#Coronavirus: Facts about Current Prevalence, Exposure Criteria and Testing Refusal for #COVID19 in BC

                                                    
Current Prevalence of #COVID19 in BC: As of March 12, 2020:

The BC Centre for Disease Control (BCCDC) reports that as of March 6th, 2020:

• 2,008 individuals and 2,803 samples were tested for COVID-19 

Note: This vastly under counts the actual numbers of people in BC who have COVID-19. Thousands of people who have had COVID-19 exposures have come to Canada since the outbreak started overseas, and began spreading from country to country. More information below about why these numbers under-represent the true prevalence rates in BC. 

117 confirmed cases in Canada: BC:46 (up 7 today); ON: 42; AB: 19; QC: 9; NB: 1

Note: Reproduction rate (R0) of COVID-19: Every 1 person with a confirmed case may/can spread the virus to 2-4 people. (2.2-3.58). Link here. 

- Research based on China. Other countries may have different statistics about virulence, or the rate of transmission.

Super-spreaders: People who can transmit the virus to more people than the average R0.  

#COVID19 (#Coronavirus) Updates: BC, Canada, and Global Data Tracker

Link: https://www.covid-19canada.com/

Fact #1: The BC Government and the BC Centre for Disease Control (BCCDC) have limited the exposure criteria for testing for COVID-19 in BC to the following: 

“Who to test: Testing is available for patients with compatible symptoms (e.g. fever, cough, or difficulty breathing) AND history of travel to affected areas including China (mainland), Hong Kong, Iran, Italy, Japan, Singapore, and South Korea two weeks prior to illness onset or other index of suspicion (e.g,. contact with an ill person with such travel history).”

Source: The BCCDC webpage for Clinical Resources and Guidelines from Health Care Professionals. Retrieved from: http://www.bccdc.ca/health-professionals/clinical-resources/novel-coronavirus-(covid-19).

The BCCDC page also states the following:

Testing and laboratory guidance: Testing requires notification and consultation with the local Medical Health Officer and the BCCDC PHL Medical Microbiologist on-call (604-661-7033).

Comment: The BC government and BCCDC have NOT been following PHAC’s exposure and testing criteria from the beginning of the COVID-19 outbreak. PHAC's criteria includes discretion about who can get tested. BC has created their own criteria that is not consistent with the Canadian government’s criteria, or international public health best practices for infectious disease management. 

Since the beginning of the COVID-19 outbreak in China, and once symptomatic people in BC and Canada started seeking medical attention and testing, the BC government has limited exposure and testing criteria. This testing limitation continues. 

Testing guidelines below demonstrate that not all individuals in BC who are part of an epidemiological cluster who become symptomatic for COVID-19 will be tested and confirmed to have the virus. This is leading to inaccurate/false reporting about the real number of cases in BC.

Vulnerable, high-risk populations are not being tested: It is also likely the case that individuals in higher-risk categories, such as seniors who experience flu symptoms, may not have been tested for COVID-19, pre- or post-death. This will lead to decreased confirmed cases for COVID-19 and confounds and under-represents that true epidemiological statistical data, and picture of COVID-19 in BC and Canada. 

Provincial Health Services Authority (PHSA): PHSA Laboratories: COVID-19 Guidance on Sample Collection and Testing as of Feb 27, 2020 

PHSA Note: Please ensure that you are using the latest guidance document, available at http://www.bccdc.ca/health-professionals/clinical-resources/coronavirus-(novel)

1) Who to test and why? 

a) Patients with respiratory illness in relation to recent travel from an affected area or, contact with a person known or suspected to be COVID-19 infected. (Samples will be tested for FLUA/B/RSV and COVID-19). 

b) We are recommending COVID-19 testing for the same patients that you would normally test for FLUA/B/RSV. (Samples will be tested for FLUA/B/RSV and COVID-19). 

c) Patients who are part of a respiratory outbreak cluster (i.e., within a household or facility). It is not necessary to test all cluster members. Testing a maximum of six members from a cluster will identify the cause of most outbreaks. (Samples will be tested for FLUA/B/RSV and COVID-19).

