CHILTON COUNTY
September 2020
Boxing to health
Inside St. Vincent’s offers sleep studies Help for ailing kidneys Understanding Medicare
TABLE OF CONTENTS COPING WITH KIDNEY ISSUES
SUICIDE PREVENTION
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TOUR ST. VINCENT CHILTON’S SLEEP LAB
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BOXING TO HEALTH
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LEARN ABOUT MEDICARE OPTIONS
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GENERAL MANAGER Brandy Clackley EDITORIAL Joyanna Love, managing editor Anthony Richards, writer Elisabeth Altamirano-Smith, freelance writer Emily Reed, freelance writer MARKETING Zack Bates, marketing consultant CUSTOMER SERVICE Kacy Barrett
ADPH COVID-19 INFORMATION 28
BULLYING PREVENTION
PUBLISHER Tim Prince
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PRESSROOM & MAILROOM Chris Love, production manager Michael Turner, assistant production manager Malinda Nance, mailroom manager
ON THE COVER: Coaches Michael Bradford and Alvin Davis of Warrior MMA Academy want to give community members a way to be fit physically and mentally.
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Dr. William Lyndon is the supervising physician at Clanton’s Fresenius Kidney Care.
Coping with kidney issues Fresenius Kidney Care provides needed services STORY BY ELISABETH ALTAMIRANO SMITH PHOTOS CONTRIBUTED
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resenius Kidney Care in Clanton is a local resource that allows kidney patients to receive the care they need without traveling long distances. Clanton Fresenius has recently expanded its facility with a larger working space and is currently awaiting approval for additional dialysis chairs that will allow the medical staff to serve up to 20 dialysis patients at one time. The facility currently has 12 chairs. An estimated 37 million American adults have chronic kidney disease (CKD), but most people do not know that they have it. CKD is a medical condition in which the kidneys fail to adequately clean the blood. According to the National Kidney Foundation, one in three adults with diabetes and one in five adults with high blood pressure have CKD. Kidney disease can have “silent symptoms,� meaning that a person may not experience complications until the disease has already done irreparable damage. For some, kidney issues might ultimately digress to kidney failure, also known as end stage kidney disease (ESKD). Patients with ESKD require either dialysis or a kidney transplant to survive.
This machine cleans the blood of kidney patients.
Fresenius Kidney Care in Clanton
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During a dialysis patient’s visit, the Fresenius staff records the patient’s weight to know how much fluid to remove, and monitors the patient’s blood pressure and heart rate every 20 minutes during the treatment. The process takes an average of four hours depending on a patient’s body size. Even though dialysis can be time consuming, kidney patients have options that optimize the quality of their life and may opt for other options more suitable for their lifestyle such as home dialysis. Dialysis patients may also travel and use other dialysis facilities during their vacations. “We like to know three to four weeks in advance, so we can make an appointment for
Staff work to get a dialysis chair ready for a patient.
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our patient at that location,” said Dr. William Lyndon, supervising physician at Clanton’s Fresenius Kidney Care. “We have patients that routinely visit Gulf Shores and have made them as far as the Grand Canyon and China. Our social worker is persistent and always works hard to take care of it (for the patient).” Fresenius Kidney Care of Clanton is managed by Nephrology Associates of Birmingham which provides many kidney resources including: helping patients maintain their kidney function; helping patients cope; and if a patient is not on dialysis, educating them on prevention. Doctors also see kidney patients at select hospitals and provide procedural troubleshooting and maintenance on dialysis ports and shunts when needed. Lyndon also sees CKD patients at St. Vincent’s Chilton specialty clinic in Clanton. Lyndon graduated with a chemical engineering degree from Princeton University. He received his medical degree from the University of South Alabama and his internal medicine residency and a nephrology fellowship at the University of Alabama at Birmingham. Lyndon served as Chief Nephrology Fellow at UAB. He is a member of the American College of Physicians and the American Society of Nephrology. “Unfortunately, CKD is often unrecognized, as the symptoms can be subtle or nonexistent during its early stages,” Lyndon said.
