Preventive Health and First Aid in the Time of COVID-19

I keep thinking about how our society is going through these super rapid changes due to the new coronavirus that causes COVID-19. I don’t think this virus is going to be a flash-in-the-pan in our shared experience either. COVID-19 will be a defining feature of our lives, the event that marks “before” and “after” for those of us who are alive and aware during this pandemic.  

One way we are going to have to change, and fast, is our approach to health. No longer can we drop in and see our primary care doctor for a truly minor inconvenience. Going to Urgent Care isn’t going to be a good choice either unless it’s for a truly urgent problem. Emergency Department visits should be reserved only for true life/ limb or vision-threatening emergencies.

Prevention of injuries and diseases must necessarily move to the forefront of our efforts. Preventive health is no longer optional, it’s what we have to do to not add additional stress onto our fragile, overburdened medical care system. Furthermore, basic first aid is no longer something we need to leave to our primary care provider. We need to learn to treat our own scrapes and bumps when it makes sense. 

I am not a doctor, or a nurse, or any sort of health care provider. I don’t even play one on TV. I am a mom, which means I can cure most minor injuries with a hug and a kiss. Please take my advice with a grain of salt. This article has, however, been reviewed by a medical care provider. Please contact your doctor if you have any sort of medical question or problem. 

Preventive Health

Preventive health care focuses on what you can do to stop yourself from needing medical care. This is a fantastic starting place for managing your own health. When I was a Peace Corps Volunteer in Bolivia, I was sent to live in a remote village. I had to hike several hours to get to a main road. I got my water from a natural spring and boiled it to kill all germs. Obviously, there was no electricity and no wi-fi. And no cell phones! 

During this time, I relied on a classic Peace Corps book from the 1970s called Where there is No Doctor. This book covers all topics in a clear, no-nonsense “I’m Ok, You’re OK” way, and is geared to low tech, low resource situations. Like, for example, when you’re a Peace Corps Volunteer living in remote Bolivia. Or now, when medical care is a whole lot less accessible. It’s a bit simple, and dated, but worth looking at. 

Either way, there are many things you and your family can do right now to have a positive impact on your health. None of this info should be new, but now would be a great time to start all of these small preventive health habits that can keep us away from the doctor’s office and hospital as much as possible:

• Stop smoking or using tobacco products of any kind
• Exercise for a minimum of 30 minutes daily  
• Eat fruits and veggies every day, if you can
• Try to avoid stress eating, eating processed foods, and foods high in cholesterol
• Brush your teeth twice daily
• Floss your teeth daily
• Get outside daily
• Wear sunscreen
• Don’t abuse alcohol or drugs
• Manage stress
• Virtually connect with friends
• Connect with family
• Try to get 7-8 hours of sleep each night, or more if you need it. And if you can’t sleep, for whatever reason, try to rest quietly.

Here are some tips on how to take care of specific parts of your body: 

Teeth: Use a soft-bristled toothbrush, floss daily, drink mostly water and don’t sip all day on sugary drinks, and use toothpaste with fluoride. 

Physical health: Your body and mind will both thank you if you move for 30 minutes nonstop each day. Take a walk, go for a bike ride, vacuum the house, play hopscotch, jump rope, get on an exercise machine at home, or do a free exercise video online. Many local studios are offering virtual classes that make it feel like you’re not exercising alone. 

Mental health: Those of us with ongoing mental health struggles with depression, anxiety, PTSD, or other conditions, need to be compassionate and loving to ourselves every single day. Being isolated, and not being able to access in-person therapy can be challenging. Some providers are offering telemedicine counseling. We need to make sure we do everything we can to keep ourselves mentally healthy. For me, this includes sleeping plenty, eating some veggies, and having a walk every day. I also need to make sure to interact (virtually or outside my home and 6 feet apart) with friends and to also take some downtime to disconnect entirely from the news. Continuing with prescribed medications is important. Please don’t stop taking medications without consulting with your doctor first. 

Eyes: Eyes are funny because I have never once considered how to keep them healthy. My eyes are very low-maintenance, so this advice comes directly from Dr. Google. The first tip is to eat lots of veggies. Green, leafy veggies are a great choice for all-around good health. Fish, eggs, nuts, and oranges are also good for eye health. Wearing sunglasses to reduce UV exposure from the sun is helpful. And a key point- something we all need to be reminded to do is to blink frequently and not focus on our screens without moving. Our eyes need to be moist and to focus on different depths frequently. 

Now let’s shift a little and talk about how to address the most minor concerns that can be treated at home with basic first aid. 

First aid is about responding to minor accidents in your home, with your family. I would never recommend offering first aid to a stranger (although you can offer a squirt of hand sanitizer and a band-aid without fear.) First aid is addressing minor cuts, sprains, burns, fevers, and bumps. 

To begin, once you make sure your mildly injured person is ok, go and wash your hands.

Cuts and scrapes: Apply pressure to the cut or scrape to stop bleeding. Then you can wash it with soap and water (just water is fine- run it under a faucet for a couple of minutes). Cover with a loose cloth or bandaid and some first aid ointment (ointment optional.)

