Looking after your health, with a little help from Covid-19

If we used to think our health was a personal matter, primarily down to genes, lifestyle and a dose of fate, the coronavirus pandemic has shown how wrong we were.

January is Health Month in The Irish Times. Throughout the month, in print and online, we will be offering encouragement and inspiration to help us all improve our physical and mental health in 2021. See
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Suddenly we were all tied together in sheltering from the single, most contagious virus we had seen in our lifetimes. The risk of being infected depended on behaviour of others as well ourselves: family members, friends and strangers. We were also, to an unprecedented extent, looking to public health doctors and politicians for advice and decisions to protect us.

The increased health anxiety we’ve all experienced to some degree has changed human behaviour, for better and for worse. The challenge now within homes and healthcare systems is to try to capitalise on the positive and discard the negative as we travel towards a vaccinated world that can cope with the coronavirus – and prepare better for the next pandemic.

While Winston Churchill said “never let a good crisis go to waste”, almost every health professional interviewed for this article warns that humans like to “revert to type” and permanent change in behaviour is very hard to make.

“We move on quickly – you can see why, it’s a good defence mechanism,” says psychiatrist Prof Brendan Kelly of Tallaght University Hospital in Dublin.

Infectious diseases consultant Dr Eoghan de Barra would like to think that our experiences would herald a transformation in thinking around healthcare and that people would recognise public health has to be adequately resourced. Yet history tells us societal memory is short. Within two years of the Spanish ’flu 100 years ago it was largely forgotten. Right now, in this pandemic, people just want to get back to normal, he says. “They’re fed up with it.”

However, what are some of the lessons we could take from the coronavirus pandemic in looking after our physical and mental health, both individually and collectively?

Acknowledge the crisis

“Many people have learned a degree of humility over the degree of control we have over our lives,” says Kelly. “It was always something of an implicit illusion that we were all-powerful and our lives were inviolable – particularly in our part of the world.”

In other countries, people are more accustomed to the vagaries of nature. “This is a lesson we can and should take with us: to value the moment more than we did because it is more fragile and we are more vulnerable than we imagined.”

The first lockdown, in particular, gave people the chance to slow down and reflect but that wasn’t comfortable for everybody, suggests clinical psychologist Trudy Meehan, a lecturer at the Royal College of Surgeons in Ireland’s Centre for Positive Psychology and Health that was established in 2019.

“I think a lot of people faced the question of what were they doing with their lives. And a lot of people I think had crisis of meaning and purpose. Some people had a crisis and were in a situation they could change and other people just had a crisis.”

For the latter she says the first thing to do is to acknowledge the crisis and then look at the meaning behind it. If you hate your job or your relationship, what is that saying about your values? “That crisis is telling you something important about something you genuinely care about. Follow that thread and it will take you out of the dark hole into something that is more positive.”

‘Lifestyle medicine’

The desire to do what we could for our own health at a time when we had no control over the coronavirus has led to increased empowerment and a boost to “lifestyle medicine”, if only we can sustain and build on it.

“We want people to have that mindset, that they can control aspects of their health and are going to change behaviours,” says Meehan. The six pillars of lifestyle medicine are: healthy eating; exercise; sleep; management of stress; relationships/connection; and reduction of harmful substances. In European regions about 86 per cent of deaths in normal times are accounted for by partly preventable conditions, such as type two diabetes, cardiovascular disease, cancer, respiratory diseases and mental health issues, she says.

“They can all be impacted and reduced by focusing on those six pillars.” Covid-19 has been most deadly for those with underlying conditions – accounting for almost 94 per cent of fatalities here, according to the Health Protection Surveillance Centre. More than 40 per of those had chronic heart disease.

The “Covid stone”, added to by Christmas excess, is likely to be the first target for lifestyle change at the moment. Although dietitian Louise Reynolds says we don’t need to beat ourselves up about it, considering the psychologically tough year we’ve had. A return to more normal routines will help shift some of the excess weight. She recommends small changes for sustainable weight loss – making consistently better food choices and building exercise into your routine.

Habit gains

It is said to take 90 days to establish a habit, so we’ve had time to acquire new ones from nine months of living with a pandemic. We could use the next three months to edit the repertoire.

“Ninety per cent of what we do in our lives is habit,” says Kelly. If we have been able to shift any of our habits in a positive direction for the three months it takes to establish a new habit, whether it was in relation to diet, drinking, exercise or sleep, we should try to keep it up.

“Every inch that we gain that becomes a habit is incredibly valuable.”

He gleans hope from some of the latest CSO data around alcohol consumption, which shows that the rate of about one in five people drinking more than they did pre-Covid has remained similar between surveys conducted in April and then again last November, but the number of people drinking less went up considerably. More than one in four (26.8 per cent) of November respondents reported that they had decreased alcohol consumption from pre-pandemic levels, compared with approximately one in six (17.2 per cent) respondents in April

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