Intermittent fasting is a term for meal timing schedules that involve voluntary fasting or reduced calories intake and non-fasting over a given period. Also called intermittent energy restriction, this controlled cycling between fasting and eating is a popular method to lose weight.

That being said, there is nothing new about it; intermittent fasting is a part of religious practices across the world, including Hinduism, Islam, Christianity, Judaism, and Buddhism. Practised throughout human history, intermittent fasting might be the secret to health! Read on to know more.

Intermittent fasting is not similar to juicing or eating raw or whole foods because it's not a diet, rather, a pattern of eating. When practising intermittent fasting, you simply schedule your meals to get the most out of them, not changing what you eat, but when you eat.

In this type of intermittent fasting, you alternate between a 24-hour fast day and a 24-hour non-fast day or feasting period. Complete alternate-day fasting or total intermittent energy restriction requires no calories to be consumed on fast days. On the other hand, in modified alternate-day fasting or partial intermittent energy restriction, consumption of up to 25 per cent of daily calorie needs is allowed on fasting days. In simple words, this type of intermittent fasting is alternating days with normal eating and a low-calorie diet.

Periodic fasting is whole-day fasting and it involves a period of consecutive fasting thats more than 24 hours. In the 5:2 diet, for example, you fast one or two days per week. Theres also the extreme version with several days or weeks of fasting! Again, during fasting days, one can go for complete fasting or consume 25 per cent of daily caloric intake.

This involves eating food only during a particular number of hours each day; examples include skipping a meal or following the 16:8 diet, which is a cycle of 16 fasting hours and eight non-fasting hours.

Tip: Understand what intermittent fasting is before changing your diet plan and meal times.

A. Intermittent fasting is a diet plan that comes with bothpros and cons, so depending on your current health and health goals, you can pick a diet or meal plan that works for you.

Avoid intermittent fasting if you:

In women, fasting can cause sleeplessness, anxiety, and hormone dysregulation indicated by irregular periods, among others. So while females should start easy with intermittent fasting, also be cautious if you:

Intermittent fasting is said to bring about positive results for people have a job that allows low-performance periods, are already into dieting and exercising, or are able to monitor calorie and food intake well.

A. Follow these tips:

Identify Your Personal Goals

Whether your goal is to lose weight or improve overall health, identify your needs before getting started on any diet or exercise plan. Consider your lifestyle and design your diet plan and meal schedules accordingly. Remember to set small, realistic goals that you can easily achieve and progress towards instead of setting unattainable goals. Not being able to meet goals will only make youupset, so take it to step by step.

Determine Caloric Needs

With intermittent fasting, simply not eating for a certain period of time wont help you lose weight; you need to create a calorie deficit so youre burning more calories than youre consuming. On the other hand, if you want to gain weight, you need to be consuming more calories than you're burning. So figure out the calories and nutrients you consume and what changes you need to makethere are several tools available for the same. You can also speak to a dietitian for guidance.

Once you figure out your goals and caloric needs, consider how you want to go about meeting your daily and short or long-term goals. Understand the basics of each type of intermittent fasting plan and select one that you think will work for you. Typically, you should stick with any method for at least a month or longer to see if it works for you or not, before trying another one.

In addition to this, remember to start slowyou want to become a healthier version of yourself, not fall ill following extreme diet plans!

A. Keep in mind that hunger passes like a wave. Don't worry about your hunger becoming intolerable; if you ignore it and divert your mind to work or other activities, you'll be okay. When you fast for an extended period of time, hunger often increases on the second day, but it starts to recede gradually. By the third or fourth day, you can expect a complete loss of hunger sensation as your body stays powered by stored body fat!

Most importantly, remember to stay hydrated as more often than not, what you perceive to be hunger is just thirst. Drink up to eight glasses of water a day and sip on juices or teas. Prefer natural sweetenersand flavour enhancers like spices and herbs over sugar or you'll simply be intaking more calories.

Also, avoid looking at pictures and videos offood to keep yourself from temptation!

