huffpost--2020-03-27--Addiction Treatment Centers Struggle To Serve Patients As Coronavirus Spreads

SEATTLE ― The spread of COVID-19 has presented a unique challenge to those fighting another life-threatening epidemic : substance use disorders , which affect about 20 million American adults each year .
Residential treatment centers , which are based on a model of group therapy and interaction among patients , are scrambling to adapt to the Centers for Disease Control and Prevention ’ s guidelines .
Those treatment centers are also facing a more existential threat : As potential patients stay away for fear of contracting the coronavirus , many smaller and publicly funded centers could run out of money @ @ @ @ @ @ @ when social isolation is driving many people with addictions to relapse .
Treatment centers are considered “ essential critical infrastructure ” under the federal guidelines that most states are using to determine which services are exempt from requirements to shelter in place .
But in order to keep people safe , they ’ re being forced to adapt in ways that go against normal methods of treatment , forgoing things like group meetings , family visits and open-door policies .
“ No one can just walk up to a treatment center anymore , @ @ @ @ @ @ @ of the American Society for Addiction Medicine , which put out its own COVID-19 guide for providers .
“ The overarching issue here is to balance the risks of the two illnesses : the risk of contracting coronavirus and developing COVID-19 versus the risk of not getting treatment for the disease of addiction.
” McKee said the need to implement social distancing — for example , by reducing the number of patients who sleep in the same room — can be hard to balance with the desire to take care of as many @ @ @ @ @ @ @ know what kind of burden it is to say , ’ We know this person needs this level of care , but we also have people right here who are sitting ducks [ for infection ] ?
” she said .
If tests for COVID-19 were available , she said , her treatment center would be able to admit or reject patients .
For now , all they can do is screen for symptoms and hope for the best .
To keep the virus out , treatment centers are cleaning more thoroughly and @ @ @ @ @ @ @ patients ’ temperatures regularly , and implementing social distancing in all group activities .
That means putting space between chairs in group therapy , spacing out or canceling mass lectures , discharging some patients early if they seem stable enough to leave without relapsing , banning hugs and eliminating visits from friends and family , among other measures that fundamentally change the nature of rehab .
At Hazelden , they ’ re even requiring new patients to come prepared with a discharge plan just in case they get infected and need to leave @ @ @ @ @ @ @ this , we want to catch it as early as possible and try and prevent that [ initial ] transmission , ” Seppala said .
Evan Haines , the co-founder and director of Alo House Recovery Centers in Los Angeles , said his staff is mostly still coming in to work , but many therapy sessions have moved to online platforms .
Haines called the remote sessions a “ stopgap ” measure .
“ Addiction treatment is something that could never be done remotely on a long-term basis because the whole nature of @ @ @ @ @ @ @ struggle is finding the supplies to keep facilities safe amid the COVID-19 crisis .
Treatment center directors , advocates and industry groups all said that inpatient facilities are facing critical shortages of supplies needed to prevent COVID-19 transmission among their vulnerable patients — everything from N95 respirator masks to bleach wipes to alcohol-based hand sanitizer , which many treatment centers don ’ t usually keep on hand because patients occasionally drink it .
Sundown M Ranch has no personal protective equipment , or PPE , of any kind .
Olalla has just “ @ @ @ @ @ @ @ , according to McKee , and is also short on thermometers and cleaning supplies .
Hazelden is hoping to get hand sanitizer from one of the distilleries that has shifted production from whiskey to grain ethanol .
And treatment programs aren ’ t just running out of supplies ; with fewer patients , many smaller rehabs , particularly those that take Medicare and Medicaid patients , are blazing through their funds .
Earley said that , unlike much of the medical system , “ addiction care is woefully underfunded .
We ’ re @ @ @ @ @ @ @ worst addiction epidemics that we ’ ve had in my career , and centers are closing .
It ’ s definitely a huge issue.
” Munson , from Sundown M Ranch , said that any state or federal stimulus package needs to include funding to help keep addiction treatment providers afloat .
The $ 2.2 trillion emergency stimulus package that passed the Senate on Thursday includes funding for mental health clinics , but experts in the industry say it ’ s unclear how much if any of that will trickle down to residential @ @ @

FollowTheFlow via Getty Images
SEATTLE ― The spread of COVID-19 has presented a unique challenge to those fighting another life-threatening epidemic: substance use disorders, which affect about 20 million American adults each year. Residential treatment centers, which are based on a model of group therapy and interaction among patients, are scrambling to adapt to the Centers for Disease Control and Prevention’s guidelines.
Those treatment centers are also facing a more existential threat: As potential patients stay away for fear of contracting the coronavirus, many smaller and publicly funded centers could run out of money and close their doors at a time when social isolation is driving many people with addictions to relapse.
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“Historically, whenever there’s a crisis in the U.S., alcohol sales and illicit drug sales increase dramatically,” said Dr. Marvin Seppala, the chief medical officer at the Hazelden Betty Ford Foundation in Beaverton, Oregon. “Day-to-day things are suddenly stressful .... In the long run, there’s going to be an increased need for treatment.”
Treatment centers are considered “essential critical infrastructure” under the federal guidelines that most states are using to determine which services are exempt from requirements to shelter in place. But in order to keep people safe, they’re being forced to adapt in ways that go against normal methods of treatment, forgoing things like group meetings, family visits and open-door policies.
Melody McKee, who until last week was the clinical program director for Olalla Recovery Services in Olalla, Washington, said her treatment center made “the difficult decision” to implement a triage system for admissions.
“The way it will work is, like, ‘Is this person literally not going to make it if they do not enter this location?’” said McKee.
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A person experiencing homelessness with no ability to access tele-health would rank high on the triage list, as would someone leaving detox who seems likely, based on their medical history, to go out and drink or use again.
Other factors that might push someone to the front of the line: frequent falls, past failure to follow through with opiate replacement therapy, suicide attempts and meth-induced psychosis. Those who don’t rank high on this kind of triage list may be turned away from treatment.
It’s a brutal calculus and a stark shift for treatment providers and advocates who have spent decades arguing for treatment on demand.
“No one can just walk up to a treatment center anymore,” said Dr. Paul Earley, president of the American Society for Addiction Medicine, which put out its own COVID-19 guide for providers. “The overarching issue here is to balance the risks of the two illnesses: the risk of contracting coronavirus and developing COVID-19 versus the risk of not getting treatment for the disease of addiction.”
Inpatient Facilities Make Tough Choices
McKee said the need to implement social distancing — for example, by reducing the number of patients who sleep in the same room — can be hard to balance with the desire to take care of as many patients as possible.
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“Do you know what kind of burden it is to say, ’We know this person needs this level of care, but we also have people right here who are sitting ducks [for infection]?” she said.
If tests for COVID-19 were available, she said, her treatment center would be able to admit or reject patients. For now, all they can do is screen for symptoms and hope for the best.
The tight quarters at residential treatment centers and the medically fragile condition of most people with serious, long-term addiction make them ideal breeding grounds for infection. Long-term intravenous drug users often suffer from a heart infection called endocarditis; people who smoke crack, meth or marijuana may have diminished lung capacity; and heavy drinkers may have multiple organ failure and a suppressed immune system.
“These are not healthy individuals,” said Lauren Davis, executive director of the Seattle-based Washington Recovery Alliance. “People whose disease is advanced enough that it would necessitate inpatient treatment are pretty much universally in the high-risk category.”
To keep the virus out, treatment centers are cleaning more thoroughly and often, checking both staffers’ and patients’ temperatures regularly, and implementing social distancing in all group activities. That means putting space between chairs in group therapy, spacing out or canceling mass lectures, discharging some patients early if they seem stable enough to leave without relapsing, banning hugs and eliminating visits from friends and family, among other measures that fundamentally change the nature of rehab.
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Fears of the growing coronavirus pandemic have changed rehab treatment, including close-contact group therapy sessions. KatarzynaBialasiewicz via Getty Images
At Hazelden, they’re even requiring new patients to come prepared with a discharge plan just in case they get infected and need to leave treatment early. “If we get this, we want to catch it as early as possible and try and prevent that [initial] transmission,” Seppala said.
Scott Munson, the CEO of Sundown M Ranch treatment center outside Yakima, Washington, said eliminating family visits has been the hardest change to swallow. “We’re really known for the quality and extent of our family involvement, and unfortunately we’ve discontinued that.”
‘Stopgap’ Measures
Evan Haines, the co-founder and director of Alo House Recovery Centers in Los Angeles, said his staff is mostly still coming in to work, but many therapy sessions have moved to online platforms. Haines called the remote sessions a “stopgap” measure. “Addiction treatment is something that could never be done remotely on a long-term basis because the whole nature of addiction is rooted in isolation.”
Another struggle is finding the supplies to keep facilities safe amid the COVID-19 crisis. Treatment center directors, advocates and industry groups all said that inpatient facilities are facing critical shortages of supplies needed to prevent COVID-19 transmission among their vulnerable patients — everything from N95 respirator masks to bleach wipes to alcohol-based hand sanitizer, which many treatment centers don’t usually keep on hand because patients occasionally drink it.
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Sundown M Ranch has no personal protective equipment, or PPE, of any kind. Olalla has just “10 to 15 masks” on hand, according to McKee, and is also short on thermometers and cleaning supplies. Hazelden is hoping to get hand sanitizer from one of the distilleries that has shifted production from whiskey to grain ethanol.
“It’s an unusual place for us to find supplies,” he acknowledged wryly.
And treatment programs aren’t just running out of supplies; with fewer patients, many smaller rehabs, particularly those that take Medicare and Medicaid patients, are blazing through their funds. Earley said that, unlike much of the medical system, “addiction care is woefully underfunded. We’re in the middle of one of the worst addiction epidemics that we’ve had in my career, and centers are closing. It’s definitely a huge issue.”
Munson, from Sundown M Ranch, said that any state or federal stimulus package needs to include funding to help keep addiction treatment providers afloat. The $2.2 trillion emergency stimulus package that passed the Senate on Thursday includes funding for mental health clinics, but experts in the industry say it’s unclear how much if any of that will trickle down to residential treatment centers.
Without outside help, Munson said, “you’ll lose beds, you’ll lose capacity and ultimately you won’t be able to replace that capacity.” The treatment industry is very capital-intensive, he said, and many facilities don’t have the reserves to retain staff if there’s a major reduction in patients. They’d likely shut down.
In the last two months, at least five treatment centers in Washington state have shut down or are about to close — three 16-bed detox centers, a rehab for low-income Native Americans and a private treatment center for women.
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Davis, with the Washington Recovery Alliance, said it isn’t just treatment centers and their staff who will suffer if they have to close their doors; patients who may have spent years working up the nerve to go to treatment will go without care.


huffpost--2020-03-27--Is It Coronavirus Or Anxiety? Yes, Some Symptoms Can Be Similar.

