Antivirus Episode #7

Here is the transcript of Antivirus Episode #7 on May 5th, 2020 to help our community of migrant domestic workers go through COVID-19 challenges.

Hi everyone,

I am Camille, Uplifters’ Head of Programs. Thank you for joining me tonight.

Uplifters is a non-profit organization dedicated to empowering underprivileged communities with online education and peer support. We offer a free online money management course for domestic workers. You just need to click “ Send Message” on our Facebook page to enroll.

Our objective with this Antivirus Video Live is first to reply to your questions if we can or collect them and get back to you later if we can’t answer them directly. Secondly, we just want to be there with you. Uplifters is first and foremost a community and we will go through these difficult times with you.

This is the 7th episode of our Antivirus series and we are very happy to be here with you tonight and to have Doctors Without Borders as our special guest.

Doctors without Borders is an international, medical humanitarian organization, which operates in more than 70 countries worldwide. They provide medical care to people affected by armed conflicts, epidemics, pandemics, natural disasters and exclusion from healthcare.

Today we are very pleased to have Eliza and Guleed from Doctors without Borders with us so we can learn more and ask our questions on how to protect our health – and our mental health! – in these Covid-19 difficult times.

If you have a fever, cough and difficulty breathing, stay home and seek medical attention. Follow the directions of your local health authority.

There are still a lot of uncertainties around Covid-19. We’ll do our best to help you differentiate fact from assumptions and opinion.

This is an information sharing broadcast about anxiety and stress management under Covid-19, not a therapy session. If needed, professional mental health support needs to be conducted by a qualified counsellor/psychologist/therapist.

Eliza Chang is a nurse specialized in infection prevention and control. Part of her role is to prevent or control the spread of infections in the community.

Guleed Dualeh is a Psychologist and works as Mental Health Activity Manager at MSF.

Hi Eliza and Guleed, welcome to our live broadcast. Thank you so much for joining us tonight!

Situation seems to stabilize in Hong Kong, with more than two weeks without any local infection. But health authorities said the epidemic could only be considered under control if no new cases were reported for at least one or two incubation periods (14 days). Social distancing measures are being eased up.

On the contrary, Singapore is seeing a spike in cases, especially among migrant workers, with the case count now exceeding 18,000. The city is still under a strict lockdown.

The virus keeps spreading in other parts of the world, including in The Philippines (with the total number of infections now being more than 9,000) and Indonesia (with the total number of infections now being more than 11,000).

The situation evolves quickly and in all cases, we should
Keep observing preventive measures
Keep in mind that the impact of Covid-19 related stress and anxiety can remain on the long term, especially for those who live far from their family.

I was thinking maybe we start with you Eliza so we can discuss how to best promote health before we zoom on the topic of mental health, which I know is of particular concern for our community.

I also encourage all of you who are with us tonight, watching this live, to ask questions and comment. We’ll do our best to reply to you.

Camille: We now know what are the key preventive measures and in Southeast Asia, they seem to be fairly respected. Could you please remind us why are they so important and how they allow limiting the spread of the virus?

Eliza: A lot of people have been asking this question, why preventive measures are so important? And how are these preventive measures that allow limiting the spread of the virus? So, first of all, with these preventive measures, it can reduce the chances of being infected, or scrubbing these viruses or other diseases by taking just all these simple preventive measures. I always emphasize to the participants in our workshop, even to our beneficiaries, that simple preventive measure really matters. It just consists of hand hygiene and respiratory hygiene, in other words it’s the cough and sneeze ethic. Because everybody knows that we should wash our hands, but we need to ensure that we wash our hands correctly and timely with soap and water. But when hand washing is not available, alcohol-based hand rub is an option. So, make sure that you rub your hands for at least 20 seconds and ensure you wash all parts of our hands, not just the palm, not just the back of your hands but all part of your hand. Because if you just rub palm to palm for twenty seconds, it doesn’t mean that you’ve cleaned your hand correctly. And also, it’s very important that we should always remind ourselves, remind the people around us to avoid touching our face with unwashed hands. Because there is an interesting study that shows that people touch their face more than 16 times in an hour. And one thing when we’re talking
about cough and sneeze ethics, it’s just that covering your nose and mouth with tissue paper or bent elbow when sneezing or coughing. Because with these simple gestures, it helps prevent the spread of droplets. As we know the main transmission mode of this virus is through droplets when we sneeze, when we cough or even when we speak.

