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Managing your health during the COVID-19 outbreak

Originally posted here

Should I go to my doctors appointments?

You should first call your doctor’s office to see if they have regular office hours or if they’re doing phone, Skype, or other types of remote visits. If you can’t have a phone or remote visit because you need a treatment, vaccine, or test, then you should ask if it’s possible to do them at a later time when it might be safer.

How do I balance my health goals with the realities of COVID-19?

Stay in touch with your healthcare team as often as possible, especially if you have any new signs or symptoms of illness. You should also reach out to them if you can’t get the medicines or foods you need.

Your main health goal is to avoid exposure to COVID-19 by staying inside and keeping a safe distance from others if you need to go out. While inside, you can relieve stress with hobbies such as reading, sewing, drawing, or board games. You should also talk with friends and family by phone, or by exercise, if allowed by your healthcare team. Be realistic with your exercise goals, and find ways to keep fit when not at the gym. For example, use stairs for a good cardio workout and look for exercise classes online. Find great tips on exercise and meditation during the outbreak here.

In time you’ll be able to return to your normal routine. But for now, you can do things you would because you were busy outside of your home. Just think how good you’ll feel if you finally clean that basement or closet–not only will you burn a lot of calories, you’ll also feel a sense of accomplishment that is very good for your health!

What is telemedicine and what do I need to know about it?

Telemedicine, also known as telehealth, allows for virtual appointments (remote visits, but in real time) with your healthcare professional using your computer, tablet, or smartphone. Check with your provider to see if they offer virtual appointments so you can reduce your exposure to the coronavirus. Many insurance plans cover telemedicine, including Medicare. Veterans also have access to telemedicine through the Veterans Administration.

Telemedicine can also include remote monitoring of your health by a healthcare professional, most often a telehealth nurse. By using a special monitor that’s connected to a blood pressure machine or other device, the nurse can check on you at any time.

Healthcare professionals can’t diagnose COVID-19 through telemedicine, but they can provide medical advice, tell patients how to quarantine and when they should go to the hospital, order tests, and write prescriptions. For more information contact the American Telemedicine Association.

Use this worksheet when at a telemedicine appointment with your healthcare professional.

Can COVID-19 cause kidney failure in otherwise healthy adults?

There have been recent reports of nonelderly adults infected with COVID-19 who have developed an acute kidney injury (AKI) — sudden loss of kidney function. These adults did not have underlying medical conditions. With proper treatment, including dialysis in severe cases, AKI can be reversible.

Acute kidney injury (AKI) and chronic kidney disease (CKD)

"COVID-19 also attacks the kidneys, not just the lungs."— Professor Carmine Zoccali, MD, President of the European Renal Association–European Dialysis and Transplantation Association (ERA–EDTA)

Acute kidney injury (AKI) is not the same as chronic kidney disease (CKD), which will eventually lead to chronic kidney failure (CKF). Neither CKD or CKF are reversible diseases. Detecting proteins and/or blood in urine labs is an early sign of kidney involvement in people with confirmed COVID-19.

AKI and COVID-19

Approximately 3% to 9% of patients with confirmed COVID-19 develop an AKI with many requiring dialysis treatments. Regardless of age, people with AKI are at increased risk of developing serious complications from COVID-19.

Long term implications of AKI

It’s recommended that recovered COVID-19 patients who had an AKI should be seen regularly by a kidney doctor, because their risk of developing chronic kidney disease is higher than others. COVID-19 patients who did not develop an AKI, but who had blood and/or protein in their urine, should be monitored since they are at increased risk of developing chronic- and end-stage-kidney disease.

What should I know about miracle cures and treatments?

"The FDA considers the sale and promotion of fraudulent COVID-19 products to be a threat to the public health."Stephen H Hahn, MD, FDA Commissioner

Unfortunately, in times of uncertainty, there are people who look to prey upon those who are vulnerable. The US Food and Drug Administration (FDA) reports there are unscrupulous companies and individuals looking to fraudulently profit by scamming people who want to prevent and/or treat COVID-19.

