D.med Homecare response to COVID-19 pandemic

A Message from our Director of Nursing

Quote and picture of the Director of nursing

Dear patients,

Your safety and well-being is our top priority. During our care and home visits to your home, we have taken all necessary precautions to protect you from infections with COVID – 19. The medical department of D.Med Homecare works closely with our therapy specialists on-site and, you can rely on us to maintain the required hygiene and quality standards even in these times.

Together we will pass this period and come out of this challenging time stronger!

Behave safely and take care of yourself!

Kerstin Gerpheide – Director of Nursing

Our advice to our patients

COVID-19 is a respiratory disease which has spread worldwide that causes diseases, which range from a common cold to much more severe symptoms, for example, Severe Acute Respiratory Syndrome. The transmission comes through the eyes, nose and mouth. Therefore, it is important to note not to touch your eyes, nose and mouth with contaminated hands. That is why it is crucial to use face masks while in public and wash your hands frequently.

Primary Symptoms

COVID-19 symptoms are very similar to the flu. Please check for these symptoms regularly:

  • Fever
  • Cough
  • Shortness of breath
  • Secondary Symptoms
  • Muscular Aches
  • Headache
  • Fatigue
  • Sore Throat
  • Diarrhoea
  • Reduced sense of taste and, or smell.

If you are experiencing any of these symptoms with any regularity immediately contact your Dialysis Team. Additionally, if you have any questions do not hesitate to get in touch with your Dialysis team.

What to do if you have COVID-19 symptoms

Contact your medical team and dialysis center via phone or email. Your medical team will go through your symptoms and then advise you on your next steps.

If you need emergency treatment, please inform your medical team and dialysis center.

Practicing Prevention at Home

Self-isolation is key to preventing both the spread and infection of coronavirus. However, while at home, it is essential to do moderate activities, this helps build your immune system. We suggest at least 20 minutes a day of physical exercise, for example, walking up and downstairs, stretching, and gymnastics.

Don’t let self-isolation affect your standard routine. Find creative ways to continue your hobbies inside, or in your garden. Now is also the perfect time to find new hobbies such as reading. Remember, it is crucial to keep socializing either through the use of digital networks or making a simple phone call.

Shopping

We suggest avoiding traveling to the store yourself when possible. Choosing a delivery service, or asking your friends/family for support will minimize the risk of infection.

However, you may need to go outside for grocery shopping. Here are some tips we have to minimize the risk of infection while shopping:

  • Prepare a list of groceries that you need to buy before leaving. That will decrease the chance of needing a return visit due to forgetting an item. But also, should lessen the time spent browsing.
  • Stock up on non-perishable foods.

Contact

If your area becomes a COVID-19 warning zone or you have had recent contact with somebody who is COVID-19 positive, tell your doctor and dialysis center immediately. Then you can be tested for coronavirus as soon as possible.

When you live with family or housemates who have symptoms of COVID-19

  • Stay home, but self-isolate in a well-ventilated room and monitor your symptoms.
  • Inform your medical team, dialysis center, and local healthcare authority.
  • Frequently sanitize and wash your hands.
  • Clean all surfaces regularly with a household cleaner and avoid sharing personal items, like dishes, towels, or bedding.

Prevention information

Washing hands

Washing your hands interrupts the transmission chain, make sure to wash your hands frequently in general.

Self-isolate

Put yourself in strict social isolation! Stay at home, don’t receive visitors, avoid any unnecessary contact. Remember: Even supposedly healthy people can carry the virus and spread the infection.

Social distancing

Always keep a distance of at least 2 meters from others (the droplet transmission only happens over up to 1.5 to 2 m). It’s especially important to avoid physical contact with people such as handshakes or an embrace.
Sneeze and cough etiquette
If you sneeze or cough, keep your distance from other people, turn away and sneeze / cough into a paper handkerchief, to dispose of immediately.
Remember: Wash or disinfect your hands afterward.

Lifestyle

One of the most important factors is getting enough sleep. Adults need seven to eight hours of undisturbed sleep. Sleep disorders or sleep apnea can, therefore, weaken the immune system.

