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Be vigilant about bug spray
Ticks and mosquitoes don’t care about COVID-19 safety protocols. They don’t care that people are trying to squeeze out the last moments of this restrictive summer by getting outdoors, hiking, or just sitting on their decks at night and feeling something that’s close to normal.
COVID-19 has commanded our attention and caused people to adapt their behaviors to prevent one major health concern, but it doesn’t mean others have been eliminated. “Masks and social distancing will do nothing to protect you from what ticks and mosquitoes potentially carry,” says Dr. Todd Ellerin, director of infectious diseases and vice chairman of the department of medicine at South Shore Hospital in Weymouth, Massachusetts, and an instructor in medicine at Harvard Medical School.
Ellerin adds another reason to remain vigilant: tick-borne illnesses and COVID-19 share symptoms, such as fevers, achiness, fatigue, sore throats, rashes, headaches, low white blood cell counts, and elevated liver functions. One illness can be confused for the other, and health care resources are used up in the process. “It adds another level of diagnostic confusion,” he says. It means taking the necessary precautions becomes more important now, but the upside is one repellent is effective for both insects.
What are some common tick- and mosquito-borne illnesses?
This list isn’t exhaustive, but common viruses associated with ticks include Lyme disease, anaplasmosis, and babesiosis. They all can occur nationwide, but the highest concentrations are in the northeast and Midwest. Borrelia miyamotoi is relatively new and rare, according to the Centers for Disease Control and Prevention, so questions about where it’s most prevalent are still being explored. And with Rocky Mountain spotted fever, over 50% of cases come from five states in the southeast and Midwest.
Common mosquito viruses include malaria, Zika, West Nile, and Eastern equine encephalitis (EEE). The CDC calls EEE rare, but Ellerin says that last year there was a spike. Massachusetts, for example, had 12 cases after reporting none from 2014 to 2018. The concern with EEE is that the virus usually runs in two-to-three-year cycles, and approximately 30% of people who become infected will die from it; that’s why mosquitoes shouldn’t be ignored. “Globally, mosquitoes actually are the most dangerous animal, causing the most deaths,” says Ellerin.
Bug spray is a safe and effective prevention strategy
Taken all together, the risks of contracting a serious illness from a tick or mosquito can seem overwhelming. However, it may be reassuring to know that over-the-counter bug sprays work well to repel ticks and mosquitoes through one of three common active ingredients: oil of lemon-eucalyptus, picaridin, or diethyltoluamide, better known as DEET. Permethrin is another one, but it’s an insecticide and is designed to be used on clothing, not skin. Ellerin says that whichever bug spray ingredients you choose, they’re safe and effective when used according to their labels.
Find the repellent that’s right for you
The choice may just come down to preference or need. DEET is the most well-known, but it can cause irritation, says Dr. Abigail Waldman, clinical director of the Mohs and Dermatologic Surgery Center at Brigham and Women’s Hospital, and assistant professor at Harvard Medical School. If that’s the case, picaridin is best for sensitive skin. Some people may prefer not to use a chemical, so oil of lemon-eucalyptus is a good option. There are two caveats, she says. It’s not recommended for children under 3 years old, and a botanical can still cause a rash; for that, after you wash with soap and water, apply an emollient, such as Vaseline or Aquaphor.
No matter what type of bug spray you choose, the concentration of the active ingredient that repels ticks and mosquitoes is important. Waldman says with DEET, you want at least 20%, but no more than 50%. With picaridin, it’s 5% to 20%. And with oil of lemon-eucalyptus, a 10% to 30% concentration is most effective.
How to safely use it
Pay attention to how you apply bug spray. Cover all exposed skin; don’t forget your head, Waldman says. For your face, spray it onto your hands first and then apply. Ellerin adds to spray your ankles and tops of shoes for low-lying ticks. And as a further means of prevention, it helps to walk on clear paths, avoiding tall grass where ticks like to reside. Wear clothes that cover your extremities and tuck pant legs into your socks. At home, mow your lawn frequently, clear away brush, and keep play areas away from shrubs, bushes, and wooded areas.
