How to socialize in a pandemic

In early March, when most Americans began social distancing, the hope was that life would get back to normal after just a few weeks. It’s become clear now that some distancing will be needed for many more months, or even years, to keep the coronavirus at bay. But quarantine fatigue is real. Abstaining from all social contact for the long haul won’t be a sustainable option for most people. So, how can we make decisions about socializing during the coronavirus pandemic?

Risk isn’t binary

Public health messaging over the past several months has focused on staying home as much as possible. Staying home alone or with your household members is still the lowest-risk choice you can make with respect to catching or spreading the coronavirus. Being in a crowded indoor environment is the highest-risk choice.

But risk isn’t binary, and there’s a lot in between those two options. Thinking about a spectrum of risk can help you choose the lowest-risk options for socializing that will be sustainable for you in the long term.

How can you assess the spectrum of risk?

The risk of contracting or transmitting the coronavirus depends on many factors. Here are some important considerations when you’re assessing risk to yourself and others.

• Know what’s happening with virus transmission in your community. Try to keep tabs on what’s happening with community spread where you live. For example, pay attention to whether the number of new cases, hospitalizations, and deaths are high or low, or increasing or decreasing. Some regions are opening while these numbers remain fairly high, so you may choose to be more conservative with your social contact than the current recommendations in your area. Just because the hair salon is open doesn’t mean you have to get a haircut.
• Consider vulnerability to the coronavirus. If you or your social contacts are particularly vulnerable to the coronavirus, either because of older age or underlying health conditions, factor this into your assessment of risk when making decisions about interactions outside of your household.
• Evaluate the risk of the activity, which includes its duration and setting. The highest risk for transmission is with close contact, prolonged interaction, and enclosed environments. In contrast, keeping a distance of at least six feet, brief interactions, and outdoor settings will keep risk lower. Sitting indoors a few feet away from a friend and having a long talk is a higher-risk situation than going for a stroll or chatting briefly with that person outdoors. Face coverings can further reduce risk, and are particularly important when interacting with people in close proximity or indoors. It also helps to use other protective measures, including frequent handwashing.

The benefits of being social

Health is more than just disease prevention. For many people, being healthy requires social interactions with friends and family, spending time outdoors, exercise, physical intimacy, and other pleasures of life. When making decisions about social contact during the coronavirus pandemic, you will need to weigh the risk of the interaction against the potential benefits to your overall health.

Harm reduction strategies can help

Unlike abstinence-only messaging, which simply tells people to stay home, a harm reduction approach meets people where they are by accepting that it isn’t always possible to eliminate risk. It supports people in making lower-risk — but not necessarily zero-risk — choices that are sustainable for them, and offers strategies to reduce any potential harms. The abstinence-only and harm reduction approaches share the same goal of reducing illness and death, but from what we know about HIV, substance use, and other areas of health, harm reduction is far more likely to work.

Several examples of harm-reduction approaches to social contact have been adopted outside of the United States. Acknowledging that single people may need physical intimacy, the Netherlands has suggested that people find a seksbuddy, with one consistent sex partner being much less likely to spread the coronavirus than having multiple partners. Several provinces in Canada have issued guidance on “double bubbles,” in which two households agree to socialize exclusively with each other without the need for physical distancing.

It’s true that every additional social interaction increases risk, but with continued social distancing from other individuals and households, harm reduction approaches might help people forego higher-risk activities, like crowded house parties, over the long term. As we enter the fourth month of this pandemic, with many more months ahead, it’s time to start thinking about sustainability.

Follow me on Twitter @JuliaLMarcus

For more information on coronavirus and COVID-19, see the Harvard Health Publishing Coronavirus Resource Center.

The post How to socialize in a pandemic appeared first on Harvard Health Blog.

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Coronavirus cases continue to rise in Kentucky; governor touches on many topics: testing, politics, schools, health disparities, etc.

State map, labeled by Kentucky Health News, shows rates through June 3. Click on it to enlarge.

