# F2: Living in a Household with Someone with Coronavirus Symptoms

# Who is this for?

Individuals and households who have one or more people with symptoms of Coronavirus and wanting to engage effectively with healthcare professionals at the right time.

# How does it benefit you?

Understanding the severity of the symptoms of coronavirus, and preparing for a call with our local healthcare system, will help us speed up calls and assist our healthcare professionals prioritize care.

# What should you do with this?

WARNING

If anyone has any of the symptoms below, call your emergency services immediately.

  • severe shortness of breath at rest
  • pain or pressure in the chest
  • cold, clammy or pale and mottled skin
  • have recently become confused
  • are difficult to rouse
  • have blue lips or face
  • have little or no urine output when they pee
  • coughing up blood

Source: Covid-19 Remote consultations

If no one needs immediate emergency help, you should review the flowchart and use the tools provided. See also F1: Preparing for Coronavirus Lock-Down for tools to help you while your household is at home.

# Flowchart

F2 Living someone symptoms flowchart-v2

# T6: Household Quarantine Area

# Why is this Important?

If you or a loved one has symptoms of coronavirus, with or without a confirmed test for the virus, you will need to create a separate space in the home for yourself or the person(s) you are caring for to prevent the spread of infection among your household.

If you live alone, make sure that your friends and neighbors on your emergency contact list are aware of your symptoms, so they can check in on you. Of course they will still need to follow isolation guidelines to do that.

# Disclaimer

The use of information on this site is at reader's own risk and no party involved in the information production can be held responsible for its use. By using the content found on this website, you further acknowledge that it is not intended to be a substitute for public health agency guidance, professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard public health agency or professional medical advice or delay in seeking it because of something you have read here.

# What You Need

Quarantine space for the person(s) with coronavirus symptoms

  • Best: A separate room per person who needs to be isolated with access to a bathroom not used by anyone else
  • Good: A separate room for people who need to be isolated
  • Adequate: An area screened off from other people in the household
  • Inadequate: No attempt to provide physical barriers at all

T2-Guidelines for People with Coronavirus Symptoms

Caretaker for the person(s) in quarantine

Someone in your household should act as the agreed caretaker for the person(s) in quarantine. Avoid anyone who is considered vulnerable or unable or unwilling to adhere to isolation guidelines. T2-Guidelines for People with Coronavirus Symptoms

Equipment to Manage the Quarantine

  • Sheets and Blankets
  • Towels
  • Clothing
  • Personal care items (eg wash kit, tampons)
  • Tissues
  • Hand sanitizer
  • Portable toilet (if available and the household does not have access to a bathroom with a toilet just for person(s) in quarantine)
  • Cleaning supplies
  • Trash bags

T3-Essential Supplies

Things to Help the Person in the Quarantine Space Cope

Expect the infected individual to spend the majority of their time here. Providing a television, books and magazines, a mobile phone or tablet or other means of entertainment, if possible, may help them to pass the time and stay positive. Many providers of video chat services are providing special deals during the pandemic – quarantine does not mean everyone should not communicate with each other regularly, they just need to do it in a way that minimizes risk of spread.

Free video conferencing

No separate room(s)?

If space is not available to prepare a separate room, separate the infected individual’s space as much as possible from any other communal space in a dwelling, and continue to practice frequent handwashing, disinfection, and isolation with the use of gloves and masks. Continue to follow CDC, WHO or your local health department’s recommended practices to prevent the spread of infection.

T4-Household Lockdown

If you have no separate room, the sites below show you how to build your own quarantine area with some basic tools.

Supplies You Will Need for Setting Up a Quarantine Room

Pandemic Prep: How to Build a Quarantine Room

# Separate clothes and bedding for washing

In addition to keeping personal care items separate, infected individuals should have a separate space to handle their soiled clothing and linens.

