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A group of researchers from the National School of Public Health (ENSP) recommends extending the current criteria for the covid-19 test, including symptoms in addition to those provided in the rule of suspicious cases of the General Directorate of Health (DGS). Mild symptoms such as headache, runny or blocked nose, sore throat and muscle aches should be taken into account and assessed, as is already being done in some European countries, he warns. The current DGS standard considers that a case of infection by the new coronavirus is suspected only when there is a cough or fever, difficulty in breathing, loss of smell or taste.
The four researchers also suggest that “a communication strategy” with the population, especially the youngest, helps to clarify which are the mild symptoms to assess, thus motivating people themselves to take the initiative to isolate themselves. for a short period of time to prevent transmission of the infection, as is already the case in several countries, in particular Germany. They even propose to give “a clear indication for the isolation of people with respiratory symptoms of any severity, ensuring their protection in relation to labor and economic issues.”
“More general restrictive measures may not contain transmission if citizens continue to devalue a set of mild symptoms,” warn Vasco Peixoto, André Vieira, Pedro Aguiar and Alexandre Abrantes, in the opinion article published this Tuesday in the Barometer. Covid-19 of the ENSP of the Universidade Nova de Lisboa.
They suggest that, at the current time of the epidemic, “any citizen with respiratory symptoms of any severity should suspect that they are infected by covid-19, limit their family, social or professional contacts until the situation is clarified and proven.” “The fact that we devalue mild symptoms and fail to screen people for these mild manifestations represents a blind spot in the control of the pandemic and may be contributing to its current lack of control in Europe in the context of increased work and social contacts associated with decreased restrictions. If we do not identify these cases, we will not be able to control the transmission chains ”, they justify.
They recall, in this sense, the conclusions of a study reported by the European Center for Disease Prevention and Control (ECDC) that analyzed the clinical characteristics of positive cases in a group of 18 European hospitals. The most frequent symptoms with positive tests and with ages between 15 and 39 years were headache (70.3%), loss of smell (70.2%) and nasal obstruction (67.8%). Then came the cough (63.2%), lack of strength (63.3%), muscle aches (62.5%) and runny nose (60.1%). At the end of the list there was a change in taste (54.2%) and sore throat (52.9%), with fever appearing in less than half of the cases (45.4%).
If symptoms such as headache, muscle aches and runny nose, among others, are included in the criteria for evaluating suspected cases of Covid-19, “more cases can be detected and appropriate public health measures taken.” Furthermore, “if citizens are sensitized to be aware of these symptoms, they can take the necessary measures to reduce transmission in the family, social and professional sphere and request tests.”
The proposal would mean that many more diagnostic tests would be performed. The use of rapid antigen tests, which began Monday in Portugal, may allow people to be tested for mild respiratory symptoms, typical of acute respiratory infections, or combinations of these, they note.
Isn’t the price to pay for more diagnostic tests in Portugal too high? “There is a cost benefit to assessing mild symptoms. Leaving the transmission of the infection uncontrolled also means doing more tests over a period of time, “replied Vasco Peixoto. “It is important to take into account what was prevented in the number of cases of infection, possible emergency shutdown and hospitalization costs ”. Despite having less sensitivity and specificity, these rapid antigen tests allow rapid and large-scale action.
The former director general of Health, Francisco George, agrees with this proposal. “There were young athletes who told me, curiously, ‘I feel like yesterday I played a rugby match’. They are general pains in the body, fatigue ”, describes George, president of the Portuguese Red Cross. “In public health, to stop the spread of infection, rapid antigen tests are irreplaceable because they allow the adoption of rapid measures,” he stresses.