“Symptoms may include swelling of the feet and ankles, shortness of breath, nausea, loss of appetite and fatigue. Detection of CKD at an early stage is important. When identified early, patients and their providers can often make medication or lifestyle changes that can either slow or stop the progression of CKD.” Diagnosis of CKD requires blood and urine tests ordered by a physician or other health care providers. These tests may be performed due to a person’s symptoms, because the health care provider feels the person is at risk for CKD due to other health problems or as part of routine screening tests. Lyndon originally was interested in a career in pharmaceuticals but during his medical training rotation became interested in the complexity of nephrology and the lab work that it included. “It was a new challenge and new problem to solve,” said Lyndon. “It allows me to help people and especially with kidney care, you can develop long relationships with the patients until they receive a kidney transplant.” According to the National Kidney Foundation, 23,400 Americans received a kidney transplant in 2019, while about 100,000 Americans are waiting for one. Fresenius Kidney Care is located at 275 Health Center Drive, Clanton, Alabama, 35045. For more information, visit www.freseniuskidneycare.com or call 205-280-4331.
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EASY WAYS TO KEEP YOUR IMMUNE SYSTEM STRONG
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he immune system is a powerful component of the human body. The immune system recognizes when viruses, bacteria and other foreign invaders enter or compromise the body, and then takes action to prevent illnesses from taking over. The average person can help his or her immune system do its job more effectively by making the immune system as strong as it can be. Harvard Medical School says that diet, exercise, age, and psychological stress may affect immune system response. Certain lifestyle choices can promote a strong immune system. Get adequate sleep. Doctors believe sleep and immunity are closely tied. A study of 164 healthy adults published by the National Institutes of Health found those who slept fewer than six hours each night were more likely to catch a cold than people who slept for more than six hours. Aim for adequate rest each night to keep your body in top form. Increase your intake of fruits and vegetables. Fruits and vegetables supply the powerhouse antioxidants that are essential for protecting a body against free radicals. Free radicals may play a role in heart disease, cancer and other diseases. Serve fruits and/or vegetables with every meal to ensure youХre getting enough antioxidant-rich foods. Consume fiber and fermented foods. Fiber can help feed the gut microbiome, which is linked to a robust immune system. The microbiome also may prevent harmful pathogens from entering the body through the digestive tract. Data also suggests that eating more fermented foods can further strengthen and populate healthy bacteria in the gut. Exercise regularly. Aim for 30 minutes of moderate exercise per day, advises the American Heart Association. Thirty minutes of exercise each day can go a long way
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toward keeping the body healthy. The U.S. National Library of Medicine says physical activity may help flush bacteria out of the lungs and airways. Exercise causes changes in antibodies and white blood cells. These antibodies and white blood cells circulate rapidly, so they may detect illnesses earlier than they would if you do not exercise. Body temperature also rises during exercise, which could naturally prevent bacteria from growing.  Try to minimize stress. According to Simply Psychology, when people are stressed, the immune systemмs ability to fight off antigens is reduced, making people more susceptible to infections. The stress hormone corticosteroid can suppress the effectiveness of the immune system. Limiting stress through meditation and breathing exercises, or trying to remove stressors from oneмs life, may help. A healthy immune system is vital to fending off or recovering from illness.
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Be the one
Everyone can help prevent suicide
FROM THE ALABAMA DEPARTMENT OF MENTAL HEALTH
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ontgomery, Ala. – All of us can help prevent suicide. Every year, the National Suicide Prevention Lifeline, other mental health organizations and individuals across the nation raise awareness of suicide prevention during September. While suicide prevention is important to address year-round, Suicide Prevention Awareness
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Month is a dedicated time to share resources and stories to shed light on this stigmatized topic. #BeThe1To is the National Suicide Prevention Lifeline’s message this month and beyond and helps spread the word about actions we can all take to prevent suicide. The campaign encourages Alabama residents to raise the conversation on suicide prevention. Specific ideas on how to do this are avail-
able at https://www.bethe1to.com/bethe1to-stepsevidence/ . The COVID-19 pandemic has caused an increase in anxiety, depression, suicide and substance use. This year’s campaign is now more important than ever. While half of individuals who die by suicide may have a diagnosed mental health condition, research shows that 90% experienced suicidal symptoms. A
