Contributors
The current COVID-19 outbreak that we are facing in Singapore is unprecedented in terms of the number of people infected and the enormity of measures undertaken in efforts to curb its spread. With the circuit breaker going to be over and seniors are encouraged to stay at home as much as possible and avoid physical contact with people outside of their household (besides now one family member). These measures, although necessary to halt the spread of COVID-19, have given rise to new challenges in the ways we used to access everyday services, including health services.
If you or a family member have chronic medical conditions, it is imperative to keep your medical conditions well-controlled during this pandemic. We know that those with diabetes, heart disease, or high blood pressure who were infected with the COVID-19 virus (SARS-Cov-2) have higher rates of complications and deaths compared to the general population.
Here are some tips to help family members with chronic conditions cope during this outbreak. Please advise or provide appropriate supervision for them to:
1. Take their medications on time, as last instructed by their doctors. This is to help prevent complications and worsening of their chronic conditions. Make sure that they have adequate supply of medications to last them till the next doctor’s visit.
2. Eat healthily. Home-cooked food with less salt and sugar, filling half of the plate with freshly cooked vegetables, one-quarter with meat, and the other quarter with carbohydrates such as rice, pasta, noodles, or potatoes, is a simple way of approximating a balanced meal. Avoid having too much snacks in between meals as they may end up overeating and gaining weight unnecessarily.
3. Now may be a good time to advise them against smoking if they do so. Studies have suggested that smokers who contracted COVID-19 tend to have more severe infections than non-smokers.
4. Avoid excessive consumption of alcohol, with not more than one standard drink per day, equivalent to a glass of 150ml of red wine or one can of mid-strength beer.
5. Avoid known triggers that may worsen their chronic medical conditions, such as environmental dust or smoke for those with asthma, alcohol and certain foods for those with gout or people on certain medications.
6. Stay active physically and mentally. They can do simple warm-up or stretching exercises at home, walk a few rounds around their block (with mask on) or walk up and down a few flights of stairs at their nearest stairwell if they live in flats or apartments. For seniors who are not so mobile, muscle strength training using small water bottles as weights or alternating from sitting to standing positions are good options to try out at home. If they are prone to falls, please check with their doctors or physiotherapists the type of exercises that they can safely do at home and provide close supervision and assistance at all times. Reading a book, solving puzzles, knitting, handicrafts, or indoor gardening, are some activities that can help keep their minds occupied.
7. Monitor own health at home. Check daily temperature, blood pressure (for those with high blood pressure) or blood glucose (for those with diabetes directed by their doctors) as appropriate. Make sure that they know how to seek medical attention if they do not feel well. Most GP clinics and polyclinics remain open during this time. Please check with their regular doctors the clinic operating hours and whether they offer “teleconsult” services.
“Teleconsult” is a medical consultation that takes place over the Internet via a video call between a patient and a doctor. It can be conducted using mobile devices (phones, tablets, or laptop) or a desktop computer with a webcam. It can be a convenient way of getting medical attention without leaving the house. During the teleconsult, the doctor and patient will be able to see each other, ask questions and interact in a similar manner as a normal face-to-face consult in the clinic. The only important difference is that the doctor will not be able to physically examine the patient. A “teleconsult” can be effective for people whose chronic conditions are stable and requires only maintenance medications. It can also be effective if you have acute symptoms like cough, cold, fever, diarrhoea or headache and are not feeling too unwell.
Your doctor will be able to advise if you need to go down to the clinic or emergency department for further examination if necessary. Medications are usually delivered to your house a few hours after the “teleconsult”. “Teleconsult” has certain advantages during this outbreak. By moving medical consultations online, we can further reduce the risk of COVID-19 spread between patients and healthcare providers. Those who are able to use their mobile phone to video call are generally capable of initiating a “teleconsult”. For those who may not be able to do so, family members can help initiate the “teleconsult” or make an appointment for them to visit their doctors in clinics in the usual way. If they have an appointment to see a specialist, usually for the management of more complex medical issues, please make sure that they continue to attend the appointment to optimise their care. If your family member with a chronic condition is living alone, do check on them regularly with a phone call to make sure that they are coping well. Provide timely help as needed.
Always remind your family members with chronic conditions to maintain safe social distancing, wear a face mask and practise good hand hygiene whenever they leave their homes. Advise them to stay up-to-date with the latest COVID-19 measures and Ministry of Health (MOH) recommendations via national news channels, newspapers or the MOH website – www.moh.gov.sg/covid-19.
** Dr Lim Chun Siong is a resident doctor at DTAP Clinic.
