Right now, we are all concerned about protecting ourselves from the dangerous COVID-19 virus.  Mask-wearing by everyone has two benefits. It protects the wearing from breathing in dangerous droplets containing the virus and catches droplets expelled from coughs or sneezes.  We are learning that many people can feel perfectly fine in the first few days of COVID-19 infection, yet they can still spread it to others.  The key point is that we all need to wear masks when we are around other people.  There are many different masks on the market.  Here is a ranking of commonly used masks from most effective to least effective.  Combinations of masks can also provide some added benefit.  I’m excluding some of the more expensive, industrial grade masks as those are not feasible to wear for most people.  Mask-wearing of any kind will always provide more protection than not having a face covering.

1. N95 or KN95 Mask- the gold standard for protection.  However, it must fit right to be protective.  Be sure to mold the wire on top around your nosebridge.  When you put it on right, you should see a little bit of the mask “suck inward” when you breathe in. You can cover the N95 with a cloth mask to increase the protection.  I would recommend using these masks when you will be in close contact or in enclosed spaces, with people who potentially could be infected.
2. ASTM level 2,3 surgical mask.  These are medical grade masks which provide some more protection than the average paper mask, are more comfortable than N95’s but the downside is that they allow for leakage of air around the sides.
3. ASTM level 1 surgical mask, can improve the quality by adding an additional cloth mask on top
4. Any surgical mask, usually have a lot of leakage on the sides, I would advise using a gaiter (see below) to close up those gaps
5. Cloth mask doubled up with filter (coffee filter, air filter or paper towel) inserted between the layers
6. Cloth mask- the thicker the fabric and tighter the weave the better.  If you hold the fabric up to the light, you should not be able to see too much light through it.  If the material is thin, double it up by folding it in half.
7. Gaiter– these were originally designed for skiers but are quite comfortable and provide decent protection.  What’s nice about them is they often have ear loops to keep the mask from falling down.  They also feel a little less restrictive.  Wearing a surgical mask underneath would provide more protection.
8. Scarf or bandana- these can be used alone or ideally with a paper mask underneath.  I would recommend these if you are in an area where you don’t plan to come into contact with other people, like when you are hiking in the woods.  You never know if you may come across someone and these can provide just enough protection.
9. Any piece of clothing or paper towel wrapped around the face.  If you find yourself without a mask, lift up your shirt collar above your nose or place a folded paper towel around your nose and mouth.  These are not the best, but can provide some protection for short periods of time.

We should all be used to wearing face coverings at this point.  The key to staying safe is knowing what protection you need and in what situation.  Think about it like part of your wardrobe choices for the day, would you wear a T-shirt to a wedding?  Would you wear a tuxedo to a picnic? Again, some protection is better than none, but planning ahead is very important.  Put an extra mask or scarf in your pocket if you are not sure.  It could save your life!

As all of us have started working from home for long periods of time, it is more important than ever to adjust your home workstation to prevent unwanted strain and injury. The neck, back, wrists, and eyes can become painful or irritated even after one day, and with prolonged work in an improper desk setup can cause severe inflammation. Here is some information to determine if your home setup is appropriate for you along with exercises to keep you mobile throughout the day.

Ergonomic Tips for Setting Up Home Work Space

• Avoid doing any work in bed or on a sofa.
• Make sure your chair and table/desk height are appropriate and that you are not hunched over.
• Adjust the monitor to arm’s length away to reduce strain on eye. The top of your screen should be at eye level. If you need to use a laptop, place it on a kickstand or books to raise the screen to eye level.
• If you are using two monitors, your body should be in the middle of the two screens
• Make sure the elbows are bent at 90 degrees
• Make sure the keyboard is placed in a position to protect wrists from being in extended position for too long.
• When using a mouse, move from elbow not shoulder to reduce overuse injury.
• Avoid resting your wrists on the desk surface as this can cause a painful condition called carpal tunnel syndrome. There are mousepads with built in wrist bumpers, but you can consider placing a rolled up hand towel to remind yourself to keep them elevated.
• When using a phone, use a headset or headphones.
• Your feet should rest comfortably on the ground. If not, then use a footrest or reams of paper
• If you have a standing desk, be sure to wear comfortable and supportive shoes. You can even stand on a yoga mat to reduce strain on the arches of your feet, as they will be supporting your weight for several hours throughout the day.

Take Breaks and Stretch Often

• Get up every hour and take breaks to walk around house, get a snack, stay hydrated, and chat with family.
• Stretching exercises have been designed to warm up muscles, improve flexibility and help prevent soft-tissue injuries. Stretches should be brief, no longer than five min in duration to complete.
• Stretching should not cause pain or discomfort. In general, you want to stretch your body parts in the direction opposite to the positions while working.
• Low Back Stretch: While standing, place both of your hands on your low back. Slowly bend backwards as far as is comfortable. Do not extend the neck to prevent straining the muscles around the neck.  Hold for five seconds then return to upright posture.  Repeat five times.
• Overhead Stretch: Reach above your head by stretching your arms up and interlocking your fingers.  Hold for five seconds, repeat five times.
• Shoulder Circles: Raise both shoulders up as far as possible toward your ears. Now make shoulder circles bringing shoulders backward, downward, forward and upward again.  Perform ten times in one direction, repeat ten times in opposite direction
• Neck Side Bend: Tilt your head sideways, pulling your ear towards shoulder.  Hold for five seconds and repeat three times on each side
• Neck Rotation: Turn your head as if looking over the shoulder, return to center.  Repeat to other side.  Hold for five seconds and repeat three times on each side.
• Wrist Stretch: Extend your arm in front with palm facing down, with your opposite hand, bend your wrist downwards until you feel a comfortable stretch. Hold for five seconds.  Repeat with palm up. Repeat in the other arm.

