Tuesday, March 17, 2020

How do I know if I have coronavirus?

The following is not medical advice. I'm posting it for myself or self-reference.

1. How do I know if I have the coronavirus or COVID-19 (i.e. SARS-CoV-2/COVID-19)? After all, its signs and symptoms are almost indistinguishable from the common cold or the seasonal flu. All three can have signs and symptoms like fatigue, fever, coughing (dry). The short answer is there's no way to know definitively without getting tested.

2. So let me ask a different question. How do I know when I need to see the doctor? The answer is: shortness of breath (SOB). The medical term for SOB is dyspnea.

3. What is SOB? SOB is, well, feeling breathless or out of breath. Of course, someone might feel breathless if they've run a long race. If they're nervous or anxious. If they're having a panic attack. If they're allergic to something. If they've been exposed to a lot of smoke or dust. If they're in love. Or for a number of other reasons. However, I'm referring to shortness of breath in the context of flu-like symptoms (e.g. fatigue, fever, coughing).

4. Here's an easy question to ask about SOB. What physical activities cause me to feel SOB? Do I feel SOB when I'm walking upstairs or uphill? Do I feel SOB when I'm doing my usual daily tasks like dressing, cooking, or cleaning? Do I feel SOB when I'm resting on the couch? Do I feel SOB when I'm lying down? Note these questions move from activities which require more physical exertion to less physical exertion.

5. If, in the context of flu-like symptoms, I feel SOB even when I'm at rest, then I should consider seeing a physician. At the very least I should consider calling a physician or other health care provider (or telemedicine) and asking whether I should go in.

6. All that said, if I live in an area with drive-through testing (and more places should be offering this with each passing day), then I could consider going to a drive-through testing site. Especially if I have flu-like symptoms. Primarily fever, coughing, SOB. SOB is typically the most concerning symptom in case of coronavirus.

a. However, drive-through testing centers may or may not accept the general public at this point in time. It varies depending on locality. I might call and ask.

b. That's because there's only a limited number of test kits available at the moment. Logistics like production, supply lines, and distribution are still less than ideal. Hence there will likely be criteria to meet before I'm able to be tested. And criteria for testing may change over time. Everyone is flying by the seat of their pants right now.

c. Nevertheless the drive-through testing centers should be free (at no cost) at most if not all places.

d. Going to a drive-through testing center minimizes the risk of infecting others including other health care workers who aren't wearing personal protective equipment (PPE). The health care workers at the drive-through testing sites will be wearing PPEs.

e. What will happen at the drive-through testing center?

They'll ask me to fill out forms.

They'll ask me screening questions to see if I meet criteria to move on because there are only a limited number of tests available. Criteria may differ depending on the site.

They'll ask my age (risk factor >60 years old). They'll ask questions about my flu-like symptoms including SOB. How long ago my symptoms started (within 14 days). How severe they are (at rest, on exertion).

They'll ask about my past medical history. In particular if I have any underlying major diseases (e.g. diabetes, cardiovascular disease, COPD).

They'll ask about my contacts. They'll ask if I've had any close contact (6 feet distance) with someone suspected or confirmed of having COVID-19.

They'll ask if I've recently traveled overseas to places with COVID-19 (e.g. China, Japan, South Korea, Iran, Europe). If I've recently traveled to any place in the US that are hot zones for COVID-19 (e.g. Washington state, California, Colorado, NYC).

They'll take my temperature, among other things.

And they'll take a swab (nasal/oral) to send off to a lab to test for the presence of coronavirus. It will take a day or two minimum before I hear results. Possibly longer.

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