26-01-2022

WeDnesDAy, JAnUAry 26, 2022
5
What does Endemic mean?
CAtHerIne PeArsOn
Health officials have been
warning for months that
COVID-19 isn't going away;
instead, it's much more
likely to become endemic
here in the United States and
abroad. Many also believe
the highly contagious
omicron variant, which
continues to drive up case
counts around much of the
country, could get us there.
While moving from our
current pandemic to an
endemic state certainly
sounds like a move in the
right direction, health
experts also caution that it
doesn't necessarily mean
what people think it does.
It's certainly not the
"normal" reality people lived
up until 2019. Nor is our
path to endemicity clear cut.
As the Centers for Disease
Control and Prevention
explains, endemic "refers to
the constant presence
and/or usual prevalence of a
disease or infectious agent in
a population within a
geographic area."
The endemic level of
disease in a given area is
basically the baseline of that
disease in a particular place.
But it's not necessarily the
desired level of disease, the
CDC clarifies. A disease
could be considered
endemic but still be pretty
widespread.
"An endemic disease is an
infection that always
remains in a given
population," Vincent Hsu,
executive director of
infection control at
AdventHealth, told
HuffPost. "It might be
limited to a particular
geographic area, such as
malaria, but could also be a
widespread infection that
has seasonal patterns, such
as influenza, or continues
throughout the year causing
generally mild illness, such
as the common cold."
And knowing when
exactly the transition from
pandemic to endemic has
happened is difficult,
because health officials and
epidemiologists may have
different thresholds for
when we've hit a sufficiently
predictable, non-disruptive
point of living with COVID.
It's a pretty nuanced term.
"Practically speaking, for
COVID to become endemic,
we would need to be at a
point where COVID is
sufficiently commonplace
that it is not causing severe
disease resulting in
hospitalizations and death,"
said Jay Lee, a family
physician in Costa Mesa,
California. "In other words,
we need community
immunity against COVID to
be high enough that we are
not seeing the levels of
hospitalization and death we
While transitioning to an endemic is a good thing, there are still some
important factors we need to keep in mind.
Photo: Orbon Alija
continue to see now."
Moving from our current
state (a pandemic) to
endemic disease sounds like
a good thing, and in many
ways it is. But some experts
worry that the general public
is assuming that endemic
disease is automatically less
damaging or dangerous.
We could get to a point
where COVID is considered
endemic, but its impact on
many people who are
infected is not minimal.
(Again, think of malaria,
which is endemic in parts of
the world and can be
deadly.)
There could also still be
unpredictable disruptions
caused by the virus that
would prompt restrictions
and closures that would not
feel at all "mild" at a society
level. If the virus continues
to infect relatively large
numbers of people, it has
more opportunities to
change its genome.
Take flu as an example.
Most people who get the
illness recover within a few
weeks, but for some, it is
deadly. Also, we sometimes
get flu pandemics which, as
the CDC explains, occur
when a new virus emerges
that is able to spread from
person to person in an
efficient and sustained way.
"What we see with
influenza is decades between
major pandemics, and the
major pandemics are due to
shuffling of segments of the
flu virus genome, which are
known as genetic shifts,"
infectious diseases expert
Stuart Ray, vice chair of
medicine for data integrity
with Johns Hopkins
Medicine, told HuffPost.
Those shifts are what
cause the major flu
pandemics we've
experienced, like H1N1 in
2009. But it's not yet clear
how much time we might get
between genetic shifts with
COVID. And if the virus is
still infecting large numbers
of people, it has more
opportunities to change its
genome. "A part of me is
hopeful that with this
omicron wave, we'll generate
enough immunity that we
don't see a lot of harm from
future infections, and that
we will reach a mild endemic
state," Ray said.
HeAltH Desk
Even before the pandemic,
Americans were among the
most stressed-out people in
the world. Then COVID
came and walloped us even
more. Name a group of
Americans, and there has
likely been a recent poll
showing their stress levels
have become unbearable:
parents, teachers, health
care professionals, teens -
the list goes on and on.
Of course, no one can selfcare
their way out this
profoundly difficult
moment, and if you're
overwhelmed, you should
reach out to your primary
care doctor or a mental
health professional ASAP.
But if you just need a way
to cope and recenter during
acutely stressful moments,
here are five incredibly
simple strategies that might
help - in 60 seconds or less.
Try them all and see what
works for you.
"You can do this if you're
waiting for a subway, waiting
for an elevator, or if you're
just unloading the
dishwasher. Think of
someone - vividly - that you
really love," Susie Moore, a
life coach and author of "Let
It Be Easy: Simple Ways To
Stop Stressing And Start
Living, told HuffPost. It can
be your child, your partner, a
friend or even your pet.
Remember what they look
like, what they smell like.
Think about how comforting
they are, or what you feel like
in their presence. "Just think
about how much you love
them," Moore said.
Researchers have found
that personal connection is
one of the four pillars of
personal happiness, and
simply focusing on someone
in this way can be enough to
help you tap into your calm,
happy place and cultivate
connection.