Read more:
Your Guide To Intermittent Fasting Is Here! - Femina

COLORADO SPRINGS How many stories about how to eat right, and not gain weight during our stay at home orders have you seen or heard? I have heard many of them, and if you're like me -- just hearing them isn't really helping me avoid the pitfalls.

Dr. Kristen Kells, D.C., B.S.c. owns Dr. Kells' Weight Loss in Colorado Springs. She has traveled her own weight loss path, losing 80 pounds nearly 20 years ago, and has been working ever since to research the science and help others find a healthy way of living.

Dr. Kells says, If putting a food plan in front of somebody or reading a story or an email worked, we would all be in perfect condition and have a six-pack.

Like so many of us, Dr. Kells is also dealing with the stresses and challenges of living life under quarantine and social distancing because of the global pandemic. She is doing it on a personal level as a wife and mother, and a small business owner.

When Colorado Governor Jared Polis ordered all non-essential business to close, Dr. Kells explains, We just scrambled, around the clock. Literally overnight, we transitioned everybody to their home so that we can still be fully functional and serve our clients. I am so blessed to have a full team working right now and that we can keep everybody employed and helping our clients. They're answering texts, phone calls, holding virtual meetings to follow up with clients. We've been able to do everything virtually and Im a little surprised we have so many people doing so well!

Emotional eating driven by stress and anxiety is something her team constantly helps clients learn how to cope with, but the isolation and stress brought on in our society by coronavirus has brought that issue to a new level for many.

Dr. Kells says, I've never seen anything like this before, nor has anybody alive. There's so much going on, and eating is one of those things that is a big challenge. Just being healthy is a big challenge.

As she learned for herself over the years, Dr. Kells says there is a science behind why some people are so susceptible to eating their emotions. Most people don't realize that in our gut we have more serotonin receptors that antidepressants target. Its that piece of our brain that tells us our happy thoughts. When we crave food there is a reason for it. Our gut has its own nervous system called the enteric nervous system, and it has serotonin receptors that are denser and more populated than in our brain. So there is a reason that we stress eat. When we crave food there is a reason for it.

Dr. Kells also points out that this is an important time to think about losing weight and getting healthy. Looking forward to a healthier body may be key to avoiding the worst symptoms COVID-19 can bring on. We know that the mortality factors for COVID-19 and other illnesses are things like obesity, heart disease, lung problems and diabetes. So the things we can control [in terms of fighting the disease] are our health issues.

While we wait for treatments, and a vaccine for the novel coronavirus, Dr. Kells says you don't have to wait to make positive changes in your life during this very abnormal time when we might be tempted to go the other way. When people start our program we say to them, This is not about us dictating something to you, this is about us working in partnership with you, to empower you. A lot of people can do quick fast weight loss and get skinny, but it's about being healthy for a lifetime. I think if we allow this situation to change us in positive ways, use it as a time for healing, self-care, self-improvement, focusing on our health, our family and our relationships and on nature, we will be a better, kinder world. That's my hope; that's what gets us all through this. What does it look like on the other end? We can use this time to help ourselves and others.

Finally, if you think now is not the time to spend money on a healthier lifestyle, Dr. Kells says, People are financially dealing with a lot of insecurities right now, and we as a small business are working really hard with people that do want to get healthy, but have some insecurities around that. We're getting creative just like a lot of small businesses are, so there are many possibilities like spreading out payments, and other ways we can help people.

If you are interested in learning more about Kells Weight Loss Center, you can visit them on Facebook, or go directly to their webpage (HERE) or give them a call in Colorado Springs at 719-259-0773.

Kellls Weight Loss is a proud sponsor of Your Healthy Family

See more here:
Your Healthy Family: Pandemic stress eating and the dangers and science behind it - KOAA.com Colorado Springs and Pueblo News

Whether youre sending a Happy Birthday! or freaking out over the latest episode of your favorite TV show, you can easily send GIFs to your friends in your Instagram messages.

To send GIFS and animated stickers through Instagrams direct message feature, you have to use one of the social platforms built-in keyboards. After starting any new conversation or opening an old private message thread, you can access the GIF and sticker keyboards by tapping the smiley face icon in the message bar.

