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Hospital Particular Gambelas

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Medical Emergency

Recommendations for specific cases - COVID-19


The Cancer Patient

Oncologist Dr André Andraz Cruz explains the impact of the new coronavirus on the cancer patient  

The coronavírus (COVID-19) is a respiratory disease caused by a new coronavírus, which was identified for the first time in the province of Wuhan, in China, in December 2019. In the majority of cases it causes minor effects similar to those of a cold or flu.

 

However, it may cause a more severe form of the disease, similar to that of Severe Accute Respiratory Syndrome (SARS), known as SARS-CoV-2, with a mortality rate proportional to age and other diseases. 

It is a highly contagious disease, through respiratory droplets and through contact with contaminated surfaces with subsequent contact of the hands with the eyes, nose and mouth.

In addition to elderly patients with chronic diseases, cancer patients with active disease or undergoing immunosuppressive cancer treatment generally have a weakened immune system. Despite the scant evidence concerning the behavior of COVID-19 infection in this pathology, the above fact constitutes an important risk factor for infection and serious complications, as well as for any other infection by another agent.

There is, understandably, fear and anxiety of patients in the face of this new reality.

Even in this pandemic phase, in the event of urgent health care treatment being necessary, the cancer patient will start / continue his treatment, without prejudice to his clinical situation. There will be occasional situations, in which the oncological disease is indolent or is well controlled, and weighing the risk of contact / infection by COVID-19, it will be possible to consider postponing the treatment.

Naturally, there is now a rigorous screening and control of all patients according to the Contingency Plan of the Hospital, in order to minimize the risk of infection in the Day Care Hospital, be it to other patients, or to the Health professional.

Another important necessity is to minimize hospital visits; ideally only for treatment ideally favoring Teleconsultations whenever possible (namely routine consultations of patients not undergoing cancer treatment). 

The measures widely recommended and widespread in the media must be strictly observed - respiratory etiquette, washing hands frequently, avoid touching the face with the hands and sharing personal objects, as well as prophylactic social isolation. In cancer patients under active and immunosuppressive treatment, the use of a mask is recommended due to the risk of infection with COVID-19 and other agents. However, placing and removal of the mask must be done correctly.

The Cancer Units of the Day Care Hospitals of Alvor and Gambelas – will continue to provide the treatment necessary to cancer patients.  

In addition to these measures, stay at home. 


The Elderly 

The impact of social isolation on the elderly  

According to the Psychologists Board during these difficult times we are going through, can give rise to a mixture of emotions difficult to manage, such anxiety, fear, anguish and or frustration. In the polder population these manifestations might have an even greater repercussion. 

 

With this in mind, the said organization has alerted to some attitudes and behavior to be adopted for those that have family members or even friends in these circumstances:

  • Phone regularly and encourage them to also phone you, show interest and available to chat.
  • Do the same to other family members or friends, so that everyone feels connected and protected.
  • Since the elderly usually find it more difficult to fall asleep, try to also call them during that period.  This will provide greater peace of mind.
  • Keep an eye on their state of Health, once or twice a day, questioning on symptoms they might be having. Even usual symptoms might be significantly different during this period. If you have any doubts call (National Health Line) SNS24 or seek a health professional.
  • Make sure they are taking their usual medication.
  • Advise them to do some physical activity, for exemple, walking around the House, or some simple exercises.
  • Question them about their meals, advise on having balanced meals, sugest diferente recipies.
  • Sugest that they should play some games that will keep them amused and motivated.
  • Show that you are greatfull for their colabotration, responsibility as a responsible citizen during these difficult times.
  • Remind them that if they wish to find further information thay need to do so from oficial sources  DGS or OMS.
  • Lastly, show your affection verbally, telling them that you love them and that they are loved.  

Interpreting children’s feelings and learning to calm them down during an isolation period

Children tend to assimilate  parents' feelings, so at a time when many parents  feel uncertain and anxious,  it is predictable that the same will happen with the youngsters.

 

 

The Portuguese Psychologists Board has issued some recommendations that can help old and young to understand and overcome these anxieties:

  • So that the child within its understanding and development can collaborate, explain how important you’re is his help.  As it is equally important to respect the respiratory etiquette and hand washing, the reason why contact with the face, hands and mouth should be avoided.
  • Don't underestimate the child’s feelings of anxiety, fear, frustration or annoyance. However, praise a positive attitude.
  • Explain that being isolated at home can also be fun: there is more time to play, you can engage in new activities, they can try out video calls and they can even organize a “logbook”, which will serve to later recall how we won this fight against the virus.
  • Convey hope and security. Tell the child that this is a passing phase; that we will not be at home forever, but since it must now be so, let us make the best of it.

Being a diabetic patient in times of a COVID-19 pandemic

Dr. Ricardo Louro, Internist and responsible for the Diabetic Out-Patient Consultation.

Due to the current pandemic circumstances associated to SARS-CoV2 (COVID-19) that is also affecting our country (SPD, SPEDM, NEDM/SPMI e APMGF), it recently become necessary for several scientific societies to reach a consensus and to issue recommendations relating to diabetic patients. 

 

 

Diabetes Mellitus (DM) makes people more susceptible, not only to the development of infections, but to conditions of greater severity and a worse prognosis.

Among the various recommendations I wish to highlight:

  • I will be postponing all my medical activity which is considered not to be of an urgent nature (out-patients consultations and appointments, exams and treatment).
  • I will be optimizing the monitoring DM patients without the presence of the patient, preferably by telephone of email. In this way medical prescriptions can be reissued and trips to the hospital to collect prescriptions can be avoided. 
  • Comply with social isolation, avoiding social contact whenever possible. If for some reason this is not possible, maintain a distance of at least 1 meter from other people.
  • Avoid contact with people that are ill or those with respiratory symptoms.
  • Wash hands frequently with soap and water or a disinfectant solution. Avoid sharing food or crockery.
  • Keep hydrated, control blood glucose and ketone levels, measure temperature regularly.
  • Should symptoms such as temperature, cough or shortness of breath arise, keep isolation at home and contact Helpline - Saúde24.

From my personal point of view, in addition to the above recommendations do not forget that good practices for controlling Diabetes should be maintained; healthy eating habits, the usual daily exercises, at home. Be sure that you have the necessary medication and the testing materials necessary for the following weeks and that you also have the necessary prescription should you run out of medication.

Stay at home, keep safe, keep your Diabetes under control.