While we’re isolating ourselves to avoid exposure to the coronavirus, there are several inexpensive gadgets that can help us identify early symptoms of the disease. One involves recent findings about a drop in oxygen levels before more noticeable symptoms develop, and the other relates to elevated temperatures as an early indicator.
A New Hampshire emergency room doctor, Dr. Richard Levitan, reported on his surprising observations after volunteering to help treat coronavirus patients in New York City. He wrote a New York Times op-ed, and appeared on CBS Morning News with Gayle King to explain. Here’s a part of that interview:
Dr. Richard Levitan: People were sick for days, and then they only came in with shortness of breath, like, the day they presented. … And they would arrive with oxygen levels that basically were incredible to us. I mean, almost unimaginable how people could be awake and alert and have oxygen levels that are half normal. … Normally we are 94% to 100% on these devices, these pulse oximeters that measure how much oxygen we have in our blood. And people were showing up with oxygen levels of 50%. Now, this matches the level of oxygen that we’ve measured on the summit of Mt. Everest. And it’s amazing to me that patients could be sick for days, getting sicker, not realizing it.
Gayle King: So they had these very low oxygen levels, but they had no sensation of, “I can’t breathe.” Is that the point you’re making?
Levitan: Yeah. Exactly.
King: You were surprised that some of them were still talking on cellphones. Why is that significant?
Levitan: You know, what is amazing to me with this disease is people’s brains are working fine. … Their oxygen levels have gone down to scary low levels, but it has happened slow enough that their body has accommodated. So they are not like every other patient we see with serious lung disease … What I’m saying is this disease kills by silent hypoxia, and patients should understand that shortness of breath is a late sign.
King: Hypoxia is what, exactly?
Levitan: Low oxygen.
King: And the reason why it’s so important to get this early warning is because it could avoid you being on a ventilator and having to be intubated, right?
Levitan: Absolutely. So, you know, we think this pneumonia basically has two phases. … This silent hypoxia period, where the oxygen’s drifting down, but you feel okay. And then the second part of this disease, the part of this disease that kills, is when all of a sudden your lungs get stiff, carbon dioxide finally starts to build up, you begin to feel short of breath, and those patients are the patients who are presenting with COVID pneumonia.
King: By then, in some cases, it’s too late. By the time you go to the hospital and you can’t breathe, it’s a very serious, often dire situation.
Levitan: Yeah, but let me just reassure people that what the lessons learned in New York are, are that we don’t have to put in breathing tubes, even in most of the people who show up with advanced COVID pneumonia.
King: We don’t?
Levitan: No. … They did a study of 50 patients, and what we learned is that even people who showed up with significant COVID pneumonia, we could keep off of ventilators three out of four of them. So 75% of patients didn’t need ventilators. But they needed oxygen. They needed to do what we call positioning maneuvers. So we put them in different positions to help open up areas of their lungs.
King: How do you know, Dr. Levitan, when you should even check your oxygen levels?
Levitan: Let’s talk about Germany. The Germans have the lowest death rates in Europe. What they do is every patient who has COVID, they visit every day and they check their oxygen and they check their vital signs. And so, what I’m saying to you is if you’re having symptoms of viral illness, if you’re known to have COVID, you should be checking your oxygen. … If you don’t have an oximeter, increased breathing may be a sign of that, but also just feeling worse.
King: I think most people listening to you will now think, “I need to get an oximeter.” Can you explain exactly what that is and how it works?
Levitan: Basically, you know, you just turn this little button on, and you put it on your finger, and within about 10 seconds or so, it displays your heart rate and your oxygen level. … I think that oximeters in the midst of a respiratory pandemic, and for the next 12 to 24 months, that the public should think of an oximeter the way they do a thermometer. … It is a tool that they can have at their home that they can check, and that they can call up their doctor and say, “Hey, my pulse oximeter is reading consistently at this number. Is that something I need to be concerned about?”
King: I think every day we’re learning something new about this COVID-19, and it seems to be such a moving target, always changing.
Levitan: What I’m telling you is actually hopeful. What we are learning about this disease is it attacks primarily through one pathway, and that’s the lungs. We know when it is going to attack. It is going to attack between five to 10 days after infection. … And we know we have a way to detect it earlier, and that way is by close monitoring of pulse oximetry. … And what I’m saying to you is that as the public health messaging shifts, … we can move the treatment curve earlier and do much better for patients.
Pulse Oximeters are available from Amazon for about $60-$80. Here’s is a link to a page of listings.
The CDC recommends to those that may have been exposed to others with the virus to take their temperature twice a day as part of their self-quarantine and monitoring. An elevated temperature can be a symptom of a virus. It’s an important element of the CDC recommendations:
- Stay home until 14 days after arrival and maintain a distance of at least 6 feet (2 meters) from others
- Self-monitor for symptoms
- Check temperature twice a day
- Watch for fever, cough, shortness of breath
- Avoid contact with people at higher risk for severe illness (unless they live in the same home and had same exposure)
- Follow CDC guidance if symptoms develop
As travelers, we’ve encountered temperature monitoring numerous times when we come into a country or pass through an airport. So if you’re sitting home during quarantine, it wouldn’t hurt to take your temperature a couple of times a day. And with one product, you’ll also be contributing to generating a health map of the country. While there are numerous digital thermometers available, you may want to consider a one being sold by Kinsa Health.
Kinsa took an ordinary digital thermometer and combined it with an app that lets us monitor our temperature and to anonymously share our results, along with millions of others, to map the country for areas of elevated temperatures. So while we take our own temperature, we help medical professionals predict where coronavirus is on the rise. The Kinsa digital thermometer connects to our smart phone over Bluetooth and records our temperatures on the phone. The thermometer costs $35 and is available from their website. There’s apparently a high demand for their devices, and it took about three weeks for my order to be fulfilled.
If nothing else, checking our temperature and oxygen levels each day provide some of the earliest indications of the virus, along with peace of mind. And who doesn’t need a some that during these times?