COVID-19 Treatment & Recovery at Home

hi everyone my name is allison warren i'm the multimedia public relations specialist here at sarasota memorial hospital in light of the ongoing covid19 pandemic we've received a number of questions about how prop how people can properly take care of themselves if they're sick with coven 19 and riding out the virus at home to help get us those answers today i'm joined by dr jack rodman the chief medical officer of first physicians group and dr joseph seaman a critical care pulmonologist thank you both for being with us thank you thank you allison so dr rodman we've previously discussed at length that many people who have covid19 have few symptoms of any and may never even know they've had the virus while others are hospitalized with much more serious symptoms what can you tell us about the disease and the number of people who are asymptomatic or have mild or moderate disease and will recover at home well i think that's the good news our epidemiologists tell us that um 80 percent of those folks that get coveted will be asymptomatic or have very mild or moderate disease and will recover at home without the need for hospitalization that is good news and dr rodman's symptoms vary widely person-to-person so what can people expect day-to-day in the course of their illness if they get covet-19 yeah so the you know the incubation period after this um exposure to this virus can be anywhere from two days to 14 days um you know the virus can't live alone without a host so it uses um humans and other animals our cells to to serve um the role of of of reproducing and and duplicating itself that that process then causes damage to our cells our epithelium what lines our upper respiratory tract are our lungs our gi tract so um you know ultimately um the the the virus can cause a multitude of symptoms based on the extent of that damage to our cells so it can be as simple and and minimal as a mild fever the most common side effects are obviously fever dry cough tiredness or fatigue and shortness of breath all right now dr seaman can you expand on the type of symptoms and when it's safe for a patient to stay home versus seek hospital care yeah that that's the the real important question is when does the illness get to a point where it's severe enough that you need to seek help as a pulmonary doc who takes care of a lot of lung patients what i try to tell my patients is to focus on their symptoms so that they can give an assessment of where they're at what kind of symptoms they're having because that's going to help direct that person to seek the care they need so for me when patients tell me they're a little short of breath they're a little calm they have some aching they have a sore throat those are all relatively mild symptoms that are uh known to be associated not only with this virus but all all typical viruses and anything that's considered mild and moderate we generally tolerate and we tell folks that they can stay at home what i've been trying to educate my patients is is to do a if they feel bad to do a critical assessment of not just their symptoms but what i call their their vital signs so if they have the capacity take their blood pressure see what their blood pressure is doing they have the ability to check their pulse what is their pulse is their pulse really high is it really low many of my patients that have lung disease have what's called a pulse oximeter or an oxygen tester that tells them how high their oxygen level is in their blood you know for most normal people without lung problems their oxygen levels should be between 95 and 100 patients with chronic lung disease or other medical conditions may have a lower oxygen level at baseline but anyone who has a low oxygen level let's say below 88 percent that person needs to contact their medical provider and have a more formal assessment so those are a few of the objective things that i look for when i'm talking to my patients over the phone to try to assess how they're doing and where i need to triage that person too so what symptoms are they experiencing the severity of the symptoms and then if they have some objective way of giving numbers their blood pressure their pulse their oxygen level because that gives me more data and more information to help give them the feedback that they need do they need to stay at home and take tylenol and rest and fluids or do they need to go to the emergency room and have a more formal evaluation such as labs x-rays do they need to be admitted and i think it's important to point out dr seaman that if you are experiencing severe symptoms definitely make sure you are seeking the hospital care don't wait until they get even worse right absolutely absolutely and and that's where i think the symptom severity as well as the objective measures help give you the confidence of how to proceed so if you're having chest pain you should not stay at home and try to tough it out if your blood pressure is severely low or severely high or you have a critically low oxygen level you shouldn't stay at home that's what the emergency room is for that's what the hospital's for we're here to support those patients and take care of those issues dr rodman for those patients who are able to tough it out at home who don't have those extremely severe symptoms are there any at-home remedies to help them manage their symptoms yeah absolutely i mean i think ultimately the goal is to help alleviate symptoms and then to prevent worsening illness while the body heals some of the simple things are are rest