Source: PHSA Laboratories. Retrieved from: http://www.bccdc.ca/resource-gallery/Documents/Statistics%20and%20Research/Statistics%20and%20Reports/Epid/Influenza%20and%20Respiratory/ERV/BCCDC_PHL_Updated_nCoV_Lab_Guidance.pdf.

Fact #2: Why People are Not Getting Tested for COVID-19 in their Health Regions

Why have Doctors in BC in Community Health and Hospitals been Limiting/Refusing Testing for COVID-19?

Health authorities in BC provide physicians operating in their health regions with clinical guidelines, direction, and updates via physician updates about how they are expected/directed to manage patients presenting with symptoms of COVID-19. 

Vancouver Coastal Health Physicians Update (February 26, 2020): 

Link: http://www.vch.ca/for-health-professionals/resources-updates/physicians-update

These guidelines have not been updated to take community transmission into consideration, and direct doctors in VCH to use the following guidelines:

The Public Health Agency of Canada recommends COVID-19 testing for:

• Patients with compatible symptoms (e.g. fever, cough or difficulty breathing) AND
• Travel within 14 days of symptom onset to an affected area including: OR 
• Close contact with a confirmed or probable case of COVID-19

Fraser Health Authority: Medical Health Officer Updates

Updated guidance for suspect cases of novel coronavirus (COVID-19) - March 4, 2020

Link: https://www.fraserhealth.ca/employees/medical-health-officer-updates/updated-guidance-for-suspect-cases-of-novel-coronavirus-march-4-2020

Consider testing for novel coronavirus for:

• Patients with compatible symptoms (e.g., fever, cough, or difficulty breathing) AND
  
• History of travel to an affected area (as of Mar. 4, 2020, affected areas include: China, Hong Kong, Iran, Japan, Italy, Singapore, and South Korea) within 14 days prior to illness onset OR other index of suspicion (e.g., contact with an ill person with travel to affected areas, contact with a confirmed or probable case of COVID-19).
  
• We do not recommend COVID-19 testing in asymptomatic patients. We have developed a patient-facing document that provides information to asymptomatic patients requesting testing, which is available here.
  

Fact #3: Who Isn’t getting Tested for COVID-19 in BC and Canada

The exposure and testing criteria is so narrow that the vast majority of people who are now becoming infected with COVID-19 in BC are unable to get tested.

Around BC and Canada people who are symptomatic who present to health care providers are being refused testing for COVID-19, because they do not meet the exposure criteria that BC (and other regions of Canada) continues to use. These include:

• Health care workers: doctors, nurses, care aides, all others, including admin staff
• First responders: police, fire fighters, paramedics, 
• Frontline helping professionals: Community/Mental health/addictions workers; social workers; therapists; housing workers, all others. 
• Airline flight crew; people working in airports.
• Transportation staff: bus drivers; skytrain attendants; ferry workers. 
• Politicians and staff: Elected officials and others. 
• Customer service and retail workers.
  

Fact #4: Community Transmission in BC and Canada 

As of March 9th, 2020 the BC government and BCCDC officials have confirmed that community transmission is now occurring for COVID-19. It has been scaling up, with thousands of Canadians exposed to individuals who are just getting diagnosed, or those who have been refused testing in their communities.

Several health care workers in BC, in different health authorities (Vancouver Coastal and Fraser Health) working in community care have been confirmed with COVID-19. These individuals do not fit the within the narrow exposure criteria for testing still being used in BC. 

Individuals/patients who became exposed and infected through these health care exposures, including patients who have been confirmed to have COVID-19, do not fit the ongoing limited and narrow exposure and testing criteria in BC or Canada.

BC and Canada’s ongoing testing criteria limitations (and test suppression in the community) also excludes family members of the affected health care workers, work colleagues, or others who they may have unintentionally exposed at home, work, or in their communities.

This means that if any of these individuals become symptomatic, they will not meet the testing criteria BC continues to refuse to update, or change, to increase the numbers of individuals who are being tested, diagnosed, identified, and for monitoring and contact tracing to occur to warn others of their exposures. All of these are best practices in public health management and responses to viral outbreaks. 

Fact #5: How Does One Get Tested for COVID-19 in BC?

Individuals who call 8-1-1 and speak with nurses are directed to go to family doctors/walk-in clinics in BC/Canada for assessment if their cases seem to warrant this. 

