Take your temperature at least 1x/day

[codejack42]

Most common symptoms are fever and dry cough. Especially in the absence of testing, a fever is the #1 thing to be looking for.

How do you know you have a fever if you don't know your regular baseline temperature? For instance, lots of people have a baseline temp that's well below 98.6 and for those people, 98.6 means they have a fever. Similar deal for people whose normal temp is well above 98.6. If people don't know their baseline temp, they can't necessarily tell when they have a fever.

So if you want to make sure you're not getting sick, or you want to validate your suspicion that you're getting sick, have a thermometer and use it daily. Hopefully it will always say you don't have a fever.

[jmcmurry]

This could be misleading though. Lots of evidence temperature fluctuates naturally. Not sure we want the worried well to be using their time this way. Comments welcome

[codejack42]

@jmcmurry point well taken. I don't think this is a "do or die" type of issue but allow me lobby a little bit nonetheless.

++++ From https://www.health.harvard.edu/staying-healthy/when-is-body-temperature-too-low "Also, they [older people] should pay extra attention to fevers. A fever of 99° F, which doesn't sound high, can be serious in an older person whose normal baseline temperature is below 97° F."

And from https://www.health.harvard.edu/staying-healthy/body_heat_older_is_colder "... A research team led by Dr. Irving H. Gomolin, chief of the Division of Geriatric Medicine at Winthrop University Hospital in Mineola, N.Y., measured the temperatures of 150 older people (average age, 80.7), 100 of whom lived in a nursing home. The researchers took oral temperatures of the nursing home residents at three different times (6 a.m., 4 p.m., and 10 p.m.) for three consecutive days and a single midday reading of the people living independently."

"The average body temperature of the nursing home residents never reached 98.6° F. At 6 a.m., it was 97.3° F; at 4 p.m., just a tenth of a degree higher; and at 10 p.m., 97.8° F — still close to a full degree below 98.6° F. The results for people living independently were similar: The average midday temperature was 97.7° F." AND "... Why is this important?" "When someone's body temperature is low to begin with, an increase may not reach fever levels, especially if you have Wunderlich's outdated standard of 100.4° F in mind. So older people can be quite ill even though they don't seem to be running a fever. Moreover, the fever response, like the overall immune response, weakens with age, so the body temperatures of older people may not increase all that much when they are ill."

"The flip side is that doctors need to be on the lookout for temperatures below about 95° F, especially in older patients. A low body temperature can be a sign of illness too, and it's often not noticed by the patient." ++++

Thus I think that low baseline and fever temperatures are a significant factor for this highly vulnerable population, and I think that since many older adults will be being cared for by non-professional younger people (kids, grandkids, neighbors, etc.), it's important that non-professional caregivers understand the facts of body temperature in older people. And of course it's important for older people to understand this themselves as well (and certainly many of them don't--many of them probably don't even view themselves as "older people").

Maybe temper the guidance with a short "don't freak out" note? Maybe something along the lines of, "Don't obsess about this, it's not worth obsessing over. It's especially not worth obsessing over in people who are generally healthy and not part of a vulnerable population. If that's you, a swing of 1.5 degrees either way is likely no big deal . Just take your temp at the same time every day to establish your baseline and casually monitor for fever. For an older person, establish the baseline and monitor for fever slightly ore casually, bearing in mind that "A fever of 99° F, which doesn't sound high, can be serious in an older person whose normal baseline temperature is below 97° F."

Thank you.

[codejack42]

ugh. Above should read: "For an older person, establish the baseline and monitor for fever slightly LESS casually..."

Maybe someday I'll be able proofread and use the "preview" function. Where there's life there's hope anyway, right?

[codejack42]

Thinking about it a little more, I realize that we are unfortunately about to experience a dramatic, drastic shift in how healthcare is rationed in the US. I think there's a good chance that the new rationing model will look a lot more like battlefield-style or field-hospital-style triage, and will thus be predicated on predicted survival rates--weighted in favor of the younger and healthier and weighted against the older and less healthy. Part of what this looks like in practice is older people being turned away from hospitals and sent back home, or even refused ambulance transport from home to hospital. I shudder to even imagine this stuff but based on reports from Italy it seems to me to be inevitable in the US. Following on, this means a lot older people who would have in the past been moved out of the hands of non-professional in-home caregivers and into hospital care will have no other option than being cared for at home by non-professionals who are working against some very bad medical odds. Were I calling the shots for an older parent or grandparent, I'd be doing my damnedest to from the very beginning to monitor them for fever from the beginning and if they were very sick and being cared for at home I'd also need to really understand what it meant when I took their temperature (e.g., is 99 degrees a fever for grandma?). So knowledge and awareness of normal and fever temperatures for older people and people with low baseline temps would seem to me to have some real importance. You know, I hate writing this kind of stuff, hate even thinking about it. But there it is. Be Love. Be well.

[siwei-wang]

With the rationing test in US, many mild symptom ppl will need to be alert by themselves. This will help to set up a baseline, i.e., an important early signal to protect those that are vulnerable.