"What Should I Do?"

A friend called today with low grade fever, body aches and chest tightness asking, what should I do?

First, we reviewed his medical history and current signs/symptoms, learning he is a healthy 59 year old.

Next I asked about exposures and current living conditions. He's been in areas with significant number of cases prior to adhering to the California self-isolation instructions. He's with his wife and 3 kids, each of whom seem fine.

Recommendations:

1. Isolate yourself from your family, even within the house. Ideally, separate into three groups, you, your wife and then your children.

2. Report any change in symptoms including monitoring your temperature.

I described usual symptoms of non-productive cough and shortness of breath as indicators of worsening infection. I emphasized that noticing these does not require visiting the doctor, ER or hospital. If/when those symptoms start, talk with your doctor to understand what might be necessary. I also explained that testing is not likely to change how his doctors would treat him nor would it change how a doctor would interpret his risk. So a test would not change treatment or outlook, plus California policies currently do not allow testing for a situation like his.

3. Use acetaminophen - not NSAIDs (such as ibuprofen, i.e., Advil, Motrin or naproxen etc.) - to treat fevers / body aches. Some data suggest using NSAIDs during COVID-19 infection can add risk of worsening your condition.

4. Call your doctor if shortness of breath becomes noticeable, and best to call even if not sure if it were bad enough to be considered bad enough (i.e., call the doctor too early not too late).

Most importantly, act as though you are infected and make sure you follow the standard guidelines for hand washing and social isolation. Protect your loved ones, assuming your actions from here on out put them at risk.