When President Joe Biden tested positive for COVID-19, he reported a runny nose, tiredness and dry cough — “mild” symptoms common at this point in the pandemic, but also many other things that doctors worry people may dismiss as unimportant.
“How many times have you or your child got a runny nose and go on with your life?” said Dr. Panajis Galyatsatos, a pulmonologist at Johns Hopkins Hospital and a critical care physician who has been treating COVID-19 patients.
“You dismiss it as an allergy and you keep infecting others,” he said. Perhaps someone around President Biden had a sore throat and hadn’t thought of anything. I appeal to everyone to be diligent.”
The country is facing another wave of cases, but most people don’t get very sick, and Galiatsatos and others who treat or study COVID-19 fear that many infections will be treated as an allergy or a minor cold or ignored entirely because people need to go to work. Or do you want a vacation?
Even those worried about the coronavirus may wonder when they need to be tested or stay home, and quick tests that miss an infection can create confusion.
Doctors say infection can make individuals sick and uncomfortable in the short and long term and put vulnerable people in the community at risk. They can also give the virus more opportunities to evolve.
The official number of cases in Maryland is still well below the peak of the epidemic in January. But it started rising again in April, with more than 1,700 infections reported Friday by the Maryland Department of Health. This is likely a much lower number because people don’t test or test at home and don’t report results. 574 people were reported hospitalized on Friday, with about 50 adults and children in intensive care.
The good news, experts say, is that vaccines, in addition to previous boosters and infections, still work to prevent people from severe disease. However, the dominant variant, BA.5, is highly transmissible and many vaccinated people become infected or become infected for the first time. Biden was vaccinated twice before falling ill last week.
Symptoms have been largely consistent during the pandemic, with people developing sore throats, coughing and congestion and then fever, aches and shortness of breath. Some people develop heart palpitations, dizziness when standing up or stomach problems. Fewer people reported loss of smell and taste than the most recent variant.
“No one should think they have a cold and not COVID,” said Dr. David Marcuse, incident leader at 13 hospitals in the University of Maryland Medical System’s COVID-19 Response System and medical advisor on COVID to Governor Larry Hogan.
“If you’re sniffing, have a fever and a sore throat, you should get tested to make sure it’s not COVID,” he said. “Test early and frequently.”
It is recommended that rapid tests be done at home three to five days after exposure. If the result is negative even after symptoms appear, test it again and even a third time, or get a more accurate PCR test done in a lab. If you are exposed and develop symptoms, assume you have COVID-19, wear an appropriate mask and distance yourself until symptoms subside, Marcuse said.
Marcuse said there are more cases this summer than last, although more people tend to stay outside where it’s safer in the warmer months. This indicates the transmissibility of BA.5 and that people may drop their defenses a lot.
This puts vulnerable people at risk; Most of those admitted to hospital are over the age of 60 or have existing health conditions such as asthma, high blood pressure, diabetes or cancer. There are still many deaths per day from COVID-19 in Maryland.
The profile of who’s in hospital at Carroll Hospital in Westminster is similar to Dr Mark Goldstein, an emergency medicine physician, although he said the numbers have been low since January. There are now five COVID-19 patients at Carroll County Hospital, compared to 70 patients at the peak.
Patients now have fewer respiratory symptoms. They suffer from nausea, aches and poor appetite, and are admitted to dehydration that can lead to kidney failure and other problems. It is a problem that amplifies in the elderly and in people with chronic diseases.
However, he cautioned, infection raises a person’s risk of related problems, including sudden death from a heart attack or stroke, as well as prolonged COVID.
“The disease is still troublesome,” Goldstein said. “It’s not something you want to have. It’s also a burden here in terms of employment. We constantly have people with COVID.”
He said that the antiviral drug Paxlovid helps eradicate a more serious disease. It has been prescribed to Biden, who is at higher risk because he is 79 years old.
Goldstein said the drug has side effects and shouldn’t be taken with some medications. Therefore, people should consult their doctor and develop a treatment plan before getting infected. If they need it, Maryland offers it at pharmacies under the “Test-Treatment” program.
Goldstein noted that antiviral is different from anti-flu, and it is expected that there will be a larger flu season this fall after two seasons with few cases. That would make testing more important, he said. The hospital has a test to distinguish between influenza, COVID-19, and RSV, which is common in children.
Galitsatos, who is also a physician at the Hopkins Post-COVID-19 Clinic, holds regular sessions with the community to answer coronavirus questions and provide advice. It has been found that a typical BA.5 case begins with a runny nose and sore throat. The fever can last a day or two, and sinus headaches and congestion can last longer. It’s also common to have a persistent cough with a lot of ‘sticky’ coming out. Babies seem to have more digestive problems.
“The key is to keep the airways open,” Galyatsatos said, which may involve using an asthma inhaler. “Avoid cough suppressants unless you have to give up a conversation or something, because the phlegm will only come back because the lungs want it out.”
Ideally, people should stay home from work or school and rest until symptoms are gone and rapid tests become negative, but he said that people with waning symptoms and no one to take care of them are likely to go to the grocery store with a proper mask. .
Call your doctor or head to the emergency room with trouble breathing, excessive dehydration, or other more serious symptoms, he said.
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Andrea Levine, a pulmonologist and critical care pulmonologist at the University of Maryland Medical Center in Baltimore who runs a post-COVID-19 clinic, said long-term COVID-19 management is more difficult, with treatment usually case-by-case.
“People are not getting sick from the virus now, which is a good thing, but a lot of people are getting it and re-infecting,” she said. “Each subsequent infection increases the chance of persistent symptoms. If you succumb to repeating this over and over again, that is not a good strategy.”
She said the vaccine appears to provide some protection against prolonged COVID, which means that fewer people are suffering from persistent conditions now than earlier in the pandemic. The shear number of cases still means a lot of long COVID. It’s unclear who will get it, although research suggests it’s more common in women and older adults.
Long-term COVID symptoms span the gamut from inconvenience to life-altering. Levine treats a nurse who used to stand on her feet all day and who can now only make telemedicine visits while lying down. Some people have very fast heartbeats and end up needing implantable heart monitors. Many of them suffer from fatigue and “brain fog”. Others lose their hair, can no longer do their daily run or get so dizzy that they can’t work.
She said there are ongoing studies to better understand the range of conditions and how to treat them.
“Every show is Russian roulette,” she said. “You can get sick and have coronavirus for a long time.”
Her defense: vaccination, reinforcement and wearing a muzzle.
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This article has been updated to correct Dr. Mark Goldstein’s affiliation with Carroll Hospital, Westminster. The sun regrets the mistake.