Six months into the COVID-19 pandemic, many are already stressed, stretched, tired, exhausted, drained, wearied, and debilitated from its multifaceted effects in our daily lives. Experts have coined the term "COVID fatigue” to describe this pandemic's harmful physical and psychosocial manifestations. It was initially used to refer to the enormous toll and burnout of the first-line health care workers who worked long hours in dire conditions. It now includes everyone living in the limbo of this pandemic. Our collective fatigue makes some people careless about masks and social distancing and is one reason we see a sharp rise in COVID-19 in our community. With others, it's not just carelessness, but it's angry resistance, and they were hit with disillusion. These people simply lost their optimism, hope, and stopped listening to health and government leaders. The ambiguities, grave intensity, and prolonged duration of this COVID-19 pandemic pose a considerable burden and stress to everyone. Our society has already lost tremendously from this crisis ranging from loss of jobs, income, education, daily- routine, sleep, security, and, most notably, loss of lives.

Based on an article published by Harvard Business Review in July 2020, the pandemic stages are akin to the five stages of grieving, and each experience was varying in duration and severity of each stage. Initially, there was much denial early on. Then anger followed because of the lockdown, and we were asked to stay home. This was followed by bargaining; OK, if we social distance for two weeks, everything will be better, right? This was followed by sadness: We do not know when this will end, and we cannot go anywhere. And finally, there's acceptance: This is really happening, and I have to figure out how to proceed with my life. Acceptance is where the power and control lie. This includes moving on with your life with some form of normalcy, including wearing a mask, keeping your distance, and practicing proper hygiene and sanitation.

We need to recognize COVID fatigue to beat the stress from this quandary by developing our individualized coping skills. We can start by being aware and by being easy on ourselves. Stress will always be a normal part of our life and something we cannot control; however, we can control our response to stress. Some of these coping strategies include keeping a positive attitude, thinking constructively, accepting that there are events you cannot control, learning to relax (including deep breathing and meditation), being physically active, eating a well-balanced meal, talking about your fears and stress, practicing mindfulness and gratitude, and getting adequate rest and sleep.

Lastly, take a regular break from information overload from social media and constant news sources from various sources. An unprecedented amount of information is constantly available for our ceaseless consumption. Information overload can lead some people into a feeling of desensitization and makes them careless and unwary of their actions. We need to be smart in discerning authentic from fictitious news by reviewing the authority of its source. Information overload may make us more confused, perplexed, and confused than enlightened and well-informed.

"Coronasomnia" is a new term coined by sleep experts due to the increasing prevalence of sleep disorders. Many people have been suffering due to the psychosocial and economic consequences of this medical cataclysm. Approximately 10-15% of the general population was already inflicted with chronic insomnia pre-pandemic. This is defined as a struggle to fall or stay asleep at least three nights a week for three months or longer. With the current crisis, insomnia has risen to 20-30%, and more often are children. Insomnia is not a trivial or benign problem. The overall impact of insomnia on quality of life is enormous and lasting.

Coronasomnia could prove to have profound public health ramifications, creating an epidemic of chronic insomnias grappling with a decrease in productivity, increased levels of anxiety, depression, hypertension, and other health problems. It's easy to see why many people can't sleep. The pandemic has heightened our worries and caused an upheaval of our normal daily routines. Insomnia is a sentinel that reflects the gravity of the current catastrophe of the world we live in.

If you're having trouble getting a restful 7-9 hours of sleep, try not to get anxious and stressed out about your sleep troubles, as worrying about insomnia will make you sleepless likely. According to the National Sleep Foundation, some of the essential pointers to help us sleep are the following: Stick to a routine (make sure you have a regular schedule and stick to your regular wake time). Be careful with naps, and the best time to nap is early afternoon and keep it around 20 minutes. Schedule in wind-down time (including deep breathing and guided meditations). Stay away from electronic before bedtime since excess light exposure can throw off your sleep and circadian rhythm. Create the ideal sleeping environment. Exercise in the afternoon. Don't have a large meal right before bed. Limit caffeine and alcohol intake. Exposure to smoke, including secondhand smoking, has been associated with insomnia. If you do wake up in the middle of the night, get out of bed. When you get sleepy and go back into bed, do not look at your clock. If you are still having difficulty falling and staying asleep, please talk to your doctor for further advice and treatment.

The pandemic has probably shattered your life, but you can still make time for endeavors you valued before COVID, like exercising and socializing. Creating a new normal, to some extent possible, can be stabilizing according to some experts. We should also make altruism a habit in our daily life. There is something powerful about giving and caring for others. Altruism has shown to be good for our health and spirit. Lending a hand and time and making donations to others may lower our blood pressure. Studies have demonstrated that volunteers tend to experience fewer body aches and pains, better overall physical health, and less depression. Altruism has shown to elevate our mood because it increases our self-esteem, which increases our level of happiness. Simple, selfless behavior gets easier the more you do it.

Lastly, be kind to ourselves as we do to others. I want to leave you with a profound quote from Mark Twain. "Kindness is the language which the deaf can hear, and the blind can see."

Dr. Ramel Carlos is a board-certified neurologist practicing in Guam for 18 years and a specialist in epilepsy and clinical neurophysiology. He is also a pediatrician, a diplomate of the American Board of Disability Analysts and the editor-in-chief of The Guam Medical Association Journal.


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