It was 3 a.m. and I was lying in bed listening to ambulance sirens. Nighttime is usually quiet in my Brooklyn neighborhood, but not in recent weeks.
Wrapped like a burrito in my heavy comforter with another blanket draped over me, I was still cold. The thermometer hadn’t strayed from 101.2° Fahrenheit since 11 p.m., which was when I arranged myself in bed in this position, staying very still. My head was throbbing as if I were suspended upside down in the air, and my chest was heavy. It felt like something could explode internally if I breathed in too deeply.
Also, I was alone.
That’s usually not a problem for me. But then, on the seventh day of my COVID-19 quarantine, it was scary as hell.
Earlier that evening, I forced myself to eat two slices of pizza that I ordered through no-contact delivery because I couldn’t muster the energy to scramble eggs and put bread in the toaster. I never showered or changed out of my pajamas because I didn’t have anything clean left that I could wear.
Usually, I’m good at self-care. I floss, make healthy food to fill my freezer, exfoliate once a week. But being sick with COVID-19 requires next-level self-care. For the roughly 36 million Americans like me who live in single-person households, knowing what to do—and when—is critical.
Thankfully, I managed to come through to the other side of what my doctor describes as a mild-to-moderate case of COVID-19 without any visits to the hospital or complications. Since I recovered, I have been thinking a lot about what I did right and what I could have done differently to make those days alone more manageable.
I hope you don’t get sick with the coronavirus, but here are my tips for how to prepare and cope if you do.
Accept that you’re sick
Remember, most people who get this virus have mild symptoms and don’t require hospitalization. However, you should keep in mind that your risk for hospitalization and severe illness increases with age and if you have any preexisting health issues. At the beginning of your illness, the symptoms are most likely to be manageable at home, so do not leave until you speak with a doctor—even if you’re equipped with a mask and gloves. You’re sick and there’s not much you can do about it, so now you need to get better and avoid exposing other people.
Contact your doctor
This isn’t the time to consult Dr. Google. You need a doctor who’s able to practice telemedicine. In fact, if you don’t have a primary care physician, it would be a good idea to establish care with one now (even if you’re well) so you’ll know who to call in case you do get sick. I reached out to my doctor, Dr. Lalita Abhyankar, a family physician at the Institute for Family Health, who put me on her calendar immediately. We had three video visits and exchanged a handful of emails through the clinic’s secured system during my illness.
Regardless of whether or not you can get tested (right now, the U.S. Centers for Disease Control and Prevention’s guidance prioritizes testing for essential workers and patients who are older or have preexisting conditions), you need a clinician who can follow your illness for two weeks to make sure you’re getting better.
Helpfully, most medical centers in the country have set up telemedicine urgent care specifically for suspected and confirmed COVID-19 patients, and many practices have shifted to virtual care.
Reach out to three friends or family members
Immediately contacting people I know and trust not only alerted them to the need to check in and look out for me, but it also helped me admit to myself that I was sick and needed to stay put. Choose people who live nearby and, if needed, could bring food or supplies to leave at your door. But also select people you know would be willing to keep their phones on at night for an emergency call if your health declines. Ask them for their support and assure them that you will keep them posted if they’re needed.
Know the most likely COVID-19 timeline
There are so many degrees of illness severity and a wide range of symptoms. However, preliminary clinical research is starting to identify a common trajectory of the illness.
“The first seven days are kind of key. It’s on day seven or eight that you end up feeling really bad,” Dr. Abhyankar told me. “Day seven or day eight is when people who have more severe illness tend to deteriorate.” She added that on day three or four the fevers tend to break, but the shortness of breath sets in later, usually by day eight.
Knowing this timeline may prevent you from overexerting yourself on the days that you feel better but may not be well enough to resume normal activity. It will also help you prioritize things that you need to get done in a short window of time to prepare yourself for potentially being sicker a few days later.
After your initial bout of symptoms, when you are feeling slightly better—possibly around day three or four—think about what you need. This might be clean pajamas (hand wash some in your bathtub or sink if you don’t have a washer-dryer in your home), groceries (get a delivery right away) or prepared meals (make a pot of soup that you can eat all week). Whatever it is, take care of it while you feel up to it.
Consider reaching out to your specialist
If you see a doctor regularly for a preexisting condition—asthma and a different respiratory condition, heart disease, high blood pressure, diabetes, mental health issues or a neurological or autoimmune disorder—it may be helpful to be in touch, especially if your symptoms are worsening. Like all viruses, COVID-19 is a systemic illness and specialists are working hard to understand how the virus affects the patient population they treat. They may be able to provide you with very specific information on what to look out for or help you monitor your health. Also, do not start or stop taking any medications for your preexisting condition without first contacting your specialist.
In my own case, I have temporal lobe epilepsy that is typically well-controlled. I started to notice a constellation of neurological symptoms that in the past have either preceded or occurred after I had a seizure, so I was concerned. We’re still learning how the virus affects the central nervous system, but in me, it appeared to make an impact. The neurologist I have seen for years ended up prescribing me a small dose of clonazepam, which he’s prescribed to me at other points in time. It helped me sleep and possibly provided some additional seizure protection. Every case is unique and a specialist who knows you knows this, too.
Have faith in telemedicine
While a doctor can’t check your blood pressure by video, she can ask you to show her where you have pain when you breathe, check if you have labored breathing after completing sentences and just generally see if you look unwell. And more advanced telemedicine programs are even cropping up that provide other ways to monitor the illness.
Mount Sinai Health System in New York City recently created Precision Recovery, a remote patient monitoring program where patients report their symptoms every day and doctors reach out if needed. The medical center will also deliver a pulse oximeter, a device that measures heart rate and blood oxygen saturation, to high-risk patients. It’s a way to evaluate lung function (the device also isn’t a bad investment for everyone to keep at home, though they’re increasingly hard to find online right now due to high demand).
“You don’t want to take the responsibility of deciding for yourself if you need to go into the hospital,” says Dr. Christopher Kellner, co-director of Precision Recovery at Mount Sinai and a neurosurgeon. “You initiate a video visit when you have symptoms that you’re worried about and you set criteria with a doctor for when you’re going to contact them again or criteria for going into the emergency room.”
Keep essentials at your bedside
For me, that included a big bottle of acetaminophen recommended by my doctor (I took 1,000 mg every six to eight hours to keep my fever down, which she said would prevent dehydration), a box of tissues, a small trash can, thermometer, hand cream, petroleum-based moisturizer, phone and laptop with chargers, a plastic cup and a large insulated water bottle filled with water so my trips to the kitchen could be less frequent. Having all these things within arm’s reach helped me stay put and prioritize rest when I needed it most.
Shower
Warm water and steam can temporarily ease many COVID-19 symptoms, but for your safety, it’s important that you take precautions before getting in the shower. You do not want to slip and fall. A shower mat can help. If you don’t have one, consider sitting in your shower or simply taking a bath, and always keep your phone nearby. But don’t do any of this if you feel wobbly or dizzy when you get out of bed.
Remember that 14 is an arbitrary number
We still don’t know for certain how long a recovered person can potentially transmit the virus. Some experts suspect that people continue to shed the virus for another week or two after an acute illness. More research needs to be done. With that in mind, try to limit the time you spend outside immediately after your two-week isolation and always wear a mask and gloves.
Out of an abundance of caution, I avoided crowded places—especially those indoors like supermarkets—the week after my isolation. I took a few socially distant walks, but not until I felt close to completely better and that was on day 17. Just take it slow.