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Psychological Fallout Of COVID 19 & How You Can Cope With It

Rishabh, a young man in his thirties, still feels throat ache sometimes and then he starts feeling low owing to the worries of his health.

Harleen, a running enthusiast has reported weakness and is unable to do long runs despite 6 months of Covid recovery period. She feels it’s more a case of lack of mental strength.

And Sunaina keeps on worrying about the long term impact of catching Covid infection on her children (age 14 and 17).

Covid has impacted all of us psychologically; even those who didn’t get the infection. All of us are worried about our health because nobody had ever seen or heard about such a pandemic before. The mortality rate was quite high in the beginning. The spread was rampant and engulfed the world like a wildfire. Italy and the US were two of the hardest-hit countries. Several other nations had an almost similar fate awaiting them. Millions of us are still coping with the covid-19 and its jarring after effects.

Grief, sadness, sense of loss, unbearable pain, and guilt have now become a part of most of our lives. But even this cloud had a silver lining and it came to us in the form of the much-awaited vaccine. However, it did come with a few misconceptions attached. Let's clear the mist right away. The claims that are being made with regards to the covid-19 vaccine such as side effects, increased risk of infection, death, reduced reproductive ability, and the like are completely false and baseless. There is nothing to fear about the coronavirus vaccine that is being administered throughout the country.

 We will get through this and we know it. Despite the losses that we have borne and the anxiety that we have lived with for more than a year, deep down we all are optimistic that the worst has passed. Still, some people around us continue to grieve for their loved ones. You are no stranger to their pain. Signs that you or someone close to you might still be grieving for their friends or family include:

 A complete loss of interest in activities and tasks that one used to enjoy before 

Withdrawal symptoms from your friends and family 

Significant decline in appetite 

Ignorance towards hygiene measures such as regular showering and oral health 

Feeling tired, fatigued, angry, guilty, or irritable

Avoiding places, people, situations, and memories

Frequent anxiety attacks and similar episodes, nightmares, and stress

 These symptoms are not just a sign that somebody might be grieving but have become our defence mechanism. They provide us with much-needed solace. They help everyone dealing with stress and anxiety create a wall around them. It is common for each one of us. 

 Is it possible to cope with this kind of stress, sadness, and guilt?

Is it possible to come out of this shell and live a normal life all over again?

Yes, it is very much practical to let all this slide. We have to get over our fears and anxieties. It is easier said than done but if we do not make up our minds and harden our hearts, things might take a turn for the worse:

 Physical reactions such as stomach problems, headaches, body pain, skin rashes 

Worsening of any chronic health that you might be struggling with at the moment 

Difficulty in sleeping or having recurring nightmares 

Lack of ability to concentrate and make decisions 

Recurring feelings of fear, frustration, sadness anger, numbness, and worry

Yes, despite all this, it is still possible to get rid of these ailments and live a normal life. We can make it through all of this and even more if we do the following without fail:

 Take A Break

If you're watching, reading, or listening to something, take a break from all of that for a moment. Disconnect your phone and turn off your TV. Prevent any kind of negativity from seeping into your life.

 Take Care Of Your Body

Start focusing on yourself again. Concentrate on breathing, stretching, and light exercise. Get plenty of sleep and eat healthy and nutritious food. Avoid excessive alcohol and tobacco. Learn to love your body. Turn it into your temple.

 Take A Minute To Unwind

Try to relax. Indulge in activities that make you happy. It is time to be a little selfish, so go on a road trip, invite a friend over, spend an entire day watching just your favourite movies. You get one life, live it.

 Take Out Time For Connections

Do not forget your friends and each one of your colleagues that stood by you. It is time to reconnect with the ones that matter. As the social distancing norms get more relaxed, reach out, start conversations, be more social and become more available.

 Take Advice

In the end, it is all about making a difference in your life. If you cannot find the courage to do it on your own, seek help from a professional. Let the pent-up stress and grief out so that you can let happiness in.

Dr. Sachin Mittal is an Endocrinologist by Training with a commitment to work for public health and personal development. Post his DM in Endocrinology from the prestigious T.N. Medical College & B.Y.L. Nair Hospital, Mumbai, India; he did a Post - Doctoral Fellowship from University College of London and Great Ormond Street Hospital, London, United Kingdom. He is also the Founding Director of Sweet Diabetes Foundation, an NGO that helps the children with Diabetes.