We ’ re navigating unprecedented times .
As the novel coronavirus continues to spread across the globe , many of us have found ourselves stuck in a cycle of anxiety and fear .
Is that tightness in your chest and the shortness of breath just your body reacting to the uncertainty around you , or could you have possibly picked up COVID-19 ?
Some of the symptoms associated with anxiety and COVID-19 can overlap .
Because of that , it can be hard to determine what you ’ re experiencing in the moment when you ’ re spiraling .
Here @ @ @ @ @ @ @ .
While difficulty breathing is a major known symptom of both anxiety and COVID-19 , there are a couple key things that ’ ll help you differentiate one from the other .
In order to understand what you ’ re dealing with , Denniston suggested taking a few moments to check in with yourself and try to think about what you were focused on before your symptoms began .
“ Maybe you ’ ve been focused on the news , financial stress or worry about finding the supplies you need , ” she @ @ @ @ @ @ @ history of anxiety ?
If so , how does what you ’ re feeling now compare to anxiety you ’ ve experienced in your body before ?
” Another quick self-check you can do is to try talking , said Anthony Freire , the clinical director and founder of the Soho Center for Mental Health Counseling in New York .
Freire , whose doctor believed he contracted the virus and has since recovered , said the most difficult part of dealing with the virus was the respiratory issues .
“ They feel the @ @ @ @ @ @ @ t get enough air , shallow breathing , ” he said .
“ If you ’ re experiencing shortness of breath , call someone .
If you ’ re able to speak and they understand you , and you aren ’ t gasping for air , then it ’ s most likely anxiety.
” How To Handle Anxiety Surrounding The Coronavirus “ If you had no anxiety whatsoever , you ’ ll probably stop observing social distancing and put yourself at risk , ” Osibodu-Onyali said .
“ When there is a new @ @ @ @ @ @ @ be alert .
Anxiety occurs because of all the unknown factors — no known cure , no known timeline about when social distancing will end and no previous experience with a pandemic.
” Lots of people have the news on 24/7 .
All this does is it increases your anxiety .
If you spend all day thinking about COVID-19 , it gives the false impression that it is the only important thing in the world .
Allow yourself to take a break .
There ’ s a lot we don ’ t know @ @ @ @ @ @ @ what kind of person you can be during all of this : Someone who follows expert recommendations , brings a smile to others by posting positive messages on social media , reaches out to loved ones and creates structure in your home .
By now , you probably know the things you should be doing to prevent picking up the virus — like washing your hands with soap and water for at least 20 seconds , not touching your face with unwashed hands and limiting contact with folks through social distancing — but @ @ @ @ @ @ @ as well .
Try to eat healthy meals , said Linda Anegawa , a physician at telehealth platform PlushCare .
You should also aim for at least seven hours of sleep and go for social distancing walks when you can ― especially if the weather is nice .
Getting adequate sun exposure , therefore vitamin D , can keep you healthy , Denniston added .

sam thomas via Getty Images
We’re navigating unprecedented times. As the novel coronavirus continues to spread across the globe, many of us have found ourselves stuck in a cycle of anxiety and fear. Is that tightness in your chest and the shortness of breath just your body reacting to the uncertainty around you, or could you have possibly picked up COVID-19?
Some of the symptoms associated with anxiety and COVID-19 can overlap. Because of that, it can be hard to determine what you’re experiencing in the moment when you’re spiraling. Here’s what you need to know.
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Anxiety Symptoms vs. COVID-19 Symptoms
“There are a few symptoms of COVID-19 that overlap with anxiety symptoms, such as shortness of breath, chest tightness, loss of appetite and diarrhea,” according to Kate Denniston, a licensed naturopathic doctor at Los Angeles Integrative Health.
While difficulty breathing is a major known symptom of both anxiety and COVID-19, there are a couple key things that’ll help you differentiate one from the other. In order to understand what you’re dealing with, Denniston suggested taking a few moments to check in with yourself and try to think about what you were focused on before your symptoms began.
“Maybe you’ve been focused on the news, financial stress or worry about finding the supplies you need,” she said. “Do you have a history of anxiety? If so, how does what you’re feeling now compare to anxiety you’ve experienced in your body before?”
If you were able to calm yourself down and find a steady breathing pattern within those few minutes, you may not be dealing with the coronavirus.
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“Shortness of breath associated with the COVID-19 infection is progressive in nature and can become life-threatening over a period of hours to days without medical care,” Sarah Johnson, chief medical officer at Landmark Recovery, said.
Another quick self-check you can do is to try talking, said Anthony Freire, the clinical director and founder of the Soho Center for Mental Health Counseling in New York. Freire, whose doctor believed he contracted the virus and has since recovered, said the most difficult part of dealing with the virus was the respiratory issues.
“They feel the same. Closed throat, can’t get enough air, shallow breathing,” he said. “If you’re experiencing shortness of breath, call someone. If you’re able to speak and they understand you, and you aren’t gasping for air, then it’s most likely anxiety.”
Another way to differentiate between COVID-19 and conditions with similar presentations include the presence of a persistent fever, typically above 100 degrees Fahrenheit.
“You might also experience other symptoms that won’t be present during an anxiety attack: a dry cough, aches and pains, tiredness and congestion,” said Ibinye Osibodu-Onyali, a licensed therapist in Murrieta, Calfornia.
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fizkes via Getty Images
How To Handle Anxiety Surrounding The Coronavirus
First of all, understand that you aren’t alone in this struggle and that feeling anxious right now is completely normal.
“A little bit of anxiety is good because it keeps you alert. It is your body’s way of protecting you from harm,” Osibodu-Onyali said.
It’s that bit of anxiousness that will “trigger you to wash your hands, stay home and just be prepared,” she added.
“If you had no anxiety whatsoever, you’ll probably stop observing social distancing and put yourself at risk,” Osibodu-Onyali said. “When there is a new situation, it is totally normal to be alert. Anxiety occurs because of all the unknown factors — no known cure, no known timeline about when social distancing will end and no previous experience with a pandemic.”
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In order to deal with the anxiety experienced during this time, Osibodu-Onyali offered a few suggestions:
Create a schedule for yourself.
Millions of people have suddenly been thrust into working from home and homeschooling. Don’t just lounge in your pajamas all day, but have a workable schedule for you and your family.
Turn off the news for a while.
Lots of people have the news on 24/7. All this does is it increases your anxiety. If you spend all day thinking about COVID-19, it gives the false impression that it is the only important thing in the world. Allow yourself to take a break.
Focus on what you can do.
There’s a lot we don’t know right now. But you can control what kind of person you can be during all of this: Someone who follows expert recommendations, brings a smile to others by posting positive messages on social media, reaches out to loved ones and creates structure in your home.
Coronavirus Preventative Measures Worth Taking
While you’re working to keep the anxiety in check, don’t forget to also stay protected from COVID-19 through necessary health measures.
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By now, you probably know the things you should be doing to prevent picking up the virus — like washing your hands with soap and water for at least 20 seconds, not touching your face with unwashed hands and limiting contact with folks through social distancing — but don’t forget to practice self-care as well.
Try to eat healthy meals, said Linda Anegawa, a physician at telehealth platform PlushCare. You should also aim for at least seven hours of sleep and go for social distancing walks when you can ― especially if the weather is nice. Getting adequate sun exposure, therefore vitamin D, can keep you healthy, Denniston added.
If you are dealing with symptoms associated with COVID-19, call your doctor or make a telehealth appointment before heading to the hospital. Monitor your temperature and track any other issues you might be having so you can communicate it to a professional.
However, there are some cases where you should seek help right away, Johnson said.
“Symptoms that signal a medical emergency and need for immediate medical attention include respiratory distress, confusion and mental status changes or high fever,” she said. “Individuals with known health problems ― such as diabetes, immune disorders and heart disease, or those in higher risk age groups ― should consult with medical providers at the first concern for infection.”


huffpost--2020-03-27--The U.S. Military Hasn’t Faced A Threat Like Coronavirus For A Century

