You washed your hands. You kept 6 feet away from everyone. You avoided touching your face and evaded anyone carrying a tissue or wearing a face mask.
Yet somehow, you have started sneezing and coughing and your chest is congested. Is it the flu (which continues to circulate in the U.S. this season, although cases are on the decline), or have you wound up with the disease du jour, COVID-19, the illness caused by the SARS-CoV-2 coronavirus?
If its COVID-19, what do you do next?
Dr. James Kugler, director of the clinical support division at the Defense Health Agency, says “watching for early symptoms are key.”
“You play an important role in helping to keep yourself and your family healthy,” Kugler in a release from the Defense Health Agency Tuesday.
The first thing you should do if you begin feeling ill is consider whether you might have been exposed to the virus, either by being in contact with a sick person or having recently traveled to a place where the illness is widespread, according to military health officials.
If it’s a possibility, call a registered nurse. For service members and all Tricare beneficiaries, there are many ways to do this, beginning with the unit or battalion aid station or the MHS Nurse Advice Line, 1-800-874-2273, pressing Option 1 in the U.S.
You can also call your military hospital, primary care team or civilian provider, or their appointment lines or reach out by going online to the MHS Nurse Advice Line website, messaging Tricare through Tricare Online, or your health facility through the MHS Genesis portal if your facility is already on the electronic health records system.
The nurse will ask you a few questions to screen you for exposure or potential infection. Then they may schedule a “virtual telephone visit” with a health care provider.
The provider will assess your symptoms and develop a treatment plan. Depending on the severity of your illness, they may recommend self-care at home or direct you to call your doctor for an in-person appointment and a test.
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Those who are mildly ill and advised to stay home may never be tested for the coronavirus, largely due to the scarcity of available test kits across the country. Still, you may be advised to contact your local or state health departments, which will provide instructions on self- and active monitoring as well as testing.
For at-home isolation, the Centers for Disease Control and Prevention recommends staying in a separate room from others, away from other people in your home, using a separate bathroom, if possible. Also, if you live with others, wear a face mask to avoid spreading the virus to them. Limit contact with pets, because although the CDC says there have been no reports of pets becoming ill, not enough is known about the new virus, first seen in Wuhan, China, to know how it affects animals.
As with any respiratory illness, including the common cold, which is caused by several other coronavirus, get plenty of rest, drink lots of fluids, such as water, soups, Gatorade or ginger ale, and take aspirin, acetaminophen, ibuprofen or naproxen for fever and aches.
Harvard Medical School officials also advise that if you choose to take cold or flu medicine in addition to pain relievers, keep track of your acetaminophen intake: it should not exceed 3,000 milligrams.
If you feel well enough, clean and disinfect “high touch surfaces,” such as bathrooms, cabinet knobs, door knobs and cooking areas every day. Continue practicing good health hygiene, to include washing your hands frequently for at least 20 seconds, using hand sanitizer with at least 60 percent alcohol, and using tissues or coughing into your sleeve.
You should expect to remain at home for up to 14 days, staying away from others and not going into public areas, including work, school or public transit “until the risk of secondary transmission to others is thought to be low,” according to the CDC.
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When making the decision to discontinue home isolation, patients should consult with their health care providers and health department.
While more than 80 percent of all cases of COVID-19 are mild, some populations — especially the elderly and those with pre-existing medical conditions — are especially vulnerable. And as with any illness, there are anomalies among those who develop severe cases, so its best to know when to go to an emergency room or call 911.
Here are the symptoms that warrant immediate action:
Worsening symptoms
Difficulty breathing or shortness of breath
Persistent pain or pressure in chest
Bluish lips, face, fingers, toes or fingernails
Lethargy or confusion
Military health officials advises that if you call 911, tell the dispatcher you suspect you have COVID-19. Likewise, when traveling to an ER, wear a face mask if you have one and inform registration of the possibility.
As of Thursday, there were at least 1,264 COVID-19 cases in the U.S., with 36 deaths. At least a dozen U.S. service members, family members or civilian Defense Department employees have suspected or confirmed cases of the illness.
The Department of Defense and Tricare have established a coronavirus page with updates about the illness.
“As always, take command of your health,” Defense Health Agency officials advised.
Patricia Kime is a senior writer covering military and veterans health care, medicine and personnel issues.