COVID-19 Patient's Guide

1. THE MEDICAL CITY
COVID-19
PATIENT’S GUIDE
Accredited by the Joint Commission International
The Medical City, Ortigas Avenue, Pasig City, Metro Manila, Philippines
(+632) 89881000 / (+632) 89887000
mail@themedicalcity.com www.themedicalcity.com

2. THE MEDICAL CITY COVID-19
PATIENT’S GUIDE
You have received this pamphlet because you were seen at The Medical City
(TMC) Emergency COVID-19 Response Unit (ER CRU) for coronavirus disease
2019 (COVID-19) counseling and/or testing.
ABOUT COVID-19
COVID-19 or coronavirus disease 2019 is a new disease caused by a strain of
coronavirus that has not been previously identified in humans. The outbreak
which started in December 2019, has affected millions of people around the
world, including the Philippines.
Similar to other respiratory illnesses, majority of COVID-19 cases? presents
as mild symptoms like runny nose, sore throat, cough, fever, and sometimes
diarrhea. In the high risk groups, it can cause severe respiratory distress.
The virus carried in droplets can be transmitted from person to person especially
after close contact with an infected patient.
WHO MAY BE SUSPECT OF HAVING COVID-19?
The following persons are screened for COVID-19:
1. Those with EXPOSURE
• Travelled to other countries in the part 14 days
• Lived with a COVID-19 patient
• Working or staying in a close environment with a COVID-19 patient
• Directly caring for a COVID-19 patient
2. Those with SYMPTOMS
• Fever
• Cough and colds
• Headache
• Diarrhea
• Sore throat
• Joint and muscle pain
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THE MEDICAL CITY COVID-19 PATIENT’S GUIDE

3. WHAT WILL HAPPEN AFTER ER ASSESSMENT?
Patients who have been seen at the ER will be classified as either non-COVID-19
case, PUM case, Suspect, Probable, or Confirmed case. They may either be
admitted in the hospital or sent home for self-quarantine.
EXPOSURE + SYMPTOMS
• If young (<60) and have no other illnesses but have MILD SYMPTOMS,
conduct HOME QUARANTINE
• If elderly (above 60yrs old), with other illnesses, and/or with SEVERE
SYMPTOMS, call the EMERGENCY ROOM for testing
OLD vs. NEW COVID-19
Case Definitions for Surveillance
SYMPTOMS NO EXPOSURE
WITH EXPOSURE
1. With travel history from a place with
local transmission
2. Close contact with a probable or
confirmed case
WITH
SYMPTOMS
NON-COVID
SUSPECT (to be tested / awaiting results)
PROBABLE (inconclusive results / test
can’t be done)
CONFIRMED (tested positive)
NO
SYMPTOMS
NON-COVID PUM
PSMID INTERIM GUIDELINES ON THE CLINICAL MANAGEMENT OF ADULT PATIENTS
WITH SUSPECTED OR CONFIRMED COVID-19 INFECTION ver 2.1 (29 April 2020)
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THE MEDICAL CITY COVID-19 PATIENT’S GUIDE

