Thread: Corona Virus

Get used to keeping your distance = 1.5 m from sick people. Imagine a bubble…

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In a world dominated by the negative, we wish to use this site to highlight the positive story of Australian general practice.

• Covid-19 blogs
• Covid-19 practical information
• Covid-19 preparation & testing
• Coronavirus visual resources
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• My GP can
• GPs can
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• This GP can
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A guide to self-isolation or quarantine with Covid-19

March 10, 2020
Information on this page is of a general nature only. For information specific to your needs, please ask a trusted health professional.Authors: Australian GPs, Dr Wendy Burton, MBBS FRACGP (Hon) and Dr Kat McLean, MBChB FRACGP FRNZCGP
Definitions

Self-isolation vs quarantine, what’s the difference?

Quarantine

• You are at risk of having the Covid-19 infection, but not actually known to be infected. You may or may not end up with it
  
• You are asked to wait it out in isolation until 14 days have passed, if you remain well. This reduces the chances of the infection spreading and applies if you have come back from the growing list of places with a lot of infection or if you have had contact with someone who is positive
  
• If you become unwell during the 14 days, testing is done and if positive, you then move into isolation phase (or hospital if very unwell)
  
• If unwell but testing is negative, we still want you to stay in quarantine until the 14 days are up, as the infection may take that long to show
  
• If well at the end of the 14 days, you may resume normal contact, providing you stay well

Self-Isolation

• You are Covid-19 positive
  
• You are well enough to be looked after at home
  
• At present (March 9, 2020) in Australia, you can come out of self-isolation if ALL of the following apply
  
  
  • it is more than 7 days since you became unwell
    
  • at least 2 days with no fever
    
  • at least 1 day of feeling better/having no symptoms
    
  • you have 2 tests 24 hours apart that are both negative
    Please take care. It seems highly unlikely that you can be reinfected, but we don’t want you getting another infection so soon after having Covid-19

THIS IS WHAT WE ARE TRYING TO DO (CLICK ON IMAGE)






Living in isolation

What’s your living situation?

Live alone? Relatively straight forward:

• NO visitors
  
• NO visits to the shops, school, university, work, park, library, movies, church/place of worship, chemist or GP
  
• NO family gatherings
  
• STAY AT HOME

Sharing a room/home with your partner or family?

• Same as above plus
  
• Can you isolate yourself from others? Stay in your room? Have your partner sleep in another room?
  
• If you can isolate yourself from others within your home, do so. For 14 days. Sorry, it’s going to be a long 14 days. Open your windows (if safe/practical)
  
• If you cannot isolate yourself within your home, cover your mouth when you cough, wash your hands frequently, wipe touched surfaces or wear disposable or clean gloves if needing access to communal areas (e.g. kitchen) and wear a face mask when others are around (further advice below)
  
• Keep in mind that most of your family will be in quarantine as they are likely to have been in close contact with you. We still want you isolated, to reduce the risk that they get it (because we don’t want them to get sick AND that will reset everyone’s 14 day self-isolation time). This will change if/when the infection becomes more widespread

Why 14 days?

Because that seems to be the longest time this virus can be incubating for, before people become sick. If you are not sick by 14 days after exposure, as far as we know, you have not got this infection





Get used to keeping your distance = 1.5 m from sick people. Imagine a bubble…







What are we trying to achieve by the isolation?

We are trying to slow down the spread of the infection
This is important because the health system will find it much harder to manage if everyone gets sick at the same time
People are at a higher risk of getting sick with Covid-19 if they have close contact with someone who already has it
Close contact is defined as having the following contact with someone who has Covid-19, this includes contact in the 24 hours before they became sick:

• 15 minutes or more face-to-face and/or
  
• More than 2 hours in the same room

This is particularly important for people at higher risk of complications from Covid-19. PLEASE, if you have or think you could have Covid-19, stay away from

• The elderly (highest risk in over 80s, but risk starting to seriously climb from 50, gets noticeably worse from there on)
  
• Those who have heart problems
  
• Those who have diabetes
  
• Those who have lung troubles e.g. asthma, emphysema, chronic bronchitis, bronchiectasis, cystic fibrosis
  
• Those who have high blood pressure
  
• Those who have cancer
  We are also concerned about those whose immune systems are low, including because of medication that they take, and our Australian Aboriginal and Torres Strait Islander populations

Ideas on what to do while in isolation

If you are unwell, you will need to manage your symptoms

For most of us, this will be like managing a cold:

• Eat well (that means fruit and vegetables, not chips and lollies!)
  
• Keep your fluids up, use paracetamol or ibuprofen for pain or high fevers
  
• Get some sleep
  
• Low grade fever in someone who is otherwise feeling ok does not have to be treated — it is part of the body’s immune response and we get better quicker if we let it be
  
• Let us know (phone your GP’s rooms for advice or state or national help lines or 000 in an emergency) if you are getting worse, especially your coughing is worsening and/or if you are having trouble breathing
  
• We are working on efficient ways to keep in touch and monitor your progress, watch this space

You will need to eat

• What do you have in the pantry/fridge/freezer?
  
• Can someone drop fresh food over (home delivery from family or friends, the supermarket, restaurants)?
  