As news develops about the coronavirus and its covid-19 disease, this item may be updated. Official state guidance is at kycovid19.ky.gov.

By Melissa Patrick
Kentucky Health News

The number of new, daily coronavirus cases in Kentucky continues to creep up, hitting a seven-day high of 295 on Thursday.

Beshear called the number "pretty high . . . elevated from where we were going for more than a week," but said it is "a little too early" to say the trend has reversed and is on an upward trajectory.

"Again, it's not enough data to say that I am concerned or to raise a high level of concern," he said, pointing to other metrics: "We have a lot of tests that are out there. We are testing more asymptomatic people than ever. Our ICU current beds are really low."

Kentucky briefly celebrated a two-week downward trajectory in new cases just last week, but starting May 28 the number jumped to 283, and for five of the last seven days the case numbers have been over 213.

Kentucky Health News chart shows cases for last two weeks and trendline for the period.

Of the 295 new cases, most of them, 149, were in Jefferson County. No one asked Beshear or Health Commissioner Steve Stack about that, and neither of them offered any comment on the unusual figure. Other leading counties were Kenton and Warren, 14 each; Boone, 13; and Clark, nine.

Beshear reported an adjusted total of 10,705 cases in the state, with at least 3,303 of them having recovered. He said 518 people are hospitalized with covid-19, including 67 in intensive care. So far, the state has had 262,714 tests.

Beshear said Kentuckians should expect to see more positive tests as the state continues to ramp up its testing and as people's contacts begin to increase with the economy reopening.

"Now, I hope that they are lower than this, but we're going to have more," he said. "We're going to watch the numbers as we continue."

Stack noted that the state's testing capacity is well above the federal guidance to test 2 percent of the population each month.

He said another way to reach this guideline is to test until the number of people testing positive for the virus is less than 3%, which indicates that enough people are being tested to find the positive cases. Kentucky is currently at 4.07%, reports the Lexington Herald-Leader.

While the state has more than enough testing capacity, Beshear said he remains worried about "testing fatigue," noting that the sign-ups in the free Kroger-sponsored sites have been slowing. He called on employers to get their employees tested regularly.

"If you are running a business, you ought to want your employees to continue to go to get tested so that someone who is asymptomatic doesn't spread it throughout the office or the factory or the environment that they work in," he said. An estimated one-fourth to one-half of the people with the virus have no symptoms but still spread it without knowing.

Deaths and classifications: Beshear announced that eight more Kentuckians have died of covid-19, bringing the state's death toll to 458.

The new dead were an 87-year-old woman from Boone County, a 72-year-old man from Franklin County, an 82-year-old man from Grayson County, a 92-year-old man from Kenton County, a 71-year old woman and 91- and 92-year-old men from Jefferson County and an 86-year-old woman from Metcalfe County.

Asked it he would consider doing a separate count of people who have died from multiple issues, he said that could be counterproductive.

"Almost everyone that has died from the coronavirus has underlying health conditions and many of them are serious and significant health conditions," he said. "I don't want to over-complicate in our numbers what this virus does. Yes, there are other causes, but without this virus in most cases, we do not believe that the death would be there.

"And there may be some that say, 'Oh, well, that's conflating it.' No, this is killing people and if we don't take it seriously, again if we pull out our numbers in different ways that let us rationalize that it is not a problem, then we don't do what is necessary to defeat it."

Politics: Asked about Attorney General Daniel Cameron's suggestion to a legislative panel that the governor's executive authority during such emergencies should be limited, Beshear referred to his presentation the day before defending to his orders and noting three studies showing they "saved thousands of lives."

"It's after we've blunted the curve and crushed the curve that politics comes back into it," he said. "But, if a future governor did not have the power to take urgent action when it is needed, it would have resulted in significant additional death. . . . Every action that I've taken is for the life and the safety of our Kentuckians."

Schools: Asked about schools reopening, Beshear said he hopes there will be a regular reopening, but cautioned that school will look much different than it currently does.