4. If you are classified as any of the above, you are advised to do the following:
• Stay at home until 14 days after the exposure event, except to get medical
care. While traveling to seek care, wear a medical mask, and practice social
distancing (at least 1 m from others). Call ahead before visiting your doctor
or the hospital.
• Separate yourself from other people in the home. Limit your movement
inside your house and avoid staying at common areas.
• Ensure that shared spaces in the house (e.g. kitchen, bathroom) are well-
ventilated. If possible, use a separate bathroom.
• Avoid sharing household items. Do not share glasses, cups, spoons, forks,
blankets,beddings, etc. After use, wash thoroughly.
• Perform hand hygiene regularly, before and after food preparation, before
eating, after using the toilet, and whenever hands are visibly soiled.
• Cover your coughs and sneezes.
• Monitor your symptoms. Should your symptoms worsen within 14 days of
exposure, call the Emergency Department at 8-988-1000 ext. 6174 before
going for possible admission.
• Please expect a call or a visit from the City or Regional Epidemiology
Surveillance Unit.
Family members taking care of PUM, suspected, or probable cases are
encouraged to do the following:
• Limit the number of caretakers of the patient. Ideally, assign only ONE
person who is in good health without risk conditions. Absolutely no visitors.
• All other household members should stay in a different room or maintain
a distance of at least 1 meter (3 feet) from the quarantined person (e.g.
sleep in a separate bed).
• If caring for a quarantined person, wear a surgical mask when in the same
room. Do not touch face masks while wearing them.
• Change masks when soiled or wet. Discard the mask after use and perform
hand hygiene after.
• All household members must practice good respiratory hygiene (cover mouth
and nose during coughing or sneezing by using surgical masks, tissues, or
flexed elbow, followed by hand hygiene).
• Avoid direct contact with body fluids, particularly oral or respiratory secretions,
and stool. Use disposable gloves when handling above fluids then perform
hand hygiene after.
• Avoid sharing household items (utensils, toothbrushes, dishes, towels,
wash cloths or bed linen) with the quarantined patient.
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5. • Clean and disinfect frequently touched surfaces (bedside tables, bedframes,
other bedroom furniture, door knobs) using a regular household disinfectant
containing diluted bleach solution (1-part bleach to 99 parts water). Clean
and disinfect bathroom and toilet surfaces at least once daily.
• Place contaminated linen, clothes and towels into a laundry bag. Clean
clothes, bedclothes, bath and hand towels, etc. using regular laundry
soap and water or machine wash at 60–90°C with common household
detergent, and dry thoroughly.
• If a household member develops symptoms of acute respiratory infection,
including fever, cough, sore throat and difficult breathing, they must report
to the ER for proper evaluation and management.
• If transporting the patient, avoid public transportation to get to the health
care facility. If possible, call an ambulance or transport the ill person with
a private vehicle.Open the windows of the vehicle if possible.
• Any surface that becomes soiled with respiratory secretions or body fluids
during transport should be cleaned and disinfected with regular household
containing a diluted bleach solution6 (1-part bleach to 99 parts water).
HOME QUARANTINE
Being quarantined means separation or restriction of movement of people who
may have been exposed to a communicable disease.
In the case of COVID-19, HOME QUARANTINE for 14 days is recommended for
the following:
Those who had direct contact with a
confirmed COVID-19 patient
Confirmed COVID-19 patients with
mild symptoms
Suspect or Probable case
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6. WHAT TO DO DURING HOME QUARANTINE
As you conduct your home quarantine, you will be endorsed to the nearest
Regional Epidemiology and Surveillance Unit (RESU) for monitoring.
Stay home
except to get
medical care
Separate
yourself from
other people
and animals in
your home
Cover your
cough and
sneezes
Call ahead
before visiting
your doctor
Wear a mask
Avoid sharing
personal
household
items
Monitor your
symptoms
Get rest and
stay hydrated
Practice hand
hygiene
Clean all high
touch surfaces
as often as
possible
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THE MEDICAL CITY COVID-19 PATIENT’S GUIDE

7. Use the space below to write information given to you upon discharge from
the hospital.
1. Where to report health checks and monitoring
2. How to report health checks and monitoring
3. How often should health checks and monitoring be conducted?
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8. DATE DAY SYMPTOMS TEMPERATURE
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THE MEDICAL CITY COVID-19 PATIENT’S GUIDE

9. HOME DISINFECTION
COVID-19 is transmitted through droplets and fomites (items that can carry
infection such as clothing, utensils, and furniture). As such, it is as equally
important for everyone to disinfect their environment as it is to perform proper
hand hygiene and cough etiquette.
On average, the virus can live in certain objects for 8-9 hours.
Thus, frequent cleaning of high-touch surfaces is encouraged.
The following formulation may be used to clean high-touch surfaces at home
to ensure the prevention of infection.
1:100
FORMULATION
1 part bleach to
100 parts water
1/4 cup bleach
(Sodium Hypochlorite)
1 gallon
water
Use a clean cloth to
wipe surfaces with the
solution
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THE MEDICAL CITY COVID-19 PATIENT’S GUIDE

10. HOME FOOD SAFETY AND NUTRITION
General Guideline for Food Safety1,2
There is currently no evidence to suggest that it can be transmitted through
food or water systems. Follow the proper home food safety advise listed below:
1. Before preparing or eating food, it’s important to wash your hands
with clean water and soap for a minimum of 20 seconds. Include
countertops and other surfaces in cleaning and disinfecting.
2. Wash your hands after handling food and food packages when you
return from the grocery store and after removing packaging from food.
3. Keep raw and cooked foods separate.
4. Practice first-in first-out when storing food items.
5. Refrigerate leftovers within 2 hours. Re-heat up to at least simmering
temperature (60-70°C).
Food Handling of PUM/Suspect on Home Quarantine3
:
1. The assigned caretaker of the patient shall serve his or her plates/
meal trays only up to the room door.
2. After eating, plates/meal trays should be picked up at the room door
by the caretaker using disposable gloves to avoid contamination.
Perform hand hygiene afterwards.
3. Eating utensils and dishes should be cleaned with soap or detergent
and water after use. Do not share eating utensils.
4. If in a shared dining space, do not share dishes and drinks with the
PUM. The patient should have his or her own serving plate. Also,
refrain from talking while eating as this produces droplets.
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THE MEDICAL CITY COVID-19 PATIENT’S GUIDE

