Earlier this week, I hosted my first Substack Live. Thank you to those who attended. It was fun and hopefully the first of many. The conversation was inspired by a thoughtful email from a subscriber, Doug, which guided the discussion.
He writes:
Hello Dr. Khan,
I was thinking about a fear I think any long Covid sufferer has and that is the fear of possible reinfection. What level of risk are you willing and not willing to accept ? What mitigation measures do you take to minimize the possibility of reinfection ? How do you explain to those that are well why you need to take such measures? I would be interested in hearing from you and others how they deal with this ever present fear.
Doug poses a timely and urgent question. It’s also a big one, so in my Substack Live I focused on how I mitigate reinfection during times of gathering, like Christmas.
With the help of attendees (remember, Doug is asking how YOU answer this question, too), we addressed risk-mitigation, balancing the benefits and risks of social engagements, and practical health tips. I shared my personal practices to avoid reinfection, as did other Long Covid, MD subscribers. We talked about some serious topics, but it was fun to be with all of you!
I’m summarizing the main points of our discussion below. Join me for my next live video by subscribing to Long Covid, MD and downloading the Substack app.
“Long Covid, MD” Substack Live Highlights:
Risk-Benefit Analysis:
I emphasized finding your "why" for participating in holiday events. Understanding your motivations can help set boundaries and plan strategies like entrance and exit times that allow you to maximize your fun and minimize exposure to infections.
Balance the risks of reinfection against the mental and emotional benefits of socializing. Socializing virtually can certainly be satisfying, but in-person events are often a special opportunity to bond with people you care about. In the case of work events, they can be important professional opportunities.
Health and Immune Preparation:
Optimize sleep, hydration, and nutrition before attending events. Clear your schedule before and after, if you can. To learn more about ways I do this, read or listen to my October Rundown.
To strengthen your body’s natural lines of defense, practice nasal hygiene regularly, using nasal saline with a neti pot or nasal saline spray. Arm & Hammer makes a nice one. Nasal wash is part of my family’s daily practice to reduce viral contact with nasal mucosa. In the Live, I detailed how I dilute oxymetazoline safely, on those occasions I have nasal congestion. Known by the brand name Afrin, the over-the-counter oxymetazoline dose is too potent to use regularly without risking damage to important nasal structures. Even diluted, oxymetazoline is best used infrequently.
Use a nasal steroid for inflammation, if needed. Remember that nasal steroids like Nasacort need to be used for about a week to work best. Systemic absorption of nasal steroids is small.
Consider probiotics like Streptococcus salivarius K12 to improve oral flora.
Environmental Control:
Opt for well-ventilated settings, open windows when possible, and use portable air purifiers.
Leverage tools like CO2 monitors to assess air quality and make informed decisions.
Managing Social Situations:
Consider wearing an N95 mask and if you’re worried about comments other people might make, prepare a short response. Keep it light, stay confident, and keep enjoying yourself.
Take breaks during events to rest and recharge and plan a treat or recovery time afterward. Identify the spots you can use to rest before you get too tired.
Psychological Resilience:
The group highlighted the importance of protecting ourselves without guilt, especially when dealing with individuals who may not respect boundaries.
I encourage you to foster connections that replenish energy rather than deplete it.
Optimistic Framing:
We reinforced how attending events for a short, joyful period can be more fulfilling than extended, stressful participation.
Encouraged flexibility, such as leaving midway through events or finding alternative ways to connect, like phone calls. Subscriber Ellen described how she uses a portable CO2 monitor at theater performances, and she’ll leave a show at intermission if levels increase too much. Better to enjoy half a performance safely than the entire show worried about reinfection. Quality over quantity!
Community and Support:
The Long COVID community has a shared struggle. Although this disease often leaves us feeling isolated, I admire our continued resilience and compassion for others.
I encouraged you to share your strategies to mitigate reinfection and help foster a collective learning environment. Leave your comment below!
Encouragement and Empathy:
We closed with a message of pride and solidarity, reminding myself and participants that our struggles are valid and that we are not alone.
Again, thank you to those of you who attended, and a deep thanks to Doug for emailing me about a very important topic. What strategies are you using this holiday season? What has worked for you and what are you considering changing?
Leave a comment below and send me your questions for a future Live. Email me at longcovidmd@gmail.com, or leave me a voicemail from your computer or phone.
Happy Celebrating!