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Cool & All-Natural Summer Drinks To Beat The Summer Heat

Do you think that the spicy fizz of a cola drink can beat the smooth texture of coconut water? Think again. Do you think that the bright and almost dangerously orange colour of that aerated liquid can beat the fresh and melting green of a homemade Aam Panna? We already know the answer but our busy lifestyle and needless dependence on cola drinks or mocktails makes us order them again and again despite full awareness of their health hazards.

 We have grown accustomed to ordering sugar syrups stuffed with carbon dioxide alongside a plate-full of junk food that we have so fallen in love with. It's as if nutrition and health have bid us adieu in this time and age. Should this be the case? Read this article if you wish to change the habit and take 2-minutes extra in making these cool summer drinks at home rather than opening a bottle or can.

 Following is a look at the most delicious yet highly underrated summer drinks that we have forgotten but should be reminded of every now and then:

 Statutory Warning: You may feel your mouth water excessively by the time you’re done reading. You may also want to throw out all your favourite colas and carbonated drinks soon after. I take full responsibility for any such actions on your part.

 1.      Watermelon Juice

About 8 ounces of watermelon juice contain 2.1 grams of carbs, 0.2 grams of protein, absolutely no fat and 9 calories. It is incredible how watermelon juice can impact your skin and hair, relieve you of muscle soreness, improve heart health and can even prevent cancer! 

 2.      Coconut Water

What comes across as a completely boring drink has a punch of flavour unparalleled by any other drink. Coconut water contains 5.4 calories. only 1.3 grams sugar and 61 milligrams of potassium, with 5.45 milligrams of sodium. It fights diabetes and has antioxidant properties. It is beneficial for prolonged exercise if you are a health freak and it keeps your hydrated throughout the day.

 3.      Jaljeera

Jaljeera is something that we have grown to love and have loved to grow on. Wasn't it our most favourite drink when growing up? Jaljeera keeps your digestion healthy. One regular glass of jaljeera contains only 4.3 grams of fat, 1.9 grams of protein, 5.5 grams of carbohydrate and 1.4 grams of fibre. It also has vitamin c, folic acid, potassium, phosphorus, calcium and zinc.

 4.      Aam Panna

All other mango drinks fall flat and pale in front of a homemade Aam Panna. A regular glass of aam panna has 179 calories with 1 gram of protein and 26 milligrams of sodium. The total carbohydrate content is 46 grams and the fact that it is rich in minerals, abundant in vitamin c, helps with intestinal disorders, cure depression, prevents cancer, helps fight diseases, is great for our eyes is just an icing on top.

 5.      Lassi

We talk so much about how we need to improve our immunity. The drink that is highly underrated here is lassi. It is loaded with good bacteria that keeps your stomach healthy and all your gut problems away. A glass of salted lassi may contain 176 calories out of which protein amounts for at least 36 calories. It also has enough carbohydrates and vitamin B2 and magnesium, sodium, potassium, phosphorus and the list goes on and on.

 6.      Nimbu Pani

Nimbu pani was a staple and is still a staple for every Indian child. There is no other drink that is more refreshing than nimbu pani and more ideal for weight loss too. How cool is that! It removes toxins from your body and is a great source of vitamin c which again boosts your immunity.

 Finally...

The natural and the most fulfilling and filling drinks that we have just read about above are not just packed with taste but health as well. They don't just keep your skin glowing and sugar levels normal but your gut happy too. Now that is a healthy and tasty way to beat the summer heat.

Dr. Sachin Mittal is an Endocrinologist by Training with a commitment to work for public health and personal development. Post his DM in Endocrinology from the prestigious T.N. Medical College & B.Y.L. Nair Hospital, Mumbai, India; he did a Post - Doctoral Fellowship from University College of London and Great Ormond Street Hospital, London, United Kingdom. He is also the Founding Director of Sweet Diabetes Foundation, an NGO that helps the children with Diabetes.

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Year 2020: Was it a blessing in disguise?

