ACC Command Surgeon, Mental Health Branch Chief, address Covid-19 reluctance Published Nov. 5, 2020 By Staff Sgt. Emili Koonce Air Combat Command Public Affairs JOINT BASE LANGLEY-EUSTIS, Va. -- Brig. Gen. Sharon Bannister, command surgeon of Air Combat Command and Lt. Col. Michael McCarthy, ACC mental health branch chief, virtually discussed staying remote and ready, with ACC Public Affairs Oct. 6, 2020. A few of the primary topics that were discussed with Bannister and McCarthy are the reluctance of reporting when having symptoms related to COVID-19 and testing availability, and, with flu season approaching, how do we determine one over the other. The Reluctance Gen. Bannister, with flu season upon us, how do we determine the difference between flu, cold or COVID-19 since the symptoms are so similar? (Bannister) You’re right the symptoms are all very similar, both diseases have symptoms such as: fever or feeling feverish/chills, cough, shortness of breath or difficulty breathing, fatigue (tiredness), sore throat, runny or stuffy nose, muscle pain or body aches, headache. Some people may have vomiting and diarrhea, though this is more common in children than adults. Because some of the symptoms of flu and COVID-19 are similar, it may be hard to tell the difference between them based on symptoms alone. If you run into any of these symptoms please don’t be reluctant to report. Contact your healthcare provider and allow them to make the determination. Testing may be needed to help confirm a diagnosis. Lt. Col. McCarthy, could you please speak about the reluctance to reporting and getting tested the command is recognizing? (McCarthy) You know, I’m not surprised that we’ve seen a reluctance for people to report and get tested. Our Airmen are so dedicated to the mission and so dedicated to their teams. A lot of the units across the command are already seeing an increase in workload, whether it’s because they’re still doing half-staff or maximizing telework because they’re trying to prevent the spread of COVID-19 and so we’ve got fewer people doing more things. I think Airmen are reluctant to add to that burden on their teams and they just want to be a team player and get the mission done. With that said, I think what’s really important to remember is the way that we get the mission done is by keeping COVID-19 out of the workplace. The way that we do that is by focusing on the fundamentals, good handwashing, maintaining physical distance, mask wear, and when you’re symptomatic stay away from your work center and talk to a healthcare provider. Testing Is there a standard at all bases for COVID-19 testing, if so, what? If not, why? (Bannister) Personnel are tested based on the Department of the Air Force tiered testing strategy which is in alignment with the Department of Defense testing strategy. We have been testing Tier 0-3 (which are our symptomatic individuals, those in identified no fail mission sets, and deployers) for months. We have just begun the last tier which is surveillance testing aimed to identify asymptomatic people who may not know they are infected. This gives leaders a better feel for the local base prevalence which may drive protective changes such as altered work schedules and added workplace health protection measures. For military operational purposes, the military will test more personnel than just those who are sick and can report positive cases to HIPAA-approved commanders who have a need to know to preserve the mission. As to why testing may differ from base to base please understand that since there are still a limited supply of tests and testing materials in the U.S. as we await FDA approvals, different bases are using different tests based on their needs and what is available for purchase. How does reporting of COVID-19 test results work for on base and off base? (Bannister) When tested on base your military treatment facility can report positive cases to HIPAA-approved commanders who have a need to know to preserve the mission. If tested off base and positive, federal and state laws require labs and providers to report the case to their state public health department. If the positive case is DoD, the state will report to the military installation. Our medical treatment facilities spend significant time building relationships with our civilian health care partners to include our local public health. This has definitely proved to be a huge benefit during this pandemic. Should ACC Airmen (Active Duty, Guard, Reserve, Civilian and Contractors) notify their supervisors themselves? (Bannister) We’re a large workforce and we all want to do the right thing. My recommendation to our responsible ACC members is it’s always beneficial to let your supervisor and chain of command know that you were tested for flu or COVID-19. Don’t wait for your public health office to do so. Teleworking While we are staying connected digitally to our work, friends and family, we are still seeing members who are dealing with feelings of isolation. How would you recommend that members deal with that? (McCarthy) So that’s a difficult question, and I’m not sure that we can completely avoid those feelings. And that’s all right. It’s appropriate to have negative emotions when bad things are going on in difficult times in your life. The real question is, “What do you do with those feelings?” Many of us are finding new ways to connect socially, but there’s not a one size fits all solution to that question. I think the best approach is really to be deliberate about making social connectiveness a priority. For some people, texting friends and FaceTime with family and loved ones will help. For other people, doing some of the new things like virtual social events, virtual concerts. For some people spending quality time with their pets or going to a public area and just walking around and being around other people in a distanced way will be restorative. And other people are going to need to create safe opportunities for face-to-face interaction. We’re