Protect your health and finances – 15 pages of advice
The NHS says it’s a fever and a cough. Yet we’ve talked to many Covid-19 victims who paint a far more complex picture...
ANEW, persistent, largely tickly cough and a temperature measuring above 37C. These, according to official NHS advice, are the two telltale signs of Covid-19. And if we come down with either, we – and our families – must confine ourselves to our homes, sleep in separate beds and turn away all visitors – for at least 14 days.
But, as the number of cases explodes across Britain, patients themselves are reporting altogether different symptoms.
Over the past week, this newspaper has spoken to sufferers both in the UK and the rest of the world to find out what Covid-19 actually feels like.
And, according to them, it can range from anything from sore eyes to mild tiredness.
For many, the cough and fever crop up a week into their illness, once they’ve unknowingly infected hundreds of others. Dr Edward Wright, virologist
and senior lecturer in microbiology at the University of Sussex, says: ‘For every one case with the typical symptoms, five to ten cases may go undetected because their symptoms may be atypical, or they could have none at all.’
All of which begs the question: if the illness can be so varied, how do you know you’ve got it?
Unsurprisingly, one of the most-Googled questions of the past two weeks is: ‘What are the first signs of Covid-19?’ We’re told spotting the signs early is crucial for stopping the spread of infection.
Government advice would suggest that the signs are easy to detect – it’s based on studies showing roughly 82 per cent of sufferers will notice a new, persistent cough, and 98 per cent will have a temperature above 37 degrees.
Yet, patients themselves have described a wide variety of early-stage symptoms, easily mistaken for ‘jetlag’, the effects of an ‘intensive gym workout’ or being ‘generally run down’.
Lidia Puerta, a 26-year-old former student at Imperial College London who is eight months pregnant, described the early stage as ‘just exhaustion’ and says she put it down to recent travels, or pregnancy.
‘Last weekend I’d just got off a flight from Madrid,’ says Lidia, who tested positive for the virus last Sunday and is in quarantine in a hospital in Singapore, where she lives. And when I arrived home, I felt more exhausted than usual and had a bad night’s sleep, feeling a bit hot and cold. But I didn’t have a fever. It was a bit like jetlag when you have been trying hard to sleep on the plane and you wake up every ten minutes.’
LIDIA only sought medical help because she was ‘over-cautious’, having returned from a high-risk area and being eight months pregnant. She says: ‘If I wasn’t pregnant, I probably wouldn’t have rushed to do the test. I would have gone later and probably infected many others instead.
‘About three days after I started to feel unwell, I coughed twice – yes, just twice – at night time, and I’ve had some phlegm.’
Since then, Lidia, who is originally from Spain, says she has been ‘completely asymptomatic’. ‘For me, it felt like tiredness,’ she says. ‘By the third day, I could sleep well.’
Her husband, Junye Huang, who has also tested positive, did not suffer from a cough either.
London-based GP Clare Gerada, who tested positive for the virus on Friday, March 13, also simply felt jetlagged at first.
Speaking from her London home where she is self-isolating, the 60-year-old says: ‘I got back from New York on the Sunday morning and by Monday, I had an irritating cough – exactly like I get when I usually come off a flight.
‘It was a bit like something was stuck in my throat. But other than that, I was absolutely fine, so I didn’t think anything of it.’
Dr Gerada’s initial symptoms were so mild, she went to work on Monday. It was 48 hours after the first warning signs that things took a turn for the worse.
‘The cough just wasn’t going, and because it was dry, scratchy and became more painful, I realised it was different to flu or anything else I’d experienced before,’ says Dr Gerada, who is the former chair of the Royal College of General Practitioners.
‘Around the second day, I developed a vice-like headache. I decided to work from home and started to feel unbearably hot. But when I went to bed, I couldn’t stop shivering. I had several blankets on me, I was wearing a thermal vest and pyjamas and was still freezing cold. Five minutes later, I was baking hot and kicking all the blankets off me.
‘For the next two days, all I could do was sleep. I lost weight because I couldn’t stomach anything. Even when I got a bit better a few days in, it still felt like the worst hangover in the world. It was the worst I have ever felt.’
Despite this, Dr Gerada managed to treat herself at home with paracetamol only.
One 43-year-old patient, who does not wish to be named for fear it could jeopardise his job, likened his initial symptoms to an intensive exercise regime.
He said: ‘I came home last Friday, feeling absolutely fine and enjoyed Saturday playing games in the garden with my fiancée and two-yearold. But then, on Sunday morning, I woke up feeling achy all over. It was as if I’d done a high-intensity workout at the gym – everything hurt.
‘I still managed to get around the house and run after my little girl, but every time I moved my legs, they felt ridiculously heavy, as though they weighed a ton.’
