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A friend posted this on Fruitcakes, it is an article from The Times newspaper. It gives helpful info that is not usually given on mainstream media.
DR MARK PORTER
What to do if you get Covid: the early warning signs that your infection may be ‘code red’
Dr Mark Porter
Monday January 25 2021, 5.00pm GMT, The Times
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We are constantly bombarded with information about the roll-out of Covid-19 vaccines and advice on how to reduce transmission and protect ourselves, but what do you do if you are one of the unlucky million or so people who are infected with the virus? Or one of a similar number likely to catch it this week?
Protocols and services for managing people with Covid vary slightly across the UK, so I will outline what is happening on my patch (Gloucestershire) as an example. Apologies for starting with the obvious, but the very first action to take if you develop symptoms is to self-isolate and book a test. All the information you need can be found at gov.uk. Or call 119 (0300 303 2713 in Scotland).
The next step is to try to avoid worrying. It is hard to generalise because the impact of Covid varies considerably depending on the individual, but most people will have only mild symptoms, between 10 per cent and 15 per cent will progress to more severe disease, and about 5 per cent will become critically ill. The younger and healthier you are, the better the outcome.
Those at higher risk include anyone over 50 (the average age of people with Covid in intensive care is 60), people from some minority ethnic groups and those with underlying health problems, including diabetes (type 1 and 2), obesity, some cancers and heart disease.
As well as your age and general health, the sort of symptoms you are experiencing can predict whether you are more likely to run into trouble. Feeling sick, and having diarrhoea, a headache, sore throat, blocked nose and loss of sense of smell/taste are what doctors classify as green symptoms, which suggest a good outcome in the absence of any other effects. A cough (particularly a productive one) and dizziness in addition to any green symptoms move you into the amber range. Aching muscles, chills, severe fatigue and, most importantly, breathlessness move you into the red zone.
If you are in the green zone, have no underlying health problems and are under 50 then it is likely that you can manage your symptoms at home with rest and paracetamol. If you have amber symptoms and/or an underlying health problem then you may benefit from further monitoring and assessment — either via 111 or your GP. This may entail a face-to-face consultation (we tend to see our patients with Covid in the surgery car park) or referral to a virtual Covid ward. If the latter, you will be offered a pulse oximeter to monitor oxygen levels at home, with daily follow-ups by phone/email from a dedicated team.
Pulse oximeters primarily measure oxygen saturation in your blood, but record pulse rate too, and changes in these can indicate worrying progression and the need for hospital admission before obvious deterioration. While people with Covid can become very ill at any stage, it is normally the beginning of the second week that worries us most. Falling oxygen levels and a rising resting pulse rate (over 100 is amber; over 131 is red) suggest worsening disease and the need for review/admission. Another indicator is resting breathing rate — anything under 20 breaths a minute is green; 21-24 is amber; 25 or more is red (although some people with pre-existing chest problems may have higher normal rates, so look for change rather than absolute thresholds).
Clinicians who have seen a lot of Covid patients take oxygen levels very seriously, because there is a small group of people in whom low readings can be the only sign of deterioration. Some with surprisingly few symptoms — including those with normal respiratory and pulse rates — can have alarmingly low oxygen levels (under 90 per cent). This condition has been termed “silent hypoxia” and can be dangerous if missed, hence the value of pulse oximeters.
In Gloucestershire we have a supply of oximeters that we can send to patients’ homes, or that can be collected from various centres (such as local minor-injuries units), to monitor people in the virtual ward. And to help us to pick up all who may benefit from this, we are sent the results of every NHS Covid test. However, please don’t assume that your doctor knows about you, and if you are concerned and have not been contacted then call 111 or talk to your GP.
You can buy your own pulse oximeter — and if you can afford it I would advise that you consider doing so — but that doesn’t mean you should rely on DIY interpretation. If you maintain good readings, but your condition is worsening, then you should still seek help.
Last but not least, please cut this out/print it off and stick it on your fridge door — where, like most notes on my fridge, I very much hope that it will never need to be looked at again.
A guide to the pulse oximeter
● Prices vary, but £20 to £30 should get you a decent one. Check that it carries the CE mark (meaning it should meet the requirements of all relevant European medical device directives)
● Don’t worry if it’s a brand you have never heard of, as few are household names. Mine is a two-year-old Nonin, but these can be expensive (the model I have is suitable for heavy/professional use)
● Cold hands, shivering and nail varnish can each affect readings
● If you buy one “just in case”, take the opportunity to record over a few days what readings are normal for you. Worrying changes in oxygen levels are not just about absolute thresholds, but what is usual for you too (some people with long-term chest disease have much lower “normal” readings, for example)
● 95 per cent oxygen saturation (or within 1-2 per cent of what is usual) or above is reassuring
● 93-94 per cent (or any reading that is 3-4 per cent less than usual for you) suggests worsening and worrying disease
● 92 per cent or less (or more than 4 per cent below what is usual) suggests severe problems
DR MARK PORTER
What to do if you get Covid: the early warning signs that your infection may be ‘code red’
Dr Mark Porter
Monday January 25 2021, 5.00pm GMT, The Times
Share
Save
We are constantly bombarded with information about the roll-out of Covid-19 vaccines and advice on how to reduce transmission and protect ourselves, but what do you do if you are one of the unlucky million or so people who are infected with the virus? Or one of a similar number likely to catch it this week?
