WELCOME!
You are visiting Dr. Cate’s COVID RESOURCE PAGE covering 4 Topics, Scroll Down to Find YOUR TOPIC (bullets are not links)
- GETTING TESTED
- TREATING SYMPTOMS Covid or Not, Symptoms Need Treatment
- COVID TEST POSITIVE? Please contact Dr. Cate
- RETURNING TO WORK
- VACCINES: WHO GETS AND WHERE
GETTING TESTED
FREE COVID TESTING LOCATIONS
CVS does not charge if you state that you have no insurance. If you do, they need to see the card and will charge the insurance but you do not pay a penny.
To find a location, google: “Where to get tested for covid-19 near me.”
When scheduling at CVS if Dr Cate or an HRBP has recommended you test, check the box that asks “I have been prioritized for testing by a doctor”
Florida Health Department also offers free testing. Click here to access their location finder: http://www.floridahealth.gov/all-county-locations.html
Quest self serve: http://patient.questdiagnostics.com/no-cost-covid-test?utm_source=questdiagnostics.com&utm_medium=email&utm_campaign=no-cost-covid&utm_content=questdirect
COVID TESTING TYPES
REGULAR TEST: Called PCR. This is most commonly what you get for free. Can be done with a swab deep in the nose OR the front of the nose OR saliva/back of the throat. All are more accurate than the antibody test. 2-5 days for results.
RAPID TEST: Called “antigen” test. Available free at a few CVS locations BUT it is accurate ONLY if you have symptoms. Do not get rapid testing when you were exposed but don’t yet have symptoms EXCEPT in Miami/Dade and Volusia when we need documentation prior to return after a team member tests positive.
RAPID BLOOD TEST: Called “antibody” test. Done with a finger stick or blood draw. Do not get this test unless requested to do so by a doctor.
Email DrCate@ABC (etc.) if you have questions on testing.
COST of TESTING
ABC insurance covers all types with no copay
The rapid test costs 100-150 depending on location
The PCR test costs 20-40 depending on location
Free testing is available at CVS and Department of Health Locations (see above under FREE TESTING)
TREATING SYMPTOMS
(For Supplements click HERE)
Cough
What can I take for covid cough OVER THE COUNTER?
For CONGESTION: Mucinex, active ingredient GUAiFENESIN. It is an ‘expectorant’ (the technical term for a compound that loosens thick mucus). It is especially important if you have a history of sinus infections, asthma or your cough is productive.
For COUGH SUPPRESSION: DEXTROMETHORPHAN, the DM in the Mucinex DM shown above. It does not make you drowsy. About 5 percent of people who take it feel it keeps them awake at night.
INTERACTIONS:
Prescription drugs may interact with certain ingredients. Therefore, you should do a quick google search on the drug you take and the active ingredient in the cough medication to avoid interactions. For example, if you take atenolol search for “atenolol dextromethorphan interactions.”
BAD COUGH
For serious cough and shortness of breath, by Prescription
Dr. Cate or your doctor can prescribe you inhalable steroids delivered by a nebulizer device can prevent hospitalization and should be prescribed for anyone with coronavirus or symptoms of coronavirus who has asthma, sleep apnea, obesity, diabetes, fatty liver or other serious underlying condition.
Nebulizer devices are available at Walgreens by prescription and over the counter at Publix and most other pharmacies.
AVOID PHENYLEPHRINE. This drug is related to sudafed and useful mostly for sinus congestion. It is added to many cough medicines so be sure to read active ingredients to avoid it. It will not help suppress a dry cough and it can make you feel like you drank way way way too much coffee.
HUMIDITY Can Help
Taking a steamy shower can help losen mucous out of your airways, as can a humidifier.
If You Have ASTHMA or HAVE EVER USED an INHALER
Be sure to have inhalers on hand. Remember, if you are coughing too much, your inhaler may not work. In that case you need a $40 Nebulizer and special medication. Your doctor or Dr. Cate can help get the medication.
OTHER SYMPTOMS
Nausea:
Benadryl (generic is diphenhydramine) can help with nausea, as can Dramamine.
Diarrhea:
Benadryl (generic is diphenhydramine) can help slow down your digestive system, as can Dramamine, and they both help you get back to sleep quickly.
To help sleep:
Sleep is important, and OTC antihistamines like Benadryl and Dramamine (generic is diphenhydramine) can help to make you relaxed and drowsy.
Tylenol PM
Nyquil help you sleep
Fever or Pain
Tylenol (acetaminophen) or ibuprofen or naproxen.
COVID TEST POSITIVE? Please contact Dr. Cate
COVID often has two phases. It may start out mild, but some folks get a second phase that is much more serious and may cause hospitalization or worse. This is why it is very important to contact Dr. Cate as SOON AS YOU ARE POSITIVE to discuss whether you are at high risk and if so she will help you to be prepared. Most doctors do not have time to discuss this second more serious phase with you until you are already sick, at which point it is often difficult or impossible to get you the medications and equipment that can be life-saving. This is why ABC offers the opportunity to speak with Dr. Cate early in the course of the illness as she is our private physician. Ask your HRBP how to get in touch or email Dr. Cate at DRCATE@ABCfws dot com or text 707 339 one nine seven six.
Everything you tell her is confidential just as it is with your regular doctor.
RETURNING TO WORK
You do not need a negative test to return to work. You just need to answer “yes” to the following three questions:
- Has it been at least 10 days since your symptoms first started?
- Has it been 24 hours since you last had a fever (without using fever-reducing medicines)?
