I DON’T HAVE COVID AND I DON’T WANT TO GET COVID. WHAT SHOULD I DO?
THIS IS CHECKLIST FOR THOSE OVER 50 (THIS LIST APPLIES TO THE YOUNGER SET BUT THE LEVEL OF CONCERN IS MUCH LESS):
- DISTANCING IS THE MOST IMPORTANT THING YOU DO TO AVOID COVID
- WEAR A MASK
- WASH HANDS FREQUENTLY, USE HAND SANITIZER FREQUENTLY
- WHENEVER AN INTERACTION CAN BE OUTSIDE IT IS FAR SUPERIOR TO INSIDE. TRY TO DO MORE OUTSIDE INTERACTIONS AND LESS INSIDE INTERACTIONS
- REDUCE EXPOSURES
- UNDERSTAND RISK BEHAVIORS AND REDUCE THEM
- KNOW YOUR RISK LEVEL
- GET TESTED IF YOU THINK YOU MAY HAVE COVID OR IF YOU HAVE BEEN EXPOSED
- BE PREPARED IF YOU WERE TO GET COVID.
- HAVE A COVID KIT AND UNDERSTANDING OF TREATMENT APPROACHES FOR HOME CARE DURING COVID
DISTANCING:
- 6+ FEET IS DESIRABLE.
- OUTDOORS IS DESIRABLE
- HUGGING GRANDCHILDREN BRIEFLY IS ACCEPTABLE. OTHERWISE, MAINTAIN DISTANCING
- HUGGING CHILDREN BRIEFLY IS ACCEPTABLE. OTHERWISE, MAINTAIN DISTANCING
MASKS:
IN ORDER OF RELIABILITY AND HELPFULNESS
- THICK CLOTH MASK
- SURGICAL MASK
- N-95 VERTICAL DUCKBILL MASK
- N-95 ROUND MASK
NOT ACCEPTABLE (THESE ARE NOT PROTECTIVE):
- THIN CLOTH MASKS OR GATERS
- MASKS WITH VALVES
EXPOSURE RISKS:
COVID RISK GRAPHIC FROM THE STATE OF ARIZONA
The website below provides information and understanding of behaviors and risks:
https://www.erinbromage.com/post/the-risks-know-them-avoid-them
KNOW YOUR RISK LEVEL:
High risk groups include:
· Age 75 or over
· Obesity (BMI 40 or above)
· Lung disease (emphysema/COPD) or current significant smokers
· Chronic kidney disease (Stage 4 disease or greater)
· Diabetes…. not well controlled (glycohemoglobin 8.0 or above)
· Congestive Heart Failure (for which you take medication)
· On immune suppressing medications for cancer or rheumatological/inflammatory conditions
Medium Risk groups may want to be more cautious but can increase activities. These include:
· Men Age 65 to 75
· Hypertension
· Diabetes…well controlled
· Asthma
· Obesity (BMI 35 or above)
COVID-19 Testing Sites
COVID-19 Testing Information
ALTERNATIVE LOCATIONS FOR COVID TESTING OTHER THAN OUR OFFICE:
Arcpoint Labs
https://www.arcpointlabs.com/scottsdale-north
CVS Health
https://cvshealth.com/covid-19/testing-locations
Walgreens
https://www.walgreens.com/findcare/covid19/testing
Aveon Health
http://aveonhealth.com/sick-visit/
Honor Healthcare
https://www.honorhealth.com/coronavirus-covid-19/testing
Mesa Community College System:
https://embrywomenshealth.com/testing-blitz/
Arizona COVID-19 hotline at 844-542-8201 for more information about testing options and availability in your area.
At Home test kits:
$109 kit: https://www.everlywell.com/products/covid-19-test
$119 kit: https://www.letsgetchecked.com/us/en/home-coronavirus-test
Zero Dollars…may be covered by insurance or by US Govt.:
https://www.pixel.labcorp.com/at-home-test-kits/covid-19-test
COVID HOME KIT:
- DIGITAL ORAL THERMOMETER: TO MONITOR FEVER.
