Delaware Public Health Officials Confirm First Flu Case of the 2020-2021 Season

DOVER (Nov. 12, 2020) – The Delaware Division of Public Health (DPH) is announcing the state’s first laboratory-confirmed case of influenza for the 2020-2021 flu season. The case, which also marks Delaware’s first pediatric case of the season, involves a child under the age of 5 from Kent County.

“With the increase in COVID-19 cases we’ve seen over the past few weeks, it is more important than ever to get the flu vaccine if you haven’t already,” said Dr. DPH Director Karyl Rattay. “The flu vaccine won’t prevent COVID-19, but it is effective at preventing the flu. The flu vaccine decreases the number of people who need to be treated for the flu. This means more health care supplies, resources, and professionals will be available on the front lines to fight the pandemic. By eliminating the need to visit your provider’s office or be hospitalized for the flu, you help lower the risk of workers on the front lines getting sick.”

The flu vaccine is recommended for Delawareans 6 months of age and older. Since it takes about two weeks after vaccination for antibodies that protect against influenza virus infection to develop in the body, it is important to get vaccinated as early as possible to give your body time to build immunity. Getting the flu vaccine now will also provide protection during the entire flu season. During the 2019-2020 flu season, Delaware recorded more than 7,000 laboratory-confirmed flu cases. Nearly 400 Delawareans were hospitalized due to the flu and 11 people died from flu complications.

A flu clinic schedule can be found at: https://dhss.delaware.gov/dhss/dph/fluclinics.html. Flu vaccines also are offered through physician offices, many pharmacies and some grocery stores. To locate where flu vaccines near you are being offered, Google “CDC flu finder” and enter a ZIP code.

The flu is easy to transmit and you can get it even from seemingly healthy, but unvaccinated, children and adults. Children, older adults, and those who have chronic underlying medical conditions are most at risk for complications from the flu and are strongly encouraged to get vaccinated now.

In addition to getting an annual flu shot, Delawareans can prevent the spread of the flu the same way they can prevent COVID-19 and other respiratory illnesses: Wash hands frequently with soap and water or use alcohol-based hand sanitizers, cover coughs and sneezes with a tissue, wear a face covering when in public when in public, maintain 6 feet of space between others, especially those who reside outside of your own home, and avoid touching your eyes, nose or mouth.

The flu and COVID-19 have many similar symptoms. They include fever or feeling feverish/chills, cough, shortness of breath or difficulty breathing, fatigue (tiredness), sore throat, runny or stuffy nose, muscle pain or body aches, and headaches. Other signs and symptoms of COVID-19 that are different from flu

include a change in or loss of taste or smell. If you are sick, the best thing to do is call your health care provider to see if you should get tested for COVID-19 or come in for a visit.

Those sick with the flu should stay home from work, school and other gatherings and not return until they have been free of fever – with a temperature of less than 100 degrees F (37.8 degrees C), without the use of fever-reducing medications – for at least 24 hours. People with flu symptoms should avoid close contact with well people in the household – you can give someone the flu 24 hours before you show symptoms and five to seven days after you get sick. Stay well-hydrated by drinking plenty of water and other clear liquids. Over-the-counter medicines can provide symptom relief, but if you suspect you have influenza, call your doctor as they may decide to provide antiviral medications to help hasten recovery and prevent serious complications. This is particularly important for those who feel very sick, are pregnant or have chronic medical conditions.

For more information about the flu and where to get vaccinated, visit flu.delaware.gov or call 1-800-282-8672.


DPH Partners With Health Care and Community Partners to Launch Fight Flu DE — Enhanced Flu Vaccination Campaign

DOVER (Sept. 29, 2020) – The Delaware Division of Public Health (DPH) is partnering with health care, faith-based and community partners to launch an aggressive communications campaign to mobilize all Delawareans to get their flu vaccinations called ‘Fight Flu DE.’ Working to reach diverse audiences through influencers and with messaging that will motivate them to get the flu vaccine, the campaign integrates grassroots outreach with mass-media marketing strategies to make sure people know where they can get a flu vaccine regardless of insurance coverage.

While DPH has always been proactive in encouraging flu vaccinations, the COVID-19 pandemic has created a greater urgency for Delawareans to get vaccinated against influenza.

