently. Where we are in this process is not necessarily where someone else is. We should not feel or impose stress to be like someone else. We want to do what we can do to cope, practice self-compassion and show grace to others (Berinato, 2020).

Additional Mental Health Resources

The video below from the World Health Organization may provide additional helpful information and tips.

COVID-19 and Mental Health from the World Health Organization

Tips from Mental Health America

More tips from the World Health Organization:

Contacts to support and help you

Optum has a toll-free 24-hour Emotional Support Help Line at 866-342-6892 for people who may be experiencing anxiety or stress around COVID-19.

The National Disaster Distress Helpline at 1-800-985-5990 offers crisis counseling and emotional support 24 hours a day for anyone experiencing distress or other mental health concerns during the COVID-19 outbreak.

Substance Abuse and Mental Health Services Administration’s (SAMHSA’s) Disaster Distress Helpline: 1-800-985-5990 or text TalkWithUs to 66746. (TTY 1-800-846-8517)

The Hopeline is also available 24 hours a day at either 919-231-4525 or 1-877-235-4525.

LME/MCOs can provide resources for Medicaid beneficiaries and individuals without insurance.

The National Suicide Prevention Hotline (1-800-273-TALK) offers free and confidential support for people in distress, prevention and crisis resources and best practices for professionals. Suicide Prevention Resource Center (SPRC) has compiled a selection of resources on mental health and coping.

Support via telehealth and emotional support lines through UNCW can be found here.

Promoting our Intellectual Wellness

Going to a fully online course schedule, being forced to learn at home, being responsible for the learning of others in your household, etcetera are all new challenges we are facing. The practices mentioned above can help all of us navigate these new challenges to our intellectual wellness. There are also practices in the next section that can be helpful. Specific tips for being a successful online learner are below:

Review the syllabus for any new information or changes. Know the syllabus and all course expectations and policies well.

Identify new/changed tasks and make sure you have access to the tools required to perform those tasks well before the due date.

Determine a way to stay organized and on schedule with your assignments. Implement your plan as soon as possible.

Check your email and Canvas course announcements regularly for updates and information from your instructors (multiple times per day).

Create a schedule for learning, doing homework and completing other responsibilities. Stick to your schedule like you would if you had to physically go to class.

Communicate with your instructor immediately if you have extenuating circumstances, questions, confusion or concerns. Always check the course syllabus for answers to questions before emailing an instructor.

Additional strategies in the next section can help as well...

Playing and Working

We are likely now working and doing homework in spaces that we previously used as a retreat from those activities...places we were able to relax, find solitude or "play". We also find ourselves in a situation where we are home more with a more flexible schedule but possibly, with many of the same demands (ex: classwork). These circumstances can leave us feeling unbalanced, out of routine, overwhelmed, lonely, and bored. You can implement the following strategies to help you thrive while working/studying from home:

Try to keep your bedroom a place only for sleeping. If possible, keep work and homework in a different space. Doing work and homework in your bedroom may make it difficult to wind down or may bring feelings of anxiety into the room...both of which can make getting good sleep difficult.

Create a space that is comfortable and practical for completing work and homework. This will help you get organized and allow you to "leave" your work and homework.

Keep a routine. Wake up at the same time each day and do your work/homework with a consistent schedule. For instance, some may find it helpful to do their virtual work for a class when they would normally attend that class. Try to go to sleep at the same time each night as well.

Get up and going! Wake up at a set time, shower, get dressed--prepare for your day like you would any other day.

Take breaks. Get outside when you are able, ideally every day. Take movement breaks around your home.

Have some fun. Find ways to enjoy yourself. Do a virtual dinner or game with friends, try a new recipe or have a dance party with those in your home.

Find some "play"/enjoyment in your work/homework and commit to a balance in play and work. We want to safeguard our time so we are not working too much. We also want to make sure we are not "playing" too much since we find ourselves with more autonomy and less accountability than usual. This time is neither a stay-cation or a reason to be plugged in 24/7. Set boundaries for working and playing.

Pace yourself between demanding or stressful activities and allow yourself time to do so. Do not procrastinate. Reward yourself in some way when you complete difficult activities.

Educate yourself on the resources to minimize financial stress due to COVID-19 and a reduced workload or being laid off. This article provides information on how to protect yourself financially from the impact of COVID-19.

Communicating

During this pandemic, we need to consider the communications given and received about COVID-19 but also how we are maintaining communication with others.

