Barts-MS rose-tinted-odometer: ★★★
Early this week my wife came down with a cold. Did she have coronavirus was the immediate question? She asked me for advice and I said she had better get herself swabbed and in the interim we should isolate ourselves. All she had was a mild headache (sinus-type), runny nose, sneezing and a sore throat. She did not have a temperature and only developed a mild cough after a few days. Her nasopharyngeal swab for coronavirus done via the post took almost 72 hours to come back and was fortunately negative.
Interestingly despite a blocked and runny nose, she did not develop loss of smell or her taste; I tested it with coffee, chocolate and some fine white wine. Although loss-of-taste (ageusia) and smell (anosmia) occur in about 40-60% of subjects with COVID-19 it is really not specific enough to exclude coronavirus infection so don’t rely on it. In addition, it may not occur until several days into the infection, prior to which you could be highly infectious and spreading the virus.
Fortunately, my wife is now much better. I suspect she had rhinovirus infection, a common cause of rhinitis or the ‘common cold’, which is now circulating as it normally does this time of year.
In response to the emerging rhinovirus problem, the BBC and most of the newspapers have run articles or special features to highlight the differences between COVID-19, influenzae and the common cold. If you look at this list of symptoms below it is simply not possible to differentiate mild infections from each virus apart. Surely, it is not about diagnosing which infection you have but making sure you don’t act as a source of coronavirus and spread the infection.
Therefore everyone with symptoms suggestive of an upper respiratory tract infection, including the common cold, should really consider themselves infected with coronavirus until proved otherwise. This means they need to get themselves swabbed and tested. Therein lies the problem. The UK at the moment does not have enough testing capacity outside of the NHS Trust’s to deal with this emerging problem. Hence anyone with a cold will probably have to self-isolate including their immediate contacts.
The other thing is the new ‘COVID-19 leper syndrome’. Even if you go outdoors or travel, for example, to work, with a blocked nose and cold-like symptoms people will treat you like a leper and run a mile. This has been happening already before the rhinovirus problem; if anyone sneezes or coughs on the underground they immediately attract dirty looks and space clears around them as if they are radioactive.
Things are only going to get worse the further we move into Autumn and Winter. In addition, young children are back in school and they are hothouses for acquiring and spreading viruses. The perfect storm is having two highly infectious viruses, which cause overlapping symptoms, circulating at the same time when we are trying to get society moving again. I can only imagine the chaos this going to cause in schools, universities and the workplace. The only solution is for the government to massively increase testing capacity ideally with the emerging point-of-care diagnostics, which can provide an answer within 60-90 minutes whether or not you have COVID-19.
It is clear to me that an effective coronavirus vaccine can’t come soon enough.