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

COVID-19 is thought to spread mainly through close contact from person to person, including between people who are physically near each other (within about 6 feet). People who are infected but do not show symptoms can also spread the virus to others. Cases of reinfection with COVID-19  have been reported but are rare. We are still learning about how the virus spreads and the severity of illness it causes.

COVID-19 spreads very easily from person to person. How easily a virus spreads from person to person can vary. The virus that causes COVID-19 appears to spread more efficiently than influenza but not as efficiently as measles, which is among the most contagious viruses known to affect people (European Centre for Disease Prevention and Control).

The time from exposure to COVID-19 to the moment when symptoms begin is, on average, 5-6 days and can range from 1-14 days. This is why people who have been exposed to the virus are advised to remain at home and stay away from others, for 14 days, in order to prevent the spread of the virus, especially where testing is not easily available (WHO).

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).

Stay safe by taking some simple precautions, such as physical distancing, wearing a mask, especially when distancing cannot be maintained, keeping rooms well ventilated, avoiding crowds and close contact, regularly cleaning your hands, and coughing into a bent elbow or tissue. Check local advice where you live and work. Do it all! (WHO)

Anyone with symptoms should be tested, wherever possible. People who do not have symptoms but have had close contact with someone who is, or may be, infected may also consider testing – contact your local health guidelines and follow their guidance.

While a person is waiting for test results, they should remain isolated from others. Where testing capacity is limited, tests should first be done for those at higher risk of infection, such as health workers, and those at higher risk of severe illness such as older people, especially those living in seniors’ residences or long-term care facilities (WHO).

In most situations, a molecular test is used to detect SARS-CoV-2 and confirm infection. Polymerase chain reaction (PCR) is the most commonly used molecular test. Samples are collected from the nose and/or throat with a swab. Molecular tests detect virus in the sample by amplifying viral genetic material to detectable levels. For this reason, a molecular test is used to confirm an active infection, usually within a few days of exposure and around the time that symptoms may begin (WHO).

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).

Antibody tests can tell us whether someone has had an infection in the past, even if they have not had symptoms. Also known as serological tests and usually done on a blood sample, these tests detect antibodies produced in response to an infection. In most people, antibodies start to develop after days to weeks and can indicate if a person has had past infection. Antibody tests cannot be used to diagnose COVID-19 in the early stages of infection or disease but can indicate whether or not someone has had the disease in the past (WHO).

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 meter 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.
  • 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).

Yes. There are three COVID-19 vaccines for which certain national regulatory authorities have authorized the use. None have yet received WHO EUL/PQ authorization but we expect an assessment on the Pfizer vaccine by the end of December and for some other candidates soon thereafter.

Large studies of 5 vaccine candidates efficacy and safety results, including these three (and for Moderna and AstraZeneca), have been publicly reported  through press releases but only one (AstraZeneca) has published results in the peer reviewed literature.  , We expect more such reports in the near future.  It is likely that additional candidates will be submitted to regulatory authorities for approval. There are many potential COVID-19 vaccine candidates currently in development.

Once vaccines are demonstrated to be safe and efficacious, they must be approved by national regulators, manufactured to exacting standards, and distributed. WHO is working with partners around the world to help coordinate key steps in this process, including to facilitate equitable access to safe and effective COVID-19 vaccines for the billions of people who will need them (WHO).

Vaccination is a safe and effective way to prevent disease and save lives – now more than ever. Today there are vaccines available to protect against at least 20 diseases, such as diphtheria, tetanus, pertussis, influenza and measles. Together, these vaccines save the lives of up to 3 million people every year.

When we get vaccinated, we aren’t just protecting ourselves, but also those around us. Some people, like those who are seriously ill, are advised not to get certain vaccines – so they depend on the rest of us to get vaccinated and help reduce the spread of disease.

During the COVID-19 pandemic, vaccination continues to be critically important. The pandemic has caused a decline in the number of children receiving routine immunizations, which could lead to an increase in illness and death from preventable diseases. WHO has urged countries to ensure that essential immunization and health services continue, despite the challenges posed by COVID-19 (WHO).

