Over the past year, the world has become firmly acquainted with terms including social distancing, incubation period, flattening the curve, quarantine and personal protective equipment.

COVID-19 has infected nearly 28 million people in the United States and contributed to the deaths of more than 488,000 since the first cases were reported in the country in February 2020. The coronavirus pandemic has altered many aspects of our lives — from where we work and learn to how we interact socially to our behavior when we go to the grocery store, to name just a few.

It has also hopefully made people more vigilant in terms of how they approach their health and well-being. From physical health and building immunity to mental health and how to maintain it, enduring and surviving a pandemic comes with lessons to be learned — for those wise enough to observe and listen.

Active Living

The immune system plays a vital role, protecting the body from harmful pathogens and other invaders that can make people sick. That’s why it’s important to maintain good physical health not only during a pandemic but always, says Dr. Salvatore Mule, a family medicine specialist based in Howell, New Jersey.

“Our immune system does an amazing job protecting us all from constant assaults from microorganisms,” Mule says. “Therefore, making sure we take steps to maintain our highest level of armor through appropriate diet, exercise and stress reduction is essential to maximize our immune system against all microorganisms, including COVID-19.”

Physical activity and regular exercise are important to maintain an overall healthy lifestyle, according to Mule.

“By regularly exercising, we are more likely to control weight gain and optimize our cardiovascular health,” he says. “This means that there will be a less likely chance of developing chronic illnesses that may weaken our immune systems, such as obesity, diabetes and heart disease.

“As most of us have been living a more sedentary lifestyle (during the pandemic), it is important to keep up with our exercise regimen to keep our immune systems strong. That is our best defense against COVID-19, in addition to social distancing.”

Any exercise that increases resting heart rate can be beneficial to overall health. This includes walking, jogging, hiking, swimming, biking and lifting weights, Mule adds.

Nutritional Necessity

When it comes to diets, there is no food that by itself in sporadic doses specifically aids in fighting off infection, says Dr. Michael L. Loftus, chief medical officer at the Jersey City Medical Center in Jersey City, New Jersey. But a well-rounded diet high in fruits and vegetables, and which includes fish, poultry and lean meats, is recommended by the American Heart Association for overall good health, he says.

“As many families are spending more time at home and making fewer trips to the grocery store, ordering dinner has become a staple for many households,” Loftus says. “Keep in mind that most restaurant foods are cooked with higher salt and fat content than the meals you may prepare yourself; and, unless labeled as a heart-healthy option, you may be better off preparing your own balanced diet at home.”

One well-publicized trend during the pandemic has been an increase in average daily alcohol consumption, he says.

“This can have significant negative long-term health implications,” Loftus says.

According to the Department of Health and Human Services, it is OK for an adult woman to consume one alcoholic beverage per day and an adult man to drink two per day, though some experts have recommended no more than one drink per day for men.

Mentally Well

Stress levels for many people have been higher than normal during the pandemic.

“While stress and how it affects our immune system still needs more study, we know that stress can affect our overall health habits, such as diet and exercise,” Mule says. “In these times, stress levels for most people are at higher levels than normal and are chronic in nature. Therefore, stress reduction is important and should be part of our daily routine.”

Coping mechanisms are different for each individual person, he notes.

“Stress reduction by exercise, meditation, listening to music, tension relaxation techniques and even yoga are just some examples we can use to reduce our daily stress,” Mule adds.

Many people who have had trouble coping with stress during the pandemic have existing mental health issues, and their struggles have in many cases been exacerbated.

“This past year has tested our mental health and emotional state in ways beyond what is typical,” says Dr. Lori Ryland, a licensed psychologist, behavior analyst and chief clinical officer at the Pinnacle Treatment Centers in Mt. Laurel, New Jersey. “Not a day goes by in which you do not hear about a challenge that is a byproduct or direct result of the COVID-19 pandemic.

“The state orders to reduce exposure to the virus and to stop the spread have increased social isolation, reduced family support and restricted healthy peer interactions. Children and teens have been at home and unable to go to school or child care. As a result, parents have been required to juggle parenting responsibilities with employment demands — if they are lucky enough to have maintained employment in the first place. In many cases, such as in the hospitality or entertainment industry, work is unavailable or severely limited, resulting in an increase in workers filing for unemployment or falling behind in bills. Cases of domestic violence and child abuse are reported to be escalating, as is drug and alcohol use and overdose.”

According to Ryland, the most common mental health issues that have arisen since the onset of the pandemic include depression, suicidal thoughts and behaviors, anxiety, substance abuse and overdose. This has for some people contributed to deteriorating physical health.

“Symptoms such as insomnia, headaches, fatigue, agitation, weight changes, difficulty concentrating, apathy, and hopelessness are escalating,” she adds.

But there are ways to cope. Dr. Marc S. Lener, a psychiatrist who has nearly 10 years of experience working with patients who have anxiety and depression, offers some mental health tips.

“For all people, basic self-care includes a balanced diet; maintaining hydration; instituting breaks through the day, especially in between endless virtual meetings; and maintaining an exercise routine,” says Lener, CEO and founder of the Singula Institute in New York City.

“Although stress was here before the pandemic, it has been a bit more weighty during the pandemic, and acutely increasing throughout each pandemic wave,” he explains. “The key to managing stress is to think of it in a biological, psychological and social context. If you are prone to anxiety, depression or trauma-related issues, it may be helpful to engage with a mental health provider to form a treatment plan. Or, if you’re already in treatment, speak to your provider about how you’re being impacted.”

In addition to self-calming techniques, meditation and mindfulness have gained more popularity over the last couple of decades as an increasing trend in mental wellness, Lener adds. Other coping strategies, such as positive self-talk and cognitive reframing, can be achieved through psychotherapy.

“Socially, the pandemic has posed challenges to social interactions, which can be solved through creative approaches and ideas that allow for some form of interaction within the boundaries of public health measures,” Lener says. “People who live alone and have the capacity can consider adopting a pet, which can provide an important emotional attachment to solve the problems of social isolation and loneliness.”

For anyone in distress or in a crisis, Lener advises to consider calling a state or local mental health crisis hotline, the National Suicide Prevention Lifeline at 800-273-8255 if someone is considering suicide, or go to the nearest emergency room for a more thorough evaluation.

Diagnosis and Prognosis

Dr. Jacob Teitelbaum, a Hawaii-based board certified internist and expert in the fields of chronic fatigue syndrome, fibromyalgia, sleep and pain, offers some advice for people if they are diagnosed with the coronavirus.

“First of all, don’t panic,” Teitelbaum says. “The vast majority of people who get the virus do fine with it. Forty percent of people have no symptoms at all. Stay hydrated and get your sleep. Avoid excess sugar like sodas or fruit juices, as these suppress immunity.”

Medical help should be sought when there is shortness of breath upon exertion, he adds.

“I recommend getting a pulse oximeter,” he adds. “This simply clips on your fingertip, and quickly and easily tells you the percent of oxygen in your blood. As long as it is over 94% most of the time, the shortness of breath is not likely to be problematic. But, if it is dropping under this, it’s a good time to get medical attention.”

To reduce symptoms, people can take supplements, stay hydrated, and get eight hours sleep per night, he says. When it comes to quarantining and returning to activities people previously did, Teitelbaum says to be smart about it.

“I recommend having a repeat PCR test at 10 to 14 days after onset,” he says. “If negative, I then usually clear people to return to work. Do common sense things, such as social distancing and wearing a mask. But be aware that you do not need to wear a mask outside, except for the brief periods that you may be within 6 feet of other people you don’t know.”