Individuals who present at many family doctors/walk-in clinics in BC/Canada are being told they do not have the capacity to test for COVID-19. Symptomatic patients are being told by community health care providers to go to local hospitals for testing. 

Upon presenting at local hospitals symptomatic people are being refused testing for COVID-19 if they do not fit the current narrow exposure criteria the BC government/BCCDC and local health authorities are still using. 

Fact #6: Epidemiological Outcome of Test Suppression in BC

Thousands of people with exposure histories, both overseas, and locally through community transmission (including the families/contacts of exposed health care workers) have been being refused testing for COVID-19 in BC, and other areas of Canada. 

Two secondary outcomes of test suppression in BC and Canada are:

People who are asymptomatic/pre-symptomatic are contributing to community transmission and spread, and scale up of COVID-19 because they have no symptoms at all, or they have milder cases and may not associate their symptoms with this virus. 

Many people with undiagnosed/untested cases of COVID-19 are not being identified, being monitored, having contact tracing done (investigating who they may have infected through contact), and they are being included in the real prevalence statistics which decreases the validity of B.C.'s reports on the true numbers of people who have COVID-19.

People are undiagnosed/untested are unaware of the risks of spreading the virus to others, and may not be using strategies, such as social distancing, to limit and contain the spread, and are contributing to the scaling up of community transmission of COVID-19.

Fact #7: BC Health Care Workers Exposed At Work 

The BC government and the BCCDC have confirmed that some of the newest confirmed cases, as of March 10th, 2020, have been health care workers. 

They have also reported that at least one of these HCW's was the index patient who exposed and transmitted the virus to others. This fits the definition of community transmission. 

None of these individuals fit within the narrow exposure criteria that the BC government and the BCCDC continue to use. This is significantly limiting the numbers of people who work in health care who can get tested for COVID-19 in BC. That is impacting the prevalence rates to identify the true numbers of of people who have it. 

The BC government and BCCDC and many elected officials, government and health authority officials continue to report we are "low risk" in BC. That is not an accurate statement.  Some of us face much higher risks, and that includes health care workers, and their families, and contacts. 

Please remember: NO ONE expects to be exposed to, or contract an infectious disease at work. All of the research and inquiries after previous epidemics, such as SARS, demonstrated that health care workers were put AT RISK on the job, with little support, inadequate personal protective equipment (PPE) provided by employers, and a lack of advocacy on the part of their professional organizations and/or unions. That is also happening for health care workers around BC and Canada with COVID-19. 

Fact#8: What Can You Do About This Situation

Speak to your Family Doctor: Insist on being tested for COVID-19 and other influenzas. If your doctor refuses to test you, or reports they don't have testing kits, ask them to chart that they have refused you testing for the reasons they give you. 

The College of Physicians and Surgeons of BC outlines Access to Medical Care for patients, advising the following of it's registrants:

The Canadian Medical Association (CMA) Code of Ethics and Professionalism is founded on the fundamental principles and values of medical ethics: compassion, beneficence, non-maleficence, respect for persons, justice and accountability. Appropriate access to medical care is a core value of Canadian society, and this access should be equally available to all patients, including those in vulnerable and marginalized populations. 

Link: https://cpsbc.ca/files/pdf/PSG-Access-to-Medical-Care.pdf.

Contact your MLA and MP

Email, or contact your MLA to tell them you want them to advocate for the exposure criteria to be changed, and updated in BC and that more testing for COVID-19 can occur in BC, or Canada.

Report local testing refusals by doctors to MLA’s: Advise them if you, anyone in your family, or in your community has been refused testing for COVID-19. BC’s elected officials have been completely silent while community transmission is spreading, including in their own ridings. 

Find out your MLA’s contact information here:

MLA’s by name: https://www.leg.bc.ca/learn-about-us/members

Search for your MLA by Postal Code: https://www.leg.bc.ca/Pages/BCLASS-Member-Search-PostalCode.aspx

Contact your MP (Member of Parliament):

Email, or contact your MP (Member of Parliament): Tell them you want them to advocate for the exposure criteria to be changed and updated in BC and that more testing for COVID-19 can occur in Canada.

