The CDC and Southern Nevada Health District are telling us to stay home, even if we’re sick. Unless we have a high fever, worsening cough, and difficulty breathing — the symptoms of COVID-19 — the best course of action is to call our doctor; if an exam is necessary, make it virtual. That means a lot of people will be staying home sick.
How do you care for someone who’s in this situation in your home? David Weismiller, a family physician and professor in the UNLV School of Medicine’s department of family and community medicine, has some advice: protect yourself, keep others away, and don’t stop washing your hands.
ARE YOU GETTING A LOT OF QUESTIONS RIGHT NOW?
Yeah, both personally and professionally. I’ve been practicing for 30 years, and so I have a network of friends who are reaching out for advice as well. Not all media and social media are necessarily reliable, and there’s a tremendous amount of angst. My personal friends are reaching out to find reliable information.
ON THAT NOTE… FIRST OF ALL, WHO SHOULD GO TO DOCTOR?
Everyone is at risk — all ages. The vast majority of people who get the new coronavirus will have mild to moderate symptoms, like fever and cough. Individuals with those systems and no underlying, preexisting health conditions should not be going to the doctor. You should assume COVID-19 is giving you the upper respiratory infection and remain at home. If your business or family situation requires you to continue with life, you may want to be tested to know if it’s COVID-19 or one of the other upper resp tract infections, such as pneumonia. But otherwise, stay at home.
SO LET’S SAY THAT PERSON WITH THOSE COVID-19 SYMPTOMS IS MY HUSBAND, AND NOW HE’S SICK IN MY HOUSE. WHAT DO I DO?
If you would happen to have a face mask, it should go on him, not you. If you’re not sick, you don’t need a face mask. In the hospital, we’re using them because … we need to protect the healthcare providers too. You could also give him a bandana or something (to wear) when you’re in the room taking care of him, to avoid droplets.
No one else should be coming into the home unless it’s absolutely essential. If you have other people living there who aren’t healthy, this may be the time for them to stay elsewhere. Your 92-year-old grandmother … can she go stay with someone else right now?
I ASSUME ALL THE SANITIZING HAS TO GO ON STEROIDS (PARDON THE EXPRESSION).
Yes, you should be washing your hands with soap and water or alcohol-based sanitizers and sanitizing surfaces with diluted bleach or a mild detergent. The CDC has recommendations for those things. When the individual has coughing or sneezing, make sure there’s something beside them to sneeze into — tissue or toilet paper, although I guess toilet paper is in short supply now.
These are the basics of how we prevent spread of any virus that’s spread through droplets. But the big issues is primary prevention: how do I keep me from getting the virus?
HOW DO YOU? PARTICULARLY IF YOU HAVE SOMEONE IN THE HOUSE WHO’S STILL GOING OUT, FOR WORK OR GROCERY SHOPPING, SAY.
That’s an excellent question. No. 1 is, many countries have put strict moratoriums on going out. No city has done that (in the U.S.), though New York is close to that. But I think the important discussion is, how do we limit people going out?
But if someone does go out, once that individual comes home, I think it’s reasonable to sanitize everything they touch. Doorknobs are a big item. Light switches. I’ve been wiping down my desk. Surfaces, the mouse they use, their phone, everything.
WHEN MY STEPKIDS USED TO GET A FEVER, THE PEDIATRICIAN WOULD TELL US TO ALTERNATE IBUPROFEN AND ACETOMENAPHIN AND PUT COLD COMPRESSES ON THEIR FOREHEAD. IS THAT THE RIGHT APPROACH TO COVID-19?
Here’s the thing with fever: If it is making you feel poorly, bring it down. But remember, these are natural defense mechanisms. We know that raising the temperature on microbes kills them. You may be better off to keep your fever. If you feel like crap, then definitely, take 1,000 milligrams of Tylenol up to three times per day, or 400 milligrams of ibuprofen up to four times a day — for a healthy adult (some people, such as those with heart issues, shouldn’t be taking ibuprofen at all; that’s something you should ask your doctor).
ARE THERE ANY OTHER REMEDIES — LIKE A COLD BATH, FOR INSTANCE?
No cold baths. We used to recommend that in the old days. We don’t do that anymore.
One thing I’m not hearing a lot about is, for most viral infections, we don’t have any treatment. For Hepatitis B and C, HIV, herpes, shingles, and a handful of others, we do have anti-virals. But for the vast majority of viruses, we don’t have treatment. It’s all symptomatic. That’s not new; that’s the norm. Now, if your illness develops to the point where you have a bacterial infection or other secondary issues — pneumonia, high fever, malaise, body aches, GI issues — then you need to be seen and you’re probably going to need emergency care, not your doctor’s office.
Watch for the red flags: High fever, shortness of breath, worsening cough. If you feel sick and don’t have one of those things, contact your physician, preferably from home. You’re probably contagious for 24-48 hours before you have symptoms and 1-2 weeks after. So, keep in mind those you come into contact with early on.
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