Category: From the Experts

COVID-19 is a respiratory illness that is spread from person to person through respiratory droplets when an infected person coughs or sneezes.  Though less likely, there is a possibility of contracting COVID-19 from touching an infected surface and subsequently touching one’s nose or mouth (Parker-Pope, 2020). Research has demonstrated that frequently touched hard-surfaces can play a role in the transmission of COVID-19 (Watson, 2020).  Therefore, cleaning, sanitizing, and disinfecting, which all reduce the risk of viral transmission, are vital in mitigating COVID-19 spread.  This much is evident by the shelves that still remain empty of most cleaning products in our grocery stores. But what good is it to have these products at your disposal without knowing their protocols of use? It is important to be able to distinguish between these tasks to perform them properly and optimize health and safety. 

Sanitizing 

99.999% Effective?

Sanitizers do not eliminate all types of germs. Sanitizing is only the reduction of germs, mostly bacteria, from surfaces. While studies support that sanitizers with a 60-95% alcohol concentration are effective at killing most microbes, they are not recommended for use on heavy soiled surfaces (“Community, Schools, Workplaces, & Events”, 2020). Sanitizing does not remove all germs or dirt from hands and surfaces. 

Cleaning

SCRUB. WASH. RINSE, REPEAT

Cleaning refers to the removal of dirt, germs, and impurities through the use of a detergent or soap and water. This method is considered the best practice to cleanse dirty hands and surfaces. Though soap and water does not kill germs, it lowers the amount of germs present and decreases the risk of spreading infection (“Coronavirus Disease 2019 (COVID-19) – Symptoms”, 2020).

Disinfection 

INACTIVATION STATION

Disinfection refers to the killing or “inactivation” of germs on a surface. This process typically involves the use of chemical agents that have bactericidal, fungicidal, and virucidal properties (“Chemical Disinfectants | Disinfection & Sterilization Guidelines | Guidelines Library | Infection Control | CDC”, 2020).

The CDC recommends the following chemical disinfectants for SARS-CoV-2, the virus that causes COVID-19:

Alcohol: Alcohol weakens proteins that make up surface-level microorganisms, destroying their structural integrity and neutralizing them. This type of disinfectant is not to be confused with some grain alcohols in beverages, including ethanol (ethyl alcohol) and rubbing alcohol (isopropyl alcohol). Alcohol-based solutions for disinfection should be at a minimum of 70% concentration to verifiably eliminate SARS-CoV-2 from surfaces. 

Chlorine and chlorine compounds: Chlorine compounds inactivate harmful microorganisms. Most commonly found in bleach, these compounds are generally available as 5.25-6.15% solutions of sodium hypochlorite (“Coronavirus Disease 2019 – Environmental Cleaning and Disinfection Recommendations”, 2020). When using bleach, take the proper precautions and read the specific dilution instructions on the product label.  Temperate water should be used for dilute bleach solutions.  Handle these solutions with gloves in a well-ventilated area. Never use bleach on food products, apply to skin, ingest bleach, or mix bleach with other chemicals (Ghapure, Hunter, Schnall, et al., 2020).

Hydrogen Peroxide: This disinfectant is most commonly used as an over-the-counter antiseptic. Hydrogen peroxide produces “free radical” compounds that interfere with crucial cellular components, neutralizing microorganisms. A 7% hydrogen peroxide solution is completely virucidal after 5 minutes of activity. 

The CDC recommends the cleaning of visibly dirty surfaces followed by disinfection for the prevention of COVID-19 and other viral respiratory illnesses in households and community settings (“Coronavirus Disease 2019 (COVID-19) – Environmental Cleaning and Disinfection Recommendations”, 2020). When in doubt, you can always refer to the EPA’s “List N” tool, which lists every product confirmed to meet criteria for use on surfaces against COVID-19. Remember to take the appropriate safety measures when using these products to prevent injury to yourself and others.

