COVID Light – What now?

Many people are asymptomatic or only experience light symptoms when infected by COVID-19. George Louw investigates how to deal with all things COVID-light

At the time of writing this article, we find ourselves in a season of runaway COVID-19 infections. In real terms, the numbers are frightening and threaten to overwhelm our healthcare infrastructures. Healthcare workers are stretched to the absolute limits of endurance and the media is filled with reports of human drama and tragedy.

There are anger and resistance against the inadequacies of the working environments in many clinics and hospitals, and the shortages of manpower and equipment, particularly personal protective equipment. Media reporting concentrates on the frontlines of this war against the virus and the trauma suffered by its casualties.

But this is just part of the reality. Those who become critically sick and the deceased makeup only very small fractions of the total infections.

The media flourishes on tales of overfull hospitals and PPE shortages, but what is an ordinary run of the mill household to do if a member tests positive without falling very ill? Although not as dramatic as the frontline war, the chances of this happening to you are far greater than that of becoming critically ill.

Our household experienced this some weeks ago when my wife had herself tested after experiencing mild flu-like body aches. Much to our surprise, the results came back positive. This left us in a quandary. What to do now? She is infected but not really sick – no fever, dry cough, shortness of breath, or sore throat. Just a loss of taste and smell, some pain, physical and mental tiredness.

I would like to share our experience with you and follow it with some general guidelines on how to deal with the homecare of a “COVID-light” infection.

The first thing we did was to contact our general practitioner (GP) for advice. The GP recommended that we buy a pulse oximeter to monitor her blood oxygen saturation and, if it remained above 90, we could continue home care. She also recommended that the whole household goes on immune-booster medications, such as vitamin C twice daily, Zinc and Vitamin D supplements, for the duration of the infection and a month thereafter.

We are fortunate enough to have two bathrooms, so, we used separate bathrooms and slept in separate bedrooms. We isolated my wife’s cutlery and crockery. We wore masks in one another’s presence, washed hands, and applied sanitiser at every opportunity. We repeatedly wiped all surfaces with a diluted bleach solution (a 1:10 dilution).

All food packages were sanitised by wiping them down with a bleach soaked cloth before storing them. After fourteen days, my wife was much better, apart from the tiredness that returned periodically for another week or so. Neither I nor our live-in domestic worker became infected.

This is the reality for many. Few people become seriously ill and we must not allow ourselves to become consumed with fear because of the media coverage. Although it is important to remain careful as we won’t know if we are part of that small percentage until it is too late. Simply keep following the regulations.

Let’s look at some COVID-19 homecare tips for caregivers (and patients) to optimally manage this scourge that is plaguing our planet.

COVID-19 caregiver toolkit

Apart from the usual caregiver routines followed with the person that you are caring for, there are five important COVID-19 focus areas that you must be aware of:

  • Caregiver personal protection measures;
  • Medication;
  • Breathing support;
  • Viral load reduction; and
  • Monitoring.

Caregiver personal protection

Have at least three cloth masks (or scarves to use as masks). Wear them always when in the vicinity of your patient and as far as possible when indoors. Make a point to go outdoors for mask-less fresh air as frequently as possible. This, of course, doesn’t include public spaces – like stores – where masks are obligated. Wash used masks daily in soap and water.

Wash your hands as frequently as you can and especially after contact with your patient. Use the regulation alcohol-based hand sanitisers regularly and apply bleach solution with a cloth to all frequently touched surfaces at least twice a day. Include all handles and doorknobs in your cleaning routine.

It is not always possible to social distance from your patient if bed turning and assistance with toilet needs are part of your duties. Medical-grade protective equipment is not readily available in home-care situations. Although not ideal, there are some home-made solutions that can assist.

Invest in a pair of rubber (dishwashing) gloves that you can frequently sanitise. Get two full-length aprons that you can wash and alternate daily. Also, get a Perspex visor to wear over your mask. This has the added advantage of protecting your eyes from virus-containing droplets.

Lastly, it is recommended that caregivers, who are caring for a patient with COVID-19, also isolate in the home where they are working – even when free of symptoms – to reduce the further spread of the virus.

Medication

Symptomatic medication is for a doctor to prescribe but ensure that the patient and the caregivers are supplied with immune-boosting agents. The medical experts advise Vitamin C twice daily along with Zinc and Vitamin D. The dosages for the latter two, as found in good multivitamin supplements, will suffice.

Breathing support

Breathing out against resistance causes a push back into the lungs that help to “pop open” the airways and assist with oxygen uptake. Two simple ways to breathe out against resistance are blowing up a balloon as far as you can with three breaths or blowing through a straw into water. If a balloon or a straw is not available, breathing out against pursed lips (like blowing a trumpet) can also be effective.

Viral load reduction

The virus lives in and spreads from the nasopharynx where the back of the nose meets up with the throat. Make up a mixture of half a teaspoon of salt and half a teaspoon of bi-carbonated soda in 500 ml of water. Gargle the mixture and drip the solution into each nostril. It will help ease build-up of the virus in the nasopharynx and (hopefully) reduce the spread of the virus to other persons.

Monitoring

The most critical indicator that medical care is needed is difficulty in breathing. When breathing is compromised, the levels of oxygen in the blood drops. A pulse oximeter is a device that clips onto the forefinger to measure the level of oxygen in the blood and the pulse rate. It can be purchased from a chemist.

Normal oxygen saturation levels are 98 to 100 percent. If your patient’s oxygen saturation remains at 95 percent or higher, continue monitoring every morning and evening. If it falls to between 90 and 94 percent, inform your doctor and do the breathing support exercises regularly. If it falls below 90 percent get medical help immediately.

If you do not have a pulse oximeter the pulse rate is a rough guide to oxygen saturation. If the pulse rate suddenly increases by more than 10 beats per minute and remains rapid after an hour or if the pulse rate remains faster than 100 beats per minute you must inform your doctor.

Please remember that low oxygen saturation can occur without signs of breathing distress, so don’t assume everything is fine just because there are no obvious breathing difficulties. When in doubt, consult with a doctor.

In conclusion, keep hopeful. The Bubonic Plague came and went, Smallpox came and went, and Spanish Flu came and went. Through all these pandemics, love prevailed and caring drove the processes of healing. Once the pandemic passed, people again shook hands, hugged one another, and kissed their loved ones. So, take heart, this too shall pass.


Ida’s Corner is a regular column by George Louw, who qualified as a medical doctor, but, due to a progressing spastic paralysis, chose a career in health administration. The column is named after Ida Hlongwa, who worked as caregiver for Ari Seirlis for 20 years. Her charm, smile, commitment, quality care, and sacrifice set the bar incredibly high for the caregiving fraternity. email: yorslo@icloud.com

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