Commanders are still requiring their subordinates to stand in close proximity during formation exercises on the base and to do physical training in the morning that involves activities like “ body drags ” and “ fireman carries , ” which require grabbing and touching other , perspiring Marines , the Marine said .
“ The six feet of social distancing was not being enforced , ” the airman said , referring to the Centers for Disease Control and Prevention recommendations that people maintain two yards of space between each other .
As America edges ever closer to being the deadly @ @ @ @ @ @ @ which has already infected over 80,000 and killed over 1,000 nationwide and led to unprecedented shelter-in-place orders in multiple states — there is growing concern among troops , their families , and epidemiologists that the Department of Defense hasn ’ t done enough to slow the spread of the virus in the military , which includes 1.4 million active-duty service members and has historically been vulnerable to outbreaks .
On Thursday , the military newspaper Task & Purpose — which has done excellent work documenting the coronavirus outbreak in the armed forces — @ @ @ @ @ @ @ Department of the Army at the Pentagon to all U.S. Army commands .
The document warned additional measures and actions needed to be taken to prevent the virus from spreading further , and instructed rapid response forces at bases in the U.S. and abroad to go into “ Health Protection Condition Delta , ” the highest level of alert .
The military has already taken many drastic measures to slow the spread of the virus — including closing schools , restaurants and other businesses on bases , and allowing service members to work @ @ @ @ @ @ @ .
But the Defense Department has also instituted a policy of “ commander ’ s discretion ” when it comes to putting troops in formation and requiring them to conduct physical training exercises .
“ I can ’ t put out a blanket policy , if you will , that we would then apply to everybody , because every situation is different , ” Defense Secretary Mark Esper said earlier this week when questioned about the military ’ s response .
“ Tell me how I do six feet distancing in an attack @ @ @ @ @ @ @ that in a bomber with two pilots sitting side by side ?
” While it ’ s tough to avoid close contact in the military , particularly during training , ignoring social distancing practices could also put service members at risk .
“ This is a very real threat to military personnel , ” Gray said , noting that military reserve units are being deployed across the country to fight the pandemic .
“ You know , usually they go in harm ’ s way , generally with fighting a war with weapons @ @ @ @ @ @ @ another example on how they ’ re going to be mobilized to fight an emerging pathogen.
” The U.S. military has faced the threat of disease before .
The 1918 Spanish flu outbreak killed nearly 700,000 Americans , including 45,000 U.S. soldiers , and is widely believed to have spread across this country in large part due to the mass movement of U.S. troops in and out of bases .
“ The military ’ s dirty little secret , if you will , is that it is highly susceptible as an organization to @ @ @ @ @ @ @ ” Dr. Nevin said .
Without the rapid development of vaccines and other countermeasures , he added , “ military personnel are at significantly increased risk by nature of the military environment .
”

LOADING ERROR LOADING
U.S. troops and their families stationed across the country are growing anxious and angry over what they say is their commanders’ lackadaisical response to the coronavirus pandemic.
“Marines are pissed,” said one low-level enlisted Marine stationed at Camp LeJeune in North Carolina who spoke to HuffPost recently on the condition of anonymity out of fear of reprisal.
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Commanders are still requiring their subordinates to stand in close proximity during formation exercises on the base and to do physical training in the morning that involves activities like “body drags” and “fireman carries,” which require grabbing and touching other, perspiring Marines, the Marine said.
Across the country at Joint Base Lewis-McChord near Tacoma, Washington, an Air Force airman sent HuffPost photos of other servicemen on the base standing in formation and playing basketball together.
He also says he witnessed groups of soldiers take the Army Combat Fitness Training test together without disinfecting the required gym equipment afterward.
“The six feet of social distancing was not being enforced,” the airman said, referring to the Centers for Disease Control and Prevention recommendations that people maintain two yards of space between each other.
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(Photo by Andy Altenburger/Icon Sportswire via Getty Images) Illustration: Damon Dahlen/HuffPost; Photos: Getty Images
As America edges ever closer to being the deadly epicenter of the historic coronavirus pandemic — which has already infected over 80,000 and killed over 1,000 nationwide and led to unprecedented shelter-in-place orders in multiple states — there is growing concern among troops, their families, and epidemiologists that the Department of Defense hasn’t done enough to slow the spread of the virus in the military, which includes 1.4 million active-duty service members and has historically been vulnerable to outbreaks.
The latest Defense Department figures show the number of confirmed coronavirus cases in the U.S. armed forces rising fast. There were 224 confirmed cases among service members as of Wednesday morning; 81 among military employees; 67 among military dependents; and 40 among military contractors.
On Thursday, the military newspaper Task & Purpose — which has done excellent work documenting the coronavirus outbreak in the armed forces — obtained an alarming document sent by the Department of the Army at the Pentagon to all U.S. Army commands.
“Mitigation measures taken by the U.S. Army to blunt the spread of COVID-19 have proven insufficient,” the message read. “COVID-19 continues to spread geographically as the number of infected persons continues to rise.”
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The document warned additional measures and actions needed to be taken to prevent the virus from spreading further, and instructed rapid response forces at bases in the U.S. and abroad to go into “Health Protection Condition Delta,” the highest level of alert.
The military has already taken many drastic measures to slow the spread of the virus — including closing schools, restaurants and other businesses on bases, and allowing service members to work from home if they’re able. But the Defense Department has also instituted a policy of “commander’s discretion” when it comes to putting troops in formation and requiring them to conduct physical training exercises.
That means that different commanders are observing ― or not observing ― matters to protect safety differently.
“The military’s dirty little secret, if you will, is that it is highly susceptible as an organization to outbreaks of particularly respiratory infectious illness.” - Dr. Remington Nevin, a physician and former Army epidemiologist
“I can’t put out a blanket policy, if you will, that we would then apply to everybody, because every situation is different,” Defense Secretary Mark Esper said earlier this week when questioned about the military’s response. “Tell me how I do six feet distancing in an attack submarine. Or how do I do that in a bomber with two pilots sitting side by side?”
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During a virtual town hall, Esper encouraged commanders to “avoid putting a large number of people in small rooms” and to “get that social distancing as best you can.”
Esper’s comments came amid multiple reports of commanders not taking the threat of the coronavirus too seriously. Last week, ProPublica reported that Navy leadership aboard the USS Boxer, a San Diego-based ship, crammed 80 senior enlisted sailors and officers into a small room to hold a meeting about, ironically, the coronavirus crisis.
It’s a difficult task for the Defense Department to strike a balance between military readiness and keeping troops safe from the virus, said Dr. Gregory Gray, a former navy epidemiologist who is now a professor at Duke University’s Global Health Institute Division of Infectious Diseases.
While it’s tough to avoid close contact in the military, particularly during training, ignoring social distancing practices could also put service members at risk. “This is a very real threat to military personnel,” Gray said, noting that military reserve units are being deployed across the country to fight the pandemic.
“You know, usually they go in harm’s way, generally with fighting a war with weapons in mind. But here’s another example on how they’re going to be mobilized to fight an emerging pathogen.”
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Men gargle with salt and water as a preventive measure against the influenza epidemic at Camp Dix, New Jersey, in September 1918. Photo by PhotoQuest/Getty Images
The U.S. military has faced the threat of disease before. The 1918 Spanish flu outbreak killed nearly 700,000 Americans, including 45,000 U.S. soldiers, and is widely believed to have spread across this country in large part due to the mass movement of U.S. troops in and out of bases.
Dr. Remington Nevin, a physician and former Army epidemiologist, told HuffPost that the “U.S. military has done a poor job of operationalizing the lessons from the 1918” pandemic.
“The military’s dirty little secret, if you will, is that it is highly susceptible as an organization to outbreaks of particularly respiratory infectious illness,” Dr. Nevin said. Without the rapid development of vaccines and other countermeasures, he added, “military personnel are at significantly increased risk by nature of the military environment.”
Still, Nevin sounded some notes of cautious optimism. The bulk of U.S. service members are young and healthy, he noted, and are thus less likely to be killed by the virus.
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huffpost--2020-03-27--New Orleans Judges Order Release Of Some Prisoners From Jail Amid Coronavirus Crisis

Judges from the Orleans Parish Criminal Court ordered the release from jail of some pretrial defendants and low-level offenders in an effort to mitigate the risk of coronavirus .
The judges ’ Wednesday order requires the sheriff ’ s office to “ immediately release ” people who who are in jail because they are awaiting trial for a misdemeanor offense , they were arrested for failing to appear at a probation status hearing , they are being held in contempt of court or they failed a drug screening after being released on bond .
“ The courts put out an @ @ @ @ @ @ @ in light of vigorous and relentless advocacy on our part , ” Derwyn Bunton , the chief district defender for New Orleans told HuffPost .
The courts “ need to go much further , ” he said .
The public defenders office identified about 200 people being held in jail on nonviolent offenses who will not be released by the judges ’ order — including a man who was arrested for petty theft at a Walgreens store and is currently imprisoned on a probation hold , Bunton said .
The order came the @ @ @ @ @ @ @ filed an emergency petition for the release of all prisoners who : “ We are putting hundreds of people in the direct path of the contagion the longer we wait , ” the Orleans Public Defenders tweeted on Wednesday .
“ We have the opportunity to jump in front of a catastrophic outbreak in the jail , if immediate action is taken.
” The growth rate of coronavirus infections in Louisiana in the two weeks that followed its first confirmed case was the fastest in the world , according to a University of @ @ @ @ @ @ @ and staffers at jails in the New Orleans area have tested positive for the highly contagious virus .
The threat of coronavirus is exceptionally high in jails and prisons because it is impossible for most incarcerated people to follow recommended guidelines on social distancing , handwashing and disinfecting surfaces .
Most prisoners sleep , shower , eat , exercise and use the phone within close proximity to others .
Medical care in detention facilities is often poor , even under regular circumstances .
Criminal justice reform advocates for weeks have been urging the @ @ @ @ @ @ @ in pretrial detention because they can ’ t afford bail and prisoners who are elderly or have pre-existing health conditions .
Ahead of the judges ’ order , the Orleans Parish Prison Reform Coalition organized a community letter-writing campaign calling for decarceration in response to coronavirus .
Depopulating the jails would “ allow us to have open ‘ flex ’ units to allow rotation of our populations , sanitization of empty units , and further separation of individuals in our custody , ” Gusman wrote in a letter to the deputy chief judge @ @ @ @ @ @ @ the release of all nonviolent offenders who have no prior criminal history .

