Nearly everyone has concerns about the Coronavirus or COVID-19. There is a lot about it on the news and in discussions with family and friends. We are taking it seriously and we recommend that you all do as well. We have been working closely with Benton County Public Health, Good Samaritan and Oregon Health Authority, (OHA) and keeping up to date on information and guidance from the Centers for Disease Control, (CDC) so that we have the clearest picture of what we should be doing for you. We highly recommend keeping up with what the CDC or OHA have on their websites.
There is much that we do not know about COVID-19 or how alike or different it is from other coronaviruses, of which there are many and are a common cause of respiratory illness. The fact that it is a respiratory virus means that the symptoms are similar to Influenza, Respiratory Syncytial Virus, Adenoviruses, Rhinoviruses and others, which are much more common. There is a cough, fever, fatigue and body aches. Unfortunately, the COVID-19 can affect people more seriously than influenza, especially the elderly and those with chronic medical problems. All these diseases are transmitted through tiny droplets generated when those infected cough or sneeze. This is a good place to give you the best point of advice. If you are feeling sick, stay home! (unless you are sick enough to be seen – worsening to the point of shortness of breath, not urinating for 12 hours, too lightheaded to stand) That will limit the spread of all these viruses, including COVID-19. The latest guideline is to stay home for at least 7 days and you also need to be symptom free for 72 hours. Washing your hands is the second most important point, good old soap and water for 20 seconds being the best choice. Hand sanitizer, greater than 75% alcohol, is the second choice.
The other thing that you can do, for the majority of us who are well, is something you can see all around called social distancing. Schools are closing, sports and music events canceled, even church services put on hold to keep big groups of people from getting together and decreasing the risk of transmission of viruses. So, stay home as much as you can and if you must go out, make it short, avoid contact with others, wash your hands, and don’t touch your face. If you have elderly family members of course support them, but limit visits. Get supplies for them and leave it on the doorstep.
Getting back to the ‘If you are sick’ point: if your symptoms are mild, annoying, and leave you feeling tired, just go ahead and treat them with Tylenol, Ibuprofen, Aleve or other over-the-counter medications. There has been some news about non-steroidal medications not being recommended due to risk of injury to the kidneys. In digging deeper into that, we have found that is more in relation to treating the ill who are elderly and already have declining kidney function. These work as well as anything that we can offer. You are welcome to call us and let us know that you are ill. Try to isolate yourself from others in the home as much as possible. Have a designated bathroom that you clean regularly, or if there is just one in the home, wipe it down after every use. Eat in the isolation room and keep at least at 6 feet (2 meters) distance from other family members.
Should the symptoms get worse, such as having trouble breathing or being so ill and fatigued that you are unable to take care of yourself, please call us. We will either have you come in or may direct you to the Emergency Room. If you come in, you will be directed to park near the back door of the CFM clinic. One of our staff will come out to take vital signs and evaluate you in your car at first. Again, this is to limit spreading viruses to others. Likely we will do influenza testing, and depending on how you look, may have you come in through the back to door to a somewhat isolated room for more examination.
This may be a good time to bring up that there is no treatment for COVID-19 or most of the other respiratory viruses, despite some rumors and the check stand newspaper headlines. Antibiotics don’t work at all; Tamiflu only works on Influenza and only if it is started within 48 hours of the start of symptoms. There is hype about Chloroquine showing anecdotal promise. Studies are in progress, but it has not been recommended for treatment given the limited, low-quality data. All we can do is determine if you need care in the hospital or can stay at home and add some more supportive treatments.
Let’s address testing, the most common question for us. Frankly, often we have to give the dissatisfying answer that we will not test. Yes, we listened to the President announce that testing would be made available all over and the companies that make tests promising to get them out fast. However, that does not mean that the delivery truck has dropped off a couple thousand test kits yet. Test supplies and capability are still in short supply and it takes 4-5 days for results to come back! We are adhering to the guidelines, broader now than last week, to test those with symptoms of fever, shortness of breath and cough, are at high risk of developing severe disease from COVID-19 and have been exposed, or are healthcare workers. As much as everybody wants to know if their symptoms are due to the COVID-19 virus, we are not able to test very many, so will test only those that it will be helpful in their management.
Thank you for helping us keep you and our community healthy during this outbreak