People with kidney disease or kidney conditions can have a weaker immune system are at higher risk for more severe illness from Corona virus infections. Since the COVID 19 outbreak can last for a long time, kidney patients with weaker immune system can find it harder to fight infections. Because of this increased risk for kidney patients, it is of primary importance to take actions that reduce the risk of exposure. These actions, as directed by the Centre for Disease Control (CDC) are to reduce exposure, slow the spread and reduce the impact of the disease.
Actions recommended for kidney patients who are at high risk of getting very sick from Coronavirus are:
- Take everyday precautions to maintain space and limit face-to-face contact with others in the neighbourhood.
- Avoid people even within the same house who are sick specially if they are coughing, sneezing or with fever.
- Stay at home and avoid gatherings and crowds. If going out in public is unavoidable, wear a face mask to limit infections.
- Wash hands often with soap and water for at least 20 seconds; especially after going to the bathroom; before eating; and after blowing the nose, coughing, or sneezing. In places where soap and water may not be accessible, use hand sanitizer with 60%-95% alcohol.
- Clean and sanitize all the things that get touched a lot, like door handles, switches, mobiles and remotes. Touching the face, mainly the nose, mouth and eyes should be avoided.
- Stock up on food supplies – Having enough household items and groceries can prepare the kidney patient to stay at home for a period of time. To decrease the risk of getting sick, it’s important to have food at home. This will help reduce the risk of infection by allowing the patient to avoid crowded spaces like grocery stores and drug stores. There are some shelf stable food choices to help follow a kidney friendly diet. Shelf stable foods last a long time without spoiling, such as cereals, dry fruits and canned foods. Stocking up a month’s worth of healthy, kidney friendly foods, fresh water and medicines is important.
- Have medical supplies on hand – Check with the renal specialist for any questions about extra essential medications may arise. If extra medications are immediately unavailable, consider ordering for medications. Over-the-counter medicines to treat fever or other symptoms and hygiene supplies such as tissues, hand sanitizers and surface disinfectants are to be included as essential supplies.
- Have a plan if taken ill – gather more information from the health care provider for monitoring symptoms indicative of COVID 19. It is good to stay in touch with others by phone or email. Help from friends, family, neighbours, community health workers etc., may be needed in case of falling sick. Have a backup on who can provide with care if the caregiver gets sick.
Community Support for High Risk kidney patients
- Community preparedness planning for COVID-19 should include kidney patients and the neighbourhood that support them in their homes, to ensure their needs are taken into consideration.
- Many of the kidney patients live in the community and many depend on services and supports provided in their homes or in the community to maintain their health and independence.
- Long-term care facilities and in-house services should be vigilant to prevent the introduction and spread of COVID-19.
Family and Caregiver Support
- Know what medications the concerned is taking (especially insulin or immunosuppressants ) and ensure to have sufficient stock.
- Monitor food and other medical supplies such as dialysis material, incontinence material, material for wound care as needed and create a surplus plan.
- Stock up on kitchen provisions to minimize trips to stores.
- For those high risk patients living in a care facility, family members can monitor the situation, ask about the health of the other residents frequently and know the protocol if there is an outbreak.
Getting in contact with the clinic or consultant if feeling sick or had contact with a confirmed COVID-19 positive person or have any other concerns, will enable the doctor to choose whether testing for the coronavirus is needed and to arrange for the needful. Furthermore, information of fever or respiratory symptoms should be shared with the staff immediately upon arrival at the hospital.
For patients on Haemodialysis
A patient on dialysis, owing to other health conditions may be subjected to higher risk of becoming seriously sick from COVID-19. Patients on dialysis should not miss their scheduled dialysis sessions. Centre for Disease Control instructs health care centres on control measures that may change time to time depending on the severity of regional outbreak. The dialysis centre’s first priority is to keep all patients safe. Dialysis centre staff are prepared to identify patients who may have coronavirus and provide them the care they need and to minimize potential exposure to other patients. Be informed that some centres may limit accompanying visitors while others may have patients wait in their cars instead of the waiting room to maintain distancing. In the unlikely event that the visiting centre is closed due to an outbreak, the centre may recommend to get dialysis at another nearby clinic. It is suggested to be in constant communication with the dialysis centre.
Safety precautions and hygienic measures at the dialysis centre
- use alcohol dispensers in patient waiting rooms. Rigorous application of disinfectants on surface contacts is also recommended
- wash hands and fistula arm before starting dialysis and thoroughly disinfect the puncture areas
- wear a mask when arriving at the centre, during the entire duration of the dialysis session and till the time of exit
Questions to know more about the precautions at dialysis centres:
- What are the measures to keep the centre infection free and maintain social distancing?
- Is it possible to wait in the car instead of in the waiting room?
- What are the immediate measures on developing any flu-like symptoms?
- Are masks to wear during the treatment, provided at the centre ?
- What procedures are followed if a patient at the centre may have COVID-19?
- How will the centre communicate to patients of any emergency information?
- What alternatives on falling sick ?
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