As winter and the holiday season approach, many officials are warning this season will be different than any in recent memory. With confirmed coronavirus cases rising rapidly throughout the country, and the flu and winter cold seasons starting, the Thomas Jefferson Health District (TJHD) recommends people not mix households for Thanksgiving—something that’s sure to be a challenge for many families.
“We are worried about what’s to come this winter, not just with the potential increase for COVID cases, but everybody being isolated and being at home. While (staying home) the safest thing to do right now, it’s not always the safest for our mental health,” said Kathryn Goodman, communications and public relations manager for TJHD.
Goodman said she’s hoping for really good weather on Thanksgiving and Christmas this year because that could allow people to see their loved ones outside, to help prevent spread of the coronavirus in a socially distanced setting.
“Getting together with multiple households in one place together, indoors, over a shared meal, is one of the riskiest things people can do this year,” she said. “It’s best that people celebrate with just their own household so they’re limiting the exposure and potential for them to get COVID and for spreading COVID.”
For those who do want to travel for the holidays, Goodman recommends quarantining up to 14 days prior to the holiday and for 14 days after the holiday to be sure you won’t spread the virus.
“We know that’s not possible for a lot of folks, but we are asking that folks at least try as much as they can,” she said.
For anyone who decides to get together, the mantra is the same as it has been: wear a mask, stay at least six feet apart, wash your hands frequently and stay home if you’re sick.
Ryan Banks, director of the Behavioral Health Division at Rappahannock Rapidan Community Services (RRCS), said she’s worried about people getting complacent with their health.
“The biggest thing that I’m worried about is just people’s fatigue over having to do things so differently,” Banks said. “I think that in the beginning, everyone thought that there was going to be a short turnaround on when this was going to be over. And now the realization that we’re in this for a while, I think it’s going to start to weigh on people a lot. And the choices that people make based off of that realization are going to be challenging and different; there are going to be some people that that’s going to really put them in a much worse place. There are going to be some people that are going to decide that they’re just giving up and they’re not going to do any of the things that they’ve been doing, up until now.”
“We want everyone to know that we understand there’s COVID fatigue; we’re tired, too,” she said. “But it is certainly a marathon and not a sprint and unfortunately, it’s not going away just yet. We know it’s really hard; it’s hard for me. This year we need to pull it back on celebrating with other households.”
When it comes to protecting your mental health, which includes emotional, psychological and social well-being, Banks recommends paying attention to your “circle of control.”
“It’s really looking at the things that we have control over for ourselves,” she said. “And being able to let go of the things we are not able to control. It really is an empowering mindset; rather than worrying about things that no matter what you do you’re not going to be able to change.”
Banks said holidays are often challenging even without a pandemic—there is extra stress caused from traveling, preparing large meals or hosting family members.
“I think the challenge is going to look different for different people, but holidays—I think—across the board are going to be difficult for everyone,” Banks said. “Keep track of ‘what do I have control over?’ I think it helps, no matter what situation you’re in. For people who have chronic mental health challenges, they really need to make sure they are staying up with appointments, keeping up with medication and such. It’s being very diligent, because again, that stays in our circle of control.”
Banks also recommended people make plans—no matter how big or small—for them to have something to look forward to.
“You can also get creative with what you do with your family,” she said. “My family is doing an online Secret Santa … and we’re mailing the gifts.”
Shannon Wright, Region Ten interim senior director of rural services, agreed.
“We’ve been recommending to folks throughout this pandemic to find ways to stay connected, but with an eye to safety,” she said. “Also, it’s important to do things that help us stay well or feel well and prioritize them—such as getting enough sleep and staying active.”
Wright said it’s important to focus on what are the most important aspects of the holiday season to preserve and have conversations about how to make it happen with your family. For Wright’s own family, it was important to just be together, and it didn’t have to be on Thanksgiving itself, so they’re planning to visit on a nice-weather day so they can be outdoors.
Goodman said the TJHD, which services the counties of Greene, Fluvanna, Louisa, Albemarle, Nelson and the city of Charlottesville, is also worried about the strain on hospitals.
“We haven’t seen too much flu yet and we don’t know what to expect,” she said. “We don’t know what the effects of flu mixed with COVID are going to be, if someone gets infected with both at the same time. We certainly encourage everybody to get a flu shot this year. The other concern over flu season happening in a pandemic is how are the hospitals going to handle that?”
Goodman said the state is seeing an increase in community-spread COVID-19 cases from social gatherings over the past month.
“And we’re worried that will continue to increase as we head into the winter and holidays,” she added.
Goodman also suggests everyone download the COVIDwise app onto their smartphone because it’s helpful in notifying people if they’ve been exposed and helps the health district with contract tracing. She said it’s estimated that 17.95% of Virginians aged 18-65 with a smartphone that could support the app have downloaded it.
Visit www.vdh.virginia.gov/covidwise to download the app.
Mental Health Resources
Health officials know the holidays are going to be challenging for many local families and individuals and want them to know help and resources are available.
“There have been substantial increases in substance use and substantial increases in overdoses,” said Shannon Wright, Region Ten interim senior director of rural services. “We met earlier today and even though overdoses are up, we suspect they would probably be up even more without Narcan. There are definitely people who are being saved from overdoses at home.”
Additionally, Wright said there are significant increases locally for rates of depression and anxiety symptoms and PTSD and stressor-related symptoms.
Kathrin Hobron, statewide forensic epidemiologist with the Virginia Department of Health’s Office of the Chief Medical Examiner, said the number of overdose deaths in the state has risen steadily since 2013 and if the trajectory stays the same the state is likely to see the largest increase yet from 1,626 in 2019 to more than 2,000 in 2020.
“Fatal drug overdose has been the leading method of unnatural death in Virginia since 2013,” she said in the October 2020 Fatal Drug Overdose Quarterly Report. “Fentanyl (prescription, illicit and/or analogs) caused or contributed to death in 59.3% of all fatal overdoses in 2019. Preliminary numbers from (second quarter) of 2020 suggest an enormous increase in fatal overdoses since the beginning of the COVID-19 national shutdown with a preliminary increase of 66.8% in 2020 compared with second quarter 2019.”
In Greene County, Region Ten offers the Medication Assisted Treatment program for those suffering from opioid addiction. Additionally, Region Ten offers monthly REVIVE overdose reversal trainings for utilization of Narcan, which is available upon completion of the trainings.
There have already been more suicides in Orange County year over year with five up to Sept. 30, 2020, and only three in 2019. Madison County has had one suicide this year with five reported in 2019. There were three suicides in 2019 in Greene County and while there were none by Sept. 30, Hobron said the 2020 numbers could change as investigations are completed.
Warning signs for mental health crisis include:
- Feeling excessively sad or low
- Extreme mood changes, including highs and lows
- Inability to concentrate
- Prolonged strong feelings of irritability or anger
- Substance use
- Physiological changes in weight, sleep or sex drive
- Thinking about suicide
- Unexplained and persistent physical issues (headache or upset stomach)
There is a regional peer-run warmline that is staffed 24 hours a day, seven days a week for those who need to talk at (833) 626-1490. For those who live in the Rappahannock Rapidan service area, there is also a crisis service phone line that is staffed at all times at (540) 825-5656. For those in the Region Ten Community Services Board area, call (434) 972-1800 for a behavioral health emergency, or call 911. Both RRCS and Region Ten offer substance use counseling, as well.
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