COVID-19: practical info on testing/treatment

In this new world we find ourselves living in, we’re learning ways to keep ourselves safe and healthy while the covid-19 pandemic sweeps the world. Stay home as much as possible. In public keep six feet apart from others. Wash your hands frequently. I would also add: be careful about your media consumption. Obsessively watching TV news reports or endlessly clicking around online will ramp up your anxiety in short order. I recommend that you limit yourself to 15 minutes at a time, maybe twice a day, and then find other ways to occupy yourself.

There’s a lot of information and misinformation flying around. As the pandemic spreads, the scene on the ground can look very different depending on which part of the world or which part of the country you’re at. I do want to share this lengthy set of guidelines that directly addresses issues of testing and treatment.

Howard Grossman is one of the longtime medical heroes of NYC’s gay community, having served people living with HIV/AIDS for many decades. Here are his common-sense recommendations for this time, with an addition I haven’t seen elsewhere: No Hooking Up. Doctor’s orders. (It takes a gay doc to have the balls to say that directly. He knows to whom he’s speaking.)

“Guidance we put out for our patients today: Many people are inquiring about Covid-19 testing and here is some guidance:

1) Current testing for Covid-19 is taking up to 7-9 days to come back from Quest. So testing will give us no immediate information and make no difference to recommendations for therapy

2) If you have symptoms of fever, chills and severe fatigue a test will not change your therapy

3) If you have those symptoms stay at home and isolate. Do not go to work, do not come to the doctor’s office and do not go to urgent care. If you have the virus you will only spread it around.

4) Whether it is Covid-19, the flu or a cold you will treat it exactly the same. Over-the-counter cold and cough medicines, Tylenol (acetaminophen) every 4 hours for fever (maximum dose 4000 mg/day and include any that is in the cold medicine), fluids (including Pedialyte to maintain electrolytes) and bedrest

5) If you have high fevers (over 104 degrees) that don’t resolve, shortness of breath or chest pain with difficulty breathing go directly to the Emergency Room at your nearest hospital. They are set up to rapidly isolate patients and treat with oxygen as needed and do the appropriate radiological procedures such as X rays. Do not go to a doctor’s office or urgent care.

6) If the newly described 45 min point-of-care test becomes available then widespread testing to know the epidemiological spread of the virus will make more sense but right now the current test will make no difference for you.

7) One reminder for many of our patients—social distancing from others can be stressful and difficult but it will make a huge difference in the course of the epidemic. None of us has natural immunity to this virus so a majority of us will probably get it. The question is when and whether the health care system will be able to handle it. If everyone gets sick at once it will overwhelm the system as is happening in Italy and potentially millions will die in the US. If we flatten the curve and spread the infection rate out over time, then the health care system will be able to focus on the sickest patients, have the equipment and supplies to do it, and not have to ration care. We may also delay things until there is a treatment or a vaccine. You can make a difference, each and every one.

8) To that end, please refrain from “hooking up.” Chatting on social media dating and hookup sites won’t endanger anyone. Continuing to meet up for sex will only put everyone at risk. PrEP won’t protect you from Covid-19. Please consider that.

Please share these facts with your neighbors and family. Remember, every time someone goes for testing who does not need it medical personnel will be using up personal protective gear that is in short supply.

Testing needs to be reserved for those already sick where it could change their therapy depending on what is found.”