If you are not yet a meditator, you have been missing out on one of the most powerful techniques for improving health and happiness. Before COVID-19, the most consistent reason many of my patients gave for not meditating was that they didn't have the time to do it. The pandemic is a perfect time to learn how to meditate. Mantra-based meditation like TM (Transcendental Meditation) has been shown to lower blood pressure, reduce levels of stress hormones, and improve focus and clarity of thought. There are many kinds of meditation but the two that I most strongly recommend are Vipassana and TM. Below is a link to each of them to help get you started:
Astonishingly, taking the necessary precautions to get COVID-19 under control has become politicized by some people who view things like physical distancing and face-coverings as statements about their political affiliation. If you see people walking around without a face-covering, in most cases it probably will not help to call them out. In my experience, most people cannot be shamed or educated into behaving responsibly by a stranger. We should try to understand that some people do not view taking appropriate precautions as a good faith effort to do their part in protecting one another and speed up our ability to return to a fully functioning economy but rather as a signifier of political affiliation. They may not realize that what they are doing is contributing to the terrible situation we find ourselves in currently. On the other hand, demonstrating solidarity with and appreciation for those who are acting responsibly reinforces good behavior and creates a positive feeling of belonging among those of us who choose to follow the science and embrace a shared sense of responsibility to ourselves, our loved ones, and our communities. A quick word of thanks, a nod, or a point and thumbs-up to someone wearing a face-covering will be received as positive reinforcement and demonstrate to others that you identify as someone who cares. In order to get past this pandemic, we need near-universal adoption of basic measures such as physical distancing and the use of face-coverings.
Gyms are places where people breathe heavily without face-coverings and that means they are high-risk places likely to be dense with viral aerosols. Hiking, running, biking, and other outdoor forms of exercise are dramatically less risky than indoor environments where people are sharing the same air. 4 minutes/day of KPT and 30 minutes/day of outdoor exercise will help manage stress and fight against weight gain which is a real problem for many of us who have become more sedentary during the pandemic. I also recommend a set of dumbbells that can be used to do hundreds of strength and cardio-pulmonary training exercises. My favorite are the ones from Bowflex that can adjust from 5 to 52.5 lbs. with a flip of a dial. They can be used to do countless exercises including as an adjunct to enhance the KPT routine (see the video entitled KPT Advanced Workout for more details).
We now understand that COVID-19 is spread through exhaling and inhaling viral aerosols but it can also be spread by touch. An infected person not wearing a face covering can cough or sneeze emitting thousands of virus-containing droplets that fall from the air quickly to land on the ground but also on chairs, desktops, counters, and other surfaces to form what are called fomites. If someone touches a viral droplet-contaminated surface or object and then touches their eyes, nose, or mouth, they can infect themselves. Fomite transmission can also take place when an infected person touches their own nose, mouth, or eyes and then touches a door handle, phone, pen, can of food, or other items that are not for their own exclusive use. If we touch a contaminated object and then touch our face, we can get infected. The bottom line: Wash well with soapy water or use an effective hand sanitizer immediately after handling anything that isn't under your exclusive control; don't touch your face (including with gloves on); use gloves in stores and discard them before entering your car or home; and decontaminate items using wipes or sprays containing at least 70% alcohol. Here is a link to the CDC recommendations for disinfecting:
As reopening unfolded around the country it became quickly apparent that the way it was conceived in most places was based on economics and politics rather than health and safety and we are seeing the effects of that now with a large swell in the wave of infections. COVID-19 seems to be spread primarily by exhaling and inhaling viral aerosols. Those aerosols are produced when people exhale forcefully, speak, sing, or shout and can hang in the air for hours in enclosed spaces that are not well-ventilated. If an infected person in a waiting room or store aisle removes their face-covering to make a phone call, they will fill the air around them with viral aerosols that can infect those around them or the next person to enter that air space. A person breathing hard on a treadmill or spin bike will create an aerosol plume around them that can endanger others. Choir practice, religious services, bars, and restaurants are places/events where people are talking, shouting, singing, etc., typically without adequate (or any) face-coverings and these are very high-risk environments for disease spread. Don't do it. Even if you live in a place that has reopened to allow such things, I strongly recommend that you avoid them at all costs.
