By Debbie Gregory.

Currently you might be working from home due to the COVID-19 pandemic. Below are a few more tips to help you get into the swing of working at home, help you be productive from your new home office and help you maintain your overall mental well-being:

Establish and Keep Regular Working Hours:

It is important to set for yourself and make clear when you are working and when you are not. If possible, try to keep with the hours you normally worked at our office. If those hours were 9am to 5pm then try to make that time period, your workday. Working from home has placed you in charge of your environment and your work schedule. This means that you will have to hold yourself accountable as well as recognizing when enough is enough and not overdoing it and burning out.

Communication is Key:

If you are just learning how to work from home, the transition will require a great deal of patience and good communication skills because you will encounter a variety of challenges in your new workday.

Put together a plan that clearly spells out expectations for how often you should check in and how you will tackle any changes or new assignments. This plan is likely to change as you go along. And that is OK.

This is a new and unique situation for everyone. It is important to make sure that you are communicating with your coworkers and managers as issues or challenges come up in order to overcome them appropriately and quickly. Never hesitate to reach out to the same people that you would normally turn to for help.

Recreate Your Commute to Help Prepare Yourself for Work:

Your morning commute does not only get you to work; it also gives your brain time to prepare for work. Just because you are not leaving your home to work right now does not mean you cannot help yourself mentally prepare for your workday in a similar manner.  If you listen to music on the way to work, start your day with the radio on. Maybe play with your pet, do a quick workout, or spend a few minutes on your favorite hobby.

The same goes for after work.  If you generally spend time commuting back home and can wind down from the day, then do something at the end of your designated workday to help unwind. Maybe walk the dog, do some yoga, or read a bit.

Remember to Socialize:

Working from home cuts you off from the casual interactions you would normally have with your colleagues.  A lot of people find this incredibly lonely and isolating. Make sure that you schedule regular talks with coworkers or managers, even if these chats are only a couple of minutes long. Additionally, try to schedule less formal chats with your coworkers such as a virtual happy hour after work or a catch-up session.  Don’t forget to schedule regular virtual visits or happy hours with your friends and family during this time too.

VAMBOA hopes that these tips will help you to prepare your home office setup and assist you in creating a productive and workday.   Remember that even though our world is upside down now, it is more important than ever to reach out, connect with and take care of one another.

BE SAFE AND OBSERVE STAYING IN PLACE AND SOCIAL DISTANCING!

By Debbie Gregory.

Due to the COVID-19 pandemic, many companies are implementing work from home policies for those employees who can reasonably complete their work from home. A lot of people suddenly need to learn how to work from home which is very different from working in the office.

Below are some tips to help you get into the swing of working at home, being productive from your new home office and maintaining your overall mental well-being:

Do Not Become Distracted from News or Anything Else:

Distractions are rampant at home and are one of the biggest challenges for people who work from a home office. There is always something that needs tending to at home whether it is your chore list, a lingering project, or a loved one.

It is important to be discipline and limit distractions in your workspace. If you need to toss a load of laundry in the dryer or quickly check the news, be sure and do so but refrain from large cleaning projects. It is important to take regular short breaks from work as you would at the office.

If you are susceptible to distraction each  time you receive a text message, news alert, or someone poking their head into your workspace, remember that all of that will still be waiting right where it is when your work day has come to a close.

Manage Your Time Wisely:

Regardless of whether you are working or not, it is essential that you set a regular schedule for your day and keep track of your tasks including those pending and completed.

You can use a variety of methods for this but here are a few cool, free online tools you may want to consider:

• Tasks and project management: Air Table, NovaTools, Trello
• Sharing documents: Dropbox, Box, GoogleDocs
• Video conferencing: Skype, Zoom, Google Meetings
• Team communication: Whatsapp online, Slack, Workplace by Facebook

Designate a Quiet Workspace or Home Office:

If you are used to going into an office every day, the separation between your job and your home is a physical separation.   You will benefit from recreating that separation as much as possible with a designated physical workspace at home. If you do not have the space for a full room to devote to this, a quiet corner in the least used room in your home will work.  This space should feel as separate as possible.

Tips for a good home workspace:

• It should be a comfortable space
• It needs to have good lighting
• Include the things you need to perform your job (printer, computer, phone, paper, pens, etc.)

It is important that your workspace is separate from your home space so that you can mentally turn “on” at the beginning of the day when you enter the space and get down to work; as well as turn “off” at the end of the day.   If you never fully disconnect from work, both your productivity and your home life will suffer so try to balance both.

Create Realistic Boundaries with Others in Your Home:

If you are suddenly working from home, you are probably not the only one in your house who is facing this new work life balance. You may find yourself at home with your spouse, children, other family, roommates, or others. It is best to set clear boundaries and share them with the other people in your home. Set times or queues for others to help them understand when you cannot be disturbed.