um it's important to just rest as your body is convalescing i would say there's one caveat to that and that's the fact that we really don't want to have secondary pneumonia so your this virus may make your body want to lay in bed um but i think it's important that you get your rest but it's also important that you sit up stand up exercise your lungs and expand them in order to prevent the potential for a secondary bacterial infection or pneumonia i think the second thing is drinking fluids and eating healthy you know you lose a lot more water in your system when you are sick and dehydration can certainly make symptoms worse and can lead to other problems so we want to really work on on that and healthy eating and then i think finally as you do work towards the leaving symptoms there are some simple over-the-counter remedies certainly acetaminophen or tylenol are is really the most useful medicine for decreasing uh headaches muscle aches and and fever that are associated with this and and and most other viruses ibuprofen um is um a second option initially we were worried about some increased risk with ibuprofen and covid i think the key is is if you do have any heart or kidney disease to really check with your provider before using a medicine like ibuprofen as well and then there are the the standard over-the-counter cough and cold medicines things that we've used throughout the years for the typical cold whether it be cough medicines or decongestants some of the saline nasal sprays but there are home remedies as much as just using a a warm shower or humidifier to help with some of these symptoms at home dr seaman are there any at-home treatments that you recommend to help those who are struggling with the disease stay out of the hospital like breathing exercises or any other exercises they can do so they don't get those secondary pneumonias that dr rodman talk about yeah unfortunately there's no clear readily available treatment for cova 19. what i'm telling my patients is if they have coven 19 and they have mild symptoms and their vital signs are normal staying at home is probably the best place for you and just like dr rodman pointed out tylenol rest fluids are really important to help give your body the energy it's meaning to fight off this illness i cannot understate the importance of moving um you know we often are when we're sick we just want to kind of lay in bed and rest but as dr rodman pointed out we have to move these folks because there's a lot of concerns about getting sicker if you're laying around and not taking deep breaths you're not coughing you're not moving because then you're at risk for a whole host of secondary problems like dr robin pointed out pneumonia blood clots and so forth so what i try to tell folks is every hour on the hour you need to get up and walk through your house for no good reason other than just to move uh you need to when you're walking take deep breaths and purposely call so you're clearing the flood from your lungs to open your lungs up and help clear the mucus there's unfortunately no readily available remedies there's no concoctions that can be delivered that's going to make this go away faster other than alleviate the symptoms so if you're having excessive coughing you can try an over-the-counter cough remedy to see if that helps improve that if you're having a sore throat you can try a lozenge to help alleviate any of the symptoms you're having but the importance of the the patient is also to make sure that their nutritional statuses is maintained and a lot of times you may not feel like eating or drinking during this illness but you have to maintain some level of caloric intake to give your body the ingredients it needs to fight off this virus and then lastly and i want to make sure that everybody continues to attend to their other medical problems if they have diabetes or heart failure or copd you oftentimes will have a medication regimen that you need to take for that disease process and you need to continue those medicines you may need to reach out to your your medical doc or your medical provider to see if you need to adjust any of your doses of insulin or any of your pills but you make sure that you continue to take care of your other medical problems dr rodman if someone is experiencing symptoms of 19 or has tested positive for covid19 who should they be turning to for medical advice do they come to the hospital immediately how should they handle that yeah i think as long as the symptoms are mild and as as dr seaman has said um you know they're they're actually sort of logging and tracking their symptoms and can kind of manage then i i think i think uh um you know the uh waiting out a typical normal course is appropriate i think that with you know heightened um um symptoms um if you're have worsening symptoms you know seven eight nine days into it i think that that's really important that you do reach out to your um your your primary care provider and um touch base with them i think it's important to call them many times your your primary care provider can give a lot of important insight and management tricks care testing options that may be available if we feel like the symptoms are worsening and certainly those red flag symptoms the serious symptoms absolutely uh emerging they must call ems um and and and and get to the emergency room and dr rodman if someone is able to ride out the illness at home how can they prevent getting loved ones around them sick yeah i think i think that's a huge um a huge aspect in management at home and