LOADING ERROR LOADING
Judges from the Orleans Parish Criminal Court ordered the release from jail of some pretrial defendants and low-level offenders in an effort to mitigate the risk of coronavirus.
The judges’ Wednesday order requires the sheriff’s office to “immediately release” people who who are in jail because they are awaiting trial for a misdemeanor offense, they were arrested for failing to appear at a probation status hearing, they are being held in contempt of court or they failed a drug screening after being released on bond.
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The Orleans Public Defenders Office welcomed the move as an initial step but estimated that it would affect fewer than 10 people.
“The courts put out an order that affected very few people, in light of vigorous and relentless advocacy on our part,” Derwyn Bunton, the chief district defender for New Orleans told HuffPost. The courts “need to go much further,” he said.
The public defenders office identified about 200 people being held in jail on nonviolent offenses who will not be released by the judges’ order — including a man who was arrested for petty theft at a Walgreens store and is currently imprisoned on a probation hold, Bunton said.
Orleans Parish District Attorney Leon Cannizzaro initially opposed efforts to reduce the jail population but said Thursday that he approves of the judges’ order.
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The order came the same day that the public defenders office filed an emergency petition for the release of all prisoners who:
Are susceptible to serious health consequences from COVID-19 because of their age or health
Are being held on misdemeanor charges or felonies that are not crimes of violence or sex charges
Are being held on probation or parole detainers
Are serving a sentence that ends within 30 days
“We are putting hundreds of people in the direct path of the contagion the longer we wait,” the Orleans Public Defenders tweeted on Wednesday. “We have the opportunity to jump in front of a catastrophic outbreak in the jail, if immediate action is taken.”
The growth rate of coronavirus infections in Louisiana in the two weeks that followed its first confirmed case was the fastest in the world, according to a University of Louisiana at Lafayette study. Several prisoners and staffers at jails in the New Orleans area have tested positive for the highly contagious virus. The threat of coronavirus is exceptionally high in jails and prisons because it is impossible for most incarcerated people to follow recommended guidelines on social distancing, handwashing and disinfecting surfaces. Most prisoners sleep, shower, eat, exercise and use the phone within close proximity to others. Medical care in detention facilities is often poor, even under regular circumstances.
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On Thursday, Sheriff Marlin Gusman asked for an even further reduction to the area’s jail population.
Depopulating the jails would “allow us to have open ‘flex’ units to allow rotation of our populations, sanitization of empty units, and further separation of individuals in our custody,” Gusman wrote in a letter to the deputy chief judge of the Criminal District Court, requesting the release of all nonviolent offenders who have no prior criminal history.
This story has been updated with comment from Chief District Defender for New Orleans Derwyn Bunton.


huffpost--2020-03-27--How To Co-Parent During The Coronavirus Pandemic

“ Thankfully , we both work in tech , so we have been able to work from home and be home with them during this time , ” she said .
“ Right now , I think doing your best is the best you can do .
If you have a co-parent who isn ’ t being as vigilant as you , it can be frustrating .
But I ’ ve just tried to do my part and gently educate my kids.
” “ Behave well ” was the overarching advice from divorce attorneys we interviewed , but if you @ @ @ @ @ @ @ still have a lot of questions : Do existing custody agreements have to be followed to a T ( even if your ex thinks they have symptoms of COVID-19 ) ?
How should you handle child support if one of you is laid off ?
Should you get any changes in writing ?
This is uncharted territory for parents and the legal community , said Alison L. Patton , a family law attorney and mediator in San Diego .
Routines have been blown apart almost overnight .
Kids ’ classrooms are at home @ @ @ @ @ @ @ , others are working from home , and those in fields like health care and other essential services are facing long , unpredictable hours .
With all this upheaval , it ’ s extra important to play nice with your ex , Patton said .
Be willing to modify child support in the event of a job loss .
Erin Levine , the founder of Hello Divorce , a legal assistance site , said that right now many parents are making modifications to child support because of widespread job loss .
If that @ @ @ @ @ @ @ , get any agreement you come to on your own with your ex in writing .
If you can ’ t agree , Levin said to consider filing a motion with the court to preserve the right to modify the amount of support you ’ re paying back to the date your income took a hit .
“ My biggest piece of advice is to be honest , and be especially thoughtful about tone when having difficult discussions with your ex , ” Levine said .
“ We ’ re all struggling .
@ @ @ @ @ @ @ the best we can right now .
The more transparent and empathetic you can be right now , the better for everyone.
” Think twice — or three times — before you send that angry text .
“ Think about how you say things , how they will be received , how they will be preserved for future litigation , ” he said .
“ No matter how right you are , the other person is also suffering .
We all are .
Fear of the unknown causes stress , and now is @ @ @ @ @ @ @ to have a child with could use your help and reassurance.
” Be understanding of your ex ’ s schedule .
“ This gives me Thursday and Friday to catch up on work which is really necessary , ” said Mitchell , who lives in northern Georgia .
“ That flexibility has been key : It ’ s hard to work at home and also supervise their home studies right now .
With this agreement , both parents get a couple of child-free days to catch up on work , and the kids @ @ @ @ @ @ @ a long time.
” Get any modifications to your custody agreement in writing .
“ I ’ d even say have your mediator or attorney draft a simple stipulation saying the amended schedule is not setting a precedent and has an end date , ” Patton said .
“ Everyone can sign it now , and it will be filed once the courts reopen .
I ’ ve been doing this for clients who are making sensible changes to the parenting schedule through cooperation but want to be sure they aren ’ t @ @ @ @ @ @ @ to get the schedule back to normal when this is over.
” If you and your ex are at odds when it comes to who has the kids right now , follow your court orders .
But if one parent may have COVID-19 , act reasonably .
Rebecca Long Okura , a family law attorney in Salt Lake City , said she ’ s heard a lot of parents ask if they can refuse to send the children to the other parent ’ s home right now .
( For instance , in @ @ @ @ @ @ @ safe social distancing practices . )
“ The simple answer is that parents have to follow their court orders , ” she said .
“ However , courts are not blind that in some cases , following the court orders is unsafe for the children .
Most courts are unable to hear cases on this issue right now because the court system is still trying to establish its own response to the coronavirus.
” That said , if one of you may have been exposed to COVID-19 , act rationally ( even if @ @ @ @ @ @ @ .
“ No one knows what judges are going to say when parents refuse to follow orders in cases where the other household is very high risk or has an infected person in the household , but I don ’ t think judges will be rigid about court orders in those high-risk cases , ” Long Okura said .
Don ’ t risk exposing your kids to COVID-19 just to enforce the custody schedule , Patton said .
“ If you and your kids have been exposed to the virus , be considerate @ @ @ @ @ @ @ and , if possible , keep the children until you ’ re sure they are not sick or carriers , ” she said .
At the end of the day , compromise now and save the fighting for later .
Family lawyers everywhere are telling their clients to compromise and get through this now and fight later , if they absolutely must , Kessler said .
“ Personally , I think the situation is evolving too quickly to reach a full , negotiated and memorialized document right now about it , ” he @ @ @ @ @ @ @ there may be ‘ corona clauses ’ where in such a situation where there is no school , the summer schedule takes over and lasts through the pandemic or other situation .
But at this point , if parents still need lawyers to argue and fight about what to do , they are in trouble .
Now is the time to work together .
”

