Do I have Covid?
So the question is often, “How do I know if I have Covid 19?” Or, “I have a fever. Is it Covid or The Flu? Or, “My child has a fever, does she have The Flu?” We see a news article about Covid symptoms or see Drs. Fauci or Birx on TV describing Covid 19 symptoms, and we go “That makes perfect sense. Of course that person would have Covid.” But when Covid comes to our doorstep, when we or a family member have mild symptoms that would have meant nothing a year ago, it becomes easily confusing to determine if it is Covid 19, even for me, a physician. FYI, I am an Adult Internal Medicine doctor, and a Pediatrician.
The Flu (Influenza) is easy to diagnose: Mild to Severe body aches (“It hurts to touch my hair!”), Fever 99-105 F, cough, sinus pain, often with a sore throat, and on a rare occasion, nausea or diarrhea. Severe cases have an increasing cough and/or shortness of breath. We swab suspected influenza patients with a rapid antigen test, and if positive, they definitely have The Flu. If negative, they could be falsely negative, and we put them on Tamiflu if symptomatic enough and if the onset of symptoms were less than three days before, just in case.
Covid 19 is trickier, starting meekly: the vampire that asks politely at the door to be let in, unlike The Flu, which is the warewolf tearing down your front door. At least with The Flu, you know what you are about to get.
So what symptoms should I look for with Covid 19?
Mild symptoms
· Runny nose and nasal congestion
· Sore throat
· Dry cough, especially if it is becoming more frequent
· Body aches of any severity
· Loose stools
· Chills
Moderate symptoms
· Loss of taste or smell
· Worsening cough.
· Pain in the chest on breathing or coughing
· Mild tightness in the chest on breathing
· Increasing fatigue
· Diarrhea
· Abdominal pain
· Headache
Severe symptoms
· Shortness of breath
· Severe chest pain on breathing
· Rapid breathing (40 breaths per minute or faster) in children
· Retractions of the skin below the ribs or at the throat/above the sternum in children
In most cases, adults get mild to moderate symptoms; and most children (infants to 12 years of age) and adolescents (teenagers) get only mild symptoms. An added complexity is that children and adolescents often have many other mild upper respiratory infections, making it more difficult to decide whom to test for Covid 19.
Did you notice I did not mention fever above? Typically people with Covid 19 have at least a low-grade fever, 99-100 degrees F, but they often do not have a fever, or at least they don’t when it is measured. Often, people have recently taken ibuprofen or acetaminophen for body aches, suppressing potential fever.
Recently, I had an adult patient come in with 2 days of a runny nose, typical of his Fall allergies, without fever or sore throat, etc. He asked if he could be swabbed for Covid 19, almost on a whim, and he was Positive on the rapid test! He had none of the other symptoms that I mentioned, and he had no known exposures.
My advice is to quarantine yourself or your child if either of you develop mild symptoms for at least two days; and if no better after that, call your physician to be evaluated and possibly tested for Covid 19 or influenza. Call sooner if you wish, of course. If you or your child gets obvious symptoms, such as body aches and a fever, definitely call to get tested for The Flu and Covid.
Many clinics, such as my clinic, are now able to test with an influenza rapid antigen test and a Covid 19 rapid antigen test, both of which are nasal swabs and usually have results in 15 minutes. Think pregnancy test: two lines mean positive for a particular virus and one line means negative.
Our clinic and others also use the Covid 19 PCR nasal test as a confirmatory test. Currently we get the results back in about 36 hours or less, and we run it if someone's rapid Covid 19 test is negative. The PCR takes longer to get results, and is sent to a nearby lab, but overall is more accurate than the rapid test. Hospitals labs, which have more equipment and personnel, may be able to get a PCR back in one day.
If you cannot be tested at your clinic, many urgent care clinics are now testing. If you have a children’s hospital nearby, as we do here in Little Rock, they usually have testing available for children and adolescents. Most hospitals and state health department units are testing. Check their web sites for details.
Bottom line: Quarantine for at least two days if with mild symptoms. Call your physician if symptoms persist or worsen. Get medical help immediately in the emergency room if you have severe symptoms.
Never hesitate to call your physician when in doubt.
Stay healthy and safe!
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