Diversity – Life as a Latina Orthopaedic Surgeon

All my life I knew I want to be a doctor; I remember my grandmother in the emergency room and that is where I convinced of what I wanted to be.

During my years in medical school, was not clear about which specialty to do, I felt that I went through all of them but that they could not fill me completely, so when I graduated my first option was to be an Infectologist, in Peru and in many Latin American countries we did a year from rural service to be able to apply for a specialty, and I went to a place in the Andes of Perú, completely deserted, where I was the highest authority in Health (a recently graduated doctor) and where domestic violence was daily bread. It was thus that I had many cases of open fractures, which we could not  treat in my health center, and we had to transfer the patients for approximately 6 hours so that they could arrive at a hospital and had a surgery, I remember a lot that the Orthopedic Surgeon of that Hospital didn’t have an assistant for the surgeries and he asked me for help, I agreed a few times reluctantly, trauma was not in my plans and little by little when I saw the recovered patients. I liked it so much that I just waited for more patients to arrive to operate them!

When I applied for the residency, I had decided that I wanted to be an Orthopedic surgeon, and when I entered my hospital there was only one female attending and I arrived after almost 10 years without a female presence.

I never considered that as a woman I was going to have another treat, but it was, the first months were not pleasant, but little by little my work spoke more about me than my gender. My great teachers are men and thanks to them I sought to specialize in knee surgery. Until now, I cannot deny having suffered from bullying and sexual harassment, but I can say that they were isolated moments overshadowed by the good memories that I have and led me to the path where I am now.

“Until now, I cannot deny having suffered from bullying and sexual harassment, but I can say that they were isolated moments overshadowed by the good memories that I have and led me to the path where I am now.”

Probably this story you heard so many times and you feel identified with it, no matters the age that you have or where you came from, or in the other hand this could be so far of what you lived,  also could be that our environment is different. Latin America has 14 countries considered to have the highest rates of gender violence in the world, according to a UN survey in 2018 and Brazil and Mexico with the highest number of cases in the region. These not inconsiderable data tell us about a sexist society, where as a woman aspiring to have economic and emotional independence can put our lives in risk. Where our governments, despite implementing laws that classify the crime as femicide, impunity for these crimes continues.

This story is not only now. Throughout history, women have been restricted from access to education and work due to socio-cultural stereotypes that prevail to date. In a region like Latin America with a high rate of femicides, high costs of living and little access to management positions, we wonder what we can do to face this panorama.

It is increasingly common to see more women in medical schools. The proportion of women students has been rising over recent years, In 2015 from 46.9% to 49.5% in 2018. In 2019, women were around 50.5% of all medical school students, however, Orthopedics and Traumatology continues to be dominated by men many times due to canons created to require more strength, a factor that has already been shown is not decisive due to the innumerable technological innovations, the Not being able to achieve a balance between work and family, more than 40 hours of work a week, night shifts, surgical shifts that with good family support and a team work can be balanced, and also due to the lack of female mentors during the career. Reports in Australia revealed that 72% of students did not choose trauma because they did not have female tutors who were referents in the specialty.

Year after year we have been able to overcome difficulties, but there comes a moment of loneliness and that is where we look for solutions, this is how great projects arise and the need to be a strong group allows that different associations born, In Latin America, Chile were the pioneers with their Female Orthopedic surgeons founded in 2019, Females represents the 6% of all the Orthopedics Surgeon of their country. In Peru from 1634 Orthopedic surgeon, only 87(5.3%) are females, and in the lately 2019 was founded the Peruvian Association of female orthopedic surgeons.

Both to achieve greater participation in the specialty, a support and incentive group to achieve professional and personal development, through academic activities such as webinars, or achieving reach and interactions on social networks.

So far, countries such as Colombia, Mexico, Ecuador, Bolivia, Argentina, Brazil, Nicaragua, Guatemala, with the name “orthowomenlatam”, with collaboration of our older associations (Chile and Peru) are attracting attention with the organization of monthly academic activities with entirely female panels, putting the eyes on us.

