A recent survey revealed that, as lockdowns from the COVID-19 pandemic are being lifted, 49% of Americans are worried about their weight, with an average of five pounds weight gain during the quarantine. In this survey, 65% of respondents have taken time off from their usual exercise routine to “let themselves go a bit.” The survey also found that 49% of the respondents were concerned that they may never regain their pre-quarantine look and weight. During the lockdown, alcohol consumption also increased along with more consumption of refined carbohydrates such as pasta, white bread, and pastries. Nevertheless, more than half of respondents made efforts to eat more vegetables, and 46% also increased their protein consumption. Exercise has been challenging during the COVID-19 pandemic, with 2 out of 3 respondents reporting “feeling physically weak.” Technology can help, and in this survey, 46% of people were exercising with the help of fitness apps, health and exercise websites, live stream workout classes, and pre-taped fitness videos. Given the evidence of who has been at greatest risk from COVID-19, more emphasis needs to be given to improving personal health, especially given the potential risk from a second wave.

For COVID-19, the time from the start of the infection to the start of the symptoms is about 5 days (though it can range between 2-14 days). This is called the incubation period. Overall, it looks like 80% of people with COVID-19 will have a mild infection or no symptoms at all, 15% will develop more serious disease, and 5% may require critical care. Researchers from Singapore reported that this period of infection in people with symptoms may begin 2 days before the start of symptoms. It can last for about 7-10 days after symptoms start. Although tests can pick up little pieces of the virus for many days or weeks after a COVID-19 infection, enough virus to cause an infection in someone else is not found after the second week of illness. Going forward, resources should focus on testing people with symptoms and suspected COVID-19 to allow quicker public health response and containment (isolation).

As the U.S. and other countries went into lockdown, saving lives from COVID-19 was the main priority. Many people reacted by buying alcohol to drink at home while in isolation. Now, as lockdown ends, we are likely to see the impact of alcohol’s harm. Two groups especially need our attention: those already struggling with alcohol dependence and those close to becoming dependent on alcohol during lockdown. For them, dependence will be triggered by sadness about a loss, job insecurity, or troubled relationships. Alcohol is strongly associated with domestic violence, and we know that there was an increase in the number of calls to domestic violence organizations during lockdown. We all must be prepared to support and help going forward.

Experiences from previous pandemics show that social isolation can be very bad for mental health. After the 2009 influenza A (H1N1) pandemic in the U.S., scores of post-traumatic stress were four times higher in children in quarantine at home compared to those not quarantined. This high stress level also applied to parents too. Almost 30% of quarantined parents reported symptoms of mental health disorders, such as trauma and anxiety. When people returned to their daily lives after SARS, many reported avoiding people who were coughing and sneezing and avoiding crowded and public spaces for many weeks. We are likely to see similar effects over the weeks and months after COVID-19.

Telehealth has existed for a while, but it was never a routine part of healthcare. With the COVID-19 pandemic, more and more doctor’s appointments are taking place using telehealth. This technology has been especially popular as part of routine diabetes care. Before, the major barrier to telehealth was not the technology or people. Rather, the biggest challenge was how to pay for it. This is changing, and now more doctors are excited to continue using telehealth with their patients. The main benefits include ease and convenience, a decrease in travel and pollution, and an opportunity for new types of group visits and support groups and with other people with diabetes. The COVID-19 crisis is giving healthcare providers valuable experience about what works well and does not work well in virtual visits. This will help improve telehealth in the future.

More than 230,000 people in the U.S. have recovered from COVID-19, but many have lasting symptoms long after their initial infection. These symptoms include fatigue, muscle aches, rashes and even heart issues. There is not enough data yet on long-term consequences for people who have had the virus. However, survivors have been taking to social media and support groups to share what they are experiencing. The World Health Organization says that the average time from the start of the illness to recovery is about 2 weeks for mild cases, and between 3 to 6 weeks for those with severe or critical disease. But many people with mild disease have actually reported symptoms lasting far longer than 14 days. When a patient tests positive for antibodies against the virus that does not necessarily mean their symptoms will stop. Some patients may continue to feel symptoms from either pieces of the virus or the body’s continued response to the virus.

For many years, doctors have been concerned about overuse of antibiotics to fight infections caused by bacteria. COVID-19 is a virus and does not respond to antibiotics. Recently, people who are hospitalized because of COVID-19 have been given antibiotics to prevent a second infection from other bacteria. This is worrying because it could lead to a situation where bacteria become resistant. This occurs when the antibiotic does not work anymore, and could leave us vulnerable to even more infections.

To control the COVID-19 outbreak, China introduced tough traffic rules and restrictions. The countrywide ban on traffic greatly lowered pollution from lack of cars and other vehicles, whereas emissions from heating in homes and industry remained fairly steady. In a recent study, the improvement in air quality was estimated to have saved many thousands of lives due to a reduction in heart attacks and other cardiovascular diseases. In fact, the decrease in the number of cardiovascular deaths could have outnumbered the deaths due to COVID-19 in China.

Type 2 diabetes and hypertension (high blood pressure) are the most common medical conditions in patients with COVID-19 infections. New evidence shows an important link to a person’s metabolism and how the virus causes such devastating effects. For example, COVID-19 has a direct negative effect on the pancreas. This is important because the pancreas is the organ that normally produces insulin, a chemical the body needs to control blood sugar levels. Doctors need to ensure early and thorough metabolic control for all patients affected by COVID-19. The bottom line: if a person is exposed to COVID-19, then excellent control of diabetes and blood pressure has to happen right away.

COVID-19 testing allows infected individuals to be identified and isolated to reduce spread, and also allows us to see who infected individuals might have come into contact with so they can take precautions as well. This is called “contact tracing.” Interpreting the results of a COVID-19 test depends on 2 things: accuracy of the test and estimated risk of the disease in the population (in other words, how common is the disease?). A single negative test should not be used to rule out the virus in patients experiencing manyCOVID-19 symptoms. If your swab test result is positive, then we can be very confident that you have COVID-19. However, if your swab test result is negative and you have strong symptoms of COVID-19, then it is safest to self-isolate.

In normal times, we all use elevators without much thought. These are not normal times due to the COVID-19 pandemic. At a basic level you might think that, as a crowded space where it is impossible to maintain safe social distance, an elevator would be a breeding ground for the virus. However, there are various other factors involved. Some infectious disease experts do not believe that airborne particles in empty elevators pose a significant risk for COVID-19. To be safe, wear a mask and wash your hands to lower your risk and, if an elevator passenger is not wearing a mask, perhaps wait for the next one.

Hispanic/Latino immigrants tend to have a relatively healthy profile upon immigrating to the United States, but with increasing length of stay, their health tends to decline. COVID-19 disparities are not the fault of those who are experiencing them, but rather reflect a society that creates health disparities in good times and inflates them in a crisis. The U.S. must develop a new kind of “herd immunity,” with resistance to the spread of poor health occurring when enough people, across all races and ethnicities, are protected and thus “immune” to negative social factors.