recent Centers for Disease Control and Prevention report revealed that 40 percent of adults said they had struggled with mental health issues or substance use issues during late June. “Most notably the COVID-19 pandemic has imposed significant psychological and social effects on everyone. This month we are emphasizing the importance of suicide prevention and the stigma surround-
ing emotional and mental challenges,” said Alabama Department of Mental Health Commissioner (ADMH) Lynn Beshear. “Because of the pandemic, our providers have increased alternative means of access such as telehealth and continue to be a beacon of light to individuals in need and help family members understand the signs and symptoms of suicidal iterations.” Every year thousands of individuals die by suicide, leaving behind friends and family members to navigate the tragedy of loss. In many cases, friends and families
affected by a suicide loss (often called “suicide loss survivors”) are left in the dark. Too often the feelings of shame and stigma prevent them from talking openly. ADMH Prevention Services Director, Beverly Johnson said, “As we are faced with COVID-19 and certain levels of uncertainty, emotional distress and anxiety can occur and we want to provide support and the necessary referral resources to those who need it.” She continued, “We observe the month of September to raise public
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awareness of suicide prevention. The annual observance yields much needed attention to such a priority area of focus for individuals and communities that we utilize those platforms throughout the year to promote emotional well-being and resource availability,” said Johnson. ADMH encourages everyone to learn more about how they can directly help someone in need. QPR (Question, Persuade, Refer) and Mental Health First Aid are two education first steps. QPR is a gatekeeper training to enable any adult to identify someone who may be suicidal, initiate a conversation, persuade the person to get help, and assist her or him in finding and accessing appropriate help. For more information on this training, please contact Katie Beaugez at 205677-6116, or visit www. ASPARC.org
Mental Health First Aid offers the education to anyone interested in skills and information to help a person developing a mental health problem or experiencing a crisis until professional treatment is obtained or the crisis resolves. For more information on this training, please contact ADMH staff member Lauren Blanding at 334-353-8866 or email lauren.blanding@ mh.alabama.gov. Veterans are 1.5 times more likely to die by suicide than Americans who never served in the military. For female veterans, the risk factor is 2.2 times more likely. Suicide prevention information is important to share with veterans, as crises can be heightened by their experiences during military service. If you’re a veteran or service member and in crisis, please call the Veterans Crisis Line for help.
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Suicide is preventable. Learn how to help and obtain resources at https://afsp.org/ take-action/. Please call the National Suicide Prevention Lifeline for 24/7, free and confidential support for people in distress, prevention and crisis resources for you or your loved ones, and best practices for professionals.
A GOOD NIGHT’S SLEEP Brandie Davis and Rachel Smith stand in one of the sleep study rooms at St. Vincent’s Chilton.
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This equipment helps staff monitor the patient during the study. The CPAP machine to the right may be used as treatment during the study.
STORY AND PHOTOS BY JOYANNA LOVE
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ow one sleeps each night can impact health in a number of ways, not just how alert they are the following day. For those having issues falling asleep or staying asleep, a sleep study may help a physician determine the cause. Such a study can be conducted at St. Vincent’s Chilton in the sleep lab. “The number one symp-
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tom will be snoring,” Rachel Smith, lead registered polysomnographic technologist at St. Vincent’s Chilton, said. Other symptoms include being sleepy during the day and having trouble staying asleep. “We are looking for several things during the study,” Smith said. “Some patients just have problems waking up often during the night, leg jerks, restless leg syndrome issue.”
The sleep lab has two rooms, so two patients per night can be monitored. “We try to set up as close to a hotel setting as possible,” Smith said. “hospital rooms seem a little more sterile, so we want to make the feel like they are at home … Each room has its own restroom (and) a full-size Sleep Number bed.” While some may have difficulty sleeping, Smith said in 10 years working in this field,
she has only had one person who could not fall asleep at all. The patient wears several electrodes as they sleep that sends data to the sleep lab computers for the registered sleep technologists to see and review. The observation also monitoring electrical activity in the brain, facial movements, restlessness and leg jerks. A patient will come back to St. Vincent’s “about a week later after the sleep study in the clinic with our medical director (Dr. Michael Connolly),” Smith said. “At that time, the results are given to the patient and course of treatment is determined.” Follow up visits for those put on treatment, usually a CPAP
According to their sleep and their breathing patterns, we could introduce treatment in the same night. — Rachel Smith
The sleep lab tries to create a hotel feel for patients.