The year 2020 brought the world to a standstill because of global pandemic Covid-19. In fact, we witnessed history in making; we would tell our future generations that there came a period in 2020 when all of us voluntary chose to stay at home, do nothing and just focused on taking care of our health. There is no denying the fact that 2020 has been a tough year; especially for the medical fraternity who is still battling the COVID-19 problem and trying its best to save as many lives as possible. The year resulted in 81 millions Corona cases worldwide and nearly 18 lakh deaths. But yes, more than 58 million people have recovered so far and more than 70% of these patients quarantined at home. The world is coming closer to getting a vaccine for COVID-19. Clinical trials have started in India as well and top leaders of the world including Joe Biden have got the vaccination administered to reflect their trust in the R&D done by medical and pharmaceutical companies. So would 2021 be free of COVID-19 and mask hassles? Well, that can be discussed later but right now I wish to share with you a few positive takeaways from this year -

1. Preventive HealthCare - Generally in our country, people prefer curative healthcare but Corona came with a no-vaccine condition. The only way to stay safe was to prevent the disease. This led to an increased awareness among masses about preventive healthcare and staying safe by following healthy lifestyle.

2. Sanitisation and Cleanliness - The best way to control the spread of Corona is to wash your hands regularly and for at least 10 to 15 seconds. India desperately needed its population to adopt sanitisation and cleanliness as a way of life. Corona did it!

3. Connecting through Digital technologies - With Corona, came lockdown! Businesses were shut down for a period because the entire country observed day and night curfew. Social distancing was practised so many businesses were temporarily closed but thanks to digital technologies, work mode was on. Doctors started giving tele-consultations to their patients; e-commerce helped many small businesses become big and education continued through zoom classes, Google classroom and various other apps which saved the day.

4. Spending quality time with Family - Lockdown period brought families together. Since the working population had no other thing to focus upon, they got the chance to spend the same time with their family. And many of them reportedly enjoyed this lockdown period.

5. Pursuing healthy habits - Gyms, restaurants and malls were closed to ensure social distancing. This led to people discovering alternate healthy habits to utilise their free time. Almost all of us went back to our passions like writing, painting, drawing, baking, stitching etc. Many of us started working out at home, or jogging, cycling and running in the nearby gardens.

6. Social service and social support - Pandemic and lockdown period witnessed people contributing to help the needy and the poor who lost their daily jobs. Langars were organised all across the nation to support such people. Indeed, this pandemic has given us a big humanitarian lesson - Whenever a challenge comes, we all stand united to fight it and win over it, together.  

7. Recognition for medical fraternity - The service done by doctors and nurses in numerous hospitals and health organisations have been duly recognised. Many doctors have lost their life while saving the patients or taking care of Covid-affected patients. Medical fraternity has been named as Corona warriors and they have been thanked by every section of the society for the work done in these tough times.

8. Home cooking - Last but a delicious positive point, people have returned back to the goodness and joy of homecooking. Restaurants were closed and home delivery was not possible so the women of our household not only managed the work on their own but served us delicious food every day. Indeed we owe the biggest gratitude to the women of our household who were strong enough to take care of the entire family and run the show without maid as well.

So as we all bid adieu to 2020, I pray to the Almighty that whatever challenges we have faced in this year, may soon fade away and 2021 brings new hopes and joys to the world! Let’s not forget the lessons we have learnt in 2020. Wishing you all a very Happy New Year!

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The Good, the Bad and the Ugly side of Screen Time

Corona Virus Pandemic has changed our lives dramatically in a number of ways. The screen time has surged up drastically during the #StayHome phase with city people in some places reporting it to be as high as 16 hours a day!

So what is Screen Time?

Every single minute we spend staring at the screen of any digital technology product is counted as Screen Time. It includes checking emails or watching movies or social media browsing and chatting with friends on Instagram or Whatsapp. Our mobile phone is our assistant, sounding board, secret-keeper and no less than a best friend. Such is its importance in our life that it goes to bed with us and it is the first thing we look at upon getting up. Some researchers have compared the increased screen time to have an abnormal impact as severe as drug addiction. All this is enough to create anxiety, especially for parents who are worried about increased screen time for their kids.

The obvious questions that arise in our minds - is excessive screen time harmful in any way in the short or the long run? Does it increase the chances of depression? Does it cut down the chances of kids having physical interactions? Are kids having excessive screen time more prone to develop obesity, sleep disorders, and other sinister metabolic problems in the long run? Does it have an abnormal impact on a child’s vision and brain development?

