COVID Take Three
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COVID Take Three
It’s the Three-Year Anniversary of the Pandemic - What Next?
This week is all about COVID.
My newsletter (below) is about managing COVID fatigue.
My podcast is a solo episode—a summary on COVID testing, treatment, masking, and risk management. Listen here!
My new opinion piece for The Hill is here.
To submit your COVID-related questions for Friday’s Q&A, click here!
I recently saw a middle-aged patient who described herself as “coming out of a COVID fog.” Not only was she fatigued from a recent bout of COVID; she was exhausted from living through 3 years of the pandemic.
My head hurts, she explained. Do you think it’s allergies? Migraines? Or could I have long COVID? We discussed the nature of her head pain, her history of spring allergies, and the data on long COVID. We also reviewed her life situation. During the pandemic, she had been working, parenting, and tending to an ill parent at once.
Her physical examination revealed borderline high blood pressure, a ten-pound weight gain, and markedly tight jaw muscles with audible “clicking” in her temporo-mandibular joint. “Good news,” I told her. “You’re more normal than you think.”
Instead of discharging pent-up adrenaline in yoga class or on long walks with friends, her stress had parked itself in her jaw. The solution for her headaches didn’t start with an MRI; it began by naming the problem: tension headaches due to the occupational hazard of being human.
She is not alone. Three years after the World Health Organization declared the COVID-19 pandemic, we have widespread population immunity against the virus. But no one is immune to the accumulated stress of life interrupted. Our story lives in our body—and the emotional, physical and mental health toll of living through a pandemic is real.
Not all of that suffering is measurable. There's no PCR test for despair. But I see the accumulated stress in people's blood pressures, in their laboratory results, and I see it in their eyes.
Health is about more than the absence of COVID-19. We are the integrated sum of complex parts. Health is about having awareness about the stories we tell ourselves, acceptance over the things we cannot control, and having more agency over our life. This begins with having access to fact-based information to care for our body and mind.
As I wrote in my OpEd for The Hill on Saturday
The pandemic laid bare the importance of healthier lifestyles and the relevance of mental health to physical health. Skyrocketing rates of depression, alcohol and drug overuse, and death by overdose should have alerted us that we need a holistic approach to health care. What COVID should have taught us is that health includes mental and physical wellbeing; it is about more than test results, and it is a lifelong process — not a pitstop or PCR test.
So together, my patient and I formulated a plan.
My advice?
To validate her own feelings. Instead of beating herself up for gaining pandemic pounds, to practice self-compassion—and to give herself permission to be human.
To accept that if we don’t appropriately cope with stress, it tends to find a home in our body. For some people it causes heart palpitations, for others it interrupts sleep. For many people it begets muscle tension, such as in the neck, shoulders and jaw.
To lean into the areas where she has agency.
For her headaches, I suggested seeing her dentist for a fitted night guard. For patients with frequent or symptomatic sleep-related teeth grinding (i.e., “bruxism,” a simple oral appliance can be fitted by a dentist to protect the teeth and help jaw tension. I also recommended that she consider physical therapy to help unlock tight jaw muscles. There’s no substitute for a good body “mechanic” when the car breaks down!
For her blood pressure, we discussed improving her sleep hygiene, cutting back on caffeine, and resuming routine exercise—then checking in again next month.
For her weight, we talked about focusing more on her habits than the number on the scale. We mapped out a plan to gradually put herself back in the driver’s seat of her routines.
For stress management, we agreed she needed to ask for help. From delegating better at work and walking outdoors while taking work-related phone calls to enlisting her spouse to drive carpool, she needed to claim more time for herself.
My shoulders just dropped two inches, she said with a smile.
No one is okay on the heels of the pandemic. The question isn't how to “win” your checkup with the doctor. The question is, How can you be a little more okay tomorrow than you are today?
On this episode of my podcast, “Beyond the Prescription,” I talk about where we are now and what to expect with COVID.
I cover various topics including:
the transition from pandemic to endemic
rapid antigen versus PCR testing
treatments, including Paxlovid
the recent Cochrane review on masks and mask mandates
vaccines and immunity
what to expect in fall 2023
addressing our pandemic story, understanding our unique risks and risk tolerance, and appropriately reckoning with vulnerability
I hope it’s helpful! As always, I welcome your comments and feedback!
Disclaimer: The views expressed here are entirely my own. They do not reflect those of my employer, nor are they a substitute for advice from your personal physician.
COVID Take Three
Thank you, Dr. Lucy for your clear and compassionate health information! I deeply appreciate the update on Covid 19 and will share it with others. A fear of dying from Covid 19 was a large part of the pandemic originally, and it remains a serious aspect during the endemic for the most vulnerable. So, I believe the pandemic also brought to light our lack of understanding and acceptance of death. I believe we really need widespread, public conversations about death and dying, and real assistance in learning both how to live while we're still alive, and how to accept and prepare for our own and others' deaths physically, emotionally, mentally, and spiritually. Maybe you could interview a death doula and/or hospice chaplain and share information and aspects of both positive and negative death experiences to illustrate we may have some choice about how we and/or our loved ones will die. I know both kinds of experiences, from family experiences and definitely prefer the former, but really have nowhere easily accessible to talk about this. No one, anywhere, has ever offered any information, insight, or experience with death without my seeking or asking. I believe teachers, medical personnel, all kinds of therapists, and both religious and spiritual leaders need to become knowledgeable and comfortable teaching and talking about death. And then, let's also talk about how to prevent and/or heal the specific trauma and grief of dying and/or losing a loved one to death. Thanks for asking for comments! Thia
Talk about mental health! People like you are lifesavers with your common sense and spot on thoughts about so many aspects of our pandemic experience! Can you talk more about your thoughts on testing with no symptoms and any reliable information about contagiousness when asymptomatic or pre-symptomatic? This has been one the most distressing triggers of anxiety and keeps many people stuck and afraid to resume much needed social interaction. We never thought about feeling fine and potentially harming others before the fear-fueling public information super-spreading! Thank you!