If you're feeling like your
anxiety is really getting the
best of you, one simple
"hack" is to write down a
designated worry time.
A few hacks for a minute
to destress
Curbing your stress doesn't have to take a lot of time.
"Many people are anxious
throughout the day and
night, and everything in their
environment gets associated
with anxiety," Robert Leahy,
director of the American
Institute for Cognitive
Therapy and author of "The
Worry Cure," previously told
HuffPost. "What if you could
put those worries up on a
shelf, and take them down
at, say, 12 p.m. for 20
minutes?"
People often think that if
something pops into their
mind, they have to worry
about it then and there. But
that's not true, Leahy said.
Instead, it can be helpful to
put a time on your calendar
when you can sit down and
really marinate in your
worries - and by the time you
do, some of them may have
faded.
So if you haven't scheduled
that designated worry time
yet, go ahead and pop it in
your calendar. You'll feel
better knowing that you've
taken steps to manage your
stress rather than trying to
ignore it or letting it control
your days.
OK, this one probably
takes more like two or three
minutes, but if you're feeling
like you need to calm down,
put on a song that you love
and dance your heart out.
Research shows that both
music and dance can lower
stress levels and increase
happiness.
If dancing isn't your thing -
or you're not in a place where
you can pull it off - simply
move your body for one
minute instead. Stretch.
Jump up and down. Hold a
single yoga pose. If you're
feeling ambitious, you can
even do a short, vigorous
Photo: Getty
chore! Try anything that will
help your body release feelgood
hormones like
dopamine and that will get
you out of your own head.
(Bonus points if you get
active while listening to a
song you really love.)
This one can be especially
useful if the cause of your
stress is a child who is midmeltdown,
but it really works
anytime you're with a friend
or loved one who is down for
a cuddle.
Here's how it works: In a
moment of stress, give your
child or partner (or whoever
you're with) a "big bear hug,"
Shonda Moralis, a women's
mindful empowerment
coach, psychotherapist and
author of "Breathe, Mama,
Breathe," previously told
HuffPost. Then take three
big inhales and three big
exhales together.
JOlIne BUsCeMI
You may have noticed that
recently, certain skin care
products aren't available to
purchase over the counter -
and while they're not exactly
considered prescription, you
have to buy them from a
doctor's office. It's called
medical-grade skin care, and
it has all the indications of an
effective product. Promoted
by dermatologists and
estheticians, these products
are described as being more
powerful and packed with
actives than products you can
buy elsewhere. But when it
comes to skin care, the way
products are marketed isn't
always indicative of what's
inside the bottle, or even what
it can do.
Compared to over-thecounter
products, medicalgrade
skin care (sometimes
called "professional-grade" or
"clinical" on labels) is touted
to be better formulated, with
higher quality and more
effective ingredients that can
reach deeper into the skin.
For this reason, some
products aren't available to be
purchased directly by the
consumer.
Brands like Obagi,
Skinbetter, PCA Skin and iS
Clinical all lie on varying
degrees of the exclusivity
spectrum - some, like iS
Clinical, are available to buy
at numerous online beauty
stores, while Skinbetter is
only available through
authorized retailers. This low
level of accessibility - along
with the stamp of approval
that comes along with only
being available through
professionals - can make it
seem as though these
products are somehow better
and more effective than
typical over-the-counter skin
care products. And not
surprisingly, they also often
come at a higher price.
While it would appear these
products are a smart choice
for those who are serious
about skin care, is this yet
another case of consumers
being duped by marketing?
Esther Olu, a cosmetic
scientist, has worked with
manufacturers to formulate
What is medical-grade
skin care?
Medical-grade skin care is often exclusively sold at your dermatologist's
office.
Photo: Morsa Images
skin care products, including
medical-grade brands. In a
December tweet, she wrote of
medical-grade products: "Any
brand can call themselves
medical grade today and
nothing would happen,"
reads the tweet. "You have
drugs and cosmetics; no in
between."
"Medical-grade is not a
regulated term, so there are
no FDA rules or industry
standards determining what
products fall into this
category," said Aegan Chan, a
board-certified
dermatologist. "These types
of products still fall into the
'cosmetics' category in terms
of FDA regulation, and
therefore cannot technically
claim to do more than
drugstore products," she said.
While there are regulations
that companies are required
to follow, these products do
not have to undergo FDA
approval, unlike prescription
skin care products that are
considered drugs by the FDA.
Even one of the biggest
reasons someone might turn
to medical-grade - the
potency and efficacy of the
product - isn't guaranteed.
"Once you go over a certain
concentration per the FDA,
you are entering
drug/prescription territory,"
Olu said. Instead, medicalgrade
brands might add
ingredients to their products
that don't necessarily work in
order to make claims when
marketing the product. (Nonmedical
brands do this, too,
Olu said).
And thanks to minimal
regulation, "there is no
required testing or
regulations around using
'higher-quality' ingredients in
those products that are
marketed as 'medical-grade,'"
Chan said.