all unique, and we’ve all got individual needs and there’s not a right way to feel connected. The point is, that it is important and it really matters that you make a priority of finding the approach that works for you. I do think it’s helpful to remember that our family, friends, and coworkers, are all experiencing similar feelings and getting outside of yourself and touching base with others, letting them know that you’re thinking about them, that you’re checking in on their wellbeing is a great way to increase your own sense of connectivity. Along with those feeling we’re also starting to hear the term COVID fatigue. What is that? (McCarthy) I think that we are all fatigued by the ongoing disruption to our lives. I don’t know anybody who enjoys wearing a mask, who enjoys not being able to attend a sporting event or a religious function or go to their favorite restaurant or send their children to school. COVID-19 has completely changed so many of the things that are normal in our lives and as a military member, it’s really changed a lot of the things that made being in the military very special such as changes of command, medal presentations, retirement ceremonies, commander’s calls, even unit physical training. A lot of those personal and professional rituals have either been changed dramatically or just aren’t happening at all, so I think that’s a big part of it, and then the second part, “Are you working from home or do you live at work?” I think for a lot of Airmen, the answer is the latter. Teleworking can provide a lot of flexibility, a lot of advantages for us, especially when we’ve got kids at home who are doing their school from home, but if we don’t set good boundaries, we can quickly find ourselves living at work. It’s recommended that teleworkers have set hours at home and have even an office area, which can provide a psychological que when those office hours are over and you leave that office area of “I’m leaving work now. I can get back to my personal time.” I’ve also heard a lot of people express concern, with things like “my boss sends emails at all hours of the day and I feel like I need to respond to them.” If those things are happening, my guess is your boss doesn’t expect that. I would really encourage people to clarify what the expectations are because if we’re working 24 hours a day, we’re living at work. That’s a recipe for burnout.” Resilience What are the signs and symptoms that someone is not effectively coping with stressors in their life? What resources are available to help? (McCarthy) Almost everyone knows what healthy behavior looks like, but when we get stressed out, we don’t do it. When people get stressed out, they tend to exercise less, not more. They tend to eat less healthy, not prioritize a healthy diet. They tend to use alcohol more, not less. They tend to be less disciplined about their sleep, their hygiene or going to bed at the same time and waking up at the same time every day. Almost everyone would say to a friend who is struggling, “You need to take care of yourself,” so we need to say that to ourselves. With that said, none of us have ever dealt with these types of stressors before and fortunately, Airmen are surrounded by people who care for them and are eager to help. If you’re having difficulty managing the stress in your life, you need to ask for help, and for some, that’s going to be reaching out to family, friends or coworkers and saying, “Hey, I’m having a hard time,” and just that conversation can meet that need. For other people, seeking help from mental health is the right answer. Other folks are going to benefit from spiritual focus and relying on the strength that they have in their faith and working with the Chaplain to seek help. While, other people need a really solution-focused approach found at the Airmen and Family Readiness Center. Again, there’s not a one size fits all answer here. I’d encourage everybody to work with your First Sergeant if you’re having a hard time finding that right fit. They are the experts on the resources that are available on base and can help plug you into a place that’s going to meet your needs. We’ve talked a lot today about the COVID-19 pandemic and how that can impact mental health. It also seems obvious that physical health can and does take an effect on your mental health. Would you be able to speak to this? (McCarthy) Yes. You are absolutely right. In the mental health world, we have a saying that exercise is the best antidepressant. Not only does exercise improve energy levels and sleep quality while reducing stress by lowering the levels of stress hormones like Cortisol and Epinephrine in your blood, but it also increases your body’s production of Serotonin and Dopamine. It’s a natural antidepressant so exercise combined with a healthy diet is key. I want to be clear, if you’re exercising regularly and you’re eating a healthy diet, it’s not going to eliminate the stress from your life. We’re still going through a difficult time, but exercise and a healthy diet are just kind of a necessary foundation to effectively relieve COVID-19 stress. Gen. Bannister, along with Lt. Col. McCarthy’s recommendations, what do you recommend we, as members of ACC, should be doing to stay healthy this fall and winter? (Bannister) Personnel can protect themselves from both flu and COVID-19 by following the force health protection measures established since the pandemic began, which include wearing a mask, staying 6 feet away from others and minimizing interactions to 15 minutes or less, washing your hands often, avoid touching your eyes, mouth and nose, and get your flu vaccine once available. If you ask me, we should have always been washing our hands during flu season so now, the optimist in me is hoping for a light flu season since our population is highly attuned to force health protection measures. For more COVID-19 information visit https://www.af.mil/News/Coronavirus-Disease-2019/ and be sure to follow all local, state and federal guidelines.