What to Do If You Have the Coronavirus and Live Alone
A helpful game plan to get through it
On March 18, a couple of weeks before his 40th birthday, Fil Vocasek spiked a fever. He knows the exact date of onset because the single, asthmatic, Manhattan-based graphic designer had started taking his temperature every day as the number of New York Covid-19 cases began ticking upward. “I have a delicate respiratory system to begin with, and I thought chances were good that I’d get it,” he says. “I always get whatever’s going around.”
When his symptoms began, he called his regular doctor, who told him that New York City was only testing patients who went to the emergency room, so he should assume he was positive for Covid-19 and self-isolate.
In normal times, people can rely on the health care system to provide care if they get sick, but the pandemic has raised the bar on how severe symptoms need to become before a trip to urgent care or the emergency room is warranted. This means those who live alone, particularly those deemed high-risk due to underlying conditions such as asthma or diabetes, need to plan for how to nurse themselves should they fall ill — and how to establish a support system of friends, family, and health care providers to assist them from afar.
“You don’t have anyone to bounce things off of,” says Steve Ommen, MD, the associate dean of the Mayo Clinic Center for Connected Care, acknowledging the unique home care challenges faced by those who live alone. “You may question whether you need to call or go in [to see a doctor], and you don’t have another person’s judgment and social support there to depend on.” And then there’s the burden of cooking, eating, and drinking enough fluids when you may feel too sick to even get out of bed as well as the psychological toll of isolation.
“We’re only hearing about the worst-case scenarios, not the people who feel crappy for a while and get better. So prepare for the worst, but don’t dwell on it.”
Being prepared to manage mild to moderate symptoms at home during the Covid-19 pandemic is crucial for all of us, whether we live alone or not.
According to Ommen, it’s generally important to maximize the amount of care that can be delivered at home in order to limit the spread of the virus. “Even for those who have other, non-Covid health care needs at this time, the more of that that can be done in the home and not at a clinic where they may be exposing themselves to other Covid patients, the better,” he says.
Here’s how to nurse yourself through Covid-19 at home alone.
Anticipate your needs
Survey your home through the eyes of a sick person. What do they want to eat and drink? What medications or supplies do they need to have on hand? Make sure those things are in place for your potential future self.
Once New York City closed its schools, Vocasek made a giant batch of chicken noodle soup and froze it. When he got sick, he was able to simply microwave the veggie-rich food he had already prepared. “There were three days that were really bad, and I was glad I had done some of that advance prep so I could just wrap up in my blanket and eat soup and go back to bed,” he says. “I gave myself a gold star on that one.” He had also stocked up on packets of Pedialyte, which helped him stay hydrated.
In addition to stocking your kitchen with easy-to-prepare, nutritious food, Ommen recommends ensuring that any prescription medications are up to date and on hand. “Make sure all your basic needs will be supplied if you can’t get to the store for some time.”
Track your data
Once Vocasek noticed his first fever, he started taking his temperature at regular intervals and tracking the numbers in a health app on his phone. “There was no one who could give [a doctor] anecdotal information about my symptoms, so I needed hard data,” he says.
Other symptoms to track include cough, shortness of breath, difficulty breathing, loss of taste or smell, or gastric symptoms. If you have a pulse oximeter (more on that below), you can also track your pulse and blood oxygen levels.
Vocasek also tracked his medications and supplements — including zinc lozenges, Mucinex, Benadryl, a multivitamin, acetaminophen, vitamin D, and nasal spray — so he could see how they correlated with his symptoms and make note of anything that seemed to help. “I like my data, and I knew it would be useful if I suddenly collapsed. I could say, ‘It’s all in my phone, here you go.’”
Many clinics and health systems have online tools that can help gauge when it might be time to seek professional care. “Mayo Clinic has tried to provide tools that people can use on their own, such as answering questions on patient portals to see if they need testing and help them make decisions about whether to contact the medical system,” Ommen explains. Apple and the Centers for Disease Control and Prevention have also created an online screening tool that provides clear instructions and next steps based on an individual’s answers to a series of questions about symptoms, exposure, and risk level.
