COVID-19 survival guide: The latest on symptoms, testing, prevention and care
Latest on testing, symptoms, caring for someone who’s sick, how to clean, not spreading the disease, helping the elderly and a shopping list.
Editor’s note: This guide will be updated as new recommendations are available.
The novel coronavirus pandemic has changed life as we know it, at least temporarily. Billions of people are sheltering in place worldwide. If you’re wondering what to do, from cleaning to testing to caring for someone who’s ill, we’ve gathered expert advice.
The first symptoms of COVID-19 typically show up between two and 14 days after exposure.
Experts say to watch for fever (88% of cases, according to the World Health Organization), dry cough (68%) and shortness of breath (about 20%). Close to 40% of those with the novel coronavirus experience exhaustion and a third complain of excess phlegm. Smaller shares complain of a runny nose or headache. If your cough isn’t dry, you are not necessarily free of the virus.
WHO said the most severe cases of the coronavirus infections may develop pneumonia, severe acute respiratory syndrome, kidney failure and even death.
The vast majority of cases — 80% — will be mild and can be managed at home without special treatment. Testing to determine if it’s COVID-19 isn’t even required in those cases. But people should stay away from others any time they are sick — and to prevent the spread to others, who may not have a mild case.
A group of ear, nose and throat doctors from the United Kingdom said that losing your sense of smell may be a hidden symptom of the coronavirus.
Diarrhea may be a more common symptom of COVID-19 than previously believed, according to a study of cases within China. Medical researchers there found that of those diagnosed with COVID-19, nearly half first complained of digestive problems. Perhaps because that wasn’t associated with a respiratory illness, it took longer for those people to be admitted — and they didn’t recover as fast or as well, either, the researchers said.
According to the Centers for Disease Control and Prevention, certain symptoms should prompt someone to seek medical attention fast, whether it’s the virus or not. They include:
- Difficulty breathing or shortness of breath
- Persistent pain or pressure in the chest
- New confusion or inability to arouse
- Bluish lips or face
Intermountain Healthcare’s online symptom checker can help people decide if they need to seek testing or by calling 1-844-442-5224.
What if I need testing?
Testing in Utah is about to get a big boost as part of the “Crush the Curve Campaign” announced April 2 by Gov. Gary Herbert and representatives of the state’s Silicon Slopes tech community. David Elkington of InsideSales.com said the tech community has come together with government, the health care sector and others to launch an effort to get everyone tested. Two new mobile sites have been set up and more will follow, with the goal of adequate testing border to border. Elkington said as more tests and lab capacity are available, more sites will be set up. He said the program is being treated as a startup and will expand as resources allow.
For now, people need to check with their health care provider so that those with symptoms can be tested, but the goal is to broaden availability to everyone as capacity expands. Go to TestUtah.com for details on the expansion.
The COVID hotline number is 1-800-456-7707.
If someone in a household is symptomatic, everyone who lives there needs to quarantine.
There are multiple drive-thru locations where people who have been verified they need the test can get one without visiting a waiting room.
Anyone who has very severe symptoms should call 911.
Basic advice hasn’t changed.
- Don’t just go to the doctor’s office or emergency room. Contact your health care provider through an online app or by phone. Virtually all of the Utah health care systems offer a telemedicine option. And every doctor’s office has someone to help you figure out how to be screened.
- A health care provider will go over your symptoms. That expert will also consider your travel history or whether you have been in close contact with someone known to have COVID-19. Priority is also expected to go to those at most risk: senior citizens and people with certain chronic medical conditions or who are immune compromised.
- If the person providing telemedicine triage decides you should be tested, you’ll be told where to get the test and a referral/authorization will be arranged.
- Take your ID.
- Once you’ve been swabbed at the back of your nose go home, self-isolate and wait it out until you hear the results.
Supply shortages related to testing remain a problem. Coronavirus.utah.gov has a donation page for people who want to help out during the crisis, including a plea for personal protective equipment — masks, face shields, gowns and gloves — for frontline health care providers and those running COVID-19 tests. Construction companies that have industrial grade N95 masks are encouraged to donate them for the public good. Veterinarians, dentists and doctors who have masks on hand they’re not using — as patients are advised to avoid nonemergency care — are also asked to share them with frontline COVID-19 care providers.
Stop the spread
Fortunately, most of the advice for what everyone can do to help contain the virus is very basic:
- Stop shaking hands.
- Stop touching your face.
