As the outbreak of COVID-19 widens, transplant patients have some special concerns. Meenakshi M. Rana, MD, the Director of Transplant Infectious Disease, Mount Sinai Health System, shares her perspectives on what transplant patients need to know about the virus.

Should transplant patients be concerned about COVID-19?

We’re just learning how this virus could potentially affect transplant patients. We do know that this virus is similar to other common respiratory viruses, and that the symptoms have a lot in common with the flu. Many of the patients affected by COVID-19 have mild symptoms, typically fever and cough. Many of them are fine at home, though some patients may have more severe complications such as pneumonia and may require hospitalization.

What is the special concern for these patients?

We are very concerned about our transplant patients because they have compromised immune systems, and they’re more at risk of having severe complications. It’s really important that our transplant patients take precautionary measures such as hand hygiene. We know the virus is spread by direct contact. However, it is easily killed simply by washing your hands with soap and water for 20 seconds, or using an alcohol-based hand sanitizer. So washing your hands is the most effective thing you can do to prevent transmission of this virus.

What other precautions should transplant patients take?

First of all, if you’re sick, please stay home. If you need to cough, don’t cough into your hands, cough into your elbow. Throughout your home, use a disinfectant to wipe off surfaces that are commonly used such as door handles, bathroom fixtures, and countertops.

As a practical precaution, make sure that you have an adequate supply of your medications at home. Call your physician and ask for a three-month supply of your transplant medications so you don’t run out.

And if you do go out, be very conscientious about hand hygiene and disinfecting surface like your phone. If you know someone is sick, this is not the time to visit with them. And in general, avoid large crowds.

What about masks?

We have been getting a lot of questions about whether protective masks are effective. We don’t think wearing a mask in public is an effective way of protecting yourself. Washing your hands and disinfecting surfaces is a much better way to prevent transmission of this virus.

What should transplant patients do if they have symptoms of COVID-19?

If you have symptoms such as fever, coughing, or shortness of breath, call your transplant provider. We want to know if our patients aren’t feeling well. We will ask about your symptoms. If you’re having mild symptoms, such as a cough, sore throat, or runny nose, we may advise you just to stay at home. We’ll follow up in a day or so to see how you’re doing. If your condition has worsened, and you have a high fever and shortness of breath, we may bring you into the hospital and evaluate you further. If you do decide to come in, we ask that you call ahead so that we know how to triage you, and so that we can determine the best location to receive you.

Meenakshi M. Rana, MD, is the Director of Transplant Infectious Disease for the Mount Sinai Health System. She is also Associate Professor of Medicine of Infectious Diseases at the Icahn School of Medicine at Mount Sinai.

As the COVID-19 spreads throughout the New York area, the Mount Sinai Health System is making it easier—and safer—to get care.

Mount Sinai Now telehealth services offer several ways to get care remotely. You don’t have to worry about crowded public transit or waiting rooms. Using your phone, tablet, or computer, you can connect with a Mount Sinai expert to get your symptoms check, have a medical consult, and get the care you need, including a prescription if appropriate.

Each of these options costs $25 per consultation, not including any rates based on your phone or internet.

Mount Sinai’s three telehealth services are:

• Video Urgent Care: Have a live online chat with an urgent care doctor in real-time. You’ll be connected within minutes with a physician who can provide an accurate diagnosis, provide next steps, and prescribe medication, if needed. This is not appropriate for emergency concerns. To get started, request a virtual doctor visit or download the free Mount Sinai NOW App in the Google Play store or iTunes. Video urgent care works with any Android or iOS phone or tablet released in the last few years, or any Mac or PC with a webcam and modern browser (Chrome, Safari, or IE 10+).
• Click4Care: Available 24/7, this service lets you complete an online health interview at your convenience. You answer a series of questions about your symptoms. We may also need a photo of any area of concerns, such as a wound. Then a Mount Sinai Health System expert will review your information and craft a treatment plan, which may include a prescription if necessary. The expert will let you know when the results are ready—usually in an hour during office hours or first thing the next morning if you fill out the form after hours. If you need a prescription, Mount Sinai staff will send it to the pharmacy of your choice.
• Text-to-Chat: This secure mobile web application allows you to talk with Mount Sinai on any mobile device. Just text 4-SINAI(474624) and our staff can arrange a virtual video visit or in-office appointment with a doctor. Within a few seconds, our staff will ask a few questions to find the best provider for you. Then you can continue your conversation in the same message window.