He pointed to recent testimony at a legislative hearing that objected to public-health suggestions for social distancing, wearing masks and keeping one group of students together all day, while teachers move from class to class. 

"If schools don't do things differently, they have an outbreak, you shut down that school," Beshear said. "I think we've seen that in France and in some other places. My hope is that we can start school normally in the fall, but those schools that are willing to embrace the things you need to do to prevent the spread are likely going to be able to continue and not have interruption." 

He said state officials are still working on guidance for schools and it this will be influenced by what happens with the virus over the next few months. 

Disparities: Beshear said he would announce actions that his administration will take to address disparities in health care and other areas among "communities of color." on Monday. North Carolina Gov. Ray Cooper signed an executive order Friday establishing a task force to address the issue, ensure that relief funds have been fairly distributed and giving minority-owned businesses access to more opportunities and resources. Beshear said he wants to change the situation, not just come up with recommendations.

For additional information, including up-to-date lists of positive cases and deaths, as well as breakdowns of coronavirus infections by county, race and ethnicity, click here.

In other covid-19 news Thursday:

• "Less than a year after Kentucky celebrated its first decline in overdose deaths in five years, evidence is building that the covid-19 pandemic and its fallout have fueled a rise in drug relapses and fatal and nonfatal overdoses in parts of Kentucky," Chris Kenning reports for the Louisville Courier Journal. 
• The long-term-care facility webpage has been updated to an easier-to-read format. It shows that 1,384 residents and 639 staff have ever tested positive for the virus, with 411 residents and 141 staff currently with it; 283 residents and two staff have died of covid-19. 
• Six Eastern Kentucky counties are among the 25 U.S. counties with the highest overall food-insecurity rates, and the covid-19 pandemic is making it worse, Liz Moomey reports for the Lexington Herald-Leader. Michael Halligan, the chief executive officer of God's Pantry Food Bank, told her that the region had never quite bounced back from the 2008 financial crisis. She writes that many food banks are just beginning to reopen. 
• Beshear announced that Nascar would be allowed to race at the Kentucky Speedway July 9-12 without fans and more information on this would be coming Monday. He said betting parlors for "historic horse racing" can open Monday, June 8, at 33% capacity. 
• Also opening Monday are in-home childcare, libraries, horse shows, and educational and cultural activities. The Kentucky Horse Park and state park campgrounds can open June 11.

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The doctor will “see” you now: Teledermatology in the era of COVID-19

The COVID-19 pandemic has transformed healthcare delivery across the world. Headlines about shortages of lifesaving resources and personal protective equipment have dominated our attention. But patients and doctors are also facing quieter challenges. Social distancing measures and concerns about transmission of the virus have significantly reduced the number of patients coming into hospitals and doctors’ offices for non-COVID-related health concerns — sometimes at a significant detriment to their health — due to delays in diagnosis or treatment.

In response, hospitals and clinics are increasingly turning to telemedicine — appointments by phone call or videoconference — as a way to safely treat patients during this public health crisis. And telemedicine visits are increasingly being covered by insurance. Dermatology is one of many medical specialties now “seeing” their patients virtually.

Dermatology is well suited to telemedicine

Dermatology is a highly visual field that is particularly well-suited for telemedicine in the current era where smartphones, tablets, and laptops are nearly ubiquitous, and can be easily used to take and send photos or to teleconference in real time. Even before the COVID-19 pandemic, studies found that teledermatology diagnoses can be accurate, result in high patient satisfaction, and allow for better access to dermatologists in areas where their numbers are limited or wait times are high.

Put your best face forward

Poor image quality can reduce the usefulness of teledermatology, but there are steps you can take to make these visits more productive.

For a start, try to send photos to your dermatologist ahead of your visit, even if your telemedicine visit will be conducted through real-time videoconferencing. Videoconferencing relies heavily on internet connectivity, bandwidth, and video quality (of both the physician and the patient), which can significantly impact image quality.