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machine, is usually every three to five years. Smith said this helps determine that the CPAP levels are what the patient needs “According to their sleep and their breathing patterns, we could introduce treatment in the same night,” Smith said. This would mean having the patient use a CPAP machine. Sometimes, patients are asked to come back to the lab another night for monitoring during treatment. Monitoring sleep includes noting when the patient falls asleep and how long they stay asleep. Having a sleep lab at St. Vincent’s Chilton keep
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patients from needing to drive to Prattville or Alabaster to have a sleep study done. So far, about 400 patients have been served. The lab sees approximately 30-35 patients each month. Connolly, medical director of the Sleep Disorders Center, refers a lot of patients from the clinic at St. Vincent’s Chilton. “He refers a lot of patients,” Smith said. However, patients can also be referred by their primary care physician. During the registration phase of setting up a patient for a study, whether insurance would cover the study or not is discussed.
Sleep apnea What you should know
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dequate sleep can recharge and rejuvenate the body, while interruptions to sleep can have the exact opposite effect. Anyone who has woken up feeling tired after a full nights sleep may be experiencing sleep apnea. According to the Mayo Clinic, sleep apnea is a potentially serious sleep disorder. Through the night, breathing repeatedly stops and starts. Obstructive sleep apnea occurs when throat muscles relax and cut off air flow. A study published in the journal Sleep Medicine Review indicates sleep apnea affects millions of Americans. Sleep apnea can be associated with increased likelihood of cardiovascular disease, stroke, motor vehicle accidents, and diminished quality of life. Furthermore, sleep apnea, which is sometimes accompanied by heavy snoring, can be disruptive not only to the sufferer, but also to a bed partner kept awake by snoring. It is important to note that sleep apnea may be present without much snoring. While sleep apnea can affect both men and women, the Mayo Clinic says men are two to three times more likely to have it than women. It is believed
that inherent differences in length and collapsibility of the upper airway, neurochemical control mechanisms, fat distribution, and hormones all contribute to the disparity of sleep apnea between men and women. Jonathan Jun, M.D., a pulmonary and sleep medicine specialist at the Johns Hopkins Center for Sleep, says during sleep apnea episodes, breathing may pause for 10 seconds or more at a time until reflexes kick in and a person starts breathing again. Breathing interruptions continually wake a person and prevent him or her from getting into a deep, nourishing sleep. The consequences can be mood swings, grogginess, lost productivity, and daytime car accidents. Other sufferers experience headaches from low oxygen or
high carbon dioxide levels during sleep. If sleep apnea is suspected, people are urged to first consult with their primary care doctors. In turn, these medical professionals can refer patients to sleep specialists. A test called nocturnal polysomnography monitors various markers while one sleeps to
determine if sleep apnea is occurring. Age, being overweight, thin neck circumference, smoking, and family history of sleep apnea are risk factors for many individuals. Dr. Jun says, Weight control is very important, says Dr. Jun. Тhere are many studies showing that losing weight can either completely cure you of sleep apnea or at least make it less severe. In addition, doctors may prescribe a continuous positive airway pressure (CPAP) device. With a CPAP device, the air pressure is somewhat greater than that of the surrounding air so it keeps the upper airway passages open, preventing sleep apnea and snoring. Sleep apnea is serious and should be addressed promptly to improve health and quality of life.
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Those new to the sport of boxing often show improvement in technique in as little as three minutes working with one of the coaches.
BOXING TO HEALTH Sport helps physical and mental well being
Davis said students who are shy at first gain confidence as they continue to practice
STORY BY JOYANNA LOVE PHOTOS BY KEITH MCCOY
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t only takes a few minutes to learn a basic move, but the positive impacts of boxing last much longer. “Boxing works your entire core, your entire body,” coach Michael Bradford of Warrior MMA Academy in Clanton said. “At the same time that you are having a full body work out, you are also learning how to defend yourself.” MMA stands for Mixed Martial Arts. The Academy offers training for those 5 years old and older with separate classes for children and adults. Some adult students have started losing weight in their first two weeks. “You burn a lot of calo-
ries,” coach Alvin Davis, who has been boxing for 15 years some as a professional, said. “We probably burn 750 to 1,000 calories in these classes. Maybe not so much with the kids, but with the adults they burn a lot of calories.” Student Lucas Kuykendall said it is a good cardio workout. Kendall, who became interested in boxing after his son started taking classes, said he has enjoyed “the exercise and learning a new skill.” “I had never done anything in boxing … and I’ve had a blast,” he said. “It’s a lot more discipline than I thought it was,” Kendall said. “There is a lot more technique
Warmups are important at the beginning of a boxing class.
A combination of jabs and blocks are essential to boxing.
