Testing positive to COVID-19 and managing COVID-19 safely at home

Dr Jan: Hi everyone, I'm Dr Jan Fizzell. I'm a Senior Medical Advisor here at the NSW Ministry of Health and I'm here with Dr Matt O'Meara, our Chief Pediatrician to talk about managing symptoms of COVID at home.

So we really want to help people understand what it means to manage COVID at home. Who's suitable for managing COVID at home and some hints and tips to try and keep yourself safe, but also how to reach out for help when you need it.

So Dr Matt, it's been a bit of a change at the moment. We know that people have been used to having a phone call from public health; a phone call from our clinical services. Things have changed from a public health point of view. We're sending them a message and asking them to complete a survey. How will people know when our NSW Health people are reaching out to them from our clinical teams?

Dr Matt: How will they know? Yeah they'll get an SMS message. Yep, so after they're told they've got a positive test, they'll get a message from health saying their child has tested positive. They've been identified as being in a low risk group, yep, and they're going to be safe to manage their COVID at home.

Dr Jan: That's right and we're using the same technique for adults as well. We're looking at what we call your risk of hospitalisation. We've got a lot of information about people who've had a lot of interface with the NSW Health system and so we look to see your vaccination status, we look to see how old you are, and so at different time points, people of different age groups may be contacted. It's really important though that if we don't contact you with a phone call and you're concerned that you might need additional help, that you call the number that's provided to you for that additional help.

So people who particularly need additional help who are adults are people who are pregnant (they definitely need to get in touch with our clinical services), people who've got chronic heart disease (so people who've had a heart attack or people who have chronic heart failure), people with kidney disease, people who are immunosuppressed, or people who are undergoing current cancer treatment, and people with long-standing lung disease we definitely need to hear from you so that we can provide you additional support. Also if you're unvaccinated, whilst we'd really love you to go and get those vaccines because they are you're absolute best protection, we may also be able to reach out to you and offer you some treatment.

Dr Matt: Yeah and things are pretty similar for kids. So if you're aged from three months up to 16, you're probably going to be low risk if you don't have a chronic health problem sort of thing that you know with chronic illness for which you need to see a specialist you're probably going to be low risk, and if you're not Aboriginal or Torres Strait Islander, you're probably going to be low risk. From managing many thousands of kids in NSW in the last couple of years, we're really confident that kids aged between three months and 16 years who don't have chronic illnesses can be safely managed at home with appropriate supports,

Dr Jan: And again, just remember most people have got their GP and their GP is able to help them, and there's also phone numbers that you'll be given to give you additional information if you need help. But for most people you're not going to need to reach out. You're going to be fine at home. You'll be able to manage your symptoms. Now the symptoms of COVID for most people are a sore scratchy throat, a runny nose, feeling hot and cold and uncomfortable, and that sort of thing can be managed with Panadol, rest and fluids. They're the key things, and for kids?

Dr Matt: For kids it's just the same. It's those general things. Fever, being unwell, tired, lethargic, it's breathing things, runny nose, sore throat, bit of a cough. Kids are more likely to get tummy upsets, vomiting, tummy pain, diarrhoea but usually that's mild and most of these symptoms only last a day or two.

Dr Jan: Yeah and I think that's the thing that we've seen. Some people who have been completely fine with their COVID diagnosis and actually didn't even know they had COVID and we've got other people who are quite unwell and I think the key thing is if your condition changes suddenly, so you've had your fever, you've taken some Panadol but you're getting up and you can't walk to the toilet, you can't walk, you know you can't go around the room without feeling short of breath, those are the sorts of warning signs that say that you really do need to be getting in touch with the clinical care team. Of course if you're an adult if you've got chest pain you can't get your breath no matter how hard you try or you're so lethargic you cannot get out of your bed, they're all warning signs that mean that you should probably be calling triple 0 rather than waiting on a call line.

What are the things in kids that we might want to call an ambulance for?

Dr Matt: So the things in kids that I'd be really worried about... They'd be having difficulty breathing, getting really dehydrated, lots of vomiting, diarrhoea and not drinking much or weeing much or being extremely lethargic so hard you know so that it's difficult to wake up. They're the things that would make me really concerned and want to call for help soon.

Dr Jan: Yeah and the key thing is when you call the ambulance make sure they know that you're COVID positive or if you decide to go to hospital and not wait for an ambulance or um you know you're well enough to go to hospital and you don't want to call the ambulance do make sure though that they know that you're COVID positive when you get there.

Dr Matt: Absolutely but there's lots of layers of help before that. Yeah there's lots of information on websites and when you're told that you're COVID positive you'll be sent links to those and they're available in a number of languages. There are call lines to provide help. There's the National Coronavirus Helpline which is 24 hours a day which will patch you through to a nurse who can help advise on your symptoms and what you should do and there's also the state support line which has got connections to nurses and doctors to help you manage things at home. So the ideal is to give you the information so that you anticipate what you might do if your child gets a fever or has a cough or starts to vomit a bit or feels unwell. So that you feel safe and supported and know where to go for help if they become more unwell.

Dr Jan: I think that's one of the key things we can already get prepared for is the idea that somebody in our household is likely to get COVID in the next you know few months or so. It's going to be a circulating illness so we just need to be ready. Things that I have at my home are things like Paracetamol. I've made sure that we've got fluids. I've got my help list of the people who are able to come and drop things off at my house or go and pick something up for me. I try and make sure that I don't nearly run out of medications before I get my next script filled and that way I've always got you know my 28 days of medication ready for me and I do the same for the rest of my family.

