The second wave of the pandemic is gaining momentum. The coronavirus is not giving up. What to do when the statistics are soaring and there are more and more people in our immediate environment who have had contact with it? It is time to realize that each of us can get infected and get sick. The probability is high, so we need to know what to do when we find out that we are "in the range" of the virus. More dangerous than COVID-19 may be a lack of reliable knowledge. That is why we have collected basic concepts and information on how to proceed in the event of infection.

Statistical data indicate that we should not panic. Analyses of the spread of coronavirus and the increase in the number of cases in the first wave of the pandemic give scientists grounds to claim that from 50 to 80 percent infected people experience COVID-19 asymptomatically or with minor symptoms of infection. In approximately 20 percent infected, the symptoms are more serious, and in several percent the disease takes on a severe and very severe form. However, these are only statistical data.

Scientific research on the health effects of virus infection SARS-CoV-2 are still ongoing, so we must avoid this risk at all costs. It is also worth organizing knowledge about how to proceed in specific cases.

QUARANTINE

In the case of people who have direct contact with infected people The Sanitary Inspectorate orders quarantine. People living with patients with confirmed SARS-CoV-2 infection (e.g. spouses, children), as direct contacts are obligatorily covered by the decision of the sanitary inspector to impose quarantine.

Quarantine lasts 10 days from the last contact with an infected person.. So if there is an infected person at home, the quarantine for household members lasts for the entire period of their isolation, plus 10 days (e.g.: 10 days of parental isolation means 20 days of children's quarantine). The patient should receive information about the imposed quarantine and its duration from the Sanitary Inspectorate. Quarantine ends when the imposed period expires and there is no separate document that would prove its end. In matters of quarantine, the patient must contact the Sanitary Inspectorate.!

Note! A patient under quarantine is a potentially infectious person, therefore he/she should maintain a sanitary regime similar to an infected person!

"The rapid increase in the number of SARS-CoV-2 infections means that primary care physicians have much more work to do," emphasizes Mariola Madler-Litera, head of the Twój Lekarz network of clinics. To make it easier for patients to access reliable information and quick help, we have set up a special hotline number for people who are sick or suspect they have been infected with COVID-19," adds the doctor.

In order to shorten the waiting time for a telephone connection with registration, the Your Doctor network has launched special e-mail addresses for handling specific matters. At recipes@localhost patients can order prescriptions for medications they take regularly, and the address vaccinations@localhost is used to book vaccination appointments. "For patients who need medical advice and information on what to do if symptoms of coronavirus infection appear, we have launched an address covid@localhost” – says Mariola Madler – Litera. According to the head of the Twój Lekarz network, such solutions help relieve the hotline.

HOW IS CORONAVIRUS INFECTION DIAGNOSED?

The basis for confirming the infection is MOLECULAR TEST RT-PCR towards SARS-COV-2. This is a so-called genetic test, the result of which we wait from 1 to 3 days. A referral for a free test can be issued by a doctor Primary Health Care /POZ/ after assessing the patient's health condition during a teleconsultation or a personal visit. People who experience symptoms characteristic of COVID-19, above all:  fever, cough, shortness of breath and breathing difficulties, muscle pain, loss of smell or taste. 

Referral to MOLECULAR TEST RT-PCR is displayed in the application www.gabinet.gov.pl. After receiving information about the referral, the patient should arrange a date for the examination at the selected collection point by phone and then go to the examination using their own transport, avoiding contact with other people.

In recent days, due to the large number of referrals for tests, there were long queues in front of the smear points and patients had problems reaching them by phone.

Mobile points in Wrocław:

• J. Gromkowski Provincial Specialist Hospital – Koszarowa 5, tel. 71 39 57 509
• Provincial Specialist Hospital in Wrocław – Henryka Michała Kamieńskiego 73A, tel. 661-924-254
• A. Falkiewicz Hospital in Wrocław – Warszawska 2 (entrance from Biegła Street), tel. 667-977-733
• SPZOZ MSWiA in Wrocław – Ołbińska 32, tel. 71-798-46-60
• T. Marciniak Lower Silesian Specialist Hospital – Emergency Medicine Center, ul. gen. Augusta Emila Fieldorfa 2, 54-049 Wrocław, phone no. 71 306 41 77
• Jan Mikulicz-Radecki University Clinical Hospital, ul. Borowska 213, 50-556 Wrocław (covered driveway to the Emergency Department) tel. 885 852 287
• Alab Laboratoria (point in Wrocław ul. Biskupia), ul. Biskupia 8a, 50-148 Wrocław tel. 71 307 95 38
• Alab Laboratoria (point in Wrocław, ul. Nauczycielska), ul. Nauczycielska 2 50-381 Wrocław tel. 71 321 03 72
• Diagnostics (point in Wrocław ul. Ziębicka), ul. Ziębicka 34-38 Wrocław (emergency room Wrocław) tel. 663 687 659

In the case of a patient who is unable to move independently, the primary care physician issues a referral for a molecular test and through the system www.gabinet.gov.pl and orders the material to be collected by the swab ambulance team.

