Sunday, March 15, 2020

Coronavirus: Home and Self-care for #COVID19; Vital Sign Monitoring; Your First Aid Kit

Due to the lack of capacity that many of our health care systems will be experiencing as the #COVID19 #pandemic continues to scale up, we may be on our own and in the position of having to provide ourselves, and our loved ones, with home and self-care. Below are resources that can help us manage the symptoms we may experience. 

Disclaimer: This is not medical advice. Always try to speak to, or see a health care provider as needed. People with more serious, or acute symptoms, and/or complex health care conditions, should seek emergency medical attention as needed. 

Symptoms: 

The Top 5 COVID-19 Symptoms: 
  1. High fever/temperature: Adults – 37°C +/- 0.6°C; 98.6°F; +/-1°F; Fever: 37.6°C (99.7°F)
  2. Cough – Dry cough, or could have a “productive” cough, with phlegm.
  3. Respiratory symptoms: Shortness of breath; difficulty breathing, decreased airways function. 
  4. Pneumonia in lungs
  5. Fatigue/malaise (feel very tired and unwell)
Tracking COVID-19 Symptoms

COVID-19 Symptom Tracker: http://www.bccdc.ca/resource-gallery/Documents/Guidelines%20and%20Forms/Guidelines%20and%20Manuals/Epid/CD%20Manual/Chapter%201%20-%20CDC/ADM_Form_Case.pdf


Vital Signs: 

Measurements of the body's most basic functions. 

  1. Body temperature
  2. Pulse rate
  3. Respiration rate (rate of breathing and oxygen in the body)
  4. Blood pressure
  5. Blood sugar: Not considered one of the vitals, per se, but lows and highs of blood sugar can affect how we're feeling.  
Equipment required to monitor vital signs at home

  1. Thermometer: Track your temperature to determine if you have a fever, and how high it gets. 
  2. Blood pressure & heart rate machine: Track BP and heart rate.
  3. Measure respiration and oxygen: Most of us don't have anything to do this at home, but this is connected to symptoms of pneumonia as we experience a more difficult time breathing. 
  4. Blood sugar monitor: We often don't properly eat while sick, so this can impact our b.s. levels, leaving us feeling poorly. If you have diabetes, or are concerned about your b.s. levels, you can use this to monitor your levels.   
Monitor and Track Vital Signs

We want to do this as this helps us determine if our functioning is getting worse, or better over time. This can help us determine if we need to seek urgent, or emergency medical attention. 

Vital Signs Tracker Charts: Find one that suits your needs here. 

Download a tracker here: https://www.bestmedicalforms.com/vital-signs-flow-sheet.html

Vital Signs Chart For All Ages


Vital Signs Apps: There may be some apps available to monitor and track vitals. Ensure you are aware of what the privacy and security issues are prior to use.  

Dr. John Campbell: Clinical features of Infection: Taking and monitoring vital signs

COVID-19 Coronavirus: Home Care for Patients with Mild Symptoms (WHO Guidance) by Dr. Alton. Dr. Bones and Nurse Amy. 

Emergency and Survival Medicine: 
Emergency First Aid Education, Information, and Resources: Articles; Books; Podcast; Newsletter

First Aid Kit for COVID-19/Other Health Issues

It’s a good idea to be proactive and here are a number of items you can have in your COVID-19 first aid kit that could come in handy if you get sick.

Thermometer: You want to monitor temperature to see if you/your loved ones have developed a fever. Disinfect this when used, especially if you are sharing this amongst family members. Probably best to have one for each person. 

Over-the-co
unter (OTC) remedies:
Managing fever, cold/flu symptoms, such as cold and sinus medications. 

Cough syrup and logenzes: This might help to decrease inflammation in your respiratory system if you develop a cough that disrupts your sleep, or other activities, or just to soothe your throat. If your cough becomes severe, or if you have shortness of breath/labored breathing, get assessed by a medical professional ASAP. COVID-19 can progress to pneumonia, which is a serious disease.

Liquids: Ensure you drink a lot of water, herbal teas, and consider things that help replace lost electrolytes, depending on your symptoms. Suggestions: drink green, or other herbal teas, drink lemon, ginger, honey and other things that increase antioxidants, and soothe the body. 

Palatable foods: When most of us are sick we don’t have much appetite, but we do need to ensure we/our loved get some food into us. Soups; bland and less spicy foods; Vitamin-C rich foods; increased antioxidant-rich and probiotic foods, and other products keep the “machine” going, and improve your immune system to help you bounce back quicker. You also want to ensure you keep your blood sugar levels reasonably managed. 

