08/01/2022
If youโre super anxious (like me) and like to have a plan in place, Dr Sara (my favourite) has detailed a good Covid safe plan here. Iโm going to be stocking up on my meds and making sure that I have Panadol etc just in case I get COVID. P.s. please donโt try and get COVID โover and done withโ, because you can be reinfected multiple times, putting yourself at more risk of complications and Long COVID. Natural immunity doesnโt last long. Get your booster when you can, wear masks and social distance when you can. โค๏ธ
What do I do if Iโm COVID positive?
*Long Post but essential reading*
As promised, today I wanted to provide some guidance for the increasing number of people in the community who are testing positive to the SARS-CoV-2 virus.
I understand that for many such a result may be met with fear, uncertainty, and a lack of direction as to what you need to do and what you should look out for as the infection progresses. This post will answer some important questions and provide some guidance.
๐. ๐โ๐ฏ๐ ๐ญ๐๐ฌ๐ญ๐๐ ๐ฉ๐จ๐ฌ๐ข๐ญ๐ข๐ฏ๐ ๐จ๐ง ๐ฆ๐ฒ ๐๐๐. ๐๐ก๐๐ญ ๐ง๐จ๐ฐ?
If youโve tested positive on a RAT in Victoria then there is no longer any need to get a PCR to confirm this. Even if the second line is faint, assume this is probable COVID-19, given the specificity of the tests (false positives are rare).
You need to isolate for a minimum of 7 days after this positive result. If your RAT is negative but you are symptomatic, then get a PCR test and assume youโre positive until you receive a PCR result stating otherwise.
๐. ๐๐จ๐ ๐ฒ๐จ๐ฎ๐ซ ๐ฉ๐จ๐ฌ๐ข๐ญ๐ข๐ฏ๐ ๐๐๐ ๐ซ๐๐ฌ๐ฎ๐ฅ๐ญ ๐จ๐ง ๐ญ๐ก๐ ๐๐ข๐๐ญ๐จ๐ซ๐ข๐๐ง ๐๐จ๐ฏ๐๐ซ๐ง๐ฆ๐๐ง๐ญ ๐ฌ๐ข๐ญ๐.
From midnight, it became mandatory for positive results from RATs to be lodged online or over the phone. This is to ensure that the positives from RATs are being included in the daily case numbers.
The website can be found here:
https://dhvicgovau.powerappsportals.com/rapid-antigen-test/
The Department will then ask you certain screening questions to ascertain your risks, supports and whether you are happy to nominate a GP for your management in the community (if required).
๐. ๐๐ง๐๐จ๐ซ๐ฆ ๐ฒ๐จ๐ฎ๐ซ ๐๐ฅ๐จ๐ฌ๐ ๐๐จ๐ง๐ญ๐๐๐ญ๐ฌ
Inform any close contacts who youโve spent >4hrs with in a household or household-like setting within the 48 hours prior to becoming symptomatic. They should undergo RAT testing and they should also start isolating for 7 days.
๐. ๐๐๐ค๐ ๐ ๐๐๐ฅ๐๐ก๐๐๐ฅ๐ญ๐ก ๐๐ฉ๐ฉ๐จ๐ข๐ง๐ญ๐ฆ๐๐ง๐ญ ๐ฐ๐ข๐ญ๐ก ๐ฒ๐จ๐ฎ๐ซ ๐๐
Most cases of COVID-19 will be mild and can be managed at home with supportive measures.
Notifying your GP serves two main purposes. The first is to update your medical file to reflect the COVID-19 infection.
The second is for those who are at risk of poor outcomes to further assess their risk, even if asymptomatic/mildly symptomatic, and, if eligible, to organise access to antiviral medication during the first 5 days of infection.
๐. ๐๐ก๐จ ๐๐ซ๐ ๐ญ๐ก๐จ๐ฌ๐ ๐ฐ๐ก๐จ ๐๐ซ๐ ๐๐จ๐ง๐ฌ๐ข๐๐๐ซ๐๐ ๐๐ญ ๐ซ๐ข๐ฌ๐ค ๐จ๐ ๐ฉ๐จ๐จ๐ซ ๐จ๐ฎ๐ญ๐๐จ๐ฆ๐๐ฌ?
The following are risk factors for poor outcomes:
โข those aged > 65 years
โข those who are unvaccinated or partially vaccinated **
โข Aboriginal and/or Torres Strait Islanders
โข pregnant women
โข comorbidities:
๐ฅ lung disease, including COPD, asthma or bronchiectasis
๐ฅ cardiovascular disease, including hypertension
๐ฅ obesity (BMI >30 kg/m2)
๐ฅ diabetes
๐ฅ renal failure
๐ฅ immunocompromising conditions
Immunocompromising conditions include:
๐ฅ Primary or acquired immunodeficiency:
- Haematologic neoplasms ie leukaemias, lymphomas, myelodysplastic syndromes
- Post-transplant: solid organ (on immunosuppressive therapy), haematopoietic stem cell transplant (within 24 months)
- Immunocompromised due to primary or acquired (HIV/AIDS) immunodeficiency
๐ฅ Other significantly immunocompromising conditions:
- Immunosuppressive therapy (current or recent)
- Chemotherapy or radiotherapy
- High-dose corticosteroids (โฅ 20 mg of prednisone per day, or equivalent) for โฅ 14 days
- All biologics and most disease-modifying anti-rheumatic drugs (DMARDs)
** if you are unvaccinated, please remember that your doctor will provide you with the same excellent care as vaccinated patients, without judgment or โI told youโ. Our aim is to ensure you make a full recovery.