Knowledge is power The best way to avoid becoming a victim of fraud is to know the facts. According to the latest guidance from the CDC, there no vaccines or drugs approved to treat or prevent COVID-19. And, while there are investigational COVID-19 vaccines and treatments in development, these investigational products are still in the early stages of development and have not yet been fully tested for safety or effectiveness.

Beware of false promises Products that claim to cure, mitigate, treat, or prevent disease, but are not proven safe and effective for those purposes, defraud consumers of money and can place consumers at risk for serious harm. Fraudulent COVID-19 products may come in many varieties, including dietary supplements, such as vitamins and minerals, foods (garlic), as well as questionable products purporting to be drugs, herbal remedies, immune boosters, medical devices, or vaccines. Using these products may lead to delays in getting proper diagnosis and treatment for COVID-19.

The FDA urges consumers and patients to talk to their healthcare providers and to follow the advice from federal public health agencies about how to prevent the spread and treatment options for people with COVID-19.

How can I protect myself if I need a blood test or other labs?

"Keep in mind that you may need a new “order” from your doctor if you use a new lab."

For routine blood draws or other kinds of labs, contact your healthcare provider to determine if the test can be postponed. If your doctor feels the test is necessary to do now, contact your lab to see if it can be done at home. Check if your lab is accepting urine samples dropped off at their site or sent through the mail. Sterile specimen cups can be purchased online or may be in stock at a local pharmacy.

If home testing is not an option, you should ask your lab, doctor, or transplant coordinator if there are any local labs that can provide in-home testing services. Not all health insurance plans cover lab visits at home, so you should contact your insurance provider to learn about your coverage.

Staying safe at the lab If the test cannot be postponed or done in your home, you should know that medical facilities are taking precautions to keep you healthy. Hospitals, labs, doctors’ offices, and dialysis centers are evaluating patients and staff, such as checking temperatures and asking questions, to assess each person for active COVID-I9. If it is suspected that someone has the virus, then those people are kept isolated from all healthy people.

Prevention tips It is also important that you take measures to help keep yourself safe and reduce the chance of getting COVID-19. Be sure to wear a mask when you go outside your home. Keep at least 6 feet distance between you and other people. Remember to wash your hands frequently and use hand sanitizer if there are no washing facilities. Avoid touching your eyes, mouth, and nose.

Be well prepared Have extra supplies on hand, including surgical masks, hand sanitizer, and disposable gloves, so that if you come into contact with someone at a medical facility or if a technician comes to your home, you are both well protected. For in-home visits be sure to disinfect any surfaces that another person may have touched, such as doorknobs and countertops.

Are transplant recipients at higher risk due to COVID-19?

Because transplant recipients take immunosuppressive drugs, they have a higher risk of infection from viruses such as cold or flu. To lower the chance of getting the coronavirus that causes COVID-19, transplant patients should follow the CDC’s guidance on how to avoid catching or spreading germs, and contact their health care professional if they develop symptoms of COVID-19.

Statement from the American Society of Transplantation (AST): We do not have specific information on whether COVID-19 infection will be more severe in transplant recipients compared to healthy people; however, other viruses often cause more severe disease in people whose immune system is low, such as transplant recipients.

Are people born with one kidney at higher risk for COVID-19?

No specific information exists about there being a higher risk for COVID-19 in people who have a single kidney as compared with the general population.

Can I be denied dialysis treatment if I have COVID-19?

No. People who are on dialysis and who have also contracted COVID-19 are considered to be at high-risk. If there is availability, these patients may even be admitted to a hospital. In the event your symptoms are mild, you should be able to go to your dialysis center for your scheduled treatments.

The Centers for Disease Control has already issued interim guidance for patients on dialysis who have COVID-19 and all centers should be following these guidelines.

If you have a confirmed case of COVID-19, or have symptoms of COVID-19, or believe you may have been exposed to the coronavirus, then call your dialysis center prior to your scheduled appointment as there may be new procedures they would like you to follow.