Dear friends, we are certainly in a difficult situation but I am equally sure that we will get out of it well and stronger than before.
In this period I thought of creating videos that help solve practical problems; we know we have to stay at home if not for absolute reasons that lead us to having to go out but beyond this, we will spend a lot of time at home, we will have the opportunity to watch the internet, watch videos and that’s why I will try to do some videos on practical, everyday topics that can help us in this difficult period: how to wear masks, what types of masks to use, the type of diet, how to wash your hands but also the type of physical activity that we can do at home, which can be very helpful in strengthening our immune defenses.
Remember that you can stay in touch with us through the website www.gennaichirurgia.it. You know that we are among the first in Italy to organize video consultations, so you can contact us at the numbers written on the website and, indeed, schedule the video consultations with us.
In short, let’s try to be together using the means that we fortunately have today (such as the internet and video conferences) and you may want to follow these videos in which I will try to give you some helpful tips on how to manage this difficult period from which I am sure, I repeat, we will come out soon from and stronger than before. See you all!
2. HOW WE GET INTO CONTACT WITH COVID19
Today, I would like to talk with you about how COVID-19 spreads. This gives us reason for some fundamental things and makes us understand why we must remain isolated as much as possible, why we must limit contact with people as much as possible and why we must wash our hands often and wash the surfaces with which we come into contact with. Let’s start with the concept: COVID-19 is a virus that is transmitted by air, directly and affects the respiratory tract.
How does direct contagion occur? It occurs mainly through what are called “droplets”, that are, when we speak, breathe, we emit small droplets with a size of 0.5 microns (and consider that the micron is a thousandth of a millimeter), therefore they are invisible droplets that manage to float in the air for a few meters. If we are in a crowded room or even if we communicate with a person at close range, these small droplets can transfer from one person to another and it is obvious that if one of the two people is positive, the carrier also infects the other (even if he is asymptomatic, because remember that unfortunately there are many carriers who do not show any symptoms, therefore not only those who have fever, for example, are infected).
Therefore, we must start from this concept that everyone can be infected and there can also be a transmission from people who have COVID-19 via their saliva or mucous membranes, with or without symptoms. These small droplets can be transmitted and go into direct contact with the mouth, mucous membranes, and eyes of someone and this is the direct way to infect. Then there are indirect ways because these droplets can fall and remain on surfaces, we then touch these surfaces, touch these objects, we put our hands onto our mouths, eyes and the infection occurs.
One of the surfaces where the virus can remain in a shorter period of time is on cardboards and paper, staying up to 24 hours. Then, it can stay up to 48 hours on steel and can reach up to 72 hours on plastic surfaces. Therefore, we must clean these surfaces and objects that we use, as often as possible.
We must wash our hands as often as possible too and always avoid bringing our hands to our mouths, noses and eyes. This implies a lot of attention and a lot of personal and material hygiene. Let me also tell you what substances are needed to clean surfaces: at least 75% alcohol, all chlorine-based solutions but also normal disinfectants often have these capabilities, so let’s get used to cleaning the objects we use very often.
I repeat: let’s wash our hands often and stay in isolation, try to have less contact with the least number of people possible in order to avoid both direct and indirect contagion.
3. PREVENTION WITH MASKS
Today I would like to talk about how to limit chances of contagion, what happens from person to person through the droplets as we said in another episode, obviously only with the means available now.
Let me remind you of some aspects — first of all, the droplets are small ones that we emit when we speak and breathe. They are small droplets that can contain COVID-19. I also remind you that not only sick people can transmit COVID-19 but unfortunately, the most subtle way of transmitting it is precisely through people who have contracted it but do not show any symptoms.
So, know that you are not sure if you speak or are in contact with people who have no fever, cough or some of the symptoms. You know that many of the transmissions take place between asymptomatic subjects who have contracted the disease.
Having said that, the first thing we have to do is try to limit direct contagion, through droplets, as much as possible. These droplets have a size of about 0.5 microns (remember that a micron is a thousandth of a millimeter, so they are tiny, invisible and can float in the air for a few meters).
