COVID-19 FAQ (Updated July 27, 2020)
What is Covid-19?
Covid-19 is the name of the disease caused by a coronavirus called SARS- CoV-2. Coronaviruses are common and usually cause mild colds or flu-like illnesses.This specific Coronavirus is a “novel” virus, meaning that it is a new virus that no one has ever seen prior to this outbreak.
Why is this coronavirus so serious?
This type of coronavirus is new. There is no natural population defense against the virus and there is no vaccine against this virus. So unlike the seasonal flu or other cold-causing viruses there is no “herd” immunity to protect us or to slow down the spread of the virus. Covid-19 appears to be moderately contagious, similar to the flu. Unfortunately for many people, Covid-19 is more severe than a typical flu. While most people who are infected with Covid-19 will have only mild symptoms of fever and cough and some may even have no symptoms at all, about 10-15% will have severe symptoms and an estimated 1-2% will die and most of those will die after a prolonged ICU stay, isolated from their family.
While the seasonal flu is also very deadly, In the US the flu infects from 40-60 million people and results is responsible for 20-60,000 deaths per year. About 0.03% to 0.15% of people with the flu will die. Covid-19 so far has infected 4.2 million people in the US and killed 147,000 (3.5% of cases) This estimate is preliminary and is likely closer to 1-2% but still at least 10X the mortality ate of the flu.
The flu season is also spread out over 8 to 9 months or longer, so the burden on our healthcare system and hospitals is not compressed into a short time span. Covid-19 is spreading so rapidly that the number of very sick people needing intensive hospital care such as mechanical ventilation to keep them alive while their body heals is much more than some parts of our healthcare system can manage. We do not have enough hospital beds, mechanical ventilators or protective equipment to provide care to a large number of very sick people. Without doing anything at all to prevent the spread, Covid-19 would likely to spread to up to 60% or more of all people. On O’ahu that would be about 600,000 people. If 10% of those 600,000 got very sick and needed hospital care, that would be about 60,000 people, and if 1% of those who got sick died, that would be about 6,000 deaths. Most of those deaths would be after a prolonged ICU stay and mechanical ventilation, if there were enough ICU beds and ventilators to care for people. If the system collapses, people would die without access to potentially life-saving care and mortality rates could be much higher.
As of today July 27, 2020, Hawai’i state has had 26 deaths attributed to Covid-19. Honolulu County has 19 deaths. Other Counties in the US similar in size to Honolulu have had from 6 deaths (Pima County, AZ) to over 2,000 deaths (Bergen, NJ) attributed to Covid-19 so far. The average number of deaths among 14 counties similar in size to Honolulu County is 571.
By practicing social distancing using masks when around people outside of our immediate family and proper hand hygiene and quarantining when we have been exposed or have traveled, we may be able to slow down the spread of the virus, make less people sick and not overwhelm our healthcare system.
How is Covid-19 spread?
Covid-19 is spread primarily by droplets that come from the nose and mouth of an infected person when they cough or sneeze or even talk. These droplets usually fall within about 6 feet of the person who coughs or sneezes and can land on other people or on surfaces like tables, chairs, floors and keyboards or phones. Smaller droplets and very small particles can float around for longer but how effective small particles are at spreading Covid-19 is not well understood yet. When we touch surfaces that are covered with droplets then touch our mouth, eyes or inside our nose, the virus can get inside of us and make us sick.
Covid-19 may be spread by people with no symptoms, but most cases appear to be spread by people who are showing symptoms.
Infected people appear to spread Covid-19 the most in the 48 hours prior to their onset of symptoms and continue spreading through the first 6 days of symptoms.
High exertion activities like exercising or singing and yelling appear to spread more droplets from deeper in the lungs that spread further.
Covid-19 does not appear to spread through food. Air currents created by air conditioning or fans appear to cause droplets to be spread further, but the virus does not appear to survive going through A/C filters and vents
How can I keep from getting or spreading Covid-19?
