Photo/Illutration A room at Toyoko Inn Tokyo-eki Shinohashimae in Tokyo’s Chuo Ward, which the Tokyo metropolitan government is using to accommodate COVID-19 patients with mild or no symptoms (Hiroki Endo)

Purplish lips and sudden feelings of suffocation are warning signs for COVID-19 patients with mild or no symptoms that their condition may have worsened, according to a health ministry self-checklist.

Currently, many mild patients are recuperating at a hotel or home under measures instituted by local governments to save hospital beds for patients with severe symptoms.

For patients at home or a hotel, the ministry is urging them to be aware of nine subjective symptoms, including an irregular pulse and chest pains.

In addition, the patients are recommending having a family member or caregiver check them for four symptoms, such as appearing pale.

Patients and caregivers are urged to go through the checklist twice a day, in the morning and evening.

When necessary, they are asked to check for each symptom three to four times a day.

Patients exhibiting any of these symptoms may require urgent medical attention.

If at least one applies, a patient should call a nurse when at a hotel or contact the local government’s consultation window immediately from home. When a patient feels a sudden change in their health anytime, the ministry is asking them to do so immediately.

Initially, all COVID-19 patients were subjected to be treated in hospitals. But soon health care facilities were overwhelmed by the increasing number of patients and hospital beds were likely to become full, forcing the ministry to change the plan.

The ministry on April 3 announced that patients with mild or no symptoms can stay at a hotel or home if doctors deem hospitalization is not necessary.

However, two men in Saitama Prefecture later died while recuperating at home and waiting for a hospital bed to become available.

The ministry has changed the guideline again and said patients with mild symptoms of COVID-19 should stay at a hotel, in principle.

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13 signs of COVID-19 progression that requires immediate medical attention

Subjective symptoms for self-check
(1) Lips turning purple
(2) Breathing faster
(3) Sudden feelings of suffocation
(4) Difficulty in breathing when moving a little
(5) Chest pain
(6) Unable to lie down, unable to breathe unless sitting up
(7) Breathing hard
(8) Suddenly breathing noisily (within 2 hours)
(9) Irregular pulse

Objective symptoms

(1) Appearing pale
(2) Acting strangely
(3) Replying absently
(4) Appearing spaced out, unable to reply