What Have I Got?

By Paul and Monica, Daily Apple Clinic

Hi everyone, we are mostly out of the flu and cold season, but we thought we might go over some of the typical symptoms we see in patients with COVID-19, respiratory syncytial virus (a.k.a. RSV), influenza (a.k.a. the flu), the common cold, and allergies, so folks could get a sense of what they may or may not have come down with. While symptoms alone will not definitively identify the virus you may or may not have, they can certainly help point toward a diagnosis. You may remember the term “tripledemic” from a couple of years ago, which referred to a combination of COVID-19, flu, and RSV at higher levels in the population. When infections occur together, they typically make you feel worse and/or for longer than from a regular cold, and it’s important to have a sense of what you may have contracted in order to heal better and quicker and protect others when you are contagious. We’ve created a comparison chart for your reference.

COVID, RSV, the flu, and the common cold all refer to viruses that cause upper respiratory tract infections and are spread in similar ways. The first three, however, have the ability to cause more serious lung illnesses and affect other parts of your body. If you have contracted either COVID or the flu, you will notice from the comparison chart that you are more likely to experience, headaches, body aches, and fever. The only way to identify the specific differences between these viruses is to conduct a test for each of them. Some tests are better than others, but positive tests will usually give a strong indication that the virus is present. Remember, too, that you may have more than one infection at the same time, and you may possibly have a bacterial infection superimposed on top of a viral infection. If your symptoms are confusing, that might be an indication for you to see someone to get checked out. Rapid tests are available in most clinics for COVID, the flu, mononucleosis, RSV and strep throat. Some can be done in combination with others. Testing can be useful in adding information to your health picture and directing your clinician to a diagnosis, so they can offer advice for appropriate care. In case you weren’t aware, COVID tests done at home or in the clinic are called antigen tests and are less accurate than the PCR tests which are sent to the lab, but both are done with a nasal swab.

COVID is a contagious respiratory disease that is usually spread when someone inhales respiratory droplets from an infected person or, much less commonly, by touching an infected surface and then touching the mouth, nose, or eyes. Symptoms can start from 2 to 14 days after exposure and last for about as long. Residual symptoms such as cough, shortness of breath and fatigue may continue for 4 to 6 weeks from your initial symptoms, and, rarely, individuals may experience more serious symptoms, such as blood clots and multisystem inflammatory syndrome in children. Remdesivir and Paxlovid are treatments that may be available to reduce your symptoms. In our clinic, we have found Paxlovid to be very effective for improving recovery and shortening the length of the illness. Unfortunately, the price has skyrocketed since the government stopped paying for it at the first of this year ($1,400 for a single course).

Influenza is caused by influenza A and B viruses and is spread in similar ways to the other viruses. Flu tends to have a more rapid onset and, like COVID, can make a person feel quite ill. An antiviral prescription may help reduce symptoms but should be given within the first 48 hours of feeling sick for the best effect. Otherwise, treatment is the same as for the other viruses. Most people recover from the flu within 5 to 7 days.

RSV causes a serious lower respiratory tract infection, usually in babies and young children, but adults can get it, too. Adults, however, usually only experience this illness as a cold. Older adults, or people with chronic medical conditions may, however, develop more serious illness. Antigen tests for RSV are readily available, but can be expensive (over $200). Individuals usually recover from RSV within a week or so.

Cold symptoms usually appear within a few days of being exposed. There is no specific cure for the common cold. Recommendations for treatment are simply over-the-counter pain relievers and cold remedies, hydration and rest. Most people recover in 3 to 10 days.

Seasonal allergies are the one diagnosis we mention here that are not caused by a virus. Rather, they occur as your immune system responds to allergens in the environment, such as tree and grass pollen. They can, however, have symptoms similar to viral infections, and therefore warrant mentioning for comparison. Seasonal allergies may also cause difficulty breathing if you have a respiratory condition known as asthma, which can be triggered by pollen exposure. Allergies are usually treated with over-the-counter antihistamines, spray decongestants and avoiding exposure to the allergens you are sensitive to.

As medical providers, we are always thinking about prevention. Vaccines are currently available for influenza and Covid. These vaccines are constantly being reconfigured as viruses mutate from one season to the next, so, unfortunately, you should continue to be vaccinated each year. The vaccines vary in effectiveness because we never know how those viruses will mutate, and it can be difficult to anticipate those changes in virulence, or severity, and transmissibility, but it is important to use them to reduce your risk.

Otherwise, it is important to reduce your risk by sticking to the following good habits:

• maintain physical distance from persons with symptoms,
• wear masks if you are ill or there is a higher likelihood of you being in contact with persons who are,
• wash your hands often with soap and water or use sanitizer with at least 60% alcohol,
• avoid crowded, indoor spaces or areas with limited ventilation,
• cough or sneeze into a tissue or the inside of your elbow,
• avoid touching your eyes, nose and mouth,
• avoid sharing common household items with sick individuals,
• keep high-touch surfaces clean with disinfectant, and
• stay home in isolation if you are sick, unless you are seeking medical care.

We hope you find this information useful and something that will both alleviate your concerns and give you the tools you need to decide if you need to see a qualified health professional.

Take good care

Paul and Monica

Daily Apple Clinic

www.dailyappleclinic.com