Ask the Rev. Doctor Maria

August 25, 2020
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The Rev. Dr. Maria Evans is serving as the Interim Rector at Christ Church in Rolla. She is also a pathologist, board certified in Anatomic and Clinical Pathology, a laboratory medical director, and has served on hospital infection control committees for over 30 years. 
My spouse is sick with COVID and recuperating at home.  I'll be honest, being the caregiver makes me nervous, because I'm not from a health care background AT ALL.  What are the things I need to pay attention to in terms of calling my doctor or going to the ER if my spouse takes a turn for the worse?  Also, how do I try to keep from infecting myself and/or the whole household?
In these days where, even before COVID, spouses and family members have had to take on more and more home health caretaking roles, I can understand how this can feel daunting.  Here's the short list of signs and symptoms that should prompt a phone call to the physician (or, after hours, a visit to urgent care or the emergency room):
1.  Sustained fever of ≥102.5  degrees Fahrenheit that does not go down after administration of Tylenol;
2.  Increasing or sudden shortness of breath;
3.  If you have a pulse oximeter at home, a value of <90% O2 saturation;
4. Persistent chest pain or pressure;
5.  Mental confusion;
6.  Bluish tinge to lips, face, fingers or toes.
This is not a complete list of course, but certainly covers the bulk of what my clinical colleagues would suggest.  It's also important to be on the lookout for signs of dehydration, such as sunken cheeks and eyes, infrequent urination, dark urine, and constant thirst.  It's easy to "get behind" even drinking water frequently, and if someone has had fever, might need IV fluids.
As to your second question, the most important thing is to try to keep the family member with COVID isolated as best as possible, with heavily shared spaces (such as the kitchen) "off limits" if you can.  If you can dedicate a bathroom in the house as specifically "theirs" it also reduces the chance of aerosolizing virus.  Six feet distance whenever possible is best, as well as masks for both of you when giving care and especially when you can't be six feet apart.  Clean surfaces they are in contact with frequently, and take extra cleaning time for shared surfaces.  Wash your hands frequently, and when doing laundry, don't shake dirty laundry so as not to launch viral particles airborne.
It's stressful, no doubt about it, and is compounded by the two most common places people acquire COVID is work and home.  My heart goes out to you for having to take on this caregiving burden!  All the same, it's not a fait accompli that others in the home will get it, and the more you and your family do to keep good isolation and hygiene, the more you help yourself stay safe.
This is also a place where even when we can't worship in our buildings, we can be the church.  We can still drop off food and run errands, call on the phone, and video chat.  Being isolated doesn't have to be isolating.  We can share cartoons and jokes on social media.  The ministry of presence is still alive and well, even when we can't be present.
I hope your loved one recovers soon, and that everyone in your household can still find moments of the peace that passes all understanding.
The Rev. Dr. Maria L. Evans
who also doubles as
Maria L. Evans, MD, FCAP, FASCP
This material is not a substitute for professional medical advice or treatment. The Episcopal Church and its affiliates do not provide any healthcare services and, therefore, cannot guarantee any results or outcomes. Always seek the advice of a healthcare professional with any questions about your personal healthcare, including diet and exercise.

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