What is Covid-19?
Covid-19 is the name of the disease caused by a coronavirus called SARS- CoV-2. This is a “novel” virus, meaning that it is a new virus that no one has ever seen before. Coronaviruses are common and usually cause mild colds or flu-like illnesses.
Why is this coronavirus so serious?
This type of coronavirus is new. There is no natural defense against the virus in the population 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 Covid-19 is more severe than a typical flu. While most people who are infected with Covid-19 will have only mild symptoms or fever and cough and some may even have no symptoms at all, about 10-15% will have severe symptoms and 2-3% will die.
While the seasonal flu is also very deadly, the flu season is spread out over several months, so our healthcare system can meet the needs of most people, and about 0.1% of people with the flu will die.
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 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 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 2% of those who got sick died, that would be about 12,000 deaths. By practicing social distancing and sheltering in place and quarantining of exposed or higher risk people, 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. 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 phone. smaller droplets and very small particles can float around for longer but do not appear to be a significant way the virus is spread. 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.
How can I keep from getting or spreading Covid-19?
- If you are sick with cough or fever, 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.
- Follow stay-in-place orders and practice social distancing, avoiding large groups and maintaining at least 6 feet of distance from other people outside of your immediate family.
- 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 the preferred method.
- 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 such as diarrhea or fatigue and headache may occur. Some people, we aren’t sure what the percentage is, may have very mild symptoms or 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 severe illness.
Because of all these reasons, we are not recommending testing for people who are at low-risk of complications. Current recommendation are that only people who are hospitalized or who are at higher risk of complications such as elderly or those with chronic medical condition such as cardiovascular disease or lung disease or who have weakened immune systems.
Certain people may be more likely to be positive, such as healthcare workers or those working in the tourist industry. Healthcare workers may be more likely to be tested so that if they are negative they may be able to return to work sooner. If you work or live in a group home or gongregate 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
If you do not have any symptoms, even if you are in a high-risk group, testing is not recommended. a negativ test on someone with no symptoms does not rule out infection, most people will not test positive until they are having symptoms. If yo udo not have symptoms, we cannot do a test to clear you to return to work.
Is there any treatment for Covid-19?
There is currently no approved treatment for Covid-19. There are some promising reports for certain medications that have been reported in the news, however they are not currently recommended or available for use except for people who have severe illness and are hospitalized. This may change soon as we get more information on the disease.
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 acteaminophen (Tylenol) instead of ibuprofen or naprosyn/naproxen for fever or pain relief assocaited with Covid-19 symptoms. If you are on NSAIDS for chronic pain or arthritic conditions, it is recommended that you continue those medications.
How is Covid-19 affecting Hawai’i?
Hawai’i is seeing daily increases in confirmed infections. Most of these cases have been in local people who have traveled to places with more active disease and in tourists. there is evidence of community spread, meaning that it is spreading between people who have not been traveling or who have not been in contact with an infected traveler. Fortunately we have not seen huge numbers of cases or large numbers of severe illnesses, but by seeing what has happened around the world and around the country, if we are not extremely careful in preventing the spread, we could see rapid spread and our hospitals could be overwhelmed.
What is Kalihi-Palama doing about Covid-19?
- We have a dedicated nurse line for your Covid-19 questions. Call 848-1438 and press 7 at the prompt 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 presenting with cough will be given a face mask to wear in the clinic at all times and all patients with fever or cough or difficulty breathing 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
- We have temporarily reduced our optometry services and have postponed dental cleanings, dietary and group meetings such as our diabetes and memory clinics. All annual physicals, well-child exams and school physicals for patients over 15 months of age are being postponed until June or later. Patients with chronic illnesses whose care cannot be safely deferred until then will still be seen.
- 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 hey have completed the expected quarantine period
- any staff who are sick with fever or respiratory symptoms are not allowed to work until they are well.
- We have cancelled our larger staff meetings and have cancelled all work-related travel.
- We are expanding our telemedicine capabilities. Call ahead of your appointment to see if your visit may be managed by video conferencing .
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 will not be positive unless you have symptoms. 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.
Someone in my home is sick but I feel fine right now, should I be tested?
No, testing on asymptomatic people is not recommended, a negative test on someone who is not showing any symptoms does not mean they are not infected. You may still have the virus, but your test may not be positive until you start showing symptoms. While most people who get sick show symptoms within 5 to 6 days after getting infected, it may take up to 2 weeks for you to start getting sick.
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 travel clearance 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 848-1438. 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.
In general, if your symptoms are mild to moderate with fever or cough and typical flu-like illnesses, it is best to stay home and not come in. Leaving your home may spread your infection to others. If you are in a high risk group such as elderly or with chronic illnesses, we may recommend that you go to a testing location to get tested.
If you 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 exposure risks or travel history.
Is KPHC able to test me for Covid-19?
We are currently able to test, however it is best if you can call first before coming in. Our supplies are limited and depending on how severe the outbreak in Hawai’i becomes, we may be unable to do testing.
Before you come in, we should be able to assess your risk factors by phone and let you know if testing is recommended.
Because the flu season is still active in Hawai’i, your provider will likely do a test for flu before testing for Covid-19. The flu test takes about 15 minutes. If you flu test is positive then we would treat you for the flu and not test you for Covid-19. If you flu test is negative then we would discuss your testing options.
For most people with mild to moderate symptoms but no other risk factors such as being elderly or having chronic illnesses, testing is not recommended. Testing for Covid-19 requires the use of protective supplies that are currently in short supply worldwide. It is critically important for us to save as many protective supplies as we can in case there is a severe outbreak and the hospitals must have these supplies to deliver care safely.
You may have heard of rapid Covid-19 test systems that can give results within 15 minutes. These systems are not currently available at our facility. Other quicker testing is likely to become available in the state soon. We will let you know when you call if we are able to do testing.
I’m uninsured, will I still be able to get tested?
Yes, a federal law was passed recently 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 of fever and/or cough or difficulty breathing plus a risk factor of travel or exposure to someone with Covid-19. 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.
Is Covid-19 going to get worse in Hawaii?
It is hard to know for sure. Some places such as Wuhan, China, Italy and New York City have had or are having devastating outbreaks. Other places such as Singapore and Taiwan have had relatively mild outbreaks. We are at a critical point now where social distancing, stay-at-home requirements, travel restrictions and quarantine requirements are our best tools to help prevent spreading and limit the impacts on our communities. Failure to control the spread now could be devastating for our state. We all have to do our part, all ages, all of us have to do our part now to protect ourselves and our neighbors over the coming day to weeks to months.
How long does it take to get my test results?
Results from testing may be back within 3-5 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. More rapid testing procedures will likely be more vailable over the coming months.
