• Dr. Ann Black

MDBox Patient Care Instructions: Coronavirus Disease 2019 (COVID-19)

#coronavirus #telemedicine #mdbox

Due to the rapidly evolving nature of the novel coronavirus outbreak, we strongly recommend that you review the coronavirus information from the Centers for Disease Control and Prevention for the latest information. You should also review local recommendations from your state’s or county’s public health department.

Coronavirus Infection (COVID-19) is a new viral disease that causes respiratory illness in people. This virus was first identified during an outbreak in Wuhan, China, but more cases have occurred in several other countries. The infection has been identified in a number of persons inside of the United States. We are providing the following information to you based on guidelines from the Centers for Disease Control, (CDC) Infectious Disease Division.

How COVID-19  Spreads

  • The virus is thought to spread mainly from person-to-person.

  • Between people who are in close contact with one another (within about 6 feet).

  • Through respiratory droplets produced when an infected person coughs or sneezes.

  • People are thought to be most contagious when they are most symptomatic (the sickest). Some spread might be possible before people show symptoms; there have been reports of this occurring with this new coronavirus, but this is not thought to be the main way the virus spreads.

  • It may be possible that a person can get COVID-19 by touching a surface or object that has the virus on it and then touching their own mouth, nose, or possibly their eyes, but this is not thought to be the main way the virus spreads.

  • The virus that causes COVID-19 seems to be spreading easily and sustainably in the community (“community spread”) in some affected geographic areas.

COVID-19 Symptoms

People who have been infected with COVID-19 have had symptoms that range from mild cold symptoms to severe respiratory illness and even death.

These are the most common symptoms. They may appear 2-14 days after exposure.

  • Fever

  • Cough

  • Shortness of breath.

What To Do if You Become Ill

Notify your MDBox provider if you have any of the above symptoms. You should also inform your provider if you have been exposed to a person with COVID-19 or have traveled within the past two weeks to a country or region with known COVID-19 cases. Your MDBox provider is a healthcare professional who has been informed about the current status of COVID-19. Your provider can advise you about when and how to get tested for the virus, and how to take care of yourself. Your MDBox provider will know how to contact your state’s public health department and the CDC to determine if you need to be tested for COVID-19.

If you decide to seek treatment in person at a local healthcare clinic such as an urgent care or at a hospital, call ahead to that facility. Notify your healthcare professional if you develop a fever and symptoms of respiratory illness, such as cough or difficulty breathing, have been in close contact with a person known to have COVID-19, or if you live in or have recently traveled to an area with ongoing spread. Tell your healthcare professional about your recent travel or contact. Your healthcare professional will also be able work with your state’s public health department and CDC to determine if you need to be tested for COVID-19.

Supportive Care Instructions for COVID-19. The following are measures you can take at home to treat your symptoms. These guidelines are similar to recommendations for influenza infections and other respiratory illnesses.

For cough:

Cover your cough. Use the inside of your elbow, not your hands. Stay away from others when coughing and wash your hands immediately after coughing. Use hand sanitizers as directed.  Over-the-counter cough and cold formulations such as combination antihistamine, decongestant, and cough suppressant medications are effective in relieving the symptoms of a cough.

These include:

  • Non-sedating antihistamines such as loratadine, fexofenadine, and cetirizine.  Decongestants such and phenylephrine and pseudoephedrine

  • Mucous relieving medications such as guaifenesin

  • Cough suppressants such as dextromethorphan.

  • Nasal saline irrigation

Drink plenty of fluids. Remaining hydrated will also relieve the symptoms of a cough. If you are an asthma patient, follow the instructions given by your healthcare provider for treatment of acute asthma attacks.

For Fever:

Take your temperature using one of the approved over the counter thermometer devices at least four times a day while you are ill. It is important to check your temperature in order to follow your fever trend. If your temperature keeps going up, stays high, or spikes, this is an important indicator that your illness may be progressing. 

Treat fever with hydration and medications.  Acetaminophen and ibuprofen are over-the-counter fever reducers that are available in tablets for adults and and liquid form for children. These medications also treat headache, body aches, and sore throat   which may come with the illness.

For Shortness of Breath:

Some patients with COVID-19 may experience rapid onset of difficulty breathing. This is one of the major signs of the illness. If you find that you are short of breath, you should immediately seek medical help. Rapid breathing, turning blue, gasping, and choking are all signs of serious infection which could be life-threatening.  If you are an asthma patient, follow the instructions given by your healthcare provider for treatment of acute asthma attacks.

