When Should You Go to the Emergency Room?

University of Arizona College of Medicine – Phoenix clinical assistant professor of Emergency Medicine Murtaza Akhter, MD, answers common questions about the novel coronavirus (COVID-19).

When should you go to an emergency room versus an urgent care facility if you think you may be infected with COVID-19?

Murtaza Akhter, MD
Murtaza Akhter, MD
You shouldn’t go to either place. Unless you have traveled to one of the endemic countries recently or have been in contact with somebody who has laboratory-confirmed COVID-19, you likely won’t get tested anyway. The tests are being rationed for only certain people. This could change, as policies seem to change day by day, but as of now, it will be a waste of everyone’s time if you went to the ER or urgent care to be tested. Of course, if you have concerning symptoms, like trouble breathing, get seen quickly. That is the case regardless of whether COVID-19 is present or not. People with respiratory struggle need to be seen immediately.  

What should I do if I can’t work from home?

There are fewer and fewer people who are not allowed to work from home. For those of us who have to go to work, we are being vigilant about washing our hands (and often wearing masks). If you're sick, don't go to work. Most employers have policies in which employees with fever or respiratory symptoms are not supposed to go to work. To reiterate, hand hygiene is critically important regardless of whether COVID-19 is present. This should be practiced all the time in all seasons in all years.

Should I worry if I am not in one of the vulnerable populations?

I would advise caution rather than worry. Anybody could potentially get sick. Secondly, and perhaps more importantly, even if you yourself don’t get severe symptoms, that doesn’t mean that somebody else with the same bug can’t. So everyone needs to practice social distancing, if not for yourself, then for others. Don’t be selfish; you could literally kill someone.

What should I do if I think I have it?

Isolate yourself. Don’t infect others! Take good care of yourself, like you should with any bug, including washing hands frequently and hydrating well. Of course, if you have severe symptoms, like trouble breathing or significant chest pain, you need to be seen quickly. Otherwise, as of now, the tests are being done mainly for people who have traveled recently to the endemic regions or who have been in contact with somebody who has been confirmed, by a laboratory, to be COVID-19 positive. Telemedicine companies are trying to take the brunt of the caseload for people who think they may have the virus but do not have life-threatening symptoms. It is possible that in the near future there will be testing available even for those without the above criteria, but time will tell.

How can I protect myself?

Protect yourself in the same way as you would for any other bug, including the flu. Namely, distance yourself from others and practice excellent hand hygiene. If you have an itch on your face, wash or sanitize your hands before scratching it. This is very hard to remember, but is probably the most important thing you can do for yourself. You can wear a mask if you need to be around others. As another example, don’t touch the brims of cups or glasses; be very careful to only grab them from the base. Many cities have banned straws for environmental reasons, and while I will be called politically incorrect for saying this, I think banning straws is a terrible idea for infectious disease purposes. Regardless, good hand hygiene needs to be practiced all the time. Some of the above examples (e.g., itch on face, brim of cup) are things that people don’t even notice, but this is very often how germs are passed. Be wary of where your hands go, and how clean they are - both now during COVID-19 season as well as after, always.

How can I help my grandparents or elderly neighbors?

The best thing you can do is to not cough on them. Do not go near them if you don't have to, precisely because infectious droplets can be so easily passed and people are careless about this. You can check on them with a phone call. If they need something like food or critical supplies, you can help by dropping items off at their doorstep. But do not mingle. If you want to see their faces or they want to see yours, use video conferencing.