Sports

Many endurance sports, especially jogging, cycling or swimming, support the immune system. As you train your muscles, your immune system is also improved. Therefore, the production of your immune cells will be maintained.

Nutrition

For an optimally functioning immune system, nutrition is probably the most significant factor. Only a balanced and varied diet offers the body everything it needs to maintain the immune system. In addition to proteins, carbohydrates, and fats, it is also vital to consume enough minerals. Calcium, magnesium, and the trace element zinc are essential for the immune system. Fresh fruit and vegetables will cover your vitamin C requirements for a balanced diet.
Discuss your nutrition with your medical team.

Medication

Do not change your medication intake without consulting your doctor. There is currently no scientifically justified need to stop taking any tablets for fear of Covid-19! Under no circumstances should people who have had a kidney transplant stop taking their immunosuppressive medication for fear of Covid-19, as they risk losing their donor’s kidney.

Q&A

The virus that causes COVID-19 most commonly spreads between people who are in close contact with one another (within about 6 feet, or 2 arm lengths).

It spreads through respiratory droplets or small particles, such as those in aerosols, produced when an infected person coughs, sneezes, sings, talks, or breathes.

  • These particles can be inhaled into the nose, mouth, airways, and lungs and cause infection. This is thought to be the main way the virus spreads.
  • Droplets can also land on surfaces and objects and be transferred by touch. A person may get COVID-19 by touching the surface or object that has the virus on it and then touching their own mouth, nose, or eyes. Spread from touching surfaces is not thought to be the main way the virus spreads.

It is possible that COVID-19 may spread through the droplets and airborne particles that are formed when a person who has COVID-19 coughs, sneezes, sings, talks, or breathes. There is growing evidence that droplets and airborne particles can remain suspended in the air and be breathed in by others, and travel distances beyond 6 feet (for example, during choir practice, in restaurants, or in fitness classes). In general, indoor environments without good ventilation increase this risk.

COVID-19 seems to be spreading easily and sustainably in the community (“community spread”) in many affected geographic areas. Community spread means people have been infected with the virus in an area, including some who are not sure how or where they became infected. (European Centre for Disease Prevention and Control).

The incubation period indicates the time from infection to the beginning of the disease. The mean incubation time (median) is given in most studies with 5-6 days. In various studies it was calculated at what time 95% of infected people had developed symptoms, with the 95th percentile of the incubation time being 10-14 days (Robert-Koch-Institut).

People with COVID-19 have reported a wide range of symptoms – from mild symptoms to severe illness. Symptoms may appear 2-14 days after exposure to the virus. If you have fever, cough, or other symptoms, you might have COVID-19. (European Centre for Disease Prevention and Control)

Rapid antigen tests (sometimes known as a rapid diagnostic test – RDT) detect viral proteins (known as antigens). Samples are collected from the nose and/or throat with a swab. These tests are cheaper than PCR and will offer results more quickly, although they are generally less accurate. These tests perform best when there is more virus circulating in the community and when sampled from an individual during the time they are most infectious. (WHO)

Currently, a variety of antigen tests for the detection of SARS-CoV-2 are offered (Robert-Koch-Institut)

To limit the risks of getting COVID-19 follow these basic precautions:

 

  • Follow local guidance. Check to see what national, regional and local authorities are advising so you have the most relevant information for where you are.
  • Stay at least 1 metre away from others, even if they don’t appear to be sick.
  • Wear a mask, especially when you can’t physically distance.
  • Manage your risks by thinking about location and setting of the event, proximity to others and time you will be at the event. In other words, consider where you are going, how close you will be to other people and how long you will be there. Avoid crowded places and events, poorly ventilated indoor locations and prolonged contact with others.
  • Open windows when indoors to increase the amount of outdoor air.
  • Avoid touching surfaces, especially in public settings, because someone with COVID-19 could have touched them before. Clean surfaces regularly with standard disinfectants.
  • Frequently clean your hands with soap and water, or an alcohol-based hand rub. If you can, carry alcohol-based rub with you and use it often.
  • Cover your coughs and sneezes with a bent elbow or tissue, throwing used tissues into a closed bin right away. Then wash your hands or use an alcohol-based hand rub (WHO).

Scientists around the world are working to find and develop treatments for COVID-19.