Heating pad/heat bags: Chills and muscle aches can occur with COVID-19, and other health issues. 

Menthol rubs and liquids:
 These often help our respiratory system and muscles when we’re feeling congestion and aches. The liquid form can be used in a humidifier. 

Purify the air of your home environment: You may want to get an air purifier, humidifiers or certain plants that improve air quality. 

Cleanse your respiratory system: Using a humidifier, a hot shower, steam, or even boiling water and using things like Vicks menthol, or cleansing and anti-septic essential oils in the water can help cleanse. 

Latex gloves: When/if you have to do self-care, such as cleansing infected areas (wounds, eye infections) you may want to use gloves, and/or disinfectant wipes. Re-infection is a risk. 

Sauna/Steam:
If you are lucky enough to have a sauna in your home (community saunas, steam rooms, or hot tubs aren’t recommended right now), consider increasing your sauna use. This leads to many different types of benefits, including cleansing your respiratory system. See here for more information about the health benefits of sauna: https://mentalhealthbc.blogspot.com/2020/01/therapeutic-benefits-sauna-and-steam.html.

Special consideration for those with respiratory ailments, such as asthma: Receive medical advice as to whether you should use a corticosteroid puffer/medication. The research on patients with COVID-49 seems to indicate this may not be medically advisable.

Baking soda & turmeric: Rash can be a symptom some may experience. Simple compresses of baking soda and water, or turmeric and water can decrease discomfort and pain. Seeking medical attention is advised if you're experiencing serious pain. 

Essential oils:
 Certain oils and scents have anti-septic, cleansing qualities. These include birch, eucalyptus, tea tree, citrus, oregano, peppermint. These should be used with caution, as there really isn’t enough research to say they are evidence-based, but many cultures have used herbal remedies for centuries so they are worth considering. 

Disinfectants: As noted above, you want to make sure you disinfect surfaces with bleach. Bleach wipes are handing to have in your kit. 

Masks: Surgical, or N95 masks for those who have COVID-19/other cold/flu symptoms can help decrease respiratory spread. Those who are providing care to loved ones with the virus should consider wearing a mask while providing personal care. 

Traditional medicine and treatments: Many cultures have their own ways of approaching disease and symptom management. Considering consulting with a traditional health care person, such as a Traditional Chinese Medicine (TCM), or Ayurvedic health practitioner if this is something you have found helpful, or is part of your culture. 

Preventative Suggestions for Improving Your Immune Function:

Note: None of these things are going to prevent you from contracting COVID-19. There is also no specific research that reports these will "cure" you from this virus. However, improving immune system functioning is helpful for preventative, and restorative measures if we become sick. 
  • Sleep: Ensure you receive as much sleep as possible. For adults the recommendation is between 7-9 hours. 
  • Vitamin D: Daily, or even weekly use increases immunity.  
  • Vitamin C: Increasing vitamin C in our diet, through fruits and drinks can be helpful for our immune system functioning. 
  • Zinc: Lozenges help with coughs, and zinc supplments may help with improving immune system function. 
  • Teas: Green tea, or others (I like 'Immune' from Tetley), can boost our anti-oxidant intake and soothe symptoms, such as sore throat. I like to add some honey, which may have additional anti-bacterial qualities. 
  • Selenium: See article here for benefits, risks/toxicity, and dietary sources. 

Note #2: Before starting the use of additional supplements, consider speaking to a medical professional in case there are any contra-indications for you, based on existing health conditions, or drug interactions. 

Nathan Crane: Enhance Your Immune System to Fight Viruses and Disease with Prebiotics and Probiotic: Provides a simple overview of the immune system, pre- and probiotics and foods that help improve immune system function. 


Find out more about Prevention and How to Manage if you have COVID-19
                 

Friday, March 13, 2020

Coronavirus: #COVID19 Symptoms, Assessment and Management of Illness


Recognizing & Managing Symptoms of #COVID19

COVID-19 is the disease that is experienced by those who have been infected by Novel Coronavirus (SARS-CoV-2). As an infectious, or communicable disease, the virus can be transmitted from people who carry the virus to others. 

The current research tells us people who have been exposed, but don’t have symptoms (“asymptomatic), can apparently transmit it to others. 

To limit the transmission to others, if you have any of the symptoms outlined below, or have been in reasonably close contact with anyone who has it, or is suspected to have #COVID19 it is probably a good idea to self-isolate, and/or stay away from others as much as possible for at least 14 days. 