  • Bag washing separately: Have the infected individual gather soiled clothing, bed linens, and towels in trash bags or a washable laundry bag to contain contamination
  • Wash with precautions: Caretakers may then handle a closed bag with gloves, and enclose it in another bag before immediately transporting it to the laundry area, where all items should be washed with detergent in the hottest water recommended
  • Cleanse hands: Caretakers should clean gloves and hands with soap and water or an alcohol-based sanitizer afterwards and disinfect any hard surfaces (see below)
  • Wash Your Hands

Source: CDC

# Disinfect

Disinfect any space every time the infected individual uses it. This is especially important if the space is in a shared area. Use a CDC recommended disinfectant, or whatever your government recommends:

  • Bleach solution: 5 tablespoons (approximately 100 ml, 1/3 cup) of bleach per gallon (approximately 4.5 liters) of water, or 4 teaspoons bleach per quart of water. Never mix with ammonia or any other cleanser and provide proper ventilation. Do not use anything past its expiration date.
  • Alcohol solution: must be at least 70%.
  • Use the disinfectant to clean all high-touch surfaces in the shared area: counters, door handles/knobs, switches, toilet flush handle, toilet lid, shower/bathtub handles, shower curtain, towel rack, medicine cabinet, sinks and faucets/taps, appliances, remote controls, electronic devices, etc..
  • Apply the disinfectant and allow it to air dry.
  • Do not share towels or wipes used for disinfecting patient areas with other areas of the house. This may spread contamination.

Source: CDC

# Don’t Share Common Items

Avoiding the use of shared spaces and items is important in preventing the spread of infection. In some cases, families and/or roommates may not be able to separate their shared spaces. Whether you can provide a separate space for a sick individual or not, a household with an infected individual should not share items such as:

  • Toothbrushes
  • Utensils
  • Disinfecting wipes
  • Towels
  • Dishes
  • Cups
  • Handkerchiefs or tissues

Source: CDC, CDC, MoH

# Household Pets

Household pets should not be cared for, played with or petted by an infected individual because this increases the risk of transmitting the virus to other people who also pet that animal.

Source: College of Veterinary Medicine, IL, American Association for the Advancement of Science

# T10: Check Severity of Coronavirus Symptoms

# Why is the Tool Helpful to You

Understanding the severity of the symptoms of coronavirus and preparing for a call with our local healthcare system will help the caller speed up calls and assist our healthcare professionals prioritize care.

It is reported that fewer than 1 in 20 people aged less than 50 years with COVID-19 needed hospital care in a recent study and, for most of us, the safest and the most comfortable place to recover from the virus is in our own household. The risks of developing severe complications increase with age and the presence of other illnesses.

Source: The Lancet

WARNING

If anyone has any of the symptoms below, call your emergency services immediately.

  • severe shortness of breath at rest
  • pain or pressure in the chest
  • cold, clammy or pale and mottled skin
  • have recently become confused
  • are difficult to rouse
  • have blue lips or face
  • have little or no urine output when they pee
  • coughing up blood

Source: Covid-19 Remote consultations

# Disclaimer

The use of information on this site is at reader's own risk and no party involved in the information production can be held responsible for its use. By using the content found on this website, you further acknowledge that it is not intended to be a substitute for public health agency guidance, professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard public health agency or professional medical advice or delay in seeking it because of something you have read here.

# What You Need

  • Sanitized thermometer, printer, paper and a pen or pencil, reputable online symptom checker
    • No thermometer? Use the back of your hand as described in 'Checking for Symptoms of a Fever' on WikiHow
  • Unsure how to sanitize your thermometer? Refer to the clear guidelines at HowToAdult

  • Emergency contact number or 'telemedicine' contact details for your local healthcare system

  • Address and directions to your nearest hospital emergency room – check your local news regularly to see if this changes

  • Telephone, smartphone or computer for phone call or video call consultation with a local healthcare professional

# What You Need to Do

  • Monitor the person with symptoms of coronavirus (we have provided a check list at the end of the document for you)
    • How often you check on them depends on the severity of their symptoms
  • Know what to do next if symptoms are Moderate and worsening
    • This will depend on what is recommended to you in your area – find out
  • Know what to do if symptoms are Severe
    • This will depend on what is recommended to you in your area – find out

# Assess the severity of coronavirus symptoms

# Simple Checklist

The paper-based checklists below and provided at the end of the document help you determine the severity of coronavirus symptoms. They are adapted for your use from a Covid-19 remote assessment in primary care infographic.

Source: BMJ

# Online Symptom Checkers

Several countries have also provided online symptom checkers for household use.

These trackers provide helpful information wherever you live, however, the recommendations they provide are focused on the country where they are published.

