As Covid-19 claims more victims by the day, every one of us is on red alert looking out for the symptoms that could mean we, too, are infected.
The World Health Organisation (WHO) says the major warning signs are fever, fatigue and a dry cough.
But it says other indicators include headache, shortness of breath, general aches and pains or a sore throat. ‘And a very few people,’ it adds on its website, ‘will report diarrhoea, nausea or a runny nose.’
However, as the virus affects more people, doctors are getting a clearer idea of other common symptoms, which may mean the WHO information is soon out-dated.
Although the WHO says a small minority of those infected with the coronavirus experience digestive symptoms, such as diarrhoea or loss of appetite, a study of 200 Covid-19 patients published in the American Journal of Gastroenterology last week found these symptoms affected almost half the patients early on in the illness.
Just yesterday, the British Association of Otorhinolaryngology — which represents experts in ear, nose and throat medicine — said even a loss of smell or taste, or the eye infection conjunctivitis, could mean someone is affected.
The World Health Organisation (WHO) says the major warning signs of coronavirus are fever, fatigue and a dry cough (stock image)
It urged anyone with taste or smell problems to immediately self-isolate — even if they have no other symptoms.
As with colds and flu, many of the symptoms those with Covid-19 experience are not actually triggered by the virus but the body’s attempts to get rid of it.
Coughing, for example, is an automatic reaction we have developed to try to expel foreign organisms, whether they are viruses or specks of dust, from the airway. Nausea and diarrhoea are believed to mark the digestive system’s attempts to flush out the virus. And symptoms such as headaches and muscle pain are thought to be caused by the inflammation that arises in tissue as the immune system floods the body with defender cells to try to quell the invasion.
But a sudden loss of taste or smell could be due to the virus destroying cells in the nose, or even the brain.
A study in the Journal of Medical Virology in February found coronaviruses such as this new strain may be able to infect the central nervous system, affecting some of the senses.
But why do we all react so differently when our bodies are invaded by the virus?
‘This is a really fundamental question that is very hard to address,’ says Peter Openshaw, a professor of experimental medicine at Imperial College London.
‘But we think it’s down to a combination of genetic differences between each one of us, and the fact that our immune systems all have their own particular strengths and weaknesses.’
Our DNA, says Professor Openshaw, controls the number and activity of the receptors we have on the surface of cells throughout our bodies which act as a target for Covid-19.
Receptors are like locks that allow the virus to get into a healthy cell and infect it. Professor Openshaw says it may be that those receptors are more prolific or more active on cells in different parts of the body in some people compared with others.
This might explain why some people get headaches from the virus, but others develop nausea or muscle ache. But it may also be due to the fact that our immune systems are good at some things and not others.
‘The immune system is extremely complicated,’ says Professor Openshaw. ‘It’s a vast network of inter-connected moving parts and everyone has different areas where their immune system is really superb and areas where it is quite deficient.’
Just how much the symptoms vary from one person to another will become clear when you read these four stories of those who have just recovered from, or who are still battling with, the virus that is changing the nature of life as we know it.
Reading the following accounts may provide valuable insight into what to watch for — and what to expect if you yourself become infected.
I lost my sense of taste and smell
Linda Carr, 69, a former TV production assistant, lives in Hethersett, Norfolk, with her husband Rodney, 64, a retired sound engineer. She says:
A fortnight ago, I suddenly lost my sense of taste and smell. It was very odd — I felt I had this horrible taste in my mouth.
Rod had been ill the week before for about four days, with aching limbs and fatigue, but as none of these symptoms matched what I’d read about Covid-19, we didn’t worry too much.
Linda Carr, 69, a former TV production assistant, lost her sense of taste and smell
I quickly developed other symptoms. I felt very sick and terribly fatigued. But I didn’t have a temperature or a cough so, again, Covid-19 was not on my radar.
Within two days I could barely stand. I didn’t have the energy to lift one foot in front of the other. Rather ominously I had also started to cough. I went to the GP to pick up some unrelated blood test results and she took my temperature and said it was high and I should go to hospital.
I felt very scared then. Rod drove me straight there and I was put in an isolation room and tested for Covid-19. My temperature turned out to be 39.9c and everyone who came into the room had to wear a mask — Rod wasn’t allowed in to see me.
The test results came two days later and confirmed I had Covid-19. I started to worry that I might not survive. I had never felt so ill. I’m fit and healthy and have no underlying illnesses. I walk miles every day and workout on a treadmill in the garage, but even I felt awful.
Doctors kept me on paracetamol and fluids and I needed oxygen tubes up my nose for two days as my blood oxygen levels had dropped so low. The care was amazing. One poor nurse had red raw hands where she’d had to wash her hands so much.
I couldn’t face eating anything while I was in hospital and have lost 10 lb in weight since my symptoms started.
On Sunday, after five nights in hospital, I was discharged. My consultant said it was heartening to see someone who had recovered. I’m still weak but now I’m in isolation at home with Rod. We have separate bedrooms and bathrooms. I have no idea where I picked this up — I certainly hadn’t been in contact with anyone who had been overseas, I’d only been to the pub and shops. People really need to stay indoors now.
