Guide to self-care:
Coping with coronavirus

As Stanford works to reduce the spread of COVID-19 (novel coronavirus), it is also important that we each take care of ourselves while we assist in individual and community efforts to prevent further spread of this virus.

See also BeWell’s response to COVID-19 for specific information on the BeWell Program, which is ongoing thanks to remote Program options.

Staying calm, managing anxiety

Even on a “normal day” in history, emotional stress can prove very challenging. So add in COVID-19, and it’s really tough. How can we stay calmer and make wiser choices?

Firstly, bear in mind that as COVID-19 news spreads, it has created heightened stress for many of us. (For others, it has added to existing anxieties.) As James Kendall, LCSW, CEAP, of Vanderbilt University states, “sensationalized stories add to our angst and panic. The stock market has responded with a downturn, and many are unsure whether to travel or attend social gatherings. It may be similar to our response to other stressful world events: HIV, H1N1, SARS, mass shootings and 9/11.” It may therefore be wise for some to limit news overexposure: sensational news stories can perpetuate unnecessary anxiety.

On the other hand, staying educated means something more than just watching TV news:

• See healthalerts.stanford.edu and Stanford Medicine’s COVID-19 Updates.
• Reporting, and self-reporting, COVID-19 cases
• This State of California website provides information on staying healthy and includes resources related to COVID-19. 
• If you are a Stanford employee, review and bookmark these important guides: Information for staff and Information for faculty and researchers from healthalerts.stanford.edu.
• View these other campus health and wellness resources
• See also the #stanford-wellness SLACK channel.

To help your state of mind as you process current events, employees may access free archived Stanford Health Improvement Program (HIP) webinars on such topics as stress, resiliency, mindfulness and many more. HIP is offering a free webinar on reducing anxiety relating to COVID-19 on April 10.

We also hope the following advice from Stanford experts will prove helpful:

Sheltering in place: A BeWell Coach’s perspective
Tips for coping with anxiety
Even if you are virus-free, COVID-19 is affecting your health: Here’s what to do
Self-care: The gift that keeps on giving
Rough day: Be grateful

As was summed up in an article published by The Greater Good Science Center UC Berkeley:

“One way is to use whatever tools you have at your disposal for keeping a cool head — like practicing mindfulness, which has been shown to both lessen emotional reactivity and help us make better decisions. We might take a walk in the park or nearby woods and let nature soothe us. Or we could talk to a friend — a calm friend, that is — who can help us reduce our anxiety. Of course, our normal ways of connecting socially — like singing together at a concert or going to large parties — may have to change. But whatever we can do to maintain an air of calm, and to spread it to those around us, the better. After all, our emotions tend to be contagious in our social circles, and we should do our best to keep fear and panic contained.”

Solo outdoor exercise and “fitness-in-place” at home

Lastly, BeWell has also long advocated that each of us carve out “alone time” — enhanced even more when combined with fresh air and exercise. Simplistic as this may sound, now more than ever, this strategy is a useful tool. Take yourself away — both physically and mentally — from coronavirus for at least a while by going out for a run or long walk, alone. 

Runners on running at Stanford
Why walk?

Note: The Stanford Dish is currently open for outdoor recreation, but the Alpine gate will be closed starting Thursday, March 26. The remaining three gates — Stanford Avenue, Gerona, and Frenchmans — will remain open. As signs at the entrance to the Dish indicate, the rules on social distancing must be observed.Please take precautions in line with the shelter-in-place order and keep a 6-foot distance from other hikers. The Dish website will be updated if conditions change.

Or, if it’s a rainy day, try these “fitness-in-place” exercises at home. See:

• BeWell in Five – exercises you can do in your home, in five minutes or less (please keep a 6-8 feet distance away from your partner or friend, if you plan to excercise with someone else).
• Stanford Recreation & Wellness videos
• Stanford Recreation & Wellness Zoom online fitness classes

Still having difficulty with emotional stress?

• Faculty, staff, and postdocs can contact the HELP Center at 723-4577.  All scheduled sessions are being held remotely (Zoom).
• Santa Clara County maintains an anonymous crisis line that is available 24 hours, 7 days a week, at 1-800-704-0900 (Mental Health Services). 
• SAMHSA’s Distress Helpline (related to any natural or human-caused disaster) is accessible 24/7 at 1-800-985-5990 or via text (send TALKWITHUS to 66746; Press 2 for Spanish).

