You wake up with a scratchy throat, a cough and a general feeling of malaise. Yet you have a busy week at work and a party to attend. So, what should you do? On the one hand, it’s October, the season of mists, mellow fruitfulness and, yes, seasonal colds. On the other hand, Covid cases are on the rise.
Professor Tim Spector, the scientific co-founder of the health app ZOE, says that ZOE data indicates that one in 26 people in the UK currently have symptomatic Covid with rates rising in all age groups – most notably the over-75s. “Latest data shows a 50 per cent rise in two weeks,” he says. “The autumn wave is here.”
Figures from the Office of National Statistics indicated that more than a million people were likely to have tested positive for coronavirus in the third week of September.
In pre-Covid times, we’d often ignore symptoms like these. The keep-coughing-and-carry-on spirit was so common that in 2004 the TUC protested about adverts for remedies such as Lemsip, which boasted they could get even the most stricken back to work to stop a rival snaffling their job.
Covid changed everything. We were ordered to test at the first sign of a sniffle, then seal ourselves and our families into our homes, unable even to take the dog for a quick walk around the block.
But nearly three years into the pandemic, with more than 90 per cent of people in the UK aged over 12 jabbed at least once, and over 70 per cent boosted, how differently should we treat our suspicious symptoms now?
The decision is made more complicated by the fact that since April we have had to pay for tests – though rapid tests are available in supermarkets and pharmacies. Sainsbury’s is selling a box of five for £9.50. Plus, there’s a huge amount of uncertainty about what symptoms are most indicative of Covid.
What to do if you feel unwell
Spector says the most likely symptom of the current iteration of Covid is a sore throat, affecting two-thirds of positive cases. A friend currently sick with Covid describes it as the “worst sore throat I’ve ever had. It’s like Alien has taken up residence in my larynx”. Others include a runny or blocked nose and cough. The classical symptoms such as loss of smell and fever are, he says, “very uncommon now”.
This prevalence means anyone being offered a booster vaccination should take up the offer, ideally alongside a flu jab to head off the “twindemic” predicted for this winter. Most of us feeling rough at the moment probably have an old fashioned cold. Spector says that ZOE data shows that they are five times more common than Covid.
Should you take a Covid test?
With so much overlap, how can you tell the difference between symptoms of Covid and a cold?
“While sneezing is more common in colds than Covid, testing is the only way to distinguish between them,” says Spector. “Covid is still worse and less predictable than a cold. It can lead to hospitalisation and is much more harmful to older people.”
He says the new etiquette should be that we treat them both in the same way, by resting at home and avoiding people, until we test negative after at least two days of the symptoms. If we test positive, we should stay at home for at least five days, provided we have “stopped feeling lousy and coughing all over the place”.
Should you wear a mask?
Yes, says Spector. “You might want to wear a mask and avoid crowded places for a few more days, as you are likely to still be slightly infectious.”
While most of us have consigned our tatty masks to the bin except for hospital visits, my daughter, 17, donned one for a theatre trip while suffering from a cold (yes, she tested) a week ago. Her view? “I don’t want people coughing over me, so I don’t cough over them.” I couldn’t help but approve of her social conscience.
What’s the official line?
The Government has removed all legal restrictions around Covid, so technically we are free to do as we please. However, the Department of Health suggests that if you have any symptoms of a respiratory infection, and do not feel well enough to go to work, you should stay at home and avoid contact with other people until your temperature goes down or you feel well.
The guidelines say you should “try” to work from home. If you do have to go out, you should wear a surgical face mask, avoid crowded or enclosed places, wash your hands and cover your nose and mouth when sneezing. If at home, open windows and clean surfaces regularly.
If you decide to test, must test because of your job (such as teaching) or want to test prior to a visit to a care home, and you are positive, the advice is similar. Echoing Spector’s advice, it also recommends you stay at home and avoid people for “five days after the day you took your test” as most people will not be infectious at that point. To be on the safe side, it suggests avoiding vulnerable people for a further five days.
Can we use our own judgement?
Eleanor Riley, professor emerita of immunology and infectious disease at the University of Edinburgh, suggests in the current situation there is a lot of scope for personal decision making.
“I think we have reached the stage in the pandemic where people need to take a personal, risk-based approach,” she says. “The virus is so widespread that individual testing and isolating is not going to have any perceptible impact on transmission. And most of us are well protected against severe disease by vaccination and/or prior infection and are at minimal risk of becoming extremely unwell.”
So, whether we test and isolate really depends on our perception of our own risk and the risk we pose to others.
People with significant comorbidities – suffering from more than one illness or disease – who may be eligible for antiviral treatments would be well advised to get themselves tested. People who are in close contact with such people should also be cautious, get tested and avoid contact with vulnerable people until they test negative.
For the rest of us, following the basic health and hygiene advice that applies to any respiratory virus and remaining aware of the vulnerabilities of others is probably the way forward.
Is there any good news?
Yes, says Spector. “Covid is still fairly mild. There’s no evidence the current wave is more severe than previous ones. Plus, if we have a November Covid peak, it is less likely to affect us at Christmas.”
Let’s hope for some seasonal cheer.
GermDefence can help you identify simple ways to protect yourself and others in your household from Covid-19 and other viruses