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involved than I ever saw.” Recently, he has been attending classes five days per week. He and friends attending the classes have all lost weight and “are getting into a lot better shape.” Kickboxing is also incorporated into the classes. “A lot of people are wanting to do new things … and everyone is wanting to get in shape now,” Bradford said. “You come here and you get sweaty. I mean soaking wet … so all of the toxins are coming out of your body.” Bradford opened the Academy as a place for the community to be introduced to boxing and mixed martial arts. “When people see their results and they build their confidence and self-esteem up, especially in today’s world — that’s what it is all about,” Bradford said. He said many have an interest in boxing right now because many things are not happening right now because of COVID-19. Although walking into a boxing class may seem intimidating, Bradford said everyone is “very friendly.” Each new student is evaluated for their skill set before joining a class. Beginner classes are available. These classes start with basic punches as students build their confidence. Bradford said many just starting out at Warrior MMA Academy have shown noted improvement in technique in as little as three minutes working with one of the coaches. The classes for children focus on having fun while teaching the moves. “You can benefit from that being an adult and a kid,” Davis said. “I have a lot of fun doing it still.” Bradford has had a few female students who first came in “scared to death” that are now confident in the sport. “We are trying to get women in here because of the way the world is right now,” Davis said. “It is a great benefit for them to learn how to defend themselves … Once women get in here doing it, they even build a lot of confidence.” Jessica Coats, who has been boxing for a year, said she has lost weight and “been in the best shape of her life”
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Boxing provides a full body workout.
Boxing classes are available for children and adults.
“We are trying to get women in here because of the way the world is right now”. “It is a great benefit for them to learn how to defend themselves … Once women get in here doing it, they even build a lot of confidence.” — Alvin Davis
Alejandro Hernandez practices his moves with coach Alvin Davis.
Boxing is not just for men. Many women have enjoyed taking classes at Warrior MMA Academy.
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Coach Michael Bradford works with a younger student.
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since taking up the sport. She hopes to be a professional boxer in the future. “Women are put in a lot of hard positions in their life where they need to know how to defend themselves,” Coats said. “That’s why I started because I felt like I didn’t know how to defend myself … then I fell in love with the sport.” She acknowledged that it can be intimidating for a woman to start a boxing class, but she said several have signed up lately and enjoyed it. Coaches have also seen changes in younger students. “They come in here and a lot of these kids are really bashful,” Davis said. “They are really timid about coming up to adults and stuff. When they get in here and they start boxing and doing this stuff, it’s like they open up and their personalities open up and they bloom.” Each boxing class begins with warmups of exercises such as sit-ups, jumping jacks, pushups, stretches and a run around the block or around town. “We usually start with a mile and a
half to two-mile run,” Bradford said. Building the physical ability to be a good boxer can take years. A variety of blocking and jabs moves are taught. Davis said it is something that someone can start small and build. In addition to the physical benefits, boxing also has mental benefits. “It’s about reading your opponent and angles, boxing a lot of times is about angles,” Bradford said. “This also builds your focus and your timing.” Nicolas Gutierrez became interested in boxing when he was 17 or 18 as a way to deal with a depressing time. “Boxing is what saved me,” Gutierrez said. Gutierrez connected with Warrior MMA Academy soon after it opened. “I am here every day as much as I can … and train as hard as I can,” Gutierrez said. He said he enjoys the discipline he has learned through boxing. “Without that, you are not going to go anywhere,” Gutierrez said. “You can be very skilled, but if you can’t
discipline yourself to actually go the extra mile, it’s not working.” As a young person, boxing gave Davis a needed outlet that kept him from getting in fights outside of the ring. Boxing increased his overall confidence, and his outbursts of anger decreased. “It gives you some kind of direction in your life, you have something that is always here,” Davis said. “You always have something you can work on.” Alejandro Hernandez, who has been boxing for a year and a half, said the sport has helped his mental health by keeping him from focusing on things he might be angry about. “I like the way that it made me feel,” Hernandez said. “I used to be overweight and it made me feel athletic. I got in shape and lost over 80 pounds doing it.” He said starting out concentration and dedication is key. Warrior MMA Academy is located in downtown Clanton. A student practices with coach Alvin Davis.
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A student practices with coach Michael Bradford.
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UNDERSTANDING COVERAGE
Those 65 and older qualify for Medicare.
