COVID @ Home

A collaborative guide to COVID-19 care

Level 2 – Emerging Symptoms

Notice if you suffer anew from any of the following, most common first COVID-19 symptoms:

Fever seems to be the most common symptom – but it’s not universal. Early data showed that gastrointestinal symptoms (diarrhea, nausea, vomiting, abdominal pain, loss of appetite) were uncommon. But more recent evidence suggests that they are common, and can even precede respiratory symptoms. Initial symptoms may also include joint / muscle pain, headache, chills, dizziness, nasal congestion, and sore throat. Loss of smell and taste lasting for several days can start early or later in the infection. So can skin symptoms like a rash on the back, chest, or stomach (in about 20% of cases in one sample), or small red or purple-colored lesions around the tip of the toes (especially in children and adolescents).

However, common colds, flu, and allergies can also cause many of the same symptoms. In fact, nasal congestion, itchy eyes, and sneezing most likely indicate a condition other than COVID-19, such as allergies. There is no single, unique COVID-19 sign or symptom. There is no way to know for sure whether you have COVID-19 without testing for it.

Is COVID-19 spread in the community where you live? Or have you been to an affected area or been around someone who was in an affected area? Then your symptoms could very well be COVID-19. But remember: In many areas, the odds that it’s something else will still be greater.

Note: Fever is not subjective. You will need a thermometer (or two, in case one breaks), and to keep track in a log of at least daily temperature. If you choose to take temperature internally (i.e., in the bottom / rectum), it will be more precise. Be sure you have enough wipes and alcohol to clean the thermometer after each use. If taking temperature orally, don’t eat or drink for 20 minutes beforehand. Either way, note the method in your illness diary (more on this below), so that healthcare personnel know which it is. (Around .7° Celsius or 1° Farenheit is often added to oral temperatures.) Here are some good instructions for how to take an oral temperature.

If you don’t have symptoms

Some people may be exposed to, carry, and infect others with the virus – without ever showing symptoms themselves. These people are asymptomatic carriers. They seem to be common; they may even number around one in four of those infected. Unless widespread testing is available where you are (which is currently a small minority of places), it may not be possible to determine if you are one of them. This is one of the reasons why everyone should currently be following the advice of public health authorities that generally includes social distancing measures covered in Level 1.

If you have symptoms

The single most important thing once you have symptoms that might be COVID-19 is to stay at home, or to go home if you discover them while not at home. Call in sick. Stay away from people as much as possible and go to a separate room if you live with others. If you live alone, let someone (friend, family) know that you are ill and will keep letting them know how you’re doing.

Symptoms? Maybe you need to register…

As this point you need up-to-date local information. Your health authorities may want to know if you have symptoms. Reasons for this may include population monitoring to see where the virus is, planning the government’s response as well as opening a channel to follow up with you personally. There may be a phone number to call if you have symptoms, or a website to visit, or an app to download. Just figure out what the authorities in your area want you to do as soon as you have isolated yourself from others.

Diagnosis

You will want to know whether what you have is just a cold, a flu or actual COVID-19. There will be different policies surrounding testing for COVID-19 based on where you are and what stage of the pandemic your area is in. Check online, call official hotline numbers, follow official guidelines. If testing capacity is limited, you may not qualify for testing, even if you have all the symptoms of COVID-19.

You may find that the official information on getting tested doesn’t always match the reality on the ground. It may be impossible to get through, the lines may be way too long, the waiting conditions may be unsafe. (You don’t want to get COVID-19 from trying to find out if you have it.)

In some cities, your regular doctor will come to your home in full gear to swab your throat. In other places, there are drive-throughs. There are also Do-It-Yourself test kits you can order by mail where you perform your own throat swab and send it to the lab for testing. The availability of all of these methods will differ depending on where you are, who you are, what stage the pandemic is in and many other factors. We cannot possibly help you further than to tell you to inform yourself as soon as you have isolated yourself.

Under no circumstances should you just show up at a doctor’s office or a hospital unannounced if you experience symptoms.

Remember: This is for your own protection as well as that of the other patients. Hospitals are bad places to be until you absolutely have to be there: You run the risk of getting additional infections that, when bacterial or fungal, are much more likely to be resistant to standard treatments due to the nature of the hospital environment. Also: Many hospitals are going to be overloaded, so waiting times may be astronomical.

Don’t Panic

For most people, this will be as bad as it gets. You’ll be a little sick, and then you’ll get better. Done.

At the same time, some people will not be so lucky. Even if only a relatively small percentage of those affected need medical care, this will put a serious strain on doctors, nurses, and available medical resources. We can all help them by staying home whenever possible.

The “Worried Well” is a medical term for people who visit the doctor when they are not really (all that) sick, because they need reassurance. The coming weeks and months are not a good time for that. This website aims to give you more confidence and preparedness in caring for yourself, friends, and loved ones until you / they actually need professional help.

