EDIT: Changed blood oxygen numbers thanks to Jay Molstad Comment
What I would do if I had COVID-19? ( I am NOT a medical professional)
Ok. So you’re sick. Maybe you have a fever and a bit of a cough. This may be COVID-19 and this may be something else like a seasonal flu. Even if you have COVID-19 the most likely outcome is that the symptoms are mild enough that you can deal with them at home. The South Korean Health Minister says 10%, so 90% you recover at home.
Dealing with mild symptoms at home:
Rest
You shouldn’t be doing anything strenuous. Just let your body fight off the virus. Maybe enjoy some shows or video games while you’re at it.
Keep drinking fluids
Staying hydrated is important generally, but especially important when you’re sick and may not be drinking and eating regularly. I would do this by drinking water, tea, and drinks made from electrolyte powders. Do make sure you’re getting electrolytes somehow (LW discussion of electorlytes).
Ask someone to check in with you regularly in case you do get worse.
A housemate or a friend could message you to check in every day or two. Being sick sucks and possibly your judgement is impaired by a fever. If you and your friend are comfortable with it you can offload the decision making on when you should be worried enough to go to the hospital.
There is some discussion of using chloroquine and/or zinc. I have not looked deeply into this. My immediate thoughts here are zinc seems low cost to take and chloroquine seems high cost to take.
When should I go to the hospital?
I’m going to write what I’d be looking for, but ultimately you must make your own decision. I am not a medical professional.
Based on Jay Molstad’s comment below I would probably head to a hospital if my blood oxygen was below 90% and I was having trouble breathing or below 85% with or without trouble breathing.
Note, you may have blood oxygen at a lower than normal range
Shortness of Breath/Difficulty Breathing
If you are having short painful breaths or having trouble breathing.
Fever above a certain point.
Sites vary here. Mayo Clinic says if the fever is above 103oF consistently or above 102oF for more than 3 days. This other site says 104oF and above is dangerous and you should seek immediate medical attention at 106.7oF
from first symptom to → Dyspnea (Shortness of breath) = 5.0 days
from first symptom to → Hospital admission = **7.0 days*
Maybe hospitals are overloaded.
Measures like the shelter in place order in the bay area will help a lot with decreasing the load on hospitals, but it’s still possible we end up with a peak at some point.
You may want to try to get in anyway. If you’re experiencing severe symptoms and have been turned away from a hospital you may want to try some things on your own.
Some people have been buying oxygen concentrators. If your blood oxygen falls below ___ or you are having a difficult time breathing. Using one or seeing if a friend has one may be helpful. I want to note again I am not a medical professional. Oxygen toxicity is a thing so it’s not like using an oxygen concentrator is risk free.
If I had an oxygen concentrator and a pulse oximeter I would consider starting at a low flow rate and slowly increasing until my blood oxygen levels were above 90%, but being careful not to continue oxygen therapy if my levels returned to normal (90-95%, could be lower if you have other factors like sleep apnea).
I asked my dad, a doctor (internal medicine). My blood oxygenation is usually around 92-93%. It can vary for a number of reasons. Anything under 90% is considered hypoxia, but the high 80s can be “normal” in a long time smoker.
The hospital is likely to be very busy and not have time for mild cases. Blood oxygenation of 92% does not warrant their attention. I’d give my doctor (or the emergency room) a call at 90% oxygenation. At 85% it’s definitely time to go to the hospital (unless they tell you otherwise). Below 80% brings a severe risk of organ failure, so that’s a life threatening emergency.
Use common sense—if your doctor is telling you one thing an a random internet comment is telling you differently, believe the doctor. Also, if your readings are going down rapidly, call your doctor. Don’t drive if you’re significantly impaired.
Blood oxygen can certainly vary between people, but I think this gives a misleading picture for many people. Most of my friends have blood oxygenation of >98, and getting to 90 would imply rampant infection and warrant hospitalization if the hospitals aren’t overrun yet. Certainly 90-95% is not “normal”, as the OP now says (the link specifically says it’s not normal).
I think people should be considering hospitalization once they’ve dropped 6% in SpO2 AND they’ve dropped below 92% SpO2. More thoughts are in my longer comment here. This covers people with unnaturally low SpO2 to begin with, while also acknowledging that many people do start from ~100% and should not wait until they have such an infection that their lungs have dropped past chronic smoker levels of impairment.
That all seems solid, but I’d still call ahead before going to the hospital. If they have more critical cases than they can handle, a mild case could wind up waiting indefinitely.
