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Psychological rehab methods that should be employed for Covid patients and those suffering from post-Covid complications. Even general people are also suffering from loneliness during the pandemic. What needs to be done?

The suffering of the survivors of Covid is not only related to the traumatic events; rather, the subsequent life events and sufferings in the post Covid life cause higher emotional problems if an adequate, community-based, psychosocial care approach is not adapted. Individuals are not in any real sense autonomous or self-sufficient, their loneliness during the pandemic is real and healing occurs in the context of family, friends, and community.
Rehabilitation introduced the notion of a bio-psycho-social medical model, initiatives need to integrate psycho social care as an essential part of the overall care and rehabilitation. Those who receive a spectrum of care including health care, psychosocial, livelihood, educational, developmental activities would have less emotional reactions, better functionality and quality of life. Effective rehabilitation methods for persons who survived Covid and those suffering from post Covid social and other traumatic events including loss of loved ones to being children who were separated from the parent due to quarantine and their complications needs to address the problems posed by various potential events.
The post Covid rehabilitation planning continuum is broad in scope and must address collaboration across agencies and organizations, advance preparations, as well as needs assessments, event management, recovery and rebuilding efforts.
It is important to facilitate understanding of the meaning of personal and community losses and also to ensure adjustment and acceptance of change. To ensure this, working with individuals/families, facilitating support groups in the community, development of community-based organizations, community solidarity, and many other interventions are crucial. Failure to provide these services definitely will show higher distress, disabilities, and lack of social well-being. Local community support in coordination with Government functionaries need to reach each every families by providing with appropriate services. It is very important to focus on population than individuals to create a supportive and a resilient community.

Adults are advised to follow COVID-Appropriate Behaviour to keep them protected from catching Covid-19 infection. How can we protect the children?

Well, older kids can follow Covid- Appropriate Behavior to protect themselves.

We do not recommend mask in children below 2 years. In fact, we have observed it is difficult to make children between 2 to 5 years wear masks. So, it is advisable to keep them indoors. But don’t forget to engage them in playful and physical activities as the first five years are crucial for a child’s mental and physical development.

Every family member who is above 18 years of age should get vaccinated. If adults are protected, our children too remain protected.

Vaccines have been found safe for lactating mothers. So, they too should take the vaccine.

We have also seen cases of new mothers contracting the disease. In such cases, how should she protect her child from getting the infection?

In such cases any person who is not COVID positive should nurse the child. However, a lactating mother should extract her milk and feed the child. If there is no one else to take care of the child, the mother should wear a double mask and face shield, wash her hands and sanitise her surroundings regularly. Mother’s milk is important for the child’s proper growth and development. The milk of an infected mother has antibodies against coronavirus.

If a child is affected by Covid-19 but parents are not, how to take care of the child? What precautions should the caregiver take to protect oneself from catching the infection?

This can happen if the child has contracted the infection from someone outside the family. So, firstly, each member of the family should get oneself tested for Covid-19. The caregiver should wear full protection gear—double masks, face shield, gloves—while nursing the child. Care should be provided under the guidance and supervision of a doctor. The caregiver and the child should isolate themselves from the rest of the family.

How is the treatment for children different from that for adults?

We don’t recommend any medicine for asymptomatic children. In mild cases, but prescribe simple paracetamol to manage fever and other mild symptoms. Similarly, diarrhoea is managed with oral rehydration fluids and plenty of fluid. In moderate to severe cases, the treatment is the same as that for adults.

Immediately consult a doctor if you observe respiratory distress, increased respiratory rate, severe cough that is interfering with feeding, hypoxia, uncontrolled fever, or any other unusual symptoms like skin rash, excessive sleepiness in children.

There are cases of Long Covid-19 in children as well, in which a patient develops a new disease such as diabetes, hypertension even after the 3-6 months of recovery. The parents should be in touch with their doctor for follow up of children who have recovered from acute COVID illness.

Are more children developing severe disease this time?

A vast majority of children either remain asymptomatic or develop a mild disease. In a household, if several adults are diagnosed with COVID 19 infection, there is a high possibility that the children will also be infected. Fortunately, in most such cases, the children particularly those below 10 years are usually asymptomatic or have mild, common cold like symptoms, or diarrhoea.

However, children with congenital heart disease, diabetes, asthma, or those suffering from childhood cancers, or on immune-suppressants are at a higher risk of developing severe disease.
The parents should watch COVID sick children closely. Many of the serious complications in children occur in or after 2nd week of acquiring the infection.

Overall, there is no evidence that children have special predilection of developing COVID 19 disease during this wave as well. Due to larger number of persons getting infected, the absolute number of affected children has also increased.

What is COVID-19 among children, its prevention and management?