Get Dressed Everyday:

This might seem like an odd tip but putting yourself together as you normally would to go to work will help you mentally prepare for your day. It is very tempting to stay in your pajamas but doing so generally leads to a slower overall start to the day and less productivity overall. It is not necessary to dress up such as wearing a suit.  It is good for your head to shower, brush your teeth do your hair, shave or put on makeup and put on something nice.   You will be surprised how much doing this will improve your outlook and keep you positive.

VAMBOA encourages everyone to practice social distancing and STAY SAFE!   Stay tuned for more tips in Part 2.

By Debbie Gregory.

It’s a good bet that you are spending a lot more time on your phone, tablet or laptop than usual. Our devices can be a lifeline of sorts.  Below are a few interesting new apps that may help you beat some boredom during this difficult time.

COVID News: Apple’s COVID-19 App:

Apple’s COVID-19 app brings together almost everything that you need to know about the virus and staying healthy that is happening right now. It also includes information on what to do if you think you may have become infected. This app is updated constantly with verifiable information.

Cooking: Project Foodie: Guided Cooking:

You may or may not know your way around the kitchen. This app will help you learn to be an overall better cook. It breaks down recipes step-by-step in video format and is led by professional chefs.  It can also be a lot of fun and encourage you to try making dishes that you might never have done.

Learning: EdX and Duolingo:

EdX offers over 2,000 classes on just about any topic that you can image and then some. Duolingo is a language learning app that is structured more like a game. It is image heavy, fast-paced, and incentivizes you to keep going with small rewards. There are 35 languages that you can try, including fictional tongues like “Star Trek’s” Klingon and “Game of Thrones'” High Valyrian.  Enjoy!

Social: Nextdoor:

Nextdoor connects you with neighbors in your specific neighborhood and some you may have never actually met in person. Though this app was popular and useful before the pandemic, it now it is a fantastic tool to help you connect with your neighbors and help each other out.   It provides you valuable information on what is happening in your neighborhood in a timely manner whether help finding a lost pet or which stores have toilet paper.

Relaxation: Stop, Breathe & Think:

This meditation app is designed to ease your mind and help you start to check and evaluate your physical and emotional well-being. The app analyzes your current state and gives you activities that will help you based on your own evaluation.  It includes things such as guided breathing, brief meditations or even calming compilations of cat videos.   This is a time with a great deal of stress and anxiety that is unhealthy for us so this app can be an excellent resource.

Exercise: Aaptiv, Peloton, and Runkeeper:

Aaptiv is an all audio-based app so you can start it, pop your phone in your pocket, and go! The Peloton app gives you 30-days of free guided workout videos (strength training classes, yoga classes, boot camps, and cooldowns too). The Runkeeper app tracks your runs and measures your progress. This one is a bit unique since you can earn rewards toward real-life training gear.  Exercise is very important, especially now and will help keep you emotionally and physically fit.

Games: Playing with friends: Heads Up! on Houseparty and Playing solo: The Sims Mobile:

Heads Up! on Houseparty is kind of like reverse charades that you play with one or more friends. The Sims Mobile is a fun condensed version of the popular videogame The Sims! You get to manipulate the life of a virtual person who can shop, date, throw parties, meet ghosts, buy homes, get a job, adopt a child, and so much more.   You can live vicariously through your virtual person.

VAMBOA is providing this information to be helpful and does not endorse any of these apps nor do we receive any compensation for featuring them.   If you have another app that will provide help or fun for others, please let us know.  Email:  info@vamboa.org.

STAY SAFE AND SOCIAL DISTANCE.

By Debbie Gregory.

We are physicians. We are experts at triaging and prioritizing action. Our decisions mean the difference between life and death. We regularly balance competing interests in the setting of constrained resources. We fight hard for our patients. Our job has been likened to “walking through minefields in clown shoes.” It breeds humility. If we make a bad decision, the unthinkable happens. And we are frequently reminded of the fragility of life. We have glimpsed the future of COVID-19 and are horrified.

At this point, New York alone is outpacing Lombardia, and the U.S. is outpacing everyone else. We are not waiting for the cavalry to ride in, because there is not one coming. It is up to us.

Here is what we should demand of our state and federal governments:

Physicians, nurses, and hospitals have been working nonstop for weeks and know the tsunami is here. We should have acted long ago, but we cannot waste time arguing about what could’ve been done. We are in the now, and we are going to need your help.

The prescription for ending this epidemic is: leadership, organization, creativity, hard work, and proven public health measures. We will need to draw on every resource to do this in the most efficient and effective manner so we can save lives, and everyone else can get back to their own.

