Asthma, reactive airway, or
other chronic respiratory
disease that requires daily
medication for control
65 years of age or older
Cough
• SpO2 <94% on room air at sea level
• <300 mm Hg
Headache
• Respiratory frequency >30 breaths/min
• Lung infiltrates >50%
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• Tracheostomy
• Gastrostomy
• Positive-pressure
ventilation not
related to COVID-19
Vomiting
Patient has at least one of these symptoms
Sore throat
Patient doesn't have
any of these symptoms
Cardiovascular
disease
Muscle pain
Chronic obstructive
pulmonary disease or other
chronic respiratory disease
Diarrhea
Fever
Shortness
of breath
A healthcare provider
told you that you are
overweight for your
age and height
My patient has at least one of these medical conditions or characteristics
Hypertension
Medical-related technological
dependence:
Body mass index (BMI)
greater than 35
Dyspnea
These do not apply to the patient
Malaise
These do not apply to the patient
Neurodevelopmental
disorders, for example,
cerebral palsy
Chronic kidney disease
Nausea
Sickle cell disease
Immunosuppressive
disease
SpO2 ≥94%
on room air
at sea level
Congenital or acquired
heart disease
Diabetes
Abnormal
chest imaging
Loss of taste
and smell
My patient doesn’t have any of these medical conditions or characteristics
Neurodevelopmental disorders,
for example,cerebral palsy
Chest discomfort
Body mass index (BMI) greater
than 35
Abnormal chest imaging
Trouble staying awake
Confusion/unresponsiveness
Patient doesn't have any of these symptoms
Immunosuppressive disease
Sp02 ≥94% on room air at sea level
Asthma, reactive airway, or other
chronic respiratory disease tha
requires daily medication for control
My patient has at least one of these medical conditions or characteristics
Shortness of breath
Bluish face/lips (a sign that you
are not getting enough oxygen)
• Tracheostomy
• Gastrostomy
Chronic obstructive
pulmonary disease
or other chronic
respiratory disease
A healthcare provider told you that yo
are overweight for your age and height
Medical-related technological dependence:
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My patient does not have any of these medical conditions or characteristics
• Positive-pressure ventilation
not related to COVID-19
Congenital or acquired heart disease
Loss of taste and smell
Eye problems, such as watery
eyes or swollen eyelids