I am Dr. Monique May, Board-certified Family Physician and Founder of Physician in the Kitchen™. Through my videos and best-selling book, MealMasters: Your Simple Guide to Modern Day Meal Planning, I help busy households enjoy healthy eating without impacting their hectic schedules. By now you may have heard of or know someone personally who has been admitted to the hospital for COVID-19. COVID-19 has a particular affinity or preference for the lungs and can cause life-threatening pneumonia. In severe cases, patients need breathing support with mechanical ventilation as they fight off the infection. But in addition to those patients, people are still needing to go to the hospital for other issues, such as heart attacks or to deliver a baby. We are accustomed to visiting our ill loved ones in the hospital, taking them flowers, candy or even a smuggled-in home-cooked meal. But what does being a patient in the hospital look like these days? Since 25% of infected people do not show any symptoms, it is impossible to know when or where you may come in contact with the virus (this is why the CDC recently recommended that everyone wear some type of cloth face covering over their nose and mouth while outside of their homes). To try to protect their staff and other patients from being infected, hospitals across the country have started restricting visitors which means their loved ones cannot come to see them. At some hospitals, they have to drop them at the hospital entrance and leave, and children are allowed to have only one adult with them during hospitalization. To gain some insight from someone on the front lines on how this affects hospitalized patients, I recently spoke with a colleague of mine who works as a hospitalist in the Atlanta area, Dr. Rita Claxton (click here to watch the full-length interview). As a hospitalist, Dr. Claxton cares for hospitalized patients as opposed to primary care doctors who see patients in their offices.
According to Dr. Claxton, she takes care of patients once they have no longer need mechanical ventilation and have recovered enough to transfer from the ICU. It is her job to continue to treat them until they are okay to go home. For COVID-19 patients this process can take at least 2 weeks. About 60% of the patients she currently cares for are COVID-19 positive. In addition to their lung status, she monitors their hearts, kidneys, and livers, as well as blood tests to see how well their bodies are fighting off the infection. But what about their emotional states? Are they depressed, anxious, sad, or frightened? Being short of breath can cause anxiety, not to mention the other aspects of the illness. Dr. Claxton stated that often the first thing her patients feel is fear and worry that they will end up on a ventilator or die from this infection. She compared their emotional responses to the five stages of grief a patient goes through when he is given a cancer diagnosis: denial, anger, bargaining, depression and acceptance. She deals with these concerns by giving them straight facts and reassuring them the best she can. For example, she tells them that only 20% of her COVID patients will require mechanical ventilation.
Nonverbal cues such as facial expression and gestures play a large part in how we communicate. But even that has been affected by COVID because hospital staff must wear masks and face shields that make their faces unreadable. This may cause anxiety for some people because they might feel like they are not getting the whole picture or are not able to “read between the lines”. It is likely difficult for physicians as well, because it may affect their ability to relay empathy and concern as they are accustomed to doing.
As for how families are kept informed about their family members, Dr. Claxton’s patients have a designated contact person or one family member whom the physician can call and give daily updates on the patient’s status. Patients also need a smart device so that they can video chat with their loved ones and see their faces. While it is not the same as being there in person, it is certainly better than not having any contact at all. This has been extremely helpful for her patients who may not speak English. The irony of the situation is that prior to this pandemic we tended to spend too much time on our electronic devices and were often encouraged to “unplug”. Now we need these devices to stay in touch with loved ones, whether they are in the hospital or at home. She also mentioned that smartphones are used to monitor patients once they leave the hospital, to make sure they are continuing to improve.
Once her patients are released, Dr. Claxton gives her patients an extensive list of what they are advised to do once they return home. Her recommendations include the following:
- Stay at home and quarantine for 14 days, preferably in their own isolated “sick” room and bathroom if possible. If they do not have their own bathroom, they need to disinfect and sanitize the bathroom daily.
- Clean and disinfect what she calls “high touch areas”, such as their phones, doorknobs, and countertops.
- Avoid public transportation (including taxis and Ubers).
- Cover their sneezes in a napkin, dispose of the napkin, and sanitize or wash their hands for at least 20 seconds (sing the Happy Birthday song twice).
- Do not share household utensils such as cups, silverware, or straws.
- Do not share towels or other personal grooming items.
- Use the sanitizing cycle of the dishwasher to kill the virus.
- Wear a mask when they go out in public.
- Notify their physician if they develop confusion, blue lips, pressure in their chest, or worsening shortness of breath because some of them may need to be readmitted. They should also call ahead when they are going to see their doctor and let them know that they are COVID-positive.
Proper nutrition before and after a diagnosis of COVID-19 is very important. Eating a variety of foods that boost your immune system, such as fruits, vegetables, spices, and herbs that contain vitamins, antioxidants, and anti-inflammatory is crucial. Click here for my blog on immune-boosting foods to add to your diet.
The coronavirus will likely be with us for several more months, and it has definitely already left its lasting effects by changing the way we do things. As we all adjust to the new normal, please keep washing your hands, staying well-hydrated, getting enough solid rest, eating healthy, exercising, and practicing social distancing (or just staying home). If you are sick cover your cough and sneezes and stay home! If your symptoms are getting worse (shortness of breath, fever, or cough), call your local healthcare facility before you go.
For more information, be sure to visit me at DrMoniqueMay.com, and join the #MealMastersCommunity at www.Facebook.com/groups/mealmasters today.