MANY BRANDS ARE FINE…HERE IS ONE EXAMPLE:
2. PULSE OXIMETER: TO CHECK OXYGEN LEVELS.
MANY BRANDS ARE FINE…HERE IS ONE EXAMPLE:
OTHER ITEMS FROM THE HOME MEDICAL KIT (SEE BELOW FOR USE OF PRODUCTS):
- TYLENOL/ADVIL/ OR ALEVE (ADVIL AND ALEVE ARE SAFE IN COVID)
- Sudafed 30mg tablets
- Chlorpheniramine 4mg tablets
- Robitussin DM syrup
- Imodium AD
CARING FOR YOURSELF IF YOU THINK YOU MAY HAVE COVID OR IF YOU HAVE BEEN DIAGNOSED WITH COVID:
- Check your temperature twice daily and keep a log. No temperature is dangerous…adults do not have to worry about this. This is just about monitoring your condition. If you have concerns, be in touch.
- Check oxygen level twice daily and keep a log. A declining oxygen level can indicate early de-compensation from COVID. Normal oxygen saturation is 97-100%. If lower than that it may be normal for you, but the trend is what matters. If you are declining into the low 90’s, if you are feeling particularly short of breath…then it is time to check checked at the Emergency Room (which is safe to do!) If you have concerns…be in touch.
- Manage symptoms just like any other viral infection (see below)
Most Common Symptoms
They consist of the same set of symptoms as the common cold/rival respiratory syndrome, but they are worse.
Common/Hallmark symptoms:
· High fever (over 100.4, but can range from 99’s to 104+)
· Fatigue
· Cough
Other symptoms can include milder issues:
· Loss of Smell and/or Taste
· Nausea without Vomiting
· Sore Throat
· Aching muscles throughout the body
· Headache
· Occasional diarrhea …
· Nasal congestion (occasional)
TREATMENT:
Symptomatic treatment for the most bothersome symptoms
- Plan to:
Monitor temperature twice daily and record. - Monitor oxygen levels twice daily and record. If dropping significantly you should be in touch.
Aches and Pains and Fever:
· Tylenol 650 – 1000mg four times per day is preferred for treating these symptoms, but if not working well, you may use:
· Advil (Ibuprofen 200mg), 2 – 3 tablets….2 – 3 x per day or Aleve (naproxen 220mg), 1 – 2 tablets…1 – 2 x per day,
· Drink good amounts of clear liquids (anything you can see through)
Sore Throat:
· Saltwater gargling
1. Dissolve 1 teaspoon of salt in a glass of warm water.
2. Gargle for 15 seconds and spit.
3. Repeat during the day every 2 – 4 hours to relieve pain.
· Pain relief medications: Advil (Ibuprofen 200mg), 2 – 3 tablets….2 – 3 x per day or Aleve (naproxen 220mg), 1 – 2 tablets…1 – 2 x per day, or Tylenol 650 – 1000mg four times per day.
Cough:
· Steam: Either in the form of a hot, steamy shower or using a hot pot of water and covering with a towel and put your head under the towel. Both methods will provide humid air to the irritated air passages and soothe the cough.
· Cough Syrup: Robitussin DM or Delsym cough syrup can be used to suppress cough.
· You may require a prescription cough syrup with Codeine. Contact me if that is the case.
Sinus Congestion and Drainage (RARE SYMPTOM):
· Use a decongestant such as Sudafed 30mg, 1 – 2 pills up to four times per day, or use a drying antihistamine such as Chlortrimeton 4mg, up to four times per day. Other cold medications (over the counter) can be used.
· Claritin, Zyrtec, Allegra will not work for congestion symptoms from an infection. Do Not Use.
Nausea Treatment:
This is the most difficult issue to treat at home as there is very little one can do to settle the stomach. Coca-Cola with the carbonation eliminated (Flat Coke), Ginger Ale, or Ginger Root…. can be tried, but these are often inadequate, and the key to getting the stomach to settle is getting a good nausea medication.
