COVID-19 – Hello Doctor

Are you a long hauler?

August 23rd, 2022 by The Hello Doctor Team

As the COVID-19 pandemic progressed, it became evident that besides the potential for causing severe illness, many people can experience prolonged COVID symptoms. These can linger from weeks to months after their initial exposure to the virus. This is called ‘long-COVID’, or ‘post-acute COVID syndrome’. Those who experience it are known as the ‘long haulers’.

As with much else about COVID-19, long-COVID symptoms and their severity differ from person to person. That said, recent studies have found that 55% of long-COVID sufferers report profound fatigue, 25% have shortness of breath, and 26% have symptoms of depression.

Does this sound familiar?

COVID is teaching us things we never thought we needed to know; and one of those is that there is no such thing as a ‘typical’ COVID response. Yes, people with underlying conditions are at higher risk of severe illness, but we’ve also seen fit and healthy people with no health issues succumb to the disease. The same goes for long-COVID. It appears that most people who experience long-term symptoms may have had health issues before contracting the virus, or they developed very severe illness during their COVID-19 infection. But some people have no underlying issues at all and had mild symptoms when infected. So, when it comes to long-COVID, there certainly isn’t a one-size-fits-all approach!

Until recently, many people who experienced long-COVID weren’t taken all that seriously. It was only after the World Health Organisation published an official definition that more attention was given to the condition.

Some of the common symptoms of long-COVID include fatigue, breathing difficulties, insomnia, pain, and brain fog. Additionally, post-COVID-19 can adversely impact multiple organ systems, including the kidneys, lungs, pancreas, and heart. Symptoms may include a new onset following initial recovery from an acute COVID-19 episode, or persistence of the initial illness. Symptoms may also fluctuate or relapse over time.

Every long-COVID patient is different, and as such, every patient will need treatment specific to their symptoms. Education, support groups, stress management, stigma management and lifestyle changes can all help ease symptoms. Sleep is especially important, as is physical activity – as much as the body will allow. An important management tool is to track your patterns. Try to identify the triggers that bring on the utter exhaustion, headache or muscle aches, and avoid those as much as possible.

Finally, don’t be afraid to be vocal about how you’re feeling. Be open and honest with your doctor and your support structures about the symptoms you may be experiencing.

References

Parenting lessons from the pandemic

May 29th, 2022 by The Hello Doctor Team

The COVID-19 pandemic has had a dramatic impact on family life. Social isolation, the increase in screen time, upended routines, distance learning and remote working all changed life as we knew it. But as time went on, the world adapted, and we developed new coping and parenting strategies.

Eventually, positive things emerged. “Families spent more time together, perfectionists learnt to let go, and many discovered a resilience they never knew they had,” says Gen Clarke, a counsellor from Johannesburg.

As life slowly returns to previous routines, it’s worth holding on to the important lessons we have learnt.

Relaxation is rudimentary

In those first few weeks of hard lockdown, many families found their schedules suddenly empty. They filled it with family games evenings, baking challenges and parent-child DIY projects. This made some feel refreshed, despite the horrors of the pandemic.

The lesson: While it’s not always possible to live at that pace, balance is key. Make more time for relaxation and bonding as a family, whether that means going on holiday, trying new hobbies over weekends, or simply making dinner time phone-free. “Say yes to fun things more often. Life is short and full of stressors, and anything that brings you and your kids joy should be a regular part of your life,” says Gen.

Perfection is not possible

With the whole family at home and everyone juggling work/school/home duties, a strange thing happened. Parents realised that, in fact, the world didn’t implode when their kids didn’t get their regular haircuts or they spent Saturday afternoon just hanging out, not doing a structured activity.

The lesson: “Don’t put so much pressure on yourself – or your kids”, says Gen. Rather, he suggests, when feeling overwhelmed, drop something from your diary instead of ‘burning yourself out’ to get everything done. Furthermore, he stresses, teach your kids to recognise when they also feel overwhelmed – it helps to let go of the need to be perfect. “Life will always present ‘curved-balls’ so that your perfect plans will fly out of the window. When you make peace with that fact you’ll feel more in control. This is an important skill for kids to learn too.”

