1st Lt. Tiffany Mendez practices donning her personal protective equipment as she prepares for the arrival of Covid 19 patients at Madigan Army Medical Center Friday March 20 2020 on Joint Base Lewis-McChord in Tacoma WA. Madigan Army Medical Center is a level II trauma center providing primary and specialty medical care to more than 100,000 service members, retirees, and families.
1st Lt. Tiffany Mendez practices donning her personal protective equipment as she prepares for the arrival of Covid 19 patients at Madigan Army Medical Center Friday March 20 2020 on Joint Base Lewis-McChord in Tacoma WA. Madigan Army Medical Center is a level II trauma center providing primary and specialty medical care to more than 100,000 service members, retirees, and families. (Photo Credit: John Wayne Liston) VIEW ORIGINAL

MADIGAN ARMY MEDICAL CENTER, Joint Base Lewis-McChord, Wash. – Editor’s Note: This is a four-part series on the symptoms, interventions, impacts and future relating to COVID-19. Watch this location for more installments.

Madigan Army Medical Center on Joint Base Lewis-McChord, Wash., first published a story on COVID-19 in January. The virus has consumed every day since; and it rages on. Where does that leave a pandemic-weary world?

As we head into the holiday season where people are yearning to gather with family and friends, and behave as normally as possible, medical professionals are encouraging caution and vigilance.

Non-Pharmaceutical Interventions

Though some of the specifics about how strict to be with different interventions have changed over time, the basics of how to respond to this virus have not. The three “W’s” serve us well. These are all measures we have heard again and again throughout this pandemic, but it is easy to be lax with them. It is important to recognize that these measures should be exercised in tandem as no single one provides nearly the protection that all three do together.

The 3W's
The “3 W’s” of wash your hands, watch your distance and wear a face covering give the best current guidance to keep safe and healthy during the pandemic. (Photo Credit: Odis Crosby) VIEW ORIGINAL

Wash your hands

Try an experiment. Spend the next hour being hyper aware of your hands. What do you do with them? What do they touch? What do they get on them? Do you touch your face? Do you wash them at all in that time? It is surprising how much our hands get into each and every hour of the day. Good hand hygiene is known to reduce the spread of germs.

Frequently wash your hands for 20 seconds, or twice through singing the Happy Birthday song, with soap and warm water. Vigorously scrub them together and make sure you cover every bit of them, including under the nails. When soap and warm water are not available, a hand sanitizer with at least 60 percent alcohol will do the trick.

For a video tutorial, check out Madigan’s own Preventive Medicine doc, Col. (Dr.) Paul Faestel by visiting Madigan’s Facebook page here: https://www.facebook.com/293304441350/videos/224547312130222

Dr. Faestel
Col. (Dr.) Paul Faestel, a physician with Madigan Army Medical Center’s Preventive Medicine Department and the director of its Public Health Residency Program, shows proper ways to cleanse your hands. (Photo Credit: Ryan Graham) VIEW ORIGINAL

Watch your distance

“Spread happens when an infected person coughs, sneezes, or talks, and droplets from their mouth or nose are launched into the air and land in the mouths or noses of people nearby. The droplets can also be inhaled into the lungs,” instructed the Centers for Disease Control and Prevention. “Since people can spread the virus before they know they are sick, it is important to stay at least six feet away from others when possible, even if you—or they—do not have any symptoms.”

What does six feet look like? Here are some common things that give a good idea of what six feet is:

two golden retrievers nose to tail; the length of a twin or full-size bed; a standard, three-seat sofa; or two shopping carts.

Wear a face covering

When medical personnel are performing procedures where they can come in contact with bodily fluids, they don personal protective equipment – PPE – in the form of gloves, gowns and masks. These masks, typically the N95 variety, have a higher level of filtration than those recommended for the general public. But, simple cotton face coverings can be very effective.

“The CDC recently released a science update highlighting that masks are protective to us, as well as to others,” said Lt. Col. (Dr.) Luke Mease, the chief of Preventive Medicine at Madigan. “So, we wear our masks to show our respect for others, but also all of us can wear this to protect ourselves.”

One of the reasons masks are so important is that people can spread the virus without even knowing they were exposed to it, before they become sick, and even if they never get sick themselves. Masking puts a barrier between you and others so that whether anyone appears sick or not, the free flow of any droplets is restricted.

To learn more about masks, to include selecting and caring for one, visit this CDC page:


Face Coverings
The value of face coverings to prevent the spread of COVID-19 is established, but the specifics are important too. Use this handy infographic to pick the right one. (Photo Credit: Kirstin Grace-Simons) VIEW ORIGINAL

Overall fitness

In addition to the 3W’s, maintaining overall fitness is a good way to combat any illness, to include infections like COVID-19.

“It's so important for us to stay physically active and physically fit. It helps us prevent infection, both COVID and other types of infection. We feel better; it is good for our mental health. So, absolutely all of us need to find ways to stay fit,” said Mease.

Stay at Home

Humans are social creatures. As such, the need to be around other people cannot be hampered long without repercussions.

Vice Adm. Jerome Adams, the surgeon general of the United States, and Lance Robertson, administrator for the Administration for Community Living, writing on the U.S. Department of Health and Human Services blog, offered some insight.

“Research tells us that social isolation can threaten health, and regular social interactions and having a strong personal network are important to a person's mental and physical health, resilience, and longevity,” they wrote. “Health concerns stemming from social deprivation include high blood pressure, sleeplessness or less restful sleep, anxiety, depression, and thoughts of suicide. In addition, lack of human interaction may increase hormone levels that contribute to inflammation and weakened immunity, thereby increasing the risk of diseases.” The article that can be accessed at: https://www.hhs.gov/blog/2020/09/10/harnessing-technology-to-address-loneliness-and-social-isolation.html.

The holidays are a time of particular interest in social activities, and gatherings among family and friends are a central part of traditions. This year, the potential to spread disease should be weighed heavily.

Like many other states, in the state of Washington, the governor has prohibited indoor social gatherings with people from outside your household unless additional quarantine and testing is performed prior; and outdoor gatherings are limited to five people from outside the household.

These, and all state guidance, can be found at: https://coronavirus.wa.gov/what-you-need-know/safe-start/whats-open-each-phase.

Recognizing that the holidays may be the only time Service Members can see family in a year, Lt. Gen. Randy George, the commanding general and I Corps commander, has chosen to allow already approved leave requests, but a 14-day restriction of movement following out-of-state travel must be observed.

Whatever choice is made, the 3W’s are essential.

Watch for the next installment of this series for information on how to deal with COVID-19 and its impacts.

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