The World is Opening Up? What are the Risks and Precautions?

Dear Members,

Hope you had a great Eid and eased back into the normal day today routine after Ramadan.

Perhaps it feels a little counter intuitive to see that as our numbers of COVID-19 infections are on the rise, the lifting of restrictions are also on the rise. This is not only happening in Egypt, it is happening globally. In a way, we have anticipated this would happen because at the end of the day economy wins and life needs to go on.

We are at a stage where the graphs and numbers no longer matter, and we should be anticipating infections to be untraceable and from any source, so i won’t be sharing scary numbers and statistics of hospital capacities or doctors getting sick, in most cases, you will only need to get treated at home, and currently, this is also the government’s protocol for most cases. I am reminding you again that we have created a virtual monitoring plan for members falling sick with Covid 19, this plan includes daily trackers and follow with us, so do not worry we got your back :)

Here are our Golden rules to protect yourself as much as you can while learning to co-exist with Covid 19 for the foreseeable future:

1- Follow a general policy of staying home and leaving your house only when absolutely necessary. if you can work from home please continue to do so.

2- The 3 Cs rule (inspired by the Japanese government), avoid Closed spaces with poor ventilation, if you must meet always choose an open space, avoid Crowded places and by crowd i mean over 4, and avoid Close contact.

3- It goes without saying, put on your mask in public places, and this includes riding in your car with a driver, taking an Uber or just buying something quickly.

4- It is your full right to not speak and deal with anyone not wearing a mask, conversation droplets is a documented source of infection. ask people dealing with you to always have a mask on, also the government’s latest fine will make people more compliant to do so.

5- Even if tourism is opening up it is not advisable to travel and to go to restaurants and to socialize. It is still a work in progress, and it will take sometime to get to the optimum protocol to make all recreational and vacation areas safe.

6- Do not take medications and treatment protocols off the Internet, most of them are not evidence-based and even if they are, most have high potential of causing complications and side effects. People are good at circulating protocols but not their adverse effects. Always talk to us before taking vitamins or any medications claiming to protect you or enhance your immune system.

7- Work on your health and on optimizing it, control any chronic condition you have. know that your health, mental and physical is your only asset to get over this surreal period of human history.

8- Daily mental exercises are essential right now, whether you meditate, write things down or are simply spending sometime in nature. we are seeing a huge spike in mental health issues and mental stressors and it is becoming a profound problem so we urge you to pay attention to that on daily basis, and make mental health time a part of your daily routine, if you need support with that or need to speak to an expert, we got your back.

9- Make sure you move daily, staying at home most of the time also has led to the rise of problems with weight, body pains and low fitness, we are not asking you to massively exercise but we are at least making sure you reach a minimum of 150 minutes a week of whole body movement, simple walking would suffice.

10- Perhaps it is the best time to track some health parameters on daily basis to help control your health, such as your daily caloric intake (try to decrease your daily target since movement is limited), track your daily steps, and track the quality of food you eat and not to mention your sleep quality.. Journaling was made for a time like this.

11- If you have to work from office, make sure your company applies safe protocols to prevent infection, such as, spacing out work areas and work tables, daily sanitation with mid day review, what solutions do they offer for the risk of circulated air conditioning flow. Bathrooms are risky, what kind of protocol will be applied there? in my opinion, your company needs to give you a clear guide on what is implemented to keep the employees safe and prevent cross contamination and contagion in work spaces.

12- Barbers and Hairdressers, the key point to remember here is that, if you must, you have to limit the time of exposure, first of all, call in and ask what precautions are they applying, is everyone wearing a surgical mask and maybe even a face shield, for ladies try to wash your hair at home, do anything that will lessen your time there, so basically only do the thing or two that you can not do at home

13- Gyms are tricky because you can not wear a mask while working out, this could lead to serious respiratory issues, i would generally avoid it regardless of what precautions are there, just because it is basically a room for group sweating and heavy breathing, so i don’t think so, but lets wait and hear what innovative methods they have to protect us.

14- Planes will also announce what air filtering system precautions to be in place, so we can not really comment on that right now but in all cases expect your mask to be worn all the time. i would be more concerned about the long squeezy lines in airports than plane seats, just because in lines, breath air is flowing in a straight line from one person to the next in line, so if someone is not wearing a mask, call him out on it and refuse to be in line.

15- How about coming to us for a physical? well we will always advice on it only if absolutely necessary and we have a couple of reasons:

a- We are a chronic disease management health system, meaning that 90% of our patients have chronic health issues, so they are considered a high risk group.

b- Doctors are highly infectious due to possible exposure in university hospitals, which our doctors are part of.

c- 90% of our medical care and treatment plans are initiated on our virtual clinic and needs no physical initiation

d- If your doctor must see you, we will triage you on the phone first and explain all our precautions before you come in

16- Most of us will be wearing cloth masks, make sure you wash them after each use, a simple wash with your regular detergent is enough to clean it and kill the virus (cloth masks are only effective if those around you are also wearing masks, it doesn’t have an active viral filtration system). surgical masks are only to be worn if you are entering into a risky area of people not wearing masks (which in such case, i would advice you to turn around and not go in) or if you are taking care of someone sick.

17- Please Please stop wearing gloves, they cross contaminate everything. your skin is a protective barrier just make sure you wash our hands regularly or use alcohol

Last two important piece of advice, one is know that there will always be risk leaving your house and going anywhere, but there are also ways to make it safer and decrease the risk exponentially but not eliminate it. Two, go back to our Patient Handout on Covid we sent you 3 months back, it has everything you need today and is a good refresher, you will find it on our blog posts.

Last follow the 3 Cs Rule

Stay Safe

Dr. Elnazer

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