By Chaya Zaetz (Cohen)
I just wanted to reach out to our community in this terribly troubling and challenging time. I’ve recently lost my dad to COVID-19, but I’ve learned and received many treatment plans and medical advice along the way. I am writing to provide you with the information I’ve received from various doctors in an attempt to save lives and help others be more prepared. To note, this is not personal medical advice as each case has its own complexities and details, however it is here so that the right questions can be asked to the medical professionals taking care of your loved one.
Of utmost importance is to be prepared. Be prepared for the minimal communication and prepared with the proper questions. Most of the time, the doctors will only call once a day, usually in the afternoon hours. Have a list of questions ready to ask. They will usually not call you back until approximately 24 hours later. Please do not pass up the opportunity to question what is going on and how they are providing the best treatment. I cannot stress this point enough!
Always ask for a detailed list of the treatment plans. For example, which medications is he/she currently on, what is his/hers oxygen level, what does he/she look like with breathing. Remember, the way your family member looks is usually more important than the oxygen level. For example, if the oxygen level is greater than 90% however he/she looks like they are having difficult time breathing, they are most probably not getting sufficient oxygenation.
There are various levels of oxygenation therapy. These are the orders that oxygen therapy usually progresses in if oxygenation does not improve. Room air, which is no oxygen therapy; nasal cannula, which is oxygen through the nose, noninvasive and usually minimal; nonrebreather mask, which is an oxygen mask, and high flow oxygen therapy, which provides a very high level of oxygen. The next step after high flow oxygen is intubation.
As soon as they get to the hospital, if they have not been getting it at home, they should be started on hydroxychloriquine, azithromycin, and zinc. Remember, hydroxychloriquine can prolong QT interval, which is a part of the electrical activity of the heart. That means that it can potentially cause abnormal heart rhythms and an EKG should be obtained on admission and at least every 2 days to monitor the QT interval. A prolonged QT interval is above 0.44 seconds.
Another very important part of the treatment plan is blood thinner medication. Every COVID-19 patient who does not have any previous bleeding history or any contraindications, should be started on a blood thinner. One example is Aspirin 325 mg. IV blood thinner may be used as well. Many critical complications of COVID-19 come from the body forming clots. If clots do form, they can present as a stroke, blood clot in the leg, lungs, or anywhere else. An IV blood thinner must be initiated immediately to prevent further clots. TPA, which is a clot buster, is also an option if benefits outweigh the risks. Ask the doctor which blood thinner they are starting your family member on. It’s vital to know it is being done.
Ask the doctor to check Vitamin D levels. Vitamin D has an effect on something in the body called interferons, which helps the body reduce inflammation. Many COVID patients have been found to be low in Vitamin D. If the levels are low, they can be easily supplemented.
In serious cases of inflammation, high dose of IV vitamin C can be administered to help reduce inflammation. To be noted is a high dose of vitamin C may injure kidneys if any kidney disease is present.
Antiviral medication is also an option to help reduce viral load. One name of a medication trialed is remdesevir.
Colchicine, usually used to treat inflammation in gout, is an option to give in an very inflammatory case of COVID to help reduce inflammation.
Many hospitals are implementing convalescent therapy where they get plasma (blood) from recovered COVID patients and infuse it into the infected patients so they can benefit from the antibodies. Ask the doctor what you can do to get that in place.
Please be on top of your loved one’s care. No one cares more than you do. You must express that. Ask every question you want. Don’t hold back.
A WhatsApp group has been created to help families going through this difficult time. It is there as a support group as well as a place where you can teach and learn from others who are going through a similar experience.
Link to group: https://chat.whatsapp.com/KJi63p2vxfN5r2N6eKMhbp
Hoping to hear only good news for now on.