Country Symptom Checker
Australia Health Direct COVID-19 Symptom Checker
Canada COVID-19 Symptom Self-Assessment Tool
Lebanon COVID-19 Symptom Checker
United Kingdom NHS Symptom Checker
United Kingdom PatientAccess Online Symptom Checker
United Kingdom COVID-19 Symptom Checker (NHS Wales)
United States CDC Symptom Self-Checker

# Severe Symptoms: Immediately call an ambulance or go to the emergency room

If any of the following symptoms develop follow the directions in your local country (eg call an ambulance):

  • Severe shortness of breath - breathless while speaking or at rest

  • Fast rate of breathing

  • Blue lips or face

  • Pulse rate greater than 100 beats per minute with confusion

  • Coughing up blood

# Moderate Symptoms: Immediately call or videocall for medical assistance

  • Very high temperature - over 103ºF or 39ºC and unmanaged by medications
  • Shortness of breath - if you feel breathless while walking a short distance or speaking a few sentences
  • Pain in your chest
  • Difficulty breathing
  • Cold, clammy or pale and mottled skin
  • Rash

# Coronavirus Symptom Checklist

Print out and use to record symptoms so you can clearly communicate them with your healthcare professionals. Adapted from Covid-19: a remote assessment in primary care.

# Disclaimer

The use of information on this site is at reader's own risk and no party involved in the information production can be held responsible for its use. By using the content found on this website, you further acknowledge that it is not intended to be a substitute for public health agency guidance, professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard public health agency or professional medical advice or delay in seeking it because of something you have read here.

  1. Severe symptoms or rapidly worsening moderate symptoms?

    • Ambulance or emergency room
  2. Moderate symptoms or rapidly worsening mild symptoms?

    • Call or video call to your local coronavirus helpline
  3. Mild symptoms?

    • Manage symptoms at home
Severe symptoms Y/N Recent changes
Are any symptoms from the Moderate Symptoms Checklist of particular concern or have worsened recently
Severe shortness of breath - breathless while speaking or at rest
Fast rate of breathing
Blue lips or face
Pulse rate greater than 100 beats per minute and confusion
Coughing up blood
Moderate symptoms Y/N Recent changes
Very high temperature (above 103ºF or 39ºC)
Shortness of breath - if you feel breathless while walking a short distance or speaking a few sentences
Pain in your chest
Difficulty breathing
Cold, clammy or pale and mottled skin
Neck stiffness
Rash
Mild symptoms Y/N Recent changes
Cough
High temperature (above 100ºF or 37.8ºC)
Fatigue / tiredness or weariness
Phlegm or sputum produced during coughing
Muscle or joint pain
Sore throat
Headache
Chills

# T11: Speaking with a Healthcare Professional about Coronavirus Symptoms

If anyone has any of the symptoms below, call your emergency services immediately.

  • severe shortness of breath at rest
  • pain or pressure in the chest
  • cold, clammy or pale and mottled skin
  • have recently become confused
  • are difficult to rouse
  • have blue lips or face
  • have little or no urine output when they pee
  • coughing up blood

Source: BMJ

# Why is the Tool Helpful to You

Many healthcare settings have established hotlines, call centers and video consultations to assess patients with possible COVID-19 symptoms. When you contact a call center or have a video consultation, you will speak with a healthcare professional who will assess the person in your household and determine your next steps. It is useful if you prepare yourself ahead of time by considering what questions your healthcare professional may ask you. This tool aims to prepare you for that conversation with your healthcare professional.

# Disclaimer

The use of information on this site is at the reader's own risk and no party involved in producing information can be held responsible for its use. By using the content found on this website, you further acknowledge that it is not intended to be a substitute for public health agency guidance, professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard public health agency or professional medical advice or delay seeking it because of something you have read here.

# What You Need

  • Writing Materials: pen, paper
  • Emergency contact number or 'telemedicine' contact details for your local healthcare system
  • Address and directions to your nearest hospital emergency room – check your local news regularly to see if this changes
  • Telephone, smartphone or computer for phone call or video call consultation with a local healthcare professional
  • Medical History (example form at the pdf link)
  • List of current medications (example form at the pdf link)

The healthcare professional will ask you detailed questions regarding your symptoms, your travel history and contact with other people who have confirmed COVID-19.

