You’re COVID-Positive, Now What?

When you develop symptoms, or have been exposed to someone with COVID-19, the first step is to “isolate from contact with others” and get tested. Once you have a positive test result, it can be confusing to know what to do next. Lyracore founder and critical care and pulmonary specialist, Dr. Alexandre Furman, answered some of the most common questions surrounding a positive COVID-19 test result and gave guidance on what to do next.

What should I do if I have tested positive for COVID-19?

First, and most importantly, stay calm! As long as you isolate yourself and contact your medical provider, you’ll be protecting yourself and others. Once you contact your medical provider, they will guide you as to the next steps. At Lyracore, we have telemedical options for visits with COVID-exposed and COVID-positive patients through their smartphones, computers, tablets and other electronic devices and are able to do an initial evaluation virtually. If deemed necessary, lab work, imaging tests and supportive measures or advanced pharmacological interventions (Antivirals, Anti-bodies etc.) will be suggested as well proper short-term clinical follow-up. By and large, the majority of people are able to stay home and recover, with only minimal and relatively simple support measures.

Some basic steps to keep in mind are:

  • Stay home
  • Separate yourself from others
  • Clean your hands often
  • Don’t share things with healthy people
  • Monitor your symptoms
  • Call ahead for medical care
  • Return to work only after recovering

Should I continue taking my medications?

Yes, this is very important. You should continue taking all your medications as you’ve been instructed by your physician, especially if you suffer from asthma, allergies or other immunological or respiratory conditions. You’ll likely stay on the medication or increase your dosage under the guidance of your physician, and, in some cases, they may add something new that could be helpful. It all depends on your symptoms, and your virtual or in-person clinical assessment, as well as as the close clinical follow-up that will help guide your provider on the best course of action.

How many days should I stay home?

The current recommendation – from time of positive result and disappearance of symptoms (cough, body ache, fever) – is to isolate at home for 10 days of isolation. In some cases, when the illness is more severe, 20 days may be recommended.

How do I self-quarantine?

The best way to self-quarantine, if you have family members living in the same home as you, is to choose one room as your quarantine room and try to stay in there as much as possible. If there are multiple bathrooms, use a separate bathroom from the other family members or occupants. In addition to isolating, here are some of the top defenses for not spreading the virus to your family members and other close contacts:

  • Frequent handwashing by all family members and all involved in your care
  • Avoid touching your face, eyes, nose and mouth
  • Wear a mask and gloves as much as possible when awake
  • Don’t share food, plates, utensils, cups, bedding or towels

What if I need more care?

If you are sick and need another family member to care for you, it’s best for one family member to be the sole care provider for a 24-hour period. They should wear an N95 mask (and you should too) and make sure all surfaces are kept clean between the infected individual and others by routinely and frequently disinfecting with approved products. (CDC link to approved disinfectant products)

Someone who is caring for a COVID-positive family member should also wear a protective gown, goggles, mask and gloves, and, once they’ve completed care, they should try to get undressed in the patient’s room. After leaving, they should immediately wash their hands and face or use an alcohol-based hand sanitizer (hands only).

What are the most common symptoms – and what should I look out for that might indicate my illness is becoming more severe?

Common reported symptoms of COVID-19 are:

  • Shortness of breath
  • Progressive breathlessness
  • Fevers
  • Chills
  • Body aches
  • Cough
  • Diarrhea
  • Stomach ache

Other, less common symptoms are:

  • Reddening of the eyes
  • Unexplained rashes
  • Cloudiness of the mind
  • Severe fatigue

Severe symptoms, which are concerning and need immediate attention:

  • Severe chest pain in any part of the chest (front, back, or sides)
  • Very high (>104F) persistent fevers over a course of 24 hrs
  • Blood in sputum
  • Severe, unrelenting headache
  • Decreased oxygen saturation levels
  • Swelling in feet, arms or face
  • Blue discoloration of tongue, nose, finger-tips or toes

What should I do if I have severe symptoms?

These symptoms are concerning and you should not wait to go to the emergency room if you are experiencing them. When you arrive, immediately state that you are COVID-positive and prepare to be isolated. Always keep your N95 mask in place.

If you can’t transport yourself to the hospital, call 911 and let them know you are COVID-postiive and experiencing severe symptoms.

What should I do if I feel my symptoms are worsening, but not severe, and may need to be seen by a physician?

It’s important to keep in scheduled contact with your medical providers so your condition can be managed appropriately. At Lyracore, we continuously maintain contact with and evaluate our patients, so that we can stay on top of their symptoms. If you feel your symptoms are worsening, call a medical provider so you can be further evaluated and screened by phone to help prevent spreading the virus.

What can I take to help myself feel better?

