COVID-19: Know when to seek medical attention August 5, 2020

04 AUGUST 2020

The Critical Care Society of Southern Africa, representing health professionals working with the critically ill in ICUs around the country, are concerned that many people suffering from COVID-19 are seeking medical attention too late, thereby making effective treatment more difficult and undermining their chance of recovery.  The Society stresses that timeous medical treatment can prevent the need for admission to ICU and being placed on a ventilator.

The Society warns that people older than 65, and those with certain underlying health conditions, such as hypertension, diabetes, obesity, HIV, asthma or chronic obstructive pulmonary disease, are at a higher risk of serious complications and death from COVID-19 and therefore should be aware of the danger signs and seek medical attention at a stage in the disease where treatment may be most effective.

Most people who become infected with the coronavirus will only experience mild symptoms. About 85% of people with the disease will recover without ever needing hospitalisation. These people should stay home so as not to infect others, and to preserve scarce hospital resources.

However, for those who do need to be hospitalised, making the right decision about when to seek help can mean the difference between life and death.

Doctors and scientists have learnt that COVID-19 progresses in three phases. The first phase includes the incubation period – in which the virus begins to multiply within the body but does not yet cause severe symptoms. Patients in this phase may experience minor symptoms that will likely feel like a cold or mild flu. No treatment is required in this phase.

The second phase is known as the pulmonary phase, because this is when symptoms shift from the upper respiratory systems (nose and throat) to the lungs. If the disease progresses to this phase, the patient will start to experience a tight chest, coughing and shortness of breath. In this phase the patient’s blood oxygen levels can become dangerously low. In addition, some people develop blood clots which can lead to a stroke.

While this is not the most dangerous phase of the disease, it is the phase where treatment may be most effective. If the patient progresses to Phase 3 of the disease their risk of death becomes much higher.

In Phase 3, the body’s inflammatory response may begin to injure vital organs such as the heart and kidneys. Many patients who reach this phase will need to be put on ventilation, meaning that their breathing is mechanically supported by machines. Treating patients in this phase is very difficult, because the damage done to the organs is often irreversible.

In light of the serious dangers of Phase 3 of COVID-19, the Critical Care Society is advising COVID-19 patients with underlying health conditions to seek help during Phase 2, when there is still time to prevent irreversible damage.

To assist you to know the right time to seek help, make sure you monitor your symptoms. Feel for a fever or if you have a thermometer, take your temperature twice a day to check whether you have a fever.  A fever is considered to be a temperature of over 38°C. If you have access to a pulse oximeter, check your oxygen saturation (SATS) levels.  Normal levels can vary, depending on factors such as altitude, but if your level drops to below 94% – 92% it could mean that your COVID is affecting your lungs and you are advised to consult your doctor or clinic.

Make a note of any other symptoms and look out for the following warning signs: difficulty breathing, pain or pressure in the chest, confusion, trouble staying awake or waking up, and a bluish tinge to the lips or face. If you notice any of these symptoms call your doctor or visit your nearest clinic.

You should also look out for the symptoms of a stroke, which include a drooping face, weakness in the arms or hands, and slurred speech. If you notice any of these symptoms, call an ambulance or go directly to hospital.

While there is still a lot that we don’t know about COVID-19, what we do know is that seeking medical attention at the right time saves critical healthcare resources and lives.



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