Five of us fell ill after a family meal
Isla Haslam, 29, a public relations consultant, lives in Balham, South London. Her brother Jonathan, 26, a market research executive, mother Jane, 56, stepfather Dave, 59, and sister Harriet, nine, have all developed symptoms. She says:
Isla Haslam, 29, a public relations consultant, lives in Balham, South London
When I saw groups of friends meeting up on Clapham Common in London this weekend, I wanted to tell them to go home and stop putting themselves and others at risk.
Two weeks ago I was like them and didn’t think twice about going to visit my family in Suffolk for an early Mother’s Day dinner.
When I arrived, my mum said we should all wash our hands and use separate towels — she was worried as my brother and I had come from London. My mum, stepdad, brother, sister and I had a lovely dinner and catch up.
I stayed overnight before travelling back to London. But the day after I left, Mum called to tell me my brother, who had stayed on for a few days, had developed a dry cough and a high temperature.
He didn’t worry about it too much at first as he thought it was due to his mild asthma, but two days later he was so short of breath Mum had to call out a paramedic.
The crew tuned up in hazmat suits and seemed fairly sure he had Covid-19. They told the rest of the family to self-isolate for two weeks.
My brother later heard that a friend he’d gone for a drink with had developed symptoms.
Around the same time, I fell ill too. It started with me feeling absolutely shattered, having an upset stomach and a runny nose. I was so exhausted I felt like I’d been run over by a bus. My brain wasn’t functioning right either — I couldn’t concentrate.
Soon I ached all over and had a tight chest. I lost my sense of smell and taste next, and my appetite. I didn’t eat for about five days in total. I also had diarrhoea.
One day I slept for 17 hours. I treated myself with Night Nurse, a sedating cold remedy.
Luckily I had the flat to myself so I could isolate, and I survived on supplies left by friends.
It was six days before there was any improvement. And, just as I was beginning to get better, my Mum developed symptoms.
She has asthma and her reliever inhaler was no longer helping the breathlessness. On Sunday, she was taken to hospital in an ambulance as a precautionary measure, but discharged on Monday morning. My stepdad and sister have also had a fever, cough and fatigue.
It is without doubt the worst illness that has taken over my family and I really want to warn people against unnecessary social contact.
Virus settled so deeply in my lungs
Thea Jourdan, 50, a writer and editor, lives in Hampshire with her husband David, 56, and their three children, Imogen, 13, Hugo, 12, and Oscar, ten. She says:
Thea Jourdan’s introduction to Covid-19 began with the slightest tickle in the back of her throat
There was no continuous cough. No burning fever. Instead my introduction to Covid-19 began with the slightest tickle in the back of my throat, coupled with a constant, dull headache.
I began to feel unwell on Thursday morning, four days after I had attended a Sunday lunch to celebrate a friend’s birthday. It was just ten of us, and we ate outdoors, picnic-style.
No one had a cough and no one was sneezing. But I now know that one guest had been at a business meeting in London a few days before the party and some people present at the meeting have since tested positive for Covid-19.
Now he, like me, and all the other guests — bar my three children — have symptoms.
Initially I felt exhausted, as if I was dragging myself through treacle and had no choice but to go to my bed. I had no meaningful cough and I wasn’t running a fever. But I had a peculiar sensation of something settling deep within my lungs, almost like breathing in talcum powder. I wanted to cough but I couldn’t.
Going upstairs, talking, even having a bath made me breathe harder. I had a sense that my blood pressure was spiking, too.
When I looked in the mirror, my face and neck looked red and puffier than normal.
I also had brain fog. I was unable even to fill out forms from the children’s schools. I just wanted to sleep, while trying to keep the kids safe and away from my quarantine area — my bedroom.
I told my husband to stay away and I tried to isolate myself from the children as much as possible — so no hugs or kisses.
The hostess of the party called me to let me know the others were ill, but I had already taken the decision to self-isolate. She told me some elderly guests were very unwell with high temperatures and exhaustive coughing.
I felt quite calm until Friday, when I started to feel as if a heavy weight was placed on my chest. I’ve never felt a virus settle so deeply in my lungs. It was scary.
I have mild asthma and found I could only draw breath properly if I stayed calm and lay on my side in bed. If I ventured from bed I felt dizzy.
Since then, the tightness in my chest has reduced, but every day brings a new symptom: aching shoulders and crippling pains in my knees, which were so bad that as I climbed into bed one night tears came to my eyes. It felt like the worst cramp imaginable running up my thigh and calf.
I have also had tummy pain and nausea. Right now, I am waiting to see if I am going to turn the corner.
I’m strong, resting as much as possible, and positive that I can beat this.
I thought my fatigue was from exercise
Fiona Bugler, 52, runs a wellbeing consultancy and lives in Brighton with her son Frankie, 23, and daughter Ciara, 19. She says:
Fiona Bugler, 52, felt unusually tired, but put it down to the after-effects of running a half-marathon at the beginning of the month
Frankie had been interning in London, commuting up every day using the Tube and doing a fair bit of socialising, too. But two weeks ago, he came home with a persistent dry cough. He was exhausted and just wanted to sleep and said he felt rough. We wondered if it was the coronavirus, but Frankie had a high temperature for only one night, so I didn’t bother seeking help as he was otherwise well.