Once you select and tap the GIF you want, Instagram will automatically send the image to your friend. At present, sending GIFs through direct message is not yet possible while on Instagrams desktop site, and can only be done through the iOS or Android apps.

Heres how to send your friend GIFS in Instagram messages on your mobile device.

1. Open the Instagram app and enter your Message window by tapping the paper airplane icon in the upper right-hand corner of your newsfeed or by swiping left.

The messages icon remains visible regardless of how far down your feed youve scrolled.Abbey White/Business Insider

2. Choose the Instagram friend you want to send a message to either by tapping an existing conversation thread or by selecting the pencil and paper icon in the upper right to pick a friend.

Tapping the New Message icon opens up a list of friends you can message.Abbey White/Business Insider

3. Tap the smiley face icon in your Message bar.

This bar looks similar to Instagrams search bar and is located at the very bottom of the screen.Marissa Perino/Business Insider

4. A new menu will pop-up. Tap the rightmost GIF icon at the bottom of it.

5. You can select a GIF from the popular list or tap the search bar to search GIPHY.

To columns of the most popular gifs will appear beneath the GIPHY search bar.Marissa Perino/Business Insider

6. As you type, GIPHY will automatically populate results. Scroll by swiping up to view all the results.

The results will change as you add more text in the search bar.Marissa Perino/Business Insider

7. Tap a GIF to send it instantly in the message thread.

As soon as you tap, it will automatically send and appear in your message history.Marissa Perino/Business Insider

Read the original here:
Beyond Weight Loss: Healthy New Year Resolutions - News Lagoon

Photo credit: Courtesy Mark Johnson

From Men's Health

Name: Mark JohnsonAge: 48Occupation: Designated Supervisor of Locomotive EngineersHometown: Davenport, Iowa

Start Weight: 286 poundsEnd Weight: 167 poundsTime Running: 10 months

On July 21, 2019, I went to a training coach. At the time, I weighed 286 pounds, and my manager at the Canadian Pacific Railway recommended I go there to learn healthy habits.

I was the walking dead. I struggled to breathe when I walked. I had tried going to the gym, but I wasnt having success. My diet at the time was fast food and heavy meals at restaurants.

As I told the coach this, he and I both knew I had to make immediate changes. I told the coach that I enjoyed runninghe liked that answer, because he said runners are dedicated to their goals. I knew that if he was going to help me, I had to want it. And if I wanted it, I had to follow the plan 100 percent.

Nutrition was easily the biggest part of my weight-loss journey. I learned how to read food labels, and I made sure to keep my fats, sodium, and added sugars down. I switched to eating a serving of lean protein and a complex carbohydrate roughly every four hours. The protein and carb had to have fewer than three grams of fat, no more than 85 mg of sodium per serving, and very little added sugar.

Meal-prepping was also part of my education. Its crucial to keep me from going out to eat or grabbing a comfort food. Once I completed it for the week, the rest of the week was easy, especially when I work long hours and travel. Plus, as I tried new foods, the meals I made tasted better and better.

Seeing the scale go down each Monday at my weekly weigh-ina requirement from my trainer to hold me accountablewas super motivating, and it helped me to keep up with my plan.

While I was eating better, I was also moving my body more. I picked running because of the mental challenge it provided, in addition to the physical. I had run previously between 2014 and 16, so I knew I shouldnt go go out fast. I could barely walk at the time, so I started by walking on the treadmill. I remember celebrating going 3.2 mph.

Story continues

But each week, I upped the speed and went a little further. Id have the TV on while I ran, and during commercial breaks, Id play with the speed and incline before returning to my comfortable setting when the program returned. When I started jogging at 4.5 mph, I knew I would never stop. By Christmas, I had lost 93 pounds.

Now, I go outside early in the mornings for runs. What I love about this sport is it doesnt require others to go for a run. You dont have to be the fastest or go the furthestyou just have to find a pace that youre comfortable with and go.

Running and improved nutrition went hand-in-hand for me. The more I improved my diet, the more weight Id lose and better fueled Id be for my runs. The more I ran, the more I wanted to fuel my runs better and lose weight.

