Two
days ago, T found (quite by chance) that the previous week she had been in
contact with a person who was now at home with the same symptoms. However, the week
before, this person had come into contact with several visitors from France and
Spain. This person didn’t have a cough or fever, but had been advised by NHS 111
to self-isolate for a week as a precaution. We were shocked. Did we all have
covid-19? None of us knew. We certainly didn’t have the key symptoms. But, disturbingly,
there was no way of finding out. The NHS wasn’t going to test any of us unless
we became seriously ill.
There
are already high levels of stress and anxiety about the coronavirus, and the great
uncertainty about whether we are (or were) positive has added significantly to
ours. Importantly, if we had lived just 30 miles south of here (in the Republic
of Ireland) we would have been tested and, if necessary, our contacts traced.
The
Government coronavirus advice focuses on those who have moderate symptoms
(fever and persistent cough). A fever is defined as a temperature of 100
degrees F or higher, which means you will be feeling very unwell. Under these
circumstances, you are going to want to stay at home and be in bed anyway,
because you won’t feel able to do much else. Thus, the Government advice seems
to be targeting an extreme minority of people who consider that it might be sensible
to go out into the world with a high fever.
The
Government coronavirus advice pays no real attention to mild symptoms. These mild
symptoms are not described, nor is any advice given about what to do in the
event of getting them. The only comment that is made is that most people will
only get mild symptoms.
Why
doesn’t the Government advise people who have mild viral symptoms of any sort
to self-isolate for a week? This failure, allied to the lack of community testing,
generates an extremely serious problem. People with mild viral symptoms are
still infectious. Indeed, these are exactly the people who are more likely to try
and carry on with their normal lives, and in so doing come into contact with plenty
of other people.
From
a medical perspective, you focus on the most unwell and pay little attention to
the less afflicted. However, from a public health perspective, you also need to
consider the impact of those you are not focusing on. In an epidemic, neglecting
those with mild symptoms will surely lead to the coronavirus spreading more widely
and rapidly.
Because
it has been a week since the symptoms first appeared, we no longer need to
self-isolate. We feel okay, but the worry hasn’t gone. In fact, given the news
from Italy, it looks like it’s all going to get a whole lot worse before it
gets any better.
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