It is critical to flatten the curve.  If our ventilators run out, like the toilet paper did, many will die unnecessarily because of shortages. Survival for those who become critically ill is poor, despite every desperate measure we take. Our horror as health care workers on the front line is that we have little to offer patients to change the course of their disease. States can bend the curve and “buy time” with decisive leadership and action. Buying time means we can:

• Create better, widely available tests to know who is infected
• Acquire PPE to protect health care workers
• Adjust our “business as usual” processes
• Discover a new therapy that makes this disease an inconvenience and not a death sentence
• Find a vaccine that is safe and effective
• Reinstate our normal life-saving care for those who are not infected

So, yes, it is incredibly important that everyone stays home now to buy us time and save lives.  But it isn’t enough. What we do with this time purchased at great expense really matters. We are at a crossroads, and the government decisions will determine the path we will take. The task may seem impossible, but it is NOT impossible.

It will take unprecedented coordination and effort, but we are fortunate to have roadmaps laid out for us by Singapore and South Korea, democratic nations that are winning the war on COVID-19. South Korea’s daily case count is declining.  As of March 23rd, there were more cased of COVID-19 diagnosed in NYC alone than the entire country of Korea. Singapore has lived with this for months longer than we have, yet life goes on, and they have not shut down schools. Their strategy and coordinated efforts have paid off. What it requires, however, is decisive and strong leadership along with the humility to recognize that this is neither “business as usual” nor “disaster as usual.” We cannot be Italy– we will fail.

Here are the immediate steps that governments should take:

Shelter in place. We must limit all nonessential contact to reduce the spread of the virus. This cannot last forever but it will be important to implement the strategies we need.

Strategic planning and organization. We should employ and leverage every resource available in our state to fight this. A team of non-medical professionals, working in parallel to our health systems, state, and universities, should be established to offload work and support the state’s COVID-19 response. Best practices and treatment breakthroughs should be distributed widely among the health care community. While the hospitals and physicians are working and preparing, this group should start now working to assist in the following ways:

• Determine a strategic plan and framework for prioritizing needs, opportunities, barriers, and communications
• Work with the state and federal leadership to overcome regulatory barriers to implementing interventions quickly
• Identify and implement initiatives that must be done at the state level and cannot be accomplished by individual health systems alone
• Identify and communicate best practices across the state to every overburdened hospital system
• Coordinate partnerships with the many corporations willing and poised to make a huge impact
• Develop and deploy technology (or workers from other industries) that can make traditional public health measures, such as contact tracing and isolation, scalable

Control hospital hot spots. Hospitals are a major source of spread for COVID-19. If patients decompensate, they tend to do so on day 7 or 8. Patients should only come to the hospital if they need services that cannot be rendered in another location. Hotels, nursing homes, conference facilities, concert venues could be repurposed to house patients who cannot care for themselves at home. We should follow Singapore and Hong Kong who set up trailer parks and dorms along with home delivery services to those in quarantine. Patients can be monitored via telemedicine for changes in respiratory rate or oxygen saturation to indicate if they need more intensive medical care. If this occurs, they can be taken to dedicated COVID-19 hospitals, where the risk to health care workers is concentrated, and there are no other patients who will become infected by nosocomial spread.

A current issue facing hospitals is the EMTALA law that states no patient can be turned away from the hospital.  Emergency physicians fully support this law, but in this case, it creates a challenge because patients cannot be directed to a designated “COVID-19 hospital” but instead must be fully assessed at whichever hospital they present to first, thus increasing and distributing the risk of health care worker exposure to COVID-19 at additional sites.

The following policies can help containment:

• Changes to hospital policies, processes, and organization to focus on containment
• Create regulatory guidance instructing patients, EMS and health systems to allow known COVID-19 patients to be sent preferentially to COVID-19 hospitals where care can be cohorted, reducing risk other patients and health care workers
• Build or repurpose alternative housing for COVID-19 positive patients who do not need critical care and the homeless who need quarantine
• Build telemedicine services to support home care and identify patients who need to be hospitalized
• Coordinate hospitals at a state level, to allow for isolation of COVID-19 positive patients in the most efficient manner, limit risk and nosocomial spread

Protect health care workers.  Even with appropriate PPE usage, American physicians and nurses have already died. Health care workers need to be appropriately protected to conserve this vital workforce,  but also to snuff out the pandemic. In Italy, nearly one in ten of those infected are health care workers.  Health care worker infection is a driving force in the spread. It is unethical to expect health care workers to martyr themselves without proper protection. And that means appropriate PPE as well as changes to the “business as usual” processes.

