We attempted follow-up phone calls on days 1, 3, 7 and 28. The follow-up calls were scripted and were not intended to provide any medical evaluation or advice (online supplemental text B). This allowed for flexibility with regard to the personnel used as volunteer callers. These callers were mostly medical students who were being pulled out of clinical rotations during the height of the pandemic. During the call, information regarding any recent healthcare interactions or hospitalisations, general symptom progression and any vital signs that had been logged since the last point of contact were collected. The caller then collected current resting and ambulatory vital signs. All of these data were logged into our REDCap QI system.

Based on the subject’s responses and vital signs, patients were triaged to either remain at home, contact their primary care physician (PCP) or were referred immediately to the ED (figure 1A). The results of the phone call were logged as notes in the medical record and if the PCP was in the health system, they were contacted by email. If needed, a physician was available for medical control for concerns that fell outside the assigned triage system. After the 7-day follow-up period, all subjects were sent an envelope with return postage to return the pulse oximeter device to be cleaned and reused. At 28 days post enrolment subjects were again contacted to assess for missed return visits and to administer a subjective survey on the experience. A telemedicine service staffed by ED physicians was also available at no charge during this time as part of our health system safety net.

To ensure access to this service for non-English speakers, our health system interpreters were used to facilitate patient instruction and follow-up calls.

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