Westend61 via Getty Images Right now, "you should be bending over backwards to be accommodating and understanding," attorneys say.
Co-parenting is full of challenges under normal circumstances. Trying to maintain a healthy parenting dynamic with your ex during a global pandemic is doubly hard.
Stephanie Sinclair knows that firsthand. The writer, who lives in a suburb near Phoenix, has two kids, ages 12 and 9, with her ex. When things first started getting bad with coronavirus in early March, she and her ex had wholly different ideas about “social distancing.”
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“Getting him to take it seriously was difficult,” she said. “He thought it was blown out of proportion and had even taken the kids to a really crowded park. And he was still taking them to group religious services even after both the CDC and the U.S. government recommended social distancing.”
Luckily, the church has since moved all services online. Sinclair, who has joint custody of the kids (they alternate weeks and swap on Monday) is taking co-parenting day by day.
“Thankfully, we both work in tech, so we have been able to work from home and be home with them during this time,” she said. “Right now, I think doing your best is the best you can do. If you have a co-parent who isn’t being as vigilant as you, it can be frustrating. But I’ve just tried to do my part and gently educate my kids.”
Sinclair has the right mentality, said Randall Kessler, a divorce lawyer in Atlanta and the author of “Divorce: Protect Yourself, Your Kids And Your Future.”
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“Behave well, for you may be judged down the road on how you handled this.” - Randall Kessler, a divorce lawyer in Atlanta
“Right now, you should be bending over backwards to be accommodating and understanding,” he told HuffPost. “We are already seeing interference with parenting time: Often the parent in control, the custodial parent, doesn’t trust the other parent to protect the children, so they don’t allow visits.”
And currently, none of this can be litigated: The courts are closed, Kessler said.
“That’s why I go back to my earlier statement,” he said. “Behave well, for you may be judged down the road on how you handled this.”
“Behave well” was the overarching advice from divorce attorneys we interviewed, but if you’re a co-parent, you probably still have a lot of questions: Do existing custody agreements have to be followed to a T (even if your ex thinks they have symptoms of COVID-19)? How should you handle child support if one of you is laid off? Should you get any changes in writing?
Below, legal experts (and co-parents themselves) share a few tips on how to co-parent during this global health crisis.
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Be flexible.
This is uncharted territory for parents and the legal community, said Alison L. Patton, a family law attorney and mediator in San Diego. Routines have been blown apart almost overnight. Kids’ classrooms are at home. Some parents are out of work, others are working from home, and those in fields like health care and other essential services are facing long, unpredictable hours. With all this upheaval, it’s extra important to play nice with your ex, Patton said.
“Unless you’re dealing with a high-conflict ex who needs clear boundaries and rules, the name of the game during the COVID-19 pandemic is flexibility and working together for the sake of the children and your own sanity,” Patton said.
Now is not the time to argue about the small stuff or rehash old conflicts.
“Most kids are already feeling unsettled and anxious,” she said. “Having their parents problem-solve and be a united team will make all the difference in how they fare during this crisis.”
SolStock via Getty Images Be flexible about child custody agreements and child support during this pandemic, experts say.
Be willing to modify child support in the event of a job loss.
Erin Levine, the founder of Hello Divorce, a legal assistance site, said that right now many parents are making modifications to child support because of widespread job loss. If that’s something you need to do, get any agreement you come to on your own with your ex in writing. If you can’t agree, Levin said to consider filing a motion with the court to preserve the right to modify the amount of support you’re paying back to the date your income took a hit.
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If you need to have this conversation with your ex, approach it with as much compassion as you can.
“My biggest piece of advice is to be honest, and be especially thoughtful about tone when having difficult discussions with your ex,” Levine said. “We’re all struggling. We’re all trying to do the best we can right now. The more transparent and empathetic you can be right now, the better for everyone.”
Think twice — or three times — before you send that angry text.
Maybe don’t send that angry text about the trip your ex took right before things got bad in your state, Kessler said.
“Think about how you say things, how they will be received, how they will be preserved for future litigation,” he said. “No matter how right you are, the other person is also suffering. We all are. Fear of the unknown causes stress, and now is the time when the person you chose to have a child with could use your help and reassurance.”
Be understanding of your ex’s schedule.
During the school year, English teacher Katie Mitchell’s two kids, ages 7 and 10, usually live with her and go to their dad’s every other weekend. Since coronavirus hit, they’ve changed things around a bit: The parents have kept the every-other-weekend rotation, but they’re splitting weekdays in half down the middle right now.
“This gives me Thursday and Friday to catch up on work which is really necessary,” said Mitchell, who lives in northern Georgia. “That flexibility has been key: It’s hard to work at home and also supervise their home studies right now. With this agreement, both parents get a couple of child-free days to catch up on work, and the kids are not away from either parent for a long time.”
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10'000 Hours via Getty Images Flexibility -- and lots of FaceTime -- is key to good co-parenting during this pandemic.
Get any modifications to your custody agreement in writing.
Because so many work lives have been upended, some exes are agreeing to slightly different terms than those outlined in their custody agreements. If you are modifying your custody agreement, consider getting it in writing, especially if you think your ex might take advantage of the amended parenting plan after the outbreak.
“I’d even say have your mediator or attorney draft a simple stipulation saying the amended schedule is not setting a precedent and has an end date,” Patton said. “Everyone can sign it now, and it will be filed once the courts reopen. I’ve been doing this for clients who are making sensible changes to the parenting schedule through cooperation but want to be sure they aren’t going to be facing a legal battle to get the schedule back to normal when this is over.”
If you and your ex are at odds when it comes to who has the kids right now, follow your court orders. But if one parent may have COVID-19, act reasonably. Rebecca Long Okura, a family law attorney in Salt Lake City, said she’s heard a lot of parents ask if they can refuse to send the children to the other parent’s home right now. (For instance, in cases where they’re worried about safe social distancing practices.) “The simple answer is that parents have to follow their court orders,” she said. “However, courts are not blind that in some cases, following the court orders is unsafe for the children. Most courts are unable to hear cases on this issue right now because the court system is still trying to establish its own response to the coronavirus.” That said, if one of you may have been exposed to COVID-19, act rationally (even if it goes against your custody agreement). “No one knows what judges are going to say when parents refuse to follow orders in cases where the other household is very high risk or has an infected person in the household, but I don’t think judges will be rigid about court orders in those high-risk cases,” Long Okura said. Don’t risk exposing your kids to COVID-19 just to enforce the custody schedule, Patton said. “If you and your kids have been exposed to the virus, be considerate of your ex, share the information and, if possible, keep the children until you’re sure they are not sick or carriers,” she said.
MoMo Productions via Getty Images Keep your ex in the loop about updates on your kid's schooling and health.
In times of crisis like this, over-communicate with your ex. Lindsey Light, a professor and mom of two kids, is generally on the same page as her ex when it comes to parenting their 8-year-old and 6-year-old. The same is true now: Her ex has a parent who is very ill and a living grandparent, so he knows the importance of social distancing. They also both recognize the importance of heightened communication between the two houses during these stressful times. “We text often, and the kids have always been allowed to call or FaceTime us as much as they want,” she said. “I forward him communication from their school, and I even sent him a copy of the schedule I’m using at home. We also are on the same page about not freaking our kids out by talking about the virus all the time or providing details that aren’t age-appropriate.”
At the end of the day, compromise now and save the fighting for later. Family lawyers everywhere are telling their clients to compromise and get through this now and fight later, if they absolutely must, Kessler said. “Personally, I think the situation is evolving too quickly to reach a full, negotiated and memorialized document right now about it,” he said. “In the future, there may be ‘corona clauses’ where in such a situation where there is no school, the summer schedule takes over and lasts through the pandemic or other situation. But at this point, if parents still need lawyers to argue and fight about what to do, they are in trouble. Now is the time to work together. ”


huffpost--2020-03-27--13 Amazing Photos You Missed This Week

13 Amazing Photos You Missed This Week

We ’ re highlighting exceptional photos from around the world for the week of March 21 to 27 .
Check @ @ @ @

We’re highlighting exceptional photos from around the world for the week of March 21 to 27. Check them out below.
(Above: After flying home from Brazil, Gavin Wolcott, 19, gets a hug from his mother, Coralee, at Spokane International Airport in Spokane, Washington, on March 24. Wolcott was serving a mission in Brazil, but his stay there was cut short due to concerns over the coronavirus. Credit: Dan Pelle/The Spokesman-Review/AP)


huffpost--2020-04-29--Avoid Buying These 7 Foods Now, And You Could Save Someone's Life

Now that many of us are stockpiling weeks ’ worth of food to minimize our outings and help quash the spread of the coronavirus , it ’ s easy to overlook that one person ’ s cache can cause problems for others who rely on certain products out of medical necessity .
All of this can domino into a compromise of a person ’ s immune function .
To top it off , the uptick in trips to the supermarket to find their MIA foods , combined with the looming possibility of additional specialist or emergency room visits , increases @ @ @ @ @ @ @ disease caused by the coronavirus .
Palm kernel oil has a similar MCT oil percentage and would be a suitable stand-in for those who don ’ t have liver or gallbladder disease , Persak said .
But because palm oils are taxing to the environment , she added , make sure the variety you choose is sustainably-sourced ( RSPO certified ) , which may require it be purchased online .
Blueberries , strawberries , raspberries , cherries and cranberries , though , are low in these minerals , and therefore safe .
But @ @ @ @ @ @ @ and frozen so attractive right now to cut down on trips to the supermarket , many renal patients are likely missing out .
And eating the slightest amount of gluten-based products is out of the question : “ To do so would cause immediate GI tract discomfort ( usually lasting a week or two ) and injure or inflame the small intestine ( which can often take several months to heal ) , ” Persak said .
Experts are still learning about the novel coronavirus .
The information in this story is what @ @ @ @ @ @ @ time , but its guidance concerning COVID-19 could change as scientists discover more about the virus .
Please check the Centers for Disease Control and Prevention for the most updated recommendations .

