Moscow residents being tested for Covid-19, the illness caused by the new coronavirus, on Thursday.
Photo: yuri kochetkov/ShutterstockAs lockdowns ease across the world, keeping the new coronavirus at bay will depend on people seeking a test or self-isolating if they suspect they have symptoms. But, five months after the virus emerged, national health authorities don’t agree on how to define those symptoms.
In countries that describe the symptoms more narrowly, including the U.K. and up to last month the U.S., some people with the disease may have been unable to get tested and may have unknowingly spread the disease by mingling in the community.
Health experts say that some authorities restricted the number of officially recognized symptoms because they didn’t have the means to test every symptomatic patient. Now, as testing capacity is growing, more governments are expanding their lists of symptoms.
But some experts say they are doing so too late, leaving people confused and cases missed.
“It’s really harmful having a definition that is too narrow, because it means a lot of people will continue to go about their daily lives not thinking they have Covid when they very well might,” said Ashish Jha, director of the Harvard Global Health Institute.
Epidemiologists, medics and others tracking the virus say that as well as the classic symptoms of continuous cough and fever that were identified at the outset in China, there are at least 12 more manifestations of the disease, including extreme fatigue, headache, sore throat, gastrointestinal problems, conjunctivitis and sudden loss of taste and smell.
“The fact that this is a multisystem disorder has been quite clear for quite some time,” says Carl Heneghan, director of the Centre for Evidence-Based Medicine at the University of Oxford.
Starting Feb. 10, just over six weeks after the virus was first publicly identified in China, the World Health Organization added gastrointestinal symptoms to the signs it suggested countries survey in their first cases. The WHO had already recommended looking for indicators of respiratory disease—a cough, fever, sore throat and runny nose. It also said other symptoms from a list of 15 including nose bleeds, rash and conjunctivitis, should be considered. By March 23, the list was updated to ask about loss of smell and taste.
Italy, Spain, Sweden, Denmark, Norway, Australia, Germany and Switzerland, among others, soon adopted the WHO list.
In the U.S., the Centers for Disease Control and Prevention cited only cough, fever and shortness of breath as ways to identify the disease. On April 27, it expanded that list of symptoms to add six more—including loss of smell and taste.
“I understand that part of what drove a narrower definition early on was we didn’t have much testing capacity,” says Dr. Jha of Harvard. “So we didn’t want a lot of people with nonspecific symptoms coming in and getting tested because we couldn’t test the people that needed to be tested.”
The U.K. and Belgium have used a much smaller number of indicators of Covid-19, the disease caused by the virus. This week, the U.K. added two more—a loss of taste and smell—to its list, which until then comprised a continuous cough and a fever.
Joyce Pinfield, a director of the National Care Association in the U.K. who runs two care homes, said she was refused tests for residents displaying symptoms other than a cough or fever, even after the government said it had expanded testing to all residents and staff of care homes at the end of April. Ms. Pinfield wasn’t able to get tests for all her residents and staff until the second week of May, she said.
In Ireland, tests are available for those with a limited number of symptoms, but not a loss of smell or taste, which experts say is one of the early and more prevalent signs of disease. France names around 10 symptoms of Covid-19.
Belgium widened the symptom criteria for testing at the start of May as it began to reopen its economy. It expanded testing from health workers with cough or fever to anyone with a much broader spectrum of symptoms, including loss of smell and taste.
Steven Van Gucht, head of viral diseases at Sciensano, Belgium’s equivalent of the CDC, says the delay in identifying other symptoms was deliberate. “It was part of the exit strategy,” he says.
“It only makes sense to do this if you can also test these people,” Dr. Van Gucht says. While the country of 11.4 million was in lockdown, he says, anyone who was ill was supposed to stay at home anyway, and so they wouldn’t risk spreading it.
Belgium has lost over 9,000 people to the disease, giving it one of the highest per-capita death rates in the world. Dr. Van Gucht puts that down to a large population of elderly people, high exposure to the virus and very accurate counting of Covid-19 deaths.