The usual approach to viral illness is the best course of action to relieve COVID-19 symptoms:

  • Rest
  • Eat a healthy diet
  • Fluids to stay hydrated
  • Sleep
  • Take your multivitamin and, if approved by your physician, other supplements like Vitamins D, B1 and C, Zinc and Melatonin may be an option
  • Pepcid can help for GI symptoms and sometimes with fending off viral symptoms

Do not start taking any medication or supplement, even an over-the-counter product, before discussing it with your provider first

How long does it take to recover?

Recovery time varies widely from a few days in very mild cases to weeks to a few months. Some patients develop protracted symptoms and their recovery takes longer, but, on average, most people completely recover in 2-3 weeks.

Patients with allergies, asthma and immunological conditions don’t seem to be having longer recovery times or more severe illness than the general population. They need to be more closely observed, but living with these conditions does not necessarily mean they will experience more severe illness or longer recovery.

What follow-up care should I get once recovered?

There is no one-size-fits-all recommendation, and you will need to follow the instructions of your physician. At Lyracore, we tend to follow up with patients at least once a week for 2-3 weeks to follow the inflammatory state and monitor for most immediate reported complications.

From there, we will continue to be in contact with the patient for about six to eight weeks to complete some formal testing and assessments of overall lung function, as well as imaging to look for any abnormalities and to determine if there is a need for further assessments.

What are some of the long-term effects or symptoms of COVID-19?

The most commonly reported long-term symptoms are:

  • Fatigue
  • Shortness of breath
  • Cough
  • Joint pain
  • Periodic chest pain
  • Anxiety
  • Poor sleep
  • Dry cough

Less commonly, long-term symptoms may include:

  • Difficulty with thinking and concentration or “brain fog”
  • Depression
  • Muscle pain
  • Headache
  • Intermitten fevers
  • Fest-beating or pounding heart (also known as heart palpitations)

Severe and more serious complications from COVID-19 do occur. These can include but not limited to:

  • Heart failure
  • Heart attack
  • Brain stroke
  • Inflammation of the heart
  • Fluid accumulation around lung or heart
  • Clotting disorders
  • As well as some others – the research and data reporting is ongoing

Continued monitoring of your condition is important so that we can be aware and assess these concerns.

Once I recover, am I immune to the virus? For how long?

That’s a great question – and the answer is that, as of right now, nobody knows. We do know that the immunity is protracted, and the antibodies do appear for a few weeks and disappear over 2-3 months. We aren’t sure if the disappearance of the antibodies means that the patient is at risk again. There is some encouraging data with the vaccine, but we really don’t have 100% confirmation, and won’t for a year or so, when we are able to analyze ongoing rates of infection as well as fully assess vaccination effects.

There is evidence that a repeat infection is possible and multiple cases in the US have been confirmed as a second- infection after a proven first.

Once you have recovered, you should resume current advised social distancing practices, wearing a mask, and all of the other safety measures advised to avoid contracting or spreading COVID-19.

Once I am recovered, when can I get the vaccine?

There is currently no specific recommendation, but you would definitely not want to get the vaccine during the acute phase. I would recommend a 4-6 week delay from acute illness, which is about the time when you would start developing the natural antibodies.

Should I get the vaccine?

The CDC recommends we all get required doses of any particular vaccine in a timely manner. As it stands right now, we do not have enough understanding to know whether one dose is sufficient, and as it stands right now second doses of current, FDA- approved vaccines are necessary, as recommended by the manufacturers. You will need to receive both doses to be considered fully vaccinated. Stay tuned regarding additional versions of vaccines in the next few weeks, produced by other manufacturers. We shall update our information page as such information becomes available.

Do I have a condition that means I would not want to get vaccinated?

This needs to be addressed on a case-by-case basis, and your unique case would need to be discussed with your provider. By and large, vaccination is a safe and effective means of getting protected.

Should I be concerned about variants or mutations of SARS-CoV-2

Variants and mutations of the virus are normal and expected, it is part of how viruses work. The current variant seems to be more infectious and easier to transmit from person-to-person and surface-to-person, and on occasion seem to produce more severe disease. There is nothing new we can do beyond our current preventative measures, so the only thing you can do right now is follow existing instructions.

Will the current COVID-19 vaccines protect from variants and mutations?

The available vaccines seem to be addressing the current variant, but there is ongoing research and data-collection that is continuing to determine efficacy of current vaccines against new viral mutants and variants. This is another reason it is important to continue wearing a mask, practice social distancing, and, if you have tested positive, isolating and disinfecting as mentioned earlier.

We’re here to help.

Lyracore Health Alliance is here to help guide you through this challenging time. From managing pre-existing conditions, to supporting you through a COVID-19 diagnosis and recovery, we’ll consider your unique situation and work with you to develop a solid clinical plan and monitor your condition closely. If you have questions or would like to see a practitioner, set up a telemedicine or in-person appointment today.