Protocols and services for managing people with Covid vary slightly across the UK, so I will outline what is happening on my patch (Gloucestershire) as an example. Apologies for starting with the obvious, but the very first action to take if you develop symptoms is to self-isolate and book a test. All the information you need can be found at gov.uk. Or call 119 (0300 303 2713 in Scotland).
The next step is to try to avoid worrying. It is hard to generalise because the impact of Covid varies considerably depending on the individual, but most people will have only mild symptoms, between 10 per cent and 15 per cent will progress to more severe disease, and about 5 per cent will become critically ill. The younger and healthier you are, the better the outcome.
Those at higher risk include anyone over 50 (the average age of people with Covid in intensive care is 60), people from some minority ethnic groups and those with underlying health problems, including diabetes (type 1 and 2), obesity, some cancers and heart disease.
As well as your age and general health, the sort of symptoms you are experiencing can predict whether you are more likely to run into trouble. Feeling sick, and having diarrhoea, a headache, sore throat, blocked nose and loss of sense of smell/taste are what doctors classify as green symptoms, which suggest a good outcome in the absence of any other effects. A cough (particularly a productive one) and dizziness in addition to any green symptoms move you into the amber range. Aching muscles, chills, severe fatigue and, most importantly, breathlessness move you into the red zone.
If you are in the green zone, have no underlying health problems and are under 50 then it is likely that you can manage your symptoms at home with rest and paracetamol. If you have amber symptoms and/or an underlying health problem then you may benefit from further monitoring and assessment — either via 111 or your GP. This may entail a face-to-face consultation (we tend to see our patients with Covid in the surgery car park) or referral to a virtual Covid ward. If the latter, you will be offered a pulse oximeter to monitor oxygen levels at home, with daily follow-ups by phone/email from a dedicated team.
Pulse oximeters primarily measure oxygen saturation in your blood, but record pulse rate too, and changes in these can indicate worrying progression and the need for hospital admission before obvious deterioration. While people with Covid can become very ill at any stage, it is normally the beginning of the second week that worries us most. Falling oxygen levels and a rising resting pulse rate (over 100 is amber; over 131 is red) suggest worsening disease and the need for review/admission. Another indicator is resting breathing rate — anything under 20 breaths a minute is green; 21-24 is amber; 25 or more is red (although some people with pre-existing chest problems may have higher normal rates, so look for change rather than absolute thresholds).
Clinicians who have seen a lot of Covid patients take oxygen levels very seriously, because there is a small group of people in whom low readings can be the only sign of deterioration. Some with surprisingly few symptoms — including those with normal respiratory and pulse rates — can have alarmingly low oxygen levels (under 90 per cent). This condition has been termed “silent hypoxia” and can be dangerous if missed, hence the value of pulse oximeters.
In Gloucestershire we have a supply of oximeters that we can send to patients’ homes, or that can be collected from various centres (such as local minor-injuries units), to monitor people in the virtual ward. And to help us to pick up all who may benefit from this, we are sent the results of every NHS Covid test. However, please don’t assume that your doctor knows about you, and if you are concerned and have not been contacted then call 111 or talk to your GP.
You can buy your own pulse oximeter — and if you can afford it I would advise that you consider doing so — but that doesn’t mean you should rely on DIY interpretation. If you maintain good readings, but your condition is worsening, then you should still seek help.
Last but not least, please cut this out/print it off and stick it on your fridge door — where, like most notes on my fridge, I very much hope that it will never need to be looked at again.
A guide to the pulse oximeter
● Prices vary, but £20 to £30 should get you a decent one. Check that it carries the CE mark (meaning it should meet the requirements of all relevant European medical device directives)
● Don’t worry if it’s a brand you have never heard of, as few are household names. Mine is a two-year-old Nonin, but these can be expensive (the model I have is suitable for heavy/professional use)
● Cold hands, shivering and nail varnish can each affect readings
● If you buy one “just in case”, take the opportunity to record over a few days what readings are normal for you. Worrying changes in oxygen levels are not just about absolute thresholds, but what is usual for you too (some people with long-term chest disease have much lower “normal” readings, for example)
● 95 per cent oxygen saturation (or within 1-2 per cent of what is usual) or above is reassuring
● 93-94 per cent (or any reading that is 3-4 per cent less than usual for you) suggests worsening and worrying disease
● 92 per cent or less (or more than 4 per cent below what is usual) suggests severe problems