The research isn’t clear on the exact period of time people can transmit or shed the virus. The most likely time we can transmit the virus appears to be in the early phase of developing symptoms. 

Location-based and surface transmission risks does not appear to be well understood at this time. However, surface contamination does happen, which is why improving our cleaning and disinfecting surfaces and objects with bleach-based products at home is very important. 

Top symptoms associated with #COVID19:

  1. High fever/temperature: Adults – 37°C +/- 0.6°C; 98.6°F; +/-1°F; Fever: 37.6°C (99.7°F)
  2. Cough – Dry cough, or could have a “productive” cough, with phlegm.
  3. Respiratory symptoms: Shortness of breath; difficulty breathing, decreased airways function. 
  4. Pneumonia in lungs
  5. Runny nose
  6. Fatigue (worse than normal for some)
  7. Malaise (feel “unwell”, lack energy)
  8. Dizziness 
  9. Headache
  10. Muscle aches 
  11. Sore throat
  12. Gastro-intestinal – nausea, vomit, diarrhea, abdominal distress, pain. 
  13. Pink eye - Conjunctivitis
  14. Rash on your body
Tracking COVID-19 Symptoms

COVID-19 Symptom Tracker: http://www.bccdc.ca/resource-gallery/Documents/Guidelines%20and%20Forms/Guidelines%20and%20Manuals/Epid/CD%20Manual/Chapter%201%20-%20CDC/ADM_Form_Case.pdf

Emergency Symptoms that Require Immediate Medical Attention

  1. Respiratory symptoms: Acute difficulty breathing/shortness of breath/laboured breathing
  2. Persistent pain or pressure in your chest
  3. New confusion or inability to rouse
  4. Bluish lips, or face
Severe Symptoms

  • Requires emergency and intensive medical intervention 
  • High Breath Rate: Over 30 breaths/min
  • Oxygen Saturation: < 93%; PF ratio > 300
  • Pneumonia à >50% of lung fields
  • Long-term impacts of COVID-19 cannot be known at this time. 

Critical Care 

  • Highest mortality rate (50:50 in first large scale research from China)
  • Respiratory system failure: patient cannot breathe on their own, requires mechanical support. 
  • Acute Respiratory Distress Syndrome (ARDS) à Can be fatal.
  • Septic shock
  • Multiple Organ dysfunction and failure: lungs; heart; kidneys; liver
  • Death: 50:50 ratio in largest research cohort in the early part of outbreak in China. 
  • Case Fatality Rate (CFR): # of deaths/ # of cases X 100 = CFR. Current CFR is between 2%-4%. (Some regions are seeing higher rates for reasons that aren't clear). 
Those with the highest risks of developing more severe or critical cases are: People with histories of respiratory illnesses; people with cardio-vascular issues; people with immune-suppression and complex health conditions; individuals with diabetes; those of older ages; and smokers.

Assessment

Call a Local Nurse Line: In BC call 8-1-1 to speak with a nurse who can do over-the-phone assessments with you.  They can assess our symptoms and recommend whether we should seek medical attention, and what urgency there is for that. 8-1-1 has translation services in 130 languages.

Call your local public health unit to find out where you should go to be assessed and tested for COVID-19.

Contact a local Centre for Disease Control (CDC) to find out where you should go to be assessed for COVID-19. In BC call the BCCDC @ phone: 604-707-2400; 

Email: admininfo@bccdc.ca

In BC if you have been tested for COVID-19 you can call 1-833-707- 2792 to speak with a nurse to get your test results. This line is available 7 days/week from 8:30 AM - 4:30 PM.

Seek medical attention at your family doctor, or local walk-in clinic: If symptoms worsen, you have complex health conditions, especially respiratory illnesses and immune-suppression. Phone the office ahead of your visit to advise of cold/flu symptoms and office protocols. 

Online Medical Care: You may want to consider signing up for, or downloading an app to receive assessment from doctors online. Ensure you understand the privacy and security issues with this. 

Check out Clinic Wait Times: There are websites that allow you to determine approximate wait times at local clinics. Medimap is one of those in BC. 

Urgent and Primary Care Centre: If your community has one of these you may be seen quicker. It is a step down from hospital, and suitable for less severe symptoms. 

BC Urgent and Primary Care Centres can be found here:

Go to your local hospital if symptoms become acute: if your breathing has become very laboured and difficult, having increased cardiac symptoms, or other symptoms worsen, call 911, or get to hospital ASAP.