Are there any things that parents of kids should put aside just in case their kids that they're looking after that's different to that? Do they need special fluids? Do they need anything special or water is just fine?

Dr Matt: Water's just fine so for kids who aren't drinking much, drink anything it doesn't really matter what. Do they need some medicines to make them feel a bit better if they've got a fever like paracetamol, ibuprofen? And the usual supplies they need – nappies, creams, all those sorts of things that you'd normally have around the house so it's just the normal stuff but thinking if I'm at home for a couple of weeks, what am I going to need to have with me and how do I get organised to get that in if I don't have it at home with me?

Dr Jan: So I think it's about all of us just getting prepared that just in the next few months, vaccinated or not, we could all potentially get COVID. But the good thing about being vaccinated is the chances are that as an adult who's had two doses plus our booster particularly, the chances that we will need intensive care or hospital are much, much reduced. And in the future, when kids get vaccinated, hopefully even those very rare cases will become not very common at all.

Dr Matt: Absolutely, because most kids have a mild illness even if they're not vaccinated you know. We'll be seeing in early January that kids from five to 11 years of age can get vaccinated and we'll be expecting adults to get their boosters in the next month or two as well so these are added layers of protection that we can have to help stop people becoming unwell

Dr Jan: And I think this is the key thing for all of us. COVID is here. It's something that is now becoming very very common so we need to make sure that our health service is available for the people who need it the most. We know that most people are actually able to manage COVID for themselves. Now one of the things that we do get asked about is there have been changes to the de-isolation process so everyone was covered well. I hope everyone in NSW by now knows that if you have COVID we really do ask you to self-isolate. For an adult, that means trying to hang out in your own room, not leave that room unless there's no one else in the house. If you've got a apartment or a house to yourself more power to you but most of us aren't in that privileged situation, if you need to share a bathroom with others being careful to clean that bathroom and also not going into shared living areas And if you do have to pass someone else wearing a mask in the house.

What about parents caring for a COVID positive child? What are some of the things they might wish to do if they're trying to protect themselves from becoming infected?

Dr Matt: They just do all the simple things...you know wash their hands, wear a mask when they're with their kids. That's about all they can do because sick kids need their parents around them as well so it's very hard to distance. But even if you can't distance there's a number of simple things they can do as well as getting vaccinated so that if their child becomes unwell they're better protected.

Dr Jan: One of the questions we have had from parents in the past is if my child's sick at home and they're absolutely full of energy, do I need to try and limit what they're doing or are they allowed to do what they can do? Within how well they feel.

Dr Matt: That's my usual advice. I've found it very hard to limit a child's activity. If they want to do things and feel well enough to do them, let them do that.

Dr Jan: And I think that's the same advice for adults as well. You know if you're feeling well enough to be exercising and you feel like you can, do what you feel that you can do. Listen to your body though and if your body's telling you to sleep because that's really common with adults, they get very, very lethargic, if your body's telling you to sleep, have a really good rest and just listen to what your body is telling you. Don't try and push through that fatigue. It's not going to do a lot of good. Just have a really good rest if your body's telling you to. If your body's telling you, you know like kids, a large number of adults don't have any symptoms. If that's the case for you, then you know, fantastic exercise what you can around your house. If you're lucky enough to have a yard or a courtyard that belongs to you, fantastic you can exercise out there but don't push too hard because we don't want to find out the hard way that things can go wrong.

I think that's the other thing though with adults. We do know that some people who are not too bad in the morning can get you know quite unwell during the day, so if you are getting unwell please make sure that you do reach out for help.

What about with kids? Do they tend to…?

Dr Matt: You know they don't tend to deteriorate too quickly. Yeah but the other thing is that other illnesses can happen at the same time. Just because you've tested positive for COVID doesn't mean that's the only illness you can have at that time. So keep common sense about you. If something doesn't seem quite right, go and get them checked. You know call for advice, see how to manage that at home and there might be occasions when your common sense tells you I'm worried about my child. You need to call for help or go and seek help.

Dr Jan: No one's going to criticise you for seeking help for your child. No, we'd always rather see three kids who we might not have needed to see them than miss the one that we didn't see that we needed to see.

Dr Matt: Absolutely but there are so many options there always have been. Yeah but now there's even more options to help you manage kids at home.

Dr Jan: Yeah and you know there's any numbers of phone lines. There's the COVID ones and then there's the more general healthdirect line. They're both able to help you. They'll give you really good solid advice on you know what you need to do with your sick kid and how to manage your child at home.

I think the key thing is look after yourselves but one of the things is if you do have symptoms at the moment, we are really asking you no matter how mild, get those symptoms tested and that way we can try and get you into the right care pathway as soon as possible. And it's the same with kids. I know I've heard a lot from people that you know my child comes home from daycare with a snotty nose every few days. But previously we were able to say well that's not likely to be COVID. Just at the moment, we'd be quite worried that it could be COVID.

Dr Matt: Yeah we want every child and every adult with symptoms that could be COVID to be tested so that we know.

Dr Jan: Well thanks everyone for listening to us. Thank you Dr Matt for being with us and I hope this information helps you.