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Here’s a great FREE option for testing if you’re sick or have been exposed to Covid
This is an interesting interview about Covid and kids! The podcast is geared towards physicians, but I think a good portion of it is helpful for everyone to hear. (Cheesy cover, solid content 😁)
As always, the best place for you to go with Covid and other health questions is your primary care doctor. They (should) know you and your particular health needs better than a blanket statement on a YouTube video and for SURE better than a politician. If you don’t have a primary care doctor I’d be happy to share more about becoming a Hope Family Medicine patient!
https://youtu.be/vCqqcPguXsA
Today I received a call about a sick toddler and offered to see them this afternoon. Then, when I realized mama needed to walk to the office in below freezing weather to get to the appointment I offered to bring the visit to their home instead 🏡
I love the flexibility allows me to meet my patients where they are (both literally and figuratively!)
Family medicine the way it was meant to be 💚
Good morning! Happy Monday and Happy New Year!
We are off to a rip roaring start of the week and year, but I absolutely have faith things will get better!
I’ve actually lost count of the number of “I think I have Covid” or “I just tested positive for Covid” or “I’m sure it’s not Covid, but…” calls I’ve had in the past week. In fact, the photo below is of my very own positive test (yes I had Covid, yes I’ve been cautious and wore a mask, yes I’ve been vaccinated, and yes I do believe my symptoms were comparably more mild likely because of the vaccine).
This is a long, but easily readable post and I hope it helps if you’re wondering what to do. As always, I am here for you and I’m rooting for you!
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Hi, I'm back as Robin-Schoenthaler-the-Boston-cancer-doctor-who-writes-about-Covid.
(And it’s okay with me if you want to share this directly from my public FB page.)
Since at least two dozen of my friends and family got Covid this week-end, and the hits just keep on coming, tonight’s missive is an updated revised version of my previous guide on managing Covid infections.
PLEASE go stock up your Covid kits. A large number of us are going to get Covid in the next couple of weeks so get your gear TODAY. In fact, go buy your oximeter TONIGHT.
And get home testing kits. I know we Americans aren’t used to scarcity and there’s a tendency to shrug one’s shoulders and say, “I couldn’t find them anywhere,” but the reality is, places run out, yes, but then they restock.
Every morning (in your spare time) just wake up and check on-line and neighborhood drug stores and big stores. Every night before bed, check again. Tests are out there; you just have to be persistent and ready to jump.
Okay, you got the dreaded email/phone call/pink line: your Covid test is positive.
For most tests, positive is essentially positive; there’s not many “false positives.”
On the other hand, if you’ve had a negative home test, it could be wrong, i.e., a “false negative.” If you’re symptomatic or had a high-risk exposure and really think you have Covid, you might consider doing a *throat* swab. We’re hearing more and more reports of throat tests turning positive before the nasal test does and there’s some emerging science showing it, too. The data is still too early for this to be part of formal guidelines but it makes sense to me and I’m now throat swabbing myself.
A positive test for most people is a rough moment but let’s put things into perspective.
First off, why did you get it? You got it because:
a) a few days ago you were exposed to somebody who was infected and
b) the vaccine’s impact is declining; it is now around 35%
c) getting a BOOSTER, however, increases protection to around 75%.
Are you in danger? If you are unvaccinated you have a thirteen times higher chance of dying of Covid than if you are vaccinated.
Fortunately the vaccines still do a fantastic job protecting most vaccinated people from anything much more than cold symptoms.
Two caveats:
1) The positive test means you are infected and infectious and you need to stay home for at least five days after your positive test. Then if you feel better and your symptoms are resolving, you can leave home — but you still need to be meticulous about masking for five more days.
2) If you have major medical issues and are at risk to get serious Covid or are profoundly immunosuppressed, you should call your doctor to see if you qualify for monoclonal antibodies or antivirals even though they are being rationed right now. Some docs are also using an anti-depressant called fluvoxamine.
But if you are unvaccinated, there is no way of telling what might happen, and you should “prepare for the worst and hope for the best.”
Everybody,
a) Call your doctor and let them know you’re positive.
b) Don’t go to the ER unless your oxygen levels decline (more below) or you can’t keep any fluids down, not even sips. The ERs are overwhelmed and will be for the next few weeks so try and stay out if possible
c) Call everybody you’ve had close contact with. Tell them to test themselves a few days after your contact or immediately if they have any symptoms.
d) Then, get yourself ready to be self-isolated and maybe sick for five days. Time to pull out “The Covid Kit.”
