Got COVID-19? How to know if you need to go to the hospital

Tessa Schrom, a University of Utah senior, left, gets a
COVID-19 booster shot from Jana Ingles, a Community Nursing
Services registered nurse at the student union Thursday, during a vaccine clinic at the school.

Tessa Schrom, a University of Utah senior, left, gets a COVID-19 booster shot from Jana Ingles, a Community Nursing Services registered nurse at the student union Thursday, during a vaccine clinic at the school. (Kristin Murphy, Deseret News)


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SALT LAKE CITY — Omicron may be milder, but the incredibly transmissible COVID-19 variant is still sending a record number of Utahns to the hospital and the state's death toll from the virus beyond 4,000 lives lost as infections continue to soar.

So when is it time for someone with COVID-19 to head to the hospital?

"In general, if you've just got a cough, sore throat, fever, muscle aches — and you can keep fluids down and breathe comfortably, then the kind of care you're used to giving at home for a bad cold or flu should be OK," said Dr. Andrew Pavia, chief of the University of Utah Health Division of Pediatric Infectious Diseases.

Utahns should, however, be on the lookout for symptoms of more serious disease.

"The most common symptom that gets people in trouble is lung involvement," usually showing up as feeling short of breath, particularly during exercise, Pavia said.

But that's not all.

"Other things that can happen with COVID that should make you want to seek medical care, because you can have blood clots that could lead to severe chest pain or swelling of a limb. There can even be neurologic complications," he said.

Even the cold and flu-like symptoms that signal omicron may be a cause to get medical help in those who are more vulnerable to COVID-19 because they're older or have underlying medical conditions that increase the likelihood of severe disease.

For them, it's important to have a fingertip pulse oximeter on hand to monitor blood oxygen levels because a drop means it's time to seek medical care, Pavia said.

Dr. Russell Vinik, U. Health chief medical operations officer, said he's recommended to his family and friends that they spend the $20 or so it costs to buy a pulse oximeter so they'll be able to key an eye on their blood oxygen levels.

"Even before COVID, it's a useful tool to have on hand," Vinik said. "I can't tell you how often I've admitted patients to the hospital way before COVID who were short of breath for five or six days and they showed up to the emergency room" with levels so low they faced severe organ damage.

"That simple tool can really help distinguish sick but doing OK versus sick and saturations less than 90%," when care is needed, Vinik said, adding not being able to get adequate oxygen — respiratory failure — is the No. 1 reason for hospitalization.

It takes a while to recover and patients usually are sent home with supplemental oxygen. And Vinik said it can be even more severe, damaging organs in the body, especially the heart and kidneys, leading to multiorgan failure and death. With COVID-19, he said the most severe consequence is significant lung damage, even from omicron.


If you're fully vaccinated, particularly if you're boosted, we continue to accumulate studies showing that the chances are quite good you are going to have an illness that is manageable. I hate to say mild, because four days in bed is not always mild. But it's going to be manageable.

–Dr. Andrew Pavia, chief of the University of Utah Health Division of Pediatric Infectious Diseases


Getting both the initial series of COVID-19 vaccines and a booster shot is still the best way to stay out of the hospital — or worse, the doctors said. More than 80% of the people hospitalized for the virus, including more young children than ever, are unvaccinated.

"If you're fully vaccinated, particularly if you're boosted, we continue to accumulate studies showing that the chances are quite good you are going to have an illness that is manageable. I hate to say mild, because four days in bed is not always mild. But it's going to be manageable," Pavia said.

It's the massive numbers of infections from omicron that's helping to fill hospitals to capacity. The latest variant is estimated to be four times more contagious than the delta variant that turned Utah and the Intermountain West into the nation's hot spot for COVID-19 last fall.

The doctors, who held a virtual news conference Wednesday, also recommended wearing high-quality, well-fitting masks indoors to help avoid transmission because, as Vinik explained, in a group of 10 people, one likely has COVID-19 at this point.

The decision to mask up is not just about protecting yourself, Pavia said, but "others around you. You're protecting the health care system and a lot of our economy in being able to go forward. So we're tired of it. People want to find reasons not to wear a high-quality mask. But please, we need to do it for a few weeks more at least."

The advice comes as the Utah Department of Health is reporting 11,608 new cases Thursday, down from records set before Gov. Spencer Cox called last Friday for most Utahns showing symptoms to skip testing and just stay home.

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