Hospitals in coronavirus hotspots across the U.S. are becoming overloaded with patients. Many people with less critical symptoms are being advised to recover at home.
If a loved one in your home tests positive for COVID-19 or exhibits symptoms similar to the virus, Dr. Joseph Khabbaza says the most important thing you can do, if able, is to provide an isolated bedroom and bathroom for the infected person.
“Now, that's not always possible in every living arrangement, but isolation is the key when you have an infected person in the household,” the pulmonary and critical care physician at the Cleveland Clinic says.
Taking care of a coronavirus patient at home comes with another challenge: safeguarding the health of other family members.
Khabbaza advises dedicating one person within the household as the primary caretaker. Others in the home can be in charge of disinfecting common surfaces and upholding rigorous handwashing, he says, because excellent hygiene will be crucial for keeping each other from becoming sick.
I possibly have an infected person or someone believed to be infected living in my home. What do I first?
“The most important thing is isolating that individual, whether they are COVID positive or if they're having symptoms suggestive of a viral infection. We should proceed as if they are infected. When able, they should have their own isolated bedroom and bathroom.”
My partner is sick and we share a bed. Should we sleep in different rooms?
“Short of the hand and face, one of the major modes of disease transmission — 15 to 30 minutes of sustained contact near an infected person — is enough to transmit the disease. So if apart all day, that's fine, but if you're sharing the bedroom, that is still enough to transmit it if your partner is infected.”
How should I handle my trash?
“The wastebasket should be lined with a bag and it should have a lid on it, and same for a laundry basket as well. And those, of course, should be in the room of the infected loved one. The caregiver should come in with gloves and mask, anytime when entering that designated room, then dispose of the trash. You could place that bag in another bag before placing that in your common garbage, if it's feasible, [because it] could help minimize some contamination from getting outside of that designated area in the house where the infected loved one may be.”
How should I take care of an infected person’s laundry?
“Kind of a similar idea when dealing with laundry and waste, [the caregiver should wear] gloves and a mask. When bringing the laundry to the laundry room or the washing machine, you don't want to be shaking the laundry — that theoretically could aerosolize some of the droplets and some of the virus. The way you'd wash any laundry is appropriate to disinfect. And then after that, same with trash, you take off the gloves, take off your mask from behind and then wash those hands immediately. If you have access to things like an apron or especially a plastic apron, those guys serve as extra barriers from preventing any contamination from your own clothing. So when available, that would be helpful and then you would remove that and wash it yourself.”
I have a large, intergenerational family all under one roof — and one of us is infected. How can I protect everyone in my family?
“Especially in these intergenerational settings, you tend to have at least one or two family members that are considered high risk just from an age standpoint, let alone from other co-morbidities or diseases that may make them higher risk as well. When you have multiple family members, you want one person to be designated as the caregiver. Everyone wants to help out when one of their own loved ones is sick. But you really want a designated one of the lower risk members of the family to be that point person.
“Always stepping back and reminding that even if there is virus around or on the counters in the kitchen or bathroom ... if the surfaces are constantly wiped, the common surfaces are disinfected — so counters, doorknobs — and if your hands are always clean, even if you slip up and touch your face, it's going to be very hard to transmit the virus and become infected. I think reminding everyone of that point is important because it empowers everyone in the family, where a lot of this in their control as long as the infected loved one is isolated and you're not having that's direct or sustained contact, that with strict hygiene, [it] is going to be very hard to get even the most at-risk family members infected.”
When is the right time to go to the hospital?
“The main indication for going to the hospital would be shortness of breath — and that kind of is a general term. But if you find you're winded just from walking from the bedroom to the bathroom, that's a good gauge that you might be short of breath because significant lung inflammation may be developing. You also may be short of breath because your oxygen level is too low. The lungs cannot absorb enough oxygen to meet the needs to do such a small task, such as walking to the bathroom. That is really the most important thing because the way this virus can kill people is by that respiratory failure that lands people on the ventilator. The earlier recognition of that, the better.”
What other COVID-19 symptoms should I be aware of?
“Shortness of breath is going to be the main thing. It's going to be very hard to have low oxygen levels not sufficient for your body's needs and to not have any symptoms from it. Now, there are a small subset of patients who their main sign may be just turning blue — their lips turning blue or their fingers turning blue. That may be their marker or sign of low oxygen. And especially if the patient is somebody who's not very ambulatory to begin with, they're not going to manifest shortness of breath potentially until late in the disease. If they're not usually walking around, that might be a little bit tougher to tease out those patients. So blue lips, blue fingertips, those could be a sign of low oxygen in somebody who is not short of breath.
"But certainly, we find this in the pulmonary and critical care world, this is almost like a silent assassin this virus, where it's been notorious that patients can be very sick, have very high oxygen requirements, but look so well visually sitting in their bed in the hospital on high amounts of oxygen, but very comfortably speaking, watching TV, texting and talking on their phone. And that does make it a bit scary. But all these patients have felt some sort of shortness of breath prior to presenting to the hospital. But that's what makes it a little bit unique from influenza, which can cause a much more rapid appearance of severe respiratory failure.”
This segment aired on April 6, 2020.