One of the most obvious systems is to protect yourself with masks. This is quite intuitive because if we wear a mask, we have three advantages — we avoid issuing droplets and therefore, avoid possibly infecting other people. We create a barrier between us and the droplets from other people. Possibly, or even involuntary, we also can limit touching one’s eyes, mouth or nose.
The usefulness of masks is absolute, both for people who are sick, asymptomatic (but positive) or even for people who are not positive nor sick but want to defend themselves from the possibility of being infected.
We know of the difficulty of finding certain types of masks, such as those called P2, P3, FFP2, and FFP3. They are certainly the best masks that guarantee maximum filtering but we know that they are difficult to find. I would say that yes, they are indicated in these moments of difficult emergencies. Above all, they are to be given only to health workers, who are in difficult conditions, are in permanent contact with affected patients. These masks that give maximum safety are certainly the most suitable, however, due to the lack of these devices, it is good that they are for now dedicated only to medical and health personnel who are in direct contact with the sick.
For people who have to go out because they are obliged by work, health reasons, or urgencies foreseen by ministerial decree, I believe that the classic surgical mask is an excellent protective system. It consists mainly of three layers — a front water-repellent layer, a middle filtering layer, and a layer that absorbs moisture and is in contact with the face and eyes.
Important thing: it must be worn in the right way. Know that the surgical mask, if well worn and intact, protects us from more than 90% of these famous 0.5-micron droplets. Therefore, it is a good system, not absolute but still good. The important thing is that it is used well and that the procedure to use it is scrupulously followed.
As we said, the surgical mask has an external part and an internal part that goes towards the mouth. This must never be reversed. You must always use the white part towards your mouth and nose. Moreover, the surgical masks have a kind of underwire on top, which is the one that is to be modeled onto the nose.
Third thing — it is essential that the surgical mask adheres completely to the face. It has to be used to protect us from droplets. If we allow them to enter from various openings, then it is clear that the mask will not work.
So, wear it, model it as you see, make the underwire adhere very well (some masks are elastic, others with laces) and once worn, model the mask even better so that it is well attached to the face and covers up well.
Remember another thing — the mask is strictly personal and should be disposable. If you have a few because there is a lack of availability, mark it with your name, keep it aside because you have to consider it a potentially very infectious object. Maybe put it in a bag and when you have to use it, you take it out and put it back in a very careful way.
Remember that the best thing would be to use it only once and then throw it away and if you have a limited supply try to
keep them very well to avoid having them in contact with other people. Finally, always wash your hands after removing the mask.
A mask is a very important and useful device to prevent the direct contagion of the virus. Learn to wear it always, especially when you are in contact with other people face to face. You can avoid wearing it when you are at home, in contact with your close circle of family members (without any illnesses or suspicion of COVID-19). However, if you should see a family member from outside (which should not happen) wear a mask. In summary, in normal conditions, in the absence of contracting the disease (or suspicion) or any illness within your family, you may not wear a mask at home. However, as soon as you go out the front door, wear one.
4. HAND WASHING
Today I want to talk to you about how you wash your hands. Why is it so important to wash your hands? Doing so can avoid what is called indirect contagion. Before, we said that COVID-19 can be transmitted through direct contagion, through what are droplets, 0.5-micron salivary droplets, half of a thousandth of a millimeter, extremely small, invisible, and can float for meters in the air. This is the direct contagion — by speaking and breathing close to people, we can emit these small droplets that can go to infect.
We have talked about the usefulness of the mask and its insulation regarding this type of problem. What we have next is the indirect contagion or the contagion that occurs by touching areas that have the presence of COVID-19 and subsequently, touching the nose, mouth, and eyes with one’s hands.
I have told you that various surfaces such as cardboards, steel and plastic can maintain the presence of COVID-19 for hours and days if not properly cleaned with suitable substances. This also applies to asphalt itself, the floor and the sidewalk. They all can maintain the presence of COVID-19 for days, so our hands, which touch objects, things that we use, can be a terrible means of indirect infection. Therefore, I put great importance on washing our hands well, following a correct procedure.