If nausea is persistent, then calling for a prescription medication is often a good idea. Phenergan (Promethazine), Compazine (prochlorperazine), Zofran (Ondansetron) are very effective in treatment. Sometimes we use them in combination either as a pill or a suppository.
The KEYS are:
1. Settling the Stomach…so that liquids can be taken
2. Focusing on Liquids…so that dehydration does not set in
3. Eating light foods… if possible (to provide energy for healing). This is not a requirement for healing from an acute GI illness; so, do not feel that the sick person needs to eat food. The only requirement is liquid intake!
When to Seek Medical Assistance
• There is no medication to treat this virus, so the resolution takes time.
Worsening symptoms/Signs of Complications:
• If you are getting significantly short of breath please be in touch. If progressive and worsening, you need to be seen and possibly hospitalized. Best to go the ER if shortness of breath is a significant symptom
How Long to Recover
• The COVID is a viral infection that will generally take from 3–7 days to develop, 3-7 days to improve and then from 3-7 days to completely resolve.
I HAVE BEEN DIAGNOSED WITH COVID…… NOW WHAT DO I DO?????
THIS IS CHECKLIST FOR THOSE OVER 50 (THIS LIST APPLIES TO THE YOUNGER SET BUT THE LEVEL OF CONCERN IS MUCH LESS):
- UNDERSTAND THE TIME COURSE OF COVID
- QUARANTINE FOR 14 DAYS FROM FIRST SYMPTOMS (IF THIS IS CLEAR) OR FROM THE DATE OF YOUR POSITIVE TEST
- MONITOR YOURSELF TWICE DAILY…TEMPERATURE AND OXYGEN LEVELS
- HYDRATE WELL, EAT IF YOU CAN
- TREAT SYMPTOMS AS REQUIRED
- KNOW THAT THE MOST IMPORTANT SYMPTOM IS TO WATCH FOR TRUE SHORTNESS OF BREATH. IF THAT DEVELOPS, GO TO THE EMERGENCY ROOM
- CONCERNS….BE IN TOUCH DURING YOUR ILLNESS AND PROVIDE US UPDATES ON FEVER AND OXYGEN LEVELS
- NO TESTING IS REQUIRED AFTER YOUR ILLNESS, ALTHOUGH YOU CAN HAVE A BLOOD TEST FOR ANTIBODIES AFTER 21 DAYS WHEN YOU ARE FREE
TIME COURSE/EXPECTATIONS:
COVID COURSE:
THREE PHASES OF COVID:
- JAILBIRD 1-10 DAYS
- PAROLE BIRD 11-17 DAYS
- FREE BIRD 17+DAYS
JAILBIRD: STRICT QUARANTINE…… 10 DAYS FROM DATE OF FIRST SIGNIFICANT SYMPTOMS IF OBVIOUS OR FROM DATE OF TESTING IF UNCERTAIN BASED ON SYMPTOMS (MUST ALSO BE FEVER FREE FOR 3 DAYS AS WELL)
PAROLE BIRD: DAY 11-17…. VERY CAREFUL WITH ALL ATTENTION TO MASKING, DISTANCING, HAND CLEANSING: NEXT 7 DAYS AFTER QUARANTINE
FREE BIRD: DAY 17 AND BEYOND….. NO RESTRICTIONS.
Although I do not recommend testing to prove the virus has cleared after infection, if you have testing and are clear, then the above protocol is not applied.
CARING FOR YOURSELF IF YOU THINK YOU MAY HAVE COVID OR IF YOU HAVE BEEN DIAGNOSED WITH COVID:
Most Common Symptoms
They consist of the same set of symptoms as the common cold/rival respiratory syndrome, but they are worse.