When taking photos, choose a solid, nonreflective background with diffuse, fluorescent lighting. Use macro mode, which is better for close-ups, if possible. Flash photograph has its pros and cons, but if there is good lighting overall, then turn off the flash, which can change the color and white balance of the photo. If you are taking a picture of a lesion, such as a mole, include a ruler, or another object for size reference, in the photo.

For videoconferencing, try to make sure you have stable internet connectivity and sufficient bandwidth before the session. Sit in a location with sufficient lighting (though it’s better if your back is not to a window), and in front of a camera that is in focus, stably positioned, and adjustable (in case the physician asks for both distant and close-up views). Depending on the part of the body in question, you may want to find a sufficiently private space for your appointment. Also remember to dress in a way that will allow easy viewing of the area of the body that the doctor needs to see.

Limitations of teledermatology may make it less useful in certain cases

Certain types of cases warrant special consideration due to the limitations of teledermatology, including image quality and lack of access to certain tools. In these cases, teledermatology is often best used as a tool for triage. The dermatologist can gather a thorough history and use the available visual information to formulate a plan for whether and when the patient should be seen in person.

One such case is the evaluation of pigmented lesions, which include freckles and moles, often in the context of whether such a lesion is cancerous. When evaluating these lesions in person, dermatologists often use a device called a dermatoscope, which illuminates and magnifies lesions so that finer details are visible. Pigmented lesions can be diagnostically challenging over telemedicine because dermoscopy is rarely available.

Hair-bearing areas such as the scalp can also be difficult to visualize well, and may need to have hair parted or removed, and photographed with special lighting. Mucosal surfaces, such as the inside of the mouth, can be similarly hard to fully visualize, and need special lighting and exposure. And while many dermatology patients can expect to have a full body skin check in the office, this is very difficult to do in a thorough and meaningful manner over telemedicine.

Finally, skin concerns that may involve a procedure, such as a skin biopsy or a medication injection, cannot be done via telemedicine. In these cases, a telemedicine visit can help guide the decision for whether the procedure is needed and how urgently.

As we continue to adjust to the effects of COVID-19, hospitals and clinics will likely be employing a hybrid strategy of telemedicine and in-person visits in order to provide the best medical care for patients in the safest environment.

The post The doctor will “see” you now: Teledermatology in the era of COVID-19 appeared first on Harvard Health Blog.

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Beshear defends actions to control virus as trendline keeps going up; nursing homes will likely be last to lift covid-19 restrictions

Today's report increased the upward tilt of the two-week trendline. (Kentucky Health News chart)

As news develops about the coronavirus and its covid-19 disease, this item may be updated. Official state guidance is at kycovid19.ky.gov.

By Melissa Patrick
Kentucky Health News

Amid further signs that the coronavirus is resurging in Kentucky, Gov. Andy Beshear offered his most comprehensive defense of his actions to control it.

"We didn't take these steps because anybody loves power or is trying to do anything; we took them to save lives," the Democratic governor said, repeatedly saying that all his moves were in step with White House guidelines.

After two weeks of a downward trajectory in new cases, a key federal metric for reopening state economies, four of the last six days have shown an increase, with today's number hitting 265. That made for a six-day average of 216, well above the previous six days' average of 128.

"I don’t think this 265 is a cause for alarm, though it is at least a reminder … that this virus is still out there and spreading," Beshear said. "We do have to watch this pretty carefully."

Health Commissioner Steven Stack used a different metric, the percentage of tests that find infection. That number has been on a slow decline for two weeks, to about 4 percent. The goal is 3 %.

Stack didn't give a number for Wednesday, but said the positive results at Kroger-sponsored testing sites, which are likely a "decent snapshot" of the overall rate in a community, are generally about 1 %, ranging from near zero to over 2%.

He said the positive rate at health departments and hospitals in the last week has ranged from 1.1% to 4.4%, and that has been "relatively consistent over the last two to three weeks." The rates have been higher at long-term-care facilities, where the state is testing all residents and employees.