Thousands of children, in all age groups, from across the country have been tested positive for Covid-19, during the second wave, creating panic among parents. The experts say that though most children develop mild disease, there is a need to keep them protected from getting infection. Dr. Narendra Kumar Arora, a paediatric gastroenterologist and a senior member of the National Covid-19 Task Force tells how to treat and care for children who have contracted Covid-19. Excerpts.

Recently, a lot of States have reported an increase in the number of children tested positive for Covid-19. Do you think more children are being infected in the second wave of the disease?

Children are as susceptible to catching the Covid-19 infection as adults and according to our latest national sero-survey also, 25 percent of children surveyed were found to be affected by Covid-19. Even children below 10 years were also found to be as infected as other age groups. National data on the disease tells us that around 3-4 percent of children were symptomatic during the first wave of Covid-19 and this percentage remains the same during the second wave also. However, since the total number of cases has gone up, it has affected more number of children this time.

How do you interpret hope to a man who has lost his near and dear ones in a span of two days due to Covid? ~ Titus Anto, Bangalore

Spiritual knowledge makes it easier to cope with the loss of a loved one. Spiritual awareness begins with understanding one’s true identity — that one is a soul. The soul is the imperishable sentient energy that gives life to the body, which is the physical medium using which the soul thinks, speaks and acts. Death is merely the soul leaving one body to take birth in another.

We come in contact with many people during the course of our life. We have brief interactions with some, and longer ones with others. The love, affection and support we receive from them creates close bonds, and when these are severed by someone’s passing away, we experience grief. But once we recognise the truth that each soul is independent and no one belongs to us forever, we do not get attached to any person. Yet we are able to have respectful, loving relations as we realise that each soul is playing a unique role in the world. When a loved one passes away, instead of creating thoughts of sorrow, we can remember their good qualities, appreciate their contribution to our life, and send them good wishes for their onward journey. If we grieve, we send vibrations of sorrow to the departed soul and disturb their peace. We must remember that we have a permanent companion and friend in God, the Father of all souls. The Supreme Soul is our eternal source of love and support. Developing a relationship with God, by regularly remembering Him, fills us with His love and peace, frees us from dependence on human supports, and makes us strong enough to guide others to connect with Him and be liberated from all sorrow.

Rajyogi B K Brijmohan, Chief Spokesman of Brahma Kumaris Organization

How to be happy and sustain that happiness, more so when the atmosphere is not conducive? ~ Yudhishtra Rakhija, Kanpur

Happiness, which is conditional, may be dependent on external circumstances or a beloved being whom you want to be with. It is all relative, as for somebody bothered with scorching heat in the summer, swimming or a boat ride may become a reason to be happy while sumptuous food may make gluttons gleeful. Then people derive happiness from wearing fragrances, high-end luxury clothing, and so on. In a way, I have covered all the five indulgences a human being wishes to have by the virtue of five sense organs.

Now, given the current scenario of imposed lockdown, your freedom to be delightful in the usual ways has got curtailed. So, when there is no way to go outside, the only way to go is inside! However, if you are bereft of an enriching experience of being with yourself, if you keep seeking the company of others, then you will find it hard to understand this. 

Be more focussed on yourself and less bothered about the whereabouts of others. This is what makes a spiritual person distinct from others. He is aware of his mind and witnesses it with aloofness. Being a witness is epitomized by the philosophy of Sankhya too. You do not have to make an effort to be a witness, you are one already. You are the absolute reality. You are Brahmn! When you are aware of your reality, where is the need to seek joy from others?

Also, know that no worldly object or pleasure accompanies you when you enter that most blissful state called deep sleep. It gives you a glimpse of what true state of meditation is like. When you start meditating, the mind will slowly turn inward and you will realise that being with your true self can give you everlasting happiness, without being dependent on situations around you. Besides, you can also turn self-sufficient by channelizing your creative energies for various art forms.

Anandmurti Gurumaa, founder of Rishi Chaitanya Ashram, Sonepat

I study in class Xll. I’m frustrated and anxious due to the postponement of exams and family problems. Please help. How to keep my mind calm and have negative thoughts when I am surrounded by so much negativity? ~ Riddhi Deb, Kolkata