- Wash your hands often for at least 20 seconds with soap and water (mentally hum the “Alphabet” or “Happy Birthday” song twice).
- Use hand sanitizer that contains 70% or more alcohol if you can’t wash your hands.
- Avoid groups of people.
- Stay about 6 feet away from others.
- Don’t go to mass events.
- Disinfect surfaces that someone with a virus might have touched or coughed or sneezed on.
- Cover your own cough and sneeze. After you throw a tissue away, wash your hands.
- If you’re sick, don’t give it to others. Isolate yourself.
If you are ill, a mask is helpful to keep your respiratory droplets in and prevent spread. Someone providing care for you benefits from wearing one. Whether others should wear a mask is still being decided. Originally, CDC and WHO said no, but the stance is softening and may even change.
As for that handshake, just don’t. Forgo the hug, too. While COVID-19 is circulating, keep your hands to yourself.
Some tap elbows. Or you can bow, nod, smile or wave.
Health and government officials are taking steps to limit the spread of the virus, from restricting large gatherings and putting schools on “soft closure” to putting restrictions on restaurants and bars to prevent people congregating close together. At least for now you can get drive-thru food or carry-out.
People who can work from home are being encouraged to do so.
Supplies for quarantine
Water, toilet paper and hand sanitizer were flying off the shelves at stores across America as people prepared for the possibility of quarantine during the pandemic. Things have stabilized a little and stores assure customers there’s not shortage; those basic supplies will continue to be available, but they have typically had to put limits on how many customers can buy so all who need them can get some. Supply and demand are expected to be more balanced soon.
You shouldn’t prepare the same as you would for an earthquake or a tornado. “Utilities will function fine. Electricity, potable water, natural gas, you’ll have all that. So set those aside and focus on the things that are really applicable in this circumstance, things you might need because you shouldn’t leave your home,” Nicholas Rupp, spokesman for the Salt Lake County Health Department, told the Deseret News.
The CDC says to call the members of your household together and formulate a plan, including how you’ll care for each other if one of you becomes ill. Those who live alone should talk to those close to them about how to take care of each other.
The household plan suggestions include getting to know neighbors, figuring out where to get outside help and making up an emergency contact list.
Food that you will actually eat, preferably that doesn’t require too much preparation if you’re sick or caring for someone who is.
Prescription medication. Most experts recommend you have a month’s supply on hand, but people will have to work with their health care provider, insurance company and potentially others to arrange that.
Over-the-counter drugs to manage symptoms.
Cleaning supplies, including for laundry, hand-washing and to disinfect. Several experts recommend products with bleach for hard surfaces like door knobs. They don’t know everything about this coronavirus strain, but bleach kills hardy norovirus.
Hand sanitizer, at least 70% alcohol. If you can’t find any at the store, don’t buy a $138 bottle. Use soap and water and, regardless, wash your hands frequently.
Baby supplies like diapers, wipes and baby’s special foods.
Pet supplies because Cinder and Fido will also need to eat for two weeks while you’re quarantined and Roscoe will need clean kitty litter, too.
Books, movies, crossword puzzles and projects to help you pass the time.
The things you need to work from home, such as a computer or the snacks and drinks you’re used to consuming at work.
Watch out for an elderly person
CDC also suggests making a separate plan for helping out elderly or frail loved ones who may or may not live with you. The advice includes:
Know the medicines he or she takes. The individual could need help arranging to have extra available.
Keep track of food and medical supplies. Someone who’s at high risk may not be able to lay in all the supplies they’ll need. Be mindful that they may need someone to drop off supplies.
If you’re helping someone stock up on nonperishable foods, make sure you know what the person likes to eat before you go shopping.
If they’re not online, help them connect so they can video chat with friends and use the many online sources to feel productive and learn new things.
Caring for someone who’s infected or has symptoms
Remember that if one of you is infected or that’s suspected, the household is quarantined for 14 days.
If you don’t have a thermometer, get one. Between uses, clean it with alcohol.
Most people will have mild or at least manageable symptoms. Treat it like the flu and keep that person away from the rest of the household.
Provide fluids, over-the-counter medicines for symptom management and nutritious food. Plan on entertainment like books or puzzles or movies to help someone who’s ill to forestall boredom.
World Health Organization guidelines for caring for someone with known or suspected COVID-19 at home say to isolate the ill person from the rest of the household, preferably with a separate bathroom, too. At the very least, the shared bathroom should be cleaned and disinfected after an infected person uses it.