PAROLE BIRD: DAY 15-21…. VERY CAREFUL WITH ALL ATTENTION TO MASKING, DISTANCING, HAND CLEANSING: NEXT 7 DAYS AFTER QUARANTINE
FREE BIRD: DAY 21 AND BEYOND. NO RESTRICTIONS.
Although I do not recommend testing to prove the virus has cleared after infection, if you have testing and are clear, then the above protocol is not applied.
QUARANTINING:
- Do not share a bathroom with housemates if possible. Use your own bathroom.
- Do not share utensils with others and clean your own utensils and/or use paper/disposable eating materials if possible.
- Wait 1 day to wash the clothing you wear. Clothing can be washed after sitting out for 24 hours (virus is not transmissible at that point via clothing). Others can wash your clothes using this approach. Leaving clothes out in a garage in the heat of summer is a good idea if available to you.
- Repeatedly cleanse surfaces in areas that you frequent….at least three times per day.
- Avoid sharing living spaces with housemates, to the extent your living situations allows.
- Wear a mask & gloves when in the presence of others. Wear when you are with others as much as possible.
- Wash your hands frequently. Use cleanser on surfaces frequently.
- Shower/bathe twice daily if possible.
- All household contacts should self-quarantine as well with only minimal outside interaction.
COVID HOME KIT:
- DIGITAL ORAL THERMOMETER: TO MONITOR FEVER.
MANY BRANDS ARE FINE…HERE IS ONE EXAMPLE:
2 PULSE OXIMETER: TO CHECK OXYGEN LEVELS.
MANY BRANDS ARE FINE…HERE IS ONE EXAMPLE:
OTHER ITEMS FROM THE HOME MEDICAL KIT (SEE BELOW FOR USE OF PRODUCTS):
- TYLENOL/ADVIL/ OR ALEVE (ADVIL AND ALEVE ARE SAFE IN COVID)
- Sudafed 30mg tablets
- Chlorpheniramine 4mg tablets
- Robitussin DM syrup
- Imodium AD
HYDROXYCHLOROQUINE IS NOT RECOMMENDED TO PREVENT OR TREAT COVID AT THIS TIME. THE DATA DOES NOT SUPPORT Its USE.
CARING FOR YOURSELF IF YOU THINK YOU MAY HAVE COVID OR IF YOU HAVE BEEN DIAGNOSED WITH COVID:
- Check your temperature twice daily and keep a log. No temperature is dangerous…adults do not have to worry about this. This is just about monitoring your condition. If you have concerns, be in touch.
- Check oxygen level twice daily and keep a log. A declining oxygen level can indicate early de-compensation from COVID. Normal oxygen saturation is 97-100%. If lower than that it may be normal for you, but the trend is what matters. If you are declining into the low 90’s, if you are feeling particularly short of breath…then it is time to check checked at the Emergency Room (which is safe to do!) If you have concerns…be in touch.
- Manage symptoms just like any other viral infection (see below)
Most Common Symptoms
They consist of the same set of symptoms as the common cold/rival respiratory syndrome, but they are worse.
Common/Hallmark symptoms:
· High fever (over 100.4, but can range from 99’s to 104+)
· Fatigue
· Cough
Other symptoms can include milder issues:
· Loss of Smell and/or Taste
· Nausea without Vomiting
· Sore Throat
· Aching muscles throughout the body
· Headache
· Occasional diarrhea …
· Nasal congestion (occasional)
TREATMENT:
Symptomatic treatment for the most bothersome symptoms
- Plan to:
Monitor temperature twice daily and record. - Monitor oxygen levels twice daily and record. If dropping significantly you should be in touch.
Aches and Pains and Fever:
· Tylenol 650 – 1000mg four times per day is preferred for treating these symptoms, but if not working well, you may use:
· Advil (Ibuprofen 200mg), 2 – 3 tablets….2 – 3 x per day or Aleve (naproxen 220mg), 1 – 2 tablets…1 – 2 x per day,
· Drink good amounts of clear liquids (anything you can see through)
Sore Throat:
· Saltwater gargling
1. Dissolve 1 teaspoon of salt in a glass of warm water.
2. Gargle for 15 seconds and spit.
3. Repeat during the day every 2 – 4 hours to relieve pain.
· Pain relief medications: Advil (Ibuprofen 200mg), 2 – 3 tablets….2 – 3 x per day or Aleve (naproxen 220mg), 1 – 2 tablets…1 – 2 x per day, or Tylenol 650 – 1000mg four times per day.