So, the second preventive measure is social distancing. Recently people keep talking about social distancing, the government has been reminding us of social distancing. So just hold a distance of 1 meter. At least 1 meter, if possible, that you can keep a distance of more than 1 meter from each other. Because when we are too close to someone, especially when that person coughs or sneezes, then we might breath in droplets. Because now that we have so many cases of asymptomatic COVID cases so we don’t know who we are we with and whether that person is healthy enough because other than COVID virus it can be just a common flu or some other infectious disease that also can spread thru droplets when we are too close together, we might just breath in the droplets directly.

The third preventive measure is avoiding crowded places. Because when the place is crowded, it’s very hard to maintain social distancing. It’s very hard to maintain 1-meter distance from each when there’s too many people. And also, you’re more likely to come in close contact with someone that might have COVID-19 or other infectious disease, they might not show symptoms yet. And of course, if you need to go to crowded places, when you have to do something there, you need to go there, you might want to wear a mask to protect yourself and also to protect others if you are not feeling so well.

The last preventive measure that I want to emphasize is, stay home if you are sick. If you have to wear a mask, you need to use it correctly. Use the mask correctly. Be responsible to yourself and the people around you. Seek medical help if you have flu symptoms and you have contacted with suspected or confirmed cases or travel history. These are the points you have to remember; you need to seek medical help, there’s no way to self-diagnose that am I having just a common flu or am I catching the virus. There’s no way to self-diagnose, you need to go see a doctor. And also, when you are seeing a doctor and you’re not feeling well, be honest. Do not feel ashamed or shy to declare your health conditions because you know yourself best when you’re not feeling well. Outsiders, your close friends, they cannot tell, cannot differentiate when you’re feeling good, feeling healthy or if you’re not feeling well today because of course we know ourselves better and also because nowadays during these pandemic people tend to feel shy or ashamed to declare that I am not actually feeling well or I have some flu symptoms because they are set to being stigmatized I think, but like I said, be honest. And talking about masks, if we wear a mask, we need to wear it correctly and dispose of it correctly. Because often people know there is a lot of education on how to wear a mask correctly but also people tend to forget when they take out their mask, they forget to dispose of it properly. Because applying and disposing of masks correctly can help prevent or slow down the spread of the virus. And also remember that masks are just an extra preventive measure, hand hygiene is still very important, it’s still the key. There’s this one that I want to emphasize to everybody including myself that all these preventive measures, that this is not a multiple-choice question with a lot of answers that we can choose. We cannot choose which one is the best preventive measure that I want to follow, because all these preventive measures have to be taken together to ensure full effectiveness. And also, one that you just have mentioned, please respect the local authorities’ guidelines or some new laws that have been implemented so always check on the latest guidelines that were released by local authorities.

Camille: How are these preventive measures adapted into daily life? What are the specificities that may apply to domestic workers as their work precisely consists in taking care of others and cleaning homes?

Eliza: Ok, so like just now the preventive measures that I’ve mentioned, we can try to think back that all these preventive measures that I’ve mentioned, is none of these are newly invented because of this coronavirus outbreak. It’s just something that we might have learned from school or from our mother or at home. It’s just some common practices because we might have forgotten all of these preventive measures or think that they are not very important and we don’t take them seriously until something happens. It’s always like that. We might know this back in school, but we are not practicing it because it is not important until something happen that were suddenly reminded of this, yeah I have learned this from school because of this outbreak so we can take this opportunity to remind ourselves, to remind the people around us to start practicing all these basic preventive measures that have been neglected for some times. So just remember this message I want to bring to everybody is to protect your loved ones, you must start protecting yourself first. So like all these preventive measures we’ve been doing, we wash our hands every day before eating or after the toilet or there must be some times that we will wash our hands, but for now during these outbreaks you just have to increase your hand washing frequency and do it correctly. We know that “yeah I wash my hand” but how long? like for 3 seconds? or as long as the water runs through your hand, is it considered clean? This is the time for you to really think about it “Am I washing my hands correctly?” “Are they really clean?” So sometimes if you keep forgetting to wash your hands before touching your face for example, you need to find ways to remind yourself, for example, a sticky note or a handmade poster on your toilet door or your living room or on a place it’s easy for you to see when you come back from outside. So, you just need to find a way to remind yourself, your family or people around you to wash your hands, dispose of your mask correctly. So, it’s like a reminder for you and the people around you.