This has all led to me getting down to 167 poundstwo pounds off of my goal weight of 165. Ive gone from barely walking to being able to run 8- to 11-minute miles. Ive gone from a size 48/50 pants to a 32. All of this in less than a year.

If others wanted to go on a similar journey, I have a few pieces of advice. First, find someone to hold you accountable. For me, it was my coach, who checked in with me and made sure I was staying honest.

Also, nutrition and exercise need to be part of your plan. There are many ways to tackle nutrition, so find the plan that works for you. Then add at least 60 minutes of exercise everyday. The key is getting yourself out there.

Finally, make the change for yourself, not because others want you to change. If you want it you will achieve it, and the more you do it, the easier it gets.

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Continue reading here:
Revamping His Nutrition and Running Daily Helped This Man Lose 119 Pounds - Yahoo Lifestyle

Let's look at life-changing habits of some people after one month of lockdown due to the virus pandemic, which yielded either positive or negative results:

Losing weight

Jem Chua

1. How much weight did you lose?

I lost 2.3kg (5 lbs)

2. Why do you think you lost weight?

I workout 4 to 5 times a week in quarantine compared to my normal of 3 to 4 times a week. I was also snacking less since there's no more temptation from officemates who love to snack!

Now, I'm mostly eating home-cooked meals since we only take out 1 or 2 times a week when we're craving for something or when my mom's lazy to cook. I only eat rice when ulam (viand) really calls for it and I've been sleeping for 8 hours compared to my usual 4 to 5 hours.

3. After quarantine, what will you do about it?

I will try to sustain a 4 to 5 times workout schedule after the quarantine. I will make up for my lost sessions with The Movement Studio and Planaforma because I really miss them.

I can limit my rice intake too, since I realized that I don't need to eat a lot of rice to get full. I will also eat out less, but maybe after I satisfy my cravings from this lockdown hehe.

Choi Co

1. How much weight did you lose?

I lost 3.6 kg (8 lbs).

2. Why do you think you lost weight?

It was a combination of exercise and diet (but not intentionally) because of quarantine.

I had less snacks because I used to have merienda (snacks) almost two times a day at work. I also did the Chloe Ting workout programs which were pretty intense, so I workout everyday and strictly eat 3 times a day only.

A solution to my sugar cravings was to switch candy, chocolate or cake with half a glass of Gatorade. It's still sweet, but it has less calories. Through this, I didn't feel so deprived of sweets.

3. After quarantine, what will you do about it?

I wanna continue my weight loss and convert fat to muscle. I also want to try and have less sweets.

I also realized that my snacking is related to stress, so I'm planning to have healthier snacks on my work shelf too.

Marco Javier

1. How much weight did you lose?

I lost a little under 3kg or 6 lbs so far.

2. Why do you think you lost weight?

I lost weight because I haven't been able to eat properly due to my new sleeping cycle. I sleep at 3 am and wake up at 11 am or 12 noon and since I work in the government, I was dealing with very urgent tasks for the past week and there's a lack of time to meal prep.

As a result, I've only been eating once or twice a day for the past week.

I think I'm also losing muscle built up from my consistent cardio routine. I haven't exercised at all since the enhanced community quarantine started.

3. After quarantine, what will you do about it?

I just want to get back to my exercise routine! Not really focused on the number on the scale at this point.

Gaining weight

Kim Uy

1. How much weight did you gain?

I gained almost 2 kg or over 3 lbs.

2. Why do you think you gained weight?

I started working out during the ECQ ,since I wanted to become fit and Ive been wanting to have an active lifestyle ever since I retired from swimming. I was gaining mostly muscle.

3. After quarantine, what will you do about it?

If time permits, I'd still love to continue doing home workouts everyday and Id love to join yoga and pilates classes every weekend next time.

Kevin Hapal

1. How much weight did you gain?

I have already gained almost 2 kg (4.4 lbs) this quarantine

2. Why do you think you gained weight?

Because Im lazy, char! The main reason I think is food Ive been eating a lot more often than Im used to. Part of it is just because Im bored out of my mind (or maybe its the stress), so Im craving for something to chew on most of the time.