that's the avoidance of affecting others and i think you know we call it home quarantine self-isolation i think first and foremost you have to have a safe place to isolate sometimes that's not so easy ideally we like to have a separate bedroom and a separate bathroom if that doesn't exist it's really important that both the patient and the caregiver are both masked and gloved we want to um wear masks wash hands regularly you know avoid sharing common items um and and um that's vital um in the home management of this cove at 19. great dr seaman how does the at-home treatment and the patients who are able to manage this disease from home differ from the patients who are sick enough to be in the hospital uh so as i mentioned before we continue all of the medicines that the patient may have related to their other medical problems the the unique things that if patients are sick enough to be in the hospital other remedies that we use are good supportive care if they have low oxygen levels we give them oxygen if they have some abnormality within their their glucose or their other medical problems start to spiral out of control we we deliver treatments that may be needed to help control those and then once we start focusing on the coba 19 treatment there are a few treatments that in the recent literature that's coming out that have shown some promise those include an oral steroid called decadron or dexamethasone there's some literature that shows that that may help shorten the the disease course and may improve outcomes so we've been using that in some patients there's a medicine called rendezvir which you all have probably seen um in the literature that's been used to treat this what's coming out now is that now rem deserver seems to play a role in a certain subset of covet 19 patients specifically those who are on oxygen but not on the ventilator um it seems that once patients make it to the ventilator reserve doesn't seem to work so we're not really giving it at that time uh and there doesn't seem to be all that helpful to people that are not on oxygen so we're not giving it to people that are not on oxygen so um there's a some nuances about the verb deserve and finally what's available to us is something called convalescent plasma and that is a medication it's not really a medication it's a blood product that's derived from patients who have had copenhagen and recovered and it's basically the antibodies from those individuals that they're receiving here at smh we're also part of a clinical trial where antibodies that have been designed by a company to attack cova 19 are being delivered that's a research study and we're proud to be one of the few places in florida to offer that study and one of 45 nationwide to do that but that those antibodies are directed directly towards the the covert 19 virus and it helps treat that so those are the things that we're doing here in the hospital thank you dr seaman now dr rodman you talk about monitoring some of those symptoms from home for those patients who are riding it out at home at what point in the fever um should they be contacting their primary care that they're concerned the fever has gone on too long i mean with coven 19 the fever can be prolonged correct absolutely um you know the average onset of symptoms after exposure is usually around four to six days um and and really it's the after those symptoms start um it's really around seven or eight days into that that symptom complex that if if we're not getting better that's certainly a time for concern if there's continued ongoing fever you know past that we would again want to make sure that we do contact our our primary care provider um and and at least discuss those issues with them um with that information that dr seaman had talked about um but but uh yeah i think the the key is control your fever that is a symptom and high fever can be um you know can cause um other things um severe things such as seizures and whatnot so we want to control that fever with tylenol secondarily ibuprofen great and dr seaman or excuse me dr rodman you also spoke about um proper nutrition and proper fluid intake what can you be more specific as to what people should be eating or any supplements they should be taking or how much they should be drinking yeah i mean i you know bottom line is um you know you want to you want high chloro content tents you want fruits and vegetables you want nutritious foods that have really the vitamins and electrolytes that will help support your body my as far as fluids go certainly water is great excessive amounts of water without some electrolyte balance can sometimes be an issue and so things like um you know uh gatorade whatnot you can dilute some of those types of um sports drinks and they work just fine as well the key typically you know and it depends on many things your your size level of dehydration but you know typically it's safe to one and a half to two liters a day of fluid um through an illness like this with fever um would be um would be adequate and and and you know again we want to look at urine output making sure you're able to go to the bathroom and and do all of that as signs that you're getting enough fluids great and dr seaman both you and dr rodman discussed that it's important to quarantine at home if you do have covet 19 can you talk about how you recommend to your patients they handle maybe distant family members or friends or neighbors who want to help them if they're home quarantining with covid19 how can they ask for help properly from those people without