Report local test refusals to MP’s and senators: Advise them if you, anyone in your family, or in your community has been refused testing for COVID-19. BC’s elected officials have been completely silent while community transmission is spreading, including in their own ridings.

Find out your MP’s contact information here: https://www.ourcommons.ca/Members/en

Advocate for your Professional Organization, Union and Employers to Do More to Protect You and Others at work. 

Contact WorkSafeBC to inspect Unsafe Workplace conditions:

Link: https://www.worksafebc.com/en/health-safety/create-manage/rights-responsibilities/refusing-unsafe-work

File a Claim if you are infected/injured at work: https://www.worksafebc.com/en/claims/report-workplace-injury-illness

References

BC Centre for Disease Control. Novel coronavirus (COVID-19). Retrieved from: http://www.bccdc.ca/health-professionals/clinical-resources/novel-coronavirus-(covid-19).

BC Government. (2020). Pandemic Preparedness: COVID-19 Preparedness and Planning Materials. Retrieved from: https://www2.gov.bc.ca/gov/content/health/about-bc-s-health-care-system/office-of-the-provincial-health-officer/current-health-topics/pandemic-influenza. 

BC Government. (2020). Pandemic Provincial Coordination Plan. Retrieved from: https://www2.gov.bc.ca/assets/gov/health/about-bc-s-health-care-system/office-of-the-provincial-health-officer/reports-publications/covid-19-technical-briefing.pdf.

Canadian Press. (2020). Nurses' unions warn national standards for coronavirus protection too low. Retrieved from: https://ca.news.yahoo.com/nurses-unions-warn-federal-standards-12000457.

Smith, M. (2020). Coronavirus is already taking a toll on Canada's front-line health-care workers. Macleans. Retrieved from: https://www.macleans.ca/society/health/coronavirus-is-already-taking-a-toll-on-canadas-front-line-health-care-workers/.

Coronavirus: Facts about Exposure Criteria, Testing and Case Surveillance for COVID-19 in Canada

                                  

“The nurses’unions warned the national guidelines to protect nurses, doctors and other hospital staff from exposure to the highly contagious virus are less stringent than those in other jurisdictions.”

Dr. BonnieHenry, British Columbia’s provincial health officer, said after announcing the death this week that an infected care aide from the same facility is believed to have worked at two other facilities.

“It’s a challenge with our system, with care homes,” she said. “We know that whether it’s care workers or nurses, even physicians, we work in many different health authorities, many different facilities sometimes. That is part of the ongoing investigation at the Lynn Valley care home, to find out exactly where everybody worked and make sure that the other facilities are investigated.” (Bains, 2020).

Fact #1: The two highest risk groups for being exposed, getting infected, and for transmitting and spreading a virus to others are family members, and health care workers. 

A great deal of epidemiological research is done to examine who is most at-risk when new infectious outbreaks and epidemics occur in Canada, and abroad. Thousands of health care workers in China have been infected by COVID-19 on the job. Many have lost their lives. 

Many of those workers unintentionally transmitted the virus to others, including other patients they were caring for, their families, and within their local communities. This is now happening across Canada according to the latest media reports that are now reporting on health care workers who are testing positive for COVID-19.

The Canadian Federation of Nurses Unions is warning that the federal public health agency's guidelines to protect front-line health-care workers from outbreaks of diseases like the novel coronavirus don't go far enough, and might be putting them and patients at risk.

Fact #2: The Public Health Agency of Canada, the agency taking the lead on managing the coronavirus/COVID-19 in Canada has:

Restricted the exposure criteria in a way that does not allow for testing of those who do not fit Canada’s narrow exposure and testing criteria. This has not changed as the epidemiological research has come out, as the virus has spread and scaled up internationally, and more health care workers are being confirmed to have COVID-19 in Canada.

- Continues to exclude ALL Canadian health care workers (doctors, nurses, residential care aides, and all others) from the exposure and testing criteria.

- Continues to exclude ALL individuals who may have been exposed to COVID-19 through health care exposures (their doctors, nurses, care aides etc.).

- Continues to exclude ALL family members, work colleagues, or others who may who may have been exposed to COVID-19 from health care exposures, or ANY other community exposures. 

- Continues to exclude ALL first responders, including police officers, paramedics, and fire fighters. 