References

Chemical Disinfectants | Disinfection & Sterilization Guidelines | Guidelines Library | Infection Control | CDC. Cdc.gov. (2020). https://www.cdc.gov/infectioncontrol/guidelines/disinfection/disinfection-methods/chemical.html#Alcohol

Communities, Schools, Workplaces, & Events. Centers for Disease Control and Prevention. (2020). https://www.cdc.gov/coronavirus/2019-ncov/community/disinfecting-building-facility.html

Coronavirus Disease 2019 (COVID-19) – Environmental Cleaning and Disinfection Recommendations. Centers for Disease Control and Prevention. (2020).https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/cleaning-disinfection.html.

Coronavirus Disease 2019 (COVID-19) – Symptoms. Centers for Disease Control and Prevention. (2020). https://www.cdc.gov/coronavirus/2019-ncov/symptoms-testing/symptoms.html

Gharpure R, Hunter CM, Schnall AH, et al. Knowledge and Practices Regarding Safe Household Cleaning and Disinfection for COVID-19 Prevention — United States, May 2020. MMWR Morb Mortal Wkly Rep 2020;69:705–709. DOI:http://dx.doi.org/10.15585/mmwr.mm6923e2external icon. 

Parker-Pope, T. (2020). What’s the Risk of Catching Coronavirus From a Surface?. Nytimes.com.  https://www.nytimes.com/2020/05/28/well/live/whats-the-risk-of-catching-coronavirus-from-a-surface.html

Watson, S. (2020). Coronavirus on Surfaces: What’s the Real Risk?. WebMD. https://www.webmd.com/lung/news/20200903/coronavirus-on-surfaces-whats-the-real-risk

General Impact

Due to the coronavirus pandemic, millions of students across the United States have had to adjust to an online educational format. In March, many colleges forced their students off-campus within the span of a few days. Thus, the college experience was transformed into classes at childhood homes with little social interaction. In turn, this drastic change in learning has impacted college students’ mental health. Students from different universities have shared their feelings about online school and its impact on their emotional health and wellbeing. A recent study assessed 195 students at a Texas university that closed all campuses in March (Son et al., 2020). The vast majority of respondents expressed increased levels of stress and anxiety due to the COVID-19 pandemic. Higher stress levels among this group are associated with increased levels of depressive thoughts (Son et al., 2020). Additionally, 91% of students reported fear and worry about their health and the health of their loved ones amidst the public health crisis (Son et al., 2020). The COVID-19 pandemic has detrimentally impacted higher education, demonstrating the urgent need to develop interventions and preventative strategies to address the mental health of college students (Son et al., 2020). Michigan State University has adjusted to the changing academic circumstances by offering more mental health services, as there was a significant increase in their usage this summer compared to last year (Ciechalski et al., 2020). COVID-19 has impacted our need to adjust and adapt to a different lifestyle at a rapid pace. Responding to the changing environment can be overwhelming, especially as we come across more unfamiliar situations with the progression of the pandemic (Wiles, 2020). 

Pros and Cons to Online School

Many students have reported feelings of isolation due to the lack of in-person relationships and face-to-face interactions with digital learning (Wiles, 2020). Increased screen time has negatively impacted student health, causing headaches, fatigue, lack of motivation, procrastination, avoidance, ineffective time management, and minimized awareness and understanding of others (Wiles, 2020). As schools increasingly adopt an online format, and several students require counseling and psychiatric services, it has become difficult for students to easily access these resources. However, there are advantages to online learning. Digital education can increase students’ levels of safety and allow them to willingly engage with learning materials from a comforting space (Wiles, 2020). This learning style also alleviates strict schedules, as many professors record lectures or conduct asynchronous sessions. Additionally, professors are understanding of this unprecedented situation and emphasize taking breaks to enhance student wellbeing. Lastly, online learning helps students practice effective time management through the “work at your own pace” model (Wiles, 2020). Establishing school routines are important coping mechanisms for young people with mental health issues. If adjustments to these new settings are not made, students could lose an anchor in their life and symptoms could worsen (Lee, 2020).