Online Information and Resources

HealthLink: Tons of information about different health concerns and conditions. https://www.healthlinkbc.ca/


Coronavirus Disease (COVID-19) Center for Disease Control: https://www.cdc.gov/coronavirus/2019-ncov/about/symptoms.html

Diagnostic Tests for Assessing COVID-19

  • Physical exam by treating physician: Listen to your lungs and breath; may examine your lymphs in your neck.
  • Nasopharangeal and/or throat swab: Sample will be tested for the presence of flu viruses (influenza A, B & SRV) and COVID-19 (if you meet the local testing and exposure criteria). 
  • Vitals: Heart rate; blood pressure; temperature. 
  • Bloodwork: C-Reactive Protein: measure of inflammation in your body (can be due to infection); others doctor feels are necessary. May get blood sugars tested if diabetic, or borderline. 
  • Urine sample may be requested to query bacterial infection
  • X-ray of lungs
  • CT scan of lungs (computer tomography) for more severe cases of respiratory distress.

WHO Report about Mild to Moderate Cases of COVID-19

Early research from China suggests that 81% of individuals who contract COVID-19 will have mild or moderate cases. While they are symptomatic they are capable of spreading the virus to others, including through community transmission. 

On March 10, 2020, the WHO held a media briefing in which the following was reported:
  • People with mild to moderate cases of COVID-19 can develop pneumonia.
  • Those who do develop pneumonia can require more intensive health care interventions.
Proactive Personal Management of COVID-19
At this stage, if you, family members, work colleagues, or others have these symptoms, you should consider yourself to possibly have an infectious disease. From there, move into an immediate plan to manage, and contain the virus from spreading. 
Self-isolate/self-quarantine
Wear a mask when being around others. 

Wash your hands A LOT, for 20 seconds. Warm, soapy water. Sing ‘Happy Birthday’ while washing, do this with your kids too. 

Disinfect surfaces and objects in your home, or other areas you have spent time, such as work. 
Become more conscious about not touching your face. Teach your kids to be more aware of this too. 

Find ways to boost your immune system. 

Improve eating, diet and nutrition: Increasing antioxidant foods increasing the bodies way of fighting off infections, and improving our immune system. 

Change your habits while in public spaces: Increase physical distance from others. Wear gloves at the gym. Consider moving your workouts, yoga and other physical exercise to home settings.

Social distancing: Consider restricting your work and community participation and travel for a time, including decrease attendance in group settings, crowds, or other events. This is especially important for those in the higher-risk categories.  Read this for more information about this behavioural method of stopping the spread. 
Hold off on travel, especially international travel: You may have to self-isolate for at least 14 days upon returning to BC, or Canada if you do. 

What to Do If You are Refused Testing or Health Care for COVID-19
Unfortunately, across BC, Canada, and other jurisdictions, people have been refused testing for COVID-19, which is called 'test suppression.' One of the outcomes of this is that there is that BC, and most other jurisdictions do not have an accurate count of all of the people with COVID-19, because the majority of people who now have it can't get tested.

Overwhelmed health care systems are also refusing health care (which includes testing) due to capacity issues. 

Email, or contact your MLA to ask where you, or your family members can get tested for COVID-19 in your community. 

Change the COVID-19 Testing Criteria: When emailing your MLA, please also tell them you want the BC to change the exposure criteria so that more testing for COVID-19 can occur in your community. 

Report local test refusals and refusals of health care to your MLA: Advise them if you, anyone in your family, or in your community has been refused testing for COVID-19, or health care. 

Find out your MLA’s contact information here:

Find MLA’s by name: https://www.leg.bc.ca/learn-about-us/members

Search for your MLA by Postal Code: https://www.leg.bc.ca/Pages/BCLASS-Member-Search-PostalCode.aspx

Email, or contact your MP (Member of Parliament) and Senators: Tell them you want them to advocate for the exposure criteria to be changed and updated in BC and that more testing for COVID-19 can occur in Canada.

Report local test refusals to MP’s and senators: Advise them if you, anyone in your family, or in your community has been refused testing, or health care for COVID-19. 

Find out your MP’s contact information here: https://www.ourcommons.ca/Members/en

Find Your Local Senators here: https://sencanada.ca/en/senators-list/

Thursday, March 12, 2020

Coronavirus: Canada and Provincial #COVID19 Pandemic Responses Increase Risk of Community Transmission; How to Contact Your Elected Officials

                                      

The words and actions of government officials speak for themselves. We're on our own, Canada!

