Many of you are testing positive for COVID-19 or are beginning to have viral illness symptoms or have family members that are having symptoms of fever, cough and or mild shortness of breath. These symptoms are best managed at home, unless shortness of breath becomes more pronounced or severe.
I wanted to give you my general recommendations on how to handle COVID-19 infection at home. Please note these recommendations are in line with the current CDC recommendations but also include what I think is best for you as my patient.
This is IMPORTANT, just because you have been tested for COVID-19 and your results are negative does not mean you do not have COVID-19. If you are having symptoms of fever, cough or shortness breath there is still a high likelihood, given the current pandemic, that you are infected with COVID-19. The sensitivity for the COVID-19 test is around 75 to 85 percent. Sensitivity measures the percentage of sick people who are correctly identified by the test as having the condition. The true positives. The COVID-19 test helps us with surveillance but does not help much clinically. As doctors we have to make clinical judgments on your condition and not rely entirely on the test. Help me with this. If you are having symptoms assume you are positive for COVID-19
My current recommendations for in home isolation are to remain in isolation until at least 10 days have passed since symptoms first appeared AND at least 5 days have passed since recovery of symptoms i.e. no fever, cough or shortness of breath.
These recommendations apply for the following people:
1. Persons who are having symptoms but not yet diagnosed positive
2. Persons diagnosed positive but having milder symptoms that can be managed at home
3.Persons diagnosed positive that have been hospitalized but have been discharged to home
Home isolation applies for all of these cases and a strict inhouse protocols to prevent spread to household members and pets are necessary.
Call me if your symptoms are worsening. During business hours please do not send me a text or call my cell phone. I’m receiving hundreds of calls and texts and its difficult to keep up with the truly sick calls or texts. In order for me to take care of you safely and efficiently, please call the office directly at 404-257-5585. I have staff that are triaging the calls in order of importance. If you are acutely ill you will receive a call back from me within 10 minutes. After hours, please call my cell phone for acute illness.
If you are prescribed a nebulizer treatment, and I will only be prescribing this in special clinical circumstances, please note that these treatments can aerosolize the virus. Do not perform nebulizer treatments while anyone else is in your room. Caregivers should wait 60 to 90 minutes after nebulizer treatment is complete before entering the room and assume that for 3 hours post treatment, the virus is aerosolized in the room so full cover should be used. If possible, nebulizer treatment should be performed in a “dirty room’ that no other person in the home will be using and that does not have air circulating from the home air-conditioning unit or where the ventilation has been covered to prevent transmission of aerosolized particles into the air system. All surfaces should be cleaned after nebulizer treatment is performed. Stop using nebulizer treatments as soon as your symptoms or shortness of breath resolve. If you have questions about this please give me a call.
Monitor your symptoms. If cough or shortness of breath worsens or fever remains high despite Tylenol then call me.
If no allergy, take Tylenol 3 to 4 times per day for fever. Do not take more than 2000 mg of Tylenol in a 24 hour period. Do not use NSAIDS.
Wash your hands with soap and water for 30 seconds frequently. Especially if you are coughing, sneezing, blowing your nose, going to the bathroom, eating or preparing food. Routinely wash your hands every 4 to 6 hours. Soap and warm to hot water is better than hand sanitizer.
Protect your psychological health. Don’t be ashamed of having symptoms or being diagnosed with COVID-19. Most of us will experience infection with this virus at some point. It’s Ok. Stay in constant phone and video communication with your friends and loved ones. We are all in this together. We will beat this.
Avoid touching your eyes, nose and mouth.
Caregivers should wear a mask and gloves when they are around you.
If caregivers do not have gloves available, then ensure hand washing or hand sanitizer use upon entering and leaving room every time.
If caregiver or patient does not have a mask then improvise. Use a scarf or use clothing with elastic bands such as underwear or shirts over the nose and mouth. Wash these in the washing machine with hot water and detergent daily.
Goggles or glasses are also recommended. Ok to use any goggles or glasses even swimming goggles.
Make sure any shared spaces in the home between you and your family have good air flow, if possible open a window.
Have another household member pick up any needed food or medication. Do not leave the home to gather these goods.
Separate yourself from other people and animals in your home.
Stay in a specific room away from other people.
Use a separate bathroom, if available. And only you should use that bathroom.
Restrict contact with pets and other animals.
Wear a facemask anytime you are anywhere near another person or animal.
Don not share any personal household items such as drinking glasses, utensils, or bedding.
Clean all “high touch” surfaces with a disinfectant wipe or spray twice daily including countertops, tabletops, doorknobs, toilets, laptops, keyboards, cellphones.
If you do go out, when you return home, before entering the main part of your house, you should take off your shoes and all your close and place these in a hamper in the garage or foyer, or a separate room. You should then take a shower or bath to reduce the chance of bringing the virus into your home.
Stay Well and Stay Home,
Dr. Edward Espinosa