The more precise and thorough data you have about the duration and severity of your symptoms, the more useful those tools can be.
Connect with your health care provider
Just because you’re staying home doesn’t mean you’re totally on your own. Your health care provider can give you information and tools both to care for yourself and plan for what to do should you need professional care — particularly for those deemed high-risk.
“It’s important to understand how your care team is handling intake during this time period so you’re already familiar with it and don’t have to discover it when you’re not feeling well,” notes Ommen.
“I told them as long as you make a joke and I laugh, then we’re good. When I stop laughing and sending memes, then I need to go to the hospital.”
Your care provider’s website or patient portal should have instructions on how to connect with them for a telehealth visit. And most hospitals are set up with a nurse triage system you can connect with by phone. “That’s a support system to help you make the decision of whether you need to be seen in person,” says Ommen.
Vocasek noted that he kept hearing that shortness of breath was cause for concern, but he didn’t really know what that meant. A nurse on a telehealth visit was able to give him much more specific advice. “She said if I can’t say more than four or five words without having to take a breath, then I should come in. That was a useful metric. When you don’t have someone else there saying, ‘It’s time to go,’ you need to figure out exactly what those metrics are.”
Ommen notes that people with underlying conditions that put them at high risk for complications for Covid-19 may also be able to borrow tools such as a pulse oximeter (a small device that attaches to the tip of a finger and reads pulse and blood oxygen levels) from their health care provider. Keeping an eye on oxygen levels provides another objective metric that can be used to decide when to seek care.
Set up social support
Make sure you maintain your social networks with calls and video chats, advises Ommen. Having a network of family and friends to check in with is important if you develop symptoms, particularly if you’re alone. Ommen suggests coming up with some “rules of engagement” with one or two trusted people, such as checking in at the same time every day and deciding together in advance what to do if symptoms escalate.
“For me, it was important to have a couple people to check in with every day,” says Vocasek. “I told them as long as you make a joke and I laugh, then we’re good. When I stop laughing and sending memes, then I need to go to the hospital.” And checking in with the same couple of people reassured him that they were tracking how he looked and sounded from day to day.
Manage your mental health
While having a few trusted people to check in with is helpful, Vocasek found it important not to broadcast his situation to the world. “I didn’t want that whole catastrophizing chorus in my messages,” he says.
Perhaps even more important than being judicious about the information you share is carefully filtering the information you’re taking in. “Figure out your trusted sources for useful information: the CDC, National Institute of Health, World Health Organization,” advises Vocasek. “Not the opinion page or the latest death tally. When you’re sick and already panicked, it will send you into a spiral. Just talk to your friends who are also in zombie preparedness mode and stay focused on the light at the end of the tunnel.”
Make a plan for the worst
The majority of people will be able to manage their symptoms at home. But if you do need to go to an emergency room, it will help to be prepared.
Vocasek prepped a go bag with printouts of his medical and insurance information, earplugs, a toothbrush and toothpaste, a pillbox, sleeping mask, and his laptop, tablet, and chargers. “No one is going to be packing a bag for you, and visitors aren’t allowed [in the ER], so whatever you walk out that door with is what you have for however long you’re there,” he says. “Just knowing I had that ready gave me peace of mind.”
He also prepaid his health insurance premium for the month of April and researched which local hospitals were in-network for his insurance.
If you do need to go to the emergency room, Ommen advises calling them before just showing up so they can give you instructions and anticipate your arrival.
And while it never hurts to be prepared, make sure you also maintain a sense of resilience and optimism. “We’re only hearing about the worst-case scenarios, not the people who feel crappy for a while and get better,” notes Vocasek. “So prepare for the worst, but don’t dwell on it.”