"So right now the data does not say that we are in an uptick," Stack said. "At worst it would be a plateau of some sort; it may still be a downward slope."

rt.live estimate of transmission rate, with low point noted

He said the CovidActNow website estimates the rate of transmission of the virus in Kentucky to be 0.96. A rate of less than 1 means the virus should eventually stop spreading because the average number of people infected by an infected person is less than 1. However, the rate estimated by the rt.live website is 0.99, and has been on an uptick since May 7, when it was 0.95.

Stack, who has expressed concern about a resurgence of the virus because not enough Kentuckians are taking it seriously, cautioned that "there is significant time delay" between actions that may increase the spread of the virus and a significant increase in cases, because of its incubation period.

"So if we are going to see a surge after a major event, it is going to be two or three weeks later that maybe we start to see a signal that there is a surge, and it's probably going to be a month and a half to two months later that we really hit a bad place," he said. "So we'll keep watching carefully."

In his presentation of his actions to combat the virus, Beshear noted that the state's mortality rate is much lower than that of the nation as a whole and the world. Kentucky's rate is 4.3%, compared to the U.S. rate of 5.7% and the world rate of 6.1%.

"We are not just beating the national and the world average, but we're doing it with a population in Kentucky that is relatively sick, that has heart and lung and kidney disease more so than many other places," he said. "Yet still, we are taking care of each other in very important ways." He estimated that the economic restrictions he imposed saved more than 10,000 lives, based on modeling that forecast tens of thousands of deaths.

Beshear said the actions he took were similar to those of other governors, and he highlighted the actions of Republican governors in Indiana, Ohio, Maryland and Massachusetts. He said actions were taken in "red states, blue states; it didn't matter." What he didn't say is that Republican governors have generally been quicker to relax restrictions than their Democratic counterparts.

Beshear reported an adjusted total of 10,410 positive cases of the virus in the state, with at least 3,283 of them having recovered. He said 488 people are hospitalized with covid-19, including 68 in intensive care, which is the lowest number for this measure the state has seen in a while.

Infant death: He said eight more people have died from the virus, including a nine-month-old girl from Hopkins County, a case he mentioned at the start of his briefing. "This is a reminder of how deadly this virus can be," he said.

Stack said that if not for the pandemic, the death would have been attributed to Sudden Infant Death Syndrome, but he said it would be counted as a covid-19 death because the infant tested positive for the virus. He said the virus may or may not have contributed to the child's death, and the truth may never be known.

He reminded parents that children "overwhelmingly do just fine" with the virus and the vast majority of them have no symptoms. Some have developed a multi-system inflammatory syndrome that is linked to the virus; Kentucky has reported four cases, and all the children have recovered. "I would encourage parents to not worry overly, but that you should be concerned," he said.

Stack also cautioned that while younger people also tend to recover from the virus or don't have symptoms, this is not always the case, pointing to a 48-year-old man from Shelby County with no pre-existing conditions who was among added today to the list of those who have died from the virus.

Stack cautioned that as the weather warms and normal activities resume, it becomes even more important to do everything we can to slow the spread of the disease, because there is no vaccine and no treatment, and no evidence that warm weather will slow the virus.

“I have tried all along not to be sensational about these things, but to be factual, to be even-handed,” he said. "This is a very serious disease. It is not influenza. . . . It can rapidly spread, it can rapidly overcome the health-care system."

Today's other deaths were two women, ages 91 and 99, from Edmonson County; an 84-year-old woman from Gallatin County; and three women, 91, 92 and 93, from Jefferson County.

In long-term care facilities, Beshear reported that 15 more residents and nine more staff have tested positive for the virus, bringing those totals up to 1,366 and 633, respectively. He said 10 more deaths in these facilities were attributed to covid-19, bringing that number up to 245 deaths.