“This year it is more important than ever to get your flu vaccine, as we are dealing with uncertainties around how flu season will look this year with COVID-19 circulating at the same time,” said Governor John Carney. “While the flu vaccine will not prevent you from getting COVID, it has many important benefits. It will reduce your chance of getting the flu and flu-related complications, while saving critical health care resources to treat COVID patients.”

Delawareans are urged to think about the Big 4 locations where they can get their flu vaccines this year:
• Medical provider offices or community health clinics
• Pharmacies
• Community Flu Clinics
• DPH Clinics for uninsured and underinsured individuals

This week, DPH will hold three community flu clinics, two on Friday, Oct. 2 – one at the Gigante grocery store on Front Street (Route 14) in Milford from 3:00 p.m. to 6:00 p.m. and one at the New Castle Farmer’s Market on Route 13 in New Castle from 3:00 p.m. to 6:00 p.m. DPH will hold a second clinic at the New Castle Farmer’s Market location on Saturday, Oct. 3 from 10:00 a.m. to 1:00 p.m., while Westside Family Healthcare will hold a free community flu clinic at its Bear facility in the Fox Run Shopping Center from 10:00 a.m. to 1:00 p.m. on Saturday, Oct. 3. Beebe Healthcare is holding the following community flu clinics:

• September 29, 1:00 p.m. – 5:00 p.m., Milton CHEER Center, 24855 Broadkill Road, Milton
• October 1, 1:00 p.m. – 5:00 p.m., Rehoboth Convention Center, 229 Rehoboth Ave., Rehoboth (walk-up and bike only)
• October 2, 12:00 p.m. – 5:00 p.m., Crossroads Church, 20684 State Forest Road, Georgetown (drive-through only)
• October 3, 9:00 a.m. – 1:00 p.m., Beebe South Coastal, 32750 Roxana Road, Frankford (drive-through only)

A list of community and DPH flu clinic sites can be found on flu.delaware.gov. In addition, the locations for flu vaccines can be found if you Google “CDC flu finder” and enter a ZIP code.

The flu vaccine has been shown to reduce the risk of flu illness, hospitalization, and death by about half.

“Getting a flu vaccine is one of the most important things that every Delawarean, 6 months and older, can do to protect themselves from flu illness,” said Molly Magarik, Secretary for the Department of Health and Social Services. “It is critically important that persons over age 65 and those with underlying medical conditions of any kind get the vaccine as soon as possible.” Pregnant women, children under age 2 and African Americans and Hispanics who are more often impacted by chronic diseases such as lung and heart disease, obesity, and asthma are also at greater risk of flu illness.

“It’s important to get a flu vaccine especially in the African American and other minority communities because of our higher risk of illness,” said Henrietta Johnson Medical Center CMO, Dr. Yvette Gbemudu. “The flu virus and other viruses can affect us more strongly without proper protection. Even if you are infected with the flu after getting a flu vaccine, studies show that your response to it will be lessened because you got the flu shot. It reduces your risk of dying from the flu, which is possible because the virus is deadly.”

It takes about two weeks after receiving the flu vaccine for antibodies that protect against influenza virus infection to develop in the body, so it is important to get vaccinated as early as possible to give your body time to build immunity. Getting the flu vaccine now will also provide protection during the entire flu season.

“It will also be vitally important that Delawareans step up their efforts around wearing face coverings, social distancing, and washing or sanitizing their hands frequently, not only to protect against COVID-19, but also against flu in the coming months,” said DPH Director Dr. Karyl Rattay. “It’s too early to know what impact these preventive measures may already be having in reducing the early spread of flu in our state, but it’s possible they may be the key to a milder flu season this year – but only if we stay vigilant in our efforts.”

In addition to these basic prevention measures, cover coughs and sneezes with a tissue, and dispose of tissues immediately. If a tissue is not available, cough or sneeze into your inner elbow. Droplets from a sneeze can travel up to six feet. Also avoid touching your eyes, nose or mouth. Keep your distance from people who are coughing or sneezing.

Some signs and symptoms of flu and COVID-19 are similar including fever, cough, sore throat, shortness of breath, runny or stuffy nose, headaches and body aches, chills and fatigue. Both COVID-19 and flu can have varying degrees of signs and symptoms, ranging from no symptoms to severe symptoms. Testing can help you determine which you have.

COVID-19 symptoms that are different from flu may include change in or loss of taste or smell. Also, flu symptoms generally come on more suddenly than COVID symptoms.

