Covid: Common Questions Asked and Answered!

As an RN Care Manager I am assisting clients daily in navigating the complexities of our health care system. Lately, things have been even more complex as most of us know! Along the way, I am asked a variety of health related questions and need to stay current with factual information for my patients as they rely upon me to be an expert in my field. Since many questions are now relating daily to Covid and information keeps changing on a regular basis I wanted to focus our blog today on some of these areas.

Here are some of the most recent, common Covid questions asked and answered:

How is Covid really Transmitted?

Spread mainly from person to person, through respiratory particles or droplets produced when an infected person coughs, sneezes, or talks or through self inoculation through direct contact with contaminated secretions.

People with COVID-19 have had a wide range of symptoms reported – ranging from none or mild to severe illness.

What are some key considerations?

Proper masking, disinfecting, and hand washing is important to deter transmission and spread.

People with COVID-19 have had a wide range of symptoms reported, ranging from none or mild to severe illness.

Symptoms may appear within 5 to 6 days. However, studies have shown that symptoms can appear as soon as 3 days after exposure to as long as 13 days later.

What symptoms do coronaviruses typically cause?

Common symptoms include runny nose, cough, fever, muscle aches, chills, fatigue, headache, sore throat, shortness of breath, loss of taste or smell, nausea, vomiting, diarrhea. In more severe cases: pneumonia, severe acute respiratory syndrome, kidney failure, sepsis, stroke, cardiac issues, and death. There may also be long term effects including respiratory and neurologic issues- this is still being examined.

What work is being done to find treatments?

More than 150 different drugs are being researched around the world.

Most are existing drugs that are being trialled against the virus.

The World Health Organization (WHO) has launched the Solidarity trial aimed at assessing the most promising treatments.

And multiple research centers around the world are attempting to use survivors' blood as a treatment.

What types of drugs might work?

There are three broad approaches being investigated:

1. Antiviral drugs that directly affect the coronavirus's ability to thrive inside the body

2. Drugs that can calm the immune system - patients become seriously ill when their immune system overreacts and starts causing collateral damage to the body

3. Antibodies, either from survivors' blood or made in a lab, that can attack the virus

What are the most promising coronavirus drugs?

Still evolving!

Currently Showing promise - dexamethasone and remdesivir.

*It is thought that antivirals may be more effective in the early stages, and immune drugs later in the disease.

1. Dexamethasone, the first drug shown to save the lives of people with Covid-19, has been hailed as a breakthrough.

Initial findings showed the low-cost steroid cut the risk of death by a third for patients on ventilators and a fifth for those on oxygen.

Coronavirus infection triggers inflammation as the body tries to fight it off.

This can prompt the immune system to go into overdrive, and it's this reaction that can prove fatal. Dexamethasone damps down this response.

2. Remdesivir: broad-spectrum antiviral medication

Clinical trials of remdesivir, an antiviral drug originally developed to treat Ebola, have also been encouraging.

A US-led trial of more than 1,000 people worldwide found remdesivir cut the duration of symptoms from 15 days to 11.

Some were given the drug and others were given a placebo treatment.

But, although remdesivir may aid recovery - and possibly stop people having to be treated in intensive care - studies have so far not given any clear indication whether it can prevent deaths from coronavirus.

Any new potential treatments this week:

UK Inhaled beta interferon double blind study:

Synairgen uses a protein called interferon beta, this protein is inhaled into lungs using a nebulizer

https://www.bbc.com/news/health-53467022

The preliminary results of a clinical trial suggest that this potential new treatment for Covid-19 reduces the number of patients needing intensive care, according to the UK company that developed it.

What about Hydroxychloroquine?

WHO Summit on COVID-19 research and innovation interim trial results show that hydroxychloroquine (used for malaria) and lopinavir/ritonavir (used to treat HIV) produce little or no reduction in the mortality of hospitalized COVID-19 patients when compared to standard of care.

Do I need and what are Orders for Life-Sustaining Treatment?

Physician (or Medical) Orders for Life-Sustaining Treatment (POLST or MOLST) or. Physician Orders for Scope of Treatment (POST)

This form is a medical order that travels with you.

This document, which varies by state, is a medical order signed by a medical professional and used for treatment.

It is generally used for frail people with an advance directive and Do Not Resuscitate (DNR) orders or when a person is nearing the end of life, such as with a terminal or serious life limiting illness.

This is a document that your doctor can discuss with you during your Advanced Care Planning discussion.

This does not name a “surro- gate” or “medical proxy.”

This document would be used together with the Living Will/Advanced Directive to guide your loved ones and your doctors in the event that you are unable to make your own decisions. See https://polst.org.

How should I launder a washable mask?

Washing machine is best!

One can include their face covering with their regular laundry.

Use regular laundry detergent and the warmest appropriate water setting for the cloth used to make the face covering.

Washing by hand

Prepare a bleach solution by mixing:

5 tablespoons (1/3rd cup) household bleach per gallon of room temperature water or

4 teaspoons household bleach per quart of room temperature water

Check the label to see if your bleach is intended for disinfection. Some bleach products, such as those designed for safe use on colored clothing, may not be suitable for disinfection.

Soak the face covering in the bleach solution for a minimum of 5 minutes.

Rinse well with cool or room temperature water.

What is a safe way to dry washable Masks:

Clothes Dryer is best!

Use the highest heat setting and leave in the dryer until completely dry.

If needing to Air dry

Lay flat and allow mask to completely dry. Best to place the cloth face covering in direct sunlight to dry.

Can you explain Covid Testing?

Contact your health provider for testing information and instructions if symptomatic!

Viral testing:

(testing for current infection)

Positive: Most likely* you DO currently have an active COVID-19 infection and can give the virus to others.

Stay home* and follow CDC guidance on steps to take if you are sick.

*If you are a healthcare or critical infrastructure worker, notify your work of your test result.

Negative: Most likely* you DO NOT currently have an active COVID-19 infection.

If you have symptoms, you should keep monitoring symptoms and seek medical advice about staying home and if you need to get tested again.

If you don’t have symptoms, you should get tested again only if your medical provider and/or workplace tells you to. Take steps to protect yourself and others.

Antibody testing:

(testing for past infection with the virus)

*FDA has authorized antibody tests for this virus that have been submitted for their review. But these tests are not 100% accurate and some false positive results or false negative results may occur.

Positive: You likely* have HAD a COVID-19 infection.

You may be protected from re-infection (have immunity), but this cannot be said with certainty. Scientists are conducting studies now to provide more information. Take steps to protect yourself and others.

Negative: You likely* NEVER HAD (or have not yet developed antibodies to) COVID-19 infection. You could still get COVID-19. Take steps to protect yourself and others

How can we prevent Covid transmission and Deaths:

-Masking and mindfulness!!!

-Improve and maximize ones overall health. Unless otherwise instructed by a health care provider - exercise daily, eat a balanced diet, ensure that you stay hydrated, wear a mask when out, practice good hand washing.

- Better manage and reduce preventable diseases such as heart disease, cancers, and diabetes.

- Be mindful, prepared, and plan well!

- Have a care plan with covid considerations! Here is a great template: https://www.cdc.gov/aging/caregiving/pdf/Complete-Care-Plan-Form-508.pdf

We are happy to assist in a variety of areas and in forming a covid plan for care!!!

Sources:

NIH

CDC

WHO

Johns Hopkins