Most skin care products -
medical-grade or not - use
similar ingredients, including
so-called fillers. "I think that's
one of the biggest
misconceptions when it
comes to medical-grade
products," Olu said. "If you
were to compare a drugstore
moisturizer to a medical
grade moisturizer, you would
notice some of the exact
emollients, waxes, etc. in the
ingredient list, but a lot of
professionals like to call them
fillers when that is not true,"
Olu said. (Fillers actually do
have a role in skin care
products, like delivering
specific ingredients to the
skin and mitigating
irritation). In some cases,
medical brands "use the same
concentrations, delivery
systems and active
ingredients that non-medicalgrade
brands do," Olu said.
Ultimately, there's no one
answer to whether medical
grade products (or
professional-grade or clinical)
are "better" or "worse" than
non-medical grade products -
if you can see through the
marketing speak. "Whether it
works depends on the
formulation and if the brand
is using the appropriate
testing to prove it," Olu said.
That testing can be the
difference between a medicalgrade
product that's worth
trying and one that isn't.
"There are some medicalgrade
brands that will submit
their products to rigorous
clinical trials, but again, that
is not a requirement and
many do not," Chan
explained. This testing isn't
limited to medical-grade
brands, however.
BrIttAny WOnG
For many struggling with
body image, heading to the
doctor for a specific health
issue or even just a routine
checkup is more stressful
than it needs to be.
Weigh-ins are a standard
practice before you see your
doctor, but if you've
experienced an eating
disorder or are selfconscious
about your
weight, jumping on a scale in
the middle of a busy hallway
is a tall order.
But here's an
underdiscussed secret: You
really don't have to be
weighed every time you go to
the doctor.
"It is entirely correct that
after age 18, most people do
not need to be weighed at
the doctor's office," Jennifer
Gaudiani, a Denver-based
physician who treats
patients with eating
disorders, told HuffPost.
Of course, there are a
handful of exceptions:
Weight understandably
needs to be tracked when a
patient with an eating
disorder has specific weight
needs in order to treat the
disease.
If someone comes in and is
concerned about
unexplained weight loss,
that needs to be measured
and watched, too.
"And young children need
to have weight and height
monitored to make sure
growth is proceeding
properly," Gaudiani said.
"Pregnant people also need
to have weights followed ?
although they don't need to
have the weights revealed or
discussed ? to be sure baby is
getting what baby needs."
But outside of exceptions
like these, Gaudiani said
she's confident that "90%" of
weigh-ins taken at medical
offices are entirely
unnecessary.
"What that means is
someone coming in to talk
about their depression,
digestion, substance use or
twisted ankle can find
themselves on the other end
of a lecture about weight and
weight loss," she said.
Is it necessary to be weighed
at the doctor’s office
That sometimes results in
weight-conscious patients
avoiding health checkups
altogether.
"Unnecessary weigh-ins
chill patients' willingness to
see medical providers, waste
everyone's time, fail to
address the most important
concerns of the patient, and
may push individuals into
cycles of dieting , maybe
some weight loss, then
regaining even more," she
said.
Given Gaudiani's thoughts
on weigh-ins, she was
thrilled last month when she
saw these "Please Don't
Weigh Me" cards trending
on Twitter.
The cards, created by
eating disorder recovery site
More-Love.org, read:
"Please don't weigh me
unless it's (really) medically
necessary," adding: "If you
really need my weight,
please tell me why so that I
can give you my informed
consent."
The cards were initially
free for individuals but now
cost $1 each due to demand.
There's an option for health
care providers to purchase a
batch, at $35 per 100 cards.
The site also offers "please
don't talk about my child's
weight" cards to parents, to
kick off important
conversations with kids
about the often unfair
conflation of weight with
good health in advance of a
checkup. (Children need to
be weighed but the card
says, "If you have any
questions, ask me when my
child is not present.")
"I'm a fan of these cards
because it's a starting point
where the patient or parent
doesn't have to come up with
all the words and reasons
themselves, but rather has
the support of the card as a
neutral object to try and
advocate for their bodies,"
Gaudiani said.
Ginny Jones, the founder
of More-Love.org, created
the initial batch of cards
back in 2019. In recovery
from her eating disorder,
Jones had begun asking not
to be weighed at doctor's
appointments. She soon
realized not everyone knew
that was an option.
Getting health care
providers on board with the
cards has been great ? 200
providers have ordered
anywhere from 100 to 500
cards for their offices, Jones
said ? but the responses
she's received from
individuals has been the
most heartening.
"The best feedback I hear
from patients is, 'I made my
first appointment in years!'"
Jones said. "I'm shocked to
hear personally from so
many people who are
delaying health care because
they hate stepping on the
scale. I love that these cards
give them the confidence to
walk back into a health care
provider's office."
Gregory Walters, a writer
and educator from
Vancouver, British
Columbia, who was
Unless there's some medical necessity, you don't have to be weighed every
time you go to the doctor.
Photo: Getty