You have convinced yourself that it's the Corona.
Is it time to panic and run to hospital nearby?
No. Please read on.
On Tuesday (3/24/20) our Department of Medicine chair was circulating "Interim Guidance for Management for SARS-CoV2 Infection (COVID-19) in Adults, Adapted from the University of Washington Treatment Guidelines " for the use of University of Oklahoma physicians.
It is "Interim Guidance" (a provisional manual) for clinicians regarding how to manage COVID19. As COVID19 treatment options are rapidly evolving, the Interim Guideline is subjected to amendments. Some local factors (like test availability and capacity of facility) will influence adherence to the Guideline.
In the Guideline, diagnosis is made by
(a) Positive nasopharyngeal swab for SARS-CoV2, or
(b) if results are pending, a presumptive case would be defined as respiratory tract infection [fever, sore throat, shortness of breath, cough] with oxygen requirements and with chest X- ray or chest ultrasound findings suggestive of COVID-19
Then they'll move on to evaluate oxygen requirement (followed by rapid pregnancy test for women with childhood potential).
(1) no oxygen requirement, no risk factors -> treat symptomatically
(2) no oxygen requirement, any risk factor ->(virologic test)->Hydroxychloroquine plus azithromycin
(3) oxygen requirement ->(chest imaging) ->Hydroxychloroquine plus azithromycin (Evaluate eligibility for cytokine blockade)
(3) oxygen requirement ->(chest imaging) ->Hydroxychloroquine plus azithromycin (Evaluate eligibility for cytokine blockade)
Hydroxychloroquine is anti-malaria med, being repurposed for the Coronavirus treatment based on early reports from China and France. It's experimental, but choices are limited at this moment.
Azithromycin is antibiotics for bacterial pneumonia. Viral pneumonia is often complicated by secondary bacterial infection and bacterial pneumonia.
The Guideline further describes risk factors, baseline evaluation, suggestions and other treatment considerations.
Such as
Avoid systemic steroids
Use of NSAID (e.g., ibuprofen, aspirin) is controversial. Consider Acetaminophen (Tylenol) for fever management
(Apparently, some of inflammation pathways may be being used to resist the virus, so that some anti-inflammatories may be counterproductive. Researchers will figure out the details later.)
(Apparently, some of inflammation pathways may be being used to resist the virus, so that some anti-inflammatories may be counterproductive. Researchers will figure out the details later.)
In short, priority is placed on patients with oxygen requirement (failing lung) with viral test-positive and/or visual pathology with imaging.
If your suspected case is mild, stay put and don't panic. That is what you can read from the guideline. After all, a majority (80% or so, or probably more considering asymptomatic infection may be widespread) do not get to the point of oxygen requirement.
If mild case patients flood clinics and demand resources (manpower, equipment, facility), that will take away the resources from severe-case patients with real need, eventually leading to more deaths.
Besides, hospitals are already a high-risk place for the contagious disease. Do you really want to go there, with only mild case of yours, risking getting and giving the virus?
They are even discussing that X-ray is preferred to CT scan, because CT scanner is much harder to clean/disinfect between uses. Practical concerns.
"Take it seriously" does not mean to run at hospital at the first sign of possible infection, but to make informed and sensible decision.
They are even discussing that X-ray is preferred to CT scan, because CT scanner is much harder to clean/disinfect between uses. Practical concerns.
"Take it seriously" does not mean to run at hospital at the first sign of possible infection, but to make informed and sensible decision.
Hope this helps.
PS1
If your case is turning severe, don't hesitate. Contact your doctor, go to hospital and get help. SARS (Severe Acute Respiratory Syndrome), caused by the virus, is no joke.
PS2
You can find this kind of professional manuals, or its "consumer version" online. It is a good source for your research.
An example is one from Johns Hopkins.
https://www.hopkinsguides.com/hopkins/view/Johns_Hopkins_ABX_Guide/540747/all/Coronavirus_COVID_19__SARS_CoV_2_
PS2
You can find this kind of professional manuals, or its "consumer version" online. It is a good source for your research.
An example is one from Johns Hopkins.
https://www.hopkinsguides.com/hopkins/view/Johns_Hopkins_ABX_Guide/540747/all/Coronavirus_COVID_19__SARS_CoV_2_
These "interim guidance" are not quite well-established yet and will be amended often. It really is like building airplane while flying.
