Health & Fitness
How the pandemic is contributing to your insomnia – CNN
https://www.cnn.com/2020/10/27/health/insomnia-sleep-problems-pandemic-wellness/index.html
Between cooling off from the stress of the workday and managing her anxiety from reading about the pandemic and politics, she’s lucky to turn in before midnight. Once the 44-year-old marketing executive falls asleep, she usually wakes up two or three times before the alarm rings around 6 a.m.
On good nights, Aswani gets four or five hours of sleep before she must wake up and jump into her roles as mother and virtual learning facilitator for her 5-year-old son. On bad nights, Aswani barely gets any sleep at all.
“I’ve never been a good sleeper, but it’s been 20 times worse since the pandemic started,” she said. “It’s gotten to the point where just thinking about sleep stresses me out.”
Aswani, from San Clemente, California, is one of many people who have experienced some sort of disruption to their usual sleeping routines since the pandemic began this March. For some, the changes are subtle — more restlessness or a poorer quality of sleep. For others, the new reality is flat-out hell: either a chronic lack of sufficient sleep or full-on insomnia.
Some experts have gone so far as to nickname the current trend “coronasomnia,” said Christina Pierpaoli Parker, postdoctoral fellow of clinical psychology and behavioral sleep medicine at the University of Alabama at Birmingham.
Whatever we call it, Pierpaoli Parker said there are strong relationships between the pandemic and sleeplessness.
“Good sleep undergirds every aspect of mental and physical health, which we need to support now more than ever,” she said. “When we create the optimal cognitive, behavioral and environmental conditions for sleep — including low ambient temperature — we also support optimal conditions for health overall.”
Sleep woes by the numbers
We can’t just blame the pandemic. Sleeplessness was a problem long before this latest crisis.
That’s because lack of sleep is associated with dysregulation of the hormones that make us hungry and tell us we’re full. What’s more, fatigue hijacks our motivation to exercise, and when we’re tired, we generally make more impulsive choices about everything — especially what we eat.
What’s plaguing us
There are several different manifestations of sleeplessness plaguing us at this point in the pandemic.
The most common of these conditions is insomnia, a sleep disorder characterized by difficulty falling or staying asleep or early morning awakenings without returning to sleep at least three nights a week for a period of at least three months. Insomnia can include one or all of these symptoms, and can impact the patient’s ability to function during wakefulness, Pierpaoli Parker noted.
Not everybody with formal sleep problems is diagnosed with full-on insomnia; most sufferers instead are plagued by anxiety about the world, and, as a result, fail to get the minimum suggested amount, resulting in a chronic lack of sufficient quality sleep.
Jennifer Martin, professor of medicine at the David Geffen School of Medicine at the University of California, Los Angeles, said both disorders are understandable since humans are wired to stay awake in the face of danger and we’re facing the first widespread global pandemic in 100 years.
“It would have been an unfortunate mistake of evolution if we were sleepy when there was a tiger outside of our cave and we went to sleep,” Martin said. “When we perceive a threat, we are awake. That’s adaptive. That’s good for us. Yet when there is a large threat in our environment like a global pandemic, one of our initial biological stress reactions is to not sleep so we can be prepared to deal with the threat.”
Why we’re up all night
Experts agree there are several factors contributing to our general lack of sleep.
First on the list: disruption to routine. Human beings operate in accordance with natural, internal processes that regulate our sleep-wake cycle and repeats roughly every 24 hours. Known as circadian rhythms, these are connected to certain external factors that happen every day: sunrise, sunset and more. Because most of us are spending more time at home, we’re all thrown off our natural respective routines, adding to an overall sense of confusion and unrest.
Without typical social time cues such as getting dressed for work or dropping off the kids at school at a certain standard time, our brains are less aware of when to prepare for sleep, said Chandra L. Jackson, Earl Stadtman investigator at the National Institute of Environmental Health Sciences.
Staying in the house, which lowers our exposure to natural light, also throws off these circadian rhythms and sleep schedules, she said.
Another explanation: Between Zoom meetings for work and people being glued to their phones, screen time is at an all-time high.
Blue spectrum light generated from screens tells the brain to stop producing melatonin, a hormone that regulates the body’s sleep-wake cycle, said Dr. David Neubauer, associate professor of psychiatry and behavioral sciences at Johns Hopkins Medicine in Baltimore.
Of course, other factors contributing to poor sleep habits include money worries, anxiety over employment and the all-too-understandable fear about actually catching Covid-19 and transmitting it to loved ones.