Contact Minister Patty Hajdu here:

Website: https://phajdu.liberal.ca/contact-us-form/

Email:
Call: Ottawa office: 1-613-996-4792 Constituency office: 1-807-766-2090 

[Ed: BE NICE/POLITE to her staff! Imagine what it would be like to work for her right now.]

Excerpts:

Between 30 per cent and 70 per cent of Canadians could become infected with the new coronavirus that causes COVID-19, federal Health Minister Patty Hajdu said Wednesday, but that number will depend on the scope and scale of the response to combat transmission.

The COVID-19 outbreak is a “national emergency and crisis," Ms. Hajdu told the House of Commons health committee, but public health officials say they won’t prohibit mass gatherings until the virus spreads more widely.

“There are a range of estimates, but I would say that it is safe to assume that it could be between 30 per cent of the population that acquire COVID-19 and 70 per cent of the population,” she said.

While most will recover, she said Canadians must work together to protect seniors, people with underlying conditions and other vulnerable groups.

“What we are saying is that each case, it’s a case-by-case basis. It will depend on the kinds of risks in your community. It will depend on the number of cases in your community,” Ms. Hajdu told reporters Wednesday.

Ontario Health Minister Christine Elliott said the province had no immediate plans to bring in tougher measures, such as banning large gatherings, closing schools or putting students returning from travel in isolation – at least until cases that cannot be linked to international travel or visitors emerge. 

“We’re not at that stage yet,” Ms. Elliott said. “… We’re watching this very, very closely.”

[Ed: Community transmission is now well established in Canada. A "Health Minister" who doesn't know that is a SCARY person!].

Bonnie Henry, B.C.'s Provincial Health Officer, said officials there are not ruling out anything, such as the cancellation of Easter church services or a delayed return to school after March break. It will all depend on what happens in the province in the next few weeks, she said.

“It’s not easy to say across the board everything should be cancelled because we want to continue with life as well,” Dr. Henry said.

Deena Hinshaw, Alberta’s Chief Medical Officer of Health, on Wednesday recommended all those who travel outside of Canada to limit their attendance at large public gatherings upon their return, and to self-monitor for symptoms. 

She said older people and people with underlying health conditions should think about the risks associated with mass gatherings, stopping short of advising against them.

The number of COVID-19 cases has increased dramatically in Canada in recent days, reaching more than 100 as of Wednesday. Those include the first cases on Vancouver Island and in New Brunswick.

The news that a man who attended the massive PDAC conference tested positive for the virus sent alarm bells across the country. Prime Minister Justin Trudeau, Ontario Premier Doug Ford and several political and business leaders were at the conference. 

Health officials say attendees should monitor themselves for symptoms for the next two weeks.

Weeks, C. (2020). Between 30 and 70 per cent of Canadians could become infected with coronavirus, Patty Hajdu says. The Globe and Mail. Retrieved from: https://www.theglobeandmail.com/canada/article-between-30-and-70-per-cent-of-canadians-could-be-infected-with/.
More Stories

Coronavirus guide: The latest news on COVID-19 and the toll it’s taking around the world

I think I may have the new coronavirus. What should I do?

What Can You Do About This Situation
 
Email, or contact your MP (Member of Parliament): Tell them you're unhappy about how the COVID-19 pandemic response has been handled by your province, and Canada and that you want to see improvements IMMEDIATELY to stop the transmission of COVID-19 in your region and Canada. 

Report local test refusals to MP’s and senators: Advise them if you, anyone in your family, or in your community has been refused testing for COVID-19. BC’s elected officials have been completely silent while community transmission is spreading, including in their own ridings.

Find out your MP’s contact information here: https://www.ourcommons.ca/Members/en

Email, or contact your MLA too: Tell them you're unhappy about how the COVID-19 pandemic response has been handled by your province, and Canada.  

Report local test refusals to MLA’s: Advise them if you, anyone in your family, or in your community has been refused testing for COVID-19. Many elected officials have been completely silent while community transmission is spreading, including in their own ridings.

Find Your Local Senators here: https://sencanada.ca/en/senators-list/ 

In BC Find Your MLA’s contact information here:


WorkSafeBC Part 2: Legislation and Policy Manuals

                                                                   Credit: WorkSafeBC Author: Young, T. (2023). WorkSafeBC Part 2: Legislat...