Guide On Living With COVID-19

KUALA LUMPUR: It has been more than a year since the first Movement Control Order stopped us in our tracks and we are still learning about the aftermath of the COVID-19 pandemic.
The more we get to know it, the better equipped we are to protect ourselves.
At the start of the pandemic, the virus was thought to spread through saliva when we speak, coughed or sneezed.
These droplets did not travel very far and that gave us a sense of safety that if we followed the social distancing protocols, wore masks and avoided direct contact, we would have been safe.
A year and a half later, this wisdom no longer holds water.
Most experts now agree that the virus is also airborne and this has been a game changer on how we can better protect ourselves.
For example, we were once obsessed with wiping down our groceries and spraying surfaces, we now know that surface transmission is less of a threat than the air we breathe.
Here, International Medical University (IMU), School of Medicine, Head of the Division of Medicine Prof Dr James Koh Kwee Choy (pictured above) explains to us some of the ways we can double up on protection.

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Keeping The Air Safer
With an airborne virus, air circulation in enclosed spaces has become an important focus. Air-conditioned offices, buildings, and modes of transportation are now seen as even higher risk as viruses in the air will recirculate through air conditioning systems.
“If you are indoors, if possible, do open the windows. If you have to be in an air-conditioned area, then make sure the air conditioner has a good filtration system,” said Prof James.
He said air conditioners that use high-efficiency particulate air (HEPA) filters such as those used in isolation wards in the hospitals, aeroplanes and some offices can keep the air safer for us—as long as they are well-maintained.
However, the everyday units that we use at home do not usually have these filters, unless we have invested in a high-end one.
To help clean the air indoors, we can use air purifiers equipped with HEPA filters.
Some come with UV lights that help to destroy viruses.
“HEPA filters help to filter out viruses so that they are not recirculated in the air and a UV light destroys the virus,” explains Prof James.
Take note though that HEPA filters come in different grades, which in turn provides different efficacy rates.
According to Prof James, if one is going to get an air purifier, get a reliable brand as cheaper products may have doubtful efficacy.
UV light room sterilisers can also help to destroy viruses. These can be useful in offices and other places with higher foot traffic.
They may be a useful alternative to complement wiping surfaces with disinfectants.
However, they should only be used with no one in the room as UV rays can damage eyes and cause skin cancer as well as kill indoor plants!

Doubling Up
Doctors and the Malaysian Ministry of Health have also started to promote double masking.
“The idea behind the double mask is to ensure that the mask fits the sides of your face snugly because if the virus is airborne, it could come through the sides of your mask. If you could wear one single mask and make sure it fits nicely to your face, that would also work,” explained Prof James.
To double mask correctly, wear a cloth mask on top of a surgical mask.

Double Mask.

The cloth mask will help to ensure that the surgical mask sits properly on the face. This also means any method that helps a mask to fit well is worth doing—for example knotting straps or using mask extenders. For children, buy masks in a size that is suitable for them.
Apart from ensuring your mask fits properly, we also need to wear it properly. A mask should not be pulled down below the nose or lifted when we speak. It should cover both nose and mouth, at all times.
“A lot of people just wear masks because they don’t want to get fined.
“They should be thinking of how a mask protects others as well as limits their own risk and exposure,” he said.

Quality Not Quantity
Most importantly, we need to ensure that we use good quality masks. The market offers many cheap masks, which although are affordable, may not be effective.
“Look at what is written on the box. It should say surgical masks or for medical use,” he said.
The masks should also be 3-ply. This can be checked by cutting a mask and looking for the extra layer inside.
“The 3-ply mask has been used by surgeons for decades so it is good enough for community use,” indicating that it is not necessary to use 4-ply masks.
There are also the KN95 or the N95 masks that are better in terms of filtration than the surgical mask, “but you have to bear in mind that these masks can be very uncomfortable to wear. You feel breathless, especially for people who already have respiratory problems, elderly people, people with heart failure and chronic smokers,” Prof James said.
Feeling breathless might also be a problem for those who double mask, but it is as simple as listening to your body.
“If your body says slow down, don’t rush. Wearing a double mask is going to be a lot more uncomfortable than wearing a single mask, but you can help yourself by doing things a little bit slower. Take deeper breaths, walk a bit slower instead of running and rushing.”

Refuse To Reuse
The biggest worry with masks however is when people reuse them. Many insist on wearing masks more than once and there are even gadgets being sold that promise to sanitise masks to make them reusable.
“This is dangerous because a mask is meant to trap droplets and whether those droplets are infected or not, it is still not clean.
“If you keep your masks long enough, you risk other things growing on it such as bacteria and fungus.”
Hence, Prof James advises that disposable masks be thrown away immediately after we use them.
“Don’t keep used masks in your car or leave them lying around. Any virus trapped on the mask can recirculate in the air.”
The same caution needs to be used with cloth masks, which should be washed with soap and water and air-dried after each use.

Post-Vaccination Freedom?
“We need to continue to wear masks and practise social distancing even after vaccination with COVID-19 vaccine, advises Prof James as we can still be infected and still infect others.
“We may be less contagious after our vaccinations, but if we hug and cry on each other’s shoulders, this makes no difference. We will pass the virus on,” he said.
He said it was important to note that currently, the number of people who are not vaccinated far outnumber the ones who are. If others around you are not vaccinated, they can end up with a severe form of COVID-19.
In Malaysia, we have recorded cases of the South African, UK and Indian variants —known to be more transmittable and associated with more severe complications. These variants have probably added to our country’s rising rate of infection and death.
“We are seeing people being admitted into hospitals for COVID-19 at Categories two or three. Overnight, they can deteriorate to a Category Four or Five where they have to be moved into ICU. There can be very fast deterioration,” warns Prof James.

Monitoring At Home
The escalating number of cases has raised fears that have caused people to rush out to buy oximeters.
While this is not harmful, when getting an oximeter, you must buy one from a reputable brand or invest in a smartwatch that is equipped with an oximeter.
“If people buy a poor quality oximeter, it may give you a good reading even if your oxygen level has dropped.
“This can then give us a false sense of wellbeing.”
An oximeter works by emitting light through a finger or an ear lobe onto a light-sensing probe in the device.
How much light passes through indicates how much oxygen is in the blood.
An oxygen level of 98 to 100 percent is normal but if it falls to 95 per cent and below, it is time to visit your doctor.
If you are feeling breathless, however, seek medical attention no matter what the oximeter reading is.
People who have lung conditions including long-time smokers may have lower levels of oxygen than the norm.
Oximeter readings can also be affected by dark nail polish, poor nutrition or even the colour of your skin.
These are important factors to take into consideration when using the oximeter.

An oximeter. Supplied.

Prevention Is Always Better Than Cure
It has been a long fight and people are getting fatigued and confused over the ever-changing SOPs (standard operating procedures mooted by the pandemic). Yet there is one thing that has remained true, and it is the conventional wisdom that prevention is better than cure.
This means a continued adherence to the now-familiar mantras.
Wash your hands. Don’t touch your eyes, mouth and nose. Practise social distancing. Wear a mask, or two. Get vaccinated and encourage others to do so. Face shields and goggles are also becoming a familiar sight especially in more crowded places such as a supermarket. These can work as an added layer of protection.
Ultimately though, Prof James says: “If it is not essential, stay at home.”

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