All these initiatives are born with the spirit of power not only to empower ourselves as women and professionals, but also in an academic and scientific effort, through mentoring, collaborations and the recruitment of medical students for the specialty, as well as promoting training during and at the end of the residency. We developed an annual plan, which involves a monthly presentation with a female speaker, a symposium with workshops and lectures, our journal club and a project to involves medical students who want to became Orthopedic surgeon. We have a WhatsApp group where we can discuss any difficult case and exchange scientific articles as well, we have medical students that every day is involving with this project. Also not all is academic, we organize every month  social meetings, nowadays because of the pandemic are by zoom, and we have activities like karaoke, stretching workshop, and also inviting any performer, and this activities are so important because we can know better each other.

We want to offer a network between us to discuss opportunities, goals and serve as a platform to solve personal problems and concerns. Unfortunately, until now there is a lack of studies with real statistics of each Latin American country in relation to women and orthopedics, we are working to make our data more valuable.

Thus, we do not seek to separate ourselves, nor to be the same, we seek to have a space where we can grow personally and professionally with other tools to achieve the same goals without fear of harassment or bullying, having female references around the world and above all, having greater participation in academic activities worldwide.

Can we do it?  Of course, there is no limit and together we will achieve it!

Dr. Claudia Arias Calderón

Hospital Nacional Edgardo Rebagliati Martins

Lima- Perú

ISAKOS Launches Gender Diversity and Inclusion Task Force

Diversity is essential to create strong and productive organisations, maximizing the strengths and talents of all members of the society. Similarly, a diverse leadership group with unique experiences and perspectives is better able to generate novel ideas and goals, contribute different approaches to an issue, and provide a fresh viewpoint to an organisation.

Orthopedic surgery as a specialty clearly has a lot of work to do in expanding diversity within its ranks. ISAKOS, as an international specialty society, is well positioned to lead the way. While the ISAKOS Biennial Congress is a tapestry of racial, ethnic, and cultural diversity, there is one noticeable lack of diversity. Reflecting orthopaedic surgery as a whole, there are very few women. Just 5-7% of US orthopaedic surgeons are women and for many developing countries this percentage is even lower. ISAKOS currently reflects that reality.

The society membership statistics were reported in the latest edition of the ISAKOS Newsletter. There are currently 2,959 members of ISAKOS, of which just 106 (3.6%) are female. Unfortunately, in the history of ISAKOS, only two women have won named research awards at the ISAKOS Congress and just one has been awarded a Conference Scholarship. There are no women on the Executive Committee or Board of Directors of ISAKOS. Nor are there any female committee chairs. In fact, currently, female members fill just 14 of 250 (5.6%) ISAKOS committee positions. The Journal of ISAKOS Editorial Board fares a bit better, with 11.5% being women.

One area of well-earned pride for ISAKOS is its commitment to addressing geographic and cultural diversity. Achieving gender diversity and inclusion presents as the next challenge for societies such as ISAKOS as well as the entire orthopaedic community. Willem van der Merwe, MD and David Parker, MD, along with the Executive Committee of ISAKOS, aim to address this challenge. With full support from ISAKOS, the Gender Diversity and Inclusion Task Force has been established and consists of eighteen female members, from North America, South America, Europe, Asia and Asia-Pacific. Dr. Laurie Hiemstra is chair of the newly formed Task Force, with Drs. David Parker and Jason Koh serving as Executive liaisons.

Under the leadership of Dr. Hiemstra, the task force will guide ISAKOS in implementing and maintaining gender diversity and inclusion principles. Dr. Hiemstra is an orthopaedic surgeon specializing in sport medicine and arthroscopic surgery in Banff, Canada. She is an Executive Committee member of the Canadian Orthopaedic Association (COA) and the Arthroscopy Association of Canada (AAC). Dr. Hiemstra was recently elected 2nd President Elect of the COA and will be the first female president of the organisation.

The first goal of the ISAKOS Gender Diversity and Inclusion Task Force is to increase the number of female members and improve engagement by highlighting the lack of gender diversity within the society. Increasing the number of female members and clearly demonstrating inclusivity and acceptance within all areas of ISAKOS will help promote the society’s commitment to improving diversity.

