Kissi Rosabel Blackwell, MD
COVID-19 Update 3/25/20
A few updates on COVID-19.
So far, in all of Wichita County, there have been 182 people tested, 47 negative tests, and 8 positive cases confirmed. You can keep up to date on these numbers at this website.
We have tested two patients at our office. One was negative and the other is pending.
Unfortunately, we are probably only on the cusp of this outbreak right now, so we need to continue to be vigilant.
There have been quite a few people contacting us with fever and cough, so I'd like to make a few recommendations on what to do if you get sick and guidelines regarding testing.
First of all, we do still have regular cold viruses and flu circulating, so just because you have symptoms does NOT mean it is COVID-19. On the other hand, we cannot test everyone, so our patients with mild cases will be handled with isolation and frequent contact with me to determine the need for testing or escalation of care.
If you were to get COVID-19, you should expect on and off fever (100.4 or greater) for several days, and sometimes weeks. You may find one day you feel better and the next day worse again. This is common and expected. The most common symptoms are dry cough, fever, body aches, and mild shortness of breath. Some also get sore throat at the beginning. Runny or congested nose is not common, but still possible. The symptoms are fairly non-specific so identifying the virus by symptoms alone is difficult. A few things you should do if you find yourself sick:
1. Rest. Remember, your body is fighting a war inside and you need to allow your body to focus on that fight.
2. Isolate yourself. Stay in one room and one bathroom in your house, if possible. Disinfect surfaces and your hands frequently.
3. Treat the symptoms. See below. Patients can contact me if symptoms become severe.
Isolation can only be lifted once you have been without fever for 72 hours off all anti-fever medications, have had improvement in respiratory symptoms, and AT LEAST 7 days have passed since the beginning of your symptoms. See the CDC recommendations here. Any household contact should stay home for 14 days and monitor themselves for fever or symptoms.
For the cough and possible congestion, you can use a combination of Sudafed, Mucinex DM, and Zyrtec over-the-counter, or your doctor may prescribe cough medication. Please check with you doctor before you start any regimen, since Sudafed can increase your blood pressure.
If you start to become more short of breath, your doctor may prescribe an inhaler to use every 4-6 hours as needed. You should avoid the use of a nebulizer machine, as this can aerosolize the virus (leave it hanging in the air). You can, however use a spacer, and your doctor can prescribe you one if you need it.
For fever and body aches, please try to use only Tylenol (acetaminophen). There is some controversy about whether it is ok to use ibuprofen and other NSAIDs. Currently, there is no clear proof that taking NSAIDs is dangerous. However, we recommend you use Tylenol (acetaminophen) for aches, pains, and fever, unless your doctor has directed you otherwise or you cannot take acetaminophen for some reason.
Remember, fever is not necessarily a bad thing. Your body creates the fever to make a hostile environment for the virus, and we don't want to interfere with this too much. If your temperature is mildly high (99-100.4), try to leave it alone and allow your immune system work. If your temperature is 100.5 or greater, and you feel badly, then take Tylenol (acetaminophen).
For possible prevention, consider starting an over-the-counter low dose zinc and vitamin C supplement. Emergen-C packets or Airborne are a good options. We don't have any clear proof these work for prevention, but the theories of why they might work are sound. You should also continue taking these if you become ill.
If at anytime the shortness of breath becomes severe or you start feeling confused and/or lethargic, please head to ER or call 911.
With regards to testing, our office is only testing current patients. We only have a limited supply of tests and are not doing widespread testing for those with only mild symptoms. Keep in mind that most people will recover on their own and the isolation is to keep others from getting sick that might be more at risk for severe illness.
Most testing locations are only testing those that have potential high risk (travel or contact with a sick individual), fever, and shortness of breath. Considerations may be made for those who are healthcare workers and/or have underlying medical conditions, such as diabetes, heart disease, lung disease, cancer, or immunocompromise. Please be aware that if you do not meet criteria, you will not be tested and will be asked to go home and self-isolate.
Unfortunately the ability of the test to completely rule out disease is limited, and a negative test does NOT necessarily mean the person does not have COVID-19. For a nasopharyngeal swab, it appears to only catch 63% of those that have the disease. This is all the more reason why we keep EVERYONE who is even mildly sick at home.
At this point, we must all act as if we had the disease and could spread it.
Staying at home. Limiting visits to grocery stores, gas stations, etc, and cleaning your hands thoroughly after any outing.
Cleaning and disinfecting all surfaces frequently, including countertops, doorknobs, light switches, and devices.
Being careful not to touch your face while you are at work or out. Remember this virus is mainly spread by contact, so wash your hands often.
Sneezing or coughing into your elbow, even if you are not sick
I hope this give you a better picture of how we are handling the situation. As always our patients have access to us by phone, email, text, and video chat, if necessary. We are seeing patients in the office for emergencies only. Please call us first before you visit our office.
Kissi Blackwell, MD