We surgeons are trained precisely to do this because you know that in the operating room we must carefully wash our hands with a specific method and specific products both before the intervention and after. We put the safety of our patients at the forefront and we protect ourselves as well. So, the importance of handwashing for us surgeons is a fundamental thing and I would also like to pass it on to you.
Now let’s go over there, to the sink, to show you a step by step process of how you will have to wash your hands and wash away COVID-19, without having any chance of indirect infection. First of all, here is what you need to have in your sink — obviously, soap, a sanitizing wipe, and alcohol or sanitizer.
Now let’s see what the procedure is — of course, turn on the faucet (better if you use hot water, obviously without burning your hands but better if hot), wet your hands and get at least halfway through your forearm, then apply the soap on your hands and lather. At this point, the washing begins and to help you with the time begin to count (use 1001, 1002, 1003, up to at least 1015).
We wash the backs of our hands, the palms of our hands, we reach the wrist and part of the forearm. Then, you begin to wash evenly between the fingers, in this way. Wash your thumbs and continue this kind of action, then rinse the soap off and do another soaping with the same method, count about 15 -20 seconds each time (the more you wash the better). Remember, your wrists and forearms and then rub your palm, the back of your hands, between your fingers and thumbs. This is very important.
At this point, rinse the soap off again.
It will not be good to close the tap with clean hands because you opened it with dirty hands. So, take your sanitizing wipe that contains a disinfectant, perhaps an alcoholic solution and go to close your tap using it. It will be better if you will clean your sink well and disinfect this area too.
At the end of the procedure, use the sanitizer which, of course, must be placed on the hands, between the fingers, wrists, and forearm.
I know, it may seem a bit long but very necessary. Know that it is fundamental to limit the indirect contagion of COVID-19.
Why is nutrition so important? First of all because we, at this stage, must keep our body strong and ready to defend itself from COVID-19. We must maintain a diet that allows our body to maintain its immune defenses high, to cope with any contact with COVID-19.
Having a healthy diet means being ready and strong against COVID-19. First of all, know that it does not mean overeating. It is not necessary. In this period, we want a balanced and low-calorie diet. Moreover, we want a low-calorie diet because we do less physical activity (and in another episode, we will also talk about what type of physical activity is possible to do within the corners of our homes. Being at home must not have you abandon physical activity completely).
Going back to the topic of nutrition, you must avoid nibbling often, limit your meals to 2, a maximum of 3 per day. Then, have a long ‘non-feeding” intervals. It would be a good idea to keep the intervals between dinner and breakfast of at least 12 hours.
What is our goal — to strengthen our body. In this period, it is indicated to increase fruit intake. Since fruits already contain fructose, that is sugar, we limit the intake of refined sugars as much as possible. We take in more oranges, tangerines, kiwis, all are rich in vitamin C but banana is also an excellent fruit. In short, eat fruits rich in vitamin C. This is very important.
Other foods that do not contain fruit sugar are also important, such as carrots and other vegetables. They are all foods rich in vitamins, which must be eaten in abundance especially in this period but without exaggeration.
Another important food is meat. I do not recommend overeating meat. The concept of having protein in your diet, which is fine, must, however, be directed towards proteins derived from fish, legumes or eggs, without exaggerating the supply of milk (including vegetable milk). Overeating protein is not correct, so eating too much meat is not good, try to have a balanced diet.
Of course, older people (over 70 years of age) need a slightly higher protein diet, so they will be able to eat a little more protein but people under 70 should have a normal protein diet and especially choosing proteins from fish, legumes and therefore avoiding other kinds of meat as much as possible.
Even cheese is very fatty and rich in milk, so limit their use. Take fruits, vegetables and proteins from fish and legumes and try not to nibble during the day and leave periods of non-feeding of at least 12 hours, for example, between dinner and breakfast the next morning.
Then we move on to supplements that are needed to integrate and help our bodies precisely. They must go to work mainly on vitamin discourse, so it is very important to take vitamin C, various minerals and also other natural substances that help strengthen our immunity, such as echinacea, which can be very very useful at this stage.
All probiotics are also important. Know that we must have great respect for our intestinal flora, which is our first barrier against infections. The production of substances very useful to our body is also useful to our immunity.