Waldman says that each parent knows the abilities of their kids, but young children shouldn’t handle bug spray on their own. The concern is that it would go into eyes, noses, ears, or mouths, and that young children tend to put their fingers in their mouths. At high exposure it can be toxic, so it’s good to avoid ingesting it at any level, and it’s a good idea for everyone to wash their hands after putting on repellent, she says.
If you’re planning to be in the sun, apply sunscreen first since it needs to sink in, then bug spray, and reapply sunscreen every 60 to 90 minutes since the repellent reduces effectiveness. As for the repellent, it usually lasts six to eight hours. If it hasn’t worn off by bedtime, you’ll want to wash it off with soap and water, as it can be irritating if left on overnight. Unless you are camping overnight in an area with ticks or mosquitoes, you don’t want it sitting on your skin if insects aren’t a concern. “If you don’t need it on, get it off,” Waldman says.
The post Be vigilant about bug spray appeared first on Harvard Health Blog.
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Mental Health in the Digital Realm
In the time of a global health crisis, when we are asked to close our doors and forced into isolation, we are left feeling deeply uncomfortable and disconnected. We have no option but to sit, stew and stir in our thoughts and emotions. The one thing that is keeping us sane, helping us feel connected and cared for and allowing us to move through the day, is the digital world. The online space is increasingly being recognized as a platform to encourage conversations around mental health. Whether it is noticing symptoms, exploring ways to cope or validating a person’s experience, it has transformed into a tool to champion the cause of caring for one’s well-being.
However, this is not a recent phenomenon. Since globalization, the development of the internet has transformed the way we access and share information, express ourselves and interact with others. We are witness to mental health emerging in the digital space. Therapists and researchers are moving beyond office walls to disseminate information. Similarly, supporters of mental health have found space for advocacy; people are able to talk about their experience of therapeutic interventions, and most importantly, individuals have discovered a place to communicate their struggles, have their voices heard and feel connected to and supported by others.
Finding a Voice Online
Traditionally speaking, the public space has been a gendered (‘male’), highly politicized domain, while minorities have been identified in the margins (Spain, 1993). Their suppression and erasure in mainstream narratives through discrimination, harassment and violence has restrained their expression, mobility and autonomy. With the development of the digital space and rise in consciousness, marginalized voices are gradually being recognized and represented. By viewing social media platforms as an extension of themselves, a medium for self-expression, they are able to share intimate details of their identities and stories (Cerni & Talmund, 2015). They provide a platform for others to practice vulnerability and unravel and explore experiences, characterized by shame and isolation, together. This has fostered connection, meaning and belonging in the online space, promoted a collaborative learning environment and encouraged marginalized communities to be seen and heard (Ansari & Khan, 2020; Leevar, 2017).
LGBTQIA, survivors of abuse and disabled community, to name a few, have created online safe spaces to hone their narratives, create awareness, dispel myths and share their difficulties and experiences for the wider audience to reflect upon. The hope is that it will spark conversations among families and peers, with a rippling effect to transform the social fabric of communities towards inclusivity and solidarity (Carras et al., 2018).
The Changing Paradigm of Therapy
De-stigmatization, psycho-education, empowerment and advocacy of individuals and communities in the online space have allowed mental health to move beyond clinical contexts. Conversations on mental health have become commonplace and are now open, accessible and available to many. This has changed the paradigm of therapy. With the intention of bringing insight and understanding to the general audience, practitioners have begun sharing their work publicly on social media platforms. They have now become a part of the larger conversation and provide the community with tools, support, and resources for those seeking it.
