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From Dentists to Playdates—Tips on Social Distancing During Coronavirus Crisis

March 20, 2020
by Colin Poitras

Millions of people across the country are hunkering down in their homes in response to social distancing mandates designed to reduce spread of the novel coronavirus. Federal and state authorities are advising people to avoid large gatherings and to keep a minimum distance of six feet of space when interacting with others. But such broad guidelines leave a lot of room for interpretation when it comes to practical applications. To help people navigate through this extraordinary time, Yale School of Public Health experts are sharing their insights on some of the more common questions that are popping up.

Is it safe for my children to go outside and play?

“Outdoor activity and exercise are an important part of a healthy lifestyle and something the whole family can do together,” says Christian Tschudi, the John Rodman Paul Professor of Epidemiology (Microbial Diseases.) “With many schools, fitness centers and gyms temporarily closed, going for a family walk or playing outside is a great way for children and adults to stay healthy. It helps reduce stress, exposes us to sunlight and fresh air, and improves sleep. All of those things boost our immune system to help fight off disease.”

Can I see my dentist if I have a cavity?

“Patients should call their dentist first as some offices are restricting treatment to those who need urgent care or emergency work,” says Melinda Pettigrew, Professor of Epidemiology (Microbial Diseases.)”If your provider is seeing patients for routine visits, then you should try to keep up with regularly scheduled health and dental appointments. The exceptions are if you are experiencing signs or symptoms of respiratory illness, you have traveled to a location with a level 3 travel health notice within the last two weeks, or have had contact with an individual diagnosed with COVID-19. The CDC’s guidance for dental care professionals during the COVID-19 outbreak is still being prepared. For now, the CDC is recommending dental care providers cancel non-emergency or elective dental procedures if patients have signs or symptoms of respiratory illness.

How can I support local restaurants and other businesses during this outbreak while still protecting myself and my family from possible infection?

Social distancing is the key,” says Yale School of Public Health Dean Sten H. Vermund, the Anna M.R. Lauder Professor of Public Health and a Professor of Pediatrics. “None of us wants to see our local small businesses in crisis due to the coronavirus. Some businesses have been told to temporarily close by state officials to help curtail spread of the virus. But others remain open with modified sales operations and hours. Here are some tips:

For restaurants, consider eating at home with take-out food. Phone ahead and pay in advance with your credit card or try to bring nearly exact change to limit contact time. Have the food delivered, if possible. Some restaurants have drive-through lanes. Use a cleaning wipe for your credit card before and after use.

For stores, avoid excessive shopping time. Make a list ahead of time and phone ahead to make sure the items you need are available. Consider using the self-checkout lane, if there is one, and wipe down the touch screen and touch pad both before and after use.”

Can my child have friends over to play? What about the birthday party invitation we received weeks ago, can my child attend?

“For these questions regarding children intermingling during the COVID-19 outbreak, some creative parenting is in order,” says Vermund. “Perhaps parents can help their child plan for an amazing ONLINE birthday celebration? For those who are invited to the virtual party, gift cards can be purchased online or cards can be shared and emailed to the child-of-the-hour. Having a child design or draw their own card adds an extra personal touch. Candles can be lit and the cake cut via Zoom or Skype or other social media apps. Before the birthday, perhaps a cupcake or two could be left at the house or apartment complex of each guest. Each virtual attendee can also convey a message of friendship and greetings to the birthday child. Even games could be played – like guessing the birthday child’s favorite color or drawing a picture of why they are happy to share the birthday child’s special day. If invited children do not have internet or computer access, perhaps they could provide text messages by cell phone or send their best wishes using through the U.S. Post. Parents might also think about postponing birthday celebrations for a few months so their children’s friends can enjoy the moment after current social restrictions lift.”

I have a family member in a nursing home that has stopped visitations. I’m concerned about them being isolated. What can I do?

“This is a very challenging issue – you want to support your parent, and make sure they feel connected, and you also want to support the nursing home in reducing spread of infection,” says Debbie Humphries, an Instructor of Public Health practice (Microbial Diseases). “If your relative is able to answer the telephone, or use any kind of technology, then you can check in regularly with telephone or video calls. If your relative isn’t able to answer the telephone, you may need to talk with nursing staff about your concern, knowing that they’re busy. Sending cards or other items through the post may be an option.”

“Contact with close family members is one of the largest influences on older adults mental and physical health,” adds Joan Monin, Associate Professor of Public Health (Social and Behavioral Sciences.) “One option people may want to consider is sending letters from children to the care facilities to combat loneliness in the facilities right now.”

An older relative has dementia. Are they more at risk during this crisis?

“According to the Alzheimer’s Association, dementia does not increase the risk for COVID-19 just as it does increase risk for flu,” says Monin. However, dementia-related behaviors, age and other health conditions can increase risk. For instance, people with Alzheimer’s disease and other forms of dementia may forget to wash their hands or take other recommended precautions. A disease like COVID-19 may also worsen cognitive impairment. Caregivers of individuals with dementia should follow CDC recommended precautions and consider these tips:

Watch for signs of increased confusion, which could indicate possible illness.

Place written reminders in strategic locations like the bathroom and elsewhere to remind people to wash their hands with soap for a minimum of 20 seconds. Show them how to properly wash their hands. For those with limited mobility, keeping hand sanitizer with at least 60 percent alcohol nearby is an alternative.

I am currently breastfeeding and worried about possibly transmitting the coronavirus to my baby. What should I do?

Professor Rafael Pérez-Escamilla, an international expert on breastfeeding and maternal and infant nutrition, encourages mothers to follow the current CDC guidelines for breastfeeding and to check the site regularly in case new information develops. For mothers with confirmed COVID-19 or who are under investigation for possible COVID-19, the CDC states:

“Breast milk is the best source of nutrition for most infants. However, much is unknown about COVID-19. Whether and how to start or continue breastfeeding should be determined by the mother in coordination with her family and healthcare providers. A mother with confirmed COVID-19 or who is a symptomatic PUI should take all possible precautions to avoid spreading the virus to her infant, including washing her hands before touching the infant and wearing a face mask, if possible, while feeding at the breast. If expressing breast milk with a manual or electric breast pump, the mother should wash her hands before touching any pump or bottle parts and follow recommendations for proper pump cleaning after each use. If possible, consider having someone who is well feed the expressed breast milk to the infant.”

I’ve heard there may be some natural remedies to stop the new coronavirus. Are any of these true? Drinking alcohol kills the virus. Gargling several times a day and drinking lots of water flushes the virus out of your system. Elderberry syrup helps fight the virus because it generates cytokines. Taking zinc or eating lots of garlic helps increase your immunity to the virus.

“Drinking alcohol won’t kill the virus,” says Humphries. “Gargling and drinking lots of water will not flush the virus out of your system. Drinking lots of water can keep you hydrated. There are no specific cures for this virus. Eating a variety of fruits and vegetables and limiting sugar and processed foods are generally good advice in staying healthy. While elderberry syrup has ingredients that are active against some bacterial and viral pathogens, we don’t know whether elderberry syrup would have any effect on coronavirus. Vitamins and minerals such as vitamin C, vitamin D, vitamin E, and zinc are important for effective immune responses against respiratory viruses; we do not know whether they play a role with coronavirus in particular.”

Submitted by Denise Meyer on March 20, 2020