It’s best to have one person designated to provide care, while other family members maintain their distance. Both the ill person and the caregiver should wear masks during interactions, but don’t reuse single-use masks and dispose of them properly.
Gloves are helpful, but should be discarded immediately in a wastebasket with a lid in the patient’s room. A caregiver should wash his or her hands thoroughly, up to at least the wrists, using soap and water. Dry hands with a paper towel and use that to turn off the water, too.
When you do the laundry, don’t shake it everywhere or pile it outside the room. Put it in a plastic bag until it’s ready to go into the wash. It can be washed with others’ clothing.
Doorknobs and other touched surfaces need to be sanitized regularly.
Consider disposing of the cardboard box items you have delivered before entering the house, then wash your hands. There are mixed messages about how long this coronavirus lives on items like cardboard. A study in the New England Journal of Medicine suggests the virus could linger at detectable levels for several hours and since packages may be handled by a number of people, including someone who’s infected but asymptomatic, precautions make sense. Efforts are being made to stop any possible avenue of spread, regardless of how remote the likelihood.
But public health officials still say that “coronaviruses do not survive long on objects, such as letters or packages. These viruses are generally thought to be spread most often by respiratory droplets, such as coughing and sneezing. There have not been any cases of COVID-19 in the U.S. associated with imported goods.”
Be ready for an emergency
Know the closest hospital and also whether it’s in-network or out of network. Have your doctor’s contact information available and it’s not a bad idea to write down your medical history. The information could be helpful in an emergency.
If it’s not an emergency, don’t go, because hospitals have their hands full right now. Experts suggest you use telehealth options or phone ahead.
Have a grab-and-go bag that includes basics like a toothbrush, snacks and a bottle of water. Waits could be especially long right now in health care settings. Don’t forget your phone charger. An emergency department doctor told The New York Times’ Tara Parker-Pope that chargers are the most requested item in an emergency room.
You should have a list of prescriptions, phone numbers for family contacts and copies of healthcare documents related to a patient’s wishes, like end-of-life documents, health care proxies, etc.
Cleaning and disinfecting
The Centers for Disease Control and Prevention believes people are most apt to be exposed to the novel coronavirus that causes COVID-19 by their closest associates — the family, friends and colleagues we hug and shake hands with and work next to.
It’s possible that touching a surface on which an infected person’s respiratory drops have fallen could spread the illness. Health experts are still learning about this strain of the coronavirus.
CDC says cleaning removes germs from surfaces, but doesn’t kill them. Disinfecting is the death blow, though it doesn’t clean the surface. You want to do both.
- Clean and disinfect areas that get touched a lot: light switches, doorknobs, toilets, water faucets, remotes, handles, tables, hardback chairs, cupboard doors.
- If you can, isolate the sick person in one room and minimize how much others are exposed to that individual.
- If it’s safe to do so (it might not be a good idea for children or adults with certain conditions), designate a set of cleaning supplies for the ill person’s room to avoid carrying products all over the house.
- A shared bathroom should be cleaned and disinfected every time an ill person uses it.
Wear disposable gloves and then toss them after each use. Don’t use reusable gloves for anything unrelated to COVID-19. Clean your hands thoroughly after you take any gloves off.
Clean surfaces with soap and water, then disinfect.
“For disinfection, diluted household bleach solutions, alcohol solutions with at least 70% alcohol, and most common EPA-registered household disinfectants should be effective,” CDC says.
Bleach can damage some surfaces, but is believed to be most effective. Use 1 part bleach for 9 parts water. Use the warmest water possible. Put the bleach in a spray bottle, then carefully add water to avoid splashing. Remember that bleach won’t maintain its effectiveness overnight once it’s been diluted. Mix a new formula each day.
The Environmental Protection Agency has created a list of products it says can claim they kill viral pathogens, including presumably this coronavirus strain. For those, follow the directions on the package.
The American Chemistry Council has a list of products that should be effective for nonporous surfaces that harbor the virus.
To clean your cellphone, follow manufacturer’s instructions. Most can be wiped down with an alcohol pad or a disinfectant wipe. Don’t spray chemicals directly on the phone and be aware bleach may harm phones.
Clothing can be washed in the warmest water deemed appropriate for the material. Don’t shake out laundry, as that could spread the virus, but you don’t have to wash the ill person’s laundry separately. Dry it completely.
Wear gloves if you are touching the ill individual, his or her laundry, garbage, etc. And wash your hands after you take off the gloves.