March 2, 2020 — Written by Dr. Patricia Blanchette, Chief Medical Officer, University Health Partners of Hawaii
Featured photo by Vina Cristobal
In preparation for the possibility of one of our clinic patients having COVID-19 and the likelihood that they will have influenza, we have taken the following steps and have the following advice for our UHP clinics.\u00a0 <\/p>\n\n\n\n
First, it\u2019s\nnot too late to receive the seasonal flu vaccine. The symptoms of flu and COVID-19 are\nsimilar. People with underlying\nrespiratory illnesses are likely to have worse symptoms if they also get\nCOVID-19. So, protect yourself. <\/p>\n\n\n\n
Recognize\nsymptoms<\/strong>: We should know that COVID-19 and influenza\npresent with similar symptoms. The\ninitial difference was that the COVID-19 patients would have a history of\ntravel to affected regions. There is a\npossibility that we will also see patients who have symptoms but have not\ntraveled to areas where COVID-19 is known to have spread. So, we should be alert to patients with\ninfluenza-like symptoms, such as fever, cough and shortness of breath. The State of Hawaii Dept of Health has\ncollected data that shows that more than 8% of patient visits to primary care\nphysicians in January\/February were for flu-like symptoms. <\/p>\n\n\n\n Wash your hands with soap and water frequently: <\/strong>\u00a0It is amazing how protective frequent hand washing is to prevent contagious illnesses.\u00a0 To remember how long you should wash your hands, sing \u201cHappy Birthday\u201d to yourself twice while doing so.\u00a0 Use plenty of soap and dry your hands well.\u00a0 <\/p>\n\n\n\n Consider Zoom or telephone visits<\/strong>: It may be possible to do a telephone or Zoom visit to help the patient avoid travel to the clinic when they are feeling sick.\u00a0 In this way they could reduce the chances of spreading influenza (flu) or COVID-19. If the provider feels comfortable doing so, providing prescriptions for the appropriate flu medicine over the phone could be done.\u00a0 If you don\u2019t know how to do a Zoom visit, someone in the UHP central office can walk you through it.\u00a0Every clinical department now has a Zoom account.\u00a0 <\/p>\n\n\n\n Immediately\nisolate a patient with flu-like symptoms in the clinic: <\/strong> We have distributed \u201cstop signs\u201d to post in\nthe clinics to alert patients that if they have flu-like symptoms to notify the\nclinic staff immediately upon their arrival. \nThe clinic staff should then don a face mask, eye shield, gloves and a\ngown, provide a surgical mask to the patient, and then isolate them in an exam\nroom by themselves. For children or\nelders who need someone to accompany them, also put a surgical mask on the\nperson aiding them. Then notify the\nexaminer of the situation and have the examiner don protective equipment before\nentering the room. <\/p>\n\n\n\n Clean\nand disinfect the clinic:<\/strong> Be sure to clean high\ntouch surfaces frequently. A reasonable cleaning schedule would be before the\nclinic opens in the morning, mid-morning, noon, mid-afternoon and after the\nclinic closes. If the clinic is open for\nirregular hours, clean and disinfect high touch surfaces every two hours. <\/p>\n\n\n\n Disinfecting sprays and solutions may come into short supply.\u00a0 If so, a 10% solution of Clorox household bleach is an excellent and very effective substitute.\u00a0 There are six different types of odors of Clorox bleach, so try to select one whose odor is not unpleasant in the clinic.\u00a0 NEVER mix bleach with ANY other chemical as this can generate a gas that is highly toxic. \u00a0When preparing a bleach solution, first wear goggles and gloves, and wear something to protect your clothes from getting a bleach splash.\u00a0 Use a container, such as a new spray bottle or another clean container.\u00a0 New spray bottles are widely available in drug and variety stores.\u00a0 Place one-ninth of the total solution that you are planning to create, then add 8 ninths of water.\u00a0 For example, use one cup of bleach to nine cups of water, or \u00bc cup of bleach to 2 \u00bc cups of water.\u00a0 Put the bleach in the container first, then add water.\u00a0 <\/p>\n\n\n\n Pay special\nattention to clean places that are frequently touched, such as door handles and\nsurrounding areas, elevator buttons, counters, telephones, keyboards, sink\nfaucets and sinks, and toilet handles. <\/p>\n\n\n\n Personal behavior: <\/strong>Cover your nose and mouth well when coughing or sneezing, cough or sneeze into your elbow if needed, and use a tissue if you can get to one quickly and then discard the tissue. Wash your hands frequently.\u00a0 Greet others without shaking hands.\u00a0 A slight bow, or fist bump, depending on the situation is enough.\u00a0 This cannot be emphasized often enough. DO NOT COME TO WORK IF YOU HAVE A COLD OR FLU-LIKE SYMPTOMS. <\/strong>\u00a0Check to see if it is possible for you to work from home, but if that is not possible, then don\u2019t come in.\u00a0\u00a0<\/p>\n\n\n\n