Mount Sinai has long been at the forefront of seamlessly integrating technology with patient care and is committed to providing high-quality care to you and your family. And Mount Sinai Now telehealth services makes it even more convenient.

As the novel coronavirus known as COVID-19 spreads around the United States, guidance for prevention and containment are being issued by the Centers for Disease Control and Prevention (CDC). People who have fever or respiratory symptoms, such as coughing and difficulty breathing, are being advised to stay at home except to get medical care. Krystina Woods, MD, Hospital Epidemiologist and Medical Director of Infection Prevention at Mount Sinai West, helps us understand the “dos and don’ts” of self-quarantining, and what that may mean for New Yorkers.

The CDC recommends staying home except to get medical care. How and why is this different from other respiratory diseases?

Many of the CDC guidelines for quarantine might be used by someone who has a severe case of the flu. But because we are just starting to understand how COVID-19 is being spread, and how long the incubation period is, the guidelines are going to be necessarily conservative.

The CDC recommends that the patient stay in a separate bedroom. And if possible, use a separate bathroom.

Yes, and that might pose a challenge to New Yorkers. Certainly, if there’s a separate bedroom and bathroom for the patient that would be best. Another strategy for roommates and spouses to consider: Is there a friend or family member the roommates or spouse can stay with? But even in small apartments, there are things you can do to protect each other. In studio apartments, separating the beds as much as possible is advisable. And because of the close proximity, the patient, roommates, and others in the household should wear masks.

If you share a bathroom, make sure you don’t share towels. The patient might bring their towel back to their own room if they have a separate bedroom. Always wipe down surfaces such as the sink, toilet handle, light switches, and door knobs with a household cleaner with disinfectant. Don’t share personal items such as toothbrushes or drinking glasses.

If the patient has their own room, they should wear a mask when they come out. And even though it’s winter, cracking a window for some ventilation is a good idea.

What precautions should people take concerning meals?

If the spouse or roommate can prepare meals for the patient, that would be best. Meals can be left outside the patient’s door, so the patient doesn’t need the kitchen. You can even text when the meal is on the way, or to communicate back and forth. Disposable plates and utensils might be an option, but not totally necessary. Washing the patient’s dishes immediately after use, and then washing your hands, should be enough.

What additional precautions should family, spouses, or roommates take?

Others in the household should wash their hands as much as possible. We touch so many things that could be contaminated without thinking: phones, microwaves, remote controls. Wash your hands before you leave home and when you get home. Wash them after touching anything the patient could have touched or used: bedding, dishes, the bathroom doorknob. Try not to touch your face, especially your eyes, nose and mouth.

If the patient has a medical appointment, it’s hard to get there without public transportation. What advice would you give?

People should avoid using subways, buses, taxis, or ride-sharing services if they’re sick. You should only go to medical appointments that are absolutely necessary, not routine appointments. Maybe a friend can give you a ride for appointments that are essential. If so, you might want to sit in the back seat instead of the passenger seat, and open the window. 

How long will the self-quarantine last?

It’s hard to provide a time frame for any self-quarantine because it depends on the severity of the disease. Some people may have a very mild case, and some may have severe symptoms. The duration of symptoms varies from person to person. But certainly, a person should be quarantined while they have a fever or respiratory symptoms such as coughing or difficulty breathing. The New York Department of Health will be monitoring each case of COVID-19 very carefully, and they will provide guidance.