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Thursday, March 19, 2020

Dear viewer, All of us are undergoing a difficult period filled with uncertainty due to the Corona Virus. The very structure of our days, the ways we interact, and our freedom of mobility have changed.  We take every precaution to prevent the microscopic intruder from invading our bodies and threatening our well-being or even our very lives. As people with disabilities and ongoing health conditions and as people connected with us, we need to be particularly cautious and prepared and consider more factors than our peers. The following is not meant to be exhaustive or prescriptive, but rather a guide to help people think through the questions that you may want to be asking yourselves when creating an emergency plan for yourself and your family.  Please consult your doctor or other relevant professionals for your medical-related questions. Maintain Basic Hygiene. One of the most effective ways to prevent the spread of viruses in general, including the COVID-19 virus, is to practice good hand hygiene. This means washing your hands thoroughly and often. Best practices suggest washing hands for at least 20 seconds, or the length of time for children to sing through the alphabet song, or happy birthday twice. Wash your hands before preparing and eating food, and after blowing one’s nose or sneezing or coughing into your hands. Sneeze and cough into the crook of your arm, or into a tissue that you throw away immediately and then wash your hands again. Use a tissue to open door handles and clean handles and surfaces thoroughly and frequently. Hand washing is seen as more effective (when done correctly) than using hand sanitizer, however, if one is out in public, a hand sanitizer with at least 60% alcohol can be effective. Try not to touch your face: eyes, nose, and mouth as this is a way that the virus can be transferred. Minimize Touching Other People. When greeting others, avoid kissing each other, hugging each other, and shaking hands. While this can be socially awkward, it can help protect yourself and others. Practicing a short sentence explaining your reasons for not touching others can sometimes help this become more natural and easier to do while at work. Teach children to use words, gestures, and deeds to show just as much affection for others and teach them age-appropriate reasons for being careful to prevent germs from spreading. Avoid Mass Gatherings Like Large Simchas, When Possible. Covid-19 is more likely to spread where there are many people packed into one place.  Assume as if everyone is a potential carrier, including you.  You don’t want to either unwittingly become infected or infect others.  If you  absolutely need to attend a public gathering, maintain a 6 foot distance between yourself and another person. Avoid Mass Transit If Possible. If one must travel by mass transit, wash your hands frequently and thoroughly, wear disposable gloves and dispose of them directly into a trash can and then wash your hands, try to avoid hands touching surfaces, try to leave some distance between yourself and the next passenger, try to stay away from people who are obviously sick, or obviously touching their face. Since those of us using wheelchairs typically sit shorter than the average person, we often get coughed or sneezed on by just being in a public space. Because of this, it is a good idea to wear a hat, and sweater/jacket that can be removed (along with shoes) at the door of your destination. After removing outer clothing, wash your hands. Try to avoid plane and boat travel if possible. If it is not possible to avoid, try to pay attention to the hygiene practices above. Check Your Medication Supply. 1. Do you have at least 2 weeks-worth of over the counter medications, including fever reducing medication for each member of the family on hand? 2. If a primary caregiver is not able to, or allowed to, go to a pharmacy to pick up medication for other conditions present, how else can medications be gotten? Do you have 2 weeks extra supply on hand? Do you have a friend or neighbor who can get it for you? Will your pharmacy deliver? What is your Dr. and pharmacy’s plan to get medications to patients if a quarantine is put in place? Will insurance allow medications that are considered “controlled substances” to be obtained in larger quantities in anticipation of a quarantine? Or as a one-time extra supply for an emergency kit? 3. Keep in contact with your Dr. and pharmacy about any supply chain issues that they are concerned about regarding the medications and supplies that you use. Find out what their plan is. Prepare for Possible Isolation or Quarantine. Isolation is used to separate ill persons who have a communicable disease from those who are healthy. Isolation restricts the movement of ill persons to help stop the spread of certain diseases. For example, hospitals use isolation for patients with infectious tuberculosis. Quarantine is used to separate and restrict the movement of well persons who may have been exposed to a communicable disease to see if they become ill. These people may have been exposed to a disease and do not know it, or they may have the disease but do not show symptoms. Quarantine can also help limit the spread of communicable disease. Clean Surfaces: Take some time to think about all of the often-used surfaces in your home, car, and on your person, that may need to be regularly cleaned. Keep in mind: smart phones and landline phones, telephone chargers, headphones, remote controls, keys, wallets, credit cards, change, paper money (use gloves to handle), car door handles, door handles, light switches, console controls, computer keyboards, books, and e-devices. Stock Up and Prepare Ahead for Isolation or Quarantine Shopping and banking are tasks that many people do in-person. It is a good idea to reasonably stock up – for 14 days – on non-perishable food items, cleaning supplies, and toiletries now so that you do not get caught in the event of a quarantine. At the same time, don’t take more than you’ll need If possible, set up bill paying, shopping, banking, and other tasks, online so it minimizes the necessity to go out in public. For those of us who have difficulty using computers and websites as a result of a disability or chronic health condition, talk to friends, family, and neighbors about having them assist in a time of emergency. Setting this up ahead of time, before it is needed, can lower the stress level during an emergency. Isolation At Home. If one person gets sick with a communicable disease (one that can easily