- If you are sick with a cough or fever, difficulty breathing, unusual headache, stomach ache, vomiting or diarrhea, fatigue or a change in your sense of taste or smell, do not go out, stay at home. Call your medical provider for advice. Do not go to the emergency room for testing unless you are very sick. Always call before you go to the ER or to your clinic. If you are very sick and having a hard time breathing, call 911.
- Practice social distancing, avoiding large groups and maintain at least 6 feet of distance from other people outside of your immediate family.
- Avoid high exertion activities in confined spaces such as gyms or yoga classes. Exercise outdoors with at least 12 feet of distance between you and others.
- Avoid crowded environments such as bars or social gatherings or parties. Crowds combined with social disinhibition from alcohol consumption makes social distancing practically impossible.
- Wear a face covering whenever you are outside your home and you are unable to consistently socially distance around other people who do not live with you, or if you are entering stores or enclosed spaces.
- If someone who does not live with you comes to visit, everyone should be wearing masks.
- The best masks are at least 2 layers of cotton or cotton with an outside layer of polyester and should cover your nose and mouth and should be comfortable.
- Children under 2 or people who already have breathing difficulties should not use face coverings.
- Clean your mask daily and adjust the elastic so your mask covers your nose and mouth
- Avoid close contact with people who are sick.
- Avoid touching your eyes, nose, and mouth with unwashed hands.
- Wash your hands often with soap and water.
- WET your hands with clean, running water.
- LATHER them with soap. Make sure to get the backs of your hands, between your fingers, and under your nails.
- SCRUB your hands for at least 20 seconds (about the time it takes to sing “Happy Birthday” twice).
- RINSE your hands well with clean, running water.
- DRY them with a clean towel or let them air dry.
- If soap and water is not available, use an alcohol-based hand sanitizer that contains at least 60 percent alcohol. Hand washing is preferred.
- Get your flu shot to reduce the chance of developing symptoms that can be confused with COVID-19. Everyone ages 6 months or older should be vaccinated against the flu.
- If you are 65 or older, or if you are younger and it is recommended by your healthcare provider, get your pneumococcal shot
- Clean and disinfect frequently touched objects such as phones, tablet computers, pens or doorknobs and surfaces using a regular household cleaning spray or wipe.
- Leave shoes outside of your home if possible or remove shoes and bag them if you must bring inside.
- If you work in healthcare, remove clothes immediately upon arriving home, before contacting anyone or any surfaces and shower immediately. Wash clothes promptly and wash hands after touching any potentially contaminated clothes or devices.
- Do not share drinks, food, utensils or toothbrushes.
- If you are sick at home, avoid contact with others, do not share items and avoid common areas. Avoid close contact (within 6 feet for more than 30 minutes) with anyone at home and especially with anyone over 60 years old or anyone with chronic heart disease, lung disease or decreased immunity.
What are the symptoms of Covid-19?
Most people who are infected will start showing symptoms after about 5-6 days, though some may start feeling sick after 2 days or as long as 14 days after getting infected. The symptoms are usually fever, cough and sometimes difficulty breathing. Other symptoms include headache, chills, stomach pain, vomiting, diarrhea, fatigue muscle aches, a change in your sense of taste or smell. Many infected people will have very mild symptoms or up to 40% may have no symptoms at all.
Is Covid-19 more dangerous for older people?
It appears that Covid-19 is usually much more serious for elderly or for those with chronic illnesses such as cardiovascular disease or chronic lung disease. The risk of death is higher. However it is important to know that Covid-19 can make relatively healthy young people extremely ill. Children under 19 years old appear to have milder illness, but it can be very serious for any age. Younger people may think they don’t need to worry much because they are not likely to get very sick, however even if they are healthy, they may spread the disease to others who may be at higher risk for more serious illness or even death. Covid-19 is not a disease of old people, it is a disease of all of us.