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Coronavirus + COVID-19 Q&A With Dr. Furman of Lyracore Health Alliance: Part 3, Exposure Prevention

Welcome to Part 3 of our multi-part Q&A with Dr. Alexandre Furman, a highly-experienced pulmonary specialist and founder of Lyracore Health Alliance. Dr. Furman has been immersed in the coronavirus pandemic since the onset and took the time to answer some common questions, giving a deeper insight into coronavirus, how it spreads, and how we can protect ourselves. 

In this blog series, Dr. Furman will help explain what this virus is, what it does, what are the known complications of the infection, recent evidence, and research-based available treatments, as well as discussions of differences of immediate effects of the virus versus “early-late” complications and late complications of the viral infection, as well as possible roads to recovery.

If you haven’t already, don’t miss Part 1 and Part 2.

Please note that information and research rapidly change as we gain more experience with this virus and, while we endeavor to keep the information on this page up-to-date, the current content is based on what was known in September of 2020. Any and all of the following information is based on available published scientific research as well as general publications in regards to this novel virus. 

How can I prevent exposure?

A few concepts and techniques have been proposed and enacted to promote a faster grasp of control of infection. These include but not limited to 

  • Social distancing
  • Personal spread prophylaxis (masking)
  • Enhanced hygiene methods 
  • Surface exposure awareness.

Social Distancing

This concept and technique is aimed at separating individuals engaged in some form of social co-interaction and introducing an increase in the physical distance between interacting individuals to approximately 6 feet (or 2 meters) in every direction. 

This limits physical contact between possibly infected individuals that are presumably without symptoms of the disease and the rest of the population who are engaged with them in a social activity that’s in relatively close proximity.

The scientific basis for this principle can be found in Evaluating the Effectiveness of Social Distancing article from August 2020’s Emergency Infectious Diseases.

Personal Spread Prophylaxis (Masking)

Masking works incredibly well, primarily for protecting other individuals from oneself and especially in a case where one person is infected and not aware due to lack of symptoms.

Face coverings (including cloth and surgical masks) are highly effective at blocking infected droplets from exiting the mouth or nose. A scientific study that demonstrates this principle can be found here.

In the case of concern of droplets traveling farther than 6 feet or of airborne spread of the virus, wearing a mask is extremely effective in preventing both. 

There is now additional scientific evidence that wearing a mask also provides some level of protection to the wearer as well. 

Finally, as I am not aware of credible scientific evidence suggesting that masks are harmful to breathing, universal masking is a win-win for the prevention of COVID-19 infection spread and thus an excellent way to curb the pandemic. 

Enhanced Hygiene Methods

Anyone may become infected when they touch a surface that has virus particles on it and then touches their own mouth, nose, or eyes. Frequent and enhanced hand hygiene is one of the best weapons in the war between human and contagious diseases. 

The following are tested and proven methods to assist in our plight concur the pandemic:

  • Wash your hands frequently with soap and water, scrubbing for at least 20 seconds, or use an alcohol-based hand sanitizer.
  • Don’t touch your face. This one requires continuous conscious effort since an average person touches their face about 23 times per hour! Nearly 50% of the time, they’re touching their mouth, eyes, or nose — the same mucosal surfaces that COVID-19 prefers to use as the entrance to the human body.
  • Cover coughs and sneezes with the inside of your elbow or upper arm. 
  • Avoid usual greeting gestures and comradery expressions such as handshakes, fist bumps, elbow bumps, hugs, and high-fives. 
  • And almost, most importantly, stay home if you are feeling sick, and seek appropriate medical guidance. Our team can help schedule an interactive televisit with one of our qualified medical providers quickly and safely from the comfort of your own home. 

Surface Exposure Awareness

This principle refers to the fact that any surface around us, from pens and paper, to steering wheels and gas tank covers, to window sills and doorknobs, to toilet seats and sink levers, as well as many others, are all potential carriers of disease and should be considered and treated as “infected” unless cleaned properly with an approved virucidal solution within a reasonable period of time. 

Since we’re not usually able to witness the actual act of cleaning of such surfaces, unless personally performed, all surface contact should be followed by all the enhanced hygiene methods listed above.

We’re Here To Help

If you suffer from a preexisting pulmonary condition, such as allergies, asthma or COPD, please reach out to our office to learn how we can help address your symptoms and create a plan. Stress and anxiety are normal in the face of a global pandemic, but you aren’t alone – we are here to help. To schedule an appointment with our qualified medical providers, including telemedicine appointments, please click here.

Coronavirus + COVID-19 Q&A With Dr. Furman of Lyracore Health Alliance: Part 2, Exposure & Symptoms

Welcome to part 2 of our multi-part Q&A with Dr. Alexandre Furman, a highly-experienced pulmonary specialist and founder of Lyracore Health Alliance. Dr. Furman has been immersed in the coronavirus pandemic since the onset and took the time to answer some common questions, giving a deeper insight into coronavirus, how it spreads, and how we can protect ourselves. 