LOADING ERROR LOADING
Now that many of us are stockpiling weeks’ worth of food to minimize our outings and help quash the spread of the coronavirus, it’s easy to overlook that one person’s cache can cause problems for others who rely on certain products out of medical necessity.
“This may not always be life-threatening,” said Eve Persak, a certified nutrition support clinician and private nutritional counselor. “Most individuals on special diets have learned from doctors or dietitians how to substitute, troubleshoot or simply ‘go without.’”
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But if the lack of the product becomes long-term ― say, due to a pandemic — it could compound into dangerous health risks, including weight loss, nutrient deficiencies or a decline in an underlying condition.
All of this can domino into a compromise of a person’s immune function. To top it off, the uptick in trips to the supermarket to find their MIA foods, combined with the looming possibility of additional specialist or emergency room visits, increases their chances of contracting COVID-19, the disease caused by the coronavirus.
To help others stay well, experts recommend the general population avoid — or minimize — purchasing certain foods until the pandemic is over. And there’s plenty of flexibility to replace them with nutritionally similar grub.
Coconut Oil
Vital for people with liver disease, gallbladder disease
Coconut oil is naturally rich in medium-chain triglycerides (MCTs). Compared to other fats, these don’t tax the liver or gallbladder the way other fats do. (MCTs bypass metabolism in the liver and don’t require as much pancreatic enzymes and bile to be digested.)
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Specialty MCT products are available, but with the lack of stock or delay in shipment from online vendors, coconut oil serves as a nice stand-in. The oil is “also far less expensive for people that require it on an ongoing basis,” Persak said.
belchonock via Getty Images For people with liver and gallbladder disease, coconut oil is a healthy fat option.
Swap it out:
Palm kernel oil has a similar MCT oil percentage and would be a suitable stand-in for those who don’t have liver or gallbladder disease, Persak said. But because palm oils are taxing to the environment, she added, make sure the variety you choose is sustainably-sourced (RSPO certified), which may require it be purchased online.
If you use coconut oil because you appreciate its high-temp cooking capacity, other fats and oils that also boast a higher smoke point include refined avocado oil, clarified butter, grassfed ghee and refined extra virgin olive oil, Persak said.
And if it’s flavor you’re after, “almond oil can provide a mild flavor and be used in both sweet and savory dishes,” said New York-based registered dietitian Jackie Elnahar.
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Frozen Berries
Vital for people with chronic kidney conditions
“For people with chronic renal conditions, there are very few fruits and vegetables that are safe to consume,” Persak said. “Most plant-based foods are rich in potassium and phosphorus — two minerals that tax the kidneys.”
Blueberries, strawberries, raspberries, cherries and cranberries, though, are low in these minerals, and therefore safe. But with fresh being harder to come by and frozen so attractive right now to cut down on trips to the supermarket, many renal patients are likely missing out.
“For many, these are also their only consistent sources of vitamin C in the diet,” Persak said.
Because vitamin C is fragile and degrades quickly, it’s not as effective a nutrient to score through vegetables (since they’re typically cooked before eating). Ditto for dehydrated fruits.
Not that you have to ditch fresh and frozen berries entirely during the pandemic, but “refraining from excessively stocking up would be a considerate gesture,” Persak said.
Swap them out: If you’re looking to enjoy similar low-sugar fruits, peaches, melon, tangerines, grapefuits and kiwis could hit the spot. You might also consider blending smoothies that star frozen mango, pineapple or frozen-from-fresh bananas for the time being.
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But if it’s the valuable anthocyanin phytochemicals from berries you’re most interested in (thanks to their anti-inflammatory, anti-viral and anti-cancer benefits), plenty of other plant-based foods offer them, Persak said. These include grains (purple and black rice, purple corn), vegetables (red cabbage, eggplant, red onion) and other fruits (red grapes, goji berries, plums).
Certified Gluten-Free Products
Vital for people with celiac disease
For people with celiac disease (or a gluten allergy), obtaining truly gluten-free foods is essential. The best way to do this is to buy products that have been certified gluten-free, which means the items meet the strictest of gluten-free standards.
“Due to shortages of standard products, like bread and pasta, some people are crossing over into the gluten-free foods sections for these purchases, and this can be a significant imposition for people with celiac disease (or parents of children with celiac),” Persak said.
When store shelves are empty of the certified gluten-free items, it can be difficult for those needing them to create meals calorie- and nutrient-dense enough to ensure a balanced diet.
And eating the slightest amount of gluten-based products is out of the question: “To do so would cause immediate GI tract discomfort (usually lasting a week or two) and injure or inflame the small intestine (which can often take several months to heal),” Persak said.
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Chicago Tribune via Getty Images Try to avoid buying gluten-free baking flours right now unless you actually have a gluten allergy.
Swap them out: Choosing regular wheat pasta and making at least 50% of the meal vegetables is the healthier alternative than the pasta itself, Elnahar said.
If you prefer or require a gluten-free diet but don’t need to eliminate it as strictly as some, consider sticking to products labeled as gluten-free but that don’t bear the full certification.
Nutritional Shakes
Vital for people with COPD, cancer
People with chronic obstructive pulmonary disease (COPD, an inflammatory lung disease that causes poor airflow and breathing difficulties) burn calories at an extremely high rate (10 times faster just from their body working harder to breath), making it necessary to eat a large amount of calories throughout the day.
“If they’re unable to gain access to foods high in calories, yet relatively healthy, they may face extreme weight loss and malnutrition,” said Trista Best, a registered dietitian at Balance One Supplements.
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One way such people typically accomplish getting the calories they need is through drinking high-protein nutritional shakes, such as Ensure.
Those going through chemotherapy for cancer can experience appetite loss, weight loss and nausea, so keeping nutritional shakes on hand can be helpful in making sure they’re getting the necessary protein, calories, vitamins and minerals for maintaining nutrition and fighting the cancer.
The problem? “It’s not uncommon for the general population to purchase these items out of fear of food loss because they supply adequate protein and calories,” Best said.
Swap them out: Opt for homemade smoothies with protein powder or lower-calorie protein shakes not marketed for medicinal purposes, Best suggested.
Whole Milk
Vital for people with COPD
“The general population begins stocking up on milk of any kind during potential food panic, but whole milk in particular is necessary for people with COPD to meet their calorie and fat needs,” Best said.
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Swap it out: Consider purchasing lower-fat milk or milk alternatives, such as almond milk, until the pandemic is over.
Rice or Oat Milk
Vital for people with gallbladder disease, pancreatitis
When someone has gallbladder disease or pancreatitis, their ability to digest fats is impaired. “Any ingestion of fat can cause an acute attack of abdominal pain and gastrointestinal distress, as well as inflammation,” Elnahar said.
This is why non-fat and low-fat dairy ― as well as dairy-free alternatives that are naturally low in fat, such as rice and oat milk ― are paramount to preventing the onset of pain.
Swap them out: When buying non-fat and low-fat dairy, don’t stockpile — only buy what you need. And instead of rice or oat milk, consider going with milk alternatives that are still dairy-free but slightly higher in fat, such as almond milk (higher by roughly 1 gram per serving).
Low Sodium Products
Vital for people with chronic kidney conditions, lung diseases, hypertension, high blood pressure
Quite a few medical conditions require significant restrictions in dietary sodium so as to avoid fluid retention. “Low sodium foods are important during this time for people with these conditions,” Best said. Otherwise, they risk compromising their health even further (taxing kidney function, developing breathing difficulties, raising blood pressure).
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With canned and pantry products in such high demand, however, many consumers are reaching for the low sodium canned products like vegetables, beans and soups when the standard versions aren’t available.
Swap them out: People who don’t have sodium concerns should try to avoid stocking up on low sodium items and stick to the standard versions when possible. Purchasing fresh or frozen is another option to save low sodium goods for people who need them most.
For anyone who’s salt-sensitive or wanting to budget their salt intake for preventative reasons, you can reduce the sodium in standard varieties of canned vegetables and beans by draining and rinsing them well before using.
“You can also trim down your overall salt intake in other ways, like using spices and herbs, reducing salts in recipes and removing the salt shaker from the kitchen table,” Persak said.
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huffpost--2020-04-29--The Volunteers Helping Muslim Medical Workers Break Fast During Ramadan

Dr. Karishma Rao was 12 hours into a 24-hour shift at a neonatal intensive care unit on Sunday when the sun set and she could break her fasting day , traditional for Muslims during the holy month of Ramadan .
It ’ s a stressful time at Children ’ s Mercy hospital , with the coronavirus outbreak spreading , and the 32-year-old had no time to step out to get a bite to break her fast or to celebrate with family and friends .
“ It was a stress that was taken off for me because I already knew that @ @ @ @ @ @ @ didn ’ t have to plan for it or work for it , ” Rao said .
“ Especially knowing that you have , like , a really long shift ahead of you still , even after iftar , I think that makes a really big difference.
” During the month of Ramadan , which began last Friday , Muslims embark on a daily fast from sunrise to sunset .
While the majority of the Muslims are forced to celebrate at home with the closures of mosques and large gatherings banned , essential @ @ @ @ @ @ @ while providing critical care for patients .
Kaitlin Abdelrahman with On Call Halal organizes and delivers halal meals to Muslim medical professionals at Kansas City-area hospitals during the month of Ramadan .
Because of social distancing during the coronavirus pandemic , the meals are loaded and unloaded from the trunk of her car .
On the first night , Abdelrahman delivered meals to Children 's Mercy hospital , Friday , Apr .
24 , 2020 .
A volunteer group called On Call Halal , launched last month by 31-year-old entrepreneur Kaitlin Abdelrahman , @ @ @ @ @ @ @ health workers in the area with free meals to begin and break their fasts during Ramadan .
The meals come from Muslim-owned restaurants that serve halal food , which is prepared through the requirements of the Islamic faith .
The idea occurred to Abdelrahman after several of her friends who were medical workers mentioned that their already long working hours nearly doubled after the coronavirus outbreak .
Many of those health care providers did not have time to find a meal to break their fasts during their hectic shifts .
Some workers did @ @ @ @ @ @ @ after the sun went down .
“ Given the importance of the timing of these meals , this partnering with On Call Halal provided The University of Kansas Health System a unique opportunity to support our Muslim employees and medical staff members by having meals available on our campus and at the right time of the day and night , ” he added .
Abdelrahman and volunteers from On Call Halal pick up meals from local businesses that cater halal food for health care workers twice a day –– for their end-of-day break-fast @ @ @ @ @ @ @ plan to continue to do so through Ramadan .
Normally , health care workers would eat these meals with one another , provided their schedules accommodated , or would go home to eat with family and friends .
But with doctors and nurses working longer hours to deal with the pandemic , many barely have time to prepare food for themselves .
Amna Humayon , the 29-year-old founder of the restaurant , said it was deeply personal to her as a family-owned business and as part of a Muslim family to give back @ @ @ @ @ @ @ restaurant for her mother , whom she said “ has always looked for ways to help out the community.
” Top left : Kaitlin Abdelrahman , left , and Sohaila Humayon of Sohaila 's Kitchen discuss logistics .
Top right : A sign hanging up at at Children 's Mercy hospital , which partnered with On Call Halal to provide meals to its fasting medical workers .
Bottom left : Kaitlin Abdelrahman talks with Ammad Humayon .
Bottom right : Some of the food delivered by On Call Halal to Kansas City-area hospitals @ @ @ @ @ @ @ its doors in early March after a statewide stay-at-home order to slow the spread of the outbreak .
Humayon was also concerned her mother would contract the virus .
She plans to open for takeout-only service this week in hopes of keeping the business afloat .
The opportunity to provide meals for health care workers is “ a godsend , ” Humayon said .
“ Everyone keeps saying they ’ ve been hit really hard , but you don ’ t really realize it until you ’ re one of them , ” @ @ @ @ @ @ @ re trying to find ways to still stay connected.
” Kashif Tufail , the owner of Chai Shai , another participating restaurant with On Call Halal , said it was important to provide a sense of comfort and normalcy to medical workers who may not have the time to run out and get food during their hectic work schedules .
“ Someone who ’ s working at a hospital and who ’ s been fasting all day gets a meal that they know is from someone who is also Muslim and understands their @ @ @ @ @ @ @ day , and that person is taking care of them a little bit by providing a meal .
I think that ’ s a nice feeling , ” said Tufail .