The second goal is to increase female representation in educational activities, the biannual Congress, and executive structure of ISAKOS. The inclusion of a larger number of women in the ISAKOS scientific meetings and bi-annual Congress will create a wider range of ideas and viewpoints, and through this, improved teaching and learning for our members. As Julie Silver, MD, from Harvard University so eloquently says “For any award (or position or lecture or role) in medicine, there are more than zero women who deserve it.”

As with all initiatives, the Gender Diversity and Inclusion Task Force cannot succeed without genuine support from male allies. The vision of the #heforshe leaders in ISAKOS, Willem van der Merwe, Guillermo Arce, David Parker, Jason Koh, Volker Musahl, and Mark Clatworthy, is extremely important. Working together towards a stronger, more diverse ISAKOS should be the goal of all our members. We urge support, encouragement, and action for this important initiative.

Dr. Mary Mulcahey

Dr. Mary Mulcahey (@marykmulcaheymd) is a member of the Gender, Diversity and Inclusion Task Force for the International Society of Arthroscopy, Knee and Orthopaedic Sports Medicine (@ISAKOS_society). She earned her MD from the University of Rochester School of Medicine (@urmedical) in Rochester, NY, completed her orthopaedic residency at the Warren Alpert Medical School of Brown University (@brownorthopedics), and did her sports medicine fellowship at San Diego Arthroscopy and Sports Medicine. Dr. Mulcahey is an Associate Professor in the Department of Orthopaedic Surgery at Tulane University School of Medicine (@tulanemed) and the Director of Tulane Women’s Sports Medicine Program (@tuwomensportsmedicine). She is currently Secretary of the Ruth Jackson Orthopaedic Society (@ruthjacksonortho), which is a position in the Presidential line. Dr. Mulcahey is also very active in the Arthroscopy Association of North America (@aanaorg), American Orthopaedic Society for Sports Medicine (@aossm_1972), and the American Academy of Orthopaedic Surgeons (@aaos_1). She is passionate about improving diversity in orthopaedic surgery. Her areas of clinical expertise include shoulder injuries, rotator cuff tears, rotator cuff tendinitis, biceps tendinitis, shoulder instability, labral tears, knee injuries, ACL tears, meniscus tears, patellar instability, and tendon injuries.

Carola van Eck, MD, PhD

Dr. van Eck is an Editorial Board member for the Journal of the International Society of Arthroscopy, Knee and Orthopedic Sports Medicine (@J_ISAKOS). She earned her MD and PhD from the University of Amsterdam, the Netherlands, and went on to complete her orthopaedic surgical residency at the University of Pittsburgh Medical Center (@UPMC) and a fellowship in orthopaedic sports medicine at the Kerlan-Jobe Institute in Los Angeles. Dr. van Eck is an active member of several organizations including the Ruth Jackson Orthopaedic Society, Orthopaedic Research Society (@ORSsociety), European Society for Sports Traumatology, Knee Surgery and Arthroscopy (@ESSKA_society), Arthroscopy Association of North America (@AANAOrg), American Academy of Orthopaedic Surgeons (@AAOS1), Dutch Arthroscopy Society (@NedVerArthro), and the American Association of Hip and Knee Surgeons (@AAHKS). Dr. van Eck is in practice at the University of Pittsburgh Center for Sports Medicine, and serves as a team physician for Robert Morris University and the Pittsburgh Passion

Laurie Hiemstra, MD, PhD, FRCS(C)

Dr. Hiemstra is Chair of the Gender, Diversity and Inclusion Task Force for the International Society of Arthroscopy, Knee and Orthopedic Sports Medicine (@ISAKOS). She earned her MD from Memorial University of Newfoundland, completed orthopaedic surgical residency at University of Manitoba, Clinical Fellowship in Orthopedic Sport Medicine at the University of Western Ontario (@WesternU), and was the 2013-2014 recipient of the Patellofemoral Traveling Fellowship. She also has a PhD in Neuromuscular Physiology. Dr. Hiemstra is an Orthopaedic Surgeon at Banff Sport Medicine (@BanffSportMed) since 2005, and is the current appointed Director of Research. She is an Assoc. Professor at the University of Calgary (@UCalgary) and Vice President of the Arthroscopy Association of Canada (@ArthroscopyCA), as well as an active member of the Arthroscopy Association of North America (@AANAOrg), American Orthopedic Society of Sports Medicine (@AOSSM_SportsMed), and Canadian Orthopaedic Association (@CdnOrthoAssoc). Dr. Hiemstra is committed to increasing inclusion and leadership roles for women and under-represented minorities in Orthopaedics, and is also a member of the International Orthopaedic Diversity Alliance (@orthodiversity).

