38 Coronavirus Questions Answered by Medisafe’s Chief Medical Officer
On April 4, our Medisafe Chief Medical Officer, Dr. Daniels Sands, M.D., M.P.H., answered dozens of questions posted by the Medisafe community about treatments, symptoms, anxiety and other tips about coronavirus.
Dr. Sands is a primary care and internal medicine physician at Beth Israel Deaconess Medical Center in Boston and an Assistant Clinical Professor of Medicine, Harvard Medical School. He is also a co-founder of the Society for Participatory Medicine. Note: Dr. Sands is not infectious disease specialist, and you should consult your personal physician for all your medical advice.
Among the questions Dr. Sands answered in the webinar:
- Is there an alternative way to test? The flu swab made my nose bleed and I am terrified to let them swab my nose again.
- I heard that letting your fever get to 102/103 helps kill the virus?
- If you have it and are cured of it, can you then get it again? Like the flu or a cold?
- Do we know yet how long a person could be asymptomatic and still be infectious? I’m asking because I am immunocompromised.
- Can the virus live on frozen-food packaging? If so, for how long?
- Should I spray my mail and packages when they arrive?
- Should I be spraying my groceries with a disinfectant when I get them home?
- If you smear Purell (60% alcohol) on the handle of a shopping cart will it keep the handle free of the virus for a certain length of time? Or can it become contaminated a minute later?
Other questions Dr. Sands answered after the webinar:
1. What should be our main concerns with this? Is the spread even slowing yet?
Dr. Sands: Main concern should be keeping yourself and your loved ones safe through physical distancing, not touching your face, coughing/sneezing into your inner elbows or a tissue that you discard, and frequent and careful hand washing with soap and warm water, especially after going out. If we do this strictly we can flatten the curve and reduce the overload of our health systems that will cause excess death. In parts of the world where they are strict about keeping people home they can contain the virus and reduce its spread.
2. What is the effect of anti-inflammatory meds on a coronavirus, should I cut down on my daily prescribed Diclofenac (2x75mg)?
Dr. Sands: There is some suggestion that patients with respiratory illness may do worse when treated with non-steroidal anti-inflammatory drugs like ibuprofen or Diclofenac. However we don’t yet know if this applies to patients like you who are already taking these drugs for other reasons, because having active pain or inflammation could theoretically impair your immune system. More importantly we have no research I have been able to find showing whether this is relevant in people with COVID-19.
So the bottom line is I would not suggest to a patient like you to make any changes. If you were to get COVID-19 you should discuss with your physician whether it would make sense to try taking less Diclofenac or to take acetaminophen or paracetamol instead–however that would not treat your inflammation.
3. I’m an asthmatic and I work at a Walmart. I’m not all that concerned about catching the coronavirus, should I be?
Dr. Sands: I don’t ever think worry is helpful, but you should be smart. It’s all about keeping your distance from others, washing hands frequently and properly with soap and warm water, and consider wearing a paper or cloth mask.
4. How risky is it for people with heart disease such as CAD?
Dr. Sands: We don’t know risks for specific groups of patients. There are many variables like your age, extent of disease, other diseases, and you overall state of health.
5. What are the chances of getting a second round of infection?
Dr. Sands: We don’t yet know.
6. Should I not leave my house if I have asthma, gestational diabetes and pregnant?
Dr. Sands: General guidelines would be for everyone to stay home as much as possible, and if you do go out to practice precautions.
7. Are people with HIV in that «high risk» category»?
Dr. Sands: If your HIV is well controlled (normal CD4 count, undetectable viral load) then I don’t think you would be high risk, but we don’t have any research to support that opinion.
8. My neighbor pets and plays with my dog sometimes, is it possible for him to either catch the virus or could the germs live on him?
Dr. Sands: Your dog cannot catch COVID-19 or be a carrier as far as we know. But your dog’s coat is a surface on which coronavirus can «live.» I am not aware of any patients who have contracted COVID-19 by touching an inanimate surface that contains coronavirus, but it is a theoretical possibility. Best practice would be for the kids to wash their hands thoroughly before and after touching your dog. As for you, you should probably wash after touching your dog, too. I don’t know how to disinfect a dog’s coat other than shampooing.
9. If someone has a lower left lobe partially collapsed from blood clots can this virus be life threatening for them.
Dr. Sands: I don’t know because there is no research to guide us, but if your lung function is otherwise normal I don’t think this would increase your risk of complications.
10. What my chances of get it I have tuberculosis and asthma and epilepsy and more?
Dr. Sands: I don’t know because there is no research to guide us, but I can give you my medical opinion. As far as we know none of these changes your risk of getting COVID-19, but the question is would they increase your risk of getting seriously ill if you do get it? Epilepsy probably does not add to your risk. Asthma if mild and well controlled may jot have a huge impact. If you have active tuberculosis that would certainly increase your risk, but I assume you don’t have it actively. Not sure about your other medical conditions that you did not list.
11. What is the best way to clean fruit & produce to eliminate COVID-19?
Dr. Sands: Just the way you’d usually clean them with water. Nothing else would be safe. If you were immunocompromised you could quarantine your produce for a day or two or you could peel them before eating.
12. How much is too much sanitizing? It took me a little over an hour and a half to sanitize tonight. My sister thinks I do too much!