Dr. Karishma Rao was 12 hours into a 24-hour shift at a neonatal intensive care unit on Sunday when the sun set and she could break her fasting day, traditional for Muslims during the holy month of Ramadan. It’s a stressful time at Children’s Mercy hospital, with the coronavirus outbreak spreading, and the 32-year-old had no time to step out to get a bite to break her fast or to celebrate with family and friends.
So it was a relief when volunteers came by to drop off a free halal meal Rao could eat with fellow Muslim staffers at the hospital ― a brief moment of relief during a crisis.
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“It was a stress that was taken off for me because I already knew that there’s food there. I didn’t have to plan for it or work for it,” Rao said. “Especially knowing that you have, like, a really long shift ahead of you still, even after iftar, I think that makes a really big difference.”
During the month of Ramadan, which began last Friday, Muslims embark on a daily fast from sunrise to sunset. While the majority of the Muslims are forced to celebrate at home with the closures of mosques and large gatherings banned, essential workers like medical professionals are fasting all while providing critical care for patients.
Kaitlin Abdelrahman with On Call Halal organizes and delivers halal meals to Muslim medical professionals at Kansas City-area hospitals during the month of Ramadan. Because of social distancing during the coronavirus pandemic, the meals are loaded and unloaded from the trunk of her car. On the first night, Abdelrahman delivered meals to Children's Mercy hospital, Friday, Apr. 24, 2020. Jill Toyoshiba for HuffPost
A volunteer group called On Call Halal, launched last month by 31-year-old entrepreneur Kaitlin Abdelrahman, is aiming to provide dozens of Muslim health workers in the area with free meals to begin and break their fasts during Ramadan. The meals come from Muslim-owned restaurants that serve halal food, which is prepared through the requirements of the Islamic faith.
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The idea occurred to Abdelrahman after several of her friends who were medical workers mentioned that their already long working hours nearly doubled after the coronavirus outbreak. Many of those health care providers did not have time to find a meal to break their fasts during their hectic shifts. Some workers did not have a proper meal until hours after the sun went down.
“It was just crazy, what they’re going through,” Abdelrahman said. A self-described problem-solver, she immediately began calling hospitals and surveyed the approximate number of Muslim workers. After securing their approvals, she called up several Muslim-owned businesses.
“It’s a twofold win because we can help support their morale and we can also support the halal restaurants,” Abdelrahman said.
Her group already committed to delivering 3,300 meals for Muslim staffers across three major hospitals: The University of Kansas Health System, Children’s Mercy hospital and Hospital Corporation of America’s Midwest Research Medical Center.
“Our health system’s response to the COVID-19 pandemic has not allowed the flexibility many of our employees and medical staff members normally have in their lives,” said Jeff Novorr, the vice president of support services at The University of Kansas Health System.
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Sohaila Humayon of Sohaila's Kitchen in the Lenexa Public Market fills containers with rice for meals she is preparing for pickup Friday, Apr. 24, 2020. Jill Toyoshiba for HuffPost
“Given the importance of the timing of these meals, this partnering with On Call Halal provided The University of Kansas Health System a unique opportunity to support our Muslim employees and medical staff members by having meals available on our campus and at the right time of the day and night,” he added.
Abdelrahman and volunteers from On Call Halal pick up meals from local businesses that cater halal food for health care workers twice a day –– for their end-of-day break-fast meal and the predawn meal –– and plan to continue to do so through Ramadan. Normally, health care workers would eat these meals with one another, provided their schedules accommodated, or would go home to eat with family and friends. But with doctors and nurses working longer hours to deal with the pandemic, many barely have time to prepare food for themselves.
The meals are paid for through sponsors and local donations collected on its website. As of Monday, On Call Halal has raised enough money to pay for 1,400 out of those 3,300 meals.
Hospital workers at Children’s Mercy in Kansas City broke their fast last Friday, the first full fasting day of Ramadan, with chicken biryani ― a hearty Pakistani dish made with rice, chicken and potatoes ― prepared by Sohaila’s Kitchen.
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Amna Humayon, the 29-year-old founder of the restaurant, said it was deeply personal to her as a family-owned business and as part of a Muslim family to give back to her community. She named the restaurant for her mother, whom she said “has always looked for ways to help out the community.”
“During Ramadan, there are so many spiritual aspects of fasting,” Humayon said. “But you look forward to breaking your fast at the end of the day and having a really delicious meal.”
Top left: Kaitlin Abdelrahman, left, and Sohaila Humayon of Sohaila's Kitchen discuss logistics. Top right: A sign hanging up at at Children's Mercy hospital, which partnered with On Call Halal to provide meals to its fasting medical workers. Bottom left: Kaitlin Abdelrahman talks with Ammad Humayon. Bottom right: Some of the food delivered by On Call Halal to Kansas City-area hospitals. Jill Toyoshiba for HuffPost/Dr. Karishma Rao
The restaurant was forced to shut its doors in early March after a statewide stay-at-home order to slow the spread of the outbreak. Humayon was also concerned her mother would contract the virus. She plans to open for takeout-only service this week in hopes of keeping the business afloat.
The opportunity to provide meals for health care workers is “a godsend,” Humayon said. “Everyone keeps saying they’ve been hit really hard, but you don’t really realize it until you’re one of them,” she said. “So we’re trying to find ways to still stay connected.”
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Kashif Tufail, the owner of Chai Shai, another participating restaurant with On Call Halal, said it was important to provide a sense of comfort and normalcy to medical workers who may not have the time to run out and get food during their hectic work schedules.
“Someone who’s working at a hospital and who’s been fasting all day gets a meal that they know is from someone who is also Muslim and understands their faith and has also been fasting all day, and that person is taking care of them a little bit by providing a meal. I think that’s a nice feeling,” said Tufail.
“It’s not about what you feed people, but how you make them feel,” he added.
Abdelrahman hopes to secure more funding for On Call Halal over the coming days. If the group exceeds the goal of enough funds to pay for 3,300 meals, it plans to expand and provide meals for more Muslim staffers at more hospitals and wants to see similar programs happen in other cities.
Abdelrahman said the entire project has been a collaborative way to show health care workers gratitude through the spirit of Ramadan and the community. All health care workers are amazing, she said.
“But especially those people that are doing it all while fasting,” she added.


huffpost--2020-04-29--U.S. Postal Service Funding Shortfall Could Derail Vote-By-Mail Efforts During Pandemic

If Congress allows the U.S .
Postal Service to fail ― as President Donald Trump seems willing to do ― the nation ’ s ability to hold free , fair elections would be at risk , as would millions of voters who would be forced to go to the polls during a pandemic if they wanted to exercise their rights .
In the 2016 election , 33 million Americans voted through the mail , using either absentee , military or mail-in ballots .
Every state anticipates a significant increase in mailed ballots due to the coronavirus pandemic , with anywhere @ @ @ @ @ @ @ near 100 % replacement of in-person voting .
All of the states rely on the Postal Service to deliver and return those ballots .
But the Postal Service projects that the drop in mail volume due to the pandemic could lead it to run out of funds in late summer or early fall .
The independent agency is asking Congress for $ 75 billion in relief funding to keep it afloat , but faces resistance from Trump .
State election officials ― Republicans and Democrats ― are joining in the call for the @ @ @ @ @ @ @ available to them to vote in the 2020 elections , given new social distancing needs stemming from the COVID-19 crisis .
“ America needs Congress to do its part to ensure the very foundation on which we conduct our elections does not crumble , ” Vermont Secretary of State Jim Condos ( D ) said .
Washington state is one of five states that conducts its elections almost entirely through the mail .
If the Postal Service is forced to halt or scale back delivery , it will affect the ability of the @ @ @ @ @ @ @ same is true of the other vote-by-mail states ― Colorado , Hawaii , Oregon and Utah .
“ The U.S.P.S .
is integral in our success as a country and ensuring everyone has access to our elections in arguably the most anticipated election in over 100 years , ” Washington Secretary of State Kim Wyman ( R ) said .
Even if Washington state were able to use a private vendor like UPS or FedEx , many voters would be disenfranchised because they use postal boxes provided by the Postal Service as their @ @ @ @ @ @ @ Service survived but was forced to cut back service , it could wreak havoc on elections .
The most troubling area would concern voters who request a ballot a week or less before Election Day ( Nov. 3 this year ) .
Service interruptions could delay the delivery of that ballot , possibly causing the voter to not receive it in time .
That would leave some voters being forced to trade their safety to exercise their democratic right to vote by appearing in-person at a time when , as most health experts @ @ @ @ @ @ @ still represent a threat .
The dangers have already been realized in Illinois and Wisconsin , where cases of coronavirus transmission and death have been tied to primaries those states held in March and April , respectively .
Trump , however , looms as the biggest obstacle ― which stems in part from his belief that the Postal Service provides Amazon with an unfair deal on package delivery ( the president blames Amazon-owner Jeff Bezos for the negative coverage he receives from the Bezos-owned Washington Post ) Last Friday , he termed the @ @ @ @ @ @ @ and he has called on it to increase package rates four or five times in order to receive relief funding .
“ But they don ’ t want to raise it because they don ’ t want to insult Amazon , and they don ’ t want to insult other companies , perhaps , that they like , ” he said .

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If Congress allows the U.S. Postal Service to fail ― as President Donald Trump seems willing to do ― the nation’s ability to hold free, fair elections would be at risk, as would millions of voters who would be forced to go to the polls during a pandemic if they wanted to exercise their rights.
In the 2016 election, 33 million Americans voted through the mail, using either absentee, military or mail-in ballots. Every state anticipates a significant increase in mailed ballots due to the coronavirus pandemic, with anywhere from a doubling of vote-by-mail to a near 100% replacement of in-person voting. All of the states rely on the Postal Service to deliver and return those ballots.
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But the Postal Service projects that the drop in mail volume due to the pandemic could lead it to run out of funds in late summer or early fall. The independent agency is asking Congress for $75 billion in relief funding to keep it afloat, but faces resistance from Trump.
State election officials ― Republicans and Democrats ― are joining in the call for the funding to ensure voters have every option available to them to vote in the 2020 elections, given new social distancing needs stemming from the COVID-19 crisis.
“America needs Congress to do its part to ensure the very foundation on which we conduct our elections does not crumble,” Vermont Secretary of State Jim Condos (D) said.
Washington state is one of five states that conducts its elections almost entirely through the mail. If the Postal Service is forced to halt or scale back delivery, it will affect the ability of the state to conduct the election. The same is true of the other vote-by-mail states ― Colorado, Hawaii, Oregon and Utah.
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“The U.S.P.S. is integral in our success as a country and ensuring everyone has access to our elections in arguably the most anticipated election in over 100 years,” Washington Secretary of State Kim Wyman (R) said.
A United States Postal worker makes a delivery with gloves and a mask in Warren, Michigan, earlier this month. ASSOCIATED PRESS
Even if Washington state were able to use a private vendor like UPS or FedEx, many voters would be disenfranchised because they use postal boxes provided by the Postal Service as their primary address.
“It would be disastrous,” Wyman said.
Another problem is that private delivery companies operate on a profit-motive and therefore aren’t required to deliver to every conceivable address like the Postal Service.
“There’s no private company that by mandate has to go to every address in the country,” said Mark Dimondstein, president of the American Postal Workers Union.
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Even if the Postal Service survived but was forced to cut back service, it could wreak havoc on elections. The most troubling area would concern voters who request a ballot a week or less before Election Day (Nov. 3 this year). Service interruptions could delay the delivery of that ballot, possibly causing the voter to not receive it in time.
That would leave some voters being forced to trade their safety to exercise their democratic right to vote by appearing in-person at a time when, as most health experts predict is likely, the pandemic will still represent a threat. The dangers have already been realized in Illinois and Wisconsin, where cases of coronavirus transmission and death have been tied to primaries those states held in March and April, respectively.
“Do we really want people to have to put their health and safety at risk in order to meet what is a constitutional right?” Condos asked.
Legislation to provide the $75 billion in relief funding enjoys bipartisan support in Congress. The request was made by the Postal Service Boards of Governors, a majority of whom are Republicans appointed by Trump.
Trump, however, looms as the biggest obstacle ― which stems in part from his belief that the Postal Service provides Amazon with an unfair deal on package delivery (the president blames Amazon-owner Jeff Bezos for the negative coverage he receives from the Bezos-owned Washington Post)
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Last Friday, he termed the Postal Service “a joke,” and he has called on it to increase package rates four or five times in order to receive relief funding. “But they don’t want to raise it because they don’t want to insult Amazon, and they don’t want to insult other companies, perhaps, that they like,” he said.
Trump has also falsely claimed that mail voting is “horrible” and “corrupt.” (He cast a ballot himself in the March Republican Party presidential primary in Florida by mail.)


