Symptoms: what you might expect if you get COVID

[nobody's_hero]

This is my personal comment to the RPF community on COVID19. I know there's a lot of misinformation going around, so if you don't choose to believe me that is your right. I am going to start by first apologizing for all the insults and shouting down I have done at times over the past years here. Since going into work 3 nights ago, my prioritization of concerns, especially in those of matters of politics, has absolutely been turned on its ass.

There is a fine line between creating mass hysteria and wanting people to be informed. I have not found that line.

For those who don't know what I do, I'm an ER nurse at a rural department in Georgia. It is not in the Phoebe-Putney hospital system, the one that you may have heard in the MSM as going through 6 months of supply of protective equipment in 1 week. That is not fake news. They have asked for volunteers in the community to start sewing together water-repellent covers for the N95's to extend their life (well beyond the manufacturer's instruction of single-use).

Hospitals are hesitant to release information because of concerns over HIPPA violations, but this was a story shared by a nurse in Albany where the virus hit hard (considering the area's capacity to handle it) in Georgia. I cannot speak to the community regarding the cases I have personally seen and come into contact with, but I will tell you, I have seen it myself.

This is from facebook (I know, I KNOW). I normally would not trust a post on facebook, but because this has been primarily shared nurse-to-nurse and I personally know some names of nurses involved in sharing it, and because I have personally cared for suspected COVID-19 patients, I can tell you the symptom progression is spot-on.

I am sharing this from a friends page !!’ Although I am a ER Nurse this was not me !!! But please read and heed warnings!!!

******* Albany,GA 31 yo healthy nurse who has lived thru personally being infected with Coronavirus and hopefully out of the dark******

#stayhome

COVID19 is not like the flu...at all... How do I know? Because I’ve lived through it to tell the tale!

Memoirs of a 31 y.o. male with no underlying health conditions.

March 3, 2020-Bronchitis like illness started, dry cough, no fever

March 5, 2020-Low grade fever starts, still thinking bronchitis

March 6, 2020-Fever climbs from 99.8 to 102.6 in one hour, thought it was flu and was now outside the Tamiflu window, stayed home for symptom management.

March 9, 2020-Fever of >102 continues, this isn’t flu, go to urgent care, diagnosed with pneumonia, started on Levaquin.

March 11, 2020-3 doses of Levaquin in, no improvement in symptoms, go to ER. Admitted, swabbed for COVID19, IV antibiotics got pneumonia on chest CT.

March 12, 2020-Get to a room and placed on supplemental oxygen via nasal cannula, 1 liter per minute (lpm). I’m only able to achieve 500 on my incentive spirometer, for perspective-my healthy lungs could hit 4000.

March 13, 2020-O2 saturation begins to decline, oxygen increased to 2 lpm, then 3 lpm, then 5 lpm. Oxygen saturation 88% on 5 lpm. The decision is made to use high flow (vapotherm) and move to ICU. Placed on 40 lpm and 60% oxygen. I’m terrified at this point because vapotherm is all that is standing between me and the ventilator. This is the moment I would have died at home had I not come to the hospital when I did. I would have respiratory arrested in my bed.

March 14, 2020-I have a bad coughing spell, my oxygen saturation drops to the 80’s. I’m still on 40 lpm and 60%. I’m trying to gasp for air, but because of the condition of my lungs, can only take small breaths without coughing more. I feel as though I’m about to die, my heart is racing, oxygen still low, and I’m sweating profusely. Im in respiratory distress! I pressed my call light trying to get the attention of anyone who can help. My nurse was in another room tending to another sick patient. Fortunately he sees me and comes to my room. I am now on 40 lpm and 100% oxygen, next step is the ventilator. I’m terrified. My breathing slows as my oxygen saturation slowly returns to the 90’s. I’m weaned back down to 60%. The same thing happens again in the night, and again I thought I was about to leave this world. Again I’m on 100%, this time for several hours. I’m slowly weaned again to 60%.

March 15, 2020-My morning arterial blood gas (which hurts like a ��) is normal. I get weaned to 50%.

March 16, 2020-My oxygen saturation is 97%, I’m weaned further to 30 lpm and 40%.

March 17, 2020-I’ve been in ICU 4 days, forced to use a bedpan because my oxygen saturation drops if I turn or even move too much. I am unable to clean myself; I’m feeling completely helpless and so embarrassed, but my nurses were great and very understanding. I now truly understand my patients’ feelings from all these years of nursing. I’m weaned to 25 lpm and 30%. I’m going to the medical floor.