Local agency helps those interested in Medicare STORY BY EMILY REED
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hose who qualify for Medicare benefits still have choices when it comes to their coverage. Providing Medicare services to those living in Chilton County has been a goal of Peach City Benefits since 2019. “In 2018, we noticed during open enrollment we were receiving quite a few calls about Medicare,” said agency owner Tamera Bulger-Hinton. “At that time, we were not certified to sell Medicare Advantage plans. We recognized the need in our community, and we wanted to be able to help. We got certified and began to sell Medicare products in 2019.” The open enrollment period for Medicare is Oct. 17 to Dec. 5. Medicare is available for individuals who are 65 and older, as well as some younger people with disabilities and certain illnesses, who could also qualify.
Bulger-Hinton said Medicare has two parts including a Part A, which is the hospital insurance, and Part B, which is the medical insurance. Part A does not have a monthly premium, but Part B does have a monthly premium. Examples of Part A coverage include inpatient care in hospitals, skilled nursing facility care, hospice care and home health care. Examples of Part B coverage include services from doctors and other health care providers, outpatient care, home health care, durable medical equipment such as wheelchairs, walkers, hospital beds and other equipment. Bulger-Hinton said it is always best to speak with an agent about Medicare so they can help determine which is best for them. “There is no clear answer as to which is best, it all depends on health, medical history, the doctor you use, and more,” Bulger-Hinton said. “I prefer to recommend the original Medicare paired with a supplement because it is less complicated.”
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Medicare options
Medicare Part D or a Medicare Advantage plan can provide prescription coverage.
Part A: covers hospitals, skilled nursing facility care, hospice care and home health care. Part B: covers services from doctors and other health care providers, outpatient care, home health care, durable medical equipment such as wheelchairs, walkers, hospital beds and other equipment. Medicare Advantage plans: adds additional benefits from private insurance companies such as prescription coverage, vision insurance or dental insurance with Medicare Parts A and B
Part D: Medicare prescription drug coverage to help cover the cost of prescriptions (Source: Social Security Administration — ssa.gov/benefits/medicare)
Justin Smith, O.D.
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Medicare Part B covers services from doctors and other health care providers, outpatient care, home health care, durable medical equipment such as wheelchairs, walkers, hospital beds and other equipment.
It is common for individuals to go without Medicare because they do not fully understand the benefits or what is offered. “There are still people who have not signed up either due to lack of knowledge, or those that are 65 and older who still have health benefits from their employer,” Bulger-Hinton said. “Most fail to realize if they do not sign up for Medicare at age 65, they can get penalized. They will be subject to late enrollment penalties, as well as a gap in their coverage.” Bulger-Hinton said a frequently asked question from individuals is what is the best plan for them. “There is original Medicare and then there are several Medicare Advantage plans,” Bulger-Hinton said. “Having options is great, but also very confusing and hard to choose from. If not careful, a wrong plan could hurt them in the long run. For example, the co-pays or deductibles could end up being too expensive with a Medicare Advantage plan.” Medicare Advantage plans are offered by private health insurance companies to provide additional coverage paid for by the individual. This can include prescription coverage, vision insurance and dental insurance.
Bulger-Hinton said when a customer inquires about Medicare with Peach City Benefits, they often begin with asking a series of questions, which will help them decide what is the best route for the customer to go. The questions include prescription history and medical history. “Some benefits to having Medicare is access to care and it is less expensive than private insurance for senior citizens,” Bulger-Hinton said. “Certain Medicare plans can also be a one stop shop for all of your health needs to include health, prescription drug coverage, dental, vision, and hearing.” Bulger-Hinton recommends using a local agent to help handle navigating the different options available for those interested in Medicare. “An agent that lives in your community is less likely to sell you a product that is not fit for you,” Bulger-Hinton said. For more information about Medicare coverage through Peach City Benefits, visit call 205-415-0834. Information about Medicare and additional providers is available at medicare.gov.
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ADPH provides clarification and guidance about COVID-19 FROM THE ALABAMA DEPARTMENT OF PUBLIC HEALTH
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s more is learned about COVID-19, the Alabama Department of Public Health (ADPH) is providing updated guidance about testing priorities, listing and defining types of tests, and quarantine and isolation requirements for COVID-19 patients and their contacts.
