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As the nights begin to close in and a distinctly autumnal air prevails, the feeling of a challenging winter ahead is hard to ignore. For many patients, a growing concern is expressed in conversations with their doctors: How will we know if our annual flu-like illness is influenza or Covid-19?
Getting a swab and getting a PCR Covid test is the obvious answer. But the turnaround time for these tests is likely to lengthen as demand increases. And since false positive and false negative test results are a reality, clinical judgment will be critical in addressing the concerns of anxious patients and their families.
Listening, and listening even more, will be key. Speaking to Medscape, an online journal for physicians, Dr. Lewis Jay Kaplan, an intensive care surgeon at the University of Pennsylvania, says that every patient has a story, “and it’s up to you to figure out which chapter they are in and what so far along what happens to be ”.
Each patient’s history can indicate the correct clinical approach. We know that, traditionally, about 80 percent of diagnoses are made by listening carefully to the patient, without any practical clinical examination. Follow-up with a series of questions about how the disease has affected them, how their symptoms are different from the usual ones, and how they responded to treatment will further refine the doctor’s assessment. A narrative medicine approach like this is especially helpful since most primary care consultations will be done via telemedicine.
Overlap
The biggest challenge in the coming months is the degree to which the signs and symptoms between Covid-19 and the flu overlap. Both suffer from fever, headache, muscle pain, cough, and fatigue.
A very stuffy and stuffy nose and a sore throat are hallmarks of the flu; shortness of breath and loss of the sense of smell and / or taste strongly point towards Covid -19. Gastrointestinal symptoms, such as diarrhea, occur in up to 40 percent of new coronavirus infection cases.
Comparison chart of coronavirus, flu and cold. Source: 2.hse.ie/conditions
But some people infected with Covid-19 have no symptoms, while others have mild symptoms. And the common cold, caused by a host of viruses, including other strains of coronavirus, remains the most likely diagnosis if someone has a runny nose, a sore throat, and a normal temperature. However, an important red flag and something that should not be ignored is the onset of shortness of breath or shortness of breath. If this happens, seek urgent medical attention.
What about the unlucky ones who were hit by the double whammy of superimposed flu and Covid-19 infection? Early studies suggest that roughly one in four Covid-19 patients has been diagnosed with an additional respiratory infection, including influenza. But researchers in Hong Kong and Japan have reported a reduction in flu cases during Covid-19 outbreaks. Preventing the flu could make the Covid pandemic more manageable, and preventing the transmission of the coronavirus could also reduce the occurrence of the flu, as seen in South Africa and Australia during the recently ended winter period in the southern hemisphere. . And while the new coronavirus may be mutating into a less virulent strain, the evidence is anecdotal at best.
Interestingly, scientists who have tracked historical epidemics have found that respiratory virus outbreaks generally do not peak during the same period of time. Although no one knows exactly why this happens, one study has postulated that temporary bursts of immunity to different viruses could be at play at the cellular level.
The best card in the winter prevention pack is to get a flu shot. This will help you escape the flu or at least minimize its effects. It will also reduce the chances of getting the flu and Covid-19 simultaneously.
I truly believe that a flu shot and a renewed zeal for hand washing and social distancing will make the coming winter bearable.