March 18, 2020-I’m weaned to 28%. I can achieve 1500 on my incentive spirometer finally. I’m hopeful to be weaned to a regular nasal cannula. The provider comes in. I’ve been waiting for my swab results. I tested positive for COVID19...6.5 days of waiting for the outside lab to process the lab. I’m relieved because I finally have a diagnosis, a reason I’ve been so sick. I’m weaned to 4 lpm on a regular nasal cannula, 4 hours later I’m weaned to 2 lpm. 4 hours later I’m weaned to room air. My oxygen saturation stats 93% and above all night.

March 19, 2020-As I write this, I’m waiting to attempt a 6 minute walk test to see if my oxygen stays up, so I can go home. I’ve had no visitors this entire time due to my isolation precautions.

Guys, this is why social isolation is a thing. As a 31 y.o., I wasn’t supposed to get sick. I wasn’t supposed to be admitted to the hospital or the ICU for that matter. We’ve already had several deaths from COVID19 in this area. I thank God I wasn’t one of them! However, many won’t be as fortunate as I have been. Many will die, especially those with any lung or heart problems. So please, I beg you to #stayhome

Now, my personal comments resume:

I wish I could stay home. I can't. I have to report to work. I cannot "social distance" from my patients. When I go into work next shift, I am praying that there will be a fresh supply of masks at my hospital system. I am praying that I am not already infected and am just waiting for a potentially 5-day minimum incubation period before I start having my first symptoms of dry cough and fever. No government official would have to curfew or mandate that I stay at home. I would do so voluntarily. By God's grace, my parents and grandparents (mostly my grandparents) taught me the importance of saving my money and due to the fact that I'm not married and essentially have no life, I hope I am set to weather this financially. As burned out as I am on nursing, I am happy to at least have job security.

This virus has a low mortality rate. That is true. However, that is also considering that resources are there to treat all of these patients. The USA, in spite of our healthcare system's flaws (aside: in my personal opinion, caused by crippling administration costs, not a flaw in capitalism but rather an attempt to jump through regulatory hoops), is much better equipped than some of the countries with much higher mortality rates. However, whether you die from this or not, YOU DO NOT WANT TO CATCH IT.

So please, RPF community members, this is not time to visit grandpa or grandma unless absolutely necessary. If you have family members who are immunocompromised with health conditions, same thing. If you are the primary caregiver of such a person, PLEASE PLEASE PLEASE make sure you are washing your hands and taking necessary precautions before touching them. This virus can exist in your system at a minimum of 3-5 days before you show your first symptoms. And that's not me trying to incite panic, that's just good hygiene practice.

[luctor-et-emergo]

Thank you and take care. You're everybody's hero now . Will keep you in my thoughts.

[nobody's_hero]

Thank you and take care. You're everybody's hero now . Will keep you in my thoughts.

My hero is some 12 year old kid making N-95s in India.

[dokkie]

Thanks for the post. I have been sorta dismissive of the virus but I am expressing some symptoms now. Sore throat, chills. Temp is 97.4 but I am having the feeling like I am about to have the flu.

I need to get tested for the flu before I can get back to work. I am scared right now

[Todd]

Thank u for the insight. I personally have not been taking it as seriously as I should. I don’t think this is a good time to be a rebel. When I went to the store today and saw a third of the people with masks and gloves I realize how much fear there is when people have to go out immediately went home felt dirty and washed my hands and told my daughter to do the same. I think you’re the first person on here who have actually heard it first hand account of the seriousness of it. Sometime you Just don’t know what to believe anymore

[Working Poor]

About 2 months ago I had a slight sore throat and a little coughing in morning for 2 days. I did not have a fever but I though it was probably an allergic reaction to something in the air.

I don't know if it had anything to do with Corona or not. During flu season I take colloidal silver everyday and spray my hands a face with it before and after entering any public place. I have also started taking vitamin C and D just to give myself more protection.

All my grandparents and parents are all passed away. Most of my friends are all in my age group(60+) we have stopped our poker games on the weekend. We call eachother on the phone. I am also staying away from my grandchildren one of them had some kind of cold( she was tested and it came back negative for virus) we have just decided it would be best for me to not be around them at this time.

[nobody's_hero]

One thing that makes the situation tricky is that it is prime pollen season across the southern USA. My car is supposed to be charcoal. It is yellow. My porch is yellow. My dog is yellow. Actually I don't have a dog it's just a pile of pollen on my porch that kind of looks like a dog (throwing in a joke). People might mistake pollen allergy symptoms for early onset COVID and the last thing you want to do is show up to an ER if you are only having allergies because honestly if you don't have a reason to be in an ER, you don't want to be there. Hospitals and health departments have set up hotlines that you can simply call from home and be directed on what to do from there. Please utilize them if you are concerned, before just showing up to an ER.