 

  • Optimal supportive care includes oxygen for severely ill patients and those who are at risk for severe disease and more advanced respiratory support such as ventilation for patients who are critically ill.
  • Dexamethasone is a corticosteroid that can help reduce the length of time on a ventilator and save lives of patients with severe and critical illness. Read our dexamethasone Q&A for more information.
  • Results from the WHO’s Solidarity Trial indicated that remdesivir, hydroxychloroquine, lopinavir/ritonavir and interferon regimens appear to have little or no effect on 28-day mortality or the in-hospital course of COVID-19 among hospitalized patients.
  • Hydroxychloroquine has not been shown to offer any benefit for treatment of COVID-19.

 

WHO does not recommend self-medication with any medicines, including antibiotics, as a prevention or cure for COVID-19. WHO is coordinating efforts to develop treatments for COVID-19 and will continue to provide new information as it becomes available (WHO).

Researchers are currently working on more than 200 potential vaccine candidates, with more than 40 vaccines already in clinical trials in healthy volunteers. All vaccine candidates are based on the basic principle of presenting parts (antigens) of SARS-CoV-2 to our immune system so that immunity to the pathogen can be built up. The different candidates use very different antigen parts and approaches. There are three main lines of development: Live vaccines with vector viruses, dead vaccines with virus proteins or mRNA/DNA vaccines. (Federal Ministry of Health)

 

Two manufacturers are currently applying for vaccine approval, Modena and Biontech/Pfizer.

People at increased risk include:

  • Older adults
  • People of all ages with certain underlying medical conditions
  • Pregnant people might also be at increased risk of severe illness from COVID-19.

(European Centre for Disease Prevention and Control)

Most people who get COVID-19 will be able to recover at home. CDC has directions for people who are recovering at home and their caregivers, including:

  • Stay home when you are sick, except to get medical care.
  • Use a separate room and bathroom for sick household members (if possible).
  • Wash your hands often with soap and water for at least 20 seconds, especially after blowing your nose, coughing, or sneezing; going to the bathroom; and before eating or preparing food.
  • If soap and water are not readily available, use an alcohol-based hand sanitizer with at least 60% alcohol. Always wash hands with soap and water if hands are visibly dirty.
  • Provide your sick household member with clean disposable facemasks to wear at home, if available, to help prevent spreading COVID-19 to others.
  • Clean the sick room and bathroom, as needed, to avoid unnecessary contact with the sick person.

However, some people may need emergency medical attention. Watch for symptoms and learn when to seek emergency medical attention.

 

When to Seek Emergency Medical Attention:

Look for emergency warning signs for COVID-19. If someone is showing any of these signs, seek emergency medical care immediately

  • Trouble breathing
  • Persistent pain or pressure in the chest
  • New confusion
  • Inability to wake or stay awake
  • Bluish lips or face

A contact is defined as anyone who had direct contact or was within 1 metre for at least 15 minutes with a person infected with the virus that causes COVID-19, even if the person with the confirmed infection did not have symptoms. Contacts should remain in self-quarantine during the 14-day monitoring period to limit the possibility of exposing other people to infection should they become ill (WHO).

If you are a possible contact, you should first be contacted by phone or in person by health authorities to determine if you meet the contact definition, which is anyone who has had direct contact or was within 1 metre for at least 15 minutes with a person infected with COVID-19. If you are confirmed as a contact, you will then be encouraged and supported to be in quarantine, which means to separate yourself from others, and to monitor your health for any signs of illness. The monitoring ends 14 days you were last into contact with the person infected with COVID-19.

By participating in contact tracing, you are contributing to controlling spread of the virus that causes COVID-19 in your area; vulnerable people will be protected, and more restrictive measures, such as general stay-at-home orders, might be avoided or minimized. This is an act of solidarity for your community (WHO).

Masks are a key measure to suppress transmission and save lives.

 

Masks should be used as part of a comprehensive ‘Do it all!’ approach including physical distancing, avoiding crowded, closed and close-contact settings, good ventilation, cleaning hands, covering sneezes and coughs, and more.

 

Depending on the type, masks can be used for either protection of healthy persons or to prevent onward transmission.