Consider using relaxation techniques to slow a rapid breath or heart rate that may be partially due to anxiety (or just to chill out):

Self-quarantine

Until tested and depending on where you are and where you have been, simply assume the patient (you? a family member?) has COVID-19. That means self-quarantine at home. No more visitors, a sign on the door, and the patient should not go out unless there is no chance of meeting anyone. Different areas have different standards for what it means to self-quarantine when there are other people in the household. If possible, you will want to err on the side of safety and try to get everything delivered for 2 weeks. Things may change, as in some areas the virus will become so common (endemic) that many people will have had it. There is no telling at what point various authorities will stop testing every potential infection, and it will differ from region to region.

Garbage

During this time at least, err on the side of caution when it comes to trash. Used tissues, paper towels, and other possibly contaminated disposable items should be bagged in disposable trash bags, tied securely, and put aside for 72 hours prior to external disposal. Some places also recommend putting these items in a second disposable trash bag. If you use communal garbage bins, disinfect the handles when possible before and after use. Wash your hands after handling trash and bins.

PPE

Now at the latest is time to think about Personal Protection Equipment (PPE). If you can get masks AND IF MASKS ARE NOT IN SHORT SUPPLY FOR DOCTORS AND NURSES WHERE YOU ARE, wear one outdoors. You are not supposed to be outdoors when you have symptoms, we know. But we mean even just when taking out the trash. If you have no mask, at least do something. Make your own using our mask-making template. Wrap a towel around your nose and mouth, breathe through a scarf, anything is better than nothing. Here are a few recommendations for PPE in the context of the COVID-19 pandemic, summarized and expanded on briefly below:

Family, flatmates, etc.

Seek up-to-date local information if you live with others. The authorities may provide you with different or more detailed instructions, advice, or even PPE materials.

Here are some general suggestions and tips for dealing with family and flatmates if you have or suspect you may have COVID-19:

In most places, there will probably come a time when the number of cases skyrockets, many people have already had COVID-19, and authorities will no longer keep records of who has had it and who hasn’t. The basics then remain the same: Try to protect other people, especially those middle-aged or older and people with existing illnesses, as much as possible. And try to minimize the spread whenever you can, as best you can. Remember: The more we can slow or stop the disease’s spread, the better it is for everyone. Because by helping to slow or stop the spread, you help lessen how overwhelmed the healthcare system is going to become. That in turn increases the proportion and number of people who need medical care (for any reason), who are able to access it. This helps doctors and nurses save more lives.

Diary

When symptoms first start is the right time to start an illness diary.

A few times a day, preferably at somewhat regular hours or points in your normal routines or rhythms (e.g., every morning before making coffee or tea), measure temperature, even if you don’t feel like you have a fever (yet). Weigh once a day if possible. Also note respiratory and heart rates in breaths and beats per minute. It will get you used to doing these things, give you practise, and (if you start early) give you some idea what (more or less) healthy values for you look like. Not necessary, but extra points for blood pressure and oxygenation (Devices to measure those are cheap, see the shopping page).

Then write down any symptoms the patient has. If he or she is in pain, where and when is the pain, and how bad on a scale of 0 (no pain) to 10 (worst pain imaginable)? How bad is the cough? What color if there is mucus being produced? Be sure to note what medication, if any, the patient takes.

Paracetamol (also known as Tylenol or acetaminophen) is a good choice for fever and pain suppression. Keeping an illness diary will also help you to keep track of how much you’ve taken, when, to ensure you treat fever adequately without taking more than the recommended amount in a 24-hour period.

Printable illness diary

We made a printable illness diary that you can use to write down all the information you collect when you take temperature, breathing rate, etc. Please check out the form and our webpage about it via the link above.

Contact lenses

Even when you are not that ill yet, it is much better to use glasses if you have them, and stop routinely putting in contact lenses in the morning. You do not want to touch your eyes more than you have to because they may get infected. If and when you do get more ill, you do not want to risk forgetting that you have them in.

Get healthy again

Feeling better?

If your symptoms go away, that doesn’t mean you should end your quarantine immediately. You need up-to-date local information again to see whether the authorities want you to register as healed, especially if you tested positive earlier. Depending on availability and local policy, you may need to be tested again. Your local health authorities may provide you with specific advice on what to do next. If so: Follow it.

Absent of up-to-date local instructions from authorities, you should err on the side of safety and try to stay in isolation for a little longer than officially indicated. The World Health Organization recommendation is to continue isolation for at least two weeks after symptoms disappear, even if you are no longer feeling sick.

If you managed to get tested, yay! You now know that your body (presumably, keep watching the latest science on this) has built immunity. Which means that this thing is over for you, and, if you are young and healthy, also that you are a more logical choice to help your family and friends when they get sick. Depending on what state the world is in, you may want to inform your employer and others who might depend on you that you’ve had it, so they know you’re immune.