Beshear said testing for the virus has been completed in about half of the state's nursing homes, and to his and others' surprise, some of them had no positive cases. Nursing home have accounted for about 58 percent of the state's covid-19 deaths.

Beshear warned against "testing fatigue," and urged Kentuckians to sign up for free, drive-thru testing sites for next week at Kroger-sponsored sites in Louisville, Lexington, Bowling Green and Elizabethtown. Spots are still available this week and sign-ups have opened for next week.

Beshear once again asked Kentuckians who are protesting against police violence to make sure they are wearing masks, social distance where possible, to protect those in their lives who may be more vulnerable to the disease, and to consider getting tested in the coming days.

In other covid-19 news Wednesday:

• The counties with the highest number of new cases Wednesday were Jefferson, 55; Fayette, 37; Boone, 30; Kenton, 27; and Warren, 24. Beshear said only one county has no reported cases. That is Robertson, which has about 2,300 people. 
• Nursing homes and medical centers will be among the last places to lift covid-19 rules, Bailey Loosemore reports for the Louisville Courier Journal. "Normal considerations where people were coming in like they used to, I think, is way down the road, maybe even until we get a vaccine or effective therapeutics," Tim Veno, president of LeadingAge Kentucky, a trade organization that represents nursing homes and assisted living centers, told Loosemore. "We hear from residents every day who want to see their loved ones, and it's very painful, with regard to that. But we also believe we have a paramount duty to protect their health and welfare."
• Emergency department visits declined 42% during the early part of the pandemic, with the steepest decreases in persons 14 or younger, females and the Northeast, all while the proportion of infectious disease-related visits was four times higher, according a study published in the Morbidity and Mortality Weekly Report of the Centers for Disease Control and Prevention. The CDC advises increased health messaging about the importance of seeking immediate care for serious conditions, and to encourage virtual visits for those who have conditions that are not emergencies.
• Among other coronavirus information, The Guardian offers a coronavirus "deaths per capita" and "cases per capita" map, pointing out that the actual death toll is thought to be far higher than the tally compiled from government figures. It says that as of June 3, Kentucky has 10 deaths per 100,000 citizens and 228 cases per 100,000.  
• Becker's Hospital Review has compiled a non-exhaustive list of data and stories about why racial disparities and covid-19 matters in healthcare. 
• The Lexington Herald-Leader explores safe sexual practices during the pandemic.

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Reuters report is another classic case study in how NOT to cover COVID-19 news

Reuters: Italian scientist Alberto Zangrillo

Four days ago, Reuters reported from Rome, “New coronavirus losing potency, top Italian doctor says.”

The statement that COVID-19 “has become much less lethal” and that “the virus clinically no longer exists in Italy” caused an uproar in the global scientific community.

But it was Reuters that gave the scientist an international megaphone.

Journalist Roxanne Khamsi was one of the first I saw to react to the Reuters story on Twitter:

Are you KIDDING ME??? @stephenjadler, as Editor-in-chief of Reuters, take this down! This is one doctor’s conjecture.

If you are a science journalist who follows me, please add your two cents here 👇 so that they get the message. h/t @anggrainiLBhttps://t.co/ZzDiiwcHaJ https://t.co/ZjLJglnyxf

— Roxanne Khamsi (@rkhamsi) June 1, 2020

Indeed, it was a train wreck Reuters story.  A rushed 348-word brief, the first two-thirds of which were nothing but stenography of the scientist’s opinion, with no clear evidence to back it up.

We often hear that science is self-correcting. In this case, journalism employed some self-correcting steps on social media and in this story from the Washington Post, “Experts dispute reports that coronavirus is becoming less lethal.” The Post story calmly explained:

The consensus among other experts interviewed Monday is that the clinical findings in Italy likely do not reflect any change in the virus itself.

(The Italian scientist’s) clinical observations are more likely a reflection of the fact that with the peak of the outbreak long past, there is less virus in circulation, and people may be less likely to be exposed to high doses of it. In addition, only severely sick people were likely to be tested early on, compared with the situation now when even those with mild symptoms are more likely to get swabbed, experts said.