The whys and hows of screen time impacts are presented in a nut-shell-

The Good part of Screen indulgence:

All screen time is not bad. Digital technologies have proved to be a blessing by allowing people to work from home and earn their livelihood. We must also appreciate the role of digital media in encouraging online learning. Our kids are taking classes online and continuing the tradition of learning even when the schools are closed. During the lockdown, mobile applications and online ordering facilities have helped people receive essentials and groceries at their doorsteps. Arogya Setu App by the Government of India has been one of the right information tools in this era of rumor-mongering and misinformation. Many patients have been able to manage their medical problems with the use of video calling and telemedicine during this extra-ordinary phase. In fact, Telemedicine as a whole, if used properly and selectively has the potential to improve access for patients and get them the best of medical opinion from experts in any part of the country from the comfort of their homes. This not only facilitates medical treatments especially in remote places of the country but also reduces the total cost of treatment and potentially improves outcomes.

The Bad part of Screen Indulgence:

Being digital-savvy is good; the problem arises when people start using digital media for unproductive activities. Too much screen time inculcates a sedentary lifestyle leading to obesity. Often young ones are seen playing games on a mobile phone rather than in the open field. Sleep disorders, behavioral problems, and anxiety are some of the potential grave impacts of screen indulgence. People who are glued to their screen for more than 8 hours a day run a risk of poor eyesight. How much is the right amount of screen time, is still a matter of debate with research showing varying results. Clearly, a lot of work still needs to be done before giving a clear answer.  

The Ugly part of Screen indulgence:

The biggest problem of increased screen time is that you are left with very little time to interact with your family. The worst part is that the food time is also getting shared as screen time. So, when you are eating food while staring at the screen; half of your senses are not even aware that you are eating and that’s the reason we never feel full even after taking a heavy meal. The sensual indulgence of almost all the activities is missing because a part of us is always involved with the screen. Many a time, kids are given smartphone-like devices to keep them quiet while adults talk. Like all of us, kids also love technology and the dopamine rush which comes when we are looking at a screen; we lose our sense of mind and control. If we do not control the screen time now; we may be very late and end up with problems that have no solution.

How to control or minimize screen time:

Let’s act before it’s too late. It would be very immature if we end up as a generation of poor eyesight, obesity, and suffering from anxiety. Depriving kids altogether of technology or taking draconian measures will create undue pressure, tension, and an uneasy atmosphere in the families besides leading to a lot of discord. Controlling screen time is no rocket science; the one-word solution is DISCIPLINE.

Let’s remember that charity begins at home. Since adults discuss likes and comments on their social media posts - does it not give a signal to the child that it’s a cool thing to do? Does it not highlight or give undue importance to this fake world of social media friends and LIKES and are we creating hollow humans in the process? So parents must stop surfing on the mobile phone at least an hour before their bedtime; they have to stop themselves from playing games or watching those useless videos online if they don’t want their children to do the same. We need to implement stricter rules at home that disallow mobile phones and television viewing while it is dinner time or family time.

Since this lockdown has given us ample time, let us all use it to bring back the charm of board games of yesteryears. You will enjoy playing real Ludo more than online Ludo. Bring back badminton into your life. Bring back chess. Also, there exist better ways of celebrating ‘me-time’ rather than engaging in digital media or doing Houseparty calls.

Let’s not forget that technology, like fire, should be our slave and not a master. Technology is meant to simplify our life and to assist us; do not make the mistake of technology overpowering our existence.

A habit can be changed by replacing it with another habit. Every habit is a cycle of Cue, followed by Craving, followed by a Routine and then ultimately a Reward. To break this habit of looking at your mobile screen every second minute, you have to first identify the cue or that stimulus or that very moment which gives you the craving to check your phone or social media. Introspect your routine and identify all those patterns that have given you this habit of screen addiction. You must ignore this screen-craving and start deviating your mind on to other things. You can develop a routine of checking mobile phone on fixed times and use the time spent on screen for some 'heartful' activities. You will definitely reap the reward in the form of rested mind, better sleep, fresh skin and even more productive days!

I wish you good luck and look forward to listening to your cues, cravings, routines, and rewards as you strive to reduce the unproductive screen time.

