To date, there are more than 3 million confirmed cases of coronavirus in the U.S.—and that figure is almost certain to rise as lockdowns loosen and states open up again. With 80% of people recovering at home, you might wonder, “What do I need to prepare myself in the event that I, or someone in my family, becomes infected?”
The items you’ll want to have on hand depend largely on how the coronavirus affects you. That’s because symptoms of COVID-19 can run the gamut—your muscle aches and dry cough may be another person’s high fever and difficulty breathing—so it can be a bit of a guessing game as to know what, exactly, to purchase pre-emptively. What’s more, the list of “typical” symptoms—which generally appear two to 14 days after exposure, according to the Centers for Disease Control and Prevention (CDC), with most people showing symptoms by days five or six, according to the World Health Organization (WHO)—keeps expanding. The CDC just added six new possible symptoms of coronavirus to its list:
- Repeated shaking with chills
- Muscle pain
- Sore throat
- Loss of taste or smell
There’s also a growing concern about a spate of new cases—in this country and others—of younger, otherwise healthy adults experiencing abnormal blood-clotting that leads to stroke. In an April 28 article published in Science, doctors theorize that this blood-clotting may also be linked to the uptick in cases of silent hypoxia—when oxygen-saturation levels in your blood cells are life-threateningly low. (The thinking is that “slight” blood clots could be clustering inside the lungs, decreasing their function.)
“We’re learning more about [COVID-19] every day. Three weeks ago, if you didn’t have a fever I wouldn’t worry about you having coronavirus. But that is not the case—people may not have symptoms at all,” says Russell G. Buhr, M.D., Ph.D., assistant professor of medicine, UCLA division of pulmonary and critical care in Santa Monica, CA.
Keeping the ever-changing, COVID-19 symptom climate in mind, here’s what the experts say you should have at home and at-the-ready, right now:
Before heading to work in the intensive care unit at UCLA Medical Center, Dr. Buhr now uses a generic analog thermometer—you know, the glass kind that you place beneath your tongue—to take his daily temperature. He bought one after originally searching online for a digital thermometer, only to discover that what should have set him back $15 was selling for double—or even triple—that amount. To add insult to injury, there was six-week back order.
“I had no idea they even still made them,” he says of the old-fashioned variety. “I walked into the campus pharmacy and it was the last one they had that wasn’t for babies.” If you’ve experienced the same kind of price gouging, don’t worry. Just go old school. “I don’t think the fancy no-touch infrared thermometers are any better than conventional digital thermometers,” he adds. What’s important is that you have some kind of thermometer on hand so you can do daily temp checks if you think anyone in your family has been exposed to the virus. (And be sure to sanitize it after every use.) Vicks ComfortFlex Digital Thermometer with Fever Insight, Walmart. Cost: $9.98. H-B Durac Plus Pocket Liquid-in-Glass Thermometer, Amazon. Cost: $16.
In the first weeks of the crisis, there was a lot of talk about acetaminophen and ibuprofen, and whether one or the other was more effective against the coronavirus—or even if ibuprofen could actually do harm.
“What we saw in this pandemic was a rush to do something. People raised the question based on mechanism pathways whether we should avoid ibuprofen. As of now, no study has shown evidence of harm for treating with ibuprofen,” says Dr. Baruch S. Fertel, M.D, director of operations and quality improvement officer for emergency services at the Cleveland Clinic in Ohio.
Taking either fever reducer is fine to help you feel better, he says. The most important thing is to make sure you’re eating and hydrating during a bout with COVID-19.
John M. Wilkinson, M.D., a family physician at the Mayo Clinic in Rochester, MN, adds, “In general, there is not any level of fever, in and of itself, that is dangerous. However, a higher fever, which doesn’t come down at all, particularly if you are having other worsening symptoms—cough, shortness of breath, chest heaviness, weakness, lightheadedness or dizziness—means you need to be seen by a medical professional without delay.”
It's also important to note how older people, and those with compromised immune systems (like cancer patients), may not necessarily show a high temperature reading. But if they are sweaty despite feeling chilled, they do need prompt medical examination, says Dr. Maryam Mahmood, M.D., an infectious disease specialist at Mayo Clinic. Tylenol (acetaminophen), Health Warehouse. Cost: $7.35. Motrin (ibuprofen): Walgreens, $6.99.