Psychological Resilience and Adjustment

The COVID-19 pandemic has forced many people, especially students, to adjust to different social and academic situations and build resilience. Improved psychological resilience has been shown through social factors and daily activities including daily sunshine for at least 10 minutes, daily exercise, perceived family and friend support, and low severity of insomnia (Killgore et al., 2020). Additionally, students have sought support from others and adopted positive or negative coping mechanisms for stress and anxiety (Son et. al, 2020). Flexibility is another important factor that allows for adaptation and strategy modification. This is a fundamental component of resilience, especially for college students (Chen & Bonanno, 2020). Moreover, mental health services at schools have utilized telehealth to continue providing students with counseling services and support groups while creating task forces dedicated to mental health (Ciechalski et al., 2020). Also, for students whose home environments are toxic and abusive, universities have reached out to students through the expansion of their social media presence and sent encouraging messages over the past few months. Bolstering psychological resilience should be a primary public health emphasis during the COVID-19 pandemic (Killgore et al., 2020). Those who actively engage in outdoor activities, exercise, and spiritual health tend to be the most resilient to the challenges to mental health imposed by the COVID-19 pandemic (Killgore et al., 2020).

Conclusion

Mental health is a prevalent public health issue that is increasingly impacted by the COVID-19 pandemic, especially among college students across the United States. Initiatives must be taken to encourage psychological resilience and provide mental health services to those in need. Now more than ever, it is crucial that every college student has a support system and can adapt to these unprecedented times.

References

Chen, S., & Bonanno, G. A. (2020). Psychological adjustment during the global outbreak of

COVID-19: A resilience perspective. Psychological Trauma: Theory, Research, Practice,

and Policy, 12(S1), S51-S54. http://dx.doi.org/10.1037/tra0000685 

Ciechalski, S., Walters, S., & Kaufman, S. (2020, September 3). College students brace for the

‘second curve’ of COVID-19 – its mental health impact.

https://www.nbcnews.com/news/us-news/college-students-brace-second-curve-covid-19-its-mental-health-n1238740.

Killgore, W., Taylor, E. C., Cloonan, S. A., & Dailey, N. S. (2020). Psychological resilience during

the COVID-19 lockdown. Psychiatry research, 291, 113216. https://doi.org/10.1016/j.psychres.2020.113216

Lee, J. (2020). Mental health effects of school closures during COVID-19. The Lancet Child 

Adolescent Health, 4(6), 421. https://doi.org/10.1016/s2352-4642(20)30109-7  

Son C, Hegde S, Smith A, Wang X, Sasangohar F. (2020, September). Effects of COVID-19 on

College Students’ Mental Health in the United States: Interview Survey Study. J Med

Internet Res 2020;22(9):e21279. https://www.jmir.org/2020/9/e21279

Wiles, G. (2020, July 30). Students share impact of online classes on their mental health. 

Students share impact of online classes on their mental health – The State News.

https://statenews.com/article/2020/07/students-share-impact-of-online-classes-on-their-mental-health?ct=content_open.

The COVID-19 pandemic has taught lessons about developing personal responsibility, adapting to societal changes, and executing strategies as a means to protect the health of all individuals. Countries around the world are discovering and reinventing new ways to respond to the global pandemic. With immense time pressure and lives at stake, it is no surprise that many countries are struggling. The United States has attempted to ensure adherence to specific guidelines such as wearing a face mask in public, practicing proper social distancing, and maintaining personal responsibility in preventing the virus. East Asian countries such as Japan, Korea, Taiwan, and Hong Kong have effectively and efficiently implemented strategies that have been relatively successful in containing COVID-19. The United States can recognize the efforts East Asian countries have made to combat COVID-19 in its own mitigation strategy improvements. In particular, Taiwan, South Korea, and Japan’s strategies can serve as an example for pandemic response and assist in improving future guidelines and plans. 

Enforced Plan and Guidelines with No Exceptions

Taiwan has a population of more than 23 million people and, at the beginning of the spread of COVID-19 in March, the country only had 451 cases and seven deaths (Farr & Gao, 2020). Taiwan had taken fast and efficient action in creating enforcements for their population and implemented consequences if individuals did not follow the specific guidelines. For most countries in the world, individuals are required to wear face masks before entering public buildings. Yet, Taiwan also established large fines if people were caught without wearing face masks in designated areas or breaking their two week quarantine requirements (Farr & Gao, 2020). This encouraged people to maintain their personal responsibility by wearing face masks and abiding by the rules. Taiwan effectively imposed restrictions for its population as a way to contain the virus. In addition to strong enforcement, Taiwan implemented travel restrictions such as limiting air travel and increasing border control. With the country’s proximity to China, the epicenter of the pandemic, public health experts urged the importance of these travel restrictions (Farr & Gao, 2020).