Therapists are sharing truths about caring for one’s emotional and mental well-being, describing what it means to be human and highlighting nuances to concepts of self-worth, attachment patterns and boundaries. There is value and responsibility in disseminating information therapists have been privileged to learn. It would be a disservice to keep this knowledge reserved for clients only, when so many can and do benefit from having access to it on their own time, from wherever they are. Opening up these conversations empowers people to care for their health. People are encouraged to explore themselves, think about specific themes and concepts, have tangible tools to discuss in therapy and are provided resources for self-reflection.
Although these platforms are not a replacement for individualized therapy, they do provide information to people who cannot access therapy, are figuring out how to access therapy, or are in therapy. It demystifies the idea that therapy is only for the deeply distressed and shifts the narrative of what support can look like; how accessible, relatable and approachable therapy can be. The ability to access low-barrier mental health information on social media can also be especially valuable to people from cultures in which mental health is seen as taboo, and introduce the idea of help-seeking in a gentle way. Additionally, the parts of themselves therapists choose to share online, reminds the audience that therapists are indeed human too and this is disrupting the power differentials that often keep people from seeking therapy in the first place. Overall, individuals are able to view therapy as a supportive, valuable part of their lives rather than scary and isolating.
Organizations Leveraging Technology to Address the Treatment Gap
Mental Health Organizations are also leveraging technology to spread awareness, provide services and build capacity of individuals and communities. In countries with abysmally low mental health professionals, organizations are addressing both the demand and supply aspect of mental health services online.
Apps tracking mental well-being, therapy chat-bots powered through artificial intelligence, online counseling, social media awareness campaigns and virtual safe space groups provide anonymous and affordable alternatives to those who cannot access conventional mental health facilities or are hesitant to do so. Additionally, through online courses, webinars and simulations, organizations are building the skills and capacity of non-specialists, within communities, as a way to close the treatment gap of mental health conditions in India. This approach has allowed mental health to move away from the medical model and towards a holistic framework, focused on community care and collective responsibility.
Limitations and Concerns
The online space cannot replace human-centered connection or cater to personalized care. No post, podcast or video can capture the complexity of being human, the essence of every individual’s experience or substitute the value of a therapeutic relationship.
The limits of social media are typically made clear through disclaimers and reminders. However, concerns of stigma, cyber-bullying, misinformation, poor representation and irresponsibility among professionals (lack of professional boundaries and inability to follow ethical guidelines) continue to threaten the conversation on mental health in the digital space. Therefore, developing digital literacy and being mindful of one’s use of the platform is important (OECD, 2018). Additionally, the audience may tailor their feed to reflect their values and interests, and along with professionals practice ethics, boundaries, integrity and intention.
Concluding Thoughts
There is an incredibly inspiring public shift in how we as a society think about mental health and seeking support for ourselves and each other. The online presence has created a safe space to have these conversations and as a result, fostered meaningful connections between people, worldwide. This community connection and healing is powerful and integral during difficult times, especially those we collectively experience together. In the time of a global pandemic, people are encouraged to compassionately explore mental health in the digital realm.
References
Ansari, J. & Khan, N. (2020). Exploring the role of social media in collaborative learning the new domain of learning. Smart Learning Environments, 7 (9).
Carras, M. et al. (2018). Commercial Video Games as Therapy: A New Research Agenda to Unlock the Potential of a Global Pastime. Frontier Psychiatry. http://dx.doi. org/10.3389/fpsyt.2017.00300.
Cerni, R. T., & Talmud, I. (2015). To Know that you are Not Alone: The Effect of Internet Usage on LGBT Youth’s Social Capital. Studies in Media and Communications, 9, 161-182.
OECD. (2018). Children and Young People’s Mental Health in the Digital Age: Shaping the Future. OECD Publishing. www.oecd.org/els/health-systems/Children-and-Young-People-Mental-Health-in-the-Digital-Age.pdf.
Spain, D. (1993). Gendered Spaces and Women’s Status. Sociological Theory, 11 (2). DOI: 10.2307/202139.
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