pass from person to person), what do you do at home to minimize others getting sick? Do you have a specific area of the house that the individual remains in? Can that person eat, sleep, receive all medical care, attend online school or work, all from this area? If caregivers enter this area, what procedures are followed to protect both the caregiver and other family members? Are bathrooms shared? If so, how can this be handled so as to minimize the spread of germs? Do people share a bedroom, can this be changed in order to facilitate isolation? Schools: By now many yeshivot, day schools and school districts have closed. The following information is helpful for students still attending school or students who return to school in the future. Talk with your school administrators regarding their emergency planning. What do they plan to do to learn if anyone associated with the school is affected? What is their plan to communicate knowledge of effected individuals to the rest of the school community? What are their plans regarding closing schools and regarding changing class sizes? What hygiene practices are being enforced now and will this be stepped up if there is a local change and what change will trigger this? Does the school have a policy regarding not allowing sick people to come? Is it enforced? Can they notify you if it happens? Will they penalize students, or staff for not coming in order to protect our health? Is documentation needed to avoid this? Is tele-education and online education possible? What accommodations will be made for those with disabilities and chronic health conditions who have difficulty using computers, the internet, and many websites such that they will receive equal access to education? In the United States, Federal laws like the Individuals with Disabilities Education Act (IDEA), the Rehabilitation Act, and the Americans with Disabilities Act all continue to apply during disasters. Children still have the right to a free, appropriate, public, education. For those living in countries outside of the U.S., you may want to check to see what local civil rights laws apply to you. Employment: What is your employer’s emergency preparedness plan? How will they know if someone associated with the place of employment is affected? How will they communicate this to their workers? Do they have policies regarding work travel? Will they require those who travel to self-quarantine upon return? Do they have a telework policy? Do they have non-punitive leave and FMLA policies? Will they allow use of telework and/or leave for those whose kids’ schools close, or for those who are caregiving for someone for whom going to school, or work, will be more dangerous? What about for an employee with a weaker immune system? In the U.S., the Americans with Disabilities Act (ADA) still applies in times of disaster. For those in the U.S., if you have already been determined by your employer to meet the criteria of having a disability on the job, will you need to request additional accommodations to be able to meet the essential functions of the job during a disaster? For those who do not already have this status, but believe you will need accommodations during a disaster, now would be the time to start this process. Everyone should remember that this is a process, so please do not wait until the last minute to start planning for what you need. For those living outside of the U.S., what local laws apply to you? Child care If schools close, do you have a friend, neighbor, or family member who can provide childcare? What is your plan if transportation is restricted in the area? If you get your childcare through an agency, how is the agency screening for infected workers? How will they communicate this to you? What are their policies about sending workers who are sick into people’s homes? What protective gear do those workers have? Do they have adequate training in the proper use of the equipment? What policies do you want to set up for your home as to who can enter and under what circumstances, in order to minimize the risk of infection. You may want to think about, and rehearse, a response to children asking why they cannot go to a public event, or why they cannot have play dates, etc. Practicing using age-appropriate responses will allow for easier, less stressful, conversations. Be creative in thinking about alternative activities now so that you are not doing as much scrambling in the moment. Obtaining Medical Care Communicate with your medical team. What is their plan for handling sick people who come to their facility? How will they communicate this plan and any current news regarding this to you/other patients? What plan/protocol does your medical provider want you to follow regarding regular maintenance health care? What if you need urgent care not related to the possible virus? What policies and procedures can be put in place to keep us as healthy as possible? Personal Assistance Services/Attendant Care/Home Nursing Services: You may want to put in place a policy about who can enter your home and under what circumstances. For those of us who rely on others for medical infusions, post-surgical care, and personal assistance duties such as showering, dressing, cooking, cleaning, eating, and attending to our mail. it is a good idea to discuss subjects such as proper hygiene, wearing protective gear, getting training on protective gear, who will supply the protective gear, what happen if one of you becomes ill, and how they will get to you if there is limited transportation, and/or a quarantine. If you get personal assistance from an agency, how will the agency learn if someone is infected? What are their work policies around coming to work sick? What will they do if your worker is not able to come to you? What protective gear will they supply their workers? Will they train them in its proper use? Again, this document is merely a guide for your consideration and is not intended for medical use. Please use common sense in implementing policies and practices that work for you and your family. Always check with your medical team to ensure that everyone is in the loop. And, if you have questions, or concerns, please do not hesitate to ask. Wishing that everyone remain virus-free! If you or anyone you know contracted the virus, we wish you or them a refuah sheleimah –complete recovery. May this all be but a distant memory very soon. Thank you to Sheryl Grossman, our board chair, for compiling the essential information and questions for this post. Yad HaChazakah Staff and Board  

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