How is it going now?
The incubation period has shortened and is most often 2–4 days. The onset of the disease is rapid, with upper respiratory tract symptoms predominating, and the loss of smell characteristic of the early years of the pandemic is now noticeably less common.
- Pain and sore throat, often very pronounced in the first days
- Runny nose, nasal congestion, sneezing
- Temperature ranging from low-grade to 39°C, usually 2–4 days
- Dry cough, hoarseness of voice
- Headache, aches, severe weakness
- Less commonly - nausea, diarrhea, decreased sense of smell and taste
The key difference from the flu is that with COVID-19, deterioration may occur late - on the 7-10th day, when the primary symptoms have already subsided. That is why people at risk are advised not to relax after the first improvement and continue to measure saturation.
When to do the test and which one
The test answers a specific question, and the reliability of the result depends on the stage of the disease at which it is done. Different methods capture different things: some detect the virus itself, others capture traces of the immune response to it.
- Экспресс-тест на антиген даёт ответ за 15–20 минут и наиболее надёжен в первые 3–5 дней при выраженных симптомах, когда вирусная нагрузка максимальна.
- ПЦР чувствительнее и остаётся положительной дольше, но результат приходит не сразу; она предпочтительна при сомнительной картине и у пациентов групп риска.
- Отрицательный экспресс-тест в первый день симптомов не исключает инфекцию: имеет смысл повторить через 24–48 часов.
- Тест на антитела не годится для диагностики острой инфекции — антитела появляются поздно и не отвечают на вопрос, болен ли человек сейчас.
- Тестирование особенно важно там, где от результата зависит решение: назначение противовирусной терапии в группе риска, контакт с пожилыми родственниками, госпитализация.
To whom is COVID-19 still dangerous?
The statement “Covid has become like a cold” is true for most people and false for a noticeable minority. The risk of severe disease is unevenly distributed, and the more factors coincide in one person, the higher it is. This is the list for which vaccination, early testing and antiviral therapy are preserved.
- People over 65, and the risk increases every decade
- Severely obese patients
- Diabetes mellitus, especially decompensated
- Chronic kidney disease and dialysis
- Chronic obstructive pulmonary disease, severe asthma, interstitial lung disease
- Heart failure, previous heart attack
- Cancer patients on chemotherapy, transplant recipients, patients on immunosuppressive therapy
- Pregnant women - the course is more severe than outside pregnancy
Treatment: what makes sense
For most people, treatment is symptomatic and is no different from help with acute respiratory viral infections: fluids, rest, antipyretics if you feel unwell, remedies for a sore throat. Specific antiviral therapy exists, but is addressed to a specific audience.
- Antiviral drugs are prescribed to patients at risk and work only when started early - in the first days of illness
- A healthy person under 50 years of age without chronic diseases usually does not require specific therapy
- Antibiotics for COVID-19 are ineffective: it is a viral infection, and they cannot be prescribed “to prevent pneumonia”
- Hormonal drugs are used only in severe cases with respiratory failure and strictly as prescribed by a doctor - in mild cases they are harmful
- Anticoagulants are prescribed by a doctor if there are indications; self-administration is dangerous due to bleeding
- Vitamins and supplements do not replace treatment and do not affect the course of the disease
A separate misconception is the desire to do a CT scan of the lungs “just in case” on the second day of illness. In mild cases without shortness of breath and normal saturation, the study does not change the tactics, but gives radiation exposure and often reveals minimal changes that frighten the patient and provoke unnecessary treatment. CT is reasonable for shortness of breath, decreased saturation, prolonged fever and suspected pneumonia.
What to do at home
Home monitoring for coronavirus infection is built around one indicator - blood oxygen saturation. It changes before significant shortness of breath appears, and this is why a pulse oximeter is more useful than a thermometer in an elderly person or a patient with chronic diseases.
- Измерять сатурацию пульсоксиметром 2–3 раза в день, если вы или ваш близкий of группы риска. Показатель 95 процентов и выше при спокойном дыхании — норма.
- Пить достаточно жидкости и не пропускать приём привычных препаратов от давления, диабета, астмы.
- Проветривать помещение и по возможности изолироваться от пожилых членов семьи.
- Наблюдать за самочувствием и на второй неделе болезни: возобновление лихорадки и одышка требуют врача.
- При положении лёжа периодически менять позу, полезно проводить время на животе — это улучшает вентиляцию нижних отделов лёгких.
- Возвращаться к нагрузкам постепенно, особенно к спорту: резкий старт после инфекции переносится плохо.
Prevention and vaccination
The goal of prevention has changed: today it is not about avoiding the virus - this is almost impossible - but about ensuring that vulnerable people survive the encounter easily. Hence the shift in emphasis.
- Vaccination remains the main tool to reduce the risk of severe disease and is primarily addressed to older people and patients with chronic diseases
- Revaccination in risk groups is discussed with the attending physician, taking into account seasonality and the epidemic situation
- Hand washing and ventilation work against all respiratory infections at once
- A mask makes sense where there are vulnerable people: in hospitals, oncology departments, when caring for an elderly relative
- Not coming to work or visiting relatives with symptoms is the most underrated measure