- Continues to exclude ALL front-line workers working with medium to high-risk patients exposed to/having undiagnosed COVID-19.

Not responded adequately to changes in the reported epidemiological risk factors, dynamics, and research coming out about health care, and community exposures.

Outcome: There are potentially thousands of individuals across Canada who have been exposed to COVID-19, are carriers/transmitters, and who are contributing to community transmission and spread in Canada. 

Public health authorities in Canada continue to state that risks of contracting COVID-19 remain low as of this week. That is not accurate, evidence-based, credible, or reliable information for Canadians/others. 

Risk Level: Canada should be seen as medium to high risk for COVID-19. People who are at higher risk of complications that could lead to more severe, or critical cases and/or those at higher risk of mortality from COVID-19 should do all they can to prevent becoming infected, such as social distancing and improved personal hygiene. 

As of March 10 2020 the Public Health Agency of Canada Exposure Criteria is:

In the 14 days before onset of illness, a person who:

Traveled to an “affected area”: China (mainland); Hong Kong; Iran; Italy; Japan; Singapore; South Korea; OR

Had close contact with a confirmed or probable case of COVID-19;

Definition: A close contact is defined as a person who provided care for the patient, including health care workers, family members or other caregivers, or who had other similar close physical contact or who lived with or otherwise had close prolonged contact with a probable or confirmed case while the case was ill. OR

Had close contact with a person with acute respiratory illness who has been to an affected area within 14 days prior to their illness onset. OR

Had laboratory exposure to biological material (e.g. primary clinical specimens, virus culture isolates) known to contain COVID-19.

Factors that raise the index of suspicion should also be considered:

Other exposure scenarios not specifically mentioned here may arise and may be considered at jurisdictional discretion (e.g. history of being a patient in the same ward of facility during a nosocomial outbreak of COVID-19).

Note: PHAC/the Federal government have not added the United States to the list of “affected countries.” 

As of March 10^th, 2020, Washington State reported 267 total cases reported statewide, with 24 deaths.

What Can You Do About This Situation

Email, or contact your MP (Member of Parliament): Tell them you want them to advocate for the exposure criteria to be changed and updated in BC and that more testing for COVID-19 can occur in Canada.

Report local test refusals to MP’s and senators: Advise them if you, anyone in your family, or in your community has been refused testing for COVID-19. BC’s elected officials have been completely silent while community transmission is spreading, including in their own ridings. 

Find out your MP’s contact information here: https://www.ourcommons.ca/Members/en

Find Canadian Senators contact information here: sencanada.ca/en/contact-information

References

Bains, C. (2020). Better protections needed for health-care workers during COVID-19: advocates. Canadian Press/Medicine Hat News. Retrieved from: https://medicinehatnews.com/news/national-news/2020/03/11/better-protections-needed-for-healthcare-workers-during-covid19-advocates/.

Canadian Press. (2020). Nurses' unions warn national standards for coronavirus protection too low. Retrieved from: https://ca.news.yahoo.com/nurses-unions-warn-federal-standards-120004579.html.

Government of Canada/Public Health Agency of Canada. B. Case Surveillance and C. Exposure criteria. Retrieved from: https://www.canada.ca/en/public-health/services/diseases/2019-novel-coronavirus-infection/health-professionals/national-case-definition.html#exposure. 

King 5 News. (2020). Here are the deaths and cases of coronavirus in Washington state. Retrieved from: https://www.king5.com/article/news/health/coronavirus/coronavirus-covid-19-deaths-cases-washington-state/281-68179a8d-9ea9-461a-9077-1f32675b802b.

#Coronavirus: #COVID-19: Prevention: Key Ways to Prevent Getting It, Not Spread it if you do & What You Want in Your First Aid Kit

As the pandemic continues to grow, prevention is a key action many of us should consider. It's also one of the few things we can have any influence over regarding our own health, and the health of those around us. 

Disclaimer: This is not medical, or health care advice, and shouldn't be taken as such. See a qualified health care provider if you are concerned about your health, or symptoms. If you/your loved ones have symptoms that become more severe, seek emergency medical assessment immediately from your local health clinic, urgent care centre, or hospital.  

