Gulf Coast Moms Blog partnered with AlphaCare Urgent Care and Dr. George Loukatos, MD to provide this educational post about COVID-19 to Gulf Coast moms. We hope you find this information valuable. Click here to view the Gulf Coast Moms Blog Facebook Live question and answer session with Dr. Loukatos.
Q: How are people diagnosed who are showing no symptoms? How do they know to get tested?
A: The current CDC recommendations are that only people showing symptoms be tested. There is little to no utility in testing asymptomatic individuals. The viral load in an asymptomatic person may not be high enough to turn the test positive, even if they are carrying the virus. Athletes, movie stars, etc who got tested without having symptoms were wasting valuable resources that should have been preserved for those who are truly sick.
Q: Is it possible to have a wet cough with COVID-19? We’ve read that the type of cough can differentiate those with a common cold and those possibly infected with the virus.
A: Yes, wet cough is definitely possible. There is no way to differentiate the cough of COVID-19 from that of the common cold, flu, or pneumonia.
Q: Which symptom(s) for COVID-19 means someone should be tested?
A: The symptoms that lead us to test patients are fever (we consider fever to be 100.4 or higher, no matter what the patient’s “normal” temperature is), cough, and/or shortness of breath. That being said, at this point we are still following the CDC recommendations and only testing people who have the above symptoms and fall into one of these sets of patients:
- Health care workers with direct contact with confirmed or presumed positive COVID-19 patients
- Pregnant women
- People living in communal settings (nursing homes, shelters, etc)
- Infants less than 10 weeks old
- Patients with immune compromising conditions (receiving chemotherapy or other immune-suppressive therapy, hemodialysis, chronic lung disease, advanced HIV, or active cancer)
Other common symptoms that we see in COVID-19 patients is muscle aches, chills, headaches, and GI complaints like nausea, vomiting, and diarrhea.
Q: Does the use of a face mask help contain the spread of COVID-19?
A: Yes. COVID-19 is spread through respiratory droplets, emitted from a person’s lungs and inhaled into the nose or mouth (or sprayed directly into the eyes) of the person it is passed to. Face masks decrease the aerosolization of the virus from symptomatic patients into the air being shared by those around them.
Q: If you are in self quarantine or self medicating, at what point do you seek medical attention? What are the early signs that you need medical attention?
A: My advice to patients is that they go to the ER if they are short of breath at rest, coughing up blood, or having severe gastrointestinal symptoms and they believe they are dehydrated. Cough, fever, and even shortness of breath with exertion can still be managed at home. However, if you have any of these symptoms, you should consult with your physician.
Q. After contracting, how long before symptoms show up?
A: The median time from contracting to symptoms is 5.5 days. This means that 50% of people show signs sooner than 5 days and 50% show signs later. The range is 2-12 days. The CDC errs on the side of caution and recommends staying quarantined for 14 days after a suspected exposure to make sure you don’t develop symptoms.
Q: How do we keep our families safe if someone in the home tests positive? Can we keep them safe?
A: This is difficult. The best option, and what the state health department is recommending, is that the other family members move out, if possible. For most of us, this is not realistic. If the family stays, the infected individual should keep their distance (quarantine themselves to one room) as much as possible, especially if they are actively coughing. They should definitely not sleep in the same bed as other family members. Infants less than 3 months of age, elderly, and immunocompromised family members should be removed from the household.
Q: How long will a COVID-19 patient be sick? Is it different for adults and children?
A: This varies depending on the individual. Some people who are infected won’t show symptoms. Others will have mild symptoms similar to a common cold. Those most severely affected will develop gradually worsening shortness of breath that may suddenly worsen, necessitating hospitalization. Children seem to be much less severely affected by the virus than adults.
Q: Can someone take Ibuprofen or other over the counter medicines?
A: This is a question that reflects how important it is for all of us to stay current on what is going on with COVID. A couple of weeks ago the World Health Organization was advising against the use of Ibuprofen in COVID-19 patients, based on recommendations of the French health minister stemming from a single study. Review of the real patient data has since debunked that. The point here is that as we learn more about the virus, resource levels change, etc. The recommendations regarding what we should do will also change. Stay informed!
Q: Are pregnant women more at risk? We’ve heard conflicting answers.
A: Yes, absolutely. This question is also addressed by the Centers for Disease Control & Prevention (CDC). Pregnancy is considered to be an immune-compromised state. Pregnant women fall into the high-risk group of patients who we test if they should become symptomatic.
Q: For expecting moms, what are the safety measures for hospital and newborns?
