Practical FAQs about COVID

Knowledge is the best antidote to anxiety regarding the unknown. Based on questions from my patients, I composed a FAQs sheet, and a list of reliable resources.  There are many emails and videos out there that can make you more anxious, so try to limit your reading to reliable sources.  Importantly, try not to read about COVID before bedtime.  Please also be aware that there are phishing schemes and other disreputable scams circulating that will try to take advantage of this time of high anxiety.  Be cautious opening emails or responding to phone calls from solicitors.

Here’s some information that I hope will be useful about safety, groceries, testing, and potential treatments and more.

 What are some ways to avoid becoming ill with COVID19?  

Coronaviruses are generally thought to be spread from person to person through respiratory droplets. Cloth facemarks are currently recommended by CDC, and now mandated by Montgomery County to wear in stores, mostly to contain your own respiratory droplets from affecting others.  These should be laundered on a regular basis.  Currently, there is no evidence to support transmission of COVID-19 associated with food. Before preparing or eating food it is important to always wash your hands with soap and water for at least 20 seconds for general food safety. 

It may be possible that a person can get COVID-19 by touching a surface or object, like a packaging container, that has the virus on it and then touching their own mouth, nose, or possibly their eyes, but this is not thought to be the main way the virus spreads.  Here’s a brief video with Dr. Sanjay Gupta about how to handle groceries, which could also be applied for takeout food.  

Based on information about this novel coronavirus thus far, it seems unlikely that COVID-19 can be transmitted through the food itself. Additional investigation is needed. 

If a person is ill or being quarantined, try to keep cleaning supplies in their room, to decrease items coming in and out of there.  Also, for laundry, do not shake it out, just wrap it up and put in the washing machine.

What is the difference between cleaning and disinfecting surfaces?

Cleaning involves wiping a surface clean, which removes dirt and germs, but doesn’t kill them.  Disinfecting requires using chemicals to kill germs on surfaces.  It doesn’t necessarily remove them or clean the surface.  To disinfect, use a product that is at least 70% alcohol (versus hand sanitizer which should have at least 60%), hydrogen peroxide, or 4 teaspoons of bleach per quart of water.  Make sure there is good ventilation when used, and never mix bleach with ammonia or other cleaners. Many simpler wipes will do.  EPA-approved products regarding COVID can be found here: 

High-touch surfaces that should be cleaned and disinfected daily if possible (OK, I admit it, I do not clean every one of these surfaces every day), include  doorknobs, handles on cabinets, light switches (no liquids here, just superficial touch with wipes), countertops, tables, desks, phones, keyboards, toilets, faucets and sinks. Consider wipeable covers for electronics.  For touch screens, use manufacturer guidance.  Consider alcohol based wipes or spray and then dry surfaces thoroughly.  

What should I do about my dry skin?

In general, hand creams that come in tubes or tubs are thicker and more helpful than the ones with pumps. Since we don’t want to cross-contaminate between family members, tubes are preferable now.  Try to apply one directly after washing, while the skin is still moist.  I will credit my son with introducing me to O’Keeffe’s Working Hands.  It is sold at Giant – and I suppose many other stores – and online, and works very well.  Also, the temperature of the water for hand washing does NOT have to be very hot to be effective.  The scrubbing action of soap is much more important, so save your hands by using warm but not very hot water. 

Is every cough these days due to COVID?

Thankfully, no!  Here is the Washington DC area, it is prime time for allergies.  We still see cough from postnasal drip, asthma, sinus infection and bronchitis, unrelated to COVID.  Please call your doctor with symptoms so we can help determine the cause. 

Does every patient with COVID have a fever?

No, in fact only about half do.  And not everyone has a cough either.  Symptoms can vary and can include loss of sense of taste or smell, GI symptoms, fatigue, and chest heaviness.  People can have a low oxygen level before they sense shortness of breath, so confusion can be a symptoms as well.  Once again, if you have new symptoms of concern, please contact your primary care doctor.  It is best to avoid visits to Urgent Care centers or emergency rooms if these are not necessary.  