Seeking solutions
For those formally diagnosed with insomnia, there are medicinal aids such as zolpidem (Ambien) or benzodiazepines (Xanax and Valium), but these require prescriptions and generally are only limited to no more than a couple of weeks.
Cognitive behavioral therapy for insomnia, or CBTi, helps people identify the underlying causes of their insomnia and adopt behaviors to change it. It usually takes six to eight sessions to work — which means sufferers experience relief about two months after they start treatment.
For those suffering from a chronic lack of sufficient sleep, experts say it’s critical to get yourself back on a regular schedule — even if it means first depriving yourself of sleep to do it.
People should get out of bed if they can’t fall asleep (or return to sleep) within 15-30 minutes, or as soon as trying to fall asleep feels frustrating, Pierpaoli Parker suggested. She added it’s important to minimize exposure to anything with blue light or a backlit screen for about an hour or two before bed. This means no television or scrolling on your phone within an hour of bedtime. Yes, really.
Other options
Tactical changes to your everyday lifestyle can improve sleep habits, as well.
“Set up your bedroom as a sanctuary for sleep and sex,” Fish, a certified sleep science coach, said. “The more you do in there during the day, the harder it will be to recognize it’s a place for sleep at night.”
Another good strategy, Kanady said, is setting aside 20 minutes each day for letting out worries and anxieties by writing them down on a piece of paper. She said that by worrying at the same time and in the same place every day, your brain will start to learn that there is a dedicated place and time for worries, and the worries will start to interfere with sleep less.
Many sleep sufferers are open to trying anything. Meg Alcazar, on the other hand, a single mother who lives in Durham, North Carolina, has had enough.
“My main issue seems to be that all the advice is about self-discipline: Cut out alcohol, don’t eat after 6 p.m., no carbs,” she said. “Our normal has already been upended, are we really to deny ourselves the few remaining pleasures for something as basic and unexciting as sleeping through the night?”
Alcazar noted that she’d rather suffer through current challenges than give up things she loves.
“The idea of living like a monk on a mountain with the world burning down around me makes me feel I’d rather just sleep when I’m dead,” she said.
Matt Villano, a writer and editor in Northern California, has had trouble sleeping since March.
Health & Fitness
Inova canceling all first-dose COVID-19 vaccine appointments – Inside NoVA
https://www.insidenova.com/headlines/inova-canceling-all-first-dose-covid-19-vaccine-appointments/article_39a1c800-5f60-11eb-a68e-2fa02b866c94.html
Health & Fitness
Coronavirus update San Antonio, Jan. 25: Leaders report 2,082 new COVID-19 cases, 13 new deaths – KSAT San Antonio
https://www.ksat.com/news/local/2021/01/26/coronavirus-update-san-antonio-jan-25-leaders-report-2082-new-covid-19-cases-13-new-deaths/
Health & Fitness
With limited vaccines, Monterey County moves to vaccine Phase 1b, Tier 1 – KSBW Monterey
https://www.ksbw.com/article/with-limited-vaccines-monterey-county-moves-to-vaccine-phase-1b-tier-1/35313986
Health & Fitness
Covid-19 masks: Which mask is best for you, and when to use it – CNN
https://www.cnn.com/2021/01/25/health/covid-19-masks-which-is-best-wellness/index.html
But instead of what pattern, logo or slogan you display, choose your mask based on its effectiveness against the deadly coronavirus in the environment you are in.
Working closely with government agencies, industry stakeholders and ASTM International, an international technical standards organization, the standards will apply to filter efficiency, sizing and fit, cleaning and recommended period of use or reuse.
For now, here’s a breakdown of respirators and masks based on current scientific knowledge, and what experts are saying on how to best use them.
N95-type masks
What would happen if every American wore an N95-type mask for four weeks in risky settings like being indoors?
N95 respirators come in many sizes to accommodate various face shapes. When fitted to the wearer’s face and worn properly, N95-type masks can trap 95% of particles around 0.3 microns, studies have shown. SARS CoV-2 can be as small as 0.1 micron in diameter — that’s about 4 millionths of an inch.
While it may seem that N95 filters would miss the tiny Covid particles, that’s not so. Most bits of virus exit the lungs encased inside larger respiratory droplets, typically much bigger than 0.3 microns.
“In a health care setting, there’s an advantage because there’s a degree of sophisticated training to inform people how to properly wear respirators which doesn’t exist in a public setting,” NPPTL’s Szalajda said.