Should I be tested for Covid-19?
When a person is tested for Covid-19, it requires the doctor or nurse to wear special protective equipment called PPE. There is a worldwide shortage of PPE equipment at this time. There is also a shortage of the chemicals used in the testing process. Also there is no effective treatment for Covid-19 at this time and most people will improve without having severe symptoms. Because of all these reasons, we are not prioritizing testing for people who are at low-risk of complications.
Current recommendations prioritize testing for people who are hospitalized or who are at higher risk of complications such as elderly or those with chronic medical conditions such as cardiovascular disease or lung disease or who have weakened immune systems should be prioritized for testing.
Healthcare workers and first responders may be more likely to be tested because their job places them at higher risk of exposure.
If you work or live in a group home or congregate facility like a nursing home or correctional facility, you may also be more likely to get tested to ensure the safety of others in the facility.
KPHC has expanded our testing capacity and we are currently prioritizing testing for people with symptoms of Covid-19 or who have had a travel or contact exposure or who are in a high-risk field of work. We will provide some lower-priority testing for situations such as asymptomatic work clearance or travel clearance as able. We are not able to test someone to allow them to complete quarantine or isolation earlier than current DOH recommendations.
Is there any treatment for Covid-19?
There are currently no approved outpatient treatments for Covid-19. Remdesivir, plasma therapy and dexamethasone are intravenous therapies available for people with severe illness in a hospital setting. They are not available for use in a clinic setting such as ours. Hydroxychloroquine is not recommended as a treatment option for Covid-19. While it held promise early on, multiple studies have shown no benefit and potential risk.
Is it OK to take ibuprofen or naprosyn/naproxen for Coivd-19 symptoms?
There have been some reports that the use of NSAIDS such as ibuprofen, (motrin) or naprosyn (aleve) may make Covid-19 symptoms worse. There is no clear evidence that this is true. Out of an abundance of caution it is recommended that you use acetaminophen (Tylenol) instead of ibuprofen or naprosyn/naproxen for fever or pain relief associated with Covid-19 symptoms. If you are on NSAIDS for chronic pain or arthritic conditions, it is recommended that you continue those medications.
What is Kalihi-Palama doing about Covid-19?
- We have a dedicated nurse line for your Covid-19 questions. Call 808-381-7009 to speak to a nurse
- We have screeners at the entrances to our main clinical sites at 915 N. King St, 952 N. King St, 710 N. King St and at our Downtown facility at 89 S. King St. All patients are required to wear a face covering when in the clinic. All patients with symptoms of Covid-19 or who have recently traveled outside of Hawai’i or have been exposed to someone with Covid-19 will be asked to go to our outside screening facility at our 915 N. King St. location.
- We have reduced seating in our waiting areas and ask that only patients with appointments or who are sick enter the clinic. One adult may accompany minors. adults with appointments are asked to not bring their children into the clinic unless there is no one to supervise them. Adult patients needing assistance may be accompanied by 1 caregiver.
- We are limiting appointments in some areas to limit crowding and to facilitate social distancing.
- We are increasing the frequency of daily cleanings in our facilities
- Any staff who have recently traveled or who have sick family members who are under investigation for COVID-19 are not allowed to work until they have completed the expected quarantine period
- Any staff who are sick with fever or respiratory symptoms are not allowed to work until they are cleared of possible Covid-19 infection and are well. We have enhanced our testing of ill or exposed staff.
- We have cancelled our larger staff meetings and have cancelled all work-related travel.
- We have expanded our telemedicine capabilities. Call ahead of your appointment to see if your visit may be managed by phone.
I just returned from traveling, do I need to quarantine?
