COVID TODAY: Treatment Horizons, What To Do And Not To Do, How To Help

GOOD NEWS ON COVID: Treatment options on the horizon.  Right now, many of these are experimental and all are reserved for hospitalized patients or those with severe disease.  We wanted to pass along the good news that science is doing its best to catch this thing.  Want to read along?  Check it out: Actermra Rx; Hydroxychloroquine and Azithromycin; Perhaps-Don’t take Ibuprofen, here’s why

Other resources: 
This Doctor Gounder knows what she is talking about.  Here’s her podcast.
Warning: She is an infectious disease specialist.
Need to go the relaxing route instead? Try getting some Headspace
Feel torn between anxiety and complacency? Read this
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• PLEASE SELF QUARANTINE FOR 5-14 DAYS TO MONITOR FOR SYMPTOMS
  • Given your exposure it is HIGHLY recommended that you are strict about self quarantine to monitor for onset of symptoms and reduce the spread of the virus to someone who have severe symptoms.
  • This includes: 
    • minimizing household contacts
    • limiting shared spaces (separate sleeping and bathroom options if available)
    • minimizing trips out of the house – please only go out for essential supplies or consider asking someone to drop off the things you need

• WHEN TO LOOK FOR SYMPTOMS: 
  • The average incubation period for the virus (time until symptoms start) is typically 5-14 days. 
  • Review symptoms below for what to be on the lookout for
  • See treatment options below for what to do if you start to have symptoms or how to prepare your home with medications.

• WHAT TO LOOK FOR:
  • Fever over 100.4 – find, get or put batteries in your home thermometer
  • Cough – typically a dry, persistent cough
  • Shortness of breath
  • Other viral symptoms may include: low grade fever, sore throat, headache, fatigue, diarrhea
  • There is no need to call if you are not experiencing red flag symptoms below, home treatment options for those with mild symptoms are reviewed below. Call or message if you have questions.

• RED FLAG SYMPTOMS: if you have these CALL and press option 1 – these symptoms are urgent
  • If you think you need breathing support or oxygen – feeling short of breath even when sitting around, breathing very rapidly, can’t catch your breath or blue around the mouth or in the fingertips
  • High, persistent fever over 103 that is not responding to tylenol/acetaminophen
  • High, persistent pulse rate over 110-120 beats per minute (adults)
  • Low blood pressure <100 systolic with dizziness, light-headedness and any of the above symptoms
  • Low oxygen level (if you are able to check) consistently below 89%
    • Check your respiratory rate; if it is over 20 breaths per minute, please call and press option 1 to talk with someone urgently

• WHEN TO CALL NEXT:
  •  If, over the next 10 days, you have any red flag symptoms, please call and press option 1

• HOME TREATMENT OPTIONS:
  • Tylenol aka acetaminophen for pain or fever
    • DOSE: 1000 mg up to three times a day (follow dosing instructions on the bottle for children’s dosing)
    • NOTE: There is concern that motrin/aleve/ibupfrofen/aspirin can increase risk for clinical worsening with COVID-19. It is best to avoid these products UNLESS you are low risk for COVID-19 and/or have no other options available to control high fevers (103-104)
  • Guaifenesin aka Robitussin aka Mucinex – for cough/expectorant
    • DOSE for adults is 600-1200 mg twice daily. This option is not best for children <6
    • Note: it’s best to use these products without sudafed or psuedoephedrine as those combo products can raise your heart rate and may not be necessary unless you have significant sinus congestion
  • Benadryl aka diphenhydramine for sleep and cough suppression (not ideal for elderly over 70 as it can cause confusion)
    • DOSE: 25-50 mg at bed for adults, 6.25 mg/dose for children 2 to 5 years of age and 12.5 to 25 mg for children 6 to 12 years
  • Flonase aka Fluticasone for nasal congestion and post nasal drip
    • DOSE: 1-2 sprays each nostril once or twice daily
  • Nasal Saline rinses for nasal congestion and post nasal drip
    • Note: Sterilize bottle after use
    • Make your own recipe: 1 cup warm water, 1 tsp salt, ½ tsp baking soda
  • Vitamins: there are many to consider
    • Vitamin D 2000-10,000 IU once daily
    • Vitamin C 1000-2000 mg daily (more causes diarrhea in some watch out)
    • Zinc 10-40 mg daily
    • N-acetyl-cysteine (NAC) helpful for those especially with asthma or lung disease 600 mg twice daily