Follow the Facts (Even if it Feels Like an Uphill Battle)
MEDICAL AND MENTAL HEALTH UPDATE
This week has been hard. Perhaps like you, I’m relying on my full arsenal of coping tools to manage the stress of the news. Last night I trotted up and down the steps at the National Cathedral for 10 minutes. Blaring my music, inhaling the fresh air, and sweating at the feet of this mighty fortress felt great. I then went home and drank a bunch of bourbon.
So today I’m good (though I suppose it depends on who you ask). However, this weekend I’m definitely planning to BLOB OUT, sleep late, hunker down with family, and declare zero expectations for being productive. The decadence of anticipated idleness is a balm!
This week I’m also seeing a BUMPER CROP of COVID cases.
As people increasingly move about, socialize indoors, and expand their bubbles, COVID case rates inevitably jump. We are seeing this trend nationally.
I get it!! We are exhausted from being exhausted. We want to enjoy socializing while the weather is nice. We’d like some payoff for being so diligent since March. We’re human!
But we have to remember that the coronavirus is ubiquitous, invisible, and opportunistic. It loves to see us congregate and let down our guard. It also preys on people who can’t avoid crowded or indoor spaces because of their work or living situation.
I, too, sometimes forget what a luxury it is to be able to distance from people, protect myself with adequate PPE, and practice telemedicine when needed at work.
This is not to say we shouldn’t move around, socialize, and live a little. We just need to do it safely.
Because I’m fielding lots of calls about symptoms, isolation, quarantine, contact tracing, and testing, today I’ll provide a fresh CHEAT SHEET on COVID protocols.
IF YOU HAVE SYMPTOMS AND DON’T KNOW (YET) IF YOU HAVE COVID:
You need to call your doctor, strongly consider getting tested, assume you have COVID until proven otherwise and isolate until you’ve made a plan with your doctor.
COVID symptoms run the gamut. The classic symptoms are sore throat, runny nose, headache, muscle aches, cough, loss of taste/smell, and/or diarrhea. You do not need to have all of these symptoms—or any!—to have COVID. Many people with COVID don’t feel terribly sick (e.g. they have a slight head cold or allergies), but even very mild symptoms are still a reason to alert your doctor, isolate, and make a plan to protect yourself and others.
IF YOU ARE SICK AND TEST NEGATIVE FOR COVID:
Could your head congestion, runny nose, and headache be from allergies? Sure. If you have fall allergies, you probably should be treating them a) to prevent sinusitis, b) to avoid confounding your symptoms with COVID, and c) to avoid the death stare from strangers when you sneeze in CVS.
Couldn’t this just be the cold you get every fall? Possibly. We are starting to see some “cold” viruses (aka non-COVID respiratory viruses like Rhinovirus) in circulation.
However, you also need to keep an open mind that your symptoms might not be allergies or a non-coronavirus virus. Ask your doctor to help you sort it out.
In short, we can’t fully trust a single negative COVID test in people with symptoms unless we have a good alternative explanation (not including from Dr. Google) for those symptoms. I’m testing patients a second time when their first test is negative and I strongly suspect COVID.
IF YOU ARE SICK AND TEST POSITIVE FOR COVID-19:
You have COVID.
You need to isolate yourself from other people for 10 days from the date of the first symptom or positive test AND have 3 days without fever and no fever-reducing medication AND have improving respiratory symptoms.
And you need to stay in close contact with your doctor.
Could it be a false positive? If you have symptoms, a positive test is very unlikely to be a false positive.
IF YOU ARE NOT SICK AND TEST POSITIVE FOR COVID-19:
You need to isolate yourself from other people for 10 days from the date of the positive test.
But could it be a false positive? It’s possible—if you don’t have symptoms AND you don’t have a known contact AND you haven’t been in any higher-risk scenarios. But please don’t assume it’s a false positive—and be sure to talk to your doctor. You might want to consider getting a PCR test which is more accurate than an antigen test depending on the clinical situation.
IF YOU FEEL WELL BUT HAVE BEEN EXPOSED TO COVID-19:
You need to quarantine yourself, call your doctor for specific instructions, and consider getting tested for COVID.
A 14-day quarantine is required for any close contact which includes household contacts.
Recall that close contact is defined as:
Being within 6 feet of an infected individual for 15 minutes or more
OR
Coming into contact with an infected person’s body fluids (e.g. an infected individual coughs or sneezes on you, kisses you, shares a water bottle with you, etc).
And remember this about the timing of virus transmission:
Individuals can spread the virus 2-3 days before they begin feeling sick, and are actually most contagious in the days before their first symptoms emerge and when symptoms begin.
After being exposed to COVID-19, it can take 3-14 (yes, three to fourteen) days for symptoms to develop (hence the reason for a 14 day quarantine which you CANNOT test out of).
The short story? This is an uphill battle, but we’re getting stronger every day living through it and keeping up with the facts.
I hope you can CHILLAX this weekend a bit like I plan to do. I’ll be back next week with more updates on isolation, quarantine, and testing.
In the meantime, mark your calendars for Monday September 28 at 8 pm! Join me and Dr. Clay Ackerly for our next Facebook Live COVID Q & A. Bring your burning COVID questions. We’ll have fun.