Elizabeth Arendt, MD

Dr. Arendt is an active member of the International Society of Arthroscopy, Knee and Orthopedic Sports Medicine (@ISAKOS) and serves on the Journal of ISAKOS Editorial Board (@J_ISAKOS). She earned her MD from the University of Rochester (@UR_Med), completed orthopaedic surgical residency at Strong Memorial Hospital, and completed sports medicine residency and fellowship at the University of Minnesota (@UMNOrthoSurg). She is a Professor and Vice-Chair in the Department of Orthopaedic Surgery at University of Minnesota Medical School (@UMNMedSchool), and is also on the Editorial Boards of several other publications including the British Journal of Sports Medicine (@BJSM_BMJ), Orthopaedics Today, Sports Medicine and Arthoscopy Review, and the American Journal of Sports Medicine (@AJSM_SportsMed). Dr. Arendt is the Medical Director for the University of Minnesota’s Inpatient Orthopaedic Ward (2007-Present) and Assoc. Medical Director of Women’s Sports Medicine at TRIA Orthopaedic Center in Woodbury, MN. She has received numerous recognitions including “Top Doctor” from Mpls St. Paul (2008, 2012-2019) and “Best Doctor” from Minnesota Monthly (2014-2017).

Dr. Ashley Bassett

Dr. Ashley Bassett is a fellowship-trained orthopedic surgeon specializing in the treatment of sport-related injuries in athletes of all ages. She received her medical degree from Rutgers Robert Wood Johnson Medical School where she was elected into the Alpha Omega Alpha Honor Society and Gold Humanism Honor Society. Dr. Bassett then completed her surgical residency at the Harvard Combined Orthopedic Residency Program. After residency, Dr. Bassett went on to earn a fellowship specializing in sports medicine at the Rothman Orthopaedic Institute at Thomas Jefferson University in Philadelphia, where she was a team physician for the Philadelphia Eagles, Phillies, Flyers and 76ers, as well as Villanova University and St. Joseph’s University Athletics. During her fellowship, she was presented the Philip Syng Physic Award for research on return to play testing after ACL reconstruction. Dr. Bassett is now the Director of the Women’s Sports Medicine Center at the Orthopedic Institute of New Jersey, the only highly-specialized center for the care of female athletes in northern New Jersey. In her free time, Dr. Bassett enjoys being outdoors, hiking and playing the occasional squash match with her husband.

COVID-19

It may seem odd that the first ISAKOS Blog post is from an epidemiologist and about an infectious disease, but that is the state of the world today.

I have been somewhat slow in composing this post during the coronavirus pandemic largely because early on there is still so much we do not know about the disease. That’s still true, but I now believe it’s past time to get this information out.

While ISAKOS is a medical/surgical society, in my interactions on twitter (@orthoepi for those who would be so kind as to follow me) I have been struck by how many orthopedic surgeons are grateful for information about how to adjust to life in the age of coronavirus. As such, if you find this blog post useful, please share it far and wide with friends, family, and colleagues. There is so much we can do to reduce the effects of this pandemic and get back to what can only be described at this point as the new normal, which I hope we can address in a future post.

For background, I have been a clinical epidemiologist at the Hospital for Special Surgery in NY for nearly 18 years focusing primarily on sports medicine and arthroplasty outcomes. While I have never studied epidemic disease professionally, I am well versed in the technical terms and understand how epidemics ebb and flow.

First off, let’s set the stage with an overview of some highlights. 

