Speed and unpredictability of COVID-19 leads Island Health to launch 'intensive' home monitoring program

The Vancouver Island Health Authority is this week launching an intensive home health monitoring program for vulnerable patients with "mild to moderate" COVID-19 symptoms.

Eligible patients include adults, especially over age 60, or those who have other health issues including heart disease, diabetes, lung disease, hypertension, are immunocompromised or those who live alone.

Patient temperatures and oxygen saturation levels will be monitored multiple times a day, to ensure they don't take a sudden turn at home alone, according to a news release from Island Health.

Those sudden turns are a fear with COVID-19 and difficult to predict for emergency doctors, like Jeff Eisen of Victoria.

Unpredictability 'scares us'

He says just how fast oxygen levels can dip and who is susceptible to the virus moving into other organs, like the heart, remain unsettling unknowns.

"It's very challenging. The short answer is: I don't know. And that scares us," said Eisen.

Eisen reads everything he can about the virus and noted a month ago that there were cases in Italy where patients appeared to be recovering and their respiratory system improving when "it hits their heart and their heart falls apart and they collapse," he said.

There are no reliable tests or predictors as to which patients are at risk of this, he said.

Every time emergency doctors discharge a patient because they do not need immediate emergency care for respiratory distress or other issues is a "judgment call," he said.

"If I was discharging somebody and saying I think you may well have COVID-19, but at the present moment you don't need to be admitted to hospital is not the same as me saying everything is going to be OK," said Eisen.

There have been two known cases in British Columbia of people who died while recovering from the virus in their own homes. Warlito Valdez, 47, died in his Richmond home on April 5 and dentist Denis Vincent, 62, died in his Vancouver home on March 22.

The B.C. Coroners Service confirmed that a third person has died of the illness outside of a health-care facility. That person tested positive for COVID-19 as a result of a post-mortem swab.

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Flozier Tabangin says her husband, Warlito Valdez, was a hero for his dedication to his job and family. She's worried about their future now that he has died of COVID-19.

These and other incidents of people who seem to be recovering from the virus, then take a turn, have medical providers wary, according to several emergency doctors who spoke to CBC.

Island Health's new plan works to mitigate any risk, by requiring daily monitoring of patients to keep on top of biometrics — such as temperature and oxygen levels — to determine if they improve or worsen.

Registered nurses actively monitor the patients between 8 a.m. and 6 p.m. daily, and patients referred to the program are considered "high priority."

Patients are sent home with a pulse oximeter to allow blood oxygen level monitoring and a tablet if they don't have the technology to install the monitoring plan on their smart phone or computer.

A pulse oximeter is a medical device that indirectly monitors the oxygen saturation of a patient's blood, usually using a finger clip and infrared light.

Their symptoms will be monitored until they are gone or the person is admitted to hospital.