COVID-19

Please note that some of the information on this webpage may be obsolete due to the constant changing of recommendations and knowledge regarding COVID-19.

We live in a scary time with COVID-19 and there is much misinformation regarding this disease. The best source of information is from the CDC. Please practice social distancing (for example, wearing a mask and staying 6 feet apart from others). There is no treatment for COVID-19 besides rest. Despite what is said in social media, there are no FDA approved drugs to specifically treat mild COVID-19 as an outpatient in healthy young people with the exception in individuals who are at high risk for severe disease. If you think you have been exposed to someone with COVID-19, please call your doctor. Generally, a person is infectious 2 days before showing symptoms to about 10 days after symptoms arise. This infectious period can be longer if that person was hospitalized with severe disease.

There has been reports of an unusual inflammatory disorder (i.e. Multisystem Inflammatory Disease in Children or MIS-C) that is compared to Kawasaki Disease or Toxic Shock Syndrome. At this time, MIS-C is thought to be separate from other diseases, is very rare, and its association with COVID-19 is not well understood. For more information, you can go to the healthychildren.org site.

Here are some resources regarding COVID-19 you may be interested in.

Free Testing Sites

There are a few free testing sites one can go to since home tests are widely available. A negative home test is not reliable to rule out COVID-19, and one will need to continue to repeat home tests (2 tests 48 hours apart) or get a PCR test or an antigen test done at a laboratory. Although the public health emergency ended on May 11, 2023, insurance companies may still cover tests done in a lab (not the home test). An option CVS although results can take at least 2 days to come back. You do NOT need a doctor’s order for these testing sites. Other options for testing are the Kapiolani Medical Center’s Pediatric After-Hours Clinic, Straub’s Urgent Cares, and Queen’s Island Urgent Care Centers, although you may have a co-pay at the Urgent Care Centers. The great thing about the urgent cares and clinics though is that someone does the swab for you, it’s not a self swab.

What to do if you are Exposed or Tested Positive for COVID-19

The CDC has a nice table and calculator on what to do regarding quarantine and isolation if you are exposed to someone with COVID-19 or is positive for COVID-19.

Know Your COVID-19 Community Level

The CDC has a new tool called COVID-19 Community Levels to help communities decide what prevention steps to take based on the latest data. Levels can be low, medium, or high and are determined by looking at hospital beds being used, hospital admissions, and the total number of new COVID-19 cases in an area. Take precautions to protect yourself and others from COVID-19 based on the COVID-19 Community Level in your area.

COVID-19 Vaccinations

COVID-19 vaccines (both Pfizer and Moderna) are now available for those 6 months and up. We are finally seeing the light at the end of the tunnel and all our sacrifices for flattening out the curve is for this moment, to have herd immunity by everyone being vaccinated. Click here on learning how to register to get your COVID-19 vaccine. Once you have received your vaccine, you can register for V-safe which is a smartphone-based tool that uses text messaging and web surveys to provide personalized health check-ins. Through V-safe, you can quickly inform CDC if you have any side effects after getting the COVID-19 vaccine. The CDC has a nice chart with the vaccine schedule for the 4 available COVID-19 vaccines approved for use in the U.S.

make an appointment for covid-19 shot

get your shot at Queen's health systems

The Covid-19 vaccine is an important tool to help stop the pandemic.

The vaccines are safe.
Every COVID-19 vaccine authorized for use in the United States is safe. These vaccines continue to undergo extensive safety monitoring. Tens of millions of people nationwide have safely received COVID-19 vaccines. There is no evidence it causes infertility. Johns Hopkins, which is an internationally well respected institution in Maryland, has a fact sheet on COVID-19 vaccine myths.

The vaccines are free.
The COVID-19 vaccines are free of charge to all people living in the United States, regardless of your immigration or health insurance status.

More benefits of vaccination.
Your chance of being hospitalized with COVID-19 becomes almost zero.
COVID-19 cases will drop, and schools and businesses will safely reopen.
Getting vaccinated yourself may also protect people around you, particularly people at increased risk of severe illness from COVID-19.

If you are still unsure whether to have your child vaccinated, Tomas Pueyo published Uncharted Territories in the New York Times on 12/21/2021. To read a summary of this article, click here.

When can I get my COVID-19 Vaccine if I recently had COVID-19 infection?

COVID-19 vaccine is recommended for all those 6 months and older, regardless of having had COVID-19 infection. Evidence shows that vaccination following infection further protects people from subsequent infection and hospitalization. If you have a COVID-19 infection, you should wait until you are not contagious anymore (for most people, 10 days after the start of their COVID-19 infection) before getting your COVID-19 vaccine. You might also want to consider delaying getting your vaccine 3 months from when you had your COVID-19 infection. However, if you have risk factors of getting severe disease or if the community level of COVID-19 is high, you might want to get your vaccine earlier. For more information, you can click here.