๐. ๐๐ซ๐ ๐๐ง๐ข๐ฌ๐ ๐ ๐ฉ๐ก๐จ๐ง๐ ๐๐ฎ๐๐๐ฒ
If you are isolating alone, arrange for a trusted friend or family member to touch base with you by phone at the same time twice a day.
This is a safety net to ensure that if you have an unexpected deterioration that you have someone who is able to alert authorities for help. Inform them that any unanswered calls at the appointed time is to be escalated.
๐. ๐๐ก๐๐ญ ๐ฌ๐ฒ๐ฆ๐ฉ๐ญ๐จ๐ฆ๐ฌ ๐ฐ๐ข๐ฅ๐ฅ ๐ ๐๐ฑ๐ฉ๐๐ซ๐ข๐๐ง๐๐ ๐๐ง๐ ๐ก๐จ๐ฐ ๐ฐ๐ข๐ฅ๐ฅ ๐ฆ๐ฒ ๐ข๐ฅ๐ฅ๐ง๐๐ฌ๐ฌ ๐ฉ๐ซ๐จ๐ ๐ซ๐๐ฌ๐ฌ?
Most vaccinated individuals will experience mild symptoms. Remember, vaccination reduces your risk of severe disease and hospitalisation.
The typical symptoms include fever, anosmia (loss of taste and smell), cough, fatigue, headache, sore throat, runny nose, shortness of breath, chills, nausea/vomiting/diarrhoea. Other symptoms include chilblains and conjunctivitis.
Symptoms can typically last 2-3 weeks, although they can run longer. Long COVID is a documented post-infection phenomenon with symptoms lasting months.
๐. ๐๐ก๐๐ญ ๐๐จ ๐ ๐ญ๐๐ค๐ ๐๐จ๐ซ ๐ฆ๐ฒ ๐ฌ๐ฒ๐ฆ๐ฉ๐ญ๐จ๐ฆ๐ฌ?
Itโs essential that you rest, stay well hydrated and try to eat well during your illness.
Manage any fevers, aches and headaches with paracetamol/ibuprofen as per label instructions.
Treat runny nose with a over the counter cold and flu medication, and sore throat with honey (a fantastic cough suppressant and excellent for sore throats), lozenges, hot drinks.
Keep extremities (toes and fingers) warm if you develop chilblains.
Use saline eye drops to manage viral conjunctivitis.
Continue to take your usual medications for your underlying chronic medical conditions. Itโs essential that these comorbidities continue to be well managed.
๐. ๐๐ก๐๐ญ ๐๐ซ๐ ๐ญ๐ก๐ โ๐ซ๐๐ ๐๐ฅ๐๐ ๐ฌโ ๐ญ๐ก๐๐ญ ๐ฌ๐ข๐ ๐ง๐๐ฅ ๐๐๐ญ๐๐ซ๐ข๐จ๐ซ๐๐ญ๐ข๐จ๐ง?
Deterioration can occur in the second week of infection, and hence itโs important to escalate things if your clinical picture deteriorates.
Patients will require escalation if they start experiencing the following symptoms.
* New or increasing shortness of breath
* Chest pain or tightness
* Syncope (fainting) or near syncope
* Altered mental state/confusion
* Severe weakness or lethargy
* Haemoptysis (coughing up blood)
* Consistently missing meals more than one day due to nausea, vomiting, diarrhoea that results in decreased oral intake and reduced urine output
* Respiratory rate โฅ 30 breaths/min
* Oxygen < 92% at rest
๐๐. ๐๐จ๐ฐ ๐๐๐ง ๐ ๐ ๐๐ฎ๐ ๐ ๐ข๐ ๐ ๐๐ฆ ๐ข๐ฆ๐ฉ๐ซ๐จ๐ฏ๐ข๐ง๐ ๐จ๐ซ ๐๐๐ญ๐๐ซ๐ข๐จ๐ซ๐๐ญ๐ข๐ง๐ ?
I always ask my patients the following questions
- Is your breathing different from yesterday?
- Can you walk at least half the distance you walked yesterday?
- Can you lie flat without worsening shortness of breath?
- Is your breathing disturbing your sleep
- How do you feel compared to yesterday?
- Are you having ongoing fevers and chills?
- Have you had any dizzy spells or faints?
If you have any doubt or concerns about your symptoms, please organise a Telehealth to discuss.
๐๐. ๐๐ก๐๐ง ๐๐จ ๐ ๐ฅ๐๐๐ฏ๐ ๐ข๐ฌ๐จ๐ฅ๐๐ญ๐ข๐จ๐ง?
The current guidance for positive cases is to isolate for 7 days. If you are still symptomatic after 7 days then please remain in isolation and Telehealth with your doctor to discuss.
If you have any specific questions please drop them below ๐๐ผ
- Sara