Chores build character

“While in a long Zoom meeting one day, my three-year-old got angsty and tried everything to get attention. In a last-ditch attempt to get her to be quiet, my spouse gave her a feather duster and asked her to start dusting,” says Elise Smit from Johannesburg. The effect was extraordinary. Her daughter loved dusting so much, she took it upon herself to do it every few days. “Of course, we finish the job when she’s done, but she loves the responsibility and feeling like an important part of the home routine.”

The lesson: Kids learn a lot from tasks around the home. Give your child age-appropriate chores to do – it teaches responsibility and can lighten parents’ loads.

Exercise is essential

With gyms closed and school sports cancelled, families had to find other ways to exercise. Some joined online exercise classes, while others played sports in the backyard or went for walks as a family. With more time on their hands, it became a regular routine for many – and home life was more peaceful for it.

The lesson: Make time for physical activity. It burns off kids’ extra energy, promotes relaxation for overworked parents and boosts everyone’s feel-good hormones. With scheduled activities back on the cards, don’t let go of the family exercise time. It can be as simple as kicking a ball around in the evenings or going for a walk in your nearest park.

Shared parenting is important

In most families, one parent carries the brunt of the parenting load, says Gen. “When both parents started working from home, the non-primary caregivers finally saw how much work goes into caring for kids and a home, and started helping out more. I have so many clients whose relationships improved because the workload was shared more equally.”

The lesson: Though it’s not always possible to have exactly equal parenting loads, find ways to help each other out more.

While we’re all eager to put the pandemic behind us, it’s worth reflecting that the circumstances gave parents and children more opportunities than ever before to spend time together, to learn and to grow. These hard-won lessons can only stand us in good stead going forward.

References

Care.com
Catalyst

A Light In The Darkness

April 28th, 2022 by The Hello Doctor Team

Over the last two years, our lives and thoughts have been inundated with the COVID-19 pandemic. However, in South Africa especially, we cannot forget another dreadful pandemic that has been raging for decades – HIV /AIDS.

As with COVID-19, the HIV/AIDS pandemic hit us out of nowhere, completely changing our understanding of the world and shattering lives globally. The world stood by in shock as fear, misinformation and panic spread.

People were afraid to talk about the virus, to go near those who might have it or tell people that they had it. Sadly, infected people passed away without having their loved ones beside them and some without proper burials funerals to mark their passing.

It is for this reason that the Global Network of People living with HIV started the International AIDS Candlelight Memorial, held on the third Sunday in May every year since 1983. On 15 May 2022, simple candle-lighting ceremonies will be held globally to remember those who have succumbed to the disease. At this time, we can honour all those who have been taken from us too soon and remember the importance of social connection, helping others and furthering understanding.

Remembering is powerful

The power of a memorial should not be underestimated. These occasions validate our feelings, acknowledge and respect our grief, and serve as a way to unite us with others who are going through the same, even if we can’t physically be together. Want to pay tribute to loved ones lost too soon? These suggestions will help you create a meaningful commemoration.

Hold a ceremony

Rituals such as a candlelight memorial serve to maintain a sense of connection with those we have lost and help us cope by offering us a sense of control, say grief researchers. A public ceremony becomes a collective validation of our emotions and, in cases like the HIV/AIDS and COVID-19 pandemics, also raises awareness and knowledge. By making it an annual event, we continue to spread the word to new people, and help to restore our sense of trust in the world. You can plan your own private memorial if you prefer: light a candle, share stories, say a prayer, recite a special poem, play music and drink a toast to your loved one – whatever is meaningful to you. Guests can attend in person or join virtually. Need help? Here’s a step-by-step guide on how to plan an informal memorial service.

