My name is Sarah - I am a GP with expertise in the science of  wellness and stress management.  In response to the coronavirus pandemic  the team at my social enterprise (EHCAP)  have made our free  e-learning modules for parents and professionals  easier to access. We know that talking about emotions and feelings is an important way for us to connect with each other and manage stress and anxiety. In these free e-learning modues you can learn about the neuroscience of stress and link with other parents and colleagues by posting comments and ideas. We continue to offer coaching in wellness and stress management throughout the pandemic.

Take a look at our trauma-informed Family Wellness Programme which provides access to straight forward psycho-education tools as well as information about the biology of stress. To get started using this programme watch this video explanation. One of the key metaphors we talk about is The Hand Model created by world reknown neuroscientist Dan Siegel. This is an interpretation by Amy- a Parent Support Advisor in Somerset.

The evidence is unequivocal that the first 1,001 days of a child’s life, from pregnancy to age two, lay the foundations for a happy and healthy life. Over 200,000 babies were born when lockdown was at its most restrictive, between 23rd March and 4th July.A survey created by Best Beginnings, Home Start and Parent-Infant Foundation suggests that the impact of COVID-19 on these babies could be severe and may be long-lasting. The report Babies in Lockdown reveals the disproportionate impact of COVID-19 and subsequent measures on those pregnant, giving birth or at home with a baby or toddler. 

There are all sorts of wonderful resources being created across the world for children. In the UK, Nosy Crow have released a free digital download of 'Coronavirus- A Book for Children' illustrated by Alex Scheffler (of Gruffalo fame) and this lovely nurse Dotty children's book was written by an Intensive Care Nurse in Southampton - Dave the Dog is worried about coronavirus . Oxford University Press have released 'Everybody Worries' as a free e-book for children worried about coronavirus with the message that we will get through this together.

There is now (added August 2020) an online NHS funded COVID resource with lots of information supporting recovery from COVID. The section on breathing difficulties is particularly useful https://www.yourcovidrecovery.nhs.uk/managing-the-effects/effects-on-your-body/breathlessness/ .

Colleagues I am working with have recommended this Facebook Page  - The Positive Path of Wellness.

Those of you who have been involved with us for a while will know that we have had a collaborative relationship with Headspace for many years. I have attached their information sheet on the evidence base behind mindfulness. Click here for free annual log ins for educators and for health care professionals.  During the pandemic Headspace is hosting  free meditations and mindfulness exercises  created for New Yorkers but open to us all.

It‘s very easy to slip into thinking about COVID-19 in terms of whether a hospital admission is required or not but dont forget although the majority will have a brief illness easily managed at home others will actually feel very unwell over quite a long time period. One of the Professors at Liverpool School of Tropical Medicine describes his experience in a British Medical Journal blog and Professor Trish Greenhalgh has written a British Medical Journal article about Long Covid.  I am now pretty much OK  but I had twelve weeks of a persistent dry cough, fatigue, breathing difficulties and racing pulse and I'd like to share some of my learning from this experience. Internationally, more and more people are talking about how long it can take to clear this virus and some very well known have gone public for example Chris Cuomo interviewed by Dr Sanjat Gupta during his illness on CNN Live and in recovery . 

Are you still deciding whether to wear a face mask or not? click here to read a pretty definitive argument by Peter Tippett.

My own top tips for preparing in advance for that moment when you think you or one of your family has COVID-19 are:

