Dr. Robin’s Covid-19 Updates

Creating a Covid Kit

Back to Basics as the Numbers Rise

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With the kinds of Covid numbers we are seeing this month, soon all of us are going to know someone who is sick, and it’s going to feel as though the noose is tightening. Those days can feel really dark.

Fact-based knowledge is my light in the darkness.

So let’s review the basics.

Q. How do I catch Covid?

A: The vast majority of the time you catch Covid from respiratory droplets coming directly from the mouth or nose of a person with Covid into your mouth or nose. Some transmission might also come from air-floating aerosols and maybe a bit of illness comes from some recently super-contaminated surface, but the vast majority of cases come from infected people with whom you have unfortunately had close contact.

Q. How long does it take to get sick from Covid?

A: It typically takes 4–6 days to get symptoms after being around somebody with Covid. It can happen in one day or after 14 days (both rare) but on average it’s under a week and 97% of the time you get symptoms by 11 days.

Q. Three friends were under the weather for just a couple of days but another friend was hospitalized for a month! Is that all the same Covid?

A: Yes, Covid has basically three ways of hitting us:

— 80–85% mild, moderate, or no symptoms (home, either mildly to medium ill or wicked super sick)

— 10–15% severe symptoms: “the sickest I’ve ever been in my life,” sometimes at home but frequently in the hospital; often with bad pneumonia or blood clots in brain, legs; heart, kidney or brain issues

— 5% critically ill, often in the ICU, sometimes on a ventilator

Q. What are the most common symptoms?

A. Let’s not forget — many people have no symptoms at all (but are still contagious! and this is a huge problem). Many other people have mild to moderate symptoms, sometimes very mild.

The most common early symptoms are:

loss of smell

body aches

headache

dry cough

fatigue

fever (not all that often)

shortness of breath, chest pressure

loss of taste

GI symptoms (diarrhea, nausea, abdominal pain)

maybe sore throat

rare stuffy nose

rare runny nose

“Covid toes” where you suddenly develop “bruises” or discoloration or pain on toes

Two caveats:

  • If you have loss of smell and one other symptom, chances are super high this is Covid.
  • During the second week, people can turn very ill very suddenly. Day Eight is considered the classic “bad day.” People become acutely short of breath, maybe confused, profoundly lethargic. These people need to go straight to the hospital!

Q. What should I do if I get sick?

A. You should self-isolate immediately with your Covid Kit. You should call your doctor and get tested. You should rest, stay hydrated, take your temperature, and check your oxygen levels with an oximeter. You should take pain- and fever-relievers and whatever cold-and-flu remedies make you feel better.

Q. When should I get tested?

A. As soon as you have symptoms. Rapid antigen tests are accurate Day 1–5 of symptoms with fast results while the “PCR” test takes days. If you’re asymptomatic or have had symptoms for more than five days, the PCR is the better test.

You should also get tested 4–7 days after exposure. That’s when you have the smallest chance of a false negative.

Q. Why should I bother getting tested?

A. It changes how long you stay quarantined/isolated (currently ten days) and how you’re treated (Tamiflu for flu, antibiotics for strep; maybe monoclonal antibodies or steroids for Covid).

Plus, it’s just better to know. For everybody. You really don’t want to be Aunt Petunia eternally telling her doc and everybody at Dunkin: “I KNOW I had Covid back in December, I was so sick. Did I tell you how how every time I turned over I groaned out loud?” Don’t be Aunt P.

Q. What’s a Covid Kit?

A. It’s a bag you should prepare today so you don’t have to shop when you’re ill (and contagious!), full of stuff to help you get safely through Covid.

It should include a thermometer (I like the Kinsa bluetooth one because then you can set up an on-line account and your family can watch your temperatures on their phone), a fingertip pulse oximeter (even the $30 ones will give you a reasonable sense of how Uncle Maskless is doing oxygen-wise), favorite pain relievers (tylenol/ibuprofen and my fave naproxen) and cold medicines, throat lozenges, gatorade or pedialyte (whichever doesn’t taste totally gross), some chicken soup or miso packets, a couple of long phone charging cords in case you end up in an ER bed where you can’t reach the wall, favorite teas and honey (I like Throat Coat), and maybe a little whiskey. (Just kidding about the latter!) (I meant Chardonnay!)

Q. After all that, can I get re-infected?

A. Yes, definitely. We don’t know how often, we don’t know all the risks; but we absolutely know the answer is yes.

And one final thing to pack in your Covid Kit: some Covid Kindness. People are going to be freaking out when you’re in quarantine. People are going to be upset and worried and may talk about fault-finding or “What did you do wrong?” In fact, YOU may be saying mean things to yourself about blame or fault or being dumb.

Now if you really did go to a maskless undistanced wedding and got Covid, then go make a giant contribution to your local hospital supporting the health care workers and then create a hashtag #delaythewedding and use your suffering to help your friends make smart decisions from here on out.

But if, like many people now, you did everything right but some random droplet just floated in from somewhere; or you had to work and you saw the customer’s mask slip; or you forgot for a minute to wash for exactly 20 seconds — maybe it’s not about blame.

We all like to think we’re in control but the fact is, lousy stuff happens to good people every day; you need look no further than the Covid isolation room — or the cancer clinic — to know this.

What is it we have in the middle of this giant “life isn’t fair” storm? Maybe all we can offer is this kind of beacon — our science-pushing, Kit-clutching, try-a-little-tenderness spotlight — illuminating how and when our generation’s tempest finally starts to run out of rain.

{Robin Schoenthaler, MD is a Boston-based cancer doctor who has been writing straightforward fact-based no-blame-no-rumors-all-science-all-the-time essays about Covid-19 since March 2020.}

Written by

Radiation Oncologist at Massachusetts General Hospital/Emerson Hospital. Writer. Teller. Mom. Currently Covid-Obsessed. , @robinshome

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