The following organizations have proudly partnered with DPH in the effort to significantly increase flu vaccinations this fall and into the winter: The Delaware Healthcare Association and its member hospital systems: Bayhealth, Beebe Healthcare, ChristianaCare, TidalHealth Nanticoke, Nemours/Alfred I. duPont Hospital for Children, St. Francis Healthcare and the Veterans Administration Medical Center; the Medical Society of Delaware; and the Federally Qualified Health Centers: Westside Family Healthcare, Henrietta Johnson Medical Center, and La Red Health Center.

“The annual influx of flu patients taxes hospital capacity. That’s a big problem during the pandemic,” said Wayne A. Smith, President & CEO of the Delaware Healthcare Association. “The best way to preserve hospital space is for everyone to get a flu shot.”

“While scientists are racing to develop a vaccine for COVID-19, the flu vaccine is readily available and can make all the difference in the fight against the flu, which kills tens of thousands of people each year. Now is the time to connect with your physician and get vaccinated,” said Joseph J. Straight, MD, President, Medical Society of Delaware.

“La Red Health Center (LRHC) is pleased to partner with the Delaware Division of Public Health in providing the flu vaccine at each of its Family Practice Sites located in Georgetown, Milford and Seaford,” said Marketing and Communications Director Kevin Loftus. “This flu season it is especially important to get the flu shot as soon as possible and LRHC encourages its patients and all residents of Sussex County to take advantage of this tremendous opportunity.”

During the 2019-2020 flu season, Delaware recorded 7,075 laboratory-confirmed flu cases. More than 362 Delawareans were hospitalized due to the flu and 11 people died from flu complications.

“Easy access to free or low-cost flu vaccines is critical to keeping our communities healthy, and ultimately, reducing the risk of severe flu symptoms that cause hospitalization,” said Tom Stephens, MD, Chief Medical Officer at Westside Family Healthcare. “During the COVID-19 pandemic, it is more important than ever to get a flu vaccine as severe complications from both illnesses can be life-threatening.”

Those sick with the flu should stay home from work, school and other gatherings and not return until they have been free of fever – with temperature less than 100 degrees F (37.8 degrees C), without the use of fever-reducing medications – for at least 24 hours. People with flu symptoms should avoid close contact with well people in the household and stay well-hydrated by drinking plenty of water and other clear liquids. Over-the-counter medicines can provide symptom relief, but if you suspect you have influenza, call your doctor as they may decide to provide antiviral medications to help hasten recovery and prevent serious complications.
For more information about the flu and where to get vaccinated, visit flu.delaware.gov or call 1-800-282-8672.

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A person who is deaf, hard-of-hearing, deaf-blind or speech-disabled can call the DPH phone number above by using TTY services. Dial 7-1-1 or 800-232-5460 to type your conversation to a relay operator, who reads your conversation to a hearing person at DPH. The relay operator types the hearing person’s spoken words back to the TTY user. To learn more about TTY availability in Delaware, visit http://delawarerelay.com.

The Delaware Department of Health and Social Services is committed to improving the quality of the lives of Delaware’s citizens by promoting health and well-being, fostering self-sufficiency, and protecting vulnerable populations. DPH, a division of DHSS, urges Delawareans to make healthier choices with the 5-2-1 Almost None campaign: eat 5 or more fruits and vegetables each day, have no more than 2 hours of recreational screen time each day (includes TV, computer, gaming), get 1 or more hours of physical activity each day, and drink almost no sugary beverages.


DPH Kicks Off 2019-2020 Flu Season with Free Vaccination Clinics

DOVER – The 2019-2020 flu season has officially arrived, and to kick off the state’s influenza prevention efforts, the Division of Public Health (DPH) will hold two free flu vaccination clinics for the public.

On Friday, Oct. 4. 2019, DPH will hold a free flu clinic at the Porter State Service Center, 511 W. 8th St., Wilmington, from 10:00 a.m. to 2:30 p.m. The first 200 people to get their flu vaccines will receive a free gift card.

On Tuesday, Oct. 8, 2019, DPH will hold a free drive-thru flu clinic at the DelDOT Administration Building, 800 S. Bay Road, Dover, from 7:00 a.m. to 6:00 p.m. or until vaccines run out. Eagle 97.7 and Cool 101.3 will hold live broadcasts. Both clinics will be held rain or shine. The flu clinics are open to individuals nine years of age and older.

