Jason started feeling sick. Not “COVID-19 sick” he wrote, but definitely sick. Though his presenting symptoms were not the classic myalgia/sore throat/cough, I told him what I’m telling everybody:

Assume it’s COVID-19.

Don’t Panic, is the first and hardest instruction to follow. But yesterday Jason earned an A+ in Coronavirus 101: What To Do When You Get Sick During a Pandemic. Jason realized he did not need medical attention, and stayed home. Jason knew COVID-19 testing was not necessary because even if he tested positive, there are no medicines to treat coronavirus (though new ones are being tested in a controlled, scientific way)… so he stayed home. Also, Jason’s COVID-19 status wouldn’t alter his behavior because he was already self-isolating, by staying home.

Social media is bursting with criticism: “I went to/called the doctor with xyz symptoms and risky exposures, AND THEY REFUSED TO TEST ME.” Angry, scared, and looking for people to blame, test-seekers are also unwittingly lowering the confidence we need to have AND SHOULD HAVE in our front line medical staff. And while they are out in the world attempting to tap limited resources unnecessarily, they’re potentially spreading COVID-19 or other pathogens. I’m going to repeat this a million times:

COVID-19 TESTING IS NOT MEDICAL CARE.

And this:

If you aren’t sick enough to consult a doctor or need the ER, you need to stay home.

This is Day 8 for Lees on Lockdown. We’re not protecting ourselves so much as shielding other people. Bernie was in and out of the hospital until Monday, so we’re assuming all four of us have been exposed and could be shedding virus with no symptoms. Does this mean after 2 weeks of isolation we can start sneaking in short visits with people who promise they have been at home, where no one is symptomatic, and everyone promises to wash their hands?

No. Nope. Not yet. No.

The most common text message in my phone right now is asking how long will this go on. And friends, there are no answers for this. We only have mathematical models, daunting statistics, and sobering graphs from experts who predict a more immediate crisis before any possibility of returning to a world where there is lots of toilet paper. But China reported no new local cases yesterday, and I’m clinging to that. Can you envision a cascade of mini celebrations as each city in the US begins reporting 14 straight days with zero positive tests? We’ll get there.

If you stay home.

This t-shirt exists, and I want it.

In a day or two, nearly all of us will have a version of this story, and this is just one example of many that I’ve gotten within the last 12 hours:

So, my wife went to Starbucks with Beka yesterday… and Beka called this morning to say she has a fever and there is a woman in Beka’s lab who is self-quarantined because her husband was in Spain for a conference in February and he’s sick. Should I be worried?

By St. Patrick’s Day, this story will be met with, “She went to STARBUCKS?” incredulity. But right now, and in the next couple of days, all of us will have a similar risk to assess as the friend of a friend of a friend that was exposed gets closer. Here is my take home message if you read no further: you are most likely going to be absolutely ok.

I write about COVID-19 yet again because my phone is on fire, because the high schoolers I spoke to yesterday were absolutely starving for information, and because you guys are reading and sharing. Many of you are leaders of organizations in your own spheres and I APPLAUD YOU for taking action early to cancel events that put us within 6 feet of each other. Your caution is helping to #flattenthecurve and will ultimately conserve resources if not save lives. By now you’ve seen that awesome graphic showing how even if we don’t prevent a single infection, by merely stretching out the rate at which that happens, fewer people die.

Here around Boston, schools are beginning to close. Unfortunately, not all of them yet, but let’s try to be kind while everyone gets on the same page. There is so much conflicting information circulating, new and alarming data hourly, and our own very human fear and skepticism to overcome. By now, I hope most of us are being mindful of how risky that Starbucks stop could be, but even the most vigilant of us will have a “Beka story” soon.

So you think you could have coronavirus… what do you do? Here is what the large medical centers are recommending right now:

Don’t panic. 80% of infected patients experience a mild or moderate course that requires NO medical treatment.

If you have no symptoms, there is nothing to do but self-isolate. Most people show symptoms within 5 days, but during that “incubation period,” if you have been infected, you are contagious even though you feel fine. THIS IS WHY WE’RE CANCELING EVERYTHING RIGHT NOW. If you think your exposure is especially risky (e.g., your college student home from abroad is feverish and coughing) you have an even bigger responsibility to self-isolate. Some patients have not reported symptoms for up to 2 weeks, which is why these “mandatory quarantines” are for 14 days.

IF YOU GET SYMPTOMS, COVID-19 looks like this: tickly throat progressing to sore throat, low grade fever, body aches, and all of those things that make you say, “ugh, I’m definitely coming down with something.” Abdominal pain, diarrhea, nausea, and vomiting are also being reported. Sneezing, runny nose, and postnasal drip is NOT how COVID-19 presents.

IF YOU HAVE COVID-19, symptoms could escalate to a persistent, dry cough and high fever. Testing kits are still not universally available and providers are hamstrung by strict criteria that indicate their use. But you don’t need it. You can call any number of hotlines if you have questions, but remember that 80% of the time, COVID-19 will run its course and you will get better within two weeks. The recommendation is that you STAY HOME and treat with Tylenol, lots of fluid and rest, hot showers to help with cough, and limiting contact with housemates. That last bit will, obviously, be difficult.

YOU NEED TO GO TO THE DOCTOR IF… you have shortness of breath and feel like you are worsening to point of needing care, and/or you are over 60, and/or you have co-morbidities like diabetes, heart disease, or are immunosuppressed. Those with risk factors should set a low bar for seeking medical attention if symptoms are consistent with COVID-19 infection. Our Taiwanese friends have offered this simple test: if you are sick and cannot take a deep breath and hold it for 10 seconds, you need to seek medical attention immediately. (NOTE: if this “breath test” is easy for you, it does NOT mean you are negative for coronavirus.)

If you have decided you need to go to the doctor, CALL AHEAD. The instructions for how each center is handling presumed COVID-19 infections are changing daily. In public, you should wear a mask (or get one as soon as you get there).

And now I leave you with a hopeful message from J.P. Hong, our dear friend from the Asan Medical Center in Korea… and the future:

“First comes denial and then confusion and then you will see so much rapid change and development in the next few days…. it will be incredible how we adapt…. and hopefully see the better side of humanity as doctors volunteer and various innovations occur to fight the virus.”

Those who have bravely canceled events and schools and gatherings are past denial, but most of us are still muddling through the confusion. I hope these guidelines help as all of us inevitably acquire our own Beka Stories.