No one is immune to COVID-19, but it impacts some populations and communities disproportionately. Everyone has a responsibility to help slow the spread of the virus in their homes, workplaces, educational institutions and other places within their communities. Because COVID-19 testing resources are not sufficient to test every person at this time, ADPH recommends the following guidance in a health alert network message to providers. Testing priorities for patients and laboratories: 1. Hospitalized individuals with signs or symptoms of COVID-19 infection. 2. Other symptomatic individuals and higher risk asymptomatic individuals including but not limited to those in long-term care facilities. 3. Other individuals not experiencing symptoms when certain conditions exist. Types of tests: 1. Diagnostic tests assess the presence of the virus at a given point in time. A negative means only that an individual was negative at the time of the test. This can be impacted by factors including but not limited to the quality of the specimen collected, the timing of collection during the incubation period, and the handling of the specimen. 2. Polymerase Chain Reaction (PCR) tests and Nucleic Acid Amplification testing (also known as viral tests) detect the RNA genetic material in the COVID-19 virus and are often collected via nasal pharyngeal, mid turbinate, nasal, oral or throat swab or saliva collection. Some of these tests are now available at the point of care. 3. Antigen tests detect the presence of COVID-19 specific protein particles and are collected via a respiratory sample. Currently, two approved point-of-care tests are being utilized.
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Isolation, quarantine and employer requirements about returning to work and retesting: 1. At the time of testing, persons are instructed to isolate at home while awaiting test results. Persons who are close contacts to COVID-19 cases must complete at least a 14-day quarantine period even with a negative test. 2. Individuals who test positive for COVID-19 should isolate from others in the home to reduce the risk of spread. If those who test positive cannot isolate from household members, then household members must remain in home quarantine 14 days after the person who tested positive is released from isolation.
3. Employers should not routinely require a negative laboratory COVID-19 test as a requirement for employees to return to work. This is because PCR tests can remain positive long after an individual is no longer infectious. Instead, symptom- or time-based methods are recommended with some very rare exceptions. However, this does not mean an employer must allow an employee who currently has COVID-19 to return to work before the employee’s infection is resolved. 4. Persons who tested positive for COVID-19 and have recovered do not need to be quarantined again or be retested for at least 90 days unless they develop new symptoms consistent with COVID-19 infection. Close contacts and when to leave quarantine: 1. A close contact is anyone who has known exposure defined as being within 6 feet of a COVID-19 infected person for
best best of the
4. Serology (antibody) tests are not diagnostic tests. These tests detect antibodies in the blood indicating possible prior exposure to COVID-19 which may develop 6-14 days after infection. Commercially available antibody tests have variable performance.
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15 minutes or greater within a 24-hour period. The 15-minute time is a cumulative period of time. For example, a close contact might be within 6 feet of a COVID-19 positive person for 5 minutes each at 8 a.m., noon and 5 p.m. This is a standard based on guidance from the CDC. 2. A person who is a close contact to a confirmed or probable COVID-19 case must complete at least a 14-day quarantine period, regardless of whether a face covering, or regular mask was worn. 3. Persons with known exposure who are determined to meet the close contact definition cannot leave quarantine, regardless of whether they test negative for COVID-19. This means that a negative COVID-19 test will not allow them to return to work, school or participate in sports or other activities. This is because a person who has been exposed to COVID-19 and meets the close contact definition has up to 14 days to become infected from the time of exposure. This period may be even longer for a small number of people. 4. Allowances regarding close contacts are made for healthcare personnel who wore the appropriate personal protective equipment. For more information about COVID-19, go to alabamapublichealth.gov.
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October is National Bullying Prevention Month FROM PACER’S NATIONAL BULLYING PREVENTION CENTER
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n 2006, PACER Center started a groundbreaking movement to raise awareness about the devastating impact and often long-term effects that bullying can cause in our nation’s youth. The result was PACER’s creation of National Bullying Prevention Month. Each October, PACER’s National Bullying Prevention Center leads a campaign that unites individuals around the nation – and the world – with the powerful message that bullying should never be a part of childhood. National Bullying Prevention Month is a wonderful opportunity to prevent bullying by encouraging everyone to act with kindness, acceptance, and inclusion. This year, a worldwide pandemic and a growing movement for racial equity and social justice have highlighted the need to unite communities for a better future. Now more than ever, it is crucial to join together in creating a world that is kinder, more accepting, and more inclusive. This month-long event is also a time to show solidarity for the one out of every five students who report being bullied each year. Bullying isn’t a childhood rite of passage; it has real implications for a child’s education, health, and safety now, and well into their future. PACER’s National Bullying Prevention Center offers age-appropriate resources to help students, parents, educators, and community members address bullying. Opportunities to get involved include:
• Celebrate Unity Day on Wed., October 21, the signature event of National Bullying Prevention Month with a simple call to action to wear and share the color to send a universal message that bullying is never acceptable behavior. Order a free Unity Day poster to show your support. • Find free distance learning resources to use in your virtual classroom to continue engaging students in social emotional learning and bullying prevention For more information about National Bullying Prevention Month, visit pacer.org for tips for parents and professionals, middle and high school students, and elementary students.
