COVID Q&A: More insights from med center experts

Mark Rupp, MD, chief of the UNMC Division of Infectious Diseases, and Armando De Alba Rosales, MD, assistant professor in the UNMC Department of Family Medicine

Mark Rupp, MD, chief of the UNMC Division of Infectious Diseases, and Armando De Alba Rosales, MD, assistant professor in the UNMC Department of Family Medicine

Earlier this week, Mark Rupp, MD, and Armando De Alba Rosales, MD, answered a variety of COVID-19 questions during a session broadcast on Facebook Live.

Dr. Rupp is chief of the UNMC Division of Infectious Diseases and Nebraska Medicine's medical director of epidemiology and infection control. Dr. De Alba is an assistant professor in the UNMC Department of Family Medicine and College of Medicine, as well as assistant dean for diversity, equity and inclusion student programs.

Here is a continuing look at their insights.

Are there treatments for COVID?

Dr. Rupp: "Though there are new medications, they are in such desperate short supply that they for the most part are not going to be available to people to rescue them if they get ill. Some of the monoclonal antibodies that people have heard about that have been developed in the last year or year-and-a-half are not effective against omicron. The virus has shifted, and those monoclonals just don’t interact with the virus any longer."  

What symptoms should people be looking for with omicron?

Dr. Rupp: "There’s less of the lower respiratory tract symptoms of shortness of breath with more of a multi-inflammatory response, sepsis kind of response. We’re seeing less of that, although there are some cases of it. And certainly, the other symptoms of fever, sore throat, headache, nasal congestion, cough — all of those we continue to see, maybe a little bit less of the reduced taste and smell."

How can I take care of myself at home with COVID to help manage symptoms?

Dr. De Alba: "Stay hydrated, have good dietary habits. Consuming vegetables and fruit, that will help a lot. Rest and isolating. I know it’s tiring. I know it’s challenging to stay at home in four walls, but it’s one of the most effective ways to protect others, particularly those who surround you."

Dr. Rupp: "I completely agree … try to self-isolate. Not infecting other family members is critical. I would say taking a little bit of acetaminophen — otherwise known as Tylenol — or Motrin or something like that is perfectly acceptable to help with the aches and pains and the headache and the fever.

"If you are at high-risk for disease progression — you’re elderly, you have underlying cardio-respiratory disease, underlying immunosuppressive disorders, had an organ transplant, you’re getting cancer chemotherapy — you really do need to plug in with your medical professional. There are some things we can offer that we’ve already talked about to try to prevent progression of the disease, and we need to keep a close eye on you. Otherwise if you’re healthy, you’re more than likely going to be able to tough this out at home, and we really don’t want you to be coming to the emergency department unless it’s really an emergency."

The Facebook Live broadcast is available on UNMC's Facebook page.

What are the guidelines for isolating and testing if there’s a case within the home?

Dr. De Alba: "It’s important to have open communication with those with whom you interact. Get to know the vaccination status of those whom you socialize with, so if there is a positive case, there can be contact tracing. If someone experiences symptoms, that person should isolate until it’s shown that they aren’t positive. The recommendation will be to get a test — a PCR continues to be the gold standard. But if that isn’t possible, and you know that you were interacting with someone who was positive and diagnosed with COVID-19, and you start to develop symptoms, you should start to follow recommendations for isolation. You should contact your health department if you don’t have access to a clinic or a hospital. Then follow their instructions, because there will be a process for contact tracing, and they will guide you when you can return to normal activities."

Dr. Rupp: "I wish we had fast, accurate, readily available cheap testing for everybody, but it’s not reality, so I think people are responding to that by sort of picking and choosing when they get tested. I understand that, and again, I would plead with folks that if they are symptomatic to take themselves out of circulation and put themselves into isolation. If they don’t have a diagnosis, it’s probably good to assume they have it, because it’s just so prevalent in the community. And so the best practice is, like Dr. De Alba said, put yourself in isolation for 10 days before you come back out. If you get a PCR test at five days and it’s negative, you can exit isolation, and if you’ve tested positive and you are feeling better and have to go back to work, please do so wearing a mask."

See this story from UNMC Today for earlier coverage of the forum. 

When should I seek medical attention?

Dr. De Alba: "If you see that your symptoms aren’t improving and are getting worse, seek medical attention. Some people have access to oximeters, and they have learned how to use an oximeter. If you have access to an oximeter and check your result and it’s below 90, seek medical attention, because that’s when you actually need to receive other complementary things that we can offer in the hospital. It’s a common question in the community, particularly where some don’t have access to a physician."

How long are masks good for?

Dr. Rupp: "When masks start to get moist, when they get soiled or they start to tear, clearly you want to change out and use a new one."

To read more about masks, see this guidance from the CDC.

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