Digital Technology and Effective Communication 

In May 2020, South Korea had the highest number of cases outside of China, but the country successfully utilized their strategies to control the spread during the summer (Zhou, 2020). Officials established drive-thru testing centers and created digital tracking technology including “CCTV footage, credit card transactions and smartphone location data to monitor potential patients” (Zhou, 2020). South Korea employed technology as a means to track potentially infected individuals and ensure quarantine compliance. South Korea’s use of technology allowed the government to stay connected with its population to ensure the proper health information was given. Their connectedness via technology advanced the South Korean population not only in contact tracing, but in providing health resources for their testing centers and treatments (Zhou, 2020). 

Pandemic Contingency Plan

East Asian countries benefited from having closer and simpler supply chains that provided essentials during the COVID-19 pandemic. Utilizing resources that were closer to home made it easier to distribute for medical and individual uses (Hub staff, 2020). Additionally, South Korean and Japanese governments stepped in to “incentivize production when the medical system lacked essential supplies” (Hub staff, 2020). This plan accounts for potential future pandemics, incorporates use of digital technology, and localizes vital supply chains to prevent lack of essential supplies (Hub staff, 2020). 

It is important to recognize other countries that could positively impact plans and guidelines for future pandemics. With the uncertainty of this public health crisis, we have embarked on this journey of learning and discovering more on how to handle pandemics and also ourselves. In the end, many countries have provided and implemented strategies on how to handle the pandemic but it is crucial to look to successful strategies as examples. 

References:

Farr, C., & Gao, M. (2020, July 15). How Taiwan beat the coronavirus. CNBC. 

https://www.cnbc.com/2020/07/15/how-taiwan-beat-the-coronavirus.html

Hub staff. (2020, May 13). East asia offers mixed lessons in COVID-19 response. Johns Hopkins University. https://hub.jhu.edu/2020/05/13/east-asian-response-to-coronavirus/

Zhou, C. (2020, April 23). Why are western countries being hit harder than east asian countries by coronavirus? ABC NEWS. https://www.abc.net.au/news/2020-04-24/coronavirus-response-in-china-south-korea-italy-uk-us-singapore/12158504

One of the major global health concerns involves air pollution. Research has demonstrated air pollution-related diseases have an extremely high mortality rate (Narain, 2020). Air pollution irritates a person’s airways and causes shortness of breath, coughing, wheezing, and other symptoms that can lead to further complications (Respiratory Health Association, 2020). This air quality issue has steadily worsened in recent years as humans have increased rates of burning fossil fuels and emitting pollutants into the atmosphere. The COVID-19 pandemic has caused lots of concern regarding air pollution as it has an overlapping negative effect on respiratory health. Air pollution has been proven to increase transmission, increase susceptibility, and worsen the severity of COVID-19 infection (Narain, 2020). Yet, even before the pandemic, health concerns linked to air pollution have been one of the leading causes of death around the world (Narain, 2020). These deaths are a result of lung cancer, heart attacks, strokes, and other health-related complications (Respiratory Health Association, 2020). Experts have shown that poor air quality makes individuals more susceptible to infection of COVID-19, a virus that attacks the respiratory system. As countries went into lockdown to prevent the transmission of COVID-19, the rate of air pollution was significantly reduced worldwide (Narain, 2020). While this decrease is reassuring for the future, data has not suggested that this decrease has had any positive immediate effects on COVID-19 transmission and further health complications (Narain, 2020).