Mark it with a monument

Beyond the act of lighting the candle, you might want to create a focal point in your home or community where you can remember those being honoured. It may be a simple home shrine with a framed photograph and votive candle, or even planting a tree or putting a plaque on a public park bench. Monuments can help us manage grief by providing a place to come to terms with events and emotions. This is particularly important in cases where we were perhaps unable to hold a memorial, for example, due to COVID-19 lockdown or the stigma that surrounded HIV/AIDS in the past. Having a place of remembrance provides a sense of connection, both to those who have passed and to others who may feel the same, even if we’ve never met them. A monument also provides a consistent place for a memorial ceremony to take place. Note that if you’re thinking of creating a public monument in your community, you will need to approach your local municipality for rules and regulations on doing so.

Leave a legacy

You might want to extend the impact of the candlelight memorial by making a donation in honour of the person who has passed. Not only are you celebrating their life by extending help to others, but research has shown that the act of giving activates the same brain regions that are associated with joy and social connection. If you’re not sure where or how to donate, consider a cause that was close to your loved one’s heart, or which supports others with similar issues.

It is not too late

Many people may have found themselves in situations where they don’t have the closure of a proper farewell or any comfort and support when they lost a loved one. However, it is never too late. Even if it is years later, having that memorial can help you heal. If you feel a yearning to commemorate and celebrate the lives of loved ones long after they’ve gone, don’t worry about what society may think – if you need it, do it when you can.

Find support

If you or a loved one are struggling with severe grief or not coping with the loss of a loved one, it’s important to seek help. Visit the South African Anxiety and Depression Support Group at www.sadag.org for support.

References

Death Studies journal
Global Network of People living with HIV
Legacy.com
South African Government

Preparing for the double whammy: Flu season+COVID-19

April 28th, 2022 by The Hello Doctor Team

If there were any positives to come out of the past 2 years living through a pandemic, it was that the annual flu season seemed to be non-existent. While for some, flu means a few days off work, a headache and a tight chest, for vulnerable groups it can be deadly. Every year influenza kills about 10,000 people of five years and older in South Africa, and annually causes millions of cases of severe illness globally resulting hundreds of thousands of deaths.

Just like COVID-19, flu virus transmission is prevented through masking, physical distancing, avoiding poorly ventilated indoor areas, good hand hygiene and isolating. This explains why the past 2 flu seasons seem to have been so mild.

Yet, as the ‘state of disaster’ ends, schools return to full-time in person learning, and mask mandates are relaxed, this 2022 flu season could be intense.

So how to how you can keep yourself healthy this flu season and prevent the double whammy?

As temperatures drop, and social gatherings move in from outdoors, the risk of flu and COVID-19 transmission increases. While there is evidence that the virus that causes the flu is happiest in cold, dry temperatures, it is also possible that flu cases spike in winter because people simply spend more time indoors, being closer to others, and with their windows closed. Colder weather and darker days also mean less opportunity for outdoor activity, and more time spent on a warm and comfy couch with a sweet treat in hand.

With that in mind, and the knowledge that flu season may be back at full strength this year, consider the following ways to stay healthy throughout winter (and beyond!):

Get vaccinated: you can have your flu vaccine and COVID-19 vaccine at the same time. A COVID-19 vaccine won’t prevent you from getting the flu, and vice versa, but both will support your own immune system and thereby also help to protect vulnerable groups.
Spend time outdoors, wash your hands and don’t unnecessarily touch your face – this applies not only to preventing COVID-19 and the flu, but literally applies to every other illness as well.
Keep your body in shape – eat well, move more, and prioritise your sleep, regardless of what the weather is doing outside.
Manage your stress – stress hormones have an annoying habit of impairing the effective functioning of your immune system. Become aware of your stress and learn some practical coping techniques.

References:

Is COVID-19 related to your genes?

April 3rd, 2022 by The Hello Doctor Team

It’s something that has puzzled researchers from the start of the pandemic – why do some people experience severe illness, and others do not? These differences extend beyond known risk factors – like age, and existing disease.

