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    Science Saturday: Regenerative approaches could foster healing from COVID-19

Regenerative Medicine aims not only to repair or restore the function of cells, tissues or organs, but also the whole person. The latter is particularly important amid the COVID-19 pandemic. Regenerative approaches draw on the body’s natural abilities to heal, focus on establishing the healing environments and building new, healthy ways of functioning. These aspects of regenerative medicine may nurture healing in people who’ve contracted the virus, those who treat it and the broader community whose lives have suddenly been changed by the pandemic.

Creating safe, trusting environments

When people are diagnosed with COVID-19, their illness may go beyond physical afflictions to a breakdown of the mind and spirit. Some Coronavirus patients are immediately isolated, separating them from the people they love. That may trigger confusion, fear, anxiety and mistrust.

In a normal health care environment, patients might be soothed by welcoming faces and warm touches of medical professionals. But in the new world of a virus to which no one is immune, caregivers must wear personal protective equipment for their own safety. The face masks that allow patient and clinician to come together safely may also be a barrier that increases isolation and fear.

Victor Montori, M.D.

“It creates a new population of people who are traumatized,” says Victor Montori, M.D., an endocrinologist at Mayo Clinic and expert leader for the Mayo Clinic Center for Regenerative Medicine. “This trauma is a response to the difficult and unbearable aspects of COVID-19. It manifests itself as emotional and physical responses. In addition to fostering conditions to prevent trauma, the regenerative approach to healing in this case might mean that as people recover from COVID, they go on to receive additional care from psychologists and social workers that would help them build trust to overcome their trauma.”

Health care professionals who are on the forefront of care may themselves suffer trauma, particularly if they witness death, see colleagues become ill or have to make difficult decisions about prioritizing care.

Dr. Montori says creating a safe, trusting environment is a good antidote to trauma.  He suggests an effective platform for healing may be trauma-informed care, a way to prevent and care for people with post-traumatic stress disorder. Trauma-informed care creates a safe environment in which trauma is noticed and a caring response developed that fosters recovery. The emphasis for caregivers is on organizational safety, trustworthiness, cultural sensitivity and collaboration.

For the patient, trauma-informed care seeks to build coping skills and foster resiliency through:

  • Managing emotions
  • Connecting with others
  • Finding hope, purpose and meaning

“To build back health, they’ll need to rehab their muscles and ability to breathe. Equally important is to regenerate the psyche and the way they trust and feel safe in the world.  Teamwork across clinical disciplines and collaboration with community partners is necessary, therefore, to work with affected patients and clinicians, so they can be supported in their healing,” says Dr. Montori.

Tapping the human mind to heal

Emotional trauma may extend beyond patients suffering with COVID-19 and those on the front lines of treating it, according to Craig Sawchuk, Ph.D., L.P., chair of Mayo Clinic Division of Integrated Behavioral Health. Fear, anxiety and stress also may be prevalent in otherwise healthy people who are overwhelmed by the societal and economic fallout of the pandemic. Psychological healing may be needed among people who fear contracting COVID-19 as well as those experiencing social isolation, job loss or financial pressures.

Craig Sawchuk, Ph.D., L.P.

“The amount of uncertainty related to COVID-19 is unprecedented,” says Dr. Sawchuk. “There has been a complete disruption of day-to-day routines. No one is certain how long it is going to last. We see stress-related problems like sleep disruption, fatigue, physical tension, irritability and worry.”  

One key way to foster psychological healing, Dr. Sawchuk says, is by taking charge of things you can control and letting go of things you can’t.

“It is important to come to a level of acceptance with the situation. That doesn’t mean you have to be OK with it,” says Dr. Sawchuk. “But, we must be aware some people will have trouble and get stuck in conditions similar to post traumatic stress disorder or significant depression. They may need ongoing treatment.”

Dr. Sawchuk recommends several pathways to healing:

  • Limiting exposure to COVID-19 related news.
  • Finding support from family, faith and friends.
  • Developing a structured daily routine that includes proper nutrition, exercise and sleep.
  • Exploring self-help resources such as mental health apps that offer coaching for stress management, worry management, positive attitude and goal setting. Psyberguide.com is a free service that provides ratings of mental health apps.
  • Seeking face-to-face counseling, including behavioral therapy and other coping strategies.
  • Making an appointment for psychiatric evaluation or medication management.

In a world that has changed dramatically in just three to six weeks of time, healing mind, body and spirit may take time.

“It’s not like a light switch in which we can instantly turn back on the economy or return to our normal social routine. It’s probably going to be more like a gradual dimmer switch. For a while, people are going to feel like they are living life walking in a minefield. They’re likely to be extra cautious about reclaiming their usual activities,” Dr. Sawchuk says.

Rebuilding health

The regenerative medicine notion of building something new to restore health may also be applied to COVID-19 healing.

Ian Hargraves, Ph.D.

“Already, we see a lot of building and creating in the way that people live with COVID-19,” according to Ian Hargraves, Ph.D., a scientist and author of a regenerative medicine position paper. “People are creating new types of social interactions based on social distancing, and they are remaking schooling through online learning. They are redefining work and family life. People are making masks and creating new senses of who they are and what their world is.”

Those recovering from the trauma of COVID-19 may not be able to go back to the way things were before the pandemic, Dr. Hargraves says. For example, they may need to continue the practice of social distancing or may need to take their temperature daily. Although the virus was thrust upon hundreds of thousands of people, those who care for people with COVID-19 can help with healing by supporting people as they rebuild their lives, relationships and outlook, he adds.

Dr. Sawchuk predicts that personal and community healing will eventually come when COVID-19 infections, hospitalizations and deaths subside. Until that time, a regenerative approach of creating an environment of trust to ease trauma, tapping the human psyche for healing and focusing on creating something new may be the catalyst for recovery and preparation for a post-COVID-19 world.

The Mayo Clinic Center for Regenerative Medicine supports programs and practices that transform the focus of health care from treating disease to one of restoring health and healing.