The National Oceanic and Atmospheric Association defines air quality as a measure of how clean or polluted the air is. The top five air pollutants include ground-level ozone, carbon monoxide, sulfur dioxide, nitrogen dioxide, and airborne particles, or aerosols (NOAA). These pollutants come from burning fossil fuels and everyday human activities such as driving. Although air pollution has been consistently increasing, the COVID-19 pandemic disrupted this pattern. As countries were forced into isolation for months, and some still are, emission rates have decreased drastically. For example, New York City only produced ¼ of its usual nitrogen dioxide emissions in September compared to in February, prior to lockdown (NASA, 2020).  While this decrease in air pollution is certainly reassuring, it is only a short-term effect unless further government and policy measures are taken. Countries such as China have already emitted dangerous levels of pollutants and, as a protective measure, incorporated masks into everyday life. Air pollution is one of many environmental risk factors that impact human health. Poor air quality specifically impacts humans as it is linked to the incidence and progression of asthma, COPD, lung cancer, ventricular hypertrophy, Alzheimer’s and Parkinson’s diseases, psychological complications, autism, retinopathy, fetal growth, and low birth weight (Ghorani-Azam, 2016). Many of these respiratory diseases such as COPD put individuals more at risk if infected with COVID-19. 

Chronic obstructive pulmonary disease (COPD) is a respiratory disease that places diagnosed individuals who are also infected with COVID-19 at higher risk of a negative outcome (Leung, 2020). Since COPD is an inflammatory lung disease that prevents airflow from the lungs, individuals experience breathing problems, coughing, and wheezing. The primary cause of COPD is smoking. Early research showing that there are more negative COVID-19 outcomes associated with COPD has indicated that this is most likely a result of poor underlying lung reserves or increased expression of the ACE-2 receptor in small airways. (Leung, 2020). 

While air quality is a pressing issue for all, as it leads to health problems with high mortality rates, it disproportionately affects individuals of vulnerable populations. Minority groups and low-income individuals are more at risk of exposure to air pollution and, in turn, the health problems associated with exposure (American Lung Association, 2020). These groups of people are typically forced to live in areas with poor environmental factors as a result of racial and socioeconomic disparities. Health care access barriers also contribute to health disparities, preventing these individuals from seeking medical attention (American Lung Association, 2020). Often, this attention is crucial to prevent and treat respiratory problems that result from air pollution. 

In order to take steps toward cleaner air that will ultimately benefit human health outcomes, policy implementations must be made. Specifically, Americans can look to scientific experts. Scientists recommend policies that promote renewable energy sources rather than fossil fuels, carbon emission regulations, and an overall reduction in waste (Narain, 2020). Neither the Earth nor humans can sustain the effects of climate change much longer and the immense amount of pollutants emitted into the atmosphere before COVID-19 detrimentally impacts human health. This unprecedented decrease in global pollution as a result of the pandemic is an opportunity for humans to combat this crisis and prolong health outcomes (Moynihan, 2020). 

Reference 

American Lung Association. (2020, April 20). Disparities in the Impact of Air Pollution. Retrieved November 03, 2020, from https://www.lung.org/clean-air/outdoors/who-is-at-risk/disparities

Ghorani-Azam, A., Riahi-Zanjani, B., & Balali-Mood, M. (2016). Effects of air pollution on human health and practical measures for prevention in Iran. Journal of Research in Medical Sciences, 21(1), 65. https://doi.org/10.4103/1735-1995.189646

Harvard School of Public Health. (2020, September 11). Coronavirus and Air Pollution. Retrieved November 03, 2020, from https://www.hsph.harvard.edu/c-change/subtopics/coronavirus-and-pollution/

He, G., Pan, Y., & Tanaka, T. (2020). The short-term impacts of COVID-19 lockdown on urban air pollution in China. Nature Sustainability. https://doi.org/10.1038/s41893-020-0581-y

Leung, J. M., Niikura, M., Yang, C. W. T., & Sin, D. D. (2020). COVID-19 and COPD. European Respiratory Journal, 56(2), 2002108. https://doi.org/10.1183/13993003.02108-2020

Moynihan, C. (2020, September 20). A New York Clock That Told Time Now Tells the Time Remaining. Retrieved November 07, 2020, from https://www.nytimes.com/2020/09/20/arts/design/climate-clock-metronome-nyc.html

Narain, U. (2020, July 2). Air Pollution: Locked Down by COVID-19 but Not Arrested. Retrieved November 03, 2020, from https://www.worldbank.org/en/news/immersive-story/2020/07/01/air-pollution-locked-down-by-covid-19-but-not-arrested

NASA, ESA, JAXA. (2020). Earth Observing Dashboard. https://eodashboard.org/?indicator=N1.