DIET RECOMMENDATIONS TO PREVENT DEHYDRATION IN ILLNESS:
Preventing dehydration is of utmost importance in an acute illness.
Clear liquids (any liquid that light can easily shine through) are the best liquids to use.
These include:
- Plain Water
- Gatorade (or other electrolyte solutions that are similar)….do not use sugar-free versions of these drinks as the calories in these drinks are helpful is treating the illness and may be the only calories the person can absorb for the first hours or days
- Tea
- Cranberry Juice, Apple Juice (watered down…mixed ½ & ½ with water), White Grape Juice
- Broth from Chicken Soup, Matzo Ball Soup, Bullion
- Popsicles
Sipping liquids …sip, sip, sip….and pushing the fluids progressively with time is the most important treatment provided. Focus on this above all else!
Foods: Maintaining good dietary intake is important during the acute phase of illness, so long as appetite is present. Do not push foods if uninterested…focus on liquids. That said, if appetite remains acceptable, food can consist of anything that interests your appetite and is tolerable. Healthier choices are best, but if you want a hamburger…go ahead! Easy to digest foods include:
- Toast (plain white bread)
- Crackers (Saltines)
- Plain Noodles
- Breakfast cereals
- Bananas, Citrus fruits
- Apple Sauce
- Cooked chicken and meats
- Macaroni (with or without cheese)
- Plain Rice
Cough:
· Steam: Either in the form of a hot, steamy shower or using a hot pot of water and covering with a towel and put your head under the towel. Both methods will provide humid air to the irritated air passages and soothe the cough.
· Cough Syrup: Robitussin DM or Delsym cough syrup can be used to suppress cough.
· You may require a prescription cough syrup with Codeine. Contact me if that is the case.
Sinus Congestion and Drainage (RARE SYMPTOM):
· Use a decongestant such as Sudafed 30mg, 1 – 2 pills up to four times per day, or use a drying antihistamine such as Chlortrimeton 4mg, up to four times per day. Other cold medications (over the counter) can be used.
· Claritin, Zyrtec, Allegra will not work for congestion symptoms from an infection. Do Not Use.
Nausea Treatment:
This is the most difficult issue to treat at home as there is very little one can do to settle the stomach. Coca-Cola with the carbonation eliminated (Flat Coke), Ginger Ale, or Ginger Root…. can be tried, but these are often inadequate, and the key to getting the stomach to settle is getting a good nausea medication.
If nausea is persistent, then calling for a prescription medication is often a good idea. Phenergan (Promethazine), Compazine (prochlorperazine), Zofran (Ondansetron) are very effective in treatment. Sometimes we use them in combination either as a pill or a suppository.
The KEYS are:
1. Settling the Stomach…so that liquids can be taken
2. Focusing on Liquids…so that dehydration does not set in
3. Eating light foods… if possible (to provide energy for healing). This is not a requirement for healing from an acute GI illness; so, do not feel that the sick person needs to eat food. The only requirement is liquid intake!
When to Seek Medical Assistance
• There is no medication to treat this virus, so the resolution takes time.
Worsening symptoms/Signs of Complications:
• If you are getting significantly short of breath please be in touch. If progressive and worsening, you need to be seen and possibly hospitalized. Best to go the ER if shortness of breath is a significant symptom
How Long to Recover
• The COVID is a viral infection that will generally take from 3–7 days to develop, 3-7 days to improve and then from 3-7 days to completely resolve.
FDA advises patients on use of non-steroidal anti-inflammatory drugs (NSAIDs) for COVID-19