Communications about COVID-19

Some of the things we hear, assume or say about COVID-19 are not true. Make sure you are collecting and relaying information from reputable sources like the CDC, WHO, and State and County Health Department. Also, consider how much communication in which you are partaking. Too much information may promote anxiety and fear. Though it is good to stay informed, take breaks from the news and social media stories about COVID-19.

There are stigmas, rumors, and prejudices regarding the virus that result in improper or cruel judgments or assessments of the situation or others. We play a role in reducing those. Below are suggestions from the CDC. You can reduce stigmas and rumors by recognizing that...

"Diseases can make anyone sick regardless of their race or ethnicity."

"For most people, the immediate risk of becoming seriously ill from the virus that causes COVID-19 is thought to be low. "

"Older adults and people of any age who have serious underlying medical conditions may be at higher risk for more serious complications from COVID-19." We all, therefore, need to play a role in protecting those at a higher risk from contracting the virus from others.

"Someone who has completed quarantine or has been released from isolation does not pose a risk of infection to other people."

"There are simple things you can do to help keep yourself and others healthy." You may have heard rumors that those not at risk do not need to worry about protecting themselves or that there is no need to be careful because we should all try to contract COVID-19 to start building immunity. There is no indication that either of these rumors is true, healthy or best for the public good. With a novel virus, we need to do everything we can to prevent contracting it and spreading it to others.

"You can help stop COVID-19 by knowing the signs and symptoms." Contact your doctor and self-quarantine immediately if you think you have signs of COVID-19 or have been in contact with someone who has COVID-19.

The below video is the World Health Organization's call to fight stigmas

Myths about COVID-19

There is a lot we do not know about COVID-19 but there is also some information circulating that we know is not true or likely not true. This link has information from the World Health Organization about COVID-19 Mythbusters like the one below.

Communicating during COVID-19

It is important to find ways to communicate effectively during COVID-19. This includes having a voice and being a good listener. Both can be challenging when we rely so heavily on written communication. Consider more care in writing emails and text messages. Consider a more thorough reading of emails and text messages to ensure you are "listening" and understanding what the other person is saying. This can be particularly true in your courses. Now that all of your courses are online, a careful and thorough reading of instructor communications is even more important than usual since you do not have that face-to-face time with them to relay information.

We can use social media to communicate but we also want to try to incorporate phone calls and video chats as much as possible. These allow for voice inflection and the video chats allow us to use and interpret body language--both are important for being understood and listening.

Intimacy

We may be able to find ways to socialize but social distancing, quarantine and isolation pose threats to our ability to feel truly connected and close to others. As humans, we desire and need meaningful connections. You may feel anxiety, worry, fear, loneliness, grief, anger, boredom, frustration, symptoms of depression, a desire to use substances to cope, uncertainty, or even ambivalence. All of the above can be typical reactions and feelings but that does not mean we should not try to cope, minimize, prevent or manage them. If you are experiencing any of these for an extended period of time (2-4 weeks), with severity, or are just concerned, contact a mental health professional immediately.

We are in a situation in which we have to get creative about making space for meaningful connections and intimacy. Loneliness, which is not the same as being alone, can have a negative impact on our health. "Loneliness involves feelings of isolation, feelings of disconnectedness, and feelings of not belonging. These feelings, in turn, are thought to reflect the discrepancy between one's desired and one's actual relationships". Some research suggests it can be as damaging to our health as smoking and more damaging than obesity (Holt-Lunstad, Smith, & Layton, 2010). Each day consider how you will connect with at least one person in a meaningful way while practicing social distancing.

Video chat or talk on the phone.

Avoid only using social media to connect with others.

Hug and show appropriate affection to those within your home.

Talk with someone about your feelings.

Do something meaningful for someone else.

Write a letter or send a card to someone that may be experiencing loneliness...consider those living in nursing homes and retirement communities.

This YouTube video offers some inspiration for connecting while honoring social distancing and quarantine.

Virtual Opportunities for Connection

Join the Greater Good Science Center Tuesdays and Thursdays for Greater Good Together: 20 minutes of connection on Facebook Live. Eve Ekman and Emiliana Simon-Thomas will lead a brief grounding practice and then offer practices to boost resilience, connection, or positivity. These sessions are FREE and are offered to give you a sense of community and connection during these hard times. They are easy to join: Just log in to their Facebook page Tuesdays and Thursdays at 1 p.m. PDT (4 p.m. EST).

