When should you seek care for COVID-19? Share this free tool

(See Spanish version here)

If you have a cough, fever, or shortness of breath, how can you tell if you've got COVID-19, a common cold, the ordinary flu, or a bad case of worry? Should you get tested? When should you seek medical care — and when should you stay home?

As a primary care doctor and a healthcare journalist, we wanted to pass along a simple self-assessment tool developed by the USC Gehr Family Center for Health Systems Science and Innovation (which MH directs) – to help individuals decide when to treat their symptoms safely at home and when to seek medical help. One of the most important things each of us can do during the ongoing pandemic is to free up medical providers to concentrate on the seriously ill.

This tool is available below and will let most people manage mild and moderate symptoms of COVID-19 effectively at home:

In collaboration with the Center for Health Journalism, the Gehr Center/Akido Labs are offering this app as a free embed in any news or health care website. Click here to access the embed code.

In addition, we have compiled some general advice and tips for self-care at home. Here they are:

Caring for yourself at home with COVID-19

Know when to seek medical care. The reasons to seek immediate care today are no different than they were before the COVID-19 outbreak. The table below offers guidance about when and how you might seek medical attention: the column on the left provides examples of reasons you might call an expert while the column on the right suggests potential reasons to seek immediate care. In both cases, however, keep in mind that it is much better – if possible – to call ahead before visiting a medical facility as many clinics, hospitals and doctors offices have special protocols in place to lower the risk of COVID-19 spread. And remember: if you have a fever and cough or other cold or flu symptoms, but are otherwise healthy, are under age 60, aren’t having difficulty breathing, and don’t feel seriously ill, you’re likely better off caring for yourself at home, without any formal medical guidance.

Severe symptoms that suggest the need for medical attention (please note that this is not intended to be a comprehensive list, but provides general guidance):

Consider calling an expert (a medical advice line, telemedicine, or your primary doctor) for guidance if you:

Considering seeking urgent medical attention (call 911 if appropriate or go to an urgent care and call ahead if possible):

Have flu symptoms and feel dehydrated or produce little urine even though you are drinking plenty of fluids

Experience shortness of breath (difficulty breathing) at rest or with light activity

Experience symptoms associated with COVID-19 like cough and fever AND you are over age 60 or have a chronic medical condition like diabetes, heart disease, or lung disease

Have chest pain

Have symptoms and were in direct contact with someone known to be infected with COVID-19 (you might be a candidate for COVID-19 testing)

Become confused or light-headed

 

Have any other worrisome symptom for which you typically would call 911

 

If your symptoms are mild, don’t go straight to a doctor’s office or urgent care. Start by calling a medical advice line or trying out telemedicine. It’s wise these days to stay away from crowded places, and that includes emergency departments, hospitals, doctors’ offices, urgent care centers, and clinics — unless you are seriously ill. These are places where you could pick up the coronavirus if you don’t have it, or spread your batch to other people.

Many health plans have 800 numbers with nurses or doctors on call to answer questions by phone, as do some doctors’ offices. Look at your insurance card and make the call. Some clinics and doctors are conducting video visits, also known as telemedicine. If you call an advice line first, you may get the guidance you need without spreading infection or unnecessarily exhausting yourself.

Until testing is widely available, save it for those sick enough to need hospitalization. Testing for COVID-19, when it becomes widely available, may improve our ability to contain the virus and limit spread. But it will not change individual medical care because there is no treatment available or necessary for mild symptoms. (People with serious symptoms, such as difficulty breathing, should get supportive care in the hospital.) Tests are currently in short supply and are being prioritized for health care workers and for those who have severe symptoms or who have been exposed to someone diagnosed with COVID-19. If you do not fall into one of those three categories, resist the urge to request testing unless public health officials want you to do so. (We know as we write this that the indications for testing may loosen as testing supplies increase.)

Practice self-care. Viral infections are dehydrating. Drink plenty of liquids. Pedialyte and soups that contain salt are helpful, as are plain water, tea, juice, and sparkling water.  Drink enough so your urine is its normal pale color and you produce as much urine as you usually put out. Note: Not urinating normally is a sign you may need medical attention. If you have special dietary restrictions due to diabetes, kidney disease, heart failure, or other condition, get medical advice by phone or email about the fluids that are best for you.

Some over-the-counter medications may help. As anyone who has experienced a cold or flu knows, over-the-counter remedies tend to provide only limited relief, and some may have side effects such as dry mouth, drowsiness, and raised blood pressure. Try flushing out your nose and sinuses with saline solution. Fever-reducers and pain medications such as Tylenol (acetaminophen) can help, and honey can be an effective cough remedy. There is anecdotal evidence that non-steroidal anti-inflammatory medications like ibuprofen or naproxen may make COVID-19 worse, though more research is needed.

If you have one or more chronic medical conditions, seek telephone advice from an expert to make sure you choose a treatment that is safe for you.

Don’t ask for antibiotics. Antibiotics do not work for viral illnesses like COVID-19. They also often cause side effects such as nausea, diarrhea, and rashes.

Get plenty of rest. Infections stress the body. Lots of rest — including sleep — will help keep your immune system strong so it can devote itself to ridding your body of the virus.

Separate yourself from others to prevent the virus from spreading. If you have the symptoms of a cold or the flu, play it safe and act as if you have COVID-19. Wear a face mask when in a room with others and if you must leave the house. Avoid close interactions with others for 14 days. If you test positive, self-quarantine.

Make sure your medical care fits your values, health status, and life goals. If you already have a terminal illness or know you don't want to be resuscitated or enter an ICU, recommendations to call 911 or go to an emergency room will probably not make sense for you. Consider making sure your primary doctor knows your wishes, connecting with a hospice if you haven't already, appointing someone to make your medical decisions in case you can't, and signing a medical advance directive, such as "Five Wishes," or Mydirectives.com, available free online, to make your preferences clear. 

Follow the advice of public health authorities. Even for those who aren’t showing symptoms, strict social distancing will slow the fueling of this pandemic.  Don’t change your behavior in order to avoid picking up the virus. Assume you have the virus, and change your behavior to avoid passing it on. Please heed the advice of your local officials.

This is a scary moment in history. No one should be faulted for feeling anxious. Most people with viral illnesses — including COVID-19 — can be cared for effectively in their own homes without seeking formal medical care and will recover within two weeks. But it’s also important to know when to seek expert care.

We hope that our simple tool for self-assessment and general advice and tips for self-care at home can ease some of the anxiety. and help you take the best care of yourself and your loved ones without putting yourself or others at unnecessary risk.

(An earlier version of this article was published in STAT.)

Michael Hochman, M.D., MPH is a primary care physician, associate professor of clinical medicine at the Keck School of Medicine of USC, and director of the USC Gehr Center for Health Systems Science and Innovation at Keck. Katy Butler is a medical journalist and author of two books about serious illness.