“Now is the time to get your annual flu shot,” said Department of Health and Social Services Secretary Dr. Kara Odom Walker, a practicing family physician. “Vaccinations not only prevent people from getting the flu, but they also can reduce the severity of flu illness and prevent visits to the doctor, clinic, emergency room and hospitalizations. Vaccinated people have less chance of missing family, school and work events due to influenza illness.”

The flu vaccine is recommended for Delawareans 6 months of age and older. Since it takes about two weeks after vaccination for antibodies that protect against influenza virus infection to develop in the body, it is important to get vaccinated as early as possible to give your body time to build immunity. Getting the flu vaccine now will also provide protection during the entire flu season. During the 2018-2019 flu season, Delaware recorded 6,387 laboratory-confirmed flu cases. More than 1,000 Delawareans were hospitalized due to the flu and 24 people died from flu complications.

“The flu is unpredictable,” said DPH Director Dr. Karyl Rattay. “Getting your annual flu vaccine is the best, most effective thing you can do to keep from getting the flu, and from spreading it to family, friends, neighbors and co-workers. The flu is highly contagious and can even be deadly so we urge you to get your flu shot early in the flu season.”

The flu is easy to transmit and you can get it even from seemingly healthy, but unvaccinated, children and adults. Children, older adults, and those who have chronic underlying medical conditions are most at-risk for complications from the flu and are strongly encouraged to get vaccinated now.

DPH also will offer other flu clinics throughout the season. A schedule can be found at https://dhss.delaware.gov/dhss/dph/fluclinics.html. In addition, flu vaccines are offered through physician offices, many pharmacies and some grocery stores. To locate where flu vaccines near you are being offered, Google “CDC flu finder” and enter a ZIP code.

In addition to getting an annual flu shot, Delawareans can prevent the spread of the flu and other respiratory illness with good hygiene: Wash hands frequently with soap and water or use alcohol-based hand sanitizers, cover coughs and sneezes with a tissue, and dispose of tissues immediately. If a tissue is not available, cough or sneeze into your inner elbow. Droplets from a sneeze can travel up to six feet. Also avoid touching your eyes, nose or mouth. Keep your distance from people who are coughing or sneezing.

Flu symptoms come on suddenly, and include fever, cough, sore throat, runny or stuffy nose, headaches and body aches, chills and fatigue. Some people get complications including pneumonia, bronchitis, and sinus and ear infections. Those sick with the flu should stay home from work, school and other gatherings and not return until they have been free of fever – with temperature less than 100 degrees F (37.8 degrees C), without the use of fever-reducing medications – for at least 24 hours.

People with flu symptoms should avoid close contact with well people in the household and stay well-hydrated by drinking plenty of water and other clear liquids. Over-the-counter medicines can provide symptom relief, but if you suspect you have influenza, call your doctor as they may decide to provide antiviral medications to help hasten recovery and prevent serious complications. This is particularly important for those who feel very sick, are pregnant or have chronic medical conditions.

For more information about the flu and where to get vaccinated, visit flu.delaware.gov or call 1-800-282-8672.

A person who is deaf, hard-of-hearing, deaf-blind or speech-disabled can call the DPH phone number above by using TTY services. Dial 7-1-1 or 800-232-5460 to type your conversation to a relay operator, who reads your conversation to a hearing person at DPH. The relay operator types the hearing person’s spoken words back to the TTY user. To learn more about TTY availability in Delaware, visit http://delawarerelay.com.

The Delaware Department of Health and Social Services is committed to improving the quality of the lives of Delaware’s citizens by promoting health and well-being, fostering self-sufficiency, and protecting vulnerable populations. DPH, a division of DHSS, urges Delawareans to make healthier choices with the 5-2-1 Almost None campaign: eat 5 or more fruits and vegetables each day, have no more than 2 hours of recreational screen time each day (includes TV, computer, gaming), get 1 or more hours of physical activity each day, and drink almost no sugary beverages.


Delaware Public Health: Flu Now Statewide

DOVER – Today, Delaware’s Division of Public Health (DPH) announced flu is officially confirmed in all three counties with new lab-confirmed cases in New Castle and Sussex counties. The first New Castle County cases include a 77-year-old woman who was discharged following a hospital stay, and a 64-year-old male. No deaths have been reported.