And a “What You Need To Know” piece in Forbes stated:

“As most horror movies have probably taught you, don’t make any assumptions that a threat has subsided until you are really, positively, absolutely sure that it has.”

Reuters itself published another story one day later, explaining:

World Health Organization experts and a range of other scientists said on Monday there was no evidence to support an assertion by a high-profile Italian doctor that the coronavirus causing the COVID-19 pandemic has been losing potency. …

“The suggestion by the Italian doctor is potentially dangerous as it gives false reassurance based on no evidence,” said Leana Wen, an emergency physician and public health professor at George Washington University. “There is no scientific evidence for there having been a change in the coronavirus. It’s a highly transmittable and highly contagious disease. We need to be as on guard as ever.”

Why weren’t those calls made to WHO and a range of other scientists before publishing the sensational Sunday story? What in the world justifies rushing a 348-word story to publication on a Sunday without doing extra research and reporting? Just because a scientist said it? COVID-19 journalism that devolves to that level of dreck is dangerous.

Reuters must examine its editorial decision-making. News spreads like a virus – globally – and causes harm when reported the way Reuters reported this story.

At the very end of the Reuters story is a link to Our Standards: The Thomson Reuters Trust Principles. One of them is this:

That no effort shall be spared to expand, develop, and adapt the news and other services and products of Thomson Reuters so as to maintain its leading position in the international news and information business.

It’s pretty clear that effort was spared in this example.

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Career-college CEO says to take a look at health care careers

By Bruce Kepley

In the mid-1990s, I started and ran a business that trained workforces on specific computer software. Large companies would hire us to come in and train their entire workforce to use the new tools the company had purchased.

It was interesting work and we were good at it, but a small segment of our business was even more interesting to me. Our industry called them “career-changers.”

These were individuals who wanted to do more than just learn a specific piece of software that they would use at their existing job. They wanted to retool their career for a newly emerging, more tech-savvy economy. The students wanted to become software developers or engineers.

Each of those students had a different personal story, but they were united in realizing that economic shifts represent opportunity for those who are willing to keep learning.

Along the way, I’ve shifted too. I moved away from workforce training, to career-oriented colleges. And I’m now the majority owner of MedQuest College, which is focused on health-career related occupations. But the students we work with today have much in common with those students I met 30 years ago.

The economic tides have shifted several times since the mid-90s. The dot.com bubble came and went. The terrorist attacks of 9/11 caused huge shifts in our national priorities and interests. Then, in 2008 we saw the beginning of the Great Recession.

What I saw each time was greater interest in education and higher enrollment at colleges like MedQuest. According to the U.S. census, enrollment jumped 29 percent at two-year colleges during the Great Recession.

Our current economic downturn is unlike anything any of us have experienced. The future is filled with many uncertainties. Unemployment has skyrocketed — and it’s hard to know how quickly those jobs can come back.

But this month, MedQuest and other colleges — proprietary, private and public — will be starting new classes. Those classes will be filled with students who see education as a path into a brighter future. At MedQuest in particular, the students tell us that by preparing for a career in health care they are choosing to be part of the solution in a time of uncertainty.

When responsible colleges see sudden growth in interest or enrollment, they worry about outcomes — will all these new students be both dedicated to finish and will there be jobs waiting for them when they are done? But my experience in previous downturns makes me confident that, in fact, education is part of the way we pull ourselves out of economic slumps.

For the high-school seniors who graduated this month, for the people who are watching health-care heroes and wondering how they can become a part of that critical industry, and for those who have suddenly experienced reduced hours, furloughs or layoffs, I recommend that you take a moment to explore higher education options. Whether you’re adding a new skill or credential, or revamping your career entirely, this may be the best time to act. That’s a way all of us can help build a better economy.

Bruce Kepley is CEO of MedQuest College in Louisville. This first appeared in the Courier Journal.