How can I get tested for COVID19?

Please be aware that despite advertisements to the contrary, there are not any home tests that are FDA-approved.   

Testing is still somewhat limited, although availability is increasing, particularly at vehicle emissions stations, hospital outpatient settings and at some private physicians and urgent care centers.  The Maryland Department of Health and the CDC have very specific criteria for testing.  Groups that should be tested include hospitalized patients, unstable patients whose care would be altered by the test result, and symptomatic people over 65, those with underlying health conditions, residents of nursing homes, longterm care facilities and other congregate living facilities, and first responders including EMS, healthcare workers and law enforcement workers.  Even with these criteria, since tests are in short supply, most people with tolerable symptoms are urged to stay at home and self-quarantine, without necessarily testing.  They should be presumed to have COVID regarding remaining isolated.  However, within the next week or so, these criteria may be liberalized as tests become more available.  Check with your primary care doctor about any symptoms that concern you.

If I think I have COVID infection, when can I return to essential contacts?

Current guidance is mainly regarding healthcare workers.  It is recommended that you stay isolated for 7 days after the onset of symptoms or 3 days after being afebrile without the use of anti-pyretics such as Tylenol, Advil, Aleve, etc., whichever is later. It is unknown how long a person sheds virus in their secretions with coughing or sneezing, but it may be for a few weeks. If you have been in contact with someone who has known or suspected COVID, you should self-isolate for 14 days.  

If I’ve had COVID19, am I immune from getting it again?

We don’t know.  Over the next several months, we hope to learn more about the IgG antibodies COVID patients develop.  These are the long-term antibodies our bodies produce and can recall with a subsequent exposure.  We don’t yet know if these antibodies will be helpful for 2 weeks, 2 months, or 2 years. Currently studies are ongoing at NIH and at additional centers to evaluate antibodies in those with recent corona virus tests as well as those who do not have a diagnosis. As this is a NOVEL coronavirus, we need time to see how this works out.  We also don’t know if this virus will be recurrent with mutations each year, like the flu virus.  It does not seem to be seasonal, as we have been seeing it in the northern and southern hemispheres simultaneously, covering opposite seasons.

Are there treatments for COVID?

We should be encouraged that many brilliant scientists are working on this as we speak.  To date, we do not have any definite treatments.  Although hydroxychloroquine and azithromycin are being used in hospitalized patients, there is only weak anecdotal evidence that they are of any benefit, and great concern that they both can have side effects, especially when used concurrently.  

Remdesivir is an antiviral agent that is being tested in randomized trials.  It will take time to acquire helpful data to guide general usage.  Tamiflu, which is used in typical influenza, is not helpful for COVID.  

Tocilizumab, an interleukin-6 antagonist that is currently used in rheumatoid arthritis (brand name Actemra), is being tested as well.  It inhibits inflammation.  The severe lung disease that COVID patients have is due mostly to the body’s inflammatory reaction to the virus, rather than to the virus itself.  

Convalescent serum, using antibodies from those who survived COVID and infusing them into currently ill patients, is another treatment that is being explored.

Above all, please take good care of yourself by getting your sleep, getting some physical activity, and trying to eat as healthfully as possible, with limited trips to the grocery store.  Non-COVID illnesses still need to be taken care of during this stressful time.  Please reach your primary doctor for any concerns.

Let us know here at Lady Docs Corner Cafe if there’s more we can answer by messaging us in the ‘Contact Us’ window.  

Stay well! 

REFERENCES: 

Re: how to disinfect  https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/cleaning-disinfection.html

Re: disinfectants active against COVID  https://www.epa.gov/pesticide-registration/list-n-disinfectants-use-against-sars-cov-2 

Re: FDA approved tests:https://www.fda.gov/medical-devices/emergency-situations-medical-devices/emergency-use-authorizations#covid19ivd