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What you should know about COVID-19 and CYBERBULLYING Parents
Cyberbullying is using a form of technology–such as the internet, cell phones, or virtual classrooms–to intentionally hurt or harm someone else. CYBERBULLYING & COVID-19 • Youth are spending more time online for school, connecting with peers, and socially interacting with friends • Kids are still adjusting to learning and interacting with their peers virtually • Many young people may be feeling new and uncertain emotions due to the pandemic, such as anxiety, anger, fear, isolation, or stress • This unprecedented period, as well as more time spent online, have the potential to cause an increase in cyberbullying behavior
REMEMBER: CONVERSATIONS WITH YOUTH ARE IMPORTANT • Start talking about online behavior as soon as they start using technology and return to the conversation as their technology use evolves • Your child may not recognize that hurtful online behavior can be cyberbullying, especially in new settings like virtual classrooms • Discuss what cyberbullying is and steps to take if they experience or witness it
IF YOUR CHILD IS BULLIED ONLINE, WHAT SHOULD YOU DO? • Be supportive of your child; you might be the first person they've told • Let them know you are there to help • Document the situation and keep a detailed record with screenshots and saved texts • If the cyberbullying is happening: - In your child’s distance learning classroom or with peers: Inform your child’s school. Most schools include cyberbullying in their bullying prevention policy. - On a social networking site: Check the safety page for ways to report and block • The most important message to give your child is that they aren't alone and that, together, you can find a solution
Scheduling annual physicals and health screenings help catch issues early
Plan ahead
How to take a more active role in your personal health
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he role individuals play in their own health care became more prominent in 2020. As a global pandemic forced people from all walks of life to prioritize their personal health each time they left their homes, many individuals sought ways to take a more active role in their health care. Proactive health care has long been touted by medical professionals, though many people still don’t take such recommendations to heart. In fact, a recent report from the Centers for Disease Control and Prevention estimated
that as much as 75 percent of health care spending in the United States is reactive in nature, meaning that money is going toward treating conditions and diseases rather than preventing them from occurring in the first place. Taking an active role in your own health care is easier than people may think. And the benefits of such a proactive approach are numerous, including a reduced risk for various diseases. • Schedule annual physicals. Annual physicals are one of the simplest and most effec-
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A proactive approach to personal health is simple and effective, potentially helping people reduce their risk for a variety of diseases and conditions.
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tive ways for individuals to take active roles in their personal health. Many health insurance plans cover annual physical exams at no cost to policy holders, and these examinations can uncover issues even when individuals are not feeling any symptoms. Annual physicals also provide great opportunities for individuals to discuss diet and healthy lifestyle choices with their physicians in relaxed settings. • Learn about the preventive services that are right for you. Individuals should speak with their physicians about which services are recommended for individuals in their situations. Screening guidelines are often age-based, but they also take personal history and family history into account. For example, the U.S. Department of Health and Human Services recommends all adults between the ages of 50 and 75 be screened for colorectal cancer, but the frequency
of those screenings will depend on each individual’s personal risk and which screening test they choose. • Embrace physical activity. The DHHS notes that regular physical activity increases a person’s chances of living a longer, healthier life. In addition, the CDC says regular physical activity reduces a person’s risk for chronic conditions, including type 2 diabetes, heart disease, various types of cancer, and even mood disorders like depression and anxiety. Access to fitness facilities may be limited or unavailable during the pandemic, but that should not deter people from exercising regularly. Walking, jogging, hiking, and cycling are great forms of cardiovascular exercise that have been linked to a host of health benefits. A proactive approach to personal health is simple and effective, potentially helping people reduce their risk for a variety of diseases and conditions.
Embracing physical activity is one way to take an active role in one’s personal health.