Symptoms of COVID 19

By dentist Dr. Richard Mitchell

UPDATE MARCH 2021

Global reported cases is now over 100 million, while reported deaths is over 2 million.

We are all concerned about the symptoms of COVID 19 infection and the worldwide  pandemic. But what exactly ARE the symptoms of covid, and is it safe to go back to the dentist yet? What extra precautions might your dentist be taking in his office to avoid infecting you, and ALSO to avoid being infected BY you?

Coronavirus particleThe virus

I am working in Spain, and on March 16 2020, the government declared a state of emergency and the country went into lock down. The information here is based on advice issued by the World Health Organization, and the American Dental Association.

To clarify 3 things first;

  • The word 'coronavirus' is used to describe any corona virus, and there are several.
  • SARS-CoV-2 is used to describe the new virus that has emerged and caused the current pandemic. It stands for Severe Acute Respiratory Syndrome CoronaVirus 2
  • Covid 19 is the word for the disease that is caused by the new virus, and it stands for Corona Virus Disease 19;  (as it was first identified in the year 2019).

Woman wearing a face maskDoes a mask help?

If you are having a dental problem, and cannot get to see a dentist for whatever reason, you can read some of my tips for home remedies HERE.

These tips may help to get you through until you can get to a dentist.

WEAR A MASK AT ALL TIMES OUTSIDE YOUR HOME

Symptoms of COVID 19

But first of all, what are the main symptoms of COVID 19 to be aware of and watch out for? There are several symptoms that may indicate you have been infected, and you may get only one symptom, or more than one; OR NONE AT ALL ! But you will still shed virus particles around you, which may hang in the air as an aerosol up to 15 feet away! Think of it as being like cigarette smoke in the air. The virus particles spread like cigarette smoke.

The main symptoms are;

  • A dry cough
  • A fever
  • Shortness of breath
  • Feeling tired and weak
  • Loss of sense of smell and taste
  • "COVID" toes and/or fingers.
  • Neurological symptoms
  • A red rash on your arms, chest, back, or legs.

Let's take a look at these one by one, and explain exactly what is meant.

A dry cough.

This is when you get a dry, tickly sensation in your throat, as if you've got a bit of dust or fine sand in there, and you have to cough. But the cough doesn't bring anything up. There's no phlegm, nothing. It's a "dry" cough. You might think that this cough would go away in a few minutes. But if it's caused by a coronavirus infection, the cough persists. You just have to keep coughing.

A fever.

The best way to check this is with a modern digital thermometer.

The normal body temperature should be between 97-99 degrees F, or 36.5 to 37.5 degrees C. (Celcius or Centigrade). If you record a temperature above 100.4 degrees F, then you have a fever.

Shortness of breath.

You may feel some difficulty breathing, as if you can't take a full breath properly. You feel a bit breathless, and try to take a deep breath to get some more air, but it doesn't work. You end up feeling that you are having to "work" at breathing, where it is normally something we don't think about doing, it just happens.

Fatigue.

You just feel tired and weak. Some people have reported getting the dry cough, then the next day feeling short of breath, then feeling better after another day or 2, only to wake up with a feeling of total fatigue.

Loss of Smell and Taste.

A lot of people who have contracted the coronavirus have reported that they lost their sense of small and sense of taste. They noticed that, among the other symptoms, they could not smell anything, and could hardly taste anything. Once the fever subsides, these senses return to normal. BUT a loss of sense of smell is NOW being recognized as  one of the FIRST symptoms of COVID.

COVID toes and / or fingers. 

Another more recent symptom accumulating more anecdotal evidence has been informally called “COVID toes or fingers.” It’s the presence of purple or blue lesions on a patient’s feet and toes, most commonly appearing in children and young adults. This is to do with abnormal blood flow. The new virus seems to affect blood clotting in some people.

Neurological Symptoms

SARS-CoV-2, the coronavirus that causes COVID-19, may cause neurological disorders by directly infecting the brain or as a result of the strong activation of the immune system.

Recent studies have found the novel coronavirus in the brains of fatal cases of COVID-19. It has also been suggested that infection of olfactory neurons in the nose may enable the virus to spread from the respiratory tract to the brain.

Cells in the human brain express the ACE2 protein on their surface. ACE2 is a protein involved in blood pressure regulation and is the receptor the virus uses to enter and infect cells. ACE2 is also found on endothelial cells that line blood vessels. Infection of endothelial cells may allow the virus to pass from the respiratory tract to the blood and then across the blood-brain barrier into the brain. Once in the brain, replication of the virus may cause neurological disorders.

Red Rash

It has recently been recognized that some people may just get a red rash as pretty much the only symptom of covid-19. Some authorities are requesting that this be officially stated by the World Health Organization.

WEAR A MASK AT ALL TIMES OUTSIDE YOUR HOME

Arm skin rash of covid 19Skin rash; image courtesy news.sky.com
Washing hands over a basinHand washing is very important

Symptoms of COVID 19 -
Why it's worse than normal influenza

There are 3 main reasons why this new virus is so much worse than normal seasonal 'flu.

1. The seasonal influenza (or "flu") virus that crops up each year changes slightly from year to year. However many people have some degree of protection from previous exposures. While this may not prevent them from getting 'flu at some time, it means that the symptoms are not so severe.

With  covid - 19, humans have NO previous exposure and therefore no resistance to the virus. This is NOT a virus that has infected humans before, and so we have no degree of immunity at all. If you are exposed to the virus, you are highly likely to get infected. And the new mutant strains are even more infectious.