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Easing stress and seeking normalcy in traumatic times

For most Americans, 2020 has already been a rough year — and it’s not even half over. A pandemic, natural disasters, economic decline, and, for many, the loss of a job have taken a toll on their mental health.

“Stress is particularly acute when you’re experiencing a situation that is outside of your control,” says Dr. Kerry Ressler, professor of psychiatry at Harvard Medical School. “You may feel stuck, frozen, or helpless.” After a traumatic period, even when things settle down, it can be difficult to move on and regain a sense of normalcy.

Reducing stress and regaining your footing

So, how can you reduce your stress and regain your footing after going through a bad time, whether that’s the result of a large-scale national emergency or even just a personal patch of bad luck?

Step back. When traumatic events are occurring, whether it’s a natural disaster, pandemic, or mass shooting, you need to stay abreast of the news, but at the same time avoid retraumatizing yourself by becoming immersed in round-the-clock coverage, says Dr. Ressler. Limit the time you spend in front of screens or reading about the events of the day. The goal is to stay informed without increasing your anxiety level. Turn off the notifications on your phone, and be particularly wary of spending too much time on social media. “People have the tendency to amplify each other’s panic,” says Dr. Ressler. “Instead, limit your exposure to checking in on the news a couple of times a day, and then turn it off. Listen to an unrelated podcast, or go for a run.”

Take action. “What we do know from research is that one of the biggest precipitators of anxiety is a feeling of helplessness, when everything seems out of your control,” says Dr. Ressler. To take back some control, get involved in activities that can help others or address the situation. Volunteer, or help with food drives. Even helping a friend or a neighbor with a problem can make you feel like you are in an active, not passive, role in the face of uncertainty. Taking on a hobby or self-improvement project can also help you move forward. If you lose your job, use some of the unexpected time to take a class or learn a new skill you’ve always wanted to master. For example, there are a lot of great apps you can use to learn a new language.

Reach out. Social connections are crucial in difficult situations. If you can’t see people in person, then connect with apps and technology, such as videoconferencing or even a simple phone call.

Get rose-colored glasses. While advice to look on the bright side in the face of hard times may seem trite and unhelpful, don’t scoff. Evidence shows that positive thinking and having the ability to reframe a situation in more positive terms can help people become more resilient in the face of problems, says Dr. Ressler. Look for silver linings whenever you can. A job loss, for example, may lead to new opportunities.

Be patient. Moving on from a traumatic event takes time. Give yourself permission to grieve. Grief doesn’t just occur when you experience a death; rather, people experience grief in many situations, says Dr. Ressler. This may include the loss of an opportunity or missing out on something you were looking forward to doing. Allow yourself time to grieve, but eventually try to ready yourself to move past it. “You can get into the habit of grief,” says Dr. Ressler. So, set small goals. Use behavioral rewards, and strategies such as deep breathing, mindfulness, aromatherapy, and physical activity to reduce your anxiety and start pushing yourself to move forward.

Seek help for depression

Get help. Make sure that sadness and stress don’t cross over into depression. “The symptoms of depression overlap with normal symptoms of stress and grief,” says Dr. Ressler. But if you start to experience significant alterations in appetite, energy, or motivation, or if you begin to get sad or tearful without knowing why — and these symptoms last for more than a week or two — these may be warning signs that you are experiencing depression and need to seek medical help.

“If you have a period of sadness that goes on for more than a couple of weeks and it’s really getting in the way of you moving on or functioning at work or home, it may be wise to reach out,” says Dr. Ressler.

Call your doctor, or healthcare plan, to learn about options. Additionally, in the US, the Disaster Distress Helpline (800-985-5990, or text “TalkWithUs” to 66746) offers emotional support and resources to people struggling in the wake of disaster, and the National Suicide Prevention Hotline (800-273-8255) offers free support for people who are in emotional distress or a suicidal crisis.

The post Easing stress and seeking normalcy in traumatic times appeared first on Harvard Health Blog.

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