The N95 mask — and its sisters and brothers — is best fitted to a person’s unique facial contours on a bare face to keep the seal tight. Then the mask must be worn properly, despite the fact that such high filtration can make breathing more difficult. N95-type masks have a much higher breathing resistance than simple surgical or fabric masks.
“I’ve seen people with a full beard wearing the N95, or they’re wearing the 95 upside down, or they just have it over their mouth and not their nose and mouth because it’s easier to breathe when you’re not covering your nose,” Szalajda said.
Note: Beware of N95 masks with exhalation valves in them, since those valves put your airflow back into the environment. Also beware of knockoff N95s being sold on the internet and at some commercial stores.
- NIOSH-approved respirators carry an approval label on or within the packaging of the respirator and on the mask itself.
- NIOSH-approved respirators will always have one of the following designations: N95, N99, N100, R95, R99, R100, P95, P99 or P100.
- You can verify the approval number on the agency’s equipment list or trusted-source page to determine if the respirator has been approved by NIOSH.
Europe’s FFP2
In response to the spread of new, more contagious variants of the coronavirus, some European countries are mandating the use of FFP1 and FFP2 masks — which stand for “filtering facepiece respirator.”
- Note: The “P” means the mask is strongly resistant to oil and can be used to protect against nonoily and oily aerosols. In comparison, the “N” on N95 means the mask is not resistant to oil and can’t be used in an oil droplet environment (such as drilling for oil).
An FFP1 filter has a minimum filtration efficiency of 80%, an FFP2 is 94% effective and a FFP3 is 99% effective against airborne infectious diseases.
Last week the German state of Bavaria mandated that citizens use FFP2 masks when shopping in stores and traveling on public transport. The German government then followed that lead, requiring everyone in the country to wear either FFP1 or FFP2 masks while at work, in shops or traveling on public transport.
KN95 and similar filtering facepiece respirators
“However, prior to selecting a respirator,” the 3M document said, “users should consult their local respiratory protection regulations and requirements or check with their local public health authorities for selection guidance.”
Surgical-grade masks
They do not “filter or block very small particles in the air that may be transmitted by coughs, sneezes, or certain medical procedures,” the FDA stressed.
“Surgical masks weren’t meant to perform the functions of the respirator,” said NPPTL’s Szalajda. “They’re not intended to be protection from inhalation particles but from contact with body fluids.”
True medical-grade masks are made of three layers of nonwoven fabric typically made from plastic. The colored top layer of fabric is made of medical-grade spunbond polypropylene, which is a resin polymer heat-bonded into a weblike structure.
Surgical masks also have small, bendable wires to help the mask stay in place, and are often tied behind the head or secured with ear ties. This design doesn’t make for a particularly great fit, especially compared to the N95, according to Szalajda.
Surgical masks are one-time use only, and if they are soiled or breathing becomes difficult, the mask should be carefully discarded and replaced, the FDA said.
Homemade cloth masks
The most common mask in use among the general public today is a fabric mask, often homemade. Effectiveness depends on the type of fabric used and the number of layers of cloth. These masks can be as little as 26% effective.
According to the CDC, “multiple layers of cloth with higher thread counts have demonstrated superior performance compared to single layers of cloth with lower thread counts, in some cases filtering nearly 50% of fine particles less than 1 micron.”
That’s good news — studies have detected SARS‐CoV‐2 in aerosols between 1 and 4 microns.
“We found that silk face coverings repelled droplets in spray tests as well as disposable single-use surgical masks,” the authors wrote, adding that silk masks “can be more breathable than other fabrics that trap humidity, and are re-useable via cleaning.”
You can also add filters to your fabric mask, according to the CDC. Some are made from polypropylene, the plastic that produces static cling; others from silver or copper, which have antimicrobial properties. Studies on the effectiveness of inserts, however, are rare, so guidance is limited.
To up their odds, people have begun layering fabric masks over surgical ones for added protection.
President Joseph R. Biden has been seen wearing two masks on numerous occasions. On Inauguration Day, Transportation Secretary nominee Pete Buttigieg and his husband, Chasten Glezman, took a selfie double-masking and inaugural poet Amanda Gorman wore a surgical mask beneath her Prada version.
It’s a behavior advocated by Joseph Allen, an associate professor at the Harvard T.H. Chan School of Public Health and the director of the school’s Healthy Buildings program.
It makes good sense to double mask, according to Dr. Anthony Fauci, now chief medical adviser to Biden.