In the U.K., medics, epidemiologists and nursing-home providers say the delay in expanding the number of symptoms the government recognizes has allowed the transmission rate to go up and tens of thousands of cases to be missed, while preventing vulnerable people from getting tested.
Jonathan Van-Tam, deputy chief medical officer for England, said the delay to adding to the “very simple, and easy-to-remember symptom cluster of cough and fever” was necessary to decide which symptoms would be useful to detect cases.
“We have taken our time in this country because we wanted to do that, again, painstaking and very careful analysis before we jumped to any conclusions,” Dr. Van-Tam told a news conference Monday.
SHARE YOUR THOUGHTS
If you or someone you know has contracted Covid-19, how did you identify your symptoms? Join the conversation below.
Covid-19 has killed more than 36,000 people in the U.K., the highest publicly confirmed death toll outside the U.S.
Data from a symptom-tracking app developed by King’s College London that has more than 3.6 million users in the U.K. suggest that 65% of people who have tested positive for the disease have experienced loss of taste or smell, compared with 34% who experienced fever and 57% who had a persistent cough.
Tim Spector, professor of genetic epidemiology at King’s College London, who leads the team behind the app, says limiting the number of symptoms in public-health messaging is costing lives. He estimates that between 50,000 and 70,000 people who had mild symptoms in the U.K. could have been spreading the virus because government websites didn’t acknowledge their symptoms.
The U.K. decision to recognize more symptoms was “better than nothing,” Dr. Spector said, but “four weeks too late when many cases could have been prevented.”
SARS-CoV-2 replicates rapidly in lungs, damaging tiny air sacs. Immune cells set off an inflammatory response against the infection, but too much inflammation can damage lung cells and blood vessels. In blood vessels, inflammation can activate proteins that form blood clots.
Clots in large blood vessels can lead to stroke or pulmonary embolisms. Microclots can make it hard for lungs to oxygenate blood; less oxygen can lead to multi-organ-system failure.
Some patients suffer heart-lining inflammation, heart attacks or abnormal heart rhythms.
Clots can cause painful, purplish swelling in the toes.
Some studies have found SARS-CoV-2 in cerebrospinal fluid. Patients have lost smell and taste. Some patients experience seizures, which are caused by abnormal brain activity, and hallucinations. Even young patients have suffered strokes, caused by clots reaching the brain.
Some patients report mild muscle and joint aches; others' pain is severe. The CDC recently added muscle pain to its symptoms list.
Some patients report gastrointestinal issues, including diarrhea. Stool samples have tested positive for SARS-CoV-2.
The CDC recently added sore throat to its symptoms list. Some patients report runny noses. Reports suggest conjunctivitis is a symptom; eye-fluid samples have tested positive for viral RNA.
Blood clots in capillaries may prevent blood from getting to kidneys, leading to acute kidney injury. Shock or a direct attack by the virus can also cause kidney injury.
STAY INFORMED
Get a coronavirus briefing six days a week, and a weekly Health newsletter once the crisis abates: Sign up here.
Write to Joanna Sugden at joanna.sugden@wsj.com
Copyright ©2020 Dow Jones & Company, Inc. All Rights Reserved. 87990cbe856818d5eddac44c7b1cdeb8
"some" - Google News
May 22, 2020 at 05:19PM
https://ift.tt/3cYZtZu
What Are the Symptoms of Covid-19? Some Countries Don’t Recognize Them All, Posing Risks to Reopening - The Wall Street Journal
"some" - Google News
https://ift.tt/37fuoxP
Shoes Man Tutorial
Pos News Update
Meme Update
Korean Entertainment News
Japan News Update
Bagikan Berita Ini
0 Response to "What Are the Symptoms of Covid-19? Some Countries Don’t Recognize Them All, Posing Risks to Reopening - The Wall Street Journal"
Post a Comment