What’s a Covid Kit?
Basically a Covid Kit includes three things: an oximeter, a thermometer and anything that helps you feel better during a cold.
• Do I really need an oximeter? Yes, particularly if you are unvaccinated, have major medical problems or are profoundly immunosuppressed.
• Do I really need a thermometer? Yes! Everybody should have a thermometer. “Feeling hot” is not enough — you need to know your temp and its fluctuations!
• What else helps during a bad cold? I personally like throat lozenges, cough medicine, tylenol/ibuprofen/naproxen, some herbal teas, chicken soup, a tiny bit of bourbon, and an updated subscription to Netflix. Some people like Gatorade and Nyquil, too.
• What else do I need to figure out ahead of time?
1) Where are you going to sleep/stay so you are isolated from everybody else? (Even more important with Omicron)
2) Who can go to the store for meds or food?
3) How are you going to get fed?
4) Who can watch and feed the kids and keep them away from you?
5) Who will help you decide if/when it’s time to go to the hospital?
6) Which Netflix shows are you going to binge?
Just like with all viruses, rest, hydration, and symptom relievers are key.
But there’s a couple of extra things with Covid, particularly if you are unvaccinated or have major medical issues:
• It’s helpful to lay on your stomach (“prone”) as much as possible to improve breathing and oxygen levels, especially if you’re feeling short of breath or congested.
• It’s probably helpful to walk around the house taking deep breaths once an hour, to open up your lungs and maybe reduce blood clots.
• It is very important to keep checking your oxygen with the pulse oximeter in your Covid Kit. If it starts to steadily decline, call your doctor’s office. If it stays below 95 (from 100), get ahold of your doctor; you may need to go to an ER. Incidentally, smart watch oxygen measurements don’t seem as reliable as pulse oximeters.
• What else might help? There’s still no clear data on zinc, melatonin, vitamin C, Pepcid, Vitamin D. Most of these fall into the “probably can’t hurt, maybe might help?” category so ask your doc.
• If you’re unvaccinated or a person at risk for severe disease (defined by CDC as certain chronic illnesses (lung, heart, obesity, diabetes, age >65, etc, etc ), you should be talking to your doctor about the monoclonal antibody Sotrovimab and/or antivirals Paxlovid and Molnupiravir. These are unfortunately in very short supply right now and are being rationed but call your doc.
It’s important to remember that most of us who are vaccinated will experience Covid as a mild or medium illness, and never end up needing to go to the hospital.
But there’s a small subset of people (~15%) who get markedly worse, usually around the second week. Getting a lot sicker means call your doctor or the ER.
Finally, a common question about “getting it over with:”
“Two people in my house have Covid. The other people in our family are vaccinated. Should we just go ahead and try and catch Covid from them since it feels inevitable?”
In any other month I would just call this a gamble. Anybody who deliberately exposes themselves to Covid is taking a calculated risk about whether they end up being part of the small percentage of vaccinated people who:
— still get severe disease or end up needing to be hospitalized
— or end up with Long Covid
— or who accidentally infect Aunt Petunia when they take her to her podiatrist.
But this month is a particularly bad month for a gamble. This month we have sky-rocketing cases, decimated medical staffs, lots of hospitals with no ER space or ICU beds, and we’ve essentially got no drugs.
So, no, I don’t think this is the month to take that particular gamble. As our beloved Kenny Rogers wrote, “You've got to know when to hold ‘em, know when to fold ‘em, know when to walk away, and know when to run.”
So no, this is not a good month to gamble on the chances your particular Covid infection will be mild. Maybe another month when you can get a bed in an ER and be seen by a healthy doc and get handed an antiviral prescription that’s easy to fill. That’s coming, maybe February, maybe March.
But not this month. This is not a good month to fold ‘em. This is a good month to hold ALL the cards — the masking, the distancing, the every possible protection — every single one.
Wow, how the weather has changed!
This is the time of year where things seem to fly by at lightning speed. We are well into open enrollment season for health care.
Have you thought much about changing plans? Certainly a lot has changed in the health care landscape and now is a great time (possibly the only time of the year) to evaluate if your plan best serves your needs.
Have questions about which plan pair best with a DPC membership? I’m happy to chat!