Dr. Sachin Mittal is an Endocrinologist by Training with a commitment to work for public health and personal development. Post his DM in Endocrinology from the prestigious T.N. Medical College & B.Y.L. Nair Hospital, Mumbai, India; he did a Post - Doctoral Fellowship from University College of London and Great Ormond Street Hospital, London, United Kingdom. He is also the Founding Director of Sweet Diabetes Foundation, an NGO that helps the children with Diabetes.

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Saving the Saviours!

A Delhi Cancer Institute has been shut for a day after a doctor tested positive for Coronavirus. The same thing happened in one of the leading medical institutes of South India. The pattern has been the same worldwide. A study published in British Medical Journal reports that some hospitals in Italy were closed down because of Coronavirus infection among doctors and nurses. Coronavirus has caused an unprecedented havoc in the healthcare systems of the most developed western nations. In India, the analogy has been raised in a global war with parallels drawn from iconic mythological war “Mahabharata”. India with its already constrained healthcare infrastructure is very much at risk and we just cannot afford this pattern to continue.

While combating COVID-19, let’s be clear – the battle is going to be long and tough so every resource matters and Health Care Worker (HCW) is one of the most precious resources. We can create Intensive Care Units (ICUs), build isolation beds, purchase ventilators- but nothing of that will work without trained manpower to run those. They cannot be produced overnight; it takes years of right training to make a HCW capable enough to save a life. Already, our number of doctors and nurses is much less than recommended and we just cannot afford to watch it reducing further. The risk of infection is exponentially higher for an HCW. In Wuhan, it was almost three times more with nearly 3300 HCWs infected. In Spain, nearly 14% of all diagnosed cases were HCWs.

Why preventing this is so vital and what happens when HCWs get infected - It creates a Cascading Effect. Let’s see how-

Contrary to what social media posts like us to believe, the treatment protocol is same –isolation, tracing, testing the contacts and isolating them as needed - this could mean a lot of people can get infection including other HCWs. A doctor in a government clinic in Delhi getting infection meant 900 of contacts falling in risk bracket. The fear of infection in the mind of other team members is reinforced. If many get infected, it compromises the hospital’s ability to serve as highlighted earlier. Also, HCWs like any other human have the anxiety of not only getting infected but of transmitting the infection to other family members. There have been stories in the U.S. of HCWs making their will.

Adequate supplies of appropriate PPE (personal protection equipment) which as per W.H.O includes – masks (Surgical and N95), goggles, gowns, hand sanitizers, soap, and water must be ensured. Along with this, a refresher training in infection prevention and control, proper usage, taking off and disposal of PPE is needed. Sharing age-old saying popular in ICUs - -Hand Washing Saves Lives- - needs to be reinforced with clear repeated communication.

As highlighted brilliantly by Dr. Atul Gawande in New Yorker, there should be a symptom check for all HCW’s reporting for work – whether they had any fever or flu-like symptoms and testing should be available as a priority for them.  

Indian Council of Medical Research has recommended the use of Hydroxy Chloroquine for the prevention of infection in personnel caring for Coronavirus patients. But due to panic created on social media, so many people who didn’t need it have bought and stocked it, which may lead to a potential shortage. The additional risk is that those who need it may not get it on time. Also, indiscriminate use can lead to resistance against the drug and even unwarranted side effects.

Equally important is to stop the hospitals from getting overcrowded. 80% of Coronavirus cases as per W.H.O. have mild disease and do not require hospitalization but just good nutrition, hydration, and isolation. In a study published in the New England Journal of Medicine, author Mirco Nacoti advocated the same as they found that hospitals in Italy were themselves becoming a big source of infection. Up to 41% of cases in Wuhan resulted from the hospital-related transmission. Dedicated hospitals for Coronavirus patients are the need of the hour. Virtual channels and Telemedicine can help more in chronic disease management, which may prove cost-effective also and help cut down Non-emergency hospital visits.

 What hurts most is the lack of compassion and care for HCWs! There have been news reports that reflect stigma and ostracization when doctors living on rent were asked to evict for the fear of spreading the infection. This is a shameful and reckless social attitude.

It was great to see people coming out to applaud HCWs -that helps boost morale, but India needs more than just clapping and lighting Diyas.

It’s imperative to take concrete judicious steps because protecting the HCWs is the foundation of building a healthy India post-Covid battle victory.