Do what you can to help prevent the spread of the virus  

Within the healthalerts.stanford.edu website, Stanford has a list of preventative strategies that include:

Get a flu shot. We strongly recommend that everyone obtain seasonal flu vaccination. Members of the Stanford community can contact the SU Occupational Health Center (Stanford employees) or go to Vaden Health Center (Stanford students) to get a flu shot.

Wash your hands often with soap and water for at least 20 seconds. If soap and water are not available, use an alcohol-based hand sanitizer.

Avoid touching your eyes, nose, and mouth with unwashed hands.

Don’t share food and drinks.

Clean and disinfect shared surfaces and objects that are touched frequently (e.g. door knobs, desks, phones).

If you can, avoid close contact with anyone with cold or flu-like symptoms.

On “social distancing”: Take that as far as you can

Expanding on the recommendation to “avoid close contact with anyone with cold or flu-like symptoms,” it is now strongly urged that everyone  abide by “the 6-feet rule,” otherwise known as social distancing — the strategy of maintaining a minimum of 6 feet between yourself and any  other individual. Why?  When someone coughs or sneezes, they spray small liquid droplets from their nose or mouth, which may contain virus. If you are too close, you can breathe in the droplets, including the COVID-19 virus if the person coughing has the disease. Most commonly, viral transmission occurs when you touch someone who has the disease, or you touch something they have touched — and you subsequently touch your face with your hands. Transmission levels are compounded by the fact that when someone gets COVID-19, they may be contagious 1-2 days prior to symptom onset. (They are, thus, COVID-19 positive, but asymptomatic.) Data also suggests that, while less common, the virus can be spread through feces/stool/bowel movements. The virus can also survive for many days on surfaces, especially metal ones. 

Information about transmission is evolving and is being closely investigated by CDC and WHO. See healthalerts.stanford.edu for updated information.

Going well beyond social distancing

Sheltering in place has become a legal ordinance in Santa Clara and six Bay Area counties, as well as in many other counties in the U.S. (See: Order of the Health Officer of Santa Clara County.) This order directs that:

“… all individuals must shelter at their place of residence except that they may leave to provide or receive certain essential services or engage in certain essential activities…. Violation of or failure to comply with this Order is a misdemeanor punishable by fine, imprisonment, or both. (California Health and Safety Code § 120295, et seq.)”

The CDC and WHO organizations both emphasize that this “shelter in place” community strategy is the key to flattening the curve of growth in new COVID-19 cases in California and eventually throughout the U.S. and the world. Data from Taiwan, Singapore and China points strongly to the positive impact of containing family units at home. Fortunately, data indicates that the transmission rate from children to adults is low. However, the adult-to-adult transmission rate is high, arguing for shelter in place by small, immediate-family units only. In other words, it is highly inadvisable to invite over a distant Aunt, a neighbor, or any other adults that do not need to be in your family residence. See Stanford’s Self-Isolation Guidelines.

COVID-19 symptoms

The current evidence is that most cases (~80%) of COVID-19 appear to be mild. The most common symptoms include fever (38°C/ 100.4 °F) and respiratory complaints such as cough and shortness of breath. Runny nose, sore throat, vomiting, and diarrhea — as reported in the landmark Feb. 7, 2020 JAMA analysis — are less commonly present. In more severe cases, infection can lead to pneumonia, severe acute respiratory syndrome, kidney failure, and even death.

Those with chronic underlying medical conditions appear to be at considerably higher risk for serious complications. Read more about COVID-19 Symptoms. 

If you get sick

Stanford employees should follow the guidelines compiled in healthalerts.stanford.edu:

• What to do if you’re feeling ill
• Where to get tested
• Guidance on working if you are sick or have been exposed to someone ill
  • Can I work? (based on symptoms)
  • Can I work? (based on exposure)

What to do if you’ve been in contact with a COVID-19-positive individual

See this Stanford guide if this applies to you.

By Lane McKenna and the BeWell staff
Originally published March 13, 2020; updated March 18, 2020