Of course, this concerns healthy unaffected people because, in the case of having symptoms or infection of COVID-19, one should follow the indications of the health care professionals who treat him or her.
Drink a lot of water, at least a liter a day. Remember another thing — fruit juices, which have nothing to do with the fruit itself have added sugars, even if it is not written on the label. Packed fruit juice is assimilated to a sugary drink. Do not take unnatural fruit juices but make homemade ones that are very useful to our health. Otherwise, the ones that are packaged ought to be banned.
I hope these little tips can be useful.
6. MOBILE PHONE AND KEYS
Dear friends, I am still here to talk to you about some useful tips and suggestions for these certainly difficult days that we will be able to overcome. Today, we talk about the objects we commonly use.
Coronavirus is spread mainly through droplets, salivary droplets that fly through the air. Of course, I would like to reiterate the importance of always using masks because, by covering the nose and mouth, we avoid or decrease the possibility of throwing these droplets in the air.
This equipment also limits the possibility of receiving these droplets and they also limit the possibility of touching your mouth, nose, and eyes with your hands.
Today, I also want to talk about those objects that can be vehicles of indirect contagion. Classics are, for example, mobile phones and keys, which we use every day.
These objects, of course, are also touched by other people but above all, they are placed in various areas, so what I recommend is — whenever possible always clean them with alcohol-based wipes but a good idea is to have at home, near the entrance, some zip lock bags, in which we can store our items once we enter the house.
With this type of bag, you can continue to use your mobile phone despite being inside it. It is important to periodically cover the mobile phone with a bag that you will change every so often.
So, get used to using a bag and if you take your phone out at home, then discard the bag. Use another one for your mobile phone next time you go out which, as already mentioned, can perfectly work even inside a simple zip lock bag.
Of course, the same thing goes for the keys — use them when you get home, put them back in this kind of bag. Then, you will do your hand washing and disinfection. These are small tricks that can help limit the spread of the virus. In the next episode, I will be speaking about staying at home and be protected.
7. PHYSICAL ACTIVITY
Today, I want to talk to you about physical activity. You know that by ministerial decree and above all, as a reasonable thing to do, we must avoid going out and having contact with people as much as possible. If we go jogging and we live in an isolated place, say in a meadow, where there is nobody for hundreds of meters, it’s obvious that we won’t potentially hurt anyone.
However, if we live in a city or town and go jogging, this is an opportunity to meet people and therefore, have the opportunity of a direct contagion as well. Remember, that the droplets may pass from one person to another even at a distance of some meters because these droplets float, plus running while breathing in more heavily, means we exhale as much.
Remember that this virus also remains on the asphalt for hours and days, which is why when you return home, the shoes you have used can be a large vehicle of infection indirectly. You take away your shoes from the ground with your hands that then become contaminated.
If you do not wash them immediately, then you risk spreading the virus. Your kid or your dog passes by the ground where your shoes have touched. This event then distributes COVID-19 inside your apartment. This is primarily the reason why isolated jogging, in this period, should be limited or eliminated.
Of course, this does not mean that we have to have a sedentary life, lying on the sofa watching television all day long because physical activity is also very useful to keep our immune defenses high (physical activity must be done, teach it also to your children who are at home).
In 10, 15, 20 minutes, depending on your habits, do physical activity and maybe take advantage by doing it all together, with the whole family, because it can also be a fun moment.
If you search on your mobile phone there are many applications, such as “7-minute workout” and others. These are programs that you can download and thanks to them, you can do exercises, choosing the duration and your level of training.
With those 7 minutes of exercise, your whole family can benefit from it, maintain joint mobility, muscle tone and keep your immune defenses high.
Some are lucky enough to have an exercise bike or gymnastic equipment at home but for those who do not have all this, it is still possible to organize some exercise in your apartment. Download these apps, there are many and very well made.
They teach exactly how to do the exercises and I repeat to you, it can also be an opportunity to make it fun with your family and children. Teach your kids to exercise, let them get used to it. Have them detached from using computers for hours and hours. This simple physical activity is very useful for prevention and raising immunity in this period in which we must defend ourselves against this COVID-19.