Around the same time I felt unusually tired, but put it down to the after-effects of running a half-marathon at the beginning of the month.
But by the next day, Friday, I’d developed a high temperature — 38.5c — and my sense of taste and smell had disappeared virtually overnight. I had no appetite.
I was aching all over and had a pain in my chest and upper back and, despite my tiredness, I found it hard to sleep. I also had a dry cough. Sometimes I would feel like I was getting better for a few hours, and then I’d feel worse or develop another random symptom such as earache.
As if that wasn’t enough, I developed an unrelated urinary tract infection (something I am prone to) and phoned my GP surgery to ask for antibiotics.
When I reeled off my other symptoms, my GP said it sounded like I had Covid-19 and should self-isolate and not go outdoors at all for at least seven days. I asked how he was coping, and he admitted he had 40 other patients to phone back after me.
To be honest, I didn’t have the energy to go out anyway. I’m an endurance athlete but I was completely floored by this.
I woke up yesterday — ten days after my symptoms started — and still felt terrible, like I had been poisoned. This is going to take some time to get over, even though I am fitter than the average person.
Can it be really be spread by petrol pumps
While doctors battle to ensure we hear the right information about Covid-19, others seem determined to misinform. Today, we take a look at the latest rumours circulating about the virus and sift fact from fantasy.
YOU CAN BE INFECTED AT THE PETROL PUMP
A social media message shared by millions online claims that NHS officials are warning that ‘the virus seems to be spreading quickly via petrol pumps’.
While it’s believed the coronavirus can survive on plastic and stainless steel for up to 72 hours, a spokesman for Public Health England says: ‘Petrol pumps are no worse than other surfaces, although we do recommend people use gloves and wash their hands after using them.’
Dr Bharat Pankhania, a lecturer in public health medicine at the University of Exeter says: ‘You cannot treat one surface as being more dangerous than another — every surface poses a potential infection risk.’
A social media message shared by millions online claims that NHS officials are warning that ‘the virus seems to be spreading quickly via petrol pumps’ (stock image)
THE VIRUS SPREADS ONLY VIA COUGHING
‘This is simply not true,’ says Dr Peter Bagshaw, a GP in Minehead, Somerset. ‘In China, six out of seven cases of coronavirus were caught from people who didn’t have this symptom.
‘This could be because they were still incubating the coronavirus or simply that they didn’t have the classic symptoms we associate with it.
‘You have to treat everyone you meet as though they may have coronavirus and every surface as if it is potentially infected with it.’
A RUNNY NOSE IS NOT A SYMPTOM, JUST A COLD
You can have Covid-19 and also have a runny nose. Early studies suggest a runny nose is a relatively uncommon symptom, but some patients do have it and the World Health Organisation includes it in its list of symptoms.
‘Not everyone will exhibit the same symptoms, so don’t be complacent if you don’t have a cough or a fever,’ says Dr Pankhania.
BLOOD PRESSURE PILLS PUT YOU AT RISK
Some stories suggest there is a link between taking ACE inhibitor drugs — prescribed for those with high blood pressure — and an increased risk of coronavirus infection. They say this is because both the virus and the medicine target the same entry point of a cell, so taking the blood pressure drugs could make it easier for someone to be infected.
In a letter in The Lancet on March 11, scientists pointed out they had not confirmed the link.
Dr Sonya Babu-Narayan, associate medical director at the British Heart Foundation, says: ‘A number of expert groups have agreed there is a lack of evidence to support speculation that ACE inhibitors increase the chances of severe Covid-19 infections.
‘Stopping taking your medication could be dangerous — putting you at increased risk of a heart attack or stroke.’
While it’s believed the coronavirus can survive on plastic and stainless steel for up to 72 hours, a spokesman for Public Health England says: ‘Petrol pumps are no worse than other surfaces, although we do recommend people use gloves and wash their hands after using them’ (stock image)
SO WHAT’S THE TRUTH ABOUT IBUPROFEN?
We’ve heard concerns that taking ibuprofen could make Covid-19 worse, but what about other non-steroidal anti-inflammatory drugs (NSAIDs)?
Ian Jones, a professor of virology at the University of Reading, says: ‘The concerns around taking ibuprofen to treat Covid-19 relate to its biochemical mode of action.
‘It had been used in outbreaks of other viruses in the hope it would reduce the ‘cytokine storm’, a potentially damaging over-reaction of the immune system that some infections trigger.
‘However, the results of these studies have generally been negative and instead use of ibuprofen and other NSAIDs seems to lead to a longer recovery time. Paracetamol works in a different way and the latest NHS advice is to take it, not ibuprofen, for sore throats, high temperatures and other symptoms of Covid-19.
‘So I’d suggest avoiding NSAIDs and using paracetamol. But if you are already taking a NSAID for another condition, speak to your doctor before stopping.’