As soon as the issue of silent hypoxia hit the news cycle a week or two ago, there was a run on Amazon of people buying pulse oximeters—an electronic, hand-held device that measures the oxygen-saturation levels in your red blood cells, as well as your heart rate. It does this by shining a light through the small blood vessels in a single finger, then calculating your oxygen levels by how red the blood is. Prices range from roughly $25 to $100, and you can find them at pharmacies, big box stores, Amazon, and medical supply shops, too. Quality and accuracy can vary from the pulse oximeters used in hospitals, which cost thousands of dollars.
Still, given the growing concern about silent hypoxia and the possible connection to blood-clotting, having such a device on hand might not be such a bad idea. “We’re seeing more and more [people] come into the emergency room with low oxygen levels who aren’t exhibiting symptoms, like being short of breath, or gasping for air,” says Dr. Mahmood.
Normal baseline oxygen saturation levels are 94% to 100%, according to a study published in Oxford Academic. Anything less than 92% is a sign of declining oxygen levels that can affect lung function—even if you don’t notice it in your own breathing. Silent hypoxics are reportedly being admitted into ERs at levels of 70%, 60%, or even lower—which would normally render a person unconscious or even kill them—although they show no outer signs of struggling to breathe. If your levels dip too low, the best person to interpret the data is a physician.
Dr. Fertel agrees. “Right now, we don’t understand why seemingly well-appearing people seem to have silent hypoxia. They are not outwardly manifesting symptoms the way you would normally see them with oxygen saturation levels at 80 percent. They don’t seem to be in distress, but they are hypoxic.”
Measuring oxygen saturation levels at home might signal you when to seek help. “I do believe that tracking oxygen levels with a pulse oximeter at home, if able, can be beneficial,” says Susan R. Wilcox, M.D., associate professor of emergency medicine, Harvard Medical School in Boston. “If your oxygen level falls below 92 percent, either at rest or with walking, it’s appropriate to seek medical care promptly.”
If your pulse-ox reading dips below 85%, don’t wait: Go to the ER, says Dr. Buhr. “Having levels between 88% to 90% can be dangerous and cause damage to the heart, brain, and kidneys.” ChoiceMMed Pulse Oximeter, Target, $34.99.
The best way to protect the rest of the household is to isolate the sick person, ideally in a separate bedroom, and have them use a different bathroom, according to the CDC. Keep a few windows open, if possible, to improve ventilation and dilute airborne virus particles. To that end, you may want to run a portable air purifier.
While an air purifier cannot kill COVID-19, it may improve air flow, which could help protect the designated caretaker. According to the FDA, “certain sterilizers, disinfectant devices, and air purifiers may help reduce this risk of viral exposure, based on our current understanding of these devices and SARS-CoV-2 [the scientific name for the novel strain of coronavirus]." Hamilton Beach TrueAir Air Purifier with Permanent HEPA Filter, Wayfair. Cost: $49.99.
Masks and Gloves
By now, we’ve all received the memo about wearing face coverings or masks in public when six feet of social distancing is impossible to maintain. And gloves can be helpful, too, when touching communal things like gas pumps or ATM machines—as long as you promptly remove and safely discard of contaminated gloves before you touch other surfaces, or worse, your own face. If you don’t have gloves available while pumping gas or touching other public surfaces, make sure you carry hand sanitizer with you and apply it generously afterward, allowing it to dry completely before touching anything else.
Remember, we all wear a face mask primarily for others’ protection (although some studies suggest caretakers wearing masks may get some degree of protection when near a sick loved one). “The mask, you should always wear,” says Dr. Mahmood, when you’re out and about. “The droplets that contain the virus can travel for six feet through the air and can land on a surface or the floor.” Still, she adds how “the important thing is hand washing. Gloves are not going to magically stop COVID. The key areas where COVID gets into body—nose, mouth and eyes—you [must] not touch those areas before you wash your hands.”
If you are caring for a sick family member, limit contact with the infected person, don’t share household items, and frequently wipe all surfaces with a disinfectant. Protective gear, hand soap, and cleaning tools are our new best friends. Disposable face masks, (pack of 50), Amazon. Cost: $39.90. Latex gloves (pack of 100), Amazon. Cost: $29.29.
Final thoughts: While this all takes some getting used to, we really have no choice. “COVID will be part of our future like the flu,” says Dr. Fertel. Fortunately, we can fight back by being stocked and ready.