The Greater Good Science Center and Reimagine are partnering to present a Daily Dose of Togetherness every Monday, Wednesday, and Friday at noon (3 p.m. EST) through April 3, 2020. It is free to join these 50-minute virtual experiments where people come together online and in community to enhance collective well-being. Find out how to register in advance and keep up with the calendar here.

Additional Resources

Active Listening: Practice

Compassion Meditation: Practice

36 Questions for Increasing Closeness: Practice

Relaxing needless fears around others: Article

Staying close while physical distancing: Podcast

The power of a gratitude letter: Podcast

Who is your rock? Podcast by Parkland shooting survivor

We recognize that some people may not be able to experience supportive and positive intimacy in their homes during this pandemic or may be struggling with past interpersonal violence. If so, reach out for support and help. If you are in any danger, contact authorities immediately. Though protection from COVID-19 is important so is your interpersonal safety

If you are in danger, call 911

This site includes a long list of resources available to survivors of relationship abuse, stalking and sexual assault

This site includes information specific to safely using technology

Help someone combat loneliness

Consider how you might be able to help someone else feel less lonely and isolated during this isolating time. Think of others and how they may be dealing with social distancing and quarantine. Even if you are handling it well there is likely someone you know that is not. You trying to connect with them in a meaningful way could be what they need.

The WHO provides some suggestions for being supportive below.

Finding Meaning

Some of us might immediately be able to see positives in the midst of this situation and others of us will struggle to see even one. There is no denying, nor should we, that our circumstances are challenging and just stink. However, it can be helpful to find some positives and some meaning in the midst of the tough. Consider what is or could be positive. Perhaps it is the availability of technology to allow you to stay connected. Maybe it is an opportunity to reconnect with someone you let drift away. It could even be the time with and proximity to your family, forcing you to spend some needed quality time with them.

You can also use this time to find some COVID-19 meaning for yourself. You might reflect on...What could bring you some meaning during this time? Do you feel you can play a role in helping someone feel less lonely? Do you have abundant access to food you could share with those that are food insecure? Are you able to safely support local businesses trying to stay afloat while honoring social distancing? Do you have a gift for writing encouraging and uplifting messages? Do you have an idea for making those on the front lines feel appreciated and supported---could you lead or help with efforts? Do you know how to make face masks to help with the shortage?

This article provides information on how we can use stress to develop courage and connection. This podcast provides information on how to find your silver linings. #ImDoingFineBecause can provide some humor and inspiration.

It is worth considering how you can use your passions, needs, gifts, resources, connections, and/or experiences during this pandemic time. Perhaps you now have the time to pick up a new hobby or pursuit. Maybe this has made you more aware of our impact on the environment. You might find yourself wanting to refocus or reprioritize your life. Or maybe you are able to help a non-profit maintain their services during this time. The options are endless and specific to you.

Resources and suggestions

FEMA resource page for "how to help" https://www.fema.gov/coronavirus/how-to-help

Keepng the greater good in mind.

Focus on acts of goodness happening despite the COVID-19 Outbreak.

How taking care of our own well-being helps others.

Think of this as an opportunity to build resilience

Try expressive writing

Transcending

Now may be a time you feel you need to be more connected to your spiritual beliefs, find ways to experience more flow, engage in a mindfulness practice, connect with nature or be part of a larger whole--even if virtually. It is important to be in tune with those needs and try to find time and resources to meet them. Below are options you can consider based on your preferences and beliefs.

If you feel you need to be more connected with your spiritual beliefs, finding ways to do so may provide you with peace and hope during these times. You can still pray, journal and read religious writings you find helpful. You might even consider doing that virtually with others or those in your household that have your same beliefs. You can also find numerous religious gatherings and teachings online.

Flow is a mental state when we feel something some refer to as "in the zone". It is believed that having regular moments of flow is good for our health. However, you may have difficulty experiencing those flow moments due to your new circumstances. If so, you can try to find times to be alone and to do activities that you can "get lost in". That could actually be homework for some people or tasks like a crafting project, a run, cooking, etc.

You can also consider practicing mindfulness during this time when it is so tempting to worry about what the future holds. You can start or maintain a meditation practice to help you manage the stressors associated with this pandemic. Engage in these practices a realistic and feasible amount of time and frequency. This site gives information on how mindfulness can help during this time.