Another thing you should probably expect is that you may not be tested for COVID right away if you are only showing a few symptoms. You might be tested to rule-out the flu and they will make decisions from there. Follow the instructions for your area with regard to where to be tested if you call a hotline and they ask you to do so.

The turn-around time for testing in my area is about 6 days. Hopefully it will be shortened. Needless to say that high-risk patients who actually have COVID 19 are so symptomatic by then, that they're already being treated for it, so the testing is kind of moot other than for tracking contacts and quarantines (and for the media to pummel you all day long with how many new cases have arisen). In other words, I would not be freaking out about the lack of test kits available. I would be concerned enough to sanitize my hands before and after using a gas pump, for example. That person in front of you who just filled his tank might not be so considerate. I'm keeping a small bottle of sanitizer in my vehicle right now just for that purpose.

As for those of you who are concerned you might be experiencing symptoms, I am going to make NO attempt to try to diagnose you over the internet. No hard feelings, I'm just a nurse, and when you start speculating on what you might have, it only creates more uncertainty and anxiety. Also, please do not go to Dr. Google to try to find out what is going on. Dr. Google always assumes the worst.

[nobody's_hero]

For those feeling anxious, keep in mind that the best thing you can do right NOW to stamp out the spread of this virus is to practice good hand hygiene. At least 20 seconds with soap under running water, scrubbing between fingers and under nails (ladies just go ahead and trim them shorter, they'll grow back), and cover your coughs with the elbow bend of your shirt (better if you have a mask to wear while around others but those are becoming hard to find). If soap/water aren't available then use sanitizer. You don't need 100gallon stockpile, just make sure you put enough on your hands to be able to rub the entire surface of your hands with it.

Prevention really is quite simple for the general public. The hard part is getting everyone to do it.

The bright side:

Family matters. I know this can't go on indefinitely, but I absolutely love the fact that parents are getting to spend more time with the kids. I love that the schools have shut down and parents get to take an active role in their kids' education (and some are really having a lot of fun with it). I love the idea of family members eating meals at the table. I know it sucks for those in financial hardship right now, but even through hardships, family matters.

Makes me feel like MURICA!

[RJB]

I am not panicking nor am I even worried, but I am taking it seriously as far as taking precautions.

[Anti Federalist]

I said it in the other thread, but I'll say it again here.

Thank you for your service.

[nobody's_hero]

updated my post to reflect that the incubation period is about a 5 day minimum, up to 14 days. Didn't want to mislead people. The point is that as healthcare workers we worry that our increased potential for exposure means we might be bringing this stuff home in spite of our efforts and we can be carrying it around for a while and that's EVERY time we come into contact with a patient.

Anyway, got a phone call. Off to work. Stay safe and wash your hands.

[Todd]

updated my post to reflect that the incubation period is about a 5 day minimum, up to 14 days. Didn't want to mislead people. The point is that as healthcare workers we worry that our increased potential for exposure means we might be bringing this stuff home in spite of our efforts and we can be carrying it around for a while and that's EVERY time we come into contact with a patient.

Anyway, got a phone call. Off to work. Stay safe and wash your hands.

Rumor has it they may quarantine hospital workers who have close proximity to those patients with symptoms to the work site and not allow them to leave for extended periods. Have no idea how they plan to have them shower/change of clothes. Not hard to eat at the staff cafeteria I guess. Any of that true?

[nobody's_hero]

Rumor has it they may quarantine hospital workers who have close proximity to those patients with symptoms to the work site and not allow them to leave for extended periods. Have no idea how they plan to have them shower/change of clothes. Not hard to eat at the staff cafeteria I guess. Any of that true?

I try to avoid rumors. I can't confirm that.

Every healthcare system in the country seems to be handling the outbreaks differently and there seems to be no absolutely no coordination or communication at all.

All I know is my tiny hospital has 3 ventilators on hand. That's it.

We are so unprepared/unable to handle it and no one is taking it seriously. I guess people will finally get it when they show up to the hospital and are told their diabetic/CHF mom or dad needs to be put on a vent but there's not one available so we're sending them to palliative care.

As of yet we have not been told at my hospital to expect extra shifts or mandates. Places like NYC or LA may be an entirely different story. I don't know. I don't work there.

It's not that hard to look at Spain or Italy and see that this isn't just some made-up overblown BS but oh well. People here believe what they want to believe. Put on a peroxide nebulizer and spray the sh!t everywhere for all I care. (worst thing you can do honestly)

Sorry. I'm tired.