There are three kinds of face coverings: respirators, masks, and wraps. Respirators make a tight seal around both the nose and mouth, thus preventing unfiltered air from being inhaled and exhaled. Since tiny viral aerosols are causing the transmission of COVID-19, it is important that all of the air we breathe be filtered when we are around people outside of our household. Respirators do the best job of this and everyone should have one for when we have to be in high-risk environments (more about that in the next Pearl). Some respirators have baffles or exhalation valves that reduce exhalation resistance by allowing you to exhale unfiltered air. These are made for tradesmen who work with toxic chemicals and are reasonably efficient at protecting the wearer but, keeping in mind that about half of infected people don't know that they have COVID-19 (because they don't have symptoms), such respirators which are fine to use while spray painting but do not protect those around you from COVID-19.
Masks fit over the nose and mouth but don't make a tight seal the way that respirators so. Masks that take replaceable filters can provide significant protection but some of the inhaled and exhaled air will still make it around the mask and therefore not get filtered. A good way to evaluate the effectiveness of your mask is to take the sunglass-test: put on the mask and a pair of sunglasses and then walk up a flight (or a few flights) of stairs to get your heart rate up. If the sunglasses fog up, it means that air is flowing around your mask and this can be dangerous in high-risk environments (more about this in the next Pearl). These masks are fine for outdoor activities like hiking or brief excursions to well-ventilated stores to pick up a few items and they do offer protection against larger droplets that might hit your face if someone sneezes or coughs on you but they are not sufficient for higher-risk environments like a shared office, busy cash register, or an hour of shopping at a place like Costco.
Wraps are typically made of cloth. They can be wrapped around the face and head more than once to provide extra layers of protection. They are often more comfortable to wear than respirators or masks and can make a better seal around the nose and mouth than many masks. Wraps made of a tightly weaved cloth (like flannel) can offer better protection than most masks and have the advantage of being washable.
The Bottom Line: I recommend everyone have at least one respirator and one mask or wrap in good condition. We need to have a face-covering on at all times when we are around people who are not members of our households including close friends and relatives. At my office, we sell respirators from O2 Canada which have a higher efficiency rating and are more comfortable for long term wear than traditional N95 respirators. If you are interested in purchasing one, let us know.
Much has been written about the financial and social stressors associated with COVID-19. As the director of a primary care practice that includes family and internal medicine, and as I continue to see a small number of patients in acute pain for chiropractic care, I have come to understand that there is another, deeply unsettling and stressful aspect to the current pandemic. In the absence of a coherent, unified message from government and public health officials, many Americans simply do not know what to believe. As we find ourselves facing a frightening swell in the wave of infection across most of the country, knowing what we can and should be doing about it is important not just for the safety of our communities but also for our own mental health. Therefore, each day for the next several days, I will be posting a KPT Pearl that will attempt to make clear some aspect of COVID-19 based on my own careful reading and understanding of the scientific data that are emerging daily. I hope that doing this will help some people to reduce the stress and anxiety caused by the inconsistent, chaotic messaging, misinformation, and in some cases, disinformation coming from public officials and news sources.
Day 1: KPT COVID-19 Pearl of the Day is: Don't Share Your Air. At the most basic level, COVID-19 is spread when infected people without proper face-coverings speak, shout, chant, sing, or breathe heavily such as during exercise, producing tiny viral aerosols, and then someone sharing their their air breathes them in. This is not the only way you can catch it or spread it but viral aerosols seem to be the chief vector of transmission. Since about half of people with active COVID-19 don't show symptoms, we should be very careful not to breathe in shared air with anyone outside of our household. The best way to do that is to isolate as much as we can and when we need to be out and around others, we should keep our face-coverings on at all times. Tomorrow's post will go into some detail about face-coverings.