There is No Treatment - God Help Us All

nfpfnp

Dear Patients and Friends:

You are likely seeing stories of people who went to urgent cares or physician's offices and were turned away from being seen. I read one of a man that ended up in the hospital due to COVID-19 with pneumonia. He was upset because an urgent care saw him but did nothing for him. And I don't blame him. It is upsetting to not have anywhere to go or anything to help you. And no idea of why we are being turned away or having nothing done. But as an urgent care provider, I understand why "nothing was done" for this patient.

Here is the problem in a nutshell: this is a virus. There is no cure. Just like the common cold has no cure. But at least with the common cold, I can treat the symptoms. With COVID-19, I am limited to the symptoms I can treat. I cannot treat you with mild or medium symptoms. I cannot give you a nebulizer treatment for shortness of breath because it aerosolizes the virus and I do not have a negative pressure room to contain it. I cannot give you steroids because it exacerbates the virus. My hands as a provider are tied. If I let you in my clinic in order to try to give you some symptom management medications, then my clinic will be infected and I have no PPE, no Lysol, no sani-wipes, nothing to protect myself or anyone else.

I feel helpless....I am helpless in that I only have my words and my heart to make you feel better. I cannot even give you a hug because of social distancing and not wishing to spread virus (which is so hard for a person like me...I am a hugger).

These are frightening times. You will have to stay home and care for yourself or your loved one until you either get pneumonia and cannot breathe or you get well. This is where we are at at this time. Any medications that you may be hearing are helping are reserved for the sickest of the sick or have no proven efficacy. And I cannot access them and neither can you. At this time you will not get tested without severe symptoms. (update: CDC released new guidelines today for testing)

COVID-19 Symptoms (You do not have to have all and DO NOT have to have fever!):

Fever
Cough
Shortness of breath...late sign
Runny nose
Sore throat
Headache
Body Aches
GI symptoms, such as diarrhea
Loss of sense of taste or smell

If you are sick...assume it is the virus. Stay home! If you have symptoms of a cold, URI or flu, stay home. This is the hardest thing to do, especially when you are afraid. But you will not get any treatment until it is severe, because there is no treatment. If you are not sure about your symptoms, call ahead to an urgent care or clinic and ask if it is something that you can come in for.

Please help stop this virus. You can have it with no symptoms and be spreading it.

Protect my mom and yours by staying home. Seek help when your symptoms are severe. Yes, you will be afraid for your life. We are all fighting for our lives at this moment.

If you are afraid and do not know what to do, ask me and I will try to help you. But please know that your family will be your caretakers at home until it is severe.

God help us all.

NormaSaline · Mar 26

Thanks Nicole! Good points (but - runny nose?).

From the point of view of today, March 26, 2020, it seems that the solution might be to start physically separating suspected Covid-19 patients from all others. What I mean is re-purposing existing facilities expressly for the purpose of treating suspected Covid-19 patients, in a separate facility, not just a separate floor. We have to do this for the safety of all non-Covid urgencies and emergencies. There are a billion details to work out and questions to answer, but that seems to be the most logical place for all large municipalities to start.

(Respectful replies welcome)

nfpfnp · Mar 26

Hi NormaSaline,

Yes, runny nose. Some patients are complaining that they feel like they have a faucet attached to them...so yes, I included it in the symptoms. I wrote this for laypersons so that basically they realize that if they are sick (at all) with virus like symptoms that they should stay at home. Not seeking care for something like a runny nose or other minor symptoms. They should quarantine at home, treat their symptoms and seek help when it becomes severe...as in cannot breathe.

I work in the community for the last few years as an NP. As an RN I was always inpatient in large facilities. It is a whole different world out here in the community and sometimes we have to put things in terms that people can understand.

I appreciate your ideas and agree that we need to separate these patients. I hope that we can get something in place soon.

rzyzzy · Mar 26

I guess the thing that bothers me the most about these guidelines is the reports that many carriers are asymptomatic or have mild symptoms. We haven’t seen any fevers at all - but a cough or a headache, or diarrhea - in a dialysis patient, that’s normal, often not a change from baseline.

We’ve been told to treat everyone as “positive”, but we can’t and aren’t doing that in my practice. Ten or twenty or fifty patients in one room at the same time is the business model. And many of them bounce into and out of the hospitals on a regular basis... with testing behind the curve, if the statistics so far are correct - we are about to lose a lot of people.

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There is No Treatment - God Help Us All

Lack of Treatment = Fear For All

COVID-19 Symptoms (You do not have to have all and DO NOT have to have fever!):

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