# What You Need to Do

Prepare for the call and then make the call.

# Be Prepared

Before the call ensure you have as much relevant information available as you can.

Source: Mayo Clinic

Personal Details

Use a Medical History form and a List of Current Medications form above to prepare before you call.

Coronavirus Symptoms

You will be asked about the symptoms you are experiencing.

Symptoms of COVID 19 may include (but are not limited to): Dry cough, difficulty breathing, fever, diarrhea, loss of sense of smell or taste, sore throat, body aches, muscle fatigue, headache. You may not possess all of these symptoms or your symptoms may vary. Refer to T1: Coronavirus Symptom Tracker, T2: Guidelines for People with Coronavirus Symptoms, T10: Check Severity of Coronavirus Symptoms and self-checkers like those listed below.

Online Symptom Checkers

Several countries have also provided online symptom checkers for household use.

These trackers provide helpful information wherever you live, however, the recommendations they provide are focused on the country where they are published.

Country Symptom Checker
Australia Health Direct COVID-19 Symptom Checker
Canada COVID-19 Symptom Self-Assessment Tool
Lebanon COVID-19 Symptom Checker
United Kingdom NHS Symptom Checker
United Kingdom PatientAccess Online Symptom Checker
United Kingdom COVID-19 Symptom Checker (NHS Wales)
United States CDC Symptom Self-Checker
  • For individuals with pre-existing medical conditions, you may be asked if there has been a change in your condition eg, if you are asthmatic they may ask how often you use your inhaler and if there has been any change in the number of times you have had to use your inhaler.
  • If you have your own thermometer and/or blood pressure monitor, you may be asked to check your temperature and/or blood pressure respectively.

Source: BMJ, Johns Hopkins, CDC

Travel History

Although COVID-19 is now spreading in most countries, you may still be asked about your travel history. Possible questions include:

  • Did you travel out of the country - where and when did you travel and return?
  • Did you come into contact with anyone who travelled out of the country or did anyone from another country stay with you?
    • Where did that person travel to?
    • When did that person leave and return?
    • How long did that person stay with you?
    • Did the individual have any symptoms during his/her stay?
    • Do you know if that person has tested for COVID-19?

Risk of Infection from Others

You may be asked about the risks of contracting coronavirus from others, such as whether or not you have had contact with confirmed COVID-19 cases. As some jobs increase the risk of exposure, you may also be asked questions about the risks associated with your employment or your voluntary work.

  • Did you have close contact with anyone who has tested positive for COVID-19?
  • What was the length of time of your interaction with that person?
  • Is anyone else in the same household unwell?
  • What is your job?

# Call your Local Healthcare Provider

Follow local recommendations for your area – eg dial the phone number provided or call the 'telemedicine' service you are advised to use.

# Next Steps

What you are advised to do next will depend on whether your risk of exposure is considered low or high, and if you are thought to have mild, moderate or severe COVID-19.

Follow the instructions given to you during the call with your healthcare professional.

# T13: Managing symptoms in a household

# Why is this important to you

Most people who get sick with COVID-19 will have only mild or moderate illness and should recover at home.

Source: WHO

It is reported that less than 1 in 20 people aged less than 50 years with COVID-19 needed hospital care in a recent study and, for most of us, the safest and the most comfortable place to recover from the virus is in our own household.

Source: The Lancet

Care at home can help stop the spread of the virus and help protect people who are at risk for getting seriously ill from COVID-19.

Older adults and people of any age with certain serious underlying medical conditions like lung disease, heart disease or diabetes are at higher risk for developing more serious complications from COVID-19 illness and should seek care as soon as symptoms start.

If you are caring for someone at home, it is very important to monitor for emergency signs, check to see if symptoms are worsening, prevent the spread of germs, help manage symptoms, and carefully consider when to consult with a healthcare professional.

Older people and vulnerable people (with certain serious underlying medical conditions like lung disease, heart disease or diabetes) should not manage their COVID-19 alone by relying on written advice.