“If you have a physical covering with one layer, you put another layer on, it just makes common sense that it likely would be more effective and that’s the reason why you see people either double masking or doing a version of an N95.” Fauci told NBC’s Savannah Guthrie.
Face shields, bandanas, gaiters, ski masks and scarves
Don’t wear scarfs or knitted ski masks as a protective measure, the CDC says. Do not wear a face shield without a mask, the agency advises, as it won’t protect against tiny airborne droplets that can float under and inside the shield. And forget bandanas and neck gaiters.
In fact, gaiter masks, also known as neck fleeces, actually increased the transmission of respiratory droplets.
Health & Fitness
Why Black Americans arent being vaccinated for COVID-19 at the same rate as whites – Yahoo News
https://news.yahoo.com/why-black-americans-arent-being-vaccinated-for-covid-19-at-the-same-rate-as-whites-225217711.html
Early data on the rollout of the vaccines for COVID-19 shows that minority populations in the United States already disproportionately affected by the pandemic are not being immunized at the same rate as white Americans.
Yahoo News Medical Contributor Dr. Uché Blackstock believes there are multiple factors contributing to this disparity.
“One of the problems that I saw very early on is that if you’re going to have mostly hospitals and pharmacies dispensing the vaccine, we’re going to miss a lot of people,” Blackstock said. According to recent research from GoodRX, minority communities tend to have fewer pharmacies per capita, which puts them at a disadvantage based on where they live.
“We need to bring the vaccines to the people,” Blackstock added, suggesting that mobile vaccination units could help increase access in areas where transportation is an issue.
In 16 states that have released preliminary data on who has received at least one dose of a COVID-19 vaccine, white residents were more likely to have received a shot than Blacks, KHN news reported. In Pennsylvania, data through Jan. 14 showed that while 1.3 percent of whites in the state had received a vaccination, just 0.3 percent of Black residents had. In Mississippi, 1.3 percent of African Americans residents have been vaccinated so far, compared with 3.5 percent of white residents.
While there are numerous factors that might account for the early discrepancy in the rate of vaccination, Blackstock thinks the pattern will hold.
“It’s the same thing that people said at the beginning of the pandemic, when there was incomplete data that showed that Black and Latinx people were also being infected and hospitalized and dying at higher rates. But then once we got the complete data it confirmed the initial data, like we already know which communities are vulnerable,” Blackstock said.
African Americans, Latinos and Native Americans die from COVID-19 at nearly three times the rate as white Americans, according to figures provided by the Centers for Disease Control and Prevention. These minority groups are also about four times as likely to be hospitalized with the coronavirus as white Americans are.
“If we’re seeing these trends at the beginning, I think now is an opportunity to respond to that data, right?” Blackstock said of the rollout of the vaccine. “To direct our efforts, according to the data. And so we’re seeing these trends this early on, we can actually try to course-correct.”
On Monday, White House press secretary Jen Psaki spoke of the challenge of meeting President Biden’s goal of vaccinating 1 million Americans every day for the next 100 days.
“It’s not just about having supply, which is pivotal, of course. It’s also about having more people that can physically put the shots into the arms of Americans and ensuring that we have places that that can be done,” Psaki said.
Biden has often spoken about the need for an equitable pandemic response. On his first day in office, he signed an executive order stating that “the COVID-19 pandemic has exposed and exacerbated severe and pervasive health and social inequities in America” and directing federal agencies to coordinate a response.
Blackstock said another factor contributing to preliminary low vaccination rates among African Americans is vaccine skepticism, which she attributed to a long-standing pattern of discrimination against minorities by the medical establishment. But she believes there are ways to combat that mistrust.
“I think, with that issue, what needs to happen is we need health care professionals and those communities to be able to have conversations with their patients about the vaccine and to answer those questions,” she said, adding that those one-on-one efforts should be bolstered by a national public health campaign to promote vaccines.
“We need to see [it] on buses and trains and billboards, social media, commercials on TV,” Blackstock said. “We need to see information out there about the vaccine, why it’s important for people to take it, and to see positive imagery around speaking of vaccines. We have not seen that at all.”
Last, Blackstock noted that some minority communities don’t have access to or proficiency with the technology required by some health systems to register for an appointment to be vaccinated.
“If you have the vaccines there, but people from the community are not able to get appointments because of the cumbersome process for signing up for a vaccine … then the people who need the vaccine aren’t going to get it right,” Blackstock added. “And we’re going to reinforce the inequities that we’ve already seen in the pandemic.”
_____
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