The supposed tell-tale cough came almost a week after the original complaints.
So are we watching out for the wrong symptoms?
‘A cough and fever are reliable indicators of this particular virus,’ says Dr Wright.
‘Coronaviruses usually result in a fever and high temperature, which are the physical signs that the immune system is kicking in and attacking the virus.
‘It’s only once the virus replicates, slightly further into the infection, that it can cause damage to the upper respiratory tract, which can result in a cough and soreness.
‘If you are younger and healthier, your immune system will be more alert to intruders and respond quickly. So you may be more likely to experience more significant fever-like symptoms faster.
‘But we don’t know for certain why some feel symptoms faster than others. That’s why community-testing people that don’t have symptoms is a good idea, so we can spot people before they develop symptoms and are infectious.’
Equally challenging are the Covid19 patients who experience few to no symptoms.
Karen Whitaker, a 35-year-old lawyer from Cape Town, bypassed the recommended temperature checks on a flight home from Munich, thinking she was feverfree, so couldn’t be infected.
‘I had a little dry cough but the symptoms didn’t develop further,’ she says. ‘I only coughed a few times. I decided to have the test [privately] mainly to prove that I was negative because I was anxious to get back to work.’
Even now, almost two weeks after contracting the virus in Germany, she says: ‘I feel surprisingly OK, if a little tired.’
Lots of other sufferers feel just ‘coldy’. One 47-year-old woman from Vo in Northern Italy – one of the regions most affected – said: ‘It was just like influenza and it quickly passed.’
The woman, a bar owner, took just two days to recover.
Infectious-disease expert Dr Neil Ferguson, who is advising the Government on Covid-19, was well enough to do a radio interview at the peak of his illness.
‘I developed a slight, dry but persistent cough and self-isolated even though I felt fine,’ he tweeted on Wednesday.
He added later: ‘At four o’clock in the morning, I got a high fever, which is somewhat better now but I still feel fairly grotty.’
The virus is said to be fatal in roughly two per cent of cases, however experts say that it’s too early to give an accurate fatality rate – and figures vary depending on the country and specific health system.
Those who are older and with heart disease or other serious conditions are most badly affected. But eight out of ten sufferers may experience a mild illness.
Last week, American researchers claimed some patients were reporting ‘nausea or diarrhoea’ – despite many symptom-checkers that have been published indicating this was rare. Other German reports document patients who feel, ‘like they have a cold’.
So should those with even the slightest sniffle take serious precautions? Perhaps, says Jonathan Ball, Professor of Molecular Virology at Nottingham University.
‘There is emerging data that suggests that in as many of 70 per cent of cases the infection will present with symptoms similar to a common cold.
‘It wouldn’t be unreasonable to
assume they can easily transmit the virus.
‘Based on Government advice – which specifies a persistent cough and raised temperature – most of the people who can potentially transmit will not be aware of the risk they pose to others and will not self-isolate.’
Dr Wright agrees: ‘Coronaviruses in general, of which there are seven different kinds, cause cold-like symptoms such as runny noses and muscle aches.
‘With this particular type, a cough and fever seem to be particularly common, but you don’t always get those.
‘If you have just a runny nose, there’s a chance you could just have the common cold virus. But there’s also a chance you could test positive for Covid-19.’
There are plenty of patients, however, who would describe their illness as anything but ‘mild’.
And not all, despite what’s being said about the ‘vulnerable’, have underlying health conditions – or are over 65.
On Friday, a gym-going motherof-two took to social media to share her ordeal, posting videos of herself in hospital with the virus, describing every breath as a ‘battle’.
TARA Jane Langston, 39, from North-West London, contracted the virus over a week ago during a trip to Poland. Doctors thought she had a chest infection but her symptoms quickly intensified, developing into pneumonia at the end of last week.
She was admitted to Hillingdon Hospital and tested for Covid-19.
In a harrowing WhatsApp video clip, she points to a nasal tube providing her with oxygen and says: ‘Anyone who is thinking of taking any chances, just take a look at me. I’m in the intensive care unit. I can’t breathe without this.’
The reason why otherwise healthy individuals become so desperately unwell from this virus is currently unknown, according to Dr Wright.
‘We don’t have a clear picture why some people may have mild disease, and others severe,’ he says. ‘It could be to do with genetics but it could be to do with the virus replicating more rapidly, killing more cells.
‘There is an argument that, in some young people, the immune system may not be developed.
‘Perhaps it hasn’t seen as many viruses as an older person’s would, so it could be slow at detecting it.’
For Dr Gerada, the severity of her illness has, oddly, restored her faith in her body.
‘It made me realise that this is a horrible, horrible virus but, for most people, our body can fight it,’ she says.
‘The immune system is incredible. If my 60-year-old body can get me through it, that bodes well for the rest of us.’