East Alabama Health issues best practices for managing COVID-19 at home

Alabama News

OPELIKA, Ala. (WRBL) – East Alabama Health is sharing a detailed information sheet with families to help them care for themselves or others who are sick with COVID-19 at home. The reference sheet includes the best advice doctors have learned after caring for sick patients since the pandemic began 18 months ago.

Chuck Beams, East Alabama Health’s Director of Pharmacy Services, says most people who get sick with COVID-19 can recover at home, especially if they are fully vaccinated. Beams, along with some of Alabama’s top COVID-19 experts, are distributing the handout called Best Practices for the Therapeutic Management of Non-hospitalized Adults with COVID-19 (scroll down to read the entire document).

“We want this document to communicate what we feel is the best ways to manage COVID at home,” said Beams.

The handout outlines Monoclonal Antibody Therapy for high risk in detail. It also shares lifestyle guidance like using a Pulse Ox to monitor oxygen, lung exercises, stomach sleeping using the prone position, and staying hydrated by drinking half your weight in ounces of water.

“So if you weigh 220, half of that is 110, so you need to drink 110 ounces of water a day to stay hydrated. The prone position is basically at night; try to sleep on your belly or your side; that will help you keep your lungs healthy. As long as you have your mask, and stay away from people walking is something you need to do if you can,” said Beams.

The sheet also includes details on how to use over-the-counter medications to treat symptoms, like Mucinex, Zyrtec, and baby aspirin. The sheet warns against using Ivermectin and Hydroxychloroquine.

“As we look at the evidence today, that’s not something we do. And believe me, if there was something we could do to make things better, we want to do that,” said Beams.

Please read the sheet in detail for yourself, and if you have any questions contact your primary care doctor.

Above all, Beams says vaccines are the best way to protect your family. Unfortunately, the vast majority of East Alabama Medical Center hospitalizations and deaths involve patients who have not received a vaccine. Meanwhile, hospitalizations are trending down at East Alabama Medical Center. However, Alabama continues averaging 50 deaths a day, as the Delta variant remains a significant threat.

East Alabama Health: Best Practices for the Therapeutic Management of Non-hospitalized Adults with COVID-19

East Alabama Health: Best Practices for the Therapeutic Management of Non-hospitalized Adults with COVID-19

Monoclonal Antibody (MAB) Therapy
If taken early, MABs can reduce the risk of
severe disease, hospitalization, and death

Criteria for use for MAB therapy:
1) Not requiring supplemental oxygen
therapy due to COVID-19 AND
2) Within 10 days of symptom onset AND
Locate a provider for MAB infusion:
1-877-332-6585
https://protect-public.hhs.gov/pages/therapeutics-distribution
3) If ANY of the following criteria are met:

  • Age > 65
  • BMI > 25 (Click for CDC BMI Calculator)
  • Pregnancy
  • Diabetes
  • Hypertension
  • Cardiovascular Disease
  • Chronic Kidney Disease
  • Chronic Lung Disease (i.e. asthma, COPD, cystic fibrosis,
    pulmonary hypertension)
  • Immunosuppressive disease or immunosuppressive
    treatment
  • Sickle cell disease
  • Medical-related technological dependence (i.e. tracheostomy
    or gastrostomy)

Symptom Management – Lifestyle & Daily Routine
Encourage patients to use a Pulse Oximeter

  • Check oxygen (SpO2) levels at least 3 times daily
  • Warm finger before each check by rubbing
    fingertip briskly on shirt or pants
  • Remove fingernail polish
  • If oxygen levels read consistently below 92%, NOTIFY YOUR DOCTOR

Encourage & describe the PRONE position

  • Encourage the patient to rest and sleep on
    their side or belly if possible
  • Cough forcibly, take several deep breaths,
    and hold them as long as possible
    throughout the day

Hydration with Water

  • 1/2 of body weight in ounces each day
    (200 lbs = 100 ounces of water/day)
  • High fevers fluid loss
    Physical Activity
  • Moderate physical activity as tolerated
  • Do not elevate heart rate over 130 beats per
    minute
  • Take deep breaths while walking and cough
    deeply

Patients with COVID-19 should continue to follow all CDC quarantine, mask, and handwashing recommendations

Symptom Management
The drugs listed in this section DO NOT treat or cure the COVID-19 virus. Currently, the only proven, effective treatment for patients not requiring hospitalization is the monoclonal antibody (MAB) therapy mentioned above. The following medications MAY be considered to reduce symptoms of the COVID-19 virus. These medications should not be taken without discussing the risks and benefits with your doctor or pharmacist first.

  • MUCINEX: 1200 mg every 12 hours (max of 14 days) – for chest congestion
  • ZYRTEC: 10 mg daily – antihistamine for runny nose and congestion
  • ASPIRIN: Optional – 81 mg daily, if not already on a blood thinner
  • BUDESONIDE: 0.5 mg/2mL via nebulizer twice daily – may reduce the time to recovery of COVID-19 and
    should be stopped after symptom resolution. Nebulizers should be used with caution in patients with
    COVID-19 as they increase the risk of viral transmission. Avoid use around other people; Use near open
    windows or areas of increased air circulation.
  • ZOFRAN: 8 mg 3 times daily as needed for nausea and vomiting
  • IMODIUM: 1 tablet as needed for diarrhea (MAX of 4 tablets/day)

Medication Management Considerations & Warnings

  • No oral steroids (prednisone, dexamethasone, methylprednisone) during the first six days of infection unless supplemental oxygen is required. Dexamethasone 6 mg once daily for a maximum of 10 days may be considered after physician reevaluation if pulmonary symptoms are still persistent after one week.
  • IVERMECTIN is NOT recommended
  • ANTIBIOTICS including azithromycin are generally NOT recommended (Bacterial co-infection rates are less than 6.5%)
  • HYDROXYCHLOROQUINE is NOT recommended
  • Many VITAMINS and other supplements have been mentioned for the treatment of COVID-19. Taking dietary supplements can enhance immunity and reduce inflammation. However, these products have not been studied in conjunction with COVID-19 and should not be seen as a treatment option for a patient with an active COVID-19 infection.

*East Alabama Health: Last Updated: 9/12/21

Copyright 2021 Nexstar Media Inc. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.

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