Yes, if you have been traveling out of state, you must quarantine at home or at your hotel room for at least 14 days. If you are not sick, there is no need to get tested for Covid-19. The test will not let you leave quarantine early. A person may be infected but the Covid-19 screening test may not be positive if done too early. Most infected people will start to have symptoms at around 5 to 6 days after they become infected but it may take up to 14 days for symptoms to show. Patients presenting to the clinic who are expected to be in quarantine will be asked to return to quarantine and may be reported to the department of transportation. If you returned from travel and have no place to safely stay, please contact us at 381-7009 and we will do our best to help coordinate your quarantine.
Someone in my home, church or workplace is sick but I feel fine right now, should I be tested?
If someone in your home or close circle of friends or co-workers has tested positive for Covid-19, you should quarantine and be tested. Your testing may be done by the Department of Health if you share a home. You can contact us at 381-7009 to discuss if testing is recommended for you and when would be the best time to get tested depending on the timing of your exposure.
Most people who are infected will start to have symptoms about 5 to 6 days after exposure and they may start to test positive up to 48 hours before symptom onset. So the ideal time to test after an exposure may be 3 to 5 days after the exposure. Testing too early is more likely to give a false negative result.
My roommate’s co-worker tested positive for Covid-19, should I be tested for Covid-19?
Your roommate or partner may need to be tested depending on the nature of their exposure. If they shared a building with the infected person but had no personal contact or if contact was brief and everyone was wearing face coverings, the risk to your roommate would be low and you would not be at any increased risk. If your roommates’ exposure was more significant then they should be tested. If they test negative and have been asymptomatic then testing would not be recommended for you. If your roommate tested positive or if they began having covid-19 symptoms, then you should notify your primary care provider or call us at 381-7009 to ask about testing.
I need clearance after my quarantine to go back to work, how do I get that?
If your quarantine is being monitored by the department of health or other public health agency then they will provide you with clearance or advise you on what to do. If you are under self-quarantine, then you can contact your provider or clinic for clearance. For clearance from quarantine after travel into Hawai’i, we will need to see your itinerary or travel documents.
I’m not feeling well and I think I might have Covid-19. What should I do?
Call the clinic that you normally go to or call our Covid nurse line at 381-7009. Use the phone menu options to speak with a nurse regarding your symptoms and your risk factors. The nurse will advise you on what to do. Do not walk-in to the clinic before calling. After clinic hours you can call physicians exchange at 524-2575 to speak to a medical provider. If your symptoms are severe with difficulty breathing or if you are getting weak or dehydrated, go to the nearest ER. Call ahead to let them know you are coming and let them know if you have recently traveled or have been exposed to someone with Covid-19. Do not use public transportation or ride sharing apps like lyft or uber. If you do not have private transportation or if you are unable to safely travel, call 911 and notify them of your symptoms, exposure risks or travel history.
I’m uninsured, will I still be able to get tested?
Yes, a federal law was passed that will provide funding to the states to test uninsured people. We will review your risk factors and discuss your testing options. You still must meet testing criteria to be tested. If you have private insurance, your insurance will cover the cost of testing as long as you meet disease testing criteria. There may be other factors to consider in your testing, but if you do not meet criteria you may be financially responsible for the cost of your test.
How long does it take to get my test results?
We currently have rapid testing available with results in 15-20 minutes. This test has a risk of false negative results so we always do a PCR confirmation test. The rapid test cannot be used for clearance for travel outside of Hawai’i at this time.
Results from PCR confirmation testing are usually returned within 1 to 2 days or possibly longer depending on the availability of testing chemicals and the numbers of tests being run at the time. If we ordered the test for you, we will receive the results. Your test results will also be reported to the Hawai’i Department of Health, so you may be contacted by someone from the state if your test is positive.
For tests done at other locations such as Queen’s Medical Center or Kapi’olani Hospital, we may not receive the results if we are not listed as your primary care provider. For tests done at CVS, urgent care centers or at other community health centers, we also may not receive the results quickly. Please call us at 381-7009 if you were tested somewhere other than KPHC and have not received any results within 2 to 3 days.
It is very important that you isolate yourself while waiting for your confirmation test results!