Sanepid is always notified about issuing a referral for a molecular test. Inspectors monitor whether the patient has reported for the test, and if the result is positive, they begin an epidemiological investigation to impose quarantine on contacts.

I HAVE NO SYMPTOMS, BUT I AM WORRIED ABOUT MY HEALTH. CAN I TAKE A TEST?

The patient can report to a paid clinic on his own. ANTIGEN TEST by registering on the website www.testprzesiewowy.pl. The SensDx technology test provides information within 15 minutes whether there is any active virus protein present in the swab. SARS-CoV2, which indicates the patient's infectiousness. The test is best performed 5-6 days after contact with an infected person or 2-3 days after the onset of infection symptoms. The test is of a screening nature, and its result is not a basis for intervention by sanitary and epidemiological services.

Diagnostic laboratories have the following available: SEROLOGICAL TESTS (IgG, IgM)which detect antibodies anti–SARS-CoV2This allows us to determine whether a person has had an infection. COVID-19. Venous blood tests performed using the immunoenzymatic method (ELISA) or chemiluminescence (CLIA) are currently considered the only reliable tests for anti-SARS-CoV-2 antibodies. Experts from the World Health Organization (WHO) point out that they cannot be considered a method for detecting active cases of the disease. Antibodies appear quite late, and their highest level occurs about 2.5-3 weeks after infection.

MY DOCTOR REFERRED ME FOR A TEST, THE RESULT IS POSITIVE – WHAT NEXT?

About the test result RT-PCR the primary care physician learns from the application www.gabinet.gov.pl and informs the patient by phone. The patient can read such information on his/her Individual Patient Account.

In the case of a person with a positive coronavirus test result the doctor makes a decision about HOME INSULATION.

The primary care physician, assessing the patient's health condition, decides on the duration of home isolation, its possible extension or termination.

HOW LONG CAN HOME ISOLATION LAST?

1. If the patient does not experience symptoms typical of COVID-19 The default duration of home isolation is 10 days from the date of the test that led to the diagnosis. COVID-19. At the end of this time, no earlier than on the 8th day the doctor provides the patient with a teleconsultation and informs him about the end of isolation. This fact is recorded in the medical documentation, but does not issue a medical certificate!

• In a patient who had symptoms of a respiratory infection, the duration of isolation is extended. The doctor records such a decision in the medical documentation, issues a sick leave certificate for the period of illness and extends the isolation in the system. www.gabinet.gov.pl

3. Home isolation lasts at least 13 days from the day the symptoms appeared (not from the date of the test!), if symptoms last longer than 10 days, the duration of isolation is extended according to the duration of the symptoms.

For example, if symptoms occur on day 5 of isolation and last for 12 days, the duration of isolation is 15 days from the date of symptom onset (not from the date of the test). If symptoms last for 20 days, the duration of isolation is 23 days from the date of symptom onset (not from the date of the test). 

Attention! The last three days of isolation must be asymptomatic – without fever, cough or shortness of breath.

PATIENT CARE IN HOME ISOLATION

People with confirmed infection SARS-CoV-2, directed to home isolation, must carefully monitor their health. It is worth keeping notes of self-observation, and in case of questions or doubts, contact the primary care clinic.

One of the effective and objective methods of assessing the health status of patients with COVID-19 symptoms is to check oxygen saturation using a finger pulse oximeter, a device available in pharmacies and medical stores. A painless and non-invasive measurement that anyone can perform on their own shows the degree of oxygen saturation in arterial blood. The norm of saturation in a healthy person is around 95 - 99% (in seniors 93 - 95%). If the saturation is lower than 90%, we are dealing with hypoxia and this requires urgent medical intervention. The patient should be aware that, as in the case of other diseases, a sudden deterioration in health is the basis for calling an ambulance.

SEVERE SANCTIONS FOR VIOLATING HOME ISOLATION ORDER

Home isolation imposes special responsibility on the people subjected to it. Patients with a positive test result SARS-CoV-2 must make every effort to limit the risk of infecting other people in their environment. Due to the possibility of endangering the health and lives of other people, disregarding sanitary regulations is subject to criminal and administrative liability. According to Article 165 of the Penal Code, the crime of "bringing danger to the life or health of many people by causing an epidemiological threat or the spread of an infectious disease" faces up to 8 years of imprisonment. People who violate the regulations on home isolation or quarantine may also be punished by the sanitary inspector with an administrative penalty of up to PLN 30,000.