• Published on: May 15, 2020
  • 4 minute read
  • By: Dr Rajan Choudhary

Living With COVID And Returning To BAU!

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Hurdles to Business As Usual – Hurdles to Life as Usual –   Living with COVID!

Obstacles to re-open the country

As we come to the 2-month mark of lockdown, its effect on the populous is becoming apparent. The extreme restrictions have had a significant impact on people’s physical health, mental health, and general livelihood, and many people are itching for life to get back to normal. Many countries including New Zealand, Germany, Italy, and Spain have seen the first peak of COVID infections pass, and some have already begun reopening parts of their economy. This has led to concerns from public health officials that relaxing the lockdown too early and too liberally will lead to a rapid increase in infection rates. Indeed, Germany has already seen an increase in R0 above 1 (one infected person will infect more than one person, causing the disease to propagate).

Trying to work out how to reopen a country without causing another spike in COVID deaths is probably the biggest issue faced by public health officials across the world. And trying to convey clear instructions to the public is an issue some countries are currently struggling with. In the next few blogs we will look at the issues faced, what has worked and what needs improvement, and what we as the public can do to keep ourselves safe.

THE MASKS WE WEAR

We have discussed masks at the start of the pandemic, and we have discussed masks as the pandemic has progressed. Why are we bringing it up again?

Masks have been a heated point of contention, but their role in public health has matured over the past few weeks. At the beginning of the pandemic, masks were a rare commodity, with DIY stores running dry of masks, stories of people stealing masks from clinical environments, and very confusing advice on whether the public should wear masks in public.

At that time the WHO had recommended only infected patients and those working with infected people wear masks, to save on the precious PPE for medical professionals. N95 respirators are seen as the gold standard in protective equipment, and hospitals are still struggling to provide staff with enough respirators, let alone the public. Concerns have also been raised on whether using masks will provide a false sense of security, especially if they stop washing hands or touch the infected parts of the masks.

But now we are past the first COVID peak, and advice on masks has changed. People should wear a mask if they are in public. Germany has implemented this advice, as has Austria for its public markets. In the US many stores are requesting public wear masks before entry. Rather than surgical masks or respirators, the use of homemade or purchased cotton masks has been encouraged.

LET’S LOOK AT WHY

Surgical masks and respirators aim to protect the user from inhaling microscopic aerosolized COVID particles. Cotton masks do not function this way. Instead, they prevent the wearer from spreading COVID by catching much larger droplets that is coughed/sneezed or generally breathed out.

The majority of people with COVID-19 are able to spread the infection to others up to 3 days before they show symptoms. Indeed as many as 50% of infections seem to occur from pre-symptomatic individuals. During this time they produce the greatest amount of viral particles, and these particles can stay in the air for several hours.  Someone with asymptomatic COVID walking around in public or in a shop could infect lots of people.

So wearing a mask, even if you are not symptomatic or around infected patients helps prevent the spread of the infection. We know already just how infective COVID-19 is, so any measures that reduces infection even a little will end up reducing spread drastically on a population level. It has been compared to seatbelts – one person might not feel the benefits, but they save thousands of lives across the country on a yearly basis.

IS THERE ANY EVIDENCE?

In our blogs, we often talk about the importance of evidence. We look at the quality of evidence, how different types of research gives good and bad evidence, and why we should always give evidence-based advice.

So is there any evidence supporting masks? We have evidence that cloth masks can stop 99% of droplets that are coughed up, and whilst it doesn’t block aerosols or actual viral particles it still has a significant impact on transmission. We also have strong evidence from high infectivity in choir groups and at call centers that the majority of transmission is via the air, rather than from surfaces.

But what about the highest level of evidence? Comparing people who do or don’t wear masks is not a study that can be easily performed or one that has been performed adequately. But why should you wait? There is minimal to no risk associated with wearing a cloth mask, it offers some protection to you and a lot of protection to the public. In these cases, we should take a precautionary approach.

We don’t have any high-quality evidence looking at hand washing or physical distancing. But precautionary measures enforced have helped reduce infectivity. The same applies to masks. The best we can offer is an Australian study looking at mask use during influenza. They found observational data suggest that transmission of viral respiratory infection was significantly reduced during the SARS epidemic with the use of face masks as well as other infection control measures” and “in an adjusted analysis of compliant subjects, masks as a group had protective efficacy in excess of 80% against clinical influenza-like illness.”. In compliant users, masks were highly efficacious.

So that’s our advice. If you're going to go out in public, wear a mask.