Also, before the quarantine, Im outside for most of the day, so I eat out, which somehow limits my eating. But now Im at home with a well-stocked refrigerator because its better to buy groceries in bulk these days and theres almost always something to munch on.

It also doesnt help that the grocery store near my place runs out of fresh produce fast, so its not easy to make more balanced meals even if I try.

Then of course, theres the fact that I dont move around as much as before. I dont consider myself an active or fit person, but I at least get to walk to work or hit the gym before the quarantine.

This time, Im lying on my bed for most of my day, even while working (lets not pretend Im the only person who does this).

I tried to buy some home workout tools, but its really hard to motivate yourself to work out here when youre not used to it. Its like my brain is wired to sleep and be lazy whenever Im at home.

I envy people who can work out anywhere because changing my daily routine proved to be quite hard for me.

3. After quarantine, what will you do about it?

I will probably (try to) go on a diet and eat healthier food again but thats maybe a week or two after the quarantine. I need to get my post-lockdown samgpyeoupsal and ramen first.

Just being realistic. I dont think I can will myself to skip eating my favorite comfort foods after being stuck at home for more than a month. I deserve it, we all do.

But yes, Ill be a slave to the gym when the dust settles. Ive never felt as unhealthy. Im afraid if COVID-19 doesnt kill me, extra servings of rice will. Rappler.com

More here:
After 1 month of lockdown, who lost and gained weight? - Rappler

The study explored when early frailty signs are detectable in people ages 40-75, and found that age is not a key determinant: Adults in their 40s, 50s, and 60s all had high rates of pre-frailty. You dont have to be in your 70s or 80s to be heading down the path to frailty, says coauthor Sue Gordon, chair of restorative care in aging at Australias Flinders University, who suggests that interventions and self-management start at 40. (Pre-frailty can even show up before 40, but lets not think about that.)

Frailty is to be avoided, because it is associated with a variety of disastrous health outcomes. Frail adults are less able to fight off illness, recover from trauma, or adapt to challenging situations.

Signs of pre-frailty commonly include slow walking speed and weak handgrip, as well as low energy/exhaustion, unintentional weight loss, and low exercise (specifically: little walking and minimal moderate or intense physical activity each week).

Pre-frailty can swiftly progress to frailty with a variety of scenarios, including depression, anxiety, low sleep quality, living alone, and low exercisewhich, researchers note, are all prevalent during the pandemic lockdown.

Rather that sitting at home and growing more frail, the researchers suggest using this time to prevent pre-frailty.

People working from home during the self-isolation period can take the opportunity to reassess their health, habits, and routines to seek ways to make their daily routines and homes better places to live, and live longer in the process, says coauthor Anthony Maeder, chair of digital health systems at Flinders University.

Here is the original post:
On lockdown and over 40: Here's how to prevent pre-frailty - Fast Company

Blake Mycoskie, the founder of TOMS Shoes, should have been able to check every box and feel happy. He was a successful entrepreneurwho innovated a give-back program--called One for One-- which was the first"buy one, give one to someone in need" model now used by Bombas and others. Toms (stands for Tomorrow, optimistic that they are improving lives) began when Mycoskie traveled to Argentina and saw many, many kids without shoes. He first went there as a contestant on the Amazing Race andreturned on vacation --which is when he made the decision to launch a shoe company and provide shoes to kids in need.

Fast forward to a day spent surfing not long ago. Everything should have been great: He had sold half of the company, was worth in the hundreds of millions of dollars and yet. . . he was depressed. In his words: not "majorly" depressed but "got to make some changes" depressed. Giving back was one of the missing pieces for Mycoskie, but so was the idea that he wasn't sure what to do with the rest of his life. Checking boxes, other people's boxes, was not enough.

The ideafor a newcompany started to take hold, one that would help people reinvent themselves, change small habits, become better at everything from sleeping to time management, drinking more water and taking care of the things that stand in the way of reaching your fullest potential. It would be called "Madefor" as in helping you answer the question: "What are you made for?" "

Everyone asks what are you made of, Mycoskie says. "But that's not the right question."