COVID-19 Vaccines for 6 Months to 4-Year-Old Children

On June 17 and 18, 2022, the FDA and CDC approved the use of both Moderna and Pfizer-BioNTech vaccines in children 6 months to 4 years of age. The Moderna vaccine (1/4 of adult dose) is a 2-dose series whereas the Pfizer vaccine (1/10 of the adult dose) is a 3-dose series. As of June 18, 2022, there has been more than 2.5 million cases and 20,000 hospitalizations in U.S. children from 6 months to 4 years of age. More than 50% of the children in this age group who were hospitalized had no underlying medical conditions. From January 2020 to May 2022, 202 children from 6 months to 4 years of age died for COVID-19, which is 1.7% of all deaths in this age group. Both vaccines are safe, although there is more chance of getting a fever (22-23%) from the Moderna vaccine compared to Pfizer vaccine (5-7%). This is more chance of fever after the 2nd dose compared to the 1st dose for the Moderna vaccine. On December 9, 2022, the CDC expanded the use of the bivalent vaccines to this age group. Children ages 6 months through 5 years who previously completed a Moderna primary series can now receive a Moderna bivalent booster 2 months after their final primary series dose. Children ages 6 months through 4 years who are completing a Pfizer primary series will receive a Pfizer bivalent vaccine as their third primary dose.

COVID-19 Vaccines for 5–11-Year-Old Children

The Pfizer COVID-19 vaccines for 5-11 year old children have received approval from the FDA and CDC on November 2, 2021., and the booster is now recommended 5 months after completing their primary series which was approved on May 20, 2022. For children 5-11 years old who are moderately or severely immunocompromised, they should receive a booster 3 months after completing their primary series. There are many locations available to receive this vaccine. COVID-19 is NOT a benign disease in children. It has had a significant impact on children’s health during this pandemic. The following are reasons from the AAP to get your child vaccinated:

Nearly 6.3 million children have been infected with COVID-19 since the pandemic’s onset. 

More than 22,400 children have been hospitalized. 
At least 605 children aged 18 and younger have died. 
5,217 patients met the case definition for multi-system inflammatory syndrome in children, and that there have been 46 deaths among these patients.  
Patients with SARS-CoV-2 infection had 16-18 times higher risk for myocarditis compared with patients without SARS-CoV-2.  
Risk of myocarditis in individuals following SARS-CoV-2 infection was 6-34 times higher compared to those who received mRNA vaccine and  Block et al., Occurrence of myocarditis, pericarditis, and anaphylaxis in children and young adults after COVID-19 vaccination compared to SARS-CoV-2 infection. Prepublication; CDC and university-affiliated authors)
Recent studies show that around 2% of children experience Post-Acute Sequelae of COVID-19 and symptoms that persist beyond 56 days.
Compared with 2019, the proportion of mental health-related visits to the emergency room for children aged 5–11 and 12–17 years increased approximately 24% and 31%, respectively.   
Between April 1, 2020, through June 30, 2021, over 140,000 children in the US experienced the death of a parent or grandparent caregiver. The risk of such loss was 1.1 to 4.5 times higher among children of racial and ethnic minorities, compared to Non-Hispanic White children.

Free At-Home COVID-19 Tests

The Biden Administration on 1/19/2022 is making every home in the U.S. eligible to order 4 free at-home COVID tests. The caveat is that it is one per household. If interested, go to COVIDtests.gov to sign up.

Paxlovid

Paxlovid (nirmatrelvir and ritonavir) is an oral antiviral medicine made by Pfizer that was granted Emergency Use Authorization (EUA) in 2022. It is for those who are 12 years and older, weighing at least 88 pounds, AND at high risk for severe disease. It is by prescription, and is taken orally as 3 pills (2 are nirmatrelvir and 1 is ritonavir) twice a day for 5 days. It is for outpatient use only for those who are POSITIVE for COVID-19 and have mild to moderate illness. It must be taken with 5 days of illness. Common side effects include altered or impaired sense of taste, diarrhea, increased blood pressure, and muscle aches. Dose adjustments must be done with those with kidney disease, and it should not be given in those with severe liver disease. There is also a long list of medications it interacts with so your doctor will need to determine if this medicine can be taken safely with your other drugs. Despite being a promising oral antiviral drug for COVID-19, it does not replace vaccinations against COVID-19, which is the best form of prevention.