NOVEL CORONAVIRUS: This virus is deadly serious – for now. We have no immunity to it and it’s killing at a higher rate than the flu. There is no vaccine. There is no proven cure. The best thing to do is not get infected and if you do get infected, do your best not infect others. The good news is that as this virus mutates it may become less dangerous (over 18-24 months) and as more and more people are infected, it will not spread as easily. We will get past this. It is not the apocalypse.

SPREAD: The virus is most often spread through close contact with an infected person. This is primarily being spread through families, close friends, or coworkers. But it can also easily spread during events were big groups of people get together such as festivals, sporting events, night clubs, or bars and restaurants. It appears most commonly spread through the air if you’re close to an infected person, though it is also spread through shaking hands with an infected person or touching a contaminated surface. Healthcare workers who have lasting sustained contact with infected patients without adequate personal protective equipment are certainly at risk. One of my first friends to become infected is a private practice allergist who had a number of his regular patients seeking help in his clinic. He had no idea what he was up against.

RISK: Everyone is at risk of COVID19 and serious complications. Children appear to have more mild disease, but some still have extremely serious symptoms. It mainly appears to effect people with other comorbidities. Obesity is a risk factor. Males are at higher risk than females. Older people are at higher risk of hospitalization and death, although even people in their 20s and 30s can end up in intensive care units and some have even died. It appears to be causing heart attacks,  strokes, and thromboembolic events in younger people with no other risk factors

PREVENTION: Simple measures like social distancing and sanitation are most effective. I recommend reading the latest JISAKOS editorial by Niek van Dijk on COVID19 which provides an excellent historic perspective on hand washing policy. https://jisakos.bmj.com/content/early/2020/05/05/jisakos-2020-000472 . Stay away from people who could be sick (which during an epidemic is almost everyone) and wash your hands anytime you touch something that you don’t know where it’s been (which is most of the things we touch outside our homes). Alcohol solutions above 62% and diluted bleach are also effective for killing the virus on surfaces. And it goes beyond saying that you should not drink bleach and alcohols produced for sanitization.

INFECTION: How do you know you’re infected? In some cases you don’t. Some people never develop any symptoms. Early in the disease you may have a fever, fatigue, diarrhea, dry cough, sore throat or some combination. Many lose their ability to smell or taste, which seems to be a telltale sign that it’s not a regular flu. Up to 90% of patients have a fever. Most people should start to feel better in 5-7 days after first developing symptoms, though some will crash again and develop shortness of breath or other serious complications. If the shortness of breath becomes unmanageable, this is the point where you should seek medical attention. Otherwise, you should be able to self-manage and let the healthcare system take care of those who are in worse condition.

RECOVERY: Once you’re feeling better, get back to work. However, understand that you may still carry the virus for as many as 2 weeks so follow those precautions so that you don’t infect others. 95% of people who have been infected will be virus free within one week after they recover, but if you are part of that 5% who still carry the virus, it is better to be cautious (remember, 5% is 1 in 20 – not a rare situation at all). Also, volunteer to help others. Donate blood if a hospital in your community is testing antibody therapies. The world needs you.

That’s it. Feel free to stop reading here if you think you’ve got this.

Please stay safe and healthy. We are stronger together (at a safe distance).

Now …

If you’d like more specific recommendations, by all means, please keep reading.

THE SPECIFICS OF PREVENTION & MANAGEMENT

For more specifics on this, I’ve put together the following “tips” for those who may be confused by all of the information you may be hearing or reading. This information comes from medical professionals, my reading of research coming out of infected areas, and my understanding of how infectious diseases spread.

WHAT TO DO NOW

I would say this to those who live in areas that are not yet affected or have relatively few cases identified.

COVID19 IS ALREADY IN YOUR COMMUNITY. This is not to alarm you, but to let you know that the number of undiagnosed cases in communities without widespread testing may be as high as 100x as what is being reported. If your town has 5 confirmed cases, you can assume that number is possibly closer to 500. This holds true until widespread testing begins. The area where I live most of the year, Fukuoka, Japan, had 656 reported cases as of May 14th. While I do not think there are 65,600 cases here due to Japanese cultural norms, I would not at all be surprised to learn there are 6,000 to 12,000 cases, because there simply isn’t enough testing being done.  Health authorities in many countries report that only 1-7 % (average 3%) of their population has currently been infected. For herd immunity, the point at which most people exposed to the virus are not at risk of getting sick, we need approximately 60% of the population infected or vaccinated according to  WHO guidelines.