A: This is also a tough one. The last place anyone should be right now is a hospital. Unfortunately, if you are due to deliver during this time, you will have to take extra precautions. Thankfully, hospitals are taking extreme measures to keep the COVID-19 patients away from the rest of the patient population.
Nursing staff for the labor and delivery floor are also taking extra precautions. To my knowledge, all of the hospitals in town will only allow the spouse into the delivery room and visitation. This means other children, grandparents, etc. will not be allowed in the hospital. While this is a drag, it is a policy in place to protect you and your baby.
Once home, my advice would be that there are no visitors to the baby until this epidemic passes or your baby is 10 weeks old. I know. It’s horrible, but these are not normal times.
Q: A lot has been said about how the virus cannot be passed from a mother to the baby either in the womb or through breast milk, but we’re curious to know if there have been many cases of newborns who have gotten the virus.
A: This is information is directly from the Centers for Disease Control & Prevention (CDC): We still do not know if a pregnant woman with COVID-19 can pass the virus that causes COVID-19 to her fetus or baby during pregnancy or delivery. No infants born to mothers with COVID-19 have tested positive for the COVID-19 virus. In these cases, which are a small number, the virus was not found in samples of amniotic fluid or breast milk.
As far as newborn babies go, infants 10 weeks old and under are one of the subset of patients that we are testing if they show symptoms of COVID-19. This is because their immunity is so low at this age, and they are more at risk to have bad outcomes. Families of newborns should be ultra-vigilant in practicing social distancing.
Another reputable resource for information is Johns Hopkins.
Q: Can I kiss and/or hug my toddler?
A: Yes (as long as you are not COVID-19 +)! Children, as we all know, are smarter than we give them credit for. They know that something is up right now, whether it is because they heard about it at school, saw it on the news, or have just noticed that quarantined grandparents are not around. And they also sense the anxiety that the adults around them are displaying. Now more than ever, they need the comfort of a reassuring hug.
Q: Sex? What are the recommendations if the spouse is still working outside of the home and they are around people all day.
A: The scientific answer to your question is that COVID-19 can be spread through saliva, semen, and vaginal secretions. That being said, if you are not completely quarantining yourselves from one another, then the likelihood that intercourse is going to increase your chances of passing the virus to one another is probably not too high. If your spouse is coughing or has been exposed to a known COVID-19 patient, then you should be keeping your distance anyway.
Q: Will more tests be available and where?
A: We hope that more tests will become available soon. With the release of the Roche 45 minute turn-around swab, turn around times for testing has gotten a little better, but the supply of swabs is still low. This is also something that is changing day to day. This is the current list of testing facilities on the coast:
Q: Can the virus live on food items that have been touched in a grocery store (i.e bread, chips)?
A: Yes. One of the things that makes COVID-19 worse than the flu is it’s ability to live on inanimate objects much longer than the flu. For example, the flu will typically live on metal and plastic for about 8 hours, whereas coronavirus hangs around for 48-72 hours. Porous surfaces such as masks, clothing, and food retain the virus for less time, but still significant at around 24 hours. This is why hand washing is so important.
Q: Is there a protocol we should follow when we return home after being out in the public?
A: Carry hand sanitizer with you. Sanitize before you get in your car to return home and wash your hands when you get home. If you went to a high-risk area, such as a hospital or doctors office, it would probably be a good idea to change out of your clothes when you get home.
Q: Is it safe to have people come into your home (i.e. biweekly housekeeper, etc.)?
A: My recommendation would be that you keep people out of your home at this time. Full social distancing is our only chance of keeping this epidemic in check.
Q: How can non-COVID patients get health care they need?
AlphaCare Urgent Care has set up a virtual visit platform. In an effort to protect patients from COVID-19 and encourage social distancing, AlphaCare visits will be via teleconference from the safety of your home. Schedule your visit online or call 228.396.3945.
About the Expert
Dr. George Loukatos is an emergency room physician and owner of AlphaCare Urgent Care. He has been practicing emergency medicine in Mississippi since completing his residency at Tulane University Hospital and Clinic in 2003. He has served as medical director of the emergency department since 2007, and also served as regional medical director for several emergency room staffing companies.
He recently left full-time work in the ER to operate AlphaCare Urgent Care, with locations in Ocean Springs and Biloxi. His vision for AlphaCare is to provide the same quality care that his patients received in the ER, in an environment that is more convenient, affordable, and comfortable than the emergency department. He recently went back to work in several emergency departments in Mississippi, Alabama, and Louisiana to help combat the COVID-19 epidemic.
Dr. Loukatos is a father to three children, Gabriel (3), Penelope (5) and Olivia (16). He, his children, and wife Christina reside in Biloxi, where they enjoy being active in the community and outdoors.