huffpost--2020-04-29--17 Common Exercise Mistakes People Make When Working Out At Home

1 .
Trusting any person who posts a workout on Instagram 2 .
Wearing yourself out to get better and faster results 5 .
Repeating the same exercise over and over again 6 .
Thinking you ’ re doing it better because you ’ re shaking 7 .
Working above or below your abilities 8 .
Pushing past your limits to do as many reps as the trainer 9 .
Not paying attention to whether you have the right form “ No one is going to correct your form like they do in guided classes at the gym , so @ @ @ @ @ @ @ takes to the time to fix it , ” says Costa .
“ You can ’ t rely on what you see on the computer screen , “ so I recommend doing the exercise in front of a mirror wherever possible.
” Don ’ t worry if this means you miss a rep or two , because what it really means is that you ’ re preventing a possible injury .
10 .
Not resting or listening to your body 11 .
Starting without warming up and doing the exercises cold 14 .
@ @ @ @ @ @ @ much for you 15 .
Turning on the TV or keeping an eye on your phone 16 .
Doing an unsupervised class if you ’ re dealing with an injury

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A previous version of this article originally appeared in HuffPost Spain.
The coronavirus lockdown has many people focusing on moving their bodies. Faced with the prospect of not being able to go to a gym or a class, many have turned to YouTube and Instagram in search of workouts.
While it’s good to exercise, of course, you also need to be careful of how it’s done. The margin of error for bad form and mistakes may increase exponentially at home.
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The good news is that fixing these issues is as easy as making them in the first place. The first step is recognizing what you’re doing wrong, so that you can address it. Here are a handful of common mistakes people make:
1. Trusting any person who posts a workout on Instagram
Not all trainers are created equal, especially if you’re not used to doing exercise and don’t keep an eye on your form.
“One of the most common mistakes today is following influencers who don’t have any training, but who do have lots of marketing behind them,” explains Beatriz Crespo, a specialist with doctoral degrees in both medicine and sports performance.
“It’s like going to a professional who says they can cure you. They’re not a doctor but they do have a marketing package that positions them as a health guru,” she continued. ”You believe them and follow everything they recommend without questioning it and without thinking about it. You follow them because it’s easy, they’ve got bright colors and play the hottest tunes.”
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2. Wearing yourself out to get better and faster results
According to Crespo, “lots of people really believe that if you don’t get tired, if you’re not stiff the next day, or if you don’t train at a high intensity and with 100% motivation every day, then you’re not making progress or doing anything to make up for being stuck inside, and that will be good for losing weight.”
In her opinion, “this is the greatest myth and lie of the sports industry,” insisting that ”’train hard’ and ’no pain, no gain’ are lies.”
3. Thinking that sweating means you’ll lose weight
Nothing could be further from the truth. You sweat when you get dehydrated, and that’s why you shouldn’t exercise wearing lots of clothing or in a very warm setting.
“When you get dehydrated, the same thing happens as when you overtrain. It’s counterproductive, and it’s also dangerous for your health,” Santiago Marchante, a member of the Spanish Federation of Personal Trainers and Fitness, previously told HuffPost Spain.
RyanJLane via Getty Images
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4. Not staying properly hydrated
Water must be by your side throughout the entire routine, said trainer Verónica Costa. Water is more than enough to keep you hydrated; you don’t need sugary sports drinks.
“Unless the exercise is aerobic and lasts a long time (more than 70-75 minutes), it makes no sense to drink those drinks. Many are also hypertonic, meaning that they’re absorbed more slowly than water, and have a high sugar content, so they can cause gastrointestinal discomfort,” Pedro Ruiz, personal trainer and coordinator of tupersonaltrainer.com, previously told HuffPost Spain.
5. Repeating the same exercise over and over again
Our body isn’t going to be better just by endlessly repeating the same workout. In fact, it can be counterproductive.
“Variety in stimuli is important to avoid strains,” Crespo said. “We spend a lot of time seated and we need sessions that make up for our sedentary daily routine by providing different stimuli based on four fundamental pillars: strength training, resistance, flexibility and speed.”
Francisco García-Muro, coordinator of physical therapy in physical activity and sports section of the Professional Association of Physical Therapists of Madrid, notes an additional problem: “Working very specific muscles can create an imbalance with respect to the rest of the body, and that ends up manifesting as a problematic condition.”
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6. Thinking you’re doing it better because you’re shaking
Don’t push yourself too hard at first or you’ll risk getting an injury.
“It’s not healthy for your muscles to shake during a plank exercise and for you to be encouraged to hold on,” Crespo said.
“Always doing everything really fast or getting really tired and finishing with your legs like Jell-O isn’t healthy either,” she continued.
7. Working above or below your abilities
You need to measure your strength to know where both your upper and lower limits are. If you want the exercise to be effective, physical therapist Pablo Olabe recommends getting a heart rate monitor. Then figure our your target heart rate for your age and health status and strive to work in that range.
8. Pushing past your limits to do as many reps as the trainer
There’s no reason for you to do the same number of reps as the online trainer who’s guiding you. Listen to your own body.
“The professional has to give you some guidelines so you can learn to monitor yourself on your own,” Crespo said. “In that sense, you need to measure the perception of fatigue that you get from the exercise or sequence of exercises suggested. From there, as a trainer, I can tell you a maximum of 20 reps and tell you the kinds of feelings I want you to get.”
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It’s advisable to stop doing the exercise when you start to feel worn out, but you still have strength to keep going: “On a scale of 0 to 10, where 0 is not tired at all and 10 is really tired, that would mean being around 6 or 7. Stop when you get there, whether it’s 6 reps, 8 reps, or the maximum of 20,” Crespo said.
visualspace via Getty Images
9. Not paying attention to whether you have the right form
“No one is going to correct your form like they do in guided classes at the gym, so you have to be the one who takes to the time to fix it,” says Costa. “You can’t rely on what you see on the computer screen, “so I recommend doing the exercise in front of a mirror wherever possible.” Don’t worry if this means you miss a rep or two, because what it really means is that you’re preventing a possible injury.
10. Not resting or listening to your body
“Rest is part of training and it’s really necessary so your body can regenerate tissues and improve bone quality after exercising,” Crespo said.
According to Olabe, it’s important to know how to listen to your body when you exercise, as well as when it should rest.
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“If we’re not able to listen to it and then the next day we don’t stop or we take it up a notch, the only thing we’ll end up doing is get injured,” he pointed out. He recommends three ways to exercise based on your baseline condition.
No regular activity: one light day of activity, one day of rest, one day of activity, one of rest. Repeat.
In good condition: two days of activity, one of rest, two days of activity. Repeat.
Regularly exercise: three or four days of activity, one of rest, three or four days of activity, one of rest. Repeat.
11. Starting without warming up and doing the exercises cold
The first thing to do before starting any round of exercise is to warm up, said Costa, who recommends spending 10 minutes on your warm-up.
“It’s like getting everything ready to go,” García-Muro added. “The warm-up reduces the risk of injuries, and it’s also how you can get the most out of the work you do.”
Even if you’ll only be working out for half an hour, you still need to warm up, either with a specific routine or by doing the first round more lightly.
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12. Overvaluing stretching
“Stretching is healthy, but it’s not a cure-all,” Crespo said.
“Our tissues are made to move. If you don’t move, you’re not going to make up for the firmness they lose with the lack of movement,” she continued.
That’s when your muscles, ligaments, and tendons become more flexible: “The tissues rub more freely against one another and you automatically feel fewer contractions or feelings of tension in different parts of the body, such as your neck, lumbar region, hips, shoulders, etc,” she said.
That’s why, to be flexible, first we need to move and then we need to stretch.
13. Undervaluing stretching
It’s not a cure-all, as mentioned, but it is necessary. In fact, Olabe recommends dedicating one session per week just to stretching.
“It’s a mistake to skip the stretching after a session, and it’s also a mistake not to dedicate entire sessions to doing a good set of stretches, myofascial release, and other techniques that are super healthy for the body,” added Crespo.
RyanJLane via Getty Images
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14. Giving up because an exercise becomes too much for you
You should stop the exercise if it becomes painful, but you can and should continue with the next one.
“Stop doing that exercise and move on to the next one because you might hurt yourself. It doesn’t matter if you skip one,” Crespo said. “If you can’t manage now, you will get there. The important thing is not to get discouraged or give up.”
15. Turning on the TV or keeping an eye on your phone
When you do exercise, the best thing to do is to leave your phone or any other distraction like the TV or a book switched off or out of reach.
“I believe that if you’re concentrating on one thing, you can’t be concentrating on another. It will be much less effective,” explained Olalla Eiriz, a trainer from VIP Training.
16. Doing an unsupervised class if you’re dealing with an injury
YouTube or Instagram classes are good, but be cautious if you have any problems or injuries.
“Anyone with an underlying problem, back pain, injuries, or who is pregnant should sign up for specific classes and do guided training,” Costa said.
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17. Focusing on the scale