• notice your symptoms from the start, slow down and potter or rest. The main features are fever, cough or chest tightness and shortness of breath but a paper in the British Medical Journal describes these symptoms in patients presenting to hospital:  77% had a fever, 81% a cough, 52% tiredness/ muscle aches, 34% headaches, 8% diarrhoea. 
• find a way to manage your anxiety - focus on what you know about 'keeping your lid down' and managing your stress, keep connecting with friends and family and  explain your physical symptoms and talk about how you are feeling emotionally.
• integrate mindful activities into your day- you may find my mindful meditations helpful
• make sure you have good quality kit- an ear or no-touch thermometer, a finger pulse oximeter and a home blood pressure monitor. Those of you who are asthmatic will also have a Peak Flow Meter.
• in my household we found that taking daily measurements as a regular twice daily activity was calming and also meant that we                           had plenty of information available when speaking with health care professionals on the phone. 
• use regular breathing exercises right from the start - this video by Dr Munshi, head of urgent care at Queen's Hospital in Romford, Essex has helped many including J.K. Rowling. If your breathing difficulties go on for weeks you may find you need to re train yourself to breathe normally during your recovery phase.
• try lying on your tummy to sleep and for about 10 minutes after your breathing exercises during the day- I found putting a cushion under my hips helpful.
• talk in advance about how you can divide up your house to minimise infection risk and if furniture needs to be moved do this while you are well. Is it going to be OK for all of you to stay in the same house If one of you is high risk? how will you manage children and other dependents?
• access support - take a look at this list of useful links recommended by professionals and families that I have coached
• give yourself time to reflect and meditate - we all need to keep as calm as we can.
• stock up your first aid kit because household accidents will still happen.  
• stock up on honey and tissues and remember your hay fever medication                                                                                                                                                                                                                                                             

The Mindful Emotion Coaching and ACE awareness (MACE) approach to stress management and wellness that we have put together is underpinned by research from Harvard University  and because of this we have access to the Harvard Medical School Coronavirus Resource Center which has a constantly updated webpage with answers to questions about things like :

• what about coronavirus and kids
• how to support children (and yourselves)
• dealing with stress, anxiety and a range of other emotions
• useful infographic on coronavirus and child development
• Professor Jack Shonkoff- the science of infective disease and how to protect child development during physical distancing
• COVID-19 - self care isn't selfish podcast from Center on the Developing Child
• COVID-19 and racial disparity - core causes of disporportionate effect 
• COVID-19 and domestic violence in the US
• Mental Health in a Locked Down World

Dr Greg L. Fricchione is the Mind Body Medical Institute Professor of Psychiatry at Harvard Medical School. In this podcast he places in context the worries we all feel at the moment and talks about positive, tolerable and toxic stress as well as the science of mindfulness and the role of mindful activities in reducing stress and anxiety. 

Entirely free to watch and share, this  video by Dr. Bessel van der Kolk provides core practices to ward off the feelings of vulnerability, isolation and fear brought on by the COVID-19 pandemic

You may be aware that legislative changes are currently in process through 'The Coronavirus Act' - if you are a health or care worker it's certainly worth keeping up with what this means for all of us on the ground.  

Justin Amery is a GP expert in end-of-life care and has put together a series of video clips  with lots of helpful ways of managing our worst fears while hoping for good outcomes. The video below is the first in his series and in it he explains to families, carers and professionals how to think ahead and have conversations about planning for the worst case scenario. It's a difficult series of videos to watch but for those of us with vulnerable relatives and friends it's an important one.

Before signing off there are more amazing things happening - take a look at  an online community built by leading experts in health and wellbeing including Ruby Wax and Dan Siegel. Ruby Wax is now offering her UK Frazzled Cafes online rather than face to face and John Kabat Zinn is back with The Awake Network offering his wisdom to healthcare professionals during this unprescedented time.

Dan Siegel is hosting a weekly 'PEPP MWe Up Talk' on a Friday at 9pm BST exploring the science of the mind and the practice of presence. with intention and compassion. In essence Dan is inviting us all to promote wellbeing with The Wheel of Awareness.

The direct URL for this page is www.carersupportmatters.co.uk  and the direct URL for the e-learning I have mentioned is www.parentsupportmatters.co.uk - please share with friends and family-

Very best wishes

Sarah

Dr Sarah Temple MRCGP

Director, EHCAP Ltd

www.ehcap.co.uk