Vaccines reduce risks of getting a disease by working with your body’s natural defenses to build protection. When you get a vaccine, your immune system responds. It:

  • Recognizes the invading germ, such as the virus or bacteria.
  • Produces antibodies. Antibodies are proteins produced naturally by the immune system to fight disease.
  • Remembers the disease and how to fight it. If you are then exposed to the germ in the future, your immune system can quickly destroy it before you become unwell.

The vaccine is therefore a safe and clever way to produce an immune response in the body, without causing illness.

Our immune systems are designed to remember. Once exposed to one or more doses of a vaccine, we typically remain protected against a disease for years, decades or even a lifetime. This is what makes vaccines so effective. Rather than treating a disease after it occurs, vaccines prevent us in the first instance from getting sick.

Currently, there is not enough evidence on the length of immunity. Experts need to gather more evidence over time about the protection provided by the vaccination to estimate the length of immunity.

Vaccination protects you from getting seriously ill and dying from COVID-19. For the first fourteen days after getting a vaccination, you do not have significant levels of protection, then it increases gradually. For a single dose vaccine, immunity will generally occur two weeks after vaccination. For two-dose vaccines, both doses are needed to achieve  are required to provide the highest level of best immunity possible.

While a COVID-19 vaccine will protect you from serious illness and death, we still don’t know the extent to which it keeps you from being infected and passing the virus on to others. To help keep others safe, continue to maintain at least a 1-metre distance from others, cover a cough or sneeze in your elbow, clean your hands frequently and wear a mask, particularly in enclosed, crowded or poorly ventilated spaces. Always follow guidance from local authorities based on the situation and risk where you live (WHO).

No, the COVID-19 vaccine will not cause a positive test result for a COVID-19 PCR or antigen laboratory test. This is because the tests check for active disease and not whether an individual is immune or not. However, because the COVID-19 vaccine prompts an immune response, it may be possible to test positive in an antibody (serology) test that measures COVID-19 immunity in an individual (WHO).

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

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.

‘Herd immunity’, also known as ‘population immunity’, is the indirect protection from an infectious disease that happens when a population is immune either through vaccination or immunity developed through previous infection. WHO supports achieving ‘herd immunity’ through vaccination, not by allowing a disease to spread through any segment of the population, as this would result in unnecessary cases and deaths.

Herd immunity against COVID-19 should be achieved by protecting people through vaccination, not by exposing them to the pathogen that causes the disease.

Vaccines train our immune systems to create proteins that fight disease, known as ‘antibodies’, just as would happen when we are exposed to a disease but – crucially – vaccines work without making us sick. Vaccinated people are protected from getting the disease in question and passing on the pathogen, breaking any chains of transmission. Visit our webpage on COVID-19 and vaccines for more detail.

To safely achieve herd immunity against COVID-19, a substantial proportion of a population would need to be vaccinated, lowering the overall amount of virus able to spread in the whole population. One of the aims with working towards herd immunity is to keep vulnerable groups who cannot get vaccinated (e.g. due to health conditions like allergic reactions to the vaccine) safe and protected from the disease.

The percentage of people who need to be immune in order to achieve herd immunity varies with each disease. For example, herd immunity against measles requires about 95% of a population to be vaccinated. The remaining 5% will be protected by the fact that measles will not spread among those who are vaccinated. For polio, the threshold is about 80%. The proportion of the population that must be vaccinated against COVID-19 to begin inducing herd immunity is not known. This is an important area of research and will likely vary according to the community, the vaccine, the populations prioritized for vaccination, and other factors.

Achieving herd immunity with safe and effective vaccines makes diseases rarer and saves lives (WHO).

Physical activity includes all forms of active recreation, sports participation, cycling and walking, as well as activities you do at work and around the home and garden. It doesn’t have to be exercise or sport – play, dance, gardening, and even house cleaning and carrying heavy shopping is all part of being physically active.

During the COVID-19 pandemic, when so many of us are very restricted in our movements, it is even more important for people of all ages and abilities to be as active as possible. Even a short break from sitting, by doing 3-5 minutes of physical movement, such as walking or stretching, will help ease muscle strain, relieve mental tension and improve blood circulation and muscle activity. Regular physical activity can also help to give the day a routine and be a way of staying in contact with family and friends (WHO).