P.S. Medical types use the word “normal” to mean “not meeting the criteria for a diagnosis”.
Normal blood oxygen saturation is 95% and above; without a history of fairly significant lung disease I’d be surprised if you were persistently under this level—note that an oximeter can give very variable readings due to artefact from all sorts of things including movement, ambient light, temperature (probably a significant one in the context of an infection if you are having a fever/rigoring/very cold fingers), and the number it spits out is the average over the last 3-12s.
If you are short of breath with coronavirus it is worth talking to a healthcare provider. If you are a generally well human and have persistent sats around 90%, go to hospital. If you have oxygen sats of 85% you are severely hypoxic and should consider an ambulance.
(I didn’t downvote your post and I applaud that you went to the effort to find out more and make actual thresholds for action)
Personally my oxygen saturation always reads 91-93%. I’m 47 years old with no known lung problems who never smoked. People vary. I’m an unusually large man, so it may be a square-cube law effect or a finger-thickness effect. It may be some other confounder.
Under normal circumstances I would agree with the rest. In the very near future healthcare providers are expected to be absolutely swamped with coronavirus cases; apparently corpses have been piling up in Italy. I think my thresholds for action are stricter than yours because I’m trying to minimize strain on the system. But at 90% your plan is to go to the hospital and my plan is to call a doctor to find out if I should go to the hospital. That’s not a huge difference.
Related: the mayor of Baltimore has requested his citizens avoid senseless gun violence for similar reasons. Things are getting weird out there.
Edited to add: It probably wouldn’t bother me so much if it wasn’t giving out negative “karma”—that’s not something I’d dole out to anyone. Or if it didn’t just take one vote (not everyone here is always as rational as they’d like to think) to remove comments from general view.
EDIT: Changed blood oxygen numbers thanks to Jay Molstad Comment
What I would do if I had COVID-19? ( I am NOT a medical professional)
Ok. So you’re sick. Maybe you have a fever and a bit of a cough. This may be COVID-19 and this may be something else like a seasonal flu. Even if you have COVID-19 the most likely outcome is that the symptoms are mild enough that you can deal with them at home. The South Korean Health Minister says 10%, so 90% you recover at home.
Dealing with mild symptoms at home:
Rest
You shouldn’t be doing anything strenuous. Just let your body fight off the virus. Maybe enjoy some shows or video games while you’re at it.
Keep drinking fluids
Staying hydrated is important generally, but especially important when you’re sick and may not be drinking and eating regularly. I would do this by drinking water, tea, and drinks made from electrolyte powders. Do make sure you’re getting electrolytes somehow (LW discussion of electorlytes).
Ask someone to check in with you regularly in case you do get worse.
A housemate or a friend could message you to check in every day or two. Being sick sucks and possibly your judgement is impaired by a fever. If you and your friend are comfortable with it you can offload the decision making on when you should be worried enough to go to the hospital.
There is some discussion of using chloroquine and/or zinc. I have not looked deeply into this. My immediate thoughts here are zinc seems low cost to take and chloroquine seems high cost to take.
When should I go to the hospital?
I’m going to write what I’d be looking for, but ultimately you must make your own decision. I am not a medical professional.
Blood Oxygen Levels
Maybe you got a pulse oximeter.
Normal blood oxygen levels are 90-95%, but can be lower if you have other factors like sleep apnea.
The WHO has been recommending to doctors to start giving oxygen therapy if the blood oxygen levels fall below 90%
Based on Jay Molstad’s comment below I would probably head to a hospital if my blood oxygen was below 90% and I was having trouble breathing or below 85% with or without trouble breathing.
Note, you may have blood oxygen at a lower than normal range
Shortness of Breath/Difficulty Breathing
If you are having short painful breaths or having trouble breathing.
Fever above a certain point.
Sites vary here. Mayo Clinic says if the fever is above 103oF consistently or above 102oF for more than 3 days. This other site says 104oF and above is dangerous and you should seek immediate medical attention at 106.7oF
It may take a few days before you know if you’re going to have severe symptoms. For hospitalized patients these were some of the timelines observed.
from first symptom to → Dyspnea (Shortness of breath) = 5.0 days
from first symptom to → Hospital admission = **7.0 days*
Maybe hospitals are overloaded.
Measures like the shelter in place order in the bay area will help a lot with decreasing the load on hospitals, but it’s still possible we end up with a peak at some point.