Dr. Sachin Mittal is an Endocrinologist by Training with a commitment to work for public health and personal development. Post his DM in Endocrinology from the prestigious T.N. Medical College & B.Y.L. Nair Hospital, Mumbai, India; he did a Post - Doctoral Fellowship from University College of London and Great Ormond Street Hospital, London, United Kingdom. He is also the Founding Director of Sweet Diabetes Foundation, an NGO that helps the children with Diabetes.

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Giving our women a healthy lifestyle is true Women Empowerment!

While the newspaper today is full of women’s dreams, rights, aspirations and equal opportunity slogans; there is no denying the fact that in a large slice of the world, girls and women remain ignorant about their health issues and the society too is careless about their health quotient. To begin with, take a look at these statistics –

Only 37% of women have access to healthcare services as compared to 67% men (as per a study by AIIMS and Harvard University)

Housewives were one of the largest groups committing suicides in India in 2018 with nearly 63 housewives killing themselves every day

More than  39% of Indian women claim they are not able to work out daily because of work responsibilities

Less than 20% of women in India have access to clean hygiene for menstrual care

And the proportion of overweight and obese women has almost doubled in India in the last 17 years

In an equitable world, women empower women; as they say, queens fix each other’s crown. On Women’s Day, I as a doctor; share some of the thoughts that women can do for other women and girls in their household. Such small actions would go a long way in building a healthy future for the Indian women –

1.  Menstruation is a taboo topic in India. But I advise all the women to talk about it especially about hygiene and cleanliness with their daughters. Do not leave this responsibility for school counselors. Talk to your girls on how unhygienic choices like cloth or husks can give them infections, rashes, and discomfort.

2.  The thyroid is a very common problem in Indian women. But it is very much manageable. So women must encourage their relatives and friends to get their thyroid function test done once they reach the age of 35 or if they notice symptoms like weakness, hair thinning, weight gain or fatigue like situation. Women must consult a doctor if thyroid function comes out of range.

3.  Rather than going on crash or fad diets, women and girls of the household should motivate each other to begin with some physical activity and devote at least 45 minutes every day. It is very important for women as well to lift weights and do strength training. Strength training would also help the postmenopausal women minimize the risk of osteoporosis, which is a common problem in this stage for women. Eat a balanced diet and pay attention to your nutritional needs. Taking Calcium and vitamin supplements as recommended after 40 are equally essential for women.

4. There is no gender bias for health problems like Diabetes, Cholesterol and Blood Pressure; women are at equal risk of heart diseases as well. So every woman should also get their yearly tests done reflecting on their overall health. After a certain age, breast mammography should be doe and periodic breast examination is also recommended. In case, women notice some spotting or irregular bleeding, Pap Smear, Uterus ultrasound, and hormonal tests should be done and the reports should be shown to a gynecologist for consultation and medication.

5. And finally, the problem of PCOS - Polycystic ovary syndrome – is for real. Nearly one in every five women is reported to be suffering from PCOS. The common symptoms are irregular periods, unwanted male-pattern hair growth or excessive facial hair and obesity. So if you see any young girl or a woman facing such challenges; instead of body-shaming her, make sure to give her emotional support and share your knowledge about the matter. Unmanaged and untreated PCOS can create the risk of heart disease, diabetes, and certain types of cancer and cholesterol problems in the long run. Hence, it calls for a serious treatment rather than a cosmetic solution!

The alchemy of women empowerment includes working for women’s health as well. And every husband also must take care of her spouse’s health just like the woman takes care of the entire household. Looking forward to more seeing more women taking charge of their health and inspiring many others in the process! Happy Women’s Day to the half of the world who is the reason for the existence of the other half.

Dr. Sachin Mittal is one of the leading endocrinologists in Tricity with a commitment to work for public health and awareness campaigns. Post his DM in Endocrinology from Topiwala National Medical College & B.Y.L. Nair Hospital, Mumbai, India; he did two years of Post - Doctoral Fellowship (Pediatric Endocrinology) from Great Ormond Street Hospital, London. Being an opinion leader in Diabetes Prevention and Management, he keeps on addressing seminars and workshops, of both medical fraternity as well as common people. He is also the Founding Director of Sweet Diabetes Foundation, an NGO that works to help the children suffering from Diabetes.