The first Sussex case was an infant who is recovering at home. None of the new cases had records that they have received their flu vaccine this season.

These cases join two other lab-confirmed cases in Kent County, 27-year-old and 39-year-old men. Neither were hospitalized. There are two main types of influenza (flu) virus – types A and B – that routinely spread in people and are responsible for seasonal flu outbreaks each year.

“Now is the time to get vaccinated. We understand none of the Delaware cases were immunized, which is not uncommon this early in the season,” said DPH Director Dr. Karyl Rattay. “But vaccination is our most effective weapon against preventing the flu and its severity. Public Health recommends getting a flu vaccine every year.”

Finding a nearby flu clinic or vaccination site is easier than ever before. Google “CDC flu finder,” enter your ZIP code, and find nearby sites offering vaccinations.

Added DPH Medical Director Dr. Awe Maduka-Ezeh, an infectious disease specialist, “It takes about two weeks after vaccination for your body to develop antibodies protect you from the flu so now is the time to get vaccinated before the busy holiday season begins. The flu vaccine is readily available through medical providers, pharmacies, and some grocery stores.”

Flu symptoms come on suddenly, and include fever, cough, sore throat, runny or stuffy nose, headaches and body aches, and fatigue. Some people get complications including pneumonia, bronchitis, and sinus and ear infections. Providers can prescribe antiviral medicines to make the illness milder, hasten recovery, and prevent serious complications, hospitalizations, and even death. DPH monitors the occurrence of influenza-like illnesses in hospitals, selected long-term care facilities, and medical clinics to track flu trends in the state.

In addition to vaccination, Delawareans can prevent the spread of the flu and other respiratory illness with good hygiene:
· Wash hands often with soap and water.
· Use hand sanitizer with 60 percent alcohol.
· Cover coughs and sneezes with a tissue or aiming for your inside elbow.
· Stay six feet away from others who are coughing or sneezing, and avoid touching your eyes, nose, or mouth.

Persons with flu-like illness should stay home from work, school, and other gatherings and not return until free of fever – 100 F (37.8 C), without the use of fever-reducing medications for at least 24 hours.

DPH is hosting public flu clinics, including some with evening hours, at various locations. For more information on flu clinics, influenza prevention, diagnosis, and treatment, call DPH at 800-282-8672 or visit flu.delaware.gov.

A person who is deaf, hard-of-hearing, deaf-blind or speech-disabled can call the DPH phone number above by using TTY services. Dial 7-1-1 or 800-232-5460 to type your conversation to a relay operator, who reads your conversation to a hearing person at DPH. The relay operator types the hearing person’s spoken words back to the TTY user. To learn more about TTY availability in Delaware, visit http://delawarerelay.com.

Delaware Health and Social Services is committed to improving the quality of the lives of Delaware’s citizens by promoting health and well-being, fostering self-sufficiency, and protecting vulnerable populations. DPH, a division of DHSS, urges Delawareans to make healthier choices with the 5-2-1 Almost None campaign: eat 5 or more fruits and vegetables each day, have no more than 2 hours of recreational screen time each day (includes TV, computer, gaming), get 1 or more hours of physical activity each day, and drink almost no sugary beverages.


Getting Your Flu Shot is Easier Than Ever Before: Attorney General Matt Denn Joins DPH at NcCo Flu Clinic to Encourage Vaccinations

DOVER – Delaware Attorney General Matt Denn joined Division of Public Health (DPH) officials to encourage all residents to get their flu shot at a free flu clinic held today in Wilmington. The clinic, held at the Porter State Service Center, was the first one in New Castle County for the 2016-2017 flu season.

A full listing of upcoming DPH flu clinics in each county can be found at flu.delaware.gov. This includes DPH’s first drive-thru flu clinic in several years, scheduled for October 27, 2016, from 10:00 a.m. to 4:00 p.m. in the parking lot of the Blue Hen Corporate Center. DPH will also provide flu shots to children ages 6 months to 18 years at the following State Service Centers by appointment: Hudson (Newark), Williams (Dover), Adams (Georgetown) and Shipley (Seaford). For a list of pharmacies and other locations where flu shots are offered near you, use the Flu Vaccine Finder on Flu.gov and enter your zip code.

