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!

This past week in the US, we have had catastrophic flooding and tropical storms in the Louisiana area and a blackout in NYC.  These unplanned events can have a devastating impact on people and their health.  We all need to be prepared at all times so we can stay healthy during these times.

• Make sure you have enough medications for you and your family’s chronic conditions (e.g. insulin for diabetics) to last for the the next 7 days
• If a medication requires cold storage, make sure to freeze some ice packs that you can place in a cooler.
• Collect clean tap water in pots and pans that you can use for drinking should the municipal water system be contaminated by the storm surge/runoff. Continue to drink only boiled water after the storm if needed.
• Make a list of your medical conditions, names of all medications and doses.  If you need to evacuate or need to go to a hospital for an injury, this information is important.  If you have a heart condition, you should have a copy of your latest EKG (electrocardiogram).  Keep these papers in a plastic waterproof sealable bag.
• Print out a list of phone numbers of family and friends.  If you lose power, you may not be able to recharge your phone and access those numbers.  This is especially important if you need to evacuate.
• Create a small bag filled with water, food (granola bars, nuts, etc), some cash and clean clothes should you need to evacuate.  (remember, you may not  be able to use ATM’s if the power goes out)
• Check on elderly relatives and neighbors.  Elderly people are most vulnerable to dehydration.  Make sure they have plenty of bottled water available.
• Write down phone numbers of all your friends and relatives.  In this day and age, few of us keep these numbers anywhere else outside of our cell phones.  Imagine if your cell phone runs out of power or if it gets damaged, you may not have a way of contacting your loved ones.
• First aid kit.  Have it accessible at all times.  Fallen trees and flying debris can cause wounds that need immediate attention.
• Clear any clutter on the floors.  If there is no electricity and it is dark, you have a chance of tripping on objects.
• Stock up on food that does not require refrigeration, such as soy milk, granola bars, cereal, and bottled juices.
• Avoid going outside, even if you think the storm has passed.  Be careful, downed power lines and falling tree branches can very dangerous.

We all have stress in our lives.  When stress builds up, it can manifest as damage to our bodies.  The mind and body are intimately connected.  When we don’t feel well in our head, our body’s organs can reflect that.  Conditions such as IBS (irritable bowel syndrome), tension/migraine headaches, and even nasal congestion (vasomotor rhinitis) can be related to our mental well being.  I remember in school when a classmate of mine always got bad “tummy aches” and diarrhea around final exams.  My recommendation is to try to recognize that you are stressed and release the tension in your mind on a regular basis.  The mind is like a cup which has a certain capacity for stress.  Too much stress added to that cup and it will overflow into other aspects of your body.  For some people, they use substance such as drugs or alcohol to relieve stress.  I strongly recommended against these as they are harmful for the body and create addiction.  In fact, they have found that many people with alcohol dependence have untreated anxiety depression.  They have turned to alcohol to self medicate their problems.

Here are positive ways to release stress:

• Meditate.  I can’t say enough about meditation.  We ALL need to be doing it on a regular basis.
• Exercise produces endorphins that help us to feel better and manage stressful situations.  If you have a situation where you feel you don’t have an answer, go for a run around the block or in a park.  The extra blood flow to the brain may even clear the cobwebs and allow you to find an answer to your problems.
• Talk to a therapist.  Many of us hold preconceived notions about psychotherapy.  Some people think it’s only for “crazy” people while others think it is a “waste of time and money” and they can do the same thing by talking to a friend or their mother.  Here is the difference, when you talk to someone you know about your issues you will unconsciously censor yourself and not likely tell the whole truth.  Let’s say you are having relationship issues with your partner and the issues are sex-related, would you be open about discussing that with your mother?  Therapists provide anonymity and allow you to open up about your problems.  And yes, they are professionals who have been trained to provide effective advice.  Many people think they are alone in their problems, but most of our problems are not unique to us.  By letting those issues surface during therapy, you will help yourself find the right answer.  The great psychoanalyst, Sigmund Freud, was once asked why he had so many Roman antiques in his office.  He said the antiques were like our deeply seated thoughts and memories.  These vases were underground and preserved for thousands of years.  When they were first unearthed, many still had original paint.  However, after they were taken out from the protective soil, they start to degrade.  They lose their structure and some will crack, chip, and painting will fade, just like our unconscious memories would if we allowed them to surface.  What a profound analogy!  We need to let go of our emotional baggage!
• Writing therapy.  If you don’t have access to a therapist immediately, take out a pen and paper and start writing.  When I was in high school in a creative writing class, we called this a “free writing session”.  Keep your pen flowing, don’t stop for at least 30 minutes and write out everything on your mind.  Don’t worry about spelling or grammar or worry that someone will read what you write.  Just write out the words.  Getting those thoughts out can be cathartic.  At the end of the 30 minutes, look at what you’ve written, acknowledge that you’re let it all out, then rip up and discard the paper.
• Art therapy.  If you are artistically inclined, paint what you feel.  Picasso had his famous “Blue Period” when he was having depression. Creating something with emotion is an effective outlet.
• Pet therapy.  Pets provide unconditional love.  Several studies have found that having pets can mitigate depression and anxiety.  If you don’t have a pet, maybe you could pet sit for a friend.
• Experiencing nature.  Seeing greenery, flowers, rivers, and lakes can be very soothing.  I think it the animal part of our psyche that needs to see nature.  If you have been living in the “concrete jungle” too long, maybe take a road trip to go hiking/running or if you don’t have too much time, go to a nearby park or waterfront.  These are great places to do meditation and deep breathing exercises.
• Take a mental health day/vacation.  If stress is building so much from work that it’s affecting your health, you may want to recharge your batteries by taking a day off.  How functional will you be at work if your stress is occupying 100% of your brain?  One of my favorite stories about Mahatma Gandhi’s life is when his assistant is reviewing his schedule for the day, which was particularly busy.  The assistant suggested that Gandhi skip his usual one hour meditation session as there were other pressing agenda items.  In response, Gandhi said, “I have so much to accomplish today that I must meditate for two hours instead of one.”  It’s difficult to realize this but we need to recharge our batteries more often when we are in stressful situations.  It is like when you use your cell phone for more hours or if you are doing many tasks on the cell phone in one day, you will need to recharge the batteries sooner than usual.
• Eat right, drink plenty of water, sleep right, avoid alcohol.  All of these three things lead to a healthier lifestyle and help us to manage stress better.  It is very important that when we are stressed out, it is even more important to keep healthy.  Some people will “stress eat”, eating high fat foods when dealing with stress, which can lead to unhealthy weight gain and further lack of energy.  Inadequate sleep during times of stress reduces our immune system’s ability to fight infection.  Ever wonder why we are more likely to get colds and flus during stressful times in our lives? It’s not a coincidence.

