Dear Signature Family,
Over the last couple of weeks, there have been a few developments regarding CoVID-19 and wanted to share our thoughts on this new information with you.
Who should be testing for acute infection and what test is best for me?
Certainly, anyone with symptoms* and/or with recent exposure** to someone who has had a positive test should consider testing. Many patients are getting testing prior to travel as well. In some situations this is mandated (by the airlines, e.g.) and in other situations it’s voluntary. Please remember that a negative test result in any of these situations is reassuring but should not replace ongoing attention to hand-washing, social distancing and mask wearing when social distancing is not possible. In the best case scenario a negative test means you are probably not infected. In the worst case, such as those who have known exposure and are now symptomatic, a negative test is more likely wrong than right. As a Signature patient, you should discuss your test results with your doctor.
* Fever or chills
Cough, Shortness of breath or difficulty breathing
Fatigue, Muscle or body aches
New loss of taste or smell
Congestion or runny nose
Nausea or vomiting, Diarrhea
** You were within 6 feet of someone who has COVID-19 for at least 15 minutes
You provided care at home to someone who is sick with COVID-19
You had direct physical contact with the person (hugged or kissed them)
You shared eating or drinking utensils
They sneezed, coughed, or somehow got respiratory droplets on you
There are currently 3 types of testing available:
Saliva collection, nasal swab and the one that tickles your brain. Some can be done from home and some require assistance from Signature staff. Each of these tests has a place in the diagnosis of CoVID-19 and we encourage you to discuss which test is most appropriate for your situation.
We recommend self-quarantining while awaiting your test results.
What’s the deal with self-isolation after getting a positive CoVID-19 test result?
The newest recommendations for patients who have symptoms and tested positive are that isolation can be discontinued 10 days after symptom-onset and your symptoms are improving and it’s been at least24 hours since your last fever (without taking any fever-reducing medication during that time).
For patients who have no symptoms and tested positive, isolation may be discontinued on the 11th day after you had your nasal swab or saliva test.
Testing is generally not recommended to determine when to end isolation.
What’s up with antibodies?
Antibodies to SARS-CoV-2 signify prior infection with the virus. They usually appear about 2 weeks after recovery from CoVID-19. At this point, we still believe that patients with antibodies are protected from re-infection and cannot infect others. Patients with antibodies can donate their plasma for use in clinical trials. 3.1% of Signature patients tested for antibodies have tested positive. We’ve had dozens of patients who reported a flu-like illness in January and February and requested antibody testing for the virus. To date, none of these patients has tested positive.
What medications work to treat CoVID-19?
Remdesivir: Effective for critically-ill hospitalized patients.
Dexamethasone: Effective for some critically-ill hospitalized patients.
Convalescent plasma: Possibly helpful, in hospitalized patients.
Hydroxychloroquine +/- Azithromycin: Not recommended in any setting due to lack of efficacy andpotential risk.
When is the vaccine coming?
At least 115 vaccine candidates have been developed and 78 are confirmed, with 4 in Phase 1 clinical trials, 2 in Phase 2, and 1 in Phase 3. At least 3 of these have demonstrated an immune response with no significant safety issues, and a limited supply of an approved vaccine may be available by the end of the year.
What are the current infection rates in our area?
North Carolina has over 124,000 confirmed cases and 1,900 deaths, with 6.9% of those tested being positive. More than 55,000 cases occurred over the past month in NC.
At Signature Healthcare, 6.1% of those tested have been positive for a total of 25 positive cases. We have had no deaths or hospitalizations.
A quick word regarding masks
We continue to recommend wearing a face mask when indoors or outdoors and social distancing is not possible.
We do not recommend wearing masks with valves. At best, they protect you from the virus but do nothing to protect everyone else from you. At worst, they protect neither you nor those around you.
A not-so-quick word about vacation plans and concierge medicine during CoVID19