[dannno]

I try to avoid rumors. I can't confirm that.

Every healthcare system in the country seems to be handling the outbreaks differently and there seems to be no absolutely no coordination or communication at all.

All I know is my tiny hospital has 3 ventilators on hand. That's it.

We are so unprepared/unable to handle it and no one is taking it seriously. I guess people will finally get it when they show up to the hospital and are told their diabetic/CHF mom or dad needs to be put on a vent but there's not one available so we're sending them to palliative care.

As of yet we have not been told at my hospital to expect extra shifts or mandates. Places like NYC or LA may be an entirely different story. I don't know. I don't work there.

It's not that hard to look at Spain or Italy and see that this isn't just some made-up overblown BS but oh well. People here believe what they want to believe. Put on a peroxide nebulizer and spray the sh!t everywhere for all I care. (worst thing you can do honestly)

Sorry. I'm tired.

I think they have figured out a way to use the general anesthesia dispensing machines as ventilators for emergencies, the FDA may have even approved the use.

They also figured out a way to turn one ventilator into up to 9 in emergencies.

[nobody's_hero]

I think they have figured out a way to use the general anesthesia dispensing machines as ventilators for emergencies, the FDA may have even approved the use.

They also figured out a way to turn one ventilator into up to 9 in emergencies.

If they can figure out how to split one nurse into 4 I'll be really impressed. Morale is pretty low among nurses as it is because coworkers they know are dying without adequate protective equipment. I've been using the same mask for the past 3 shifts and I don't know if it is even effective anymore. They're supposed to be single-use.

It really sucks to be trying to fight a losing battle and outside the hospital walls people are wiping their boogers all over each other and getting furious when government tells them they can stop or go under lockdown.

[dannno]

If they can figure out how to split one nurse into 4 I'll be really impressed. Morale is pretty low among nurses as it is because coworkers they know are dying without adequate protective equipment. I've been using the same mask for the past 3 shifts and I don't know if it is even effective anymore. They're supposed to be single-use.

It really sucks to be trying to fight a losing battle and outside the hospital walls people are wiping their boogers all over each other and getting furious when government tells them they can stop or go under lockdown.

How many serious cases of COVID-19 is your hospital treating?

Right now there's only 2,112 serious cases in the whole US. I think there's more hospitals than that?

[Okie RP fan]

Good thread, thanks OP.

[nobody's_hero]

How many serious cases of COVID-19 is your hospital treating?

Right now there's only 2,112 serious cases in the whole US. I think there's more hospitals than that?

It's not a matter of "how many serious cases" there are. It's about hospitals reaching capacity and after that point it becomes un-manageable. That's when you see a spike in deaths. We have 3 ventilators and only a handful of staff at my hospital. (We're rural, but it's still spreading—unfortunately it's believed it spread rapidly at first through church gatherings). That means we can reasonably treat 3 people at a time with acute respiratory distress syndrome (ARDS). That means once we hit capacity, everyone who comes in after that has a drastically increased chance of dying because there just aren't resources to perform proper interventions. We're seeing it in Italy, Spain, and soon France. I don't even think we could obtain enough sedation agents to keep people under while they're intubated, even if we did find a way to increase the number of patients who could be hooked up to one ventilator.

Keep in mind during this time you still have other emergencies requiring intubation and ventilators, not just COVID-19. I seriously doubt they're going to even attempt to track the number of people who will be affected indirectly by this. No one's even thinking about that angle.

I'm gonna be taking a break from Ron Paul Forums for a while. I recently had a check up with my doctor and my TSH is through the roof, which I attribute to 7 years straight of nightshift and stress. I feel like I've done the best I can to try to inform people on this but I'm going to focus my efforts more locally. Our hospital administration is doing absolutely nothing to try to educate and inform the public and they've been reactive instead of proactive since the onset. They are failing miserably. The only people speaking out on this are nurses and doctors and honestly healthcare wouldn't be in this mess if we had left it between doctors and patients to begin with.

[Anti Federalist]

Be nice if he could update us.

[Anti Globalist]

Thank you for your service.

[nobody's_hero]

Be nice if he could update us.

Don't know what I should say. As mentioned before, people will believe what they want to believe.

Much of what I would say is anecdotal anyway.