In this blog series, Dr. Furman will help explain what this virus is, what it does, what are the known complications of the infection, recent evidence, and research-based available treatments, as well as discussions of differences of immediate effects of the virus versus “early-late” complications and late complications of the viral infection, as well as possible roads to recovery.

If you haven’t read Part 1, catch up here

Please note that information and research rapidly change as we gain more experience with this virus and, while we endeavor to keep the information on this page up-to-date, the current content is based on what was known in September of 2020. Any and all of the following information is based on available published scientific research as well as general publications in regards to this novel virus. 

How are we commonly exposed to SARS-CoV-2?

Many mechanisms of exposure have been proposed over the past few months. However, the most common exposure mechanism remains direct contact with an individual with current infection, symptomatic, or asymptomatic (without any symptoms).

Direct exposure is usually in the form of direct contact with the infected person’s mucous membranes, such as through kissing, coughing, sneezing, or otherwise touching mucous membranes of the infected individual. 

Exposure within your own environment is known to occur as well; for example, contact with a surface upon which an infected individual has sneezed or has been in contact with has been documented.  

Airborne transmission, such as presents in well-known infective entities such as tuberculosis, has been suspected and should be avoided if possible. The presence of the virus in the stool samples and urine samples has been reported — however, currently, such transmission is not been fully understood.

For the full list of possible mechanisms, please refer to the Centers for Disease Control website.

What should you do if you suspect you have been exposed?

This is a great question — and a very common one! If you suspect that you have had possible exposure to an individual with suspected and or proven infection, you should quarantine yourself immediately and contact your licensed medical provider for further instructions. You do not need to go to your doctor’s office or the emergency room unless you have been advised to do so, as you could risk infecting others and may not need in-person medical attention.

We’re Here To Help

If you suffer from a preexisting pulmonary condition, such as allergies, asthma, or COPD, please reach out to our office to learn how we can help address your symptoms and create a plan. Stress and anxiety are normal in the face of a global pandemic, but you aren’t alone – we are here to help. To schedule an appointment with our qualified medical providers, including telemedicine appointments, please click here.

Coronavirus + COVID-19 Q&A With Dr. Furman of Lyracore Health Alliance: Part 1

A highly-experienced pulmonary specialist, Dr. Furman has been immersed in the coronavirus pandemic since day 1. Here he answers some common questions and gives a deeper insight into coronavirus, how it spreads and how we can protect ourselves. In this blog series, Dr. Furman will help explain what this virus is, what it does, what are the known complications of the infection, recent evidence and research-based available treatments, as well as discussions of differences of immediate effects of the virus versus “early-late” complications and late complications of the viral infection, as well as possible roads to recovery.

Please note that information and research rapidly changes as we gain more experience with this virus and, while we endeavor to keep the information on this page up-to-date, the current content is based on what was known in September of 2020. Any and all of the following information is based on available published scientific research as well as general publications in regards to this novel virus. 

What exactly is COVID-19 and how does it relate to the coronavirus?

COVID-19 is the infection caused by SARS-CoV-2, a novel type of the previously well-known family of Corona Viridae viruses. These viruses are responsible for the majority of upper respiratory infections in humans. This novel type of the virus has unfortunately wreaked havoc across the world and caused morbidity and mortality over the past few months. 

What are the signs of coronavirus infection?

Not surprisingly, as with any viral infection in any human being, the most common signs of infection include:

  • malaise (feeling unwell)
  • coryza (nasal congestion)
  • febrile illness (elevated temperature which, in some individuals can reach upwards of 105-106 Fahrenheit)
  • chest pain
  • progressive shortness of breath, especially with activity
  • stomach discomfort, abdominal pain, diarrhea, nausea, and vomiting
  • loss of appetite
  • anosmia (loss of ability to smell)
  • conjunctivitis (reddening of the eye)
  • neurological and psychiatric symptoms, which may include but are not limited to migraines as well as personality changes, irritability, frank delirium (abnormal reactions to external stimulus), frank psychosis, and some others.

As you can see, all these symptoms are generally nonspecific and can be associated with other viral and bacterial infections as well as other non-infectious ailments and maladies and a wide range of true psychiatric disorders in any human being.

If any of these signs and symptoms of the disease appear in any individual, such individual is warranted to be evaluated by a licensed medical provider to further assess the need for testing and close clinical follow-up. 

We’re Here To Help

If you suffer from a preexisting pulmonary condition, such as allergies, asthma, or COPD, please reach out to our office to learn how we can help address your symptoms and create a plan. Stress and anxiety are normal in the face of a global pandemic, but you aren’t alone – we are here to help. To schedule an appointment with our qualified medical providers, including telemedicine appointments, please click here.