You may want to try to get in anyway. If you’re experiencing severe symptoms and have been turned away from a hospital you may want to try some things on your own.
Some people have been buying oxygen concentrators. If your blood oxygen falls below ___ or you are having a difficult time breathing. Using one or seeing if a friend has one may be helpful. I want to note again I am not a medical professional. Oxygen toxicity is a thing so it’s not like using an oxygen concentrator is risk free.
If I had an oxygen concentrator and a pulse oximeter I would consider starting at a low flow rate and slowly increasing until my blood oxygen levels were above 90%, but being careful not to continue oxygen therapy if my levels returned to normal (90-95%, could be lower if you have other factors like sleep apnea).
WHO recommendations to clinicians were.
Start at 5 L/min and titrate flow rates to reach target SpO2≥90% in non-pregnant adults and SpO2≥92-95 % in pregnant patients.
It’s unclear to me what concentration of oxygen they were using.
I asked my dad, a doctor (internal medicine). My blood oxygenation is usually around 92-93%. It can vary for a number of reasons. Anything under 90% is considered hypoxia, but the high 80s can be “normal” in a long time smoker.
The hospital is likely to be very busy and not have time for mild cases. Blood oxygenation of 92% does not warrant their attention. I’d give my doctor (or the emergency room) a call at 90% oxygenation. At 85% it’s definitely time to go to the hospital (unless they tell you otherwise). Below 80% brings a severe risk of organ failure, so that’s a life threatening emergency.
Use common sense—if your doctor is telling you one thing an a random internet comment is telling you differently, believe the doctor. Also, if your readings are going down rapidly, call your doctor. Don’t drive if you’re significantly impaired.
Blood oxygen can certainly vary between people, but I think this gives a misleading picture for many people. Most of my friends have blood oxygenation of >98, and getting to 90 would imply rampant infection and warrant hospitalization if the hospitals aren’t overrun yet. Certainly 90-95% is not “normal”, as the OP now says (the link specifically says it’s not normal).
I think people should be considering hospitalization once they’ve dropped 6% in SpO2 AND they’ve dropped below 92% SpO2. More thoughts are in my longer comment here. This covers people with unnaturally low SpO2 to begin with, while also acknowledging that many people do start from ~100% and should not wait until they have such an infection that their lungs have dropped past chronic smoker levels of impairment.
That all seems solid, but I’d still call ahead before going to the hospital. If they have more critical cases than they can handle, a mild case could wind up waiting indefinitely.
P.S. Medical types use the word “normal” to mean “not meeting the criteria for a diagnosis”.
Normal blood oxygen saturation is 95% and above; without a history of fairly significant lung disease I’d be surprised if you were persistently under this level—note that an oximeter can give very variable readings due to artefact from all sorts of things including movement, ambient light, temperature (probably a significant one in the context of an infection if you are having a fever/rigoring/very cold fingers), and the number it spits out is the average over the last 3-12s.
If you are short of breath with coronavirus it is worth talking to a healthcare provider. If you are a generally well human and have persistent sats around 90%, go to hospital. If you have oxygen sats of 85% you are severely hypoxic and should consider an ambulance.
(I didn’t downvote your post and I applaud that you went to the effort to find out more and make actual thresholds for action)
Personally my oxygen saturation always reads 91-93%. I’m 47 years old with no known lung problems who never smoked. People vary. I’m an unusually large man, so it may be a square-cube law effect or a finger-thickness effect. It may be some other confounder.
Under normal circumstances I would agree with the rest. In the very near future healthcare providers are expected to be absolutely swamped with coronavirus cases; apparently corpses have been piling up in Italy. I think my thresholds for action are stricter than yours because I’m trying to minimize strain on the system. But at 90% your plan is to go to the hospital and my plan is to call a doctor to find out if I should go to the hospital. That’s not a huge difference.
Related: the mayor of Baltimore has requested his citizens avoid senseless gun violence for similar reasons. Things are getting weird out there.
I’d appreciate knowing why someone downvoted this.
Me too. If there’s something wrong with my plan, I’d prefer to find out the easy way.
It’s a bit of a peeve of mine this down voting without explanation, but I’m getting used to it! I up-voted yesterday :)
blood oxygen—Hb/O2 dissociation curve.
Edited to add: It probably wouldn’t bother me so much if it wasn’t giving out negative “karma”—that’s not something I’d dole out to anyone. Or if it didn’t just take one vote (not everyone here is always as rational as they’d like to think) to remove comments from general view.