Test to Treat

The Biden-Harris Administration launched a new nationwide Test to Treat initiative in March to give individuals an important way to quickly access free lifesaving treatment for COVID-19. Through this program, people are able to get tested and – if they are positive and treatments are appropriate for them – receive a prescription from a health care provider (either on site or through telehealth), and have their prescription filled all at one location. To go to the Test to Treat Locator, click on the button below to find participating sites.

Test to Treat Locator

Regeneron (REGEN-COV) Treatment

Regeneron is a combination treatment using 2 monoclonal antibodies that is a treatment available to outpatients with COVID infection. It is not FDA approved, but has FDA Emergency Use Authorization (EUA). It involves an IV infusion for 20 minutes with an additional 1 hour observation period to watch for side effects. The patients who can receive Regeneron must have the following criteria:

a. Patients with mild to moderate COVID-19. This is defined as NOT requiring supplemental oxygen or hospitalization.
b. Patients ≥ 12 years of age and weighing at least 40 kg.
c. Onset of symptoms within 10 days of treatment.
d. Patients with high-risk of progression to severe disease, defined as one or more of the following:

• Older age (for example age ≥65 years of age)
• Obesity
• Pregnancy
• Chronic kidney disease
• Diabetes
• Immunosuppressive disease or immunosuppressive treatment
• Cardiovascular disease (including congenital heart disease) or .hypertension
• Chronic lung diseases (for example, chronic obstructive pulmonary disease, asthma [moderate-to-severe], interstitial lung disease, cystic fibrosis and pulmonary hypertension)
• Sickle cell disease
• Neurodevelopmental disorders (for example, cerebral palsy) or other .conditions that confer medical complexity (for example, genetic or .metabolic syndromes and severe congenital anomalies)
• Having a medical-related technological dependence (for example, tracheostomy, gastrostomy, or positive pressure ventilation (not related .to COVID-19)

e. No identified social barriers (transportation, etc.).
f. NOT hospitalized due to COVID-19.
g. NOT requiring oxygen therapy due to COVID-19.
h. NOT requiring an increase in baseline oxygen flow rate due to COVID-19 in patients on chronic oxygen for underlying non-COVID-19 related comorbidity.
i. NO history of severe anaphylaxis or severe hypersensitivity reactions.to REGEN-COV (Regeneron).

If you meet the criteria, you can talk to your doctor or call Queen’s COVID Infoline at (808) 691-2619.

Doc, I am sick. What should I do?

The CDC has recommendations on what to do if you are sick, when to quarantine or isolate yourself from others, when you can be around others, how to disinfect your home, and what to do if parents (or caregivers) are sick. Click on What to Do If You Are Sick.

Coronavirus Self-Checker by the CDC

To know what the symptoms of COVID-19, are, you can go to the CDC page on Symptoms of COVID-19. There is a handy Coronavirus Self-Checker on this page that can help you make decisions on when to seek testing and medical care.

Queen’s Health Systems COVID-19 Infoline

The phone number is (808)691-2619 and is open 24/7. You can talk to a registered nurse and get your medically-related questions answered. For more information, go to the QHS Covid-19 website.

COVID-19 testing for Individuals Who Need Clearance for Travel, Work, School, or Athletics

Clinical Laboratories of Hawaii (CLH) is doing COVID-19 anterior nares specimen collections by appointment. The anterior nares collection is different to the nasopharyngeal (NP) swab in that the collection site is in your nostrils rather than deeper as in the NP swab. This nasal specimen collection is for screening patients who:

Have not been exposed to COVID-19 (non-exposure only).
Are not symptomatic.
Need a test for preoperative, travel, return to work, school or athletic clearance.

Once you receive your order from your physician, you can make an appointment at one of CLH’s satellite laboratories in advance online at ClinicalLabs.com or by calling 679-4122 on Oahu. Make sure you bring your lab order, a valid form of identification (driver’s license or state ID), and your insurance card. You will need to check with your insurance to see if the test is covered.

On the Clinical Labs home page, click on Book An Appointment on the top, press Find by Location and select COVID-19 Nasal Swab Screening (Feeling Well) from the drop down menu on Filter by Service.

Is Air Travel Safe during COVID-19?

The Journal of the American Medical Association published a Patient Information page on October 1, 2020, stating that the risk of contracting COVID-19 during air travel is low.

American Academy of Pediatrics Guidance during COVID-19

The AAP continues to expand its materials on COVID-19. In addition to their main page on COVID-19, the AAP Healthy Children.org site has a number
of useful articles that you might be interested in.

Help for Patients Who Have Lost Insurance Coverage

HMSA has provided information to help those who have lost their insurance coverage during COVID-19. For more information, click here.