By Dr. Susan Eldrich
Every day there are more COVID-19 cases identified in New York State. NYC has especially been affected, most likely due to our population density and tourism. Numbers of cases continue to grow, with peak numbers estimated to be weeks away.
Most patients testing positive have viral symptoms of achiness, headache, cough, fever and congestion and recover at home. Up to 50% of cases also may have diarrhea. Older patients may present with altered mental status and low-grade fevers and need to be carefully monitored. Some patients go on to have more severe disease and need to be hospitalized for symptomatic treatment such as IV fluid hydration, antibiotic therapy and ventilator support. Some patients have been on ventilators for up to or over 21 days, which is placing a strain on intensive care units.
I have participated in a teleconference with numerous hospitals in New York and Connecticut. They discussed the use of hydroxychloroquine for treatment of the virus, as well as azithromycin for co-infection with bacterial infections. Hydroxychloroquine is being distributed to many patients who are symptomatic for the COVID-19 virus, as it has had positive outcomes in some patients.
Many people have left New York City for Connecticut, upper New York State and Long Island, which has placed a considerable strain on the smaller hospitals and supermarkets in these areas. If you can, please stay at home. New York City has greater resources available than smaller towns do. New York City, New Jersey and Connecticut are now under travel warnings, but not quarantine.
The Javits Convention Center is to have just under 3,000 beds, specifically for patients with the virus. The hospital ship, the USS Comfort, will be docked on the West Side, and will manage patients without the virus, taking some of the burden off of NYC hospitals.
If you do have the COVID-19 influenza virus, you will have to self-quarantine for 14 days from symptom onset, as you may continue to shed virus during this time and can spread it to others. Some patients continue to test positive after this period.
Recommendations include hand and face washing immediately after getting home, using Purell, alcohol or other antiseptic agents, not sharing towels or kitchenware with ill contacts, removing yourself from sick contacts (if possible), wearing masks and gloves when necessary and staying home if you are ill. Remember to practice social distancing and limit the number of people you come in contact to 2 others at a time. Families and roommates can stay together, of course.
It is not necessary to use alcohol on your face. If you do, absolutely avoid getting it in the eyes, as it can cause severe inflammation of eyes, like a chemical burn.
Use any hand cream for mild to severe skin dryness after the use of Purell or other antiseptic agents.
If a member of your family has a flu, they should wear a mask. You should wear a mask when caring for them. This guideline should be used by patients that have any of the influenza viruses now, as a public health measure.
Door knobs, keyboards, sinks and light switches in heavily used areas should be cleaned frequently. Try to have a month supply of medication on hand, in case there is a disruption in supply.
Try to have a week’s supply of food available. So far, the supply chain has not been disrupted, however some supermarkets have closed for cleaning after their employees have tested positive for COVID-19.
I recommend that those over 70 or have diabetes, immune or infectious disorders such as cancer, HIV, heart or lung disease stay at home.
If you have a flu-like illness and respiratory symptoms worsen, please call your physician, 311 or 844-NYC-4NYC. You may also call your local ER or urgent care for an appointment for COVID-19 testing. Check the internet for other up to date information regarding management of your symptoms. Other information, such as for food resources in the community, is also available on line.
Although these are stressful times, it is important that you remain level-headed, think about your family, friends, neighbors and stay calm. This will end, even if it takes months. It is important for those of us who are healthy and mobile to look after those who may not be able to leave their homes.
Dr. Elrich is a board-certified neurologist who also manages certain internal medicine disorders. She is credentialed with Mt. Sinai West, St Luke’s and Stonybrook-Southampton Hospital. She also works in telemedicine.
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