More cases of colds and flu likely
AS SOUTH Africa navigates the autumn and winter months during the Covid-19 pandemic for a second year, it is likely to be more challenging this time around.
That’s because we will probably see more cases such as flu.
This is because there are more people moving about this year, compared to the same time last year, when the country was adhering to harder lockdown regulations that restricted movement and socialising.
The POST spoke to Dr Lashika Athmaram, a general medical practitioner with special interests in travel medicine, aesthetic medicine and diabetic care.
She said more people were already suffering with congestion, runny noses and the like. But Athmaram said there were indicators within the first few days that would help to differentiate between a cold or flu virus and Covid-19.
“Going into winter, we are going to get a few different viruses that come about, apart from the influenza virus. These are the viruses that give you the so-called head cold and sniffles.
“At the moment, one of the viruses going around is Rhinovirus. It affects your sinuses, so from day one you will sneeze a lot, have a runny nose and congestion. That is not typical of Covid-19.
“By day two, you will have a very runny nose and a headache, and possibly a slight fever by day three or so.
“Whereas with Covid, if you are symptomatic, you will present with fatigue, maybe a fever and a sore throat is common. But hardly ever are sinus symptoms common presenting factors with Covid.”
Athmaram said there were a fair amount of sinus infections seen over the past few weeks.
“We have seen a lot of acute sinusitis and upper respiratory infections. Personally, I have not had anybody so far (with these symptoms) who tested positive for Covid.”
Be proactive
With the change of season, Athmaram suggested being proactive about boosting one’s immunity.
“It’s about maintaining what we have been doing throughout the pandemic – maintaining your daily doses
of vitamin C and vitamin D, and maybe take a multivitamin.
“Also eat healthily. The most important is the non-pharmaceutical prevention, which is social distancing, mask-wearing and sanitising.”
She said taking the annual flu vaccine was also important, particularly for people with comorbidities such as asthma and diabetic patients.
“In pre-Covid times, this would be the part of the year where we would focus on influenza prevention with flu vaccines, especially among people with comorbidities. They are encouraged to take flu vaccines to prevent influenza, viral pneumonia and related complications. It is the very same now with Covid.
“We can’t put influenza in the back seat because of Covid. It is still there.
“During this time last year, we did not see too many influenza cases because we were on a hard lockdown.
“People were more vigilant with masks and social distancing and they were not socialising that much. But now people have let their guard down and they are socialising.
“There are a lot of events and so forth. So we may see more influenza cases this year.”
Long-Covid also a factor
Athmaram said this year, patients battling Long-Covid could be added to the vulnerable group who should also be cautious over the flu season.
“What we are seeing now, after our second wave, is a lot of patients with lung damage, fibrosis and lung collapse from their Covid pneumonia.
“These patients are highly susceptible to being hospitalised again if they, for example, were to contract influenza.
“They would be in trouble. So it is important for them, like those with comorbidities, to get the flu vaccine.
“This year there is the Tetravalent flu vaccine which can protect you against four strains of the influenza virus as compared to the two previous years when it was just three.
“This also stimulates the immune system so that you have some kind of immune protection or it puts your immunity on alert for any other infection.”
Recommended groups for 2021 flu vaccine
In a statement, the National Institute of Communicable Diseases (NICD) said with the circulation of severe acute respiratory syndrome coronavirus-2 (Sars-CoV-2) – the virus that causes Covid-19 – it recommended the influenza vaccine.
It said it was likely that the two viruses would be circulating simultaneously, and the flu vaccine might help to decrease the burden on the health-care system.
The institute highlighted the following groups as recommended to receive the influenza vaccination in 2021:
Health-care workers
Persons older than 65 years Persons with underlying chronic health conditions HIV-infected adults Pregnant women at any stage of pregnancy, or post-partum Residents of old-age homes, chronic care and rehabilitation institutions Persons aged 6 months to 18 years on long-term aspirin therapy Children aged 6 months to 5 years and their household contacts or caregivers
Any persons wishing to minimise the risk of influenza acquisition.
Identifying Covid-19 from flu
Athmaram said in the first seven to 10 days of a Covid-19 infection, depending on your immunity, it was more like a viral infection.
“You have fatigue and body pain and then the inflammatory phase kicks in. That’s when you get Covid pneumonia – after the first 10 days of your infection – that is the acute phase of the Covid infection.
“The long-term Covid patients are those who are now suffering from the complications from the inflammation. It’s not only the lungs that become inflamed, it’s an inflammatory process that affects the entire body.
“We are treating patients today for fatigue, who had Covid in December. There are patients who have ‘brain fog’ because they have had neural complications from the Covid infection in the brain and in the nerves.
“They have loss of memory and they are unable to focus.
“It ranges from that to chronic headache and then there is the damage to your lungs.
“These patients tend to get secondary bacterial infections because their lungs are damaged. So there's no Covid virus by now in their bodies. The virus came, did its damage in the first seven days, and it's gone. But now patients are dealing with all the fibrosis and the damage that the inflammation has caused, which has led to long-term Covid.”
On edge
Athmaram said as the Covid infection increased, medical workers remained on edge behind the scenes, waiting for the third wave.
“It is being monitored closely. We can see the numbers increasing in certain parts of the country so we are on edge.
“This is why the non-pharmaceutical preventative measures remain the most important and the best prevention. Sanitise and social distance.
“Also wear a double mask – a surgical mask and over that a cloth mask – if you go into a high-density area or if you cannot avoid going into a busy place, like supermarkets.
“And I think that it is important to mention the Covid vaccine. We seem to be having a lot of what we call vaccine hesitancy. People need to be encouraged to register and take the vaccine.”