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Printable PDF of Agudah Guidance for COVID Information and Preparation from Medical Professionals

Our committee of physicians has prepared the following guidance for our community. Please read this entire document. We would have made it shorter if that was possible. This information can
make the difference.

As many of us have seen and heard about the devastating effects of COVID-19/Coronavirus, we present an initiative to help support the community manage under these very trying and stressful
times.

This initiative is based on Healthcare Access, Contact and Observation, and Preparation of an Action Plan.

The information provided below is NOT meant to be a substitute for professional medical advice, diagnosis, or treatment from your treating physician. We recommend that you seek the advice of
your primary health care provider with any questions you may have regarding the COVID virus or any other medical condition. You should not disregard such professional medical advice or delay in seeking it because of the information provided in this document.

For any non-medical assistance please contact covid19@agudathisrael-oh.org or call 216-848-0379.

If you are having chest pain, shortness of breath, dizziness, a severe headache or other potentially life-threatening problems, go to the nearest emergency department or call 911.

Quick Guide

Do you think you may have Coronavirus (COVID-19)?

1. If you are having chest pain, shortness of breath, dizziness, a severe headache or other potentially life-threatening problems, go to the nearest emergency department or call 911.
2. If you have any concerns, even on Shabbos or Yom Tov, call 911. Paramedics will come & they can take any necessary vitals
3. If you are having any one of the following symptoms: fever above 100.4 (or above 99.6 for patients above 60 years of age or immunosuppressed), cough, diarrhea, fatigue or shortness of breath
   1. Call your Primary Care Physician
   2. Cleveland Clinic Express care online  download from http://www.CCF.org  24/7
   3. Virtual visits through UH  http://www.uhhospitals.org
4. Once you are COVID positive
   1. If you are at home – set up a buddy to check up on you (or call us & we will provide one to you)
   2. If you are under the care of a physician and have been advised to use an oximeter to monitor your pulse and oxygenation levels  contact Agudah to get oximeter via covid19@agudathisrael-oh.org or 216-848-0379
   3. Provide name of your physician
   4. Confirm that you have instructions for use
   5. We will make arrangements to get an oximeter to your home.
5. Advance Planning
   1. Prepare PCP phone numbers & download virtual visit app
   2. Keep on hand Pedialyte or other electrolyte solution in case of illness & need to rehydrate.

In Depth

Healthcare Access

If you are having chest pain, shortness of breath, dizziness, a severe headache or other potentially life-threatening problems, go to the nearest emergency department or call 911.

In many cases, you may have any one of the following symptoms: fever above 100.4 (or above 99.6 for patients above 60 years of age or immunosuppressed), cough, diarrhea, fatigue or shortness of breath and will need to know your options for getting care. You cannot currently go to a site to get tested for COVID-19 without an order from a physician. If you have a Primary Care Physician, please call them first as they have the best knowledge of your medical history and can provide the best possible care. If you do not have a PCP or would like a virtual visit you can get one through the Cleveland Clinic Express care online. This visit gives you the opportunity to speak with a medical professional on your smart phone or computer without having to leave your home (during the virtual visits, medical professionals will be able to order COVID testing if they feel it is medically necessary and can guide you on next steps). You can access an online virtual visit through http://www.CCF.org. Click on “start a virtual visit” to start the process. There is an app to download onto your computer or smart phone and from there you can start your visit.

Advance preparation is ideal so you have what you need when you are not feeling well. Find your PCP’s phone number and leave it by your phone or enter it as a contact in your phone while you are still feeling well. Download the CCF Express care app in advance in case you need it – it is easy to put on a phone or computer and it is open 24/7 for care. You will need to enter your name address, email address & insurance information. At this time patients will not be charged for the virtual visits over and above what is covered by insurance. Once in the site, there is a list of physicians whom you could choose & it details the number of patients waiting for a visit before you. It only takes a few minutes to set up and is very easy to use.

Virtual visits are also available through University Hospitals – follow the links for same day care on http://www.uhhospitals.org

It is recommended that if you have to go to the ER, you stay in the same hospital system as your primary care provider for more cohesive care.

Contact and Observation

It will be important for our community to connect with those in quarantine so they do not feel isolated. In particular, our friends experiencing symptoms from the virus, may require additional attention. Toward this end, a team of healthcare professionals in the community have advanced an initiative to help prevent potentially dangerous consequences of isolation. This is especially helpful for individuals who are living alone.

Buddy System

The committee recommends the creation of a buddy system for our friends who test positive for COVID 19 and find themselves in mandatory quarantines. Each person who is positive for COVID 19 should ask a friend (outside of the household) to establish twice daily contact via telephone or (preferably) video chat. The buddy will act as a “second set of eyes” in addition to any family members who are in the home. It is challenging to evaluate a patient’s medical condition, but some basic indicators certainly include common sense determination of whether a person is eating, drinking, and breathing properly (is the patient breathing faster than usual). Additionally, community volunteers who are willing to perform this role with confidentiality and discretion have been identified for anyone who has trouble identifying their own “buddy”. Please let us know if you need a buddy (covid19@agudathisrael-oh.org or call 216-848-0379).

Equipment

Once you are COVID positive and under the care of a physician, you may be advised to monitor your pulse & oxygenation levels. This is a device that is easy to use. A probe that is placed on a fingertip, and painlessly, without penetrating the skin, measures heart rate (pulse) and oxygen in the bloodstream. The exact details for how to use the device, management and expectations for oxygen will be determined by your physician because readings are to be interpreted differently for each individual person, their particular health needs and medical condition. It would be ideal if every household has a functioning thermometer for each quarantined person in the home – for those in self-quarantine after exposure as well as those in mandatory quarantine and known to be COVID positive.

Agudah has acquired a limited number of pulse oximeters. If needed and recommended by your health care provider, please email covid19@agudathisrael-oh.org or call 216-848-0379 with your request, the name of your physician and confirm that you have instructions for use & we will make arrangements to get an oximeter to your home.

Change in Condition

If there is a noticeable change in the observed condition or pulse oximeter readings of a quarantined person, a buddy can help (encourage) the person seek medical care.

Preparation of an Action Plan

Prepare

Everyone should develop a plan of action upon learning of his or her COVID 19 diagnosis. It is important to recognize that only a very small percentage of people infected by COVID 19 will require emergency medical care, but if such care is required, it can be engaged more effectively when there is a pre-specified plan of action.

Calling 911

Anyone experiencing a true medical emergency should call 911 for immediate attention. If you have any concerns, even on Shabbos or Yom Tov, call 911. Paramedics will come & they can take any necessary vitals.

Individuals should be aware that no will be able to accompany the patient to the hospital (unless the patient is a minor). DO NOT let that prevent the patient from going to the hospital and getting the care they need.

Hydration

We would also like to encourage and emphasize maintaining hydration if you are ill. Everyone should consult their rav for any shaila, but we are sharing that per the psak of Rav Boruch Hirschfeld as well as information verified by Cleveland Kosher the following options are available and are OK for use on Pesach for Cholim, although they do contain kitniyos. First choice would be Pedialyte as well as WHO oral rehydration solution. Other options would include Gatorade or Powerade. There is also an at home rehydration solution. Recipe: 8 teaspoons of sugar, 1 teaspoon of salt, 1 liter of water (approximately 5 cups). Stir the mixture until the salt and sugar dissolve.

It is our prayer and hope that everyone will stay healthy and have a Chag Kosher V’Sameach.