If you don’t have a mask, you can order one online. Or be adventurous. Make one out of an old T-shirt or sock. Here are some ways to make one without needing to sew.

https://www.theguardian.com/us-news/2020/may/11/make-non-medical-coronavirus-face-mask-no-sewing-required masks

https://www.youtube.com/watch?v=r51YroAFPds DIY Face Mask

MORE INFORMATION

https://www.fast.ai/2020/04/20/skeptics-masks/#mightnt-people-handle-their-masks-wrong-and-make-things-worse Masks - FAQ

https://www.bmj.com/content/369/bmj.m1435 face masks for the public

https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)30918-1/fulltext wearing face masks in the community during the COVID-19 pandemic: altruism and solidarity

https://twitter.com/trishgreenhalgh/status/1253244613927874560 twitter trisha

Dr Rajan Choudhary, UK, Chief Product Officer, Second Medic Inc

www.secondmedic.com

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Teen Mental Health – Signs Parents Must Never Ignore

Teenage years are a time of transformation—emotionally, physically, and mentally. While moodiness and rebellion may seem like part of the package, sometimes these behaviors can hide serious mental health issues.

Today, more teenagers are struggling with anxiety, depression, stress, and even thoughts of self-harm—but many go unnoticed because the signs are subtle.

As a parent or guardian, it’s crucial to know the early signs of mental health problems in teens. Let’s explore the red flags you should never ignore and how you can help your child feel supported and heard.

 

Why Teen Mental Health Matters More Than Ever

In India and around the world, teen mental health issues are on the rise due to:

  • Academic pressure
     

  • Social media stress
     

  • Body image concerns
     

  • Bullying or peer pressure
     

  • Family conflicts
     

  • Hormonal changes
     

Ignoring early signs can lead to worsening conditions or even risky behavior. Early action is the key to prevention and healing.

 

5 Warning Signs of Teen Mental Health Issues

 

1. Withdrawal from Family and Friends

If your once-social teen starts avoiding friends, skipping family dinners, or isolating in their room more than usual—it could be a sign of depression or anxiety.

What to watch for:

  • Saying "I’m fine" but acting distant
     

  • Losing interest in favorite activities
     

  • Avoiding calls or texts from friends
     

 

2. Sudden Drop in Academic Performance

Stress, low motivation, or emotional exhaustion often lead to a dip in school performance. If your child suddenly starts failing or avoids school altogether, take it seriously.

What to watch for:

  • Skipping homework or classes
     

  • Teachers reporting attention issues
     

  • Saying "What’s the point?" or "I don’t care anymore"
     

 

3. Changes in Eating or Sleeping Habits

Teen depression often changes daily habits. Some teens may sleep or eat too much, while others may lose their appetite and suffer insomnia.

What to watch for:

  • Skipping meals or binge eating
     

  • Staying up all night
     

  • Always feeling tired
     

 

4. Talk of Hopelessness or Self-Harm

If your teen talks about feeling worthless, says things like “No one cares” or shows an interest in self-harm—it’s a serious red flag.

What to watch for:

  • Negative self-talk
     

  • Writing or drawing about death
     

  • Wearing long sleeves to hide cuts
     

Tip: If you hear even a hint of suicidal thoughts, seek professional help immediately.

 

5. Unexplained Aches and Pains

Sometimes mental health problems appear as physical complaints, especially in teens who struggle to express emotions.

What to watch for:

  • Frequent stomach aches, headaches, or nausea
     

  • No clear medical cause
     

  • Always feeling “sick” before school or social events
     

 

How to Support Your Teen

As a parent, your role is not to fix everything but to listen and support. Here’s how:

  • Create a safe space: Let your teen know they can talk without judgment
     

  • Ask open-ended questions like:
    “How have you been feeling lately?”
    “Do you want to talk or just need someone to listen?”
     

  • Avoid dismissing their emotions with phrases like:
    “You’ll get over it” or “It’s just a phase”
     

  • Encourage healthy routines:
    Regular sleep, a balanced diet, physical activity, and tech breaks
     

 

When to Seek Professional Help

Call a psychologist, counselor, or pediatrician if you notice:

  • Signs persist for more than 2–3 weeks
     

  • Risky behavior like substance use, aggression, or self-harm
     

  • Extreme withdrawal or refusal to attend school
     

  • Talk of suicide or self-hatred
     

 

Useful Health Checks for Teens (Available at SecondMedic.com)

Mental health issues can also be connected to physical imbalances. Consider these lab tests (via Thyrocare):

Thyroid Profile

Hypothyroidism or hyperthyroidism can affect mood and energy.

Vitamin D Test

Low vitamin D is linked to fatigue, depression, and anxiety.

CBC (Complete Blood Count)

To rule out anemia or infections that might affect mood or focus.

CRP Test (C-Reactive Protein)

Detects inflammation, which can also impact mental well-being.

These tests are easily bookable online with home sample collection and fast results.

 

Conclusion

As a parent, you play a key role in recognizing early warning signs and guiding your teen to emotional well-being. What may look like rebellion, laziness, or "drama" could actually be a silent cry for help.

Stay present. Stay open. And most importantly—act early.

If you're unsure about what’s normal and what’s not, just remember this: Teen mental health – signs parents must never ignore could be the first step to saving a life.

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