The influenza ward of the U.S. Naval Hospital on Mare Island, California, 1918

The influenza ward of the U.S. Naval Hospital on Mare Island, California, 1918 Navy file photo

What Will You Do If You Start Coughing?

“Stay home” is not a sufficient plan.

COVID-19 is not the flu. We have a vaccine for the flu. We have anti-viral medications designed to treat the flu. We have a sense of what to expect when we catch the flu, and when it’s necessary to seek medical attention. Doctors have experience treating the flu, and tests to help diagnose the flu, right there in the office, while you wait.

Against the new disease, we have none of this. This coronavirus is unknown to our species. Once it breaks into one of our cells, the extent of its spread through the body seems to vary significantly. The experience can slowly progress from the familiar—cough, congestion, fever—to a life-threatening inflammatory response as the virus spreads down into the lungs, filling the airways with fluid. Survivors can have permanent scarring in the lungs. The virus can also spread into other organs, causing liver damage or gastrointestinal disease. These effects can play out over longer periods than in the flu, sometimes waxing and waning. Some patients have begun to feel better, then fallen critically ill. The disease can be fatal despite receiving optimal medical care.

None of this is meant to cause panic. Panic is not useful. But as we all begin to comprehend the nature and extent of the new virus and its spread, questions should arise about what to do with those early, familiar symptoms. At what point should you ask for testing? When do you need to self-quarantine, and for how long? Who needs to be in a hospital, and who can ride things out at home? If you’re sick, should you bring your illness into a crowded clinic or emergency department, possibly shedding virus that infects others? Should you stay home, maybe using telemedicine, and risk infecting roommates or family members?