I think I have coronavirus symptoms. When should I go to hospital?

Katie Russell
Boris Johnson is being cared for at St Thomas' Hospital in London
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When Boris Johnson was admitted to an intensive care unit this week, the news shook the nation. 

Johnson first revealed that he had “mild” symptoms of the virus on 26 March, and he made consistent, if brief, public appearances in the days after.

After eight days locked inside his flat in Downing Street, the Prime Minister reported that he still had a high temperature so had to continue self isolating – but even then, he conveyed the message in a self-shot video. Johnson looked unwell, certainly, but it did not appear to be a picture of a man who would soon require medical treatment.

But coronavirus can progress at speed, especially if the body is not able to defeat the virus during the first week or so of symptoms. On Sunday, the Prime Minister was advised to attend hospital for "routine" checks by his doctors; yesterday, he was moved to intensive care at 7pm after experiencing difficulties breathing.

If you, too, have been experiencing mild symptoms of Covid-19, here’s what you need to know about whether or not you need to seek hospital treatment.

What is a normal temperature, and what is a 'coronavirus temperature'?

It almost goes without saying that the first step is to correctly identify that you have coronavirus symptoms – and while you have have heard about these repeatedly over previous weeks, it bears repeating them here.

One of the main indicators that you could have coronavirus is that you have a high temperature or fever. A normal body temperature is around 37C, although it does vary slightly throughout the day and can be impacted by exercise. 

If you have a temperature of 38C or over, you are considered to have a high temperature or fever. However, it is not necessary to take your temperature to find out if you have a fever. According to the NHS website, you could have a fever if you feel hot to touch on your chest or back. 

If this is the case, the NHS website recommends you stay at home: “If you have a high temperature, it could be coronavirus. To protect others, do not go to places like a GP surgery, pharmacy or hospital. Stay at home.”

The other common symptom of Covid-19 is a persistent dry cough – meaning, a cough that does not produce phlegm. It’s a persistent cough if you are coughing a lot for more than an hour, or if you have three or more coughing fits within 24 hours. If you usually have a cough, you might notice it is worse than usual. 

If you have a dry cough, you should self-isolate for a week. Be aware, however, that your cough could last for several weeks, even after the infection has cleared. You do not have to self-isolate for the entirety of this time, according to the NHS, as the infection will be gone.

I've lost my sense of taste and smell – is that a bad sign?

The cough and fever are the most well-known signs of Covid-19, but there are other symptoms to look out for - including fatigue, shortness of breath and the loss of taste and smell.

A recent study of more than 500 Britons who tested positive for the virus found that 60 per cent lost their sense of taste or smell, compared with 19 per cent who tested negative. 

Lead researcher Professor Tim Spector, of King's College London told The Telegraph: "When combined with other symptoms, people with loss of smell and taste appear to be three times more likely to have contracted Covid-19 according to our data, and should therefore self-isolate for seven days to reduce the spread of the disease.” 

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When to go to the hospital

If you have symptoms of coronavirus, the official NHS guidelines are that you should not leave your house. Even if you have symptoms, it could be nothing to worry about. About 80 per cent of people who get Covid-19 experience a mild case – similar to a regular cold – and recover without needing any special treatment, according to the World Health Organisation (WHO). 

That being said, one in six who get Covid-19 do become seriously ill and develop breathing difficulties. Older people and those with underlying health problems (such as high blood pressure or diabetes) are more susceptible to developing a more serious form of the illness. 

So, when should you seek medical help? From a lay perspective, the key thing to know is that if your symptoms get worse, last longer than seven days, or you feel you cannot cope at home, you should call the NHS 111 service. Health professionals will then decide on the correct course of action.

Certain symptoms are also a red flag that suggest you need hospital admission, according to new NICE guidelines, published on Friday, for the medical community. The following could indicate a more severe form of the pneumonia, caused by Covid-19: 

  • Severe shortness of breath at rest or difficulty breathing

  • Coughing up blood

  • Blue lips or face

  • Feeling clammy and cold with pale or mottled skin

  • Collapse or fainting

  • Becoming difficult to rouse 

  • Feeling confused 

  • Little or no urination. 

Older people, or those with impaired immunity or reduced ability to cough and clear secretions, are more likely to develop severe pneumonia. Because this can lead to respiratory failure and death, typically these people would have gone to hospital before the pandemic – but the choice is not so straightforward now. “In these exceptional circumstances, the benefits, risks and disadvantages of hospital admission for pneumonia must be considered so as to ensure that the patient receives the most appropriate care,” a NICE spokesperson said.

“There is a risk that a patient could spread or contract COVID-19 in hospital, therefore patients who present with mild symptoms of pneumonia and who can manage at home will benefit most from homecare. The new guidance is there to support healthcare staff in their decision making.”