Key Ways to Prevent Contracting COVID-19

Change and improve your personal hygiene habits: Become more conscious and increase handwashing – when you come home from being outside; before and after preparing and eating food. 

Stay home if you are sick: Don’t expose others to any kind of communicable diseases, including the common cold, different forms of influenza, and COVID-19.

Wash your hands thoroughly: Use warm water and soap and wash for 20 seconds, sing ‘Happy Birthday.’ 

Decrease touching your face, eyes, nose: Become a lot more conscious of this.

Change how you cough: Cough into your arm, and don’t use your hands. Immediately wash your hands if you do cough, or sneeze onto them. 

Teach your kids/others to wash their hands properly, and not to touch their faces.

Use paper towels, or tissues to dry your hands, when touching surfaces, and dispose of these. 

Individual towels: Each person has their own hand towels, face cloth, bath towel.

Disinfect surfaces with bleach: Use bleach wipes, or products, and increase the frequency of this, especially if someone in the household is sick with anything, including someone with suspected, or confirmed COVID-19.

Regularly disinfect high-risk objects: door knobs, smartphones, home and work phones; toilets; taps (bathroom and kitchen); increase awareness of the objects you touch – and then wipe them down. 

Increase laundry frequency for washing towels, sheets, and anything that is touched. Consider using bleach.  

Increase your personal distance from others: You may want to become more conscious about staying about 2 metres away from others, if possible. 

Avoid medium to high-risk environments: Certain environments are higher-risk, its best to avoid them if possible, especially for those who have serious health conditions, and immune-suppression. See here for more information: https://advocacybc.blogspot.com/2020/02/coronavirus-covid-19-exposure-and.html.

Avoid crowded areas and events: Unfortunately, while we’re seeing an upswing, this is something people should consider. 

Proactive self-isolation: If you have come from a high-risk country, or have been in contact with people with suspected, or confirmed COVID-19, consider proactively self-quarantining, and reducing contact with others, because although you may not have symptoms, or develop it, you could still be a carrier and can transmit the virus to others. 

Wearing a mask: It’s not clear this prevents people from picking up this virus, but for those who are immune-suppressed, it may be something to consider because there are still a lot of other viruses around, and catching one of those could lower your immunity further. 

Boost your immune system: Increase your immunity through improving the quality of foods and nutrition you take in. Increasing antioxidants, and micro-nutrients. 

Improve sleep quality and quantity: Improve your sleep hygiene and habits, generally. Adults require 7-9 hours per night. This makes a HUGE difference in the strength of our immune system. 

Exercise: This is one of the best things to strengthen your immune system. You don’t have to be a marathon runner, get out and walk every day, if possible. Take the stairs over the elevator. Look for ways to move your body more. 

Monitor and Track symptoms: Get a thermometer to track your temperature. If you get a fever, carefully monitor this. 

If you have symptoms: In BC you can call 811 and speak with a nurse to review symptoms, have assessments completed, and they will recommend whether you should seek medical attention in person. 

Consider applying for Online Medical Care: If this is an option in your area, this may be a good way to avoid going into high-risk health care environments to be assessed, and/or having prescriptions given to you. Carefully consider the information, privacy and security issued related to the apps and programs used. 

Use plastic gloves: When doing certain activities, such as caring for sick people in your household, you may want to use gloves, and dispose of them each time you use them. 

If You Have COVID-19: How to Prevent Spread

Self-isolate/quarantine: Decrease the numbers of people you can potentially transmit the virus to.

Reduce contact with others: Stay home! Minimize and reduce contact with anyone in, or outside of the home. 

Wear a N95 mask to prevent spread when out in public, or around others at home. 

Ensure you have medical care to manage the symptoms that arise: You may want to consider online medical care if this is an option for you. 

First Aid Kit for COVID-19/Other Health Issues

It’s a good idea to be proactive and here are a number of items you can have in your first aid kit that could come in handy if you get sick.

Thermometer: You want to monitor temperature to see if you/your loved ones have developed a fever. Disinfect this when used, especially if you are sharing this amongst family members. Probably best to have one for each person. 

Over-the-counter (OTC) remedies for managing fever, cold/flu symptoms, such as cold and sinus medications. 