11. Eating for your health4,5
:
The healthiest meals emphasize balance and variety. Immune-enhancing nutrients
from fruits and vegetables are important, as well as energy-giving whole carbs
and muscle-building lean meats. Follow the TMC Wellness Plate as your guide.
Currently, there are no known cures for COVID-19, though research
is underway to develop a vaccine. Untested and unregulated
nutrition supplements/products promoted as a prevention or cure
to COVID-19 may be dangerous and potentially life threatening.
If you experience poor appetite and have a decreased food intake for three days
or more, or you have other medical condition that needs a special diet, get in
touch with us at the Nutrition Management Services, 8988-1000 local 6510,
Monday to Saturday, 9am – 5pm.
• Color your plate with a variety
of fruits and vegetables.
- Include citrus fruits & berries; leafy
vegetables like camote tops,
malunggay, spinach; bell peppers,
broccoli, carrots, squash
• Choose high fiber whole breads
and whole grains such as
brown rice, wheat bread, whole
grain cereals, oats, popcorn,
quinoa, sweet potatoes with
skin
• Choose omega 3-rich fishes
like salmon, mackerel,
herring, sardines, tuna
• Opt for lean meat sources
such as skinless chicken/
poultry, pork or beef without fat;
eggs for additional high quality
protein; vegetable proteins like tofu
and beans
• Fat sources that may help boost your
immune system include avocado, olives, nuts
and seeds; vegetable oils like olive oil, rapeseed
oil, soybean oil
• Hydrate well and drink plenty of water. For females, drink 8
or more glasses of water. For males, drink 10 or more glasses of
water. (FNRI)
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THE MEDICAL CITY COVID-19 PATIENT’S GUIDE

12. MAINTAINING PHYSICAL ACTIVITY
Benefits of exercises and physical activities:
1. Reduces the risk for heart disease, hypertension and diabetes
2. Builds muscle and bone
3. Increases stamina and flexibility
4. Prevents falls
5. Improves mood and brain functions
6. Helps strengthen your immune system
Reminders before proceeding with the exercise program
Please consult your attending physician before starting this exercise program.
TIPS:
1. Make a workout plan and monitor your progress.
2. It is recommended that these exercises be done at a regular time.
3. Start gradually with at least one set of 6 repetitions per exercise.
You can gradually add more repetitions per set as your strength and
endurance improve.
Stop the exercises if you experience:
1. Shortness of breath/difficulty in breathing
2. Dizziness, lightheadedness, or headache
3. Chest pain or palpitations
4. Fatigue or exhaustion
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THE MEDICAL CITY COVID-19 PATIENT’S GUIDE

13. Recommended exercises that can be done at home:
1. Breathing exercises
Place one hand on the chest and one hand on the belly. Breathe in
through the nose and watch the belly rise) with pursed lips exhalation
(breathe in for 2 seconds and breathe out for 4 seconds) for 1minute
and then increase to 2 minutes
Inhale Exhale
Inhale Exhale
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THE MEDICAL CITY COVID-19 PATIENT’S GUIDE

14. 2. Stretching exercises
15-18 seconds hold x 3-5 reps x 1-2 sets, may gradually increase to
10 reps x 3 sets
• neck and upper back
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THE MEDICAL CITY COVID-19 PATIENT’S GUIDE

15. • overhead upper extremity
• lumbar/ lower back
• hamstrings, quadriceps and calf muscles
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THE MEDICAL CITY COVID-19 PATIENT’S GUIDE

16. 3. Strengthening exercises
6 seconds hold x 6-8 reps x 1-2 sets, may gradually increase to 10
reps x 3 sets
• wall push-ups
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THE MEDICAL CITY COVID-19 PATIENT’S GUIDE

17. • biceps (with light weight or bottled water)
• triceps
• crunches
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THE MEDICAL CITY COVID-19 PATIENT’S GUIDE

18. • alternating leg raises
• squats
• lunges
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THE MEDICAL CITY COVID-19 PATIENT’S GUIDE

19. • calf raise
4. Balance exercises
• standing single leg stance (10-15 seconds)
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THE MEDICAL CITY COVID-19 PATIENT’S GUIDE

20. • walking on a straight line
5. Walking around the room for 10 minutes 2x a day up to 15 minutes
2x a day.
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THE MEDICAL CITY COVID-19 PATIENT’S GUIDE

21. Sources:
1. Academy of Nutrition and Dietetics. https://www.eatright.org/coronavirus
2. US Food and Drug Administration. https://www.fda.gov/food/food-safety-during-emergencies/food-safety-
and-coronavirus-disease-2019-covid-19
3. Department of Health MD-2020-0090. https://www.doh.gov.ph/sites/default/files/health-update/DM-
Interim%20Guidelines%20for%20Home%20Quarantine.pdf
4. Diet and Inflammation. https://www.eatright.org/health/wellness/preventing-illness/can-diet-help-with-
inflammation
5. Benefits of turmeric tea. https://www.medicalnewstoday.com/articles/319638#preparation
6. Center for Disease Control and Prevention (CDC)
7. Department of Health (DOH)
For additional inquiries, you may contact the following:
• The Medical City (TMC) COVID-19 Hotline: 8-988-1000 / 8-988-7000
• Department of Health (DOH) Hotline: 8-711-1001 / 8-711-1002
• Food and Nutrition Research Institute (FNRI)
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THE MEDICAL CITY COVID-19 PATIENT’S GUIDE