Lighting Tips

• The light source near your workspace should be positioned ideally at a 45 degree angle from the eyes
• Avoid having windows or bright lights behind the computer screen.
• Adjust the brightness and contrast of monitor to suit the environment. Reduce the brightness of screens (computer, phones, or tablet) at night before bedtime.
• Workers over fifty years old often require twice as much light to complete tasks comfortably.

Preventing Eye Strain

• 20/20/20 rule. Every twenty minutes, look at a point twenty feet away for twenty seconds.  This allows the eyes to stretch out muscles and reduce eyestrain.
• Use natural tears and blink often. When we stare at computer screens for long periods of time, we naturally stop blinking, which is how our eyes normally stay moist.  Blinking and using natural saline tear drops can help soothe your eyes and feel less tired.  Applying a washcloth moistened with warm water, with gentle pressure over the eyes can also be effective.

Take some time to make sure you feel comfortable in your workspace and not try to “make do” with your current setup.   You may find this could improve your productivity and prevent injuries.

Vitamin D is a necessary vitamin that we get from certain foods, such as fortified dairy, eggs, and sardines.  Some scientists believe that low levels of this vitamin can contribute to anxiety and depression, and reduce our immune systems putting us at risk for colds/flus that many of us experience in the winter months.  Ever wonder why we feel more energetic in the summertime?  We need approximately 15 minutes of exposure to the sun to activate this vitamin.  If you aren’t exposed to the sun for this amount of time, your levels will certainly be low.

Nursing home residents almost always have chronically low levels of vitamin D as they are indoors for much of the day.     Glass blocks the rays of sun needed for us to process vitamin D, so even sitting in a sunny windowsill is not adequate.  COVID19 has ravaged nursing homes, and low levels of vitamin D, while not the immediate cause, still could have contributed to its spread and severe symptoms.

Right now, most of us are not likely to be getting adequate amounts of sun each day due to isolation restrictions or being forced to stay home if we do have COVID19.  I recommend taking a supplement with 1000 IU of Vitamin D3 per day during this time.  Be sure to take it with food as it is a fat soluble vitamin and preferably in the morning.  Take a walk whenever it is sunny (while maintaining at least 6 foot distance from others AND I would recommend wearing a mask).

Many of us are suddenly have suddenly been thrown into a different work-life balance in the past few weeks, with social distancing and home isolation rules.  No longer are we commuting to our jobs and the only people we see are the ones in our homes.  This can prove to be a difficult situation to get work done, but it doesn’t have to be.

Here are some tips and information on how to actually be more productive working from home.

• You save on time not having to commute!  Yes, those wasted minutes, half hours, or hours on trains/buses/cars are now yours again!  Make good use of the time that is back into your life.
• Put on clothing that you would normally wear to work.  Your clothing can help set the mood.  Many studies have found that people will sit up straighter when wearing formal clothing such as suits.
• Set defined wake times and sleep times.  Our bodies like routines.  Keeping a set schedule allows our mind to know what it should be doing.
• Set up a morning “starting work” ritual and and evening “ending work ritual” to create a demarcation in time between your “home leisure” and “productive work” times.  A 5 minute meditation or yoga session would be a great way to separate the chapters of your life.  I like to go for a run at the end of the day.
• Have sensory cues for the different aspects of your day.  For example, some people will wear cologne or perfume when they go to work. Continue this routine while at home and you will be subconsciously “cueing” your mind into getting into a work mode.
• Try to work in an area of your home designated for work such as a study.  Set up your desk as closely to where you would normally work.
• Take “virtual water cooler breaks”.  Part of work life is socializing with your co-workers.  Set up times when you video chat with co-workers.
• Avoid unnecessary trips to the kitchen.  We often eat out of boredom or under stress.  Hunger is sometimes a manifestation of thirst.  Try drinking a warm cup of tea first and see if you are still hungry 20 minutes later.
• Keep distractions to a minimum.  Would you normally have the TV news on while you are at work?  Right now, the news is quite grim and depressing and could certainly cause you to lose your focus on your tasks.
• Have appropriate lighting in your work area. Natural light is best for most people, so open the shades or turn on some lights if it is cloudy day.
• Use earplugs if your environment is noisy or if you have loud kids.
• Some studies have found that having pets around can actually reduce stress and increase productivity. Keep Fido around while you’re working.
• Assess your desk/table height.  If you start feeling back pain, you may need to adjust the heights a little.  You can also be creative and make your own standing desk with some plastic storage boxes.
• Wear a clean pair of shoes in the house.  Being barefoot can create excess strain on the feet and your arches to flatten out.  Sneakers or supportive dress shoes would be ideal.
• Put a calendar and clock in your desk area. Sometimes the days can seem like a blur.  Having a concrete sense of time can help to keep you motivated.
• Reduce non-essential smartphone use.  It’s tempting to check social media or the news in between reading work emails.  Resist the temptation.  Perhaps you can put those apps into a separate folder away from your main screen during weekdays to reduce the temptation.