How To Navigate COVID-19 Without a Primary Care Physician

If you think you’re coming down with COVID-19, your first instinct might be to call your primary care physician (PCP). But what should you do if you don’t have one? The answer depends on the severity of your symptoms, Robert Baldor, MD, professor of family medicine and community health at the University of Massachusetts Medical School, tells Verywell.

However, Baldor adds that if you don't have a PCP, it might be a good idea to seek one out as soon as possible. "[It's] worth being proactive," he says. “It helps to be established with a primary care provider because you never quite know what's around the corner. So I would say, yes, make that call today."

Monitor Your Symptoms

The vast majority of COVID-19 cases—80%, according to Baldor—are asymptomatic or only mildly symptomatic and, as a result, don’t require medical attention. If you fall into this category, Baldor says, you don’t even really need to check in with a doctor—you can weather it out at home with the aid of Tylenol and vitamin C and D supplements. (Non-steroidal anti-inflammatory drugs such as Naproxen and Ibuprofen may exacerbate symptoms).

It’s only once you start having difficulty breathing, which is called “dyspnea,” that you should be concerned. “The threshold that people talk about is an oxygen concentration of 93%,” he says. If yours is below that, you’re in the danger zone. 

You can tell if you’re dyspneic by timing your breaths. If you’re inhaling more than 30 times per minute, you’re struggling to breathe, even if you don’t feel any different. If you’re severely dyspneic, you should seek medical attention right away, likely at an emergency room.

However, Baldor says, the exact place you go could change depending on “what’s happening in the local medical community.” Many hospitals, particularly those in big cities, are overwhelmed with COVID-19 patients and would be hard-pressed to accommodate any more. 

“The people who are getting admitted are really the folks who are pretty sick, and part of [the reason for] that is, you know, we're running out of space,” he says.

Urgent care clinics, he says, are not really viable alternative options. “In fact, I think even if you called an urgent care center to say ‘I'm having trouble breathing,’ even before COVID-19, they probably would say to you, ‘Go to the emergency room,’” he says.

Go to the Emergency Room If You're Having Trouble Breathing

If you do end up making it to an emergency room, you’ll receive several tests:

• Pulse oximetry to measure your blood oxygen levels
• Chest X-ray or CT scan to examine your lungs for signs of infection
• Bloodwork to identify any outstanding coagulopathy (blood clotting issues)

Baldor says there are very few medications that emergency physicians can prescribe for severe COVID-19 besides the standard over-the-counter offerings. While they can provide you with respiratory sensors such as pulse oximeters and respiratory aids such as albuterol inhalers, they reserve serious medications like dexamethasone—the steroid that President Donald Trump reportedly took during his stint at Walter Reed National Military Medical Center back in October—for the critically ill.

“With the flu, of course, we've had antiviral medications, like Tamiflu, we could give," Baldor says. "Well, we don't have anything like that yet for this particular virus... [Although] there's been some looking at using these monoclonal [antibody] theories and so on.”

Monoclonal antibody therapy involves the intravenous delivery of laboratory-made proteins to provide an immune boost. The COVID-19 formulation, bamlanivimab, received an emergency use authorization from the Food and Drug Administration on November 9 and has since been shown to be beneficial in a subset of the disease population.

They “can be used to treat outpatients, particularly those at high risk of going on to have severe disease,” Yuka Manabe, MD, associate director of global health research and innovation at the Johns Hopkins University School of Medicine in Maryland, tells Verywell. 

Finding a Doctor Is Your Best Bet 

If you’re mildly or moderately rather than critically ill, both Baldor and Manabe say, it can’t hurt—and it often helps—to consult with your primary care physician if you have one. Your PCP will have a strong knowledge of any personal risk factors and preexisting conditions that might increase your risk, such as a heart condition, COPD diagnosis, or high BMI, and can advise you on a course of action. 

If you don't have one, try to find a doctor available in your insurance network. “Having a primary care physician who can monitor you remotely and help patients decide if and when they may need oxygen or hospitalization is important,” Manabe says.  

“If you can't breathe, you've got to go to the emergency room," Baldor says. "But short of that, if you are in a stage of being dyspneic, having some difficulties, you can come into my office and we can do a pulse oximetry just to see. Sometimes, people feel short of breath but the pulse ox is okay. Anxiety can be a component of that. So the question would be: What would they do for you in the emergency room that would be different than what we would do for you in the office?”

Many PCPs are conducting appointments remotely to minimize the spread of COVID-19. Known as “telemedicine,” virtual medical care has exploded in popularity since the beginning of the pandemic.

If you don’t have and aren’t able to find a primary care physician—there is a shortage in many locales, Baldor says—Manabe recommends buying a pulse oximeter to monitor your oxygenation. (However, it might yield inaccurate results if you have darker skin.)

"Pulse oximetry can be a good way to monitor how patients are doing while isolating at home,” Manabe says. 

Even if you have the good fortune to be asymptomatic, Baldor says, it’s important to continue to follow public health guidelines. Wear a mask, wash your hands regularly, stay six feet or more away from people outside of your household, and avoid “being in the public as much as possible."

The information in this article is current as of the date listed, which means newer information may be available when you read this. For the most recent updates on COVID-19, visit our coronavirus news page.