- Have your symptoms, such as cough or headache, improved?
TRANSMISSION TIMING
I think I’ve been exposed, how long until I start feeling sick?
If you were exposed to someone with coronavirus, expect to develop symptoms somewhere between 2 and 14 days, but if you haven’t developed any symptoms before 12 days there’s less than 3% chance you will.
Cites a study that investigated incubation time and concluded that the median for developing symptoms is 5.1 days, and 97.5% of those developing symptoms do so within 11.5 days.
Someone I live with has been diagnosed with COVID. What is the chance I will get it?
About 15 %. However that was before we had a protocol on isolation, so it’s probably much less if you adhere to the isolation guide outlined in the article below.
https://www.medrxiv.org/content/10.1101/2020.03.03.20028423v3
The household secondary attack rate was 15%, and children were as likely to be infected as adults.
If you never never had symptoms
You may discontinue home isolation when at least 14 days have passed since the date of their first positive COVID-19 diagnostic test and have had no subsequent illness
Retesting not necessary
“We know that if you are 10 days since the onset of your symptoms and at least 3 days [asymptomatic], and that may actually go down in the future, but 3 days asymptomatic, you are no longer contagious,” Giroir said.
He added that some individuals are being tested three or six times, which is not necessary, at least for the average individual who has been isolating at home.
Repeat testing will still be recommended for the critically ill and individuals with immunosuppression or immune deficiencies, said Giroir. People who fall into a grey area will need to consult with their clinicians, he said.
The repeat tests are “clogging up the system,” Giroir said. He also added that they can be a “disservice” to some people, as they might stay out of work longer if they continue to test positive when they are no longer infectious.
REINFECTION
Can you be reinfected after you recover?
Probably not. They said “maybe” at first but now realize that was probably wrong.
HOUSEHOLD CLEANING
Key areas of the kitchen are fridge door handles, oven knows, microwave handle and buttons, and the faucet, in addition to flat surfaces.
In addition to household disinfectants, consider appropriately diluted bleach or rubbing Keep in mind, cleaners can be damaging so before you use, make sure the cleaner of choice will not damage the surface.
CDC guidance on household cleaning
https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/disinfecting-your-home.html
SOCIAL DISTANCING AT HOME
Follow the same rules that you would at work, specifically keep a minimum of 6 feet distance and no touching. This includes pets.
Good article on how to live with someone who has the virus, discusses bedroom, bathroom and kitchen safety with diagrams.
FACE MASK ALTERNATIVE
For folks with difficulty breathing through a regular mask this high tech mask pushes the air into the mask making breathing easier. $50-60
https://www.amazon.com/dp/B086Z2B2F8/ref=cm_sw_r_sms_awdb_imm_t1_q2TSFbRR14SQ5
RESEARCH
MILD DISEASE
“Together, these findings suggest a more efficient transmission of SARS-CoV-2 than SARS-CoV through active pharyngeal viral shedding at a time when symptoms are still mild and typical of upper respiratory tract infection. Later in the disease, COVID-19 then resembles SARS in terms of replication in the lower respiratory tract. Of note, the two patients who showed some symptoms of lung affection showed a prolonged viral load in sputum.”
ADDITIONAL SYMPTOMS
“After analyzing data from 1.5 million users between March 24 and 29, the team found that 59% of people who had received a COVID-19 diagnosis experienced a loss of smell and taste.” “Among those who had tested negative for COVID-19, only 18% reported a loss of smell and taste.”
“The study authors also note that six of the patients with COVID-19 had no respiratory symptoms but did experience digestive symptoms.” [204 patients]
SEVERE DISEASE
Virological assessment of hospitalized cases of coronavirus disease 2019
https://www.medrxiv.org/content/10.1101/2020.03.05.20030502v1.full.pdf
IMMUNITY
“ using antibodies from four mice that had been immunized against SARS-CoV reduced infection with a model virus that contained SARS-CoV-2’s spike proteins.
The infection was reduced by 90% in cell cultures.”
Six Types of Symptom Sets
https://www.medscape.com/viewarticle/934132?src=mkm_covid_update_200720_mscpedit_&uac=139841DZ&impID=2468783&faf=1
TRANSMISSIBILITY
Surgical masks cut transmission about 50%
N99 by about 70%
Mutation increased transmissibility 10X
https://www.medicalnewstoday.com/articles/why-does-sars-cov-2-spread-so-easily
- SARS-CoV-2, however, has a specific structure that allows it to bind “at least 10 times more tightly than the corresponding spike protein of [SARS-CoV] to their common host cell receptor.”
- Partly, this is due to the fact that the spike protein contains a site that recognizes and becomes activated by an enzyme called furin.
- Furin is a host-cell enzyme in various human organs, such as the liver, the lungs, and the small intestines. The fact that this enzyme resides in all of these human tissues means that the virus can potentially attack several organs at once.
- SARS-CoV and coronaviruses in the same family do not have the same furin activation site, some studies have shown.
- The “furin-like cleavage site” recently discovered in SARS-CoV-2 spike proteins may explain the viral life cycle and pathogenicity of the virus, say researchers.
VACCINES: WHO GETS and WHERE
Stay up to date here: https://floridahealthcovid19.gov/COVID-19-Vaccines-in-Florida/
So far only
- People over age 65
- Extremely vulnerable, as deemed by their treating provider usually in nursing homes or hospitals
- Healthcare workers
If you qualify, get in line here: https://myvaccine.fl.gov/