Testing for the Virus

Laboratory testing for COVID-19 is now available at major national lab testing companies. MDBox does not currently have the ability to directly perform this testing. Please discuss with your MDBox provider whether or not you should be tested for COVID-19. If your provider recommends testing or you feel that you need to be tested, ask for instructions on where to go for testing. It is important to follow safety precautions while waiting for testing to be done.

If you have chronic illnesses such as heart disease, emphysema, asthma, diabetes, HIV, are undergoing treatment for cancer, and other serious and chronic disease states you should seek help at a hospital emergency room or urgent care clinic. Remember if you suspect you may have COVID-19 call ahead.

Steps to help prevent the spread of COVID-19 if you are sick

If you are sick with COVID-19 or suspect you are infected with the virus that causes COVID-19, follow the steps below to help prevent the disease from spreading to people in your home and community.

Stay home except to get medical care.

People who are mildly ill with COVID-19 are able to isolate at home during their illness. You should restrict activities outside your home, except for getting medical care. Do not go to work, school, or public areas. Avoid using public transportation, ride-sharing, or taxis.

Separate yourself from other people and animals in your home.

  • People: As much as possible, you should stay in a specific room and away from other people in your home. Also, you should use a separate bathroom, if available.

  • Animals: You should restrict contact with pets and other animals while you are sick with COVID-19, just like you would around other people. Although there have not been reports of pets or other animals becoming sick with COVID-19, it is still recommended that people sick with COVID-19 limit contact with animals until more information is known about the virus. When possible, have another member of your household care for your animals while you are sick. If you are sick with COVID-19, avoid contact with your pet, including petting, snuggling, being kissed or licked, and sharing food. If you must care for your pet or be around animals while you are sick, wash your hands before and after you interact with pets and wear a facemask. See COVID-19 and Animals for more information.

Call ahead before visiting your doctor

If you have a medical appointment, call the healthcare provider and tell them that you have or may have COVID-19. This will help the healthcare provider’s office take steps to keep other people from getting infected or exposed.

Wear a facemask

You should wear a facemask when you are around other people (e.g., sharing a room or vehicle) or pets and before you enter a healthcare provider’s office. If you are not able to wear a facemask (for example, because it causes trouble breathing), then people who live with you should not stay in the same room with you, or they should wear a facemask if they enter your room.

Cover your coughs and sneezes

Cover your mouth and nose with a tissue when you cough or sneeze. Throw used tissues in a lined trash can. Immediately wash your hands with soap and water for at least 20 seconds or, if soap and water are not available, clean your hands with an alcohol-based hand sanitizer that contains at least 60% alcohol.

Clean your hands often

Wash your hands often with soap and water for at least 20 seconds, especially after blowing your nose, coughing, or sneezing; going to the bathroom; and before eating or preparing food. If soap and water are not readily available, use an alcohol-based hand sanitizer with at least 60% alcohol, covering all surfaces of your hands and rubbing them together until they feel dry.

Soap and water are the best option if hands are visibly dirty. Avoid touching your eyes, nose, and mouth with unwashed hands.

Avoid sharing personal household items

You should not share dishes, drinking glasses, cups, eating utensils, towels, or bedding with other people or pets in your home. After using these items, they should be washed thoroughly with soap and water.

Clean all “high-touch” surfaces everyday

High touch surfaces include counters, tabletops, doorknobs, bathroom fixtures, toilets, phones, keyboards, tablets, and bedside tables. Also, clean any surfaces that may have blood, stool, or body fluids on them. Use a household cleaning spray or wipe, according to the label instructions. Labels contain instructions for safe and effective use of the cleaning product including precautions you should take when applying the product, such as wearing gloves and making sure you have good ventilation during use of the product.

Monitor your symptoms

Seek prompt medical attention if your illness is worsening (e.g., difficulty breathing). Before seeking care, call your healthcare provider and tell them that you have, or are being evaluated for, COVID-19. Put on a facemask before you enter the facility. These steps will help the healthcare provider’s office to keep other people in the office or waiting room from getting infected or exposed. Ask your healthcare provider to call the local or state health department. Persons who are placed under active monitoring or facilitated self-monitoring should follow instructions provided by their local health department or occupational health professionals, as appropriate. If you have a medical emergency and need to call 911, notify the dispatch personnel that you have, or are being evaluated for COVID-19. If possible, put on a facemask before emergency medical services arrive.

Discontinuing home isolation

Patients with confirmed COVID-19 should remain under home isolation precautions until the risk of secondary transmission to others is thought to be low.


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