Cases of Covid-19 are on the rise across the country and the world. So what do you do if you or a family member is diagnosed with Covid-19? For obvious reasons, nothing you read here should take the place of guidance your doctors would give you if this situation were to occur, but, we hope, it will help you lay out a plan for how to approach this difficult scenario.
First, don't panic. By no means is a diagnosis of Covid-19 a death sentence, although for certain at-risk groups the rate of hospitalization and mortality do, of course, go up. Johns Hopkins mortality analyses show that the overall mortality rate here in the United States is a little over 2.6 percent, but that's across all age groups. For people at higher risk, such as those who are over 65, obese, immunocompromised, and-or suffer from certain cardiovascular conditions or diabetes, that number does go up. There are some data recently published in the Journal of Hospital Medicine that show mortality rates appear to be declining, which likely reflects several things, not least of which is that doctors and hospitals are learning how to treat this pandemic more efficiently in terms of what medications and treatments might be effective.
But we're not out of the woods yet, which is why we should all be motivated to take this seriously.
If you receive a Covid-19 diagnosis, what comes next? The majority of patients will be able to ride out the illness at home, but there are still certain steps everyone should take. First, notify any close contacts you may have had preceding your diagnosis so that they can take the appropriate steps themselves. The definition of close contacts as provided by the Centers for Disease Control has changed recently and is now, "someone who was within six feet of an infected person for a cumulative total of 15 minutes or more over a 24-hour period starting from two days before illness onset."
In many jurisdictions, the departments of health may notify close contacts via contact tracing, but you should still do your part. In addition, you need to let your primary care doctor and any relevant specialists you see know about your diagnosis so they can help coordinate your care, and you should notify your employer as soon as possible as well. This is especially important if you are in an at-risk population.
Second, you should absolutely isolate at home. Isolation is different from quarantine and involves staying in a part of your house away from anyone who is not also positive with the virus, using a separate bathroom, eating food by yourself, and avoiding all contact. This should continue until at least 10 days have passed since any symptoms first appeared (or your first positive Covid-19 test result) and until you have passed at least 24 hours without fever and any symptoms you do have are generally improving. Some symptoms can linger for weeks or months. Ask a friend or family member to grocery shop and leave groceries and household items on your porch for you to get, and stay safe. Disinfect any surfaces you touch regularly, and always wear a mask anytime circumstances force you to interact with someone, even for brief periods of time.
Third, while you are isolating, monitor your symptoms closely to see if there's a point at which you would be better served by going to a hospital. This is a crucial step because patients with symptoms that can be monitored at home should avoid overwhelming our hospitals, but sometimes symptoms progress and need more care. You can use a thermometer and pulse oximeter if you have these, and if your fever stays high despite treatment with Tylenol or your oxygen saturation starts to drop from your normal baseline with minimal or even no exertion, then you should call your doctor to discuss going to a hospital. If you don't have these monitoring tools, then let your symptoms be your guide. If you have new chest pain, shortness of breath, a worsening severe cough, or even signs of cyanosis such as blue lips or fingers indicating oxygen levels are low, go to the emergency room for evaluation.
Fourth, discuss with your doctor if and when it makes sense to repeat testing. In some individual cases (say, if you're an essential worker), it may make sense to return to work earlier than the 10-day period provided you have two negative tests in a row, but this should be reviewed with your physician before you make a decision.
There are more nuances to what to do in this situation, of course. You should stay well-hydrated, and be sure to eat properly depending on how you feel and what you can tolerate. While there are few treatments for Covid-19 other than supportive care, it may make sense depending on your specific medical history to take Tylenol or Motrin for any aches, if your doctor says you can take them. Most important, remember not to panic and to review these recommendations with your doctor and take it one day at a time.
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Joshua Potter, D.O., is a physician with Stony Brook Southampton Hospital's Meeting House Lane Medical Practice who specializes in family and neuromusculoskeletal medicine. He oversees the practice's Shelter Island office. Opinions expressed in this column are his personal and professional views and not necessarily those of his employer.