He aligned the perfect partners, a dream team of a Stanford neurologist, a former Navy SEAL and himself, both seeker and finder. Theyfound other experts andtogether they created a uniquecurriculum guide that would help people to learn how to use scientifically proven techniques and behavioral changes to break bad habits, one by one--over the course of ten months--and ponder the bigger question: What are You Made For? It may not be what you think.

Made For launched right before this period of a forced time-out from the grind, and Mycoskie sees a strange synergy to the sheltering-at-home timeframe and his guidedprogram for change.The cost is steep: Made For customers pay $75 a month (all at once for $750 or ten payments of $95 one chunk at a time); they receive a kit or box with a self-improvementprops in it (it is proprietary but the websiteoffers a water bottle, a modern version of an hourglass timer,other beautifully curated items. They read a short article and start to learn to modify their behavior from the kit, tackling sleep, hydration, time management, etc. one each month. (MyCoski is quick to add that they do consider "scholarships" for those who need one.)

"You may think you have one of these under control but you learn you could do much better," he says.Here is what Blake has learned (his sleep habits needed a complete makeover) and what he wants you to get from the journey if you sign up to be a participant and use this gift of time to work on your essential self. Surprisingly people keep writing in that they are losing weight, though weight loss is not part of the plan. "It's just that as they get more mindful about what they are drinking, they get more mindful about everything," he explains. Blake's take:

A. The Toms story really leads to this story. It's an evolution of where I'm trying to help people and why. I sold the company four years ago and I felt that in that moment, at that time, I was checking some boxes that would make me feel fulfilled. I couldn't give it all theattention, [as I did when I founded it] because I just got married and had a child and I had worked since I was 18 years old and I was ready to take a break.

I had checked all the boxes that society and my parents told me would lead to a happy and fulfilled life. I got to the point where I had mild depression and contemplated taking anti-depressives, but really I found there were parts of my life that I was neglecting.

And that would create more of a feeling of wellbeing. Being in modern times, we are all constantly thinking 'I should be doing more.' But ultimately what led to going down this path and turning it into a business was meeting my partner, Pat who believed in teaching people practices to improve people's lives. So I started going down my own path.

A. Then we met Andrew Huberman, from Stanford, where they were really great research on some best practices and how to change some habits that would lead to people improving their lives. Pat's background in the military as a Navy Seal really resonated withme as well. But at that point, I had no idea that it would lead to creating a ten-month program that would lead to this kind of work

We launched this justtwo weeks before coronavirus pandemic hit. We had 1,300 people go through the beta last year and got incredible testimonials about how it improved their lives. The program helped them take control over small things that gave them a big impact. People say these gave them self control and self-agency. They feel a lack of control. They don't know whenthis crazy time is going to end, whether the will have a job afterward, or how to pay their rent. There is a total lack of control.

We have people in it who say it's the perfect time to help them have something good to take out of it--to be stronger.

A. Yes. You find the few small things that you can do every day that you can build a routine around, and that will help you get through this.

One example is a simple one. I do it every morning. I try to wake up every morning and not go to my digital devices first thing, and have 20 minutes to drink a cup of coffee or tea. I wake up before my kids, and I do a simple breathing exercise. Not an elaborate meditationbut I connect with myself and the day and that prepares me for everyone and everything I could be hit with. I am actually quarantined with my ex-wife, my current wife, and my kids who are 2 and 5, so I know there are things I can't control.

If you can move your body, but how do you connect with how your body moves, so it can feel good with all your environments. What are the basic movements everyone can do regardless of your fitness level; something that you can do every day, whether you are going for a walk or a vigorous workout. Something you can do every day and give structure to my day as well.

A. People are snacking like crazy. when you have stress. One way people deal with stress is by eating. And there is a whole month in Madefor where we focus on intuitive eating and we document what they are eating and how they feel after. If you bring intention and pay attention to what you're eating and how you're feeling and when you do that you will decide to eat better. Not any single diet works for everyone. But something important is what works for you. The only way to know that is to keep track of what you're eating and how you're feeling after. If eating a bunch of chips and sugary cereal probably not.