It’s time to contact your health care provider if:

• The cut is deep and/or is causing major bleeding.
• The cut appears infected- it is red, warm, and is causing pain or swelling. This will take at least 24 hours to develop and likely more like 48 hours after getting cut.
• If there are foreign objects in the wound.
• If the wound is caused by an animal/or human bite.
• If the injured person has not had a tetanus shot (or if you are unsure about this.)

Sprains: How do you know if you likely sprained your ankle or if you broke it?

• Can you bear weight on the limb, even with a limp or pain – if yes, more likely to be a sprain
• Is the ankle tender over the hard bony prominence of the ankle or just below that? If below, more likely to be a sprain.
• If you can not bear weight on the injured ankle, or if the injured area is numb, it may be broken. 

Sprains use a memorable mnemonic: RICE. 

R– Rest your sprained part.

I– Ice your sprain, but don’t apply ice directly to your skin.

C– Use an ace bandage or cloth to wrap the sprain. Not so tightly as to cut off circulation.

E– Elevate your sprain. Keep it raised above your heart, when possible. This means lying down and elevating your ankle higher than your heart with pillows.

You can also take acetaminophen for pain if you’d like (we are not recommending ibuprofen at this time as the World Health Organization is unsure of how ibuprofen interacts with a COVID-19 infection. PLEASE contact your doctor before taking any medicine.)

Burns: Minor burns, ones that look like a sunburn or possibly have a few blisters may generally be treated at home. To begin, run cool water over the burn. You can submerge your burned part in an ice water bath. You can typically take acetaminophen for pain, but due to WHO advice, PLEASE contact your doctor before taking any medicine. You can apply aloe vera or lotion over a burn, but not if there is broken skin. If you have burns to the face or burns caused by breathing in super hot air (blasts, indoor fires, etc), it is best to get a medical evaluation or consult immediately.

Bumps on the head: Bumps are tricky. It’s easy to know that if you have a gigantic, bleeding wound that you need to seek medical help. But what if the injury is on your head? How do you know when it needs to be evaluated?

A bump that comes with nausea, unsteadiness, headaches or lethargy or confusion should be evaluated by a medical professional. In kids, continuous crying, a bulging soft spot, or constant vomiting- and any of the adult symptoms should be checked, even by telemedicine, by a health care provider. 

If the bump to the head is minor and doesn’t require a doctor’s visit, the injured person should be watched for any signs of change in alertness.

Fever: A normal body temperature is somewhere between 97-99 degrees Fahrenheit. A fever is typically 100 F or higher. Generally, the treatment of fevers is about keeping the sick person comfortable so they can rest. There is no emergency in getting the temperature down, and in fact, our immune system works better at higher temperatures to help us fight off infection.

Some young children can have febrile seizures with rapid changes in temperature (it’s not the height of the fever, but the rate of change that causes this.) These seizures, by definition, occur in the setting of fever, last for less than a minute, are followed by 5-10 minutes of being “out of it,” and while terrifying, are not dangerous. If your child (over 3 months) has a febrile seizure, call your doctor and get further instructions on what to do. Fevers are not, in and of themselves, dangerous. 

The treatment of fevers in adults and children is different. 

Fever in children:

• Encourage your child to drink fluids.
• Don’t give aspirin.
• Keep your child comfortable so they can rest.
• Give acetaminophen (Tylenol or paracetamol) per bottle instructions or consult a physician for dose. 
• Tepid sponge baths are the best way to help the body cool naturally. Evaporative losses are great at cooling you down. Repeat as often as needed.

Seek medical care or consult for a fever in a child:

• 3 months or younger.
• Who shows signs of dehydration like no wet diapers in 8-10 hours, crying without tears, dry mouth, or refusing to drink. 
• Stiff neck or headache
• Stomach pain
• Trouble breathing
• Rash
• Swelling in joints

Fever in adults:

• Drink liquids
• Take acetaminophen (Tylenol or paracetamol) per bottle instructions to relieve discomfort.
• Tepid sponge baths are useful and can be repeated as needed.

Seek medical care or consult for fever in an adult if they experience:

• Chest pain. 
• Severe headache.
• Trouble breathing.
• Stomach pain.
• Repeated vomiting.
• Dry mouth, dark urine, or inability to drink liquids.
• Pain in back or during urination.

While these tips and suggestions may be quite basic, they can go a long way to help you take control of your health and keep you and your family as healthy as possible. As Benjamin Franklin said, “An ounce of prevention is worth a pound of cure.” This phrase rings true now and we really have to do our best to keep ourselves and our families healthy. The less need we have for medical care, the more medical care providers can focus on COVID-19 and other urgent health concerns. 

Again, I am not a doctor. While this advice has been reviewed by Mario Trabulsy MD, it is really important that you trust your gut and call your medical provider if you think you have an urgent issue. Prevention and first aid are essential to maintaining your family’s health.