The crisis standard of care is triggered by the need for containment, not by volume surges. We can accomplish this with changes to our operations. In the SARS response in Taiwain utilizing best practices for isolation and triage dramatically reduced health care worker and patient infections. In the 18 hospitals implementing these best practices, zero health care workers and only two patients developed nosocomial SARS infection. In contrast, in the 33 control hospitals, 115 HWSs, and 203 patients developed SARS. Health care workers do not need to die to provide care. If they do, it is a failure of leadership, not knowledge or technology.

Deploy federal disaster assistance. FEMA is an expert in disaster management and communications. The National Guard could be directed to provide boots-on-the-ground assistance. Among the many ways they could help:

• Deploy to hospitals and serve as “dofficers” to watch health care workers as they doff (take off) their PPE to be sure they are not self-contaminating during this most critical step
• Assist in rapid deployment of video intercom technology
• Set up tent triage to contain and limit the spread of infection
• Create community COVID-19 housing in a hotel or other location
• Assist in performing mass screening and testing
• Perform contact screening per Department of Health protocols

Expand proven public health measures:  The lack of testing has been catastrophic because traditional public health surveillance and case tracking measures have not been available. It is nearly impossible to screen for this virus, given that infected patients can be minimally symptomatic with a diverse array of symptoms. As soon as testing comes available, either PCR or antibody testing it should be ramped up and deployed as quickly as possible We will need to change our normal business practices and make this testing widely available.   We need a method to track and communicate results to patients and the department of public health.   Singapore and South Korea perform “contact tracing” on COVID-19 positive patients and isolate individuals who are at high risk of contracting the virus.  Dr. Tedros Ghebreyesus, the World Health Organization’s director-general, gives this advice: “Find, isolate, test and treat every case, and trace every contact.”

The U.S. is on the verge of becoming the new epicenter for this pandemic.  Medicine is only one small tool in this war. Society must do their part.

All of our lives will depend on it.

Amy Cho, Mark Pappadakis and Theresa Tassey are emergency physicians Sunny Jha is an anesthesiologist.

Reprinted from KevinMD.Com – Social Media’s Leading Physicans’ Voice

By Debbie Gregory.

By now you most likely know that the United States government is sending out economic impact payments or “stimulus” checks to many of its citizens. With these checks come criminals who would like to see that money in their pockets instead of yours.

We want to cover below in this article who should be getting a stimulus check as well as what scams are going on targeting these checks.

Who will get a stimulus check?

• A person who filed a federal tax return in either 2018 or 2019
• People who receive Social Security or other retirement benefits
• People who receive public benefits like SSDI, disability, or veterans’ benefits
• People who do not have to file a federal tax return, including people who made no income or made less than $12,200 (or $24,400 for married couples)

Eligible individuals do not need a minimum income for the Payment.

However, for higher income individuals, the Payment amount is reduced by 5% of the amount that your adjusted gross income exceeds:

• $75,000 for individual taxpayers
• $112,500 for taxpayers filing as head of household
• $150,000 for taxpayers filing a joint return), until it is $0.

The $1,200 Payment for eligible individuals with no qualifying children ($2,400 for married couples filing a joint return) will be reduced to $0 once adjusted gross income reaches the following thresholds:

• $198,000 for taxpayers filing a joint return
• $136,500 for taxpayers filing as head of household
• $99,000 for all others

How do you get your check?

Most people will not have to do anything. You will either receive your stimulus check through the United States mail or through direct deposit. The IRS will use the same payment method that you selected for them to use for your tax return (if applicable) in either 2018 or 2019.

If you have questions you can go directly to the IRS’ site at irs.gov/coronavirus.

For example:

• If the IRS doesn’t have your direct deposit information and you would prefer they directly deposit your check simply click on “Get My Payment” and let them know where to send your direct deposit
• If you don’t usually file a tax return, click “Non-filer” to figure out what you need to do to claim your money, if anything
• To check on the status of your payment, click on “Get My Payment”

Avoiding Stimulus Payment Scams:

Unsurprisingly criminals are targeting these stimulus checks. What should you be on the lookout for? Some criminals are trying to convince people that they need to pay a fee to receive their stimulus payment, you do not have to pay any fee(s). They are also trying to get people to give them their Social Security number, bank account number, or government benefits debit card account number, DON’T!

• Only use the IRS’s official website (irs.gov/coronavirus) to submit information to the IRS regarding your stimulus check
• The IRS will NEVER contact you by phone, email, text message, or social media with information about your stimulus payment
• The IRS will NEVER ask you for your Social Security number, bank account, or government benefits debit card account number
• There are zero fees that you need to pay in order to get your stimulus money

If you have seen any of these types of scams please report them to the Federal Trade Commission at ftc.gov/complaint.

If you want more information or simply wish to keep up with the latest scams, sign up for the FTC’s consumer alerts.