Surviving Covid-19…and Beyond

You were coughing, exhausted, achy, and you had a headache. If you breathed in quickly, you coughed a lot. You thought you might be a little short of breath, but wondered if you were just anxious.

You actually managed to find a place to get tested. Someone inserted a cotton swab so deeply up your nose that it felt like your eyeball was pushed out (don’t worry, it wasn’t). They said your symptoms looked like Covid-19, but that yours was probably a mild case.

Since you don’t have any significant health problems, you were told to go home and self-isolate. And because your mind is pretty much a panicked blur, you were grateful to receive printed instructions about what self-isolating actually means. (Spoiler alert: it means keeping your infected self away from those who are not infected.)

Click here for advice from Johns Hopkins on self-isolating and also on self-quarantining and social/physical distancing. This information definitely takes precedence over anything you’ll hear from Trump, Alex Jones, or the AK-47-armed Duck Dynasty crowd picketing the Michigan governor.

The next day they called you, confirmed your positive Covid-19 test, and asked about your contact with other people. Since there’s no cure for the virus, you were told you had to wait for your immune system to decimate it and that this would take about two weeks, but you were warned to expect to feel fragile for about four weeks.

Covid-19 symptom relief
Here are my recommendations for symptom relief:
For achiness  We’re now giving the OK to non-steroidal anti-inflammatory drugs (NSAIDS). If your stomach can tolerate an NSAID, take either ibuprofen (200-400 mg three times daily) or Alleve (200 mg every 12 hours). If you’re sensitive to NSAIDs, use acetaminophen (Tylenol Extra Strength, two every four hours).

Cough  If you’ve got a persistent non-productive (ie, no sputum) cough and you can’t get anyone to phone in a prescription, purchase any over-the-counter cough syrup with the letters DM at the end, like Robitussin DM. The DM stands for dextromethorphan, which suppresses dry, nagging-type coughs.

If you can find someone to phone in a prescription, ask for Tessalon Perles (200 mg) and take three or four daily. This is sodium benzoate, a superb non-narcotic cough suppressant. (Vicodin and Norco are also excellent cough suppressants, but since they contain codeine, asking for one of them might get you permanently labelled as a drug-seeking patient.)

If you have asthma, you likely have an albuterol inhaler around the house. Use it if you’re feeling short of breath. These are called rescue inhalers for good reason. If you’re coughing constantly or mildly short of breath, a couple of deep inhalations can give you relief in a minute or two. If you find your inhaler’s expiration date has passed, use it anyway. The medication inside lasts a couple of years beyond the date.

Some people with asthma use a daily inhaler that combines albuterol with a steroid (Advair, Symbicort) and these can be used as well. The steroid can help reduce inflammation triggered by the virus.

If breathing becomes really difficult, get to an emergency room pronto.

Here’s a list of supplements that may be useful to increase immune function
If you’ve been reading our Health Tips, you’re aware of this list.  While these supplements can be used to support the immune system during many viral infections, at this time there is no concrete evidence to show whether or not they are useful against Covid-19.  This list does not take the place of official recommendations by the CDC or other government agencies.
—Vitamin C  2,000-3,000 mg daily
—Vitamin D  5,000 IU daily
—Zinc  30-50 mg daily
–An immune-boosting mushroom blend, such as Reishi 415 or 5 Defenders.
–An immune-boosting herbal blend, such as EHB by Integrative Therapeutics.

Additionally, consider adding the following:
—Andrographis (200 mg twice daily).  This is an herb with proven anti-viral activity and good immune support.
—Nattokinase (once daily). This is a mild blood thinner that may be effective in blocking the hypercoagulable complication of the cytokine storm. Don’t take it if you’re already on a blood thinner.

When you can safely end self-isolation is a best guess
The current recommendations are very unscientific. Follow this advice from the CDC (click here for more):

Persons with Covid-19 who have symptoms and were directed to care for themselves at home may discontinue isolation under the following conditions:
–At least 3 days (72 hours) have passed since recovery, defined as resolution of fever without the use of fever-reducing medications.
–Improvement in respiratory symptoms (eg, cough, shortness of breath).
–At least 7 days have passed since symptoms first appeared.
–Repeat Covid-19 testing. Ideally, you want to know that you are completely free of Covid-19. When more tests are available, let 7 to 10 days pass of being fever-free and symptom-free and get tested twice more, separating the tests by at least 24 hours

In other words, two negative swabs, 24 hours apart.

It’s perfectly reasonable to ask “How do I know for sure that I’m not contagious?” You can’t know for certain without those two tests. Sadly, we’re lagging behind much of the world in the availability of test kits. We don’t have enough kits right now for the luxury of follow-up testing.

It’s currently thought that by the time your self-isolation is over, the virus has weakened enough to not infect others.

Does this happen frequently? We just don’t know. Our knowledge of the virus is evolving rapidly. Here’s more on virus relapse/reactivation/re-infection.

Be well,
David Edelberg, MD