putting them at risk yeah that's that's the hard part here because uh one of the unfortunate things with all of the social and physical distancing and quarantining means that we're no longer social beings and um that has led to lots of issues with isolation [Music] and made it so much more difficult because when anyone's sick we as humans want to to go and help alleviate the burden of disease on our loved ones and unfortunately we shouldn't do that and we can't do that because then that could spread the illness however that doesn't mean you can't help you can still continue to support that person you can continue to help that person it's just you have to change the way you do that so calling and checking on them two three times a day to make sure that they're doing okay they're still toughing it out and their symptoms haven't gotten worse that's one thing so regular communication and regularly checking on them if they don't have the things that i mentioned before to help monitor their disease and their symptoms maybe you can help get them a blood pressure cup maybe you can help get them a little pulse ox checker those are some things that you could do is provide them the tools that they need to self-monitor at home as dr robin pointed out staying hydrated and keeping your protein intake and your nutritional intake up is important so maybe you can go to a publix forum and get some groceries you can take those groceries and drop them off at the front door for them maybe they are so sick that they can't make their own meals maybe you can prepare a few meals and take them and drop them off at their front door so there are things that you can do to continue to support that person you can continue to engage them and continue to to give them the things that they need to take care of themselves at home great thank you dr seaman and dr rodman as floridians we are you being prepared we're used to having hurricane preparedness kits for example so some people are starting to talk about covid preparedness um what would you tell someone they should have in their coven prepare kit yeah well i think you know i think a kobe kid is in in a great idea um i mean first and foremost you want your emergency contacts you want your family friends caregivers you know to remain connected the phone number of your primary care provider and even the emergency room and ems i think it's important to have face masks and gloves for to present for your caregiver and for you if you can't meet the social distancing ability as you're self quarantining so the thermometer that we talked about as far as monitoring your fever if you do have chronic illnesses and and have a pulse oximeter that's an important piece of that covet care kit certainly the household cleaning supplies disinfectant sanitizing types of things that you need to manage around the house while you're um self-quarantining extra sheets and towels and then a notebook you need to write some of this down how are you feeling what are the vitals what are the questions that you want to ask um whether it be a a friend family neighbor or your provider great you've both given us so much great information is there anything else you want to add or anything you want to say to those people who are currently toughing it out at home well this is a this is a tough tough um illness and it's a tough situation more will be um coming down the pike even with the outpatient management and um i think that um more directives will come over time and we hope that um this is just a the start of um how we better learn to manage this over time especially at home dr anything else you want to add no i just uh you know it's amazing to be part of a team um here at smh that's taking care of these patients and you know it's the full spectrum it's the outpatient providers it's the inpatient providers it's the nurses the therapists the physical therapists the nutritionists the the hospitality staff have just been amazing through all of this and it's so rewarding to be part of that care team to be able to do that and it's such a good feeling to know that we're doing what we're trained to do but that same feeling can also be achieved by people at home helping out their neighbors helping out their friends helping out their loved ones to get through this and you know the team doesn't just start with taking care of their neighbors or their friends or their loved ones that sick with this uh wearing a mask and being keen on social distancing and hygiene is also taking care of the community as a whole um so the more we we kind of uh help to take care of our community the less of an issue this is going to be and and how we're all in this together and that sense of accomplishment's going to happen when we drive down all of these numbers and we see less of an issue in our community it's a wonderful point thank you so much dr seaman and thank you again dr rodman it's such helpful information for the community and and for those who are fighting coven 19 at home or or may in the future so thank you again and of course we encourage everyone to get the very latest information from smh.com covid19 there are wonderful resources there as well and we encourage everyone to stay safe stay healthy wear their masks wash their hands stay safely distant from those they love and care about and again stay healthy have a great day

Channel: SMHCS

Views: 1,517,462

Keywords: health, hospital, wellness, disease, prevention, surgery, sarasota, florida

Id: x2ipw0Mt6g8

Length: 24min 16sec (1456 seconds)

Published: Thu Jul 23 2020