Cough syrup and logenzes: This might help to decrease inflammation in your respiratory system if you develop a cough that disrupts your sleep, or other activities, or just to soothe your throat. If your cough becomes severe, or if you have shortness of breath/labored breathing, get assessed by a medical professional ASAP. COVID-19 can progress to pneumonia, which is a serious disease.

Liquids: Ensure you drink a lot of water, herbal teas, and consider things that help replace lost electrolytes, depending on your symptoms. Suggestions: drink green, or other herbal teas, drink lemon, ginger, honey and other things that increase antioxidants, and soothe the body. 

Palatable foods: When most of us are sick we don’t have much appetite, but we do need to ensure we/our loved get some food into us. Soups; bland and less spicy foods; Vitamin-C rich foods; increased antioxidant-rich and probiotic foods, and other products keep the “machine” going, and improve your immune system to help you bounce back quicker.

Heating pad/heat bags: Chills and muscle aches can occur with COVID-19, and other health issues. 

Menthol rubs: These often help our respiratory system and muscles when we’re feeling congestion and aches. 

Purify the air of your home environment: You may want to get an air purifier, humidifiers or certain plants that improve air quality. 

Cleanse your respiratory system: Using a humidifier, a hot shower, steam, or even boiling water and using things like Vicks menthol, or cleansing and anti-septic essential oils in the water can help cleanse. 

Latex gloves: When/if you have to do self-care, such as cleansing infected areas (wounds, eye infections) you may want to use gloves, and/or disinfectant wipes. Re-infection is a risk. 

Sauna/steam: If you are lucky enough to have a sauna in your home (community saunas, steam rooms, or hot tubs aren’t recommended right now), consider increasing your sauna use. This leads to many different types of benefits, including cleansing your respiratory system. See here for more information about the health benefits of sauna: https://mentalhealthbc.blogspot.com/2020/01/therapeutic-benefits-sauna-and-steam.html.

Special consideration for those with respiratory ailments, such as asthma: Receive medical advice as to whether you should use a corticosteroid puffer/medication. The research on patients with COVID-49 seems to indicate this may not be medically advisable.

Baking soda & turmeric: Rash is a little known/discussed symptom. Simple compresses of baking soda and water, or turmeric and water can decrease discomfort and pain. Seeking medical attention is advised if you're experiencing serious pain. 

Essential oils: Certain oils and scents have anti-septic, cleansing qualities. These include birch, eucalyptus, tea tree, citrus, oregano, peppermint. These should be used with caution, as there really isn’t enough research to say they are evidence-based, but many cultures have used herbal remedies for centuries so they are worth considering. 

Disinfectants: As noted above, you want to make sure you disinfect surfaces with bleach. Bleach wipes are handing to have in your kit. 

Traditional medicine and treatments: Many cultures have their own ways of approaching disease and symptom management. Considering consulting with a traditional health care person, such as a Traditional Chinese Medicine (TCM), or Ayurvedic health practitioner if this is something you have found helpful, or is part of your culture. 

Videos

Things to Know About Preventing Coronavirus. UC Davis Health.

Medcram: Coronavirus Epidemic Update 17: Fighting Infections with Sleep (3 minutes in)

References

Swartzberg, J. (2015) 14 Ways to Improve Your Sleep: What can you do about those lost Zs if you do need more sleep? Here are 14 solid, proven, healthy ways to get better sleep. HuffPost. Retrieved from: https://www.huffpost.com/entry/14-ways-to-improve-your-sleep_b_8692440.

Medical News Today. The best foods for boosting your immune system. Retrieved from: https://www.medicalnewstoday.com/articles/322412#which-foods-boost-the-immune-system. 

Center for Disease Control. Prevention and treatment. Retrieved from: https://www.cdc.gov/coronavirus/2019-ncov/about/prevention-treatment.html.

Government of Canada. Coronavirus infection: Prevention and risk. Retrieved from: https://www.canada.ca/en/public-health/services/diseases/coronavirus/prevention-risks.html.

Government of Canada. Coronavirus Disease (COVID-19): Frequently Asked Questions (FAQ). Retrieved from: https://www.canada.ca/en/public-health/services/diseases/2019-novel-coronavirus-infection/frequently-asked-questions.html. 

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