Madefor is all remote. We had no idea how it was going to happen ... Two things in the science that aretrue: You can't learn a new habit while you're learning something else. You can't listen to a podcast and change your life; You may be stimulated but you don't start that new habit from it. So we only focus on one thing at a time. You get a box that has all the tools and information to learn this new practice that month. Everything comes in the box. So the more you can focus on Madefor without digital distraction, the more you will do it.

A. The biggest change is Iput more emphasis on how I prepare for going to sleep and how I wake up and that improves the quality of my sleep. Starting two hours before going to bed, I get ready for sleep. So the protocols change and it helps me sleep better.

A. Life will not be normal again.People are learning to ask questions, to rethink theirenvironment, and capitalism, and government. And to engage with those things that we can control. The more you have personal control over your wellness and energy level, the more it will be better for you.

We didn't have a name for this until recently. I kept realizing the "made for" idea came up. The question we are trying to help people answer is what am I made for? We are helping people answer that question. You've got to have the stillness to answer it. That is why we made it analog. It forces people to be still and answer that question.

See the original post:
Toms Founder Wants to Help You Break Bad Habits and Self Reinvent - The Beet

My dad is dying. This simple WhatsApp message from my niece in Mallorca told me what I had known for three days. My brother Gabriele subsequently died of complications arising from a Covid-19 infection, aged 69.

I had been in regular contact with him for the weeks preceding his death. He was a respected English language teacher in Bergamo, Lombardy, epicentre of the Covid-19 epidemic in Italy. Our calls had gone from disbelief at the hysteria surrounding the virus, a disbelief I shared, despite having the medical knowledge as a GP to have known better, to concern, as he developed symptoms suggestive of an infection.

As the illness progressed, so did the frequency of calls. He was not eating or drinking much, losing weight, constantly feverish and sleeping for most of the day. His wife was alone nursing him, as Italy was in lockdown and her two daughters living locally were not allowed to visit.

I would be asked to encourage him to eat, drink, take his medication. He was apathetic and said things like: I feel like an alien has taken over my body. We became alarmed when he developed confusion for a few hours, but relieved when he finally started eating the following day, on day six of a severe illness. We felt he had turned the corner.

That same night he became increasingly breathless. His confusion returned. All the reasons we had given for calling an ambulance manifested rapidly and overwhelmingly. My last conversation with him was to plead with him to get into the ambulance, in order to spare his wife the trauma of nursing him to his death at home.

He was lucky. Despite health services crumbling under the onslaught of the epidemic, the ambulance responded rapidly. There was even more luck when a bed was found in a local hospital. I suppose he could be considered lucky for having been intubated and ventilated despite his age. Because within 24 hours of his hospitalisation, he was in the intensive care unit (ICU) on life support. His chances had gone from 14 per cent while he was at home, to no better than 50 per cent now that he was in ICU.

They deteriorated further when he developed sepsis over the next two days, with multiple blood clots and kidney failure. He was hitting the worst-case scenario milestones with alarming regularity. There could only have been one outcome.

There was no possibility of being with my family in Italy at their time of loss, there were no planes. His wife, in quarantine, had to grieve in solitude. There was no consolation for her or his daughters.

Once more unto the breach this quote kept springing to mind as I confronted the second pandemic of my lifetime. My time as a rural doctor in Kwazulu Natal, epicentre of the global HIV pandemic, had exposed me to the destructive force of a global viral pandemic, but this was a different beast.

I doubt that Covid-19 will claim the 32 million lives that HIV has, but the rapidity and ferocity of the epidemic has startled with its aggression. With HIV, the slow progression of the disease always made you feel as if you could offer some form of care or kindness, some modicum of control, but this virus is merciless, random and medically disempowering.

The 105 Italian doctors dead due to the virus attest to the exposed position we occupy as healthcare providers. But this is not the time for hesitation, it is time to Hold hard the breath and bend up every spirit to his full height. This is the time to unite as we have, hold fast as we have and set the teeth, because it will require sacrifices of us all to contain this global threat.

Dr Giovanni Baldassini is a GP at the Cork Road Clinic in Mallow, Co Cork

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An Italian doctor in Ireland: My brother died in Bergamo from Covid-19 - The Irish Times