Dear Riddhi,

No doubt the Covid-19 pandemic has devastated the entire world.  A vast majority of the human population has been very badly affected.  What is the way out?  Should we keep worrying and get into anxiety, frustration, etc?  No.  Rather, it is time to come forward and take a lead role because you are young and are in a far more advantageous position compared to the older people.  In your own family you must cheer up others with your positivity and enthusiasm.  Please look at the world outside.  Compared to millions of people you and your family are far better off.  As far as exams are concerned, you are in the same position as others.  Lakhs of students are suffering in the same way.  You shouldn’t be anxious at all.  Swami Vivekananda says that every one of us is blessed with infinite knowledge, power, glory, etc.  You are the maker of your own destiny.  The idle mind is devil’s workshop.  Saturate your mind with powerful ideas of Swami Vivekananda.  Please read these two books i.e. “Letters of Swami Vivekananda” and “Lectures from Colombo to Almora”.  You will feel tremendously energized and enthused.  Even a very small booklet “Thoughts of Power” contains very powerful messages of Swami Vivekananda.  You must have already prepared well for your Board exams.  So, you need not spend too much time on academics.  Keep just revising.  But, use this opportunity to saturate yourself with Swami Vivekananda’s powerful man-making and character-building messages.  You should never entertain any negative idea.  Rather, you should be an inspiration for others.  Because you have too much of free time, why not try a new hobby or spend quite some time in strengthening your existing skill i.e. music, art, etc.  You can also try your hand at cooking or helping your mother in household work.  But, the main support and strength would come from the ideas of Swami Vivekananda.

Swami Shantatmananda, Head, Ramakrishna Mission, Delhi

I have a friend, who seems depressed. His mom (he lost his father when he was very young) said he likes talking to me. I have been trying to find out why he is so sad. I tried asking him about his feelings to which he said that he feels like a destroyer. After he lost his father, the closest person for him was his granny, who died a month ago. His girlfriend also left him two months ago. This has only added to his pain. I just don’t know what to do or say to him to make him feel better. As a friend, what can I do to help? ~ Anonymous

He’s fortunate to have a caring friend in you. Dig a bit and ask him to specify what he means by being a destroyer? Does he believe he’s cursed? That life has chosen him to be the ‘sufferer’? Ideas like these can be quite detrimental to his emotional wellness and in a way will lead him to create a self-fulfilling prophecy. Our ideas facilitate how we react to circumstances. If he has come to believe that life has conspired to give him trouble, he will find it very hard to cope. One way to help is to give perspective about the things going ‘right’ in his life. The human tendency is to focus on the not so good and we need to train ourselves to learn gratitude and thankfulness. So if you can help him direct his mind to count his blessings in spite of having challenges at hand, you will do him a world of good.

I feel depressed every now and then during this lockdown period. No offline classes in college have made it worse. All I can do all day is overthink things that don’t even have anything to do with me. I’m losing focus and energy to do anything else. Sometimes it just feels too much. Please help ~ Anonymous

When we think too much, it means that a part of us (the part that copes by “fight” response) is trying to flash thoughts at you in order to keep you vigilant as it feels you are under threat. Our brain is wired to cope in this way by evolution. This means that we need to do more activities that make us feel safe and calm. Look up “activities to regulate the vagus nerve” and use that to soothe yourself. The other important thing to do is socialise in whatever way you can, for example, going for walks etc with a mask. Seeing some people is better than none. Also try and organise game or movie nights online with your friends.

I feel very lonely. My husband died a few years ago. The worst thing is that I was not supported by my in-laws. They never took care of me after his death. I was in a job but had to leave it though I need the money. I am frightened about the current situation. I am becoming sick day by day as I am going through depression. I want to travel to feel better but I don’t have friends to travel with plus it is impossible during the lockdown. I did not get into a relationship after my husband’s death. I want to be happy but don’t know how to. Please help ~ Anonymous

When we put our well-being into another person’s hands, we will always be susceptible. A loss of a spouse is traumatic and nothing can take away your grief. Self-support is the best support — this belief needs to be underscored in your mind. What can I do, with where I am, and with what I have, is a good way to begin. Unfortunately, too many of us do not ask accountability of ourselves when we find ourselves in distress. All problems have solutions, albeit not necessarily the most optimal ones. It is important to direct the mind to find those. That means not allowing oneself to wallow and instead trying to find purpose in what would otherwise be a meaningless existence. As Viktor Frankl said, “Everything can be taken from a man but one thing: the last of the human freedoms — to choose one’s attitude in any given set of circumstances, to choose one’s own way.”

I am 42 and have fully recovered from Covid. My wife, 41, took care of me and supported me all around. Without her sacrifice I could not have recovered so fast. We are back to normal life but she is not mentally prepared to resume physical proximity. Is there anything wrong in my expectations or does she need to divert her mindset? ~ Anonymous

Issues of communication and consent are always important in intimate relationships, especially when your spouse’s comfort levels and concerns around touch and close contact have changed after being infected with Covid-19. It’s also absolutely normal to not feel like engaging in any sexual activity during this time. The anxiety that comes along with the pandemic, the stress of working from home while also managing the house and the worry she may feel for you can suppress her sexual drive. Don’t force yourself to feel something that isn’t coming naturally. Once things get better, your partner’s sexual drive may return to how it was before. It’s important to talk with your partner about what kind of behaviour she wants to engage in first. Remember that fondling, PDA (public display of affection), cuddling and kissing are also forms of physical intimacy, so enjoy them as much as possible.

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