If you feel you need to be intentional about feeling connected to something bigger than yourself, explore your virtual options to do so. Consider joining a group showing support for those serving in the medical field. Be part of a food collection or distribution for others that are food insecure. Find ways to help those who have lost their jobs or are underemployed.

Or maybe you just need to spend time observing places you enjoy that you cannot visit. You can do so virtually. Below is a resource for checking out numerous beaches but there are similar sites for zoos and aquariums.

Additional Resources

Find an app you enjoy. Examples include 10% Happier, Calm and Headspace

Find a podcast you find helpful. There are numerous options available, some of which are hosted by UNCW faculty.

Use the resources on the CHHS Chill site

Practice self-compassion and loving-kindness

Conclusions

We find ourselves in a time of uncertainty and not knowing when it will end. It is a time for us to practice self-compassion and grace to others. It is also a time to be flexible and creative.

This chapter included a wide variety of suggestions and options to help you live well through COVID-19. However, be okay with some days not being okay. Take it day to day, doing the best you can at the moment. When you are struggling, reach out, connect, and reflect. Give yourself and others grace, compassion and patience.

To close, below are suggestions from Greater Good Magazine: Science-based Insights for a Meaningful Life. You might consider posting these questions to prompt you to consider them each day.

Six Daily Questions to Ask Yourself in Quarantine

More information can be found here.

What am I grateful for today?

Who am I checking in on, or connecting with, today?

What expectations of “normal” am I letting go of today?

How am I getting outside today?

How am I moving my body today?

What beauty am I creating, cultivating, or inviting in today?

We hope you found at least nuggets of relevant and helpful information in this COVID-19 and Wellness Chapter and that you feel more equipped to live well despite this pandemic. May you thrive in the midst of uncertainty and challenge.

Miscellaneous Resources

World Health Organization Q&A: https://www.who.int/news-room/q-a-detail/q-a-coronaviruses

NC Department of Health and Human Services FAQ: https://www.ncdhhs.gov/covid-19/faq

UNCW Healthy Hawks "Managing Wellbeing": https://uncw.edu/healthyhawks/managingwellbeing.html

References

Berinato, S. (2020, March 23). That Discomfort You're Feeling Is Grief. Retrieved from https://hbr-org.cdn.ampproject.org/c/s/hbr.org/amp/2020/03/that-discomfort-youre-feeling-is-grief?fbclid=IwAR22T_115_nt37mfTdsVSUXnSNFZfJRvnpaZhlecMA3TQ_gP5oxY9e7W6x8

Centers for Disease Control and Prevention. (2020, March 21). Reducing Stigma. Retrieved from https://www.cdc.gov/coronavirus/2019-ncov/symptoms-testing/reducing-stigma.html

Centers for Disease Control and Prevention. (2020, March 21). Coronavirus Disease 2019 (COVID-19). Retrieved from https://www.cdc.gov/coronavirus/2019-ncov/index.html

Food and Drug Administration. (n.d.). Coronavirus Disease 2019 (COVID-19). Retrieved from https://www.fda.gov/emergency-preparedness-and-response/counterterrorism-and-emerging-threats/coronavirus-disease-2019-covid-19

Holt-Lunstad, J., Smith, T., & Layton, B. (2010). Social Relationships and Mortality Risk: A Meta-analytic Review. SciVee. doi: 10.4016/19911.01

Hughes, M. E., Waite, L. J., Hawkley, L. C., & Cacioppo, J. T. (2004). A Short Scale for Measuring Loneliness in Large Surveys. Research on Aging, 26(6), 655–672. doi: 10.1177/0164027504268574

Maragakis, L. (2020, March 31). Coronavirus, Social Distancing and Self-Quarantine. Retrieved from https://www.hopkinsmedicine.org/health/conditions-and-diseases/coronavirus/coronavirus-social-distancing-and-self-quarantine

NCDHHS. (n.d.). COVID-19: Managing Your Overall Health. Retrieved from https://www.ncdhhs.gov/divisions/public-health/coronavirus-disease-2019-covid-19-response-north-carolina/managing-health

New Hanover County Health Department. (n.d.). Coronavirus Information: Health: New Hanover County: North Carolina. Retrieved from https://health.nhcgov.com/your-environment/public-health/coronavirus/?752

World Health Organization. (n.d.). Coronavirus. Retrieved from https://www.who.int/emergencies/diseases/novel-coronavirus-2019

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