• They should avoid direct contact with you, drop the food at the doorstep (yes, that’s what isolation means) and leave

You will need to clean







This is more important if others are sharing the space with you, but at some stage, the house will need to be cleaned. Based on what we know about previous outbreaks (SARS and MERS), Coronavirus can live, on average, 4-5 days, but some survived at room temperature for up to 9 days
For the basics, including hand washing, coughing, social distancing (the bubble) and trying to stop germs transferring, especially from children, click here
For cleaning surfaces

• The CDC recommend you put disposable gloves on (or if using reusable ones, don’t use them for any other purpose), but this is difficult for most. Do what you can with what you have, but either way wash your hands afterwards
  
• Use a detergent first (I just use washing up detergent and warm water)
  
• For suitable surfaces, follow with diluted bleach e.g. White King Bleach (sodium hypochlorite 4% chlorine) 1-part bleach, 7-parts water.
  
• A combined commercial spray is fine to use instead of the above two step process. Most household disinfectants are based on benzalkonium chloride, with 0.05% the concentration recommended
  
• Alcohol wipes or sprays are suitable alternatives, e.g. for phones, where Apple does NOT recommend bleach and please don’t get the phone wet!
  
• Wipe the benches and frequently touched surfaces such as tables, doorknobs, doorbell if getting deliveries, light switches, cupboard and drawer handles, desks, toilets, taps and sinks twice a day
  
• Once you are finished cleaning, dispose of/remove the gloves and wash your hands
  Further resources from the CDC are here

Stop shaking hands


There are so many safer options, use one of these or invent your own!







Other cleaning essentials:

• After using the toilet, close the lid, flush and wash your hands. The Covid-19 virus can be detected in poo and by closing the lid before flushing, you reduce the risk of the virus becoming airborne and spreading the infection further
  
• If there is only one toilet in the household, clean (as above) the toilet seat, flusher, tap, sink, door handles (i.e. any surface that may have been touched) each time it’s been used by the person who is sick. Two toilets? Sick person gets one, everyone else uses the other one! Ditto for shower/bath
  
• Change sheets and towels regularly, keep the towel of the sick person separate from other towels e.g. in their room and have a separate towel for them to wipe their hands on after washing
  
• Wash the floors once a day
  
• Clean down hand-held devices and surfaces hands touch regularly— gaming controls, mobile phones, tablets, keyboards (e.g. with alcohol spray or alcohol wipes)
  
• The sick person is excused from setting the table, cooking, washing up and unpacking the dishwasher and they are to have their face mask in place when in the same room as others, so will be eating away from those who are well, preferably in their own room
  
• No sharing of food or drink that’s been in contact with the sick person, into the bin with their leftovers!
  
• You can wash clothes the usual way, you don’t need to separate out the clothes or towels from the sick person, but do wash your hands after putting the washing into the machine. Please don’t shake the clothes out before washing — this increases the risk of viral particles becoming airborne. Dry clothes well before putting them away. Use a disposable or washable clothes bin liner
  
• The sick person should have their own rubbish bin, which is lined with a disposable liner. Gloves on when emptying is good advice and wash hands well after taking the rubbish out
  
• If you have an unwell young child, try to have one person providing their care, who is very careful about how they interact with others who are well. Now is the time to consider extending their electronic time (just for now). Most kids will be excited about this and it helps by keeping them occupied and distracted

Keep occupied!







You will need to keep occupied

• See if you can work or study from home
  
• If you have children, ask their school if they can complete schoolwork from home.
  
• Maintain connection with friends, family, neighbours, your community – there are so many options, consider setting up regular phone calls to check in with and check on others
  
• Keep active – consider ways to do this from home e.g. spring clean or organise the house, download an exercise app, check out YouTube exercise or dance classes. Movement matters
  
• Try to limit how much you follow the news, be aware that there are some weird suggestions out there and be mindful of the effect it can have upon children. Checking in once a day is enough!
  
• Catch up on that series you’ve been meaning to read/listen to/watch
  
• Dust off the board games and playing cards
  
• Practice your music/learn to play an instrument
  
• Organise your digital (or actual) photos
  
• Breathe (take a deep breath, focus on the moment, stay calm. Breathe)
  
• Sing
  
• Write—your journal, a song, a blog, a screenplay, a book, a letter. Be creative
  
• Do some virtual museum visiting here
  
• Australians can call the national Coronavirus Health Information Line on 1800 020 080 if they can’t find what you are looking for in their online resources, found here

Mental health considerations

• Keep your mind occupied with meaningful and creative pursuits
  
• It is OK to not be OK, but try not to panic, this will not help
  
• Head to Health has some great online mental health resources
  
• Contact your GP if you need additional support
  
• There are lots of great no/low cost apps or websites you can utilise, and a number you can work through with your children
  
  
  • This Way Up ($55, you will need a referral from your doctor)
    
  • Smiling Mind (free, children and adults)
    
  • Mood Gym (free, adolescent and adult)
    
  • The Brave Program (free, children 7 - 17 years)

THIS WILL PASS

MOST OF US (80-85%) WILL BE FINE

WE HAVE CAPACITY TO HELP THE 15-20% IF WE MANAGE WELL

TOGETHER IS HOW WE WILL GET THROUGH THIS

Advice current as of March 12 2020
Information collated from multiple sources including GPs Down Under,World Health Organisation; WHO Myth Busters; Australian Department of Health; ABC; CDC; Ian Mackay; Dr James Wei












Tags dr wendy burton, dr kat mclean, coronavirus, covid-19, covid-19 basics, guide to covid-19






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