The best way to make a big change in your life (losing weight, practicing meditation, reaching your career goals, etc.) is by achieving smaller goals.  I find making S.M.A.R.T. goals to be extremely helpful.  Here’s how.

Start by choosing a goal that’s really important to you, yet small enough to achieve. Turn it into a SMART goal for the coming week. One that’s Specific, Measureable, Action-based, Realistic, and on a Timeline, so that when you get to the end of that week, you will be able to gauge how well it worked for you.

Here’s an example: I will choose salad with dressing on the side for lunch instead of my usual sandwich with chips on Monday, Tuesday, and Thursday next week.

Then, gauge how confident you are that you will actually achieve this goal. On a scale of 1 (not going to happen) to 10 (I am totally sure I will do this), a 7 is usually enough to result in success. If it’s lower, what one more thing could you do to be sure it will happen? Maybe a reminder in your Smartphone, a friend to share that healthier lunch with you, or picking up pre-made salads to bring to work.

Finally, be sure to reward yourself when you achieve your goals.  Here are some healthy rewards that you can use to celebrate your success.

We are at a low point in human history right now, literally.  As a people, we are sitting the most amount of time ever in human history.  Even just 20 years ago, we got much more exercise than we do now.  Remember going to the bank and waiting on line, and depositing your hard earned paycheck (literally a paper check!)?  Or how about walking in a shopping mall and going from store to store every weekend?  Now we have our salaries directly deposited to our bank, most of our things delivered to our doorstep and shopping while sitting on the couch.

All this sitting is taking its toll.  We are becoming more obese and along with that, the incidence of diabetes and high blood pressure is also increasing.  Prolonged sitting is also leading to chronic back pain.  I believe that fifty years from now, we will look back on sitting the same way we look at smoking now.  Why the hell were we sitting for so long throughout the day?  Isn’t it obvious that sitting is killing us?

Is there a solution to this chronic sitting?  Yes, let’s start standing.  There are many standing desks available on the market.  Many companies now provide sit/stand convertible desks for their employees.  Some of them even make it mandatory that their employees use this type of desk!  Quite progressive thinking in my opinion.  You can’t expect workers to sit at their desks for eight to ten hours each day, working for several years, and not realize that they are going to suffer health consequences over the long term.

Are there downsides to standing desks?  Yes, while the standing desk can alleviate pressure on the spine, it can worsen any preexisting knee, ankle or foot issues.  Some people will slouch over the standing desk, especially if the height is too low.  Here are a few tips to prevent these issues:

• Avoid standing all day.  I personally believe 100% standing is not the ideal solution. I would recommend perhaps our day should be divided, about 60-75% standing and 25-40% sitting.  So a typical schedule would be to start the day off standing, sit from noon and an hour after lunch (I believe sitting is better for digestion than standing), then raising it back up for the rest of the day.  This way, when you come back to work the next day, the desk is in the standing position ready to start over.  I often see people who are very enthusiastic about standing desks for about one month, then they get “bored with the new toy” and end up just sitting at the desk.  Make sure you are consistent with using the standing desk and keep using it.
• Purchase an “antifatigue mat“.  this is a squishy cushion-type area rug that relieves the stress on your feet.  Standing all day on a hard surface can take it’s toll on your feet.  Ask any waitress or cashier, and I’m sure they will tell you they wished they had a “sitting” job.
• Wear comfortable shoes.  Now that you are standing for longer periods of time, any weakness or inadequate support to your feet can result in pronounced pain or stress on the small bones and joints.  Obviously, wearing high heels, flats, or being barefoot would not be advisable.  I usually recommend wearing sneakers or a dress shoe that is designed with a good arch support.
• Stretch every so often.  Here are some stretches to loosen up the lower back.

If you don’t currently have a standing desk, you can try to avoid sitting.  Set your smart phone to buzz every hour to remind you to take a “standing break”.  How about standing when you are answering a phone call, or use a headset during a conference call, so you can stand up and walk around?  Some smart watches and activity trackers can also alert you to move if you’ve been sitting too long.