To answer this question, researchers began studying the genetics of people exposed to the SARS-CoV-2 virus and were able to identify links between developing the disease and variations in specific parts of their DNA.

What they found was that a region on chromosome 3 (called 3p21.31) is significantly associated with severe COVID-19 and increased risk of respiratory failure and death. The possible reason for this is that this region of DNA is specifically associated with inflammation – one of the biggest culprits in COVID-19 disease severity.

Interestingly, what they also discovered was that there is a protective region on chromosome 12, associated with a reduced risk of intensive care for COVID-19 patients. They suggested that this region plays an important role in counteracting viral attacks, which would explain why people with this variation did not get as sick.

So, what does this mean for you? Well, unless you have a genetic test, you won’t know if you have the COVID-19 genes. The point to remember is that your genetic make-up is not your destiny (so don’t blame your parents) – you actually have the power to outsmart them. Your lifestyle choices can essentially turn your genes ‘on’ or switch them ‘off’. Decisions you make about how much TV to watch (hopefully as little as possible), and what foods to eat (lots of fresh food and no fast foods) can actually make changes at the level of your DNA. This, in turn, can lower your risk of disease… be that COVID-19, heart disease or cancer.

References:

Zeberg, H., Pääbo, S. The major genetic risk factor for severe COVID-19 is inherited from Neanderthals. Nature 587, 610–612 (2020).
Zeberg, H., Pääbo, S. A genomic region associated with protection against severe COVID-19 is inherited from Neandertals. PNAS (2021)
Kousathanas, A., Pairo-Castineira, E., Rawlik, K. et al. Whole genome sequencing reveals host factors underlying critical Covid-19. Nature (2022)

Fully vaccinated? Now what?!

March 8th, 2022 by The Hello Doctor Team

Let’s be clear – there is no quick fix to immediately ‘boost’ your immunity – no ‘wonder supplement’ or ‘power food’ will suddenly strengthen your immune system. However, living a healthy lifestyle does go a long way to keep your immune system strong. This has been found in a recent study showing that exercise may strengthen the antibody response to vaccination – both the COVID-19 vaccines and the annual flu vaccines.

Another recent study found that if you are physically active, you are up to 50% more likely to have higher antibodies after being vaccinated, compared to someone who is inactive. As this protects you from severe disease, hospitalization drops by around 35%.

Regular exercise results in elevated levels of the antibody immunoglobulin IgA. This antibody coats the mucosal membrane of your lungs and other parts of your body where viruses and bacteria can enter. In addition, physical activity also increases the number of CD4+ T cells responsible for alerting the immune system of an attack, and then helping to regulate its response.

So, if you’re looking for one thing you can do to stay healthy during the anticipated 5^th wave, or the annual flu season, look no further than your running shoes. It does seem there isn’t much exercise CAN’T do when it comes to keeping you healthy over the next few months… and beyond!

References

Chastin, S.F.M., Abaraogu, U., Bourgois, J.G. et al. Effects of Regular Physical Activity on the Immune System, Vaccination and Risk of Community-Acquired Infectious Disease in the General Population: Systematic Review and Meta-Analysis. Sports Med 51, 1673–1686 (2021)
Justus Hallam, Tyanez Jones, Jessica Alley, Marian L. Kohut,
Exercise after influenza or COVID-19 vaccination increases serum antibody without an increase in side effects. Brain, Behavior, and Immunity, Volume 102, 2022, Pages 1-10
https://link.springer.com/article/10.1007/s40279-021-01466-1
https://doi.org/10.1016/j.bbi.2022.02.005

Baffled about boosters?

February 14th, 2022 by The Hello Doctor Team

A common argument against COVID-19 vaccination is “Surely the vaccines can’t be effective if I require a booster?”

All vaccines work to train the immune system to recognise foreign invaders and produce antibodies that will attack them. But the strength of the initial immune response, and the amount of time the antibodies will last, varies depending on both the pathogen the vaccine is fighting, and the vaccine itself. Measles antibodies, for example, are long lasting, which is why only children get the jab.