Source: CDC, WHO

WARNING

Red Flag symptoms

  • Severe shortness of breath at rest
  • Difficulty breathing
  • Pain or pressure in the chest
  • Cold, clammy, pale or mottled skin
  • New confusion
  • Becoming difficult to rouse
  • Blue lips or face
  • Little or no urine output
  • Coughing up blood

Source: BMJ

# Disclaimer

The use of information on this site is at reader's own risk and no party involved in the information production can be held responsible for its use. By using the content found on this website, you further acknowledge that it is not intended to be a substitute for public health agency guidance, professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard public health agency or professional medical advice or delay in seeking it because of something you have read here.

# What You Need

  • Thermometer (if not available use the back of your hand as described in 'Checking for Symptoms of a Fever' on WikiHow)
  • Face masks for both the infected person and the carer (T3i Face Masks)
  • Printed symptom tracker provided in T10: Check Severity of Coronavirus Symptoms or an online tool like that provided by the UK group Patient Access
  • Pen and paper
  • Access to telephone, smartphone or computer for phone call or video consultation with local healthcare professional
  • Emergency contact number or telemedicine details for your local healthcare system
  • Address and directions to your nearest emergency department
  • Access to basic medication, food and water
  • Review also T6: Household Quarantine Area and T10: Check Severity of Coronavirus Symptoms

# What you need to do

  • Nominate someone to regularly monitor changes in symptoms of the person in quarantine with suspected COVID-19
  • Make sure the person in quarantine has their usual medication unless advised not to by their doctor
  • Make sure the person in quarantine has enough water and food
  • Practice social distancing
  • Regularly clean the quarantine area and any areas shared with the rest of the household

Monitor symptoms

Know what to do if symptoms become rapidly moderate or any severe symptoms appear

Let your doctor know right away if symptoms worsen. For most people, symptoms last a few days and get better after a week. However, it is possible that their symptoms become more severe with time, so it is very important to keep monitoring for any worsening symptoms. See also:

T10: Check Severity of Coronavirus Symptoms

T11: Speaking with a Healthcare Professional about Coronavirus Symptoms

COVID-19 symptoms can worsen swiftly

If the person in quarantine has symptoms that are worsening, seek advice. This is particularly critical if that person has severe symptoms. People with COVID-19, particularly those in risk groups, can progress from mild to moderate to severe symptoms.

If you are afraid, please seek advice. That is what health professionals are there for.

Source: Patient info

Treatment and Medication

Currently, no antiviral medication is approved to treat COVID-19. Any medication is directed at relieving symptoms and may include:

  • Pain relievers (ibuprofen or acetaminophen)
  • Cough syrup or medication

Is it safe to take over the counter medication (eg. NSAIDS) to treat symptoms of COVID-19?

If you are not allergic to NSAIDs, yes, but keep yourself informed.

There is currently no evidence establishing a link between NSAIDs (e.g., ibuprofen, naproxen) and worsening of COVID-19. Worldwide health agencies are continuing to monitor the situation and will review new information on the effects of NSAIDs and COVID-19 disease as it becomes available.

Since some doctors remain concerned about NSAIDs, it still seems prudent to choose acetaminophen first. However, if you suspect or know you have COVID-19 and cannot take acetaminophen, or have taken the maximum dose and still need symptom relief, taking over-the-counter ibuprofen does not need to be specifically avoided.

Patients who have any questions should speak to their doctor or pharmacist. There is currently no reason for patients taking ibuprofen to interrupt their treatment, based on the above. This is particularly important for patients taking ibuprofen or other NSAID medicines for chronic diseases.

Source: FDA

Blood Pressure Medication

Regular medication, including ACE inhibitors and angiotensin receptor blockers, should be continued.

The ESC Council on Hypertension strongly recommend that physicians and patients should continue treatment with their usual anti-hypertensive therapy because there is no clinical or scientific evidence to suggest that treatment with angiotensin converting enzyme inhibitors (ACE-i) or Angiotensin Receptor Blockers (ARBs) should be discontinued because of the Covid-19 infection. Cardiovascular disease patients who are diagnosed with COVID-19 should be fully evaluated by a healthcare professional before adding or removing any treatments, and any changes to their treatment should be based on the latest scientific evidence.

Source:ESC, CDC

Water and Food

Make sure the sick person in quarantine drinks 3 to 4 liters, 6 to 8 pints, to stay hydrated and rests at home.

Source: NASEM

Protective Measures

Social Distancing

Hand Washing