SOCIALLY DISTANCE. Coronavirus is primarily spread through contact with an infected person. The easiest way to social distance is to assume you are infectious and keep at least 1 to 2 meters away from anyone else as much as possible. Work from home if your job allows it. Don’t see friends or family any more than necessary. If you choose to continue to socialize, keep your social circle small and avoid crowded places. Use video chat or the telephone to keep up with those important to you.

DEVELOP GOOD SANITARY HABITS. Before the virus is widespread in your community is the time to start new, better habits around keeping clean. Don’t touch your face. Many of us touch our face hundreds of times a day without realizing it. Start realizing it. Wash your hands like a Take your shoes off at the front door (or in the garage if you have one). Change your clothes as soon as you get home. Don’t re-wear clothes you’ve worn outside. Avoid touching more surfaces than necessary when in public. These habits may seem like overkill now, but they’re easier to adapt when you’re not in the center of a crisis than when you are.

BUILD UP YOUR IMMUNE SYSTEM. Get enough sleep. Don’t drink too much alcohol. Don’t smoke or vape. Eat fresh, nutrient rich foods. Stress is hard on the immune system and as we face this disease, all kinds of stress is likely to occur. So it’s vital that we all get some downtime – read a book, watch a movie, enjoy a hobby. This applies triply if you develop COVID19. Do your best to stay hydrated, fed, and well rested. Your immune system will need the energy.

DON’T PANIC SHOP. Buy what you need, but don’t hoard necessities that others need as well. In case you get stuck indoors during the peak of the epidemic and you need to stock up food, then choose foods that can be stored for weeks or months like pasta, rice, beans, canned vegetables, canned fish, etc. Try to limit grocery shopping to no more than once or twice a week.

WEAR A MASK IN CROWDED PUBLIC PLACES. If you are sick it lessens your chance of spreading the virus. It also prevents you from so easily inhaling someone else’s cough or sneeze droplets, which is more likely in a crowd. Also, please note that “do not touch your face” also applies to “do not touch your mask” – if the mask has kept virus from contacting with your nose or mouth the virus may still be on your mask so touching it may contaminate your hands. Some masks can be reused if gently washed with soap and warm water. You don’t need to treat them as disposable.

Note: if you’re in a high risk area it may be best to dispose of them after a single use, but since we don’t know just how long this is going to last, even a good supply of masks may dwindle quickly. I’m currently switching back and forth between 2 masks which I wash and hang to dry as soon as I return home.

IF YOU LIVE IN A PLACE WITH WIDESPREAD INFECTION

ASSUME EVERYONE YOU MEET IS INFECTED. Do not take anyone’s seeming lack of symptoms to be a sign of safety. Just because you know someone personally doesn’t mean they don’t carry the virus. Many cases of infection appear to have been from someone who was infected, but 1-2 days before they showed symptoms, so most people are infectious before they know it.

ASSUME EVERY PUBLIC SURFACE IS INFECTED. The virus can survive in indoor air for about 3 hours (ventilation may clear it away more quickly) and on hard surfaces for up to 3 days. Wear rubber gloves when you are going someplace where you may need to touch public surfaces. If using disposable rubber gloves, dispose of them upon returning home. Use recommended medical glove removal technique (check YouTube).

DELIVERIES. In this environment, it’s better to order delivery and be exposed to one person than to venture out and be exposed to many. However, this is not good for the delivery person (other than the paycheck). If you order delivery, ask the delivery person to leave the packages at the door. Tip them well if tipping is customary in your community. They’re risking their health and life to get supplies to you. If you go out for shopping instead, stay 1-2 meters from anyone, wear a mask, and wear rubber gloves.

UNPACKING DELIVERED OR PURCHASED ITEMS. Keep in mind that the delivery person is probably not the only person who has handled the items you had delivered (or the items you picked up on the store shelves). Unpack them outdoors or in your entryway. Once you’ve opened the outer package (preferably with gloves), sanitize your hands before removing the interior items. Dispose of the outer packaging immediately.

