Keep the Facts at your Fingertips
MEDICAL AND MENTAL HEALTH UPDATE
Wowzers, what a week!
The GREAT news: 1) the Moderna and Pfizer vaccines both look excellent; 2) a new study suggests that our immunity from a novel coronavirus infection may last for years; and 3) the FDA finally authorized the first COVID-19 self-administered home test. Hope is alive, and help is on the way. YES. YES. YES.
The BAD news: COVID cases are soaring. We’ve lost a quarter of a million American lives. The virus is everywhere. And winter is just getting started.
The DELAYED GRATIFICATION news: The more you hunker down now and learn to love the interior of your home (and brain), the better off you’ll be once we’re on the other side of this beastly badness in spring 2021.
What to do now? Go back to basics.
Why? Because it’s easy to forget basic pandemic principles when we’re trying to work/parent/care-take/sleep/hydrate/meditate/exfoliate/get out of bed in the morning.
Even my most savvy patients forget all the rules when they come in contact with a COVID-positive person.
And this week I’m fielding an exponential increase in “what should I do if….” questions from my patients. It feels a lot like last March and April—but without the daffodils and jean shorts.
So here are some facts at your fingertips to get you through the next few months.
Are you with me? Let’s go!
WHAT TO DO IF YOU WERE IN CONTACT WITH SOMEONE WITH COVID-19:
First, recall that close contact is defined by the CDC as:
Being within 6 feet of an infected individual for a total of 15 minutes or more over a 24-hour period.
Being in direct contact with an infected person’s body fluids (e.g. via a cough, sneeze, kiss, or shared water bottle).
Also recall that:
Every situation has nuance. You can get COVID-19 even if you were in contact with an infected person for less than 15 minutes and didn’t even smooch!
The likelihood of infection depends on the length of interaction with an infected person and the type of interaction
coughing/sneezing releases many more virus particles than speaking which releases more virus particles than breathing
brief, fleeting contact with an infected person (e.g. passing by someone on a walk) is very unlikely to cause transmission of COVID-19.
examples of high risk scenarios: restaurants, bars, gyms, hair and nail salons, and basically ANY indoor, poorly-ventilated location with other people. Note that most schools are not considered high risk because they are taking so many precautions!
People are most contagious during the 48 hours before symptoms begin. Example: if you had lunch outside with someone two days before they got sick, that is considered a high risk contact and is reason for you to quarantine.
Steps to take after exposure to COVID-19:
Self-quarantine for 14 days.
Call your doctor to decide 1) your level of risk and 2) when/how to get tested.
Get a test—ideally a nasal PCR test if you do not have symptoms. (Here I am in testing mode in our parking garage last night.) After an exposure, you should wait at least 3 days—and ideally 4-5 days—before getting a test. Why? Because even the best test will not turn positive during the viral incubation period.
Know that you cannot test out of quarantine. I will repeat this unpleasant truth: a negative test within the 14 days of quarantine does NOT release you early. Why? After an exposure to COVID-19, it can take up to 14 days to become infected.
Watch for common early symptoms of COVID-19 (e.g. fatigue, body aches, cough, sore throat, fever, headache, loss of taste/smell.)
If you feel sick, stay in contact with your doctor to help you monitor symptoms and determine if you need to seek in-person or emergency medical care.
The bottom line? When in doubt, quarantine and get a test. If the test is negative and your contact was medium to high risk, you still need to ride out the full 14 days of quarantine.
And now for some FAQs:
Q: What happens if one person in the family is exposed to COVID but feels fine? Does the whole family need to quarantine?
A: Technically, no. Only the exposed person needs to quarantine. However, there is so much variability in the extent and timing of exposures—plus unique medical vulnerabilities for each of us—that this is where I suggest you call your doctor for specific advice.
For example, the whole family should quarantine if a family member had a high risk exposure AND wasn’t aware of the contact’s positive test result or symptoms (and therefore was not taking special precautions within the house).
Q: What if the exposed family member ends up getting sick?
A: Then the sick person needs to isolate for 10 days, starting at day 1 of symptoms. And the rest of the family needs to quarantine for 14 days, starting on the last day of contact with the sick family member.
Q: What if we can’t feasibly isolate my family member with COVID (e.g. what if I am caring for him/her while sick or don’t have space to fully isolate or even socially distance)? How long is my quarantine then?
A: First, be sure that all family members wear masks indoors, avoid close contact, and wash hands. Your 14-day quarantine would start at the last day of your loved one’s 10-day isolation period.
Q: What in the heck is the difference between isolation and quarantine?
A: Isolation means the sick person is fully and strictly separated from other people. Quarantine means separating and restricting the movement of people exposed to COVID (or other contagious diseases) to see if they become sick.
Q: Should I travel over Thanksgiving?
A: Ideally, no. Just today, the CDC revised their guidelines, urging people not to travel this holiday season. I wholeheartedly agree. As sad as it is to abandon many of our Thanksgiving traditions, by staying put we are paying it forward for more celebrations to come.
Q: Are we EVER going to get through this?
A: Yes. We will. And the more we invest in your safety, health and wellbeing NOW, the better off we’ll be in the spring of 2021 (jean shorts notwithstanding).
And last: HERE is the LIVE COVID Q & A with me and Dr. Ackerly from earlier this week where we answered many of your burning questions. We’ll do it again soon.
I will see you next week. Until then, be well.