“I’ll by no means know if I had covid,” Bernstein mentioned. “If I’d have identified extra again then about how severe it was, I’d have been rather more anxious.”
Six months later, on the verge of one other flu season, People know much more about covid-19, the illness brought on by the novel coronavirus. Sadly, medical doctors could also be simply as a lot at midnight in relation to distinguishing it with no lab take a look at for influenza or a number of different frequent seasonal viruses, together with adenovirus or RSV. All of those illnesses usually share preliminary signs which will embrace a cough, fever, fatigue and muscle aches.
“We’re going to be completely confused,” predicted Arnold Monto, an epidemiologist on the College of Michigan College of Public Well being.
Thus far, covid-19 has only one frequent telltale symptom, Monto mentioned, which is a particular lack of style and odor. Greater than 85 p.c of sufferers reported this symptom in a latest European examine of 417 folks with gentle to average circumstances of the illness.
Folks with influenza or a foul chilly and nasal congestion might also lose their sense of odor. The distinction with covid-19 is that the loss is sudden and extra profound — affecting even the flexibility to tell apart between candy and bitter — and should occur with no stuffy nostril, mentioned Carl Philpott, a College of East Anglia ear, nostril and throat professional.
Philpott, one of many authors of a small examine not too long ago described in a letter to the editor within the journal Rhinology, gave odor and style exams to 30 folks matched for age and intercourse. Ten had been identified with covid-19; 10 had dangerous colds and 10 served as a wholesome management group.
In an electronic mail, Philpott mentioned the discovering presents a approach to discriminate between covid-19 and influenza or a chilly when typical exams aren’t out there. A College of East Anglia assertion mentioned the discovering supported the speculation that covid-19 infects the mind and central nervous system. Philpott mentioned individuals who suspect they’ve covid-19 would possibly display themselves at residence, by sniffing merchandise corresponding to espresso and oranges.
A rarer covid-19 symptom which will provide one other warning signal is dyspnea, or problem respiratory. The Facilities for Illness Management and Prevention lists this as one in all solely two signs (together with lack of style and odor) not generally shared with influenza. Researchers have reported it in about 50 p.c of sufferers with extreme circumstances of the illness, saying it tends to look a couple of week after onset, and normally alerts a severe respiratory downside.
Medical doctors can be on the alert for these two signs within the coming weeks, but a number of specialists mentioned there’s nonetheless sufficient overlap with signs of different respiratory diseases to boost issues that they’ll be flummoxed.
“Let’s simply think about you will have an individual of their 60s with diabetes and hypertension who has a fever and cough,” mentioned Paul Sax, medical director of the Division of Infectious Ailments at Brigham and Ladies’s Hospital in Boston. In attempting to tell apart between influenza and covid-19, he mentioned, “There’s no approach a doctor can confidently inform one from the opposite.”
The stakes of uncertainty are excessive, provided that swift differentiation between covid-19 and the flu might assist save lives. Time-tested anti-viral drugs, accredited by the Meals and Drug Administration, can struggle influenza and comparable diseases whilst they’re powerless towards covid-19. However sufferers with covid-19 ought to be quarantined as quickly as attainable, provided that on common it’s practically twice as contagious as influenza. What’s extra, folks contaminated with covid-19 might be contagious for about twice so long as for these with the flu.
If coronavirus take a look at outcomes have been as quickly delivered in america as they’re in lots of different nations, medical doctors would have much less trigger for concern in regards to the elusive job of attempting to inform the distinction from flu on the cellphone or within the workplace, specialists mentioned.
Covid-19 outpatient exams at the moment are rather more extensively out there all through america than they have been final March, however in some components of the nation the place labs are backlogged, delays in reporting outcomes are nonetheless frequent. A health care provider in Georgia not too long ago tweeted to complain about delays of two to 3 weeks, which might make contact tracing inconceivable.
Quest Diagnostics experiences that it has carried out 12.5 million exams for the coronavirus to this point with outcomes now out there in a single to 2 days. In distinction, medical doctors can take a look at for influenza of their places of work and get outcomes inside an hour, Monto mentioned. Because the flu season approaches, producers have been engaged on a mixed take a look at for the coronavirus and influenza with plans to have it out there in public hospitals in coming weeks, mentioned Erica Shenoy, affiliate chief of the An infection Management Unit at Massachusetts Normal Hospital. This, she mentioned, would possibly ultimately assist scale back demand for take a look at provides.
Researchers finding out the novel coronavirus suspect that the primary motive it’s a lot extra deadly than influenza is due to the fierce approach our immune programs might overreact to a comparatively unfamiliar an infection.
The CDC has been finding out a uncommon however lethal immune-system response to covid-19 in younger folks, referred to as MIS-C for multisystem inflammatory syndrome in kids, through which numerous physique components turn out to be infected, together with the center, lungs, kidneys, mind, eyes and gastrointestinal organs.
A gentler immune system response has been a consider “covid toes,” the painful, itchy rash that has appeared on the toes and fingers of many kids and younger adults with in any other case gentle or asymptomatic circumstances.
A serious unknown is what might occur when flu and covid-19 strike concurrently. Early on within the pandemic however on the tail finish of final 12 months’s flu season, Stanford College researchers reported that 20 p.c of a pattern of sufferers had each diseases without delay. Whereas the phenomenon has but to be studied in depth, some specialists fear that having each on the identical time might enhance the toll on the immune system, worsening signs and impairing restoration.
The Stanford group drew no conclusions about that concern. “That’s an experiment we’re going to conduct in October, whether or not we need to or not,” mentioned one of many authors, medical virologist Benjamin Pinsky. However their examine emphasised that having one sickness presents no safety towards additionally having the opposite.
Bernstein, who has been sheltering in place together with her boyfriend and their cat, Sgt. Pepper, mentioned the couple has so faithfully remoted themselves since March that she hopes they’ll keep wholesome by way of the approaching flu season. She nonetheless plans to get vaccinated this month — and has stocked up on rest room paper and tuna, in case the double-whammy of flu and covid-19 brings again the chaos of March.
What to be careful for
Influenza and covid-19 share so many signs that medical doctors count on it will likely be difficult to inform them aside within the coming flu season. Beneath is a listing of main signs of every illness, in line with the Facilities for Illness Management and Prevention. Not everybody who has both illness can have all or any of those signs.
Shortness of breath or problem respiratory
New lack of style or odor
If you’re ailing with covid-19 or suppose you might need been uncovered, the CDC recommends that you simply keep residence besides to get medical care. Keep in contact along with your physician, calling earlier than you go to the workplace. Get relaxation and keep hydrated. Keep away from public transportation, ride-sharing or taxis. However name a health care provider instantly when you or somebody is exhibiting any of those signs:
Persistent ache or stress within the chest
Lack of ability to wake or keep awake