ITEMS YOU BRING INTO YOUR HOME. Wash any items you can with soap and water. Things that can’t be washed should either be wiped down with alcohol or left in an unused part of your living space for 3-4 days.  After finishing this cleaning process, wash your hands thoroughly.

IF YOU GET SICK

Despite taking precautions, some of us may still develop COVID19. Here’s what to do if you get sick.

STAY HOME and in a separate room than those you live with who are not yet sick. You being sick does not guarantee they will catch it so be careful for their sake. If someone in your home has already recovered from the virus, they’ll need to be the one who takes care of you. They’ll need to be doubly careful not to infect others who have not yet gotten sick by following the precautions above. If someone lives with you, clean up everything you touch in shared spaces with soap and water or alcohol.

DON’T SEEK MEDICAL ATTENTION unless your symptoms become serious. Emergency departments are being overwhelmed with too many people seeking care. Most “mild” cases start to recover in about 5 days after onset of the symptoms, so hold out at least that long if you can. I wrote “mild” because apparently even mild cases are often miserable with fever, sore throat, cough, body aches, and tiredness. Shortness of breath is a common symptom with more serious cases of COVID19, but even some of them can be self-managed. Lying on your stomach can help relieve this symptom and emergency room physicians have even avoided putting people on a respirator by having them lie on their stomach.

IF YOUR SYMPTOMS GET WORSE. If your symptoms worsen or do not start to get better within about 7 days, call your physician (or a helpline that’s probably been set up in your community). They will instruct you what to do. It is at about this time that a diagnostic test may be necessary since you may need medical attention to recover. They should also let you know which warning signs represent an emergency for which you should go to the hospital. Some physicians are suggesting that if you develop shortness of breath, that’s when you should go to the hospital.

IF YOUR HOUSEHOLD FAMILY MEMBER GETS SICK

Many of us may end up caring for loved ones who get sick. Just because they’ve gotten sick doesn’t mean you will. If you follow the above suggestions and those below, you have the best chance of avoiding infection.

SEPARATE LIVING AREAS & BATHROOMS. Ideally the sick person should have their own bedroom and bathroom. If there is only one bedroom, the sick person should be isolated there and others should sleep in the main living area. If there is only one bathroom it will need to be thoroughly cleaned every time the sick person uses it. Soap and water or alcohol will do the trick. If they’re too fatigued to do it, someone else will have to do it for them.

TAG TEAM IF YOU CAN. If more than one healthy person lives in the house, you should work together – one to collect and clean possibly contaminated clothing, dishes, etc. and the other to open and close doors, get soap, etc. If there is only one other person in the house, you should be extra careful in sanitizing anything you touch after cleaning up for your sick family member.

AVOID HIGH RISK FAMILY MEMBERS. If an elder or someone with other medical problems lives in the same home, their caregiver should not also care for the person with COVID19. If there is only one caregiver available, the high risk family member should be isolated or moved to another residence if possible.

IF YOU’VE RECOVERED

CONSIDER DONATING PLASMA. A number of hospitals around the world are testing the ability of the antibodies in survivors’ blood to help those currently sick with the virus to fight it off more effectively. This could save lives.

GET BACK TO WORK. Society is going to need the economy to keep moving forward. Goods and services will still need to be made and delivered. Those who recover are an invaluable part of that. However, understand that you may still be carrying the virus so keep using those precautions to make sure you don’t get others sick.

CONSIDER VOLUNTEERING. There are so many things that need to be done and in many cases those who would be doing them are either at risk of getting sick or are too sick to do them. Find what help is needed in your local community, and volunteer to help.

FINAL THOUGHTS

COVID19 is a legitimate pandemic and a threat to our health and welfare. However, it is not an invincible disease. It’s just a virus just like any other and can be killed very easily with soap and water or high alcohol solutions. We just need to get into good habits of social distancing and sanitation. With just those two main things, we can beat this together to prevent further illness and death.

Please stay safe and healthy. We are stronger together (at a safe distance).

-Stephen L. Lyman, PhD JAPAN, Communications Committee Chair