National Oceanic and Atmospheric Administration. US Department of Commerce. https://www.noaa.gov/.

Respiratory Health Association (2020, October 07). Understanding Air Pollution. Retrieved November 07, 2020, from https://resphealth.org/clean-air/understanding-air-pollution/

Venter, Z. S., Aunan, K., Chowdhury, S., & Lelieveld, J. (2020). COVID-19 lockdowns cause global air pollution declines. Proceedings of the National Academy of Sciences, 117(32), 18984–18990. https://doi.org/10.1073/pnas.2006853117

Zinke, L. (2020). Air quality during COVID-19. Nature Reviews Earth & Environment, 1(8), 386–386. https://doi.org/10.1038/s43017-020-0087-1

This is an important time in America and, if eligible to, you should vote by November 3rd. Less than a week away, many people worry about whether it is safe to vote in-person on election day amidst the COVID-19 pandemic. There are several safe practices to engage in while voting to limit the risk of viral transmission. To reduce the number of people at poll locations on election day and maintain social distancing, voters are not limited to casting ballots in person. Alternative options include early voting, mail-in ballots, and designated drop-off boxes. 

Mail-In Ballot or Drop Off

In Maryland, the last day to request a mail-in ballot was October 20th (Maryland State Board of Elections, 2020). If you are one of the many Americans who requested a ballot through this service, you have two options on how to submit it. You can either send the ballot via mail or drop it off at a designated drop-off box location. Drop off locations are listed on the ballot and available at iwillvote.com, along with nearby voting locations. Make sure to follow all directions carefully when you receive and fill out your ballot so your vote can be counted. This is the safest option for voting because the risk of viral transmission is lowest. Some Americans are choosing one of these two options but others believe that in-person is the best way possible to vote. 

Vote Early

Voting early will likely reduce the risk of transmission due to fewer crowds and lines. In Maryland, anyone who is registered to vote can vote early. States have different rules and dates when it comes to voting early. Visit https://www.usa.gov/election-office to find your official state voting website. For example, Maryland’s State Board of Elections has a website for people to learn how to register to vote, where to vote, and how to check their ballot status (Maryland State Board of Elections, 2020). Voting early is another great option if you are worried about the number of people you will be around on election day. It is still crucial to maintain social distancing of at least six feet whenever possible and to adhere to state and local guidelines for public health precautions (CDC, 2020). 

In-Person

In-person voting carries the risk of COVID-19 transmission but these risks can be mitigated. If you plan to vote in-person, make sure to wear a mask or facial covering. Face shields, while not mandated, can provide extra protection to concerned individuals. Wearing gloves will minimize the risk of viral transmission through touching infected surfaces. Furthermore, it is important to be prepared and to keep your hands clean. Make sure you use hand sanitizer, whether you decide to wear gloves or not (CDC, 2020). Hand sanitizer may also be available at polling stations, along with extra masks and gloves. While voting can be stressful, especially amidst fear about COVID-19, the pandemic should certainly not dissuade anyone from doing so. Taking the proper precautions and evaluating all voting options, the risk of viral transmission can be mitigated and people can feel confident about safely voting. 

References

“Absentee and Early Voting.” USAGov, www.usa.gov/absentee-voting. 

Elections, Maryland State Board of. Early Voting, elections.maryland.gov/voting/early_voting.html. 

I Will Vote, iwillvote.com/. 

Mai Tuyet Pho, MD. “How to Stay Safe on Election Day When You’re Voting during a Pandemic.” UChicago Medicine, UChicago Medicine, 13 Oct. 2020, www.uchicagomedicine.org/forefront/coronavirus-disease-covid-19/voting-safety. 

Tips for Voters to Reduce Spread of COVID-19. (n.d.). Retrieved October 30, 2020, from https://www.cdc.gov/coronavirus/2019-ncov/daily-life-coping/going-out/voting-tips.html