Thread by @tmprowell

Well, I got 2 messages before 9am from friends telling me they have #COVID19 in their households. And in the 12 mins since, I’ve just heard about 4 more. So Merry Exponential Growth #Omicron #Christmas. 🌲 😫

A quick 🧵 on what to do if that’s you since I’m typing it anyway.

1/ The first thing to say is that if someone has #COVID19 symptoms (#Omicron most common: nasal congestion/runny nose, scratchy sore throat, fever, & aches), you have to assume they have it. You may not have a test (urgent cares are still open & do) or they may still be neg.

2/ You, as the person exposed to the one with symptoms, have to assume that you both do & don’t have #Omicron too. Wait, what? 🤔

I mean: assume you could infect others now & take care to avoid exposing them, BUT don’t assume it’s too late for you to avoid getting it.

3/ Especially in households with #vaccinated (& #boosted) family members, I have seen people manage to limit #Omicron to the first person who was infected. This #CovidVariant is incredibly contagious, but It CAN be done. Don’t give up on the idea!

4/ If you have N95/KN95/KF94 masks, get in them immediately. If you have only 1, put the sick person in it for source control. If you have >1 but not enough for all put the sick one & the highest risk (older, #immunocompromised) people in them. Then get outside, & leave🚪open.

5/ Fresh air is a friend & shared air is an enemy. The more you can ventilate your 🏠, now & until this is over, the better. You want the concentration of #omicron in air as low as possible. This ⬇️ odds of infection & may make you less sick if you do get infected.

6/ Plan to bundle up if you’re in a 🥶 climate, because you’re going to need to leave 🪟 & 🚪 open enough for air exchange, esp for next 5d or so, & a cross draft. If you have a fresh HVAC filter, change it. If a hardware place is open, get a MERV13 HVAC filter. (Amazon has too.)

7/ Run the fan on your thermostat on high. Filter that #Omicron 🦠!

If you need supplies of any kind, please do curbside pickup or same-day delivery or drive-thru. No one exposed should be indoors in public, & def not the one with symptoms, to prevent further spread.

8/ If you don’t have any N95/KN95/KN94 masks, please see if a nearby friend or neighbor has unused ones you can have & order them replacements. The nonprofit @projectn95 (projectn95.org) is a great place to get them. Your backup plan for right now is a surgical 😷.

9/ A surgical 😷 (ASTM level 3, 3-ply is best) has good filtration but usually not good fit. There are often gaps. Knot ear loops where they join the 😷 & then tuck to improve the mask fit. Here’s a short video demo: . Put a cloth 😷 over the surg 😷.

10/ Now it’s time to create the space where the infected person or people will isolate for 10d to let #Omicron run its course. This prior 🧵 of mine covers what is helpful to have in there & other things to consider.

https://twitter.com/tmprowell/status/1473043842966470656

11/ This whole scenario assumes that things are going ok with the person who has #Omicron. How do you know if they are ok? As I mentioned before, if you have a pulse oximeter (O2 sat monitor)—the thing drs put on your fingertip to measure O2–use it. See guide in 📸 .

12/ If you don’t have a pulse oximeter, many pharmacies carry them. They are over the counter. Ask the pharmacist if you don’t see them. You can order them online from many places too. Get one highly rated by many people. They need not be expensive. $15 gets a very good one.

13/ Some of your devices (smart watches, fitness trackers) can detect ❤️ rate (60-100 normal for adults) & less reliably O2 levels. If you have them & they read low O2 levels, def do call a dr or seek care. Video calls on 📱 or 💻 are helpful to check on the sick as well.

14/ If the person w/ #Omicron is high-risk (especially #immunocompromised, organ or bone marrow transplant, active #cancer, #pregnant, #diabetes, older, etc), they should contact a dr even if they seem ok. There are outpatient treatments that sig ⬇️ risk of being hospitalized.

15/ These include monoclonal antibodies (some brands no longer work vs #Omicron, but 1 called sotrovimab remains effective). It is given IV as a single dose. There are also two types of pills taken for 5d at home. All are in short supply at the moment. google.com/amp/s/abcnews.….

16/ All of these things to treat outpatients w/ #Omicron, the monoclonal antibody sotrovimab, as well as the pills (Paxlovid: google.com/amp/s/www.nyti…) & (molnupiravir: google.com/amp/s/www.nyti…) are new, so they are being reserved for higher-risk folks while supply increases.

17/ If you are not the sick person, but one of the exposed, & you can walk-up/drive-up (NOT indoors & ONLY in a 😷!) to #GetVaccinated, do it. If age 16+ & 6+ mos post dose 2 of vaccine (or 2+ post J&J), go #GetBoosted now! The booster protects w/in a wk! Vaccines.gov

18/ If you are just reading this crisis 🧵 & being 😅 it doesn’t apply, know that if you are indoors w/ people from outside your household, you WILL be exposed to #Omicron. The only Q is whether you’ll get infected. If you wear a very good 😷 & are careful, you CAN prevent it.

19/ If you are high-risk #immunocompromised or #immunosuppressed, we know that #vaccineswork less well in many of you. While you should still #GetVaccinated & #GetBoosted, an injection (Evusheld) can ⬇️⬇️ your risk of #COVID19. It’s given every 6 mos. fda.gov/news-events/pr…

20/ This 🧵 doesn’t include every single thing you or your dr can do for #Omicron, & it shouldn’t be read as medical advice. It’s info. Unfortunately everyone in #MedTwitter is swamped both officially at work & at home w/ sick pts, so this is my attempt to help inform all. /End

21/ P.S. Routine infection control measures still matter. #WashHands, etc. Don’t forget #commonsense.
When can you get back to life after having/being exposed to #Omicron? See 👇from @CDCgov. If you were 🤒, #GetVaccinated, if not already, or #GetBoosted in 10+ days. #MedTwitter

In case you’re wondering how your mask will fare in this #Omicron #Christmas gathering scenario, read this tweet & the one just after it in the same thread. #GetOutside! 😉

https://twitter.com/tmprowell/status/1474162934762856458

For those who cannot find or do not meet criteria for the existing monoclonal antibodies or pills to treat #COVID19, consider enrolling in #clinicaltrials online. They ship meds to your home & can help us find new treatments for #Omicron. #MedTwitter

https://twitter.com/hollyby/status/1474793611099140096