Dr. Sands: If you and your family members are washing your hands when you come home and are not sick then you don’t need to be sanitizing much.
13. What symptoms should a person have before seeking medical attention?
Dr. Sands: You should always talk to your physician. In general mild symptoms can be managed at home. If you’re having shortness of breath or unable to take fluids or control your fever you need to seek medical attention, especially if you are immunocompromised or have other serious medical conditions or are elderly.
14. How does the virus affect those with controlled type 2 diabetes?
Dr. Sands: We don’t have enough data to know.
15. Why some do and some don’t have severe symptoms
Dr. Sands: We don’t yet know why.
16. I heard letting your fever get to 102/103 degrees helps kill the virus?
Dr. Sands: As discussed in the webinar, no this does not help kill the coronavirus.
17. If you have mg, lupus, COPD & others wouldn’t it be worse to get tested? There is no cure and I have a trilogy?
Dr. Sands: Each health system has different testing capacity and protocols. In most cases today you would not be tested unless you had symptoms, but this may change.
18. Can plasma from a recovered coronavirus-infected individual be safely transfused to a patient presently on dialysis?
Dr. Sands: If someone has recovered then their blood should not be infectious. And this seems to be a respiratory virus that is not transmitted through blood contact.
19. Has anything been found to medically help with this situation for those that have contracted this?
Dr. Sands: This is an area of active research. So far nothing is a silver bullet.
20. What natural remedies or medication can you take to help fight the coronavirus?
Dr. Sands: There is no credible research about prevention. The best thing you can do is support your immune system through adequate sleep, plenty of fluids, good nutrition, exercise, and stress reduction.
21. Do I need to wear a mask? I want to, my husband doesn’t.
Dr. Sands: We discussed this in the webinar. New guidelines suggest everyone should wear at least a cloth mask when going out, but this is controversial. But what is not controversial is that you should wear a mask if you’re symptomatic.
22. What is your best advice for those that are immunocompromised?
Dr. Sands: Keeping your distance from others/stay at home, washing hands frequently and properly with soap and warm water, and wear a paper or cloth mask if you have to leave your home. Also support your immune system through adequate sleep, plenty of fluids, good nutrition, exercise, and stress reduction.
23. What precautions do you recommend for people with respiratory conditions like asthma and COPD?
Dr. Sands: Keeping your distance from others/stay at home, washing hands frequently and properly with soap and warm water, and wear a paper or cloth mask if you have to leave your home. Also support your immune system through adequate sleep, plenty of fluids, good nutrition, exercise, and stress reduction.
24. Why can some people overcome the virus while others die.
Dr. Sands: Older people and people with other medical problems seem to get more ill and sometimes die. But sometimes even younger healthier people get seriously ill. I don’t know for sure but it probably as something to do with the strength of your immune system and underlying lung disease. There may be other risk factors for poor prognosis, but we need more study.
25. Is it true that a combination of malaria drugs and a z-pack are being used to treat patients with the coronavirus?
Dr. Sands: Yes as part of clinical trials. The data to support this is of poor quality so far. Research is underway.
26. Is it true that drugs like ibuprofen and naproxen are not safe to take with the coronavirus but Tylenol or acetaminophen is what should be taken? Please explain.
Dr. Sands: There is some suggestion that patients with respiratory illness may do worse when treated with non-steroidal anti-inflammatory drugs like ibuprofen or naproxen. We have no research I have been able to find showing whether this is relevant in people with COVID-19. If you can adequately treat your symptoms with acetaminophen/paracetamol that would be a good first line but if you can’t you could try ibuprofen or naproxen. But make sure you take no more than than the doses printed on the bottle–but less if you have liver disease or drink alcohol regularly.
27. If a person contracts COVID-19, do they continue to take their medicines as usual?
Dr. Sands: Yes.
28. What is the COVID-19 exactly? Is it viral or bacterial and do they have anything that helps?
Dr. Sands: COVID-19 is a coronavirus, so it not a bacteria. This makes it more challenging to treat and we don’t have any effective treatments right now, but clinical trials are underway.
29. Having had a kidney transplant 1.5 years ago I am on anti-rejection drugs. In addition I am 71 and have a stint in my heart and diabetes . What addition to the standard precautions what more can I do?
Dr. Sands: Keeping your distance from others/stay at home, washing hands frequently and properly with soap and warm water, and wear a paper or cloth mask if you have to leave your home. Also support your immune system through adequate sleep, plenty of fluids, good nutrition, exercise, and stress reduction.
30. I am 56 years old with congestion heart failure, COPD… Should I wear mask and gloves to the store or doctor’s appointments even if I’m not sick?
Dr. Sands: I would suggest you wear a mask when you go out and especially to medical appointments.
Links Mentioned by Dr. Sands:
- How to disinfect yourself, your home and your stuff (Wired)
- Video: How doctors wash their hands properly
- A practical guide to staying safe during the coronavirus pandemic (Harvard Medical School)
Some Official COVID-19 Sources:
- The latest information from the U.S. Centers for Disease Control is here
- The latest information from the World Health Organization is here
- The National Suicide Prevention Lifeline is here
Medisafe links:
Download the App Today
Dosage scheduling. Time-of-day scheduling. Adjustments. Avoid skipping.