The Porter Service Center flu clinic provided a festive atmosphere with a live DJ spinning music and staff handing out free gift cards to the first 150 people to receive their flu shots. Attorney General Denn was one of 218 individuals to receive a flu shot at the event. The Delaware Division of Public Health is promoting the importance of annual flu vaccination this year through its statewide “Vaccination: protecting each other” outreach campaign. The campaign is aimed at urging people who are not considered at high risk for getting the flu to get vaccinated. Even those not in a high-risk group, likely live or interact with those who are such as young children, older adults or those with underlying health conditions or weakened immune systems.

“As the father of two young boys, I want to make sure I protect myself from getting the flu, and prevent them from catching it from me,” said Attorney General Denn. “The protection offered by vaccinations is important for everyone, not just those at high risk.”

“Getting your flu vaccination is easier than ever before with all of the locations available to Delawareans,” said DPH Director Dr. Karyl Rattay. “We are hoping to again reduce the number of influenza cases in Delaware this flu season. The best protection against getting the flu is to take a few minutes of your time to receive a vaccination. We hope the majority of Delawareans follow Attorney General Denn’s lead and get vaccinated for the upcoming season.”

Last flu season, there were 2,064 flu cases reported in Delaware including six flu-related deaths. This year’s vaccine helps to protect against up to four strains of influenza. The flu clinic also served as a preparedness exercise, so DPH staff could practice their readiness in the event of a large-scale health emergency and test the ability to accommodate people with disabilities. American Sign Language interpreters were on hand to assist the deaf and hard of hearing , and bilingual staff were available to assist with translations.

DPH urges all Delawareans 6 months of age and older who have not yet been vaccinated against the flu to get a vaccination as soon as possible. The flu is easy to transmit and the vaccine is the best protection. The vaccine is readily available through medical providers, pharmacies, and some grocery stores. DPH is conducting public flu clinics including some with evening hours at various locations in the state. For DPH flu clinic schedules this season, visit http://dhss.delaware.gov/dhss/dph/fluclinics.html.

Flu vaccination reduces the risk of getting sick from the flu or spreading the disease to others. It is especially important that the following groups get flu shots:

• Seniors;
• Pregnant women and their household contacts;
• Caregivers and household contacts of children younger than 6 months, since those children are too young to receive the vaccine;
• Those with chronic conditions or compromised immune systems;
• Food service providers;
• Health care providers.

Delawareans are also encouraged to prevent infection by taking simple everyday measures such as washing hands, using hand sanitizer, covering coughs and sneezes and staying at home when sick. These efforts help stop the spread of respiratory illnesses including flu.

Flu symptoms come on suddenly, and include fever, cough, sore throat, runny or stuffy nose, headaches and body aches, and fatigue. Some people get complications including pneumonia, bronchitis, and sinus and ear infections. Providers can prescribe antiviral medicines to make illness milder, hasten recovery, and prevent serious complications, hospitalizations, and even death.

Beginning in October each year, DPH monitors the occurrence of influenza-like illnesses in hospitals, selected long-term care facilities, and medical clinics to track flu trends in the state.

For more information on influenza prevention, diagnosis and treatment, as well as for a listing of DPH flu clinics visit flu.delaware.gov or call DPH at 888-282-8672. DPH’s seasonal flu shot clinics are intended for Delawareans age nine and older who have no healthcare provider or whose insurance does not cover flu vaccinations. Those with Medicaid or Medicare are welcome to attend but should bring their insurance card since their insurance will be billed accordingly.

A person who is deaf, hard-of-hearing, deaf-blind or speech-disabled can call the DPH phone number above by using TTY services. Dial 7-1-1 or 800-232-5460 to type your conversation to a relay operator, who reads your conversation to a hearing person at DPH. The relay operator types the hearing person’s spoken words back to the TTY user. To learn more about TTY availability in Delaware, visit http://delawarerelay.com.

Delaware Health and Social Services is committed to improving the quality of the lives of Delaware’s citizens by promoting health and well-being, fostering self-sufficiency, and protecting vulnerable populations. DPH, a division of DHSS, urges Delawareans to make healthier choices with the 5-2-1 Almost None campaign: eat 5 or more fruits and vegetables each day, have no more than 2 hours of recreational screen time each day (includes TV, computer, gaming), get 1 or more hours of physical activity each day, and drink almost no sugary beverages.