I haven't really been following statistics, politics, social media, or conspiracies. Just trying to figure this virus out has been enough to keep nurses, doctors, and respiratory therapists occupied enough. ANYONE who tells you they have all the answers if full of @^*#. I certainly don't have the energy to argue. I'm not at all surprised that it got politicized. —Disappointed but not surprised. I don't really see it as a battle cry for freedom but I'm not oblivious to the impact on the economy, so I keep my mouth shut and stay out of those arguments. Guess ultimately we'll just see what happens.

a few thoughts from what I've seen over the past 6 weeks.:

#1) Doctors get to be doctors. Almost every diagnosis has a well-established set of steps and procedures that must be followed to treat patients. Doctors are not trained to be doctors anymore, they are trained to follow practices and protocols. If a, then do x .Much of the protocols come from the guys up top as a way to ensure the hospitals get reimbursed from medicare/Medicaid for the services they perform. But seeing as this virus is new, doctors actually get to use critical thinking and their understanding of the human body to (try to) successfully treat patients. There's not yet an establishied "right" way to treat COVID, it seems. There are lots of "wrong" ways but it serves as a humbling reminder that medicine is not an exact science.

#2a) I'm sick of being called a hero. I don't feel like a hero, unless heroes are meant to be expendable, in which case I fit the bill. We're still reusing protective equipment that's meant to be disposable and making our own gowns. Right now you'd probably think I was the most bitter hero in the history of heroes. I just came off a 12 hour shift wearing an N-95 that was a bit too small but beggars can't be choosers and you use what you're given. At least the seal was tight. Really tight. My face looks like I just tried to break up a fight between two bouncers at a bar. Normally I work in the emergency department but last night I was pulled to one of the dedicated COVID units and I will tell you that I have no idea how those nurses do it every time they work. In the ER we're only suiting up when a patient has to be intubated and there's a reasonable risk of spreading droplets, then we hand them off to someone else and it becomes their problem for the rest of their shift. Those nurses on COVID floor are taking care of confirmed positive patients and are supposed to wear the equipment all the time when in the room.

#2b) We're being offered incentive pay for caring for COVID patients. I don't want incentive pay. I want proper gear. Incentive pay does me no good if I'm dead.

#3) The tests are unreliable. Certainly not reliable enough to follow trends. The media has waaaay over-hyped the importance of it, and I said from the beginning that it doesn't really matter what is causing the respiratory distress. COVID or not, the goal is to get the patient out of distress and have a manageable airway. I want to say the occurrence of false negatives is high. I would assume if there are false negatives there are also false positives, but I've seen more than a few patients with severe ARDS who are negative for COVID when tested. They're also negative for flu, and sputum cultures aren't turning up anything bacterial. Now, I don't know what else is going around that can cause a patient to rapidly develop bilateral pneumonia, but either (a) we're tracking the wrong germ or (b) the tests are just unreliable. I think the tests are unreliable. The flu test has a certain window of days after onset where you must test for it, and outside that window the test may come back as a false negative. We don't really know what that window is for COVID. So we've got these patients who die of pneumonia-unspecified. The doctors make the call based on common symptoms and other substantiated findings (elevated liver enzymes, ground-glass opacities of the lungs on CT, elevated cardiac enzymes). If the doctors ultimately have enough cause to determine it's COVID, I would trust them more than a Q-tip with boogers on it. The sad part is that the families want answers and we have none to give. What really sucks is that they aren't allowed at the bedside for their loved one's final moments. Thank God that as of yet I've not had to make one of those phone calls.

#4) It's a very humbling experience to know that you really don't know jack about what you're dealing with. We don't know what makes a 95 year old pull through despite all odds, and a 29 year old essentially healthy young-adult get wiped out in 48 hours. Exceptions to the rule, I guess. I've heard the theories that certain blood types may be more affected. Maybe it's genetics. Who knows. I'm curious to learn more about it but right now there's so much conflicting information being spread around about the virus that it's utterly useless to try to learn only from literature at this stage.

#5) Census is down in a lot of specialties. We've got OR nurses floating in departments because there's nothing else for them to do. I guess it's the last step before layoffs. It's definitely a bad time to have one of those sweet, office nursing jobs. The retirement process for those who qualify has been expedited. Used to be you had to give 90-days notice. Now you could probably just call up out of the blue, tell them you're retiring, and they'll send you an engraved plaque in the mail thanking you for your years of service and a buh-bye now.

#6) As for where we go from here, I'm keeping my mouth shut. I have no suggestions for extending quarantines or reopening. I think no one really knows what will happen if we act a certain way, or what would have happened if we'd done something differently. I'm not bold enough to develop strong opinions on it, but I will say that if it gets to a point where I feel like I'm trying to bail water out of a leaky boat while other people are dumping it in, well, someone else can take over this job.