Many people are in this situation.  Maybe you have COVID-19.  Maybe you have symptoms. Maybe you were exposed.

So now what? Isolate? Get a test?  Go to the ER? How do you care for yourself?

There is so much cross chatter in American society about the coronavirus – unfortunately some of it from outside health care – that it can be hard to know what to do.

UC Davis Health family and community medicine physicians Sky Lee and Grace Amadi have been guiding their patients through the COVID-19 confusion-and-anxiety maze.  Their advice can be a compass for anyone facing these questions.

They both start with this: Remember, many other people are wading through uncertainty.  They don’t know all the answers, either.

“You have a lot of factors working against you right now,” said Amadi, an assistant clinical professor.  “You’re not alone in being confused. Experts don’t have all the answers, either.”

“It’s not just Sacramento or California,” said Lee, an assistant professor.  “It’s the nation. There’s so much we still don’t know. There are testing shortages.  This is still a new illness.  There are real reasons why there is uncertainty.

First  steps

“Talk to your doctor,” Lee said. “It’s never wrong to call your primary care providers for anything, whether you think it’s COVID-19 or a problem with diabetes or allergies.  Most clinics have a 24-hour triage line.”

“You have a lot of factors working against you right now. You’re not alone in being confused. Experts don’t have all the answers, either.” — Grace Amadi

Many providers and clinics are advising patients to stay home if they have mild COVID-19-like symptoms.  That can add to their anxiety.  Amadi said remember that your providers can still help.

“We can always do a video visit or a call,” she said.  “We can help you figure out what’s going on.  It’s still allergy season.  Flu season will be coming.  It can be confusing or frightening, and we know you don’t need more stress.”

However, if your symptoms or issues are more than mild – including trouble breathing, lips or fingers turning blue, a persistent fever over 101 degrees, pain in your chest, or other real discomfort – check with your primary care provider immediately or go to your emergency room.

“Don’t be afraid to go to the ER if your primary care provider recommends it or you have serious symptoms,” Lee said.  “They have good protocols to protect against COVID-19.  And don’t be embarrassed if it turns out to be nothing serious.  That’s much better than ignoring something that is serious, including COVID-19.”

If you do go to an ER, call ahead and let them know you may be a possible COVID-19 patient.  That will help them be ready for you.

What to look for

According to health coaches in Maidu CA, many people are falling into an in-between category – they don’t feel quite right, but they don’t want to overact.  Once again, both physicians said call your doctor when you’re unsure.

The list of COVID-19 symptoms continues to evolve as experts get more experience.  According to the Centers for Disease Control and Prevention, they include:

  • fever
  • dry coughs
  • respiratory illness that includes shortness of breath
  • muscle pain
  • headache
  • new loss of taste or smell
  • sore throat
  • chills
  • repeated shaking with chills
  • diarrhea

Sinus problems, nausea or vomiting are not thought to be COVID-19 symptoms.

The problem for many people is that some of these can also be symptoms of allergies or a cold.  And experts are still uncertain exactly when they might appear after exposure to COVID-19.

The CDC gives a large range.  It says symptoms may appear 2-14 days after exposure.  Often, they tend to peak after 5-7 days, Amadi said.

“But that’s generally,” she said.  “People have usually seen the worst of it by days 10-14.  Usually.  If you’re watching your symptoms at home and they start to get better, you can be reasonably assured that they won’t get worse.”

None of this is written in stone, however. “Information is still changing almost every day as we learn more,” Amadi said.

Should you get tested?

“This has been a moving target because there are shortages,” Lee said.  “That’s one reason you should start by calling your provider.  They can help you decide about testing.”

One issue is that testing is taking so long – from scheduling to waiting for results – your doctor may recommend against a test if you have minor symptoms, Lee said.

“Understandably, getting a test may relieve some anxiety,” she said.  “But clinically speaking, if your symptoms are mild, it may not change how we help you manage them.”

The current guidelines show who will be prioritized for tests:

  • People in the hospital and having symptoms, or people about to be hospitalized for a procedure.
  • Health care workers and people in group living facilities.
  • First responders and other social service employees.
  • People exposed to infected individuals in places where the COVID-19 risk is high.

If you don’t fit these guidelines, or are not feeling serious symptoms, there’s a good chance you’ll have to wait a few days to get a test.  That might not be so bad, Lee said.

“It might take a few days after you were exposed for the viral load to build up,” she said.  “Waiting a few days could ensure an accurate test.”

Then, many people are waiting a week or more to learn their results.  What do you do in the meantime?

Act as if you have COVID-19

“The first thing is, limit your exposure to everyone, even your family,” Amadi said.  “Unfortunately, that isn’t easy for anyone, and can be impossible for many people.”

The steps remain the same.  Try to keep a six-foot distance, have everyone in the household wear a mask, everyone wash their hands regularly for 20 seconds.

If you’re trying to isolate with others in the home, also try to:

  • Keep windows open as much as possible.
  • Use one dedicated set of utensils, plates, glasses and cups.
  • Prepare your own food, if you can.
  • Stay in a room with the door closed, if possible.
  • Use separate towels.
  • Try to avoid playing with pets – who may not understand why.
  • Tell small children they are being superheroes by wearing a mask.
  • Eat, drink, sleep

“There’s no special formula.  Just do the normal things to stay healthy,” Amadi said.  “It’s the same important advice we always give.”

That means:

  • Sleep well – as much as possible considering your anxiety levels.
  • Drink fluids.  Try to go light on coffee or soda with caffeine and alcohol.  All can dehydrate you.
  • Eat a balanced, plant-based diet.  This is not the time for specialty or pop-culture diets, they said.

Eat lots of vegetables,” Lee said.  “Eat a normal healthy diet.  Your body needs a full range of nutrition.”

An occasional indulgence of high-fat comfort foods or an extra beer or glass of wine is fine in moderation – but be careful that indulgent eating and drinking doesn’t become your long-term coping habit, especially if you have other chronic conditions such as diabetes.

“Everyone wants a little ice cream now and then,” Lee said. “But there’s a lot of stress eating right now.  COVID-19 is not ending any time soon. Eventually you’ll be done isolating and you don’t want those indulgences to become the norm. You need to find healthy outlets to manage stress.”

Can you exercise?

Yes!  This is the ‘Fitness Virus’.  The better your physical fitness, the stronger and more effective your immune system will function.

Any exercise, even just going for a walk, tends to relieve stress, which strengthens your immune system.  But what if you’re not feeling well?

The short answer: Give it a try but err on the side of caution.

“This is a listen-to-your-body situation,” Amadi said. “Exercise is good for you in so many ways, but if you’re short of breath, it can be a bad idea.”

One last thing: Go easy on yourself

“There is already so much anxiety about the pandemic, don’t add in unrealistic demands on yourself,” Lee said.  “You don’t need to learn a new language.  You don’t need a new skill.  It’s OK that you’re just trying to cope.  Just know, this is not a hopeless situation.  I see resiliency and strength in people every day.  It might take a while, but we’re making our way through it.”