And also, been saying that be responsible, start practicing the correct hygiene, the cough and sneeze ethic and also help the younger children, the younger ones adhering to all these practices. We as an adult we can set as a role model to tell the younger ones that you have to practice these preventive measures correctly by showing them the way or by leading them to do it correctly and also we can do like when we’re meeting our friends or family or colleagues, we can remind each other to practice all these preventive measures, and also please do it in a good way, friendly way to avoid conflict because we don’t want to act like a teacher telling you what to do, we don’t want to make people feel bad for not doing it correctly, so do it in a good way and friendly way because it take time for people to understand and accept, they might understand that they need to do all of these preventive measures but it also takes time to accept, “yes I need to do it and do it correctly” and the final part is make it as part of daily routine because I believe that everybody understand the need of washing your hand, the need of maintaining social distance but will people accept it and make it as part of daily routine? So we just need to do our part in ensuring a better and healthier community because all these preventive measures seem small but they actually play a very crucial role in preventing the spread of virus to protect us, to protect everybody. Like I mentioned before, to protect your loved ones, you must protect yourself first.

Camille: Our community reported facing difficulties related to their well-being, often related to the stress and worries they may feel when it comes to how Covid-19 could impact their lives. It is true that the situation sometimes feels overwhelming. Are these feelings normal and can they be managed?

Guleed: Thank you again for having us here this evening. Are these feelings normal and they can be managed? I would say yes to both of them actually. These feelings are normal because the situation that we’re facing is not a normal situation. We have never been in a situation like this before, this is a new virus. So yes, It’s definitely normal to feel overwhelmed, or stressed or anxious or all of the above. Everybody is different and everybody’s reactions are also different. A lot of thoughts are flying through our minds in these times. You know can I get infected, can I infect others, what about my job, will anything happen to my job, are we missing out events, I’ve planned a lot of things that was supposed to do and now suddenly there’s all of these restrictions that are put on un in terms of gatherings, travelling, meeting. Some of us might be living abroad so we might be restricted in going home or having family members come to us. All of the emotions that we’re going through, it’s very normal to go through them at this time. I think also if we think about it, we’ve been on this for quite some time now. We’re almost going on six months since we’ve been facing the coronavirus and now the Covid-19 as it’s called. That’s a long period to be exposed to uncertainty. I say uncertainty because we don’t know how long this will go on. We don’t have a playbook, we don’t have experience with it as per say. That in itself can be very stressful for even the best of us. But what I will say though in terms of can it be managed,i would say yes it is possible to manage it. We have to remember that this is not the first time that we have been faced with the challenge. This is not the first time that we’ve been faced with something where we have to overcome some adversity. I just wanna remind everybody and that is also something that we put as a reminder in our workshops for stress and anxiety management. We do have the capacity to overcome challenges. We do have it and I wholeheartedly believe that we will be able to overcome this challenge as well.

Camille: It is well known that under high stress we sometimes don’t know what to do, what to start with to make the situation better. When we feel down, it sometimes seems impossible to start feeling better again. Efforts feel too difficult. Are there easy things we can do to feel better?

Guleed: It is interesting that you said easy, Camille because it can seem overwhelming to even do minute things that you were able to do before. You might be a very resilient person in general then suddenly it’s hard to get out of bed or it’s hard to make a decision or it’s hard to stand your ground in a given situation whatever it might be. I think the first thing I would say is be kind to yourself. Start by some self-compassion. It’s very stressful as it is and you know we might not have the same amount of energy that we used to. Do some small adjustments, small things that if you change it up might have a huge impact on you and on your well being in general. There’s the basic things like sleep. Make sure that you have sufficient enough rest. If we don’t have enough rest, there’s a chance of becoming more hypersensitive to everything that we’re presented with and we’re presented with a lot these days. So good sleep, good nutrition, a little bit of exercise as well and having a sense of routine. Keep a sense of routine. Even though there might be a lot of restrictions that have been put on us try to see if you can keep some routines going, some healthy routines. I think those are some of the things that you can do. I think also there’s so much information going around in the news outlets and in social media. There’s so many experts and everybody has an opinion about Covid-19 but again we have to remember we don’t really know what it is or how long it will last. So to limit all of that information try to stick with one news outlet, a trusted news outlet. Don’t check the news the first thing you wake up and throughout the day and it’s the last thing you see before you go to bed. Keep yourself updated, have a conversation going and stay connected with your communities as well. Sometimes we feel that what we’re going through is something that we’re only going through ourselves but this is a global pandemic which means that not only in our inner circle but globally we are experiencing some of the same feelings and some of the same challenges as well.

Camille: I do agree with you. There’s a lot of information out there and sometimes it’s very difficult to navigate all that information. It can feel very stressful so maybe one thing that I personally do is I pick my 2 or 3 reliable media and I stick to them. Only when I have a question that I can’t find an answer to then I will start asking around. Community support is key for sure.

Guleed: Absolutely and also how do we navigate something that we haven’t experienced before. It is a challenge and it is definitely difficult but it’s not the first time that we’re faced with difficulties like this. One of the main things we can do is put a perspective on it and just remember this will not last forever. And we’re talking about compassion also. Set some realistic expectations on yourself. Nothing is gonna be perfect. There might be a lot of plans and a lot of things that have fallen through but it’s beyond our control.

Camille: What makes the situation feel that overwhelming is also that we may feel powerless; like the whole Covid-19 situation being completely out of our own control as individuals. Yet, we still need to adapt and navigate changes brought in by Covid-19 into our lives. But how can we do that when we feel anxious, scared or hopeless? What are the specific strategies that you would advise us to follow?

Guleed: There are different ones. We utilize them in the workshops that we have. Breathing is key. It’s definitely one that we always go back to. It’s something that you can do anywhere anytime. It doesn’t cost anything. It doesn’t require a lot of knowledge. It just requires you, yourself and take in some deep breaths. We also went through mindfulness which is something that you can try out. Everybody usually has access to either social media or YouTube. There are a lot of guided meditations. There’s some guided mindfulness exercises that one can do. I also encourage socializing. We hear social distancing. It is a new term that we have been so familiar with now. It’s not necessarily social distancing. It’s physical distancing, that’s what we have to remember. We don’t have to distance ourselves socially because that can be even more anxiety inducing. The fact that we can’t connect with our community, our family members, our friends and loved ones. We still can do that in a different way. Zoom has been a big hit now. Try to meet up with people virtually or in smaller groups, whatever is possible where you are. Remind yourself of some winning strategies that you have used before that worked for you before. Again as I said to begin with this is not the first time that we’ve been faced with adversity that we have been able to overcome. We can overcome this as well. We do have the skills.Also remember that when you do connect with friends and family it’s normal to talk about Covid-19. It’s such a big part of our lives now. It has become such a big part of our realities. But put it in the back burner a little bit. Reconnect on things that are not related to this because our lives are still going on. Reconnect with the things that bring you joy or joyous memories or plan for things that you are looking forward to, there might be weddings or birthdays, whatever it might be. Remember the joyful things as well. Spirituality, if that is something that can feed your soul. Look into your communities as well. Stay informed with trustworthy outlets as we said before which is also important. And then if those things, and this is just a couple of the examples that we’ve been going through and the things you can do for coping, if they don’t really work, seek help. There is help to be given. Camille you showed the hotlines for some of the crisis hotlines that people can call into. Utilize them. Utilize your communities. Keep the conversation going. What you’re feeling and what you’re going through, it’s not just you. You’re not alone in this.

Camille: This is very clear. Thank you, Eliza and Guleed. It was very informative. I found it very reassuring as well. Thanks a lot for your kind words and encouragement. Again we’ll get through it together. This too shall pass. Thank you so much, Eliza and Guleed.

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