Added to the complexities of how long antibodies last, is the extent to which a virus can mutate. And we know that COVID is a master of mutation! A rapidly evolving virus can trick a trained immune system and cause illness by changing its appearance or finding new ways to attack. Trying to create a vaccine to detect every new mutation is like trying to hit a moving target… tricky, but not impossible. COVID-19 is not the first virus to do this… and that is why there is a new flu vaccine released each year.

Vaccines do more than just help the immune system to produce antibodies. Vaccines educate the entire immune system, including T-cells, a type of white blood cell involved in removing pathogens from the body. There is growing evidence that even though COVID-19 variants may evade vaccine-induced antibodies, other aspects of a vaccine-boosted immune system, including T cells, are not as easily fooled!

The current evidence available suggests that while there is a waning immune response from the initial COVID-19 vaccine doses, those who have a booster dose have superior protection against severe disease. In other words, a third dose simply tops up the immune response, supercharging it’s potential to fight off whatever mutation it may have to face next.

References:

Duration of Protection against Mild and Severe Disease by Covid-19 Vaccines. N Engl J Med 2022; 386:340-350
The Harvard Gazette. Breaking down boosters
National Institute of Communicable Diseases. COVID-19 Booster Shot FAQs

What COVID-19 has taught us about human connection

February 14th, 2022 by The Hello Doctor Team

One thing we have learned from the COVID-19 pandemic experience is that we are not happy when we are separated from others – loved ones, colleagues and even people we do not know. We like to go to restaurants, coffee shops and just hang around people. Not only do we like it, but the pandemic has also highlighted how we need connection for our mental and emotional wellbeing. Sometimes it seems that it is only when things are taken away, that we learn to appreciate their value and importance.

Now, with the COVID-19 restrictions gradually being lifted, we can be more aware of caring for our connections with this deeper understanding.

Healthy relationships are equivalent to a healthy life

Have you ever noticed that the more you spend time with someone, the more you like them? This is called the exposure effect. Being repeatedly exposed to someone with whom you share common interest means you are more likely to like them and become friends. So, if you want to forge new relationships you will have to show up, consistently. Check in with your colleagues, even when there is not a specific work issue to discuss. Visit your friends regularly or arrange meet-ups. Arrange to meet outdoors as a COVID-19 precaution. Use social media to sustain your relationships too. Connect with your friends by text, commenting on and liking their social media posts, and even better – with video and phone calls.

How can I make and keep friendships?

Be approachable

Smiling and being nice may sound superficial, but it has a large impact on how likely people are to want to befriend you. Smiling plays a big role. Studies show that the number of times you smile during a conversation has a direct effect on how friendly you appear to others. So, if you are meeting on Zoom or on a WhatsApp video call, turn on your camera and look into the lens so the person can see your eyes connecting with them. The time of hiding with cameras off is over – it is no good for your mental and emotional health.

Be a good listener

Listening to someone shows that you care and support them. When you spend time with a loved one, give them your undivided attention. When chatting online, keep your eyes on the screen. When physically present with them, turn your phone to silent and give your undivided attention.

Give them space when needed

Everyone needs space to either be alone or spend time with other people. Clinging to them could push them away.

Be the friend you would like to have

Treat your relationships the same way you would like to be treated. Try your best to be thoughtful, kind, trustworthy and reliable.

Do not pressure them with expectations and rules

The best relationships often develop naturally, with time. Do not put pressure on them to spend all their spare time with you or to get comfortable quickly. Allow the friendship to grow stronger with time.

Make time

Spending time with friends often means that you will bond more, so schedule regular hangouts that suit everyone. For example, go on an outing once a month or grab a quick coffee together before or after work. Setting the next date after a get-together is a good way to ensure you will see each other regularly.

We all need friendships, love and connection to flourish so reach out, be kind, show appreciation and gratitude. It is amazing how the more you give, it somehow comes back in unexpected ways.