Behavior Change Guidelines for Organization and Community Leaders

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Republished from Coronavirusdiabetes.org

CORONAVIRUS + DIABETES

The global outbreak of the novel coronavirus (COVID-19) has added new challenges, fears, and uncertainties for people living with diabetes, as members of the diabetes community are among the most vulnerable to serious complications caused by the virus. But there’s some good news: together we have the power to shape what happens next. Every action to curb the spread of the virus represents countless infections prevented. We have a simple goal: to tap in to the power of the diabetes community to save lives.

Not everyone with diabetes faces the same personal risk, but we’re only powerful against coronavirus when we work together. For those with less well-controlled diabetes, this campaign focuses on minimizing exposure. But for those younger and healthier with less immediate risk, it emphasizes the need to take every precaution to keep others in our community safe.

Get involved: Join us in spreading the word about the importance of these actions to the community you serve. E-mail coronavirus@beyondtype1.org and we’ll add your organization to the growing list of sharing partners around the world. Work with us to translate, customize, and share resources to protect the diabetes community.

BEHAVIOR CHANGE GOALS

The following set of behavior change goals and recommendations for people with diabetes during the COVID-19 outbreak were created by the JDRF – Beyond Type 1 Alliance and endorsed by the American Diabetes Association, Harvard Medical School, and the International Society for Pediatric and Adolescent Diabetes (ISPAD).

Not everyone is able to take every precaution – but every precaution taken makes a difference.

Together as a community, we will work to:

  1. Reduce or eliminate our exposure to the novel coronavirus by:
    1. Establishing and maintaining strict hygiene
    2. Minimizing our physical interaction with others
    3. Taking extra precautions if we do have to go out
    4. Changing how we work to make it safer
  2. Increase our baseline health to lower the risk of severe infection by:
    1. Managing our diabetes as well as we possibly can
    2. Maximizing our baseline health
    3. Getting treated quickly if we do get sick

BEHAVIOR CHANGE RECOMMENDATIONS

Reduce or eliminate exposure to the novel coronavirus.

Shared Goal Individual Behaviors
Establish and maintain strict personal hygiene.
  • Act as though you have COVID and could pass it on.
  • Wash your hands regularly and thoroughly everytime you come into contact with an out-of-home item or place, following each use of the rest room, and prior to touching your face.
  • Regularly clean and disinfect high-touch / high-risk surfaces in your home, including toilets, sinks, and door handles in ablution facilities after each use, as well as keyboards, door handles, bedside tables, and taps/faucets in kitchens.
  • Avoid touching your face.
  • Cough or sneeze into elbows or handkerchiefs.
Minimize physical interactions with others.
  • Minimize contact with individuals outside of your immediate household.
  • Stock up on food, supplies, and medications (as budget permits) to minimize trip frequency – e.g. to as little as once or twice a week. Get supplies delivered with a no-contact drop off if you can, either through local delivery options or by asking friends or family to shop and deliver goods for you.
  • Make alternative arrangements for routine medical care:
    • Ask your clinic/doctor about local options to have medications mailed to you or dropped off by the pharmacy.
    • Use telehealth for medical appointments if possible – but reach out to healthcare providers several weeks ahead of needed routine appointments to arrange them.
  • Replace normal social activities with remote ones that don’t put you at risk, such as voice or video calls, online activities or even talking to neighbors through the window. Experiment to find what works.
Take extra precautions when out in public.
  • Try to adjust your schedule to avoid times when lots of people are out.
  • Leverage dedicated shopping times for vulnerable people if available in your community.
  • Practice physical distancing – maintain a distance of at least 2 meters / 6 feet at all times.
  • Wear a cloth mask or face covering in public places.
  • Carry hand sanitizer (if available) and wash your hands as soon as you enter or exit your home, or touch anything outside (or that has been outside) of your home.
  • Exchange goods at a 2 meters / 6 feet distance to protect store and delivery workers as well as yourself.
Make work as safe as possible.
  • Work from home if possible and supported by your employer, even if it’s just for part of the week or part of a day.
  • If not possible, look into modifications in how you work that enables you to maintain a distance of at least 2 meters / 6 feet at all times.
  • See if you can adjust your work schedule to be in your workplaces at hours when there are fewer people present.
  • Talk to your employers about flexible work options for higher-risk individuals. This may include:
    • Swapping tasks with high-risk coworkers that may allow them to stay home or maintain physical distancing.
    • Working remotely where high-risk coworkers are not able to do so, to reduce the number of people present in the workplace.

Increase baseline health to lower the risk of severe infection.

Manage diabetes as well as you can.
  • Check your blood sugar levels more often; your body may react differently under these new circumstances. Prioritize keeping blood sugar levels in target range during this stressful time.
  • Familiarize yourself with how to check for ketones. Check for ketones regularly, regardless of blood sugar levels
  • Secure sufficient levels of essential supplies, including ketone strips and severe hypoglycemia treatment (glucagon).
  • Maintain a routine of physical movement and blood sugar friendly eating.
  • Contact your doctor or health professionals by phone / telehealth if possible if you have questions or concerns about the management of your diabetes.
  • Lean on your community for help – none of these behaviors are easy, and everyone needs support. Find digital and online communities and make a habit of checking in there regularly.
Maximize baseline physical and mental health.
  • If you smoke or vape, at least stop until you are safe from COVID-19.
  • Prioritize five things: rest, hydration, nutrition, physical activity, and (remote) socialization with others. Experiment until you find what works and build good habits.
  • Exercise inside or in isolated areas with minimal exposure to both surfaces and other people.
  • If you are struggling with feeling isolated or your mental health, seek online or telephone help.
  • Stay in contact with friends and family.
If you get sick, get treated quickly.
  • Develop daily habits of tracking health:
    • Record your base-line heart rate each morning to act as an early warning signal.
    • Similarly, measure your temperature with a thermometer, if possible.
  • If you become sick / develop a fever, your insulin management may need to be adjusted; contact your doctors or appropriate health professionals to discuss how best to manage this. Never stop taking your insulin.
  • If you become sick, you should attend your clinic if you have a fever, you have fruity breath, vomiting, weight loss, dehydration, confusion, or hyperventilation.

Resources

“Face coverings, masks and COVID-19”, Harvard University https://harvard.edu/sites/default/files/content/2020_04_06_COVID-19_CDC_Mask_Recs_A2.pdf

“Socialize remotely”, Harvard University, https://www.harvard.edu/coronavirus/socialize-remotely