2. During a normal 'flu outbreak, each person with 'flu can be expected to infect about 1 other person - on average. With the Coronavirus, current figures suggest that each person with the covid19 virus is likely to infect at least 2 other people - perhaps MORE with the new variants that have appeared in the U.K., South Africa and Brazil. These variants have been seen worldwide and are now spreading aggressively.

3. This virus started spreading at an exponential rate, then slowed down over June and July 2020. It accelerated again in the Northern Hemisphere winter - December 2020.   Just click on this link to see the figures at worldometer.info, and be sure to scroll down the page, past the figures, to see the graphs of cases. We are maybe just about seeing the plateau of new cases and deaths, as lock down restrictions and vaccines start to take effect.

4. The death rate;  WHO Director-General Tedros Adhanom Ghebreyesus said that globally the seasonal flu kills about  0.1% of those infected, while about 2% of reported COVID-19 cases have died.

So the total number of people who will eventually die from this new virus is likely to be measured in the MILLIONS worldwide.

Update MARCH 2021 - According to Johns Hopkins data, global deaths from Covid-19 infection is now reported to be over 2 million, while over 100 million people worldwide have been infected. That is a death rate of OVER 2%.

In the USA alone, over 300,000 - (three hundred thousand) -  new cases were being confirmed EVERY DAY in January 2021, while the death rate was over 4,000 - (FOUR  thousand) - each and EVERY DAY during January 2021. That's 4,000 people being killed by covid-19 every day. Thankfully, rates of infection and deaths are now going down, due to better anti-infection measures and the vaccines beginning to have an effect.

The vaccines now available seem to have slightly different rates of effectiveness, but it's important to realize that they ALL prevent severe covid, hospitalization and deaths by 100%. So it doesn't matter WHICH vaccine you are offered - just get it!

WEAR A MASK AT ALL TIMES OUTSIDE YOUR HOME.

Symptoms of COVID 19 -
Who is most at risk?

Approximately 80% of people who become infected have mild to moderate symptoms. Some people get the infection but experience no symptoms and show no signs of infection. These are the 'silent spreaders',  who spread the virus without realizing it.

But around 14% have more serious symptoms, especially men.

You are more at risk of developing serious symptoms of COVID  if you fall into one of these groups;

  • You are over 60 years of age.
  • You have a pre - existing medical condition, such as high blood pressure, diabetes, heart disease, lung disease or cancer.
  • You are overweight.

It seems that the older you are (over 60), the higher the risk. Rather oddly, children do not seem to develop symptoms anything like as severe as adults.

HOWEVER, being younger (say 30 years old) and fit (being a marathon runner or training for an Iron Man triathlon) is no guarantee that you will have only a mild infection. There are documented cases of people like this needing to spend 2 weeks in an intensive care unit, on a ventilator.

This disease is unpredictable, and CAN kill even young people. And then there is 'long covid', where the main symptoms subside, but you're left with fatigue and exhaustion for MONTHS afterwards,

According to the BBC on July 9 2020;  "A June 17 study published in the New England Journal of Medicine focused on potential genetic factors in severe cases of COVID-19 with respiratory failure. The study involved nearly 2,000 patients with COVID-19 at seven hospitals located in Spain and Italy. Researchers observed that type O blood was associated with slightly more protection from the virus, while those with type A blood may be more vulnerable to the disease."

Symptoms of COVID 19 -
How to protect yourself

  • To dispel one myth immediately - wearing a face mask - ANY face mask -  DOES reduce the virus being expelled by you, if you are already infected. This protects others, and reduces transmission of the virus between people by about 65%.

  • And wearing a good quality mask such as an N95 or FFP2 standard mask will also protect YOU from getting the virus off others.


Face mask FF2 - N95 standardLook at the small print above the large CE letters; FFP2 CN95

WEAR A MASK AT ALL TIMES OUTSIDE YOUR HOME

There are many other myths about eating garlic, saline solutions for your nose, and taking antibiotics. All are useless against the covid-19 virus.

SO, what actually works?

First, The main mode of transmission is by droplets expelled into the air when you talk, cough or sneeze,  which are then inhaled by someone else. The virus can also travel as an aerosol, which can hang in still air for quite some time. Think of it like cigarette smoke.

The virus can spread like cigarette smoke. If you can smell smoke in the air, you are inhaling particles that were in the smoker's lungs moments before. That's how it spreads.

These 2 ways the virus is passed on mean that the best protection is to wear a good quality face mask ALL THE TIME when you are outside your home, and always keep a distance of at least 10 feet from everyone else.

Next, get a coronavirus vaccine as soon as you can - any vaccine.

It's turning out that the virus does not spread so well by touching hard surfaces. The main way the virus spreds is through the air.

BUT it's still prudent to avoid direct contact with anyone else, such as shaking hands, hugging and kissing. The virus can be transmitted by direct contact.

Second, wash your hands with hot water and soap for at least 20 seconds. And do it every hour. Normal soap contains fats which dissolve the virus shell, so is very effective. Alcohol-based hand sanitizers also work, but not quite as well as soap and water!

Third, do NOT touch your face, especially mouth, nose and eyes with your hands. This is something we all do without noticing or thinking about it. But touching your face with a finger that has virus on it will allow easy entry into your body.

Fourth, avoid touching any surfaces in public that others have touched, like ATM buttons or touchscreens, elevator buttons, door handles, railings, tables, and even bank notes. Use contactless card payments at the supermarket where possible.

Even better, do your grocery shopping online and get home delivery.

If you cannot avoid this sort of contact, use a hand sanitizer frequently, and wash your hands with soap and water as soon as possible. And don't touch your face.

Fifth, avoid crowded situations as far as possible, such as supermarkets, public transport such as buses, trains and aircraft, and places with many visitors like museums, cinemas and restaurants/bars. If you cannