How to tell if it is Covid-19 or something else?

Dr Farhad Kapadia

An interactive digital social sanchar, which means a discussion or talk show, with a health focus, ‘Monsoon Maladies in the Time of Covid,' was all about clearing the air when it came to ailments brought about by the season, and the novel Coronavirus. How can one differentiate between these two? Is it wise to handle these ailments at home? These were just some of the queries Dr Farhad Kapadia, consultant physician and intensivist, P D Hinduja Hospital and Medical Research Centre, took on.

Indrani Malkani, managing trustee and chairperson of VCAN, which stands for V-Citizens Action Network, that organised this session late on Thursday evening and is a non-profit public trust, stated that the monsoon has brought challenges of water borne and air-borne diseases. The crux was how can one differentiate between a monsoon related ailment and Covid-19? Can a person with Covid-19 also get a monsoon ailment like malaria, dengue, leptospirosis for instance? There is also the overall hesitancy of going to a medical facility in these times because of fear, the trustee pointed out, so it is vital that we tackle this.

Early bird
Dr Kapadia said, "Certain maladies are more common in the monsoon, especially water and air-borne diseases. Walking through dirty water during the monsoon allows infections to enter through cracks in the skin. This is called leptospirosis."

He said not all these illnesses can become life-threatening. Dr Kapadia stressed though, that the earlier the treatment starts, "within two to three days, the better. The later it begins five to six days for the same illness, it can become life-threatening." He had several take-home messages for his interactive audience: one was not to ignore a high fever or one that lasts over two days. "Do not try to sort out these matters over the phone and do not self-medicate. Consult a doctor and err on the side of early unnecessary investigations rather than delayed investigations." The doc added, "I am quite certain that despite my saying this, people will continue administering antibiotics and it is disheartening at times to see that people who come to us, have already started self-medication, switching between different antibiotics in their effort to get well."

In a message he called by far the most important, the doctor did some tough talking as he said, "recognise some danger signs when you are unwell, like undue breathlessness and lightheadedness. If you have confusion or other subtle neurological changes for instance, this is non-negotiable. You have to go to hospital rather than take a let us ‘wait and see' approach at home."

The expert added that "the vast majority of monsoon illnesses are mild and self-limiting. A little bit of patience and control over switching multiple medications will serve you well."

Covid-19 or not?

So, how does one differentiate between viral fever, reaction to allergies and the novel Coronavirus? His answer was, "We cannot reliably distinguish between them. The symptoms and signs reflect the immune system of the host (patient) fighting the invader (pathogen)." He did say though that the history and sequence of events do give a clue, and it is tests that will confirm the diagnosis. "There is no way without a test," he said. There was one vital point he made though, that in Covid-19, the oxygen levels tend to fall early. "You may be feeling well, but oxygen may plunge alarmingly low very early in Covid-19. In other illnesses, usually oxygen levels will fall later as the disease progresses and you start feeling increasingly unwell."The doc said that precautions against transmission of flu and Covid-19 are quite similar, hygiene, distancing and masks, and now, in case of Covid-19 vaccines too. "In countries which take throat swabs to document flu cases, it has been seen that the poor flu has no way to transmit now because there is so much accent on hygiene," stated the marathon-running, musician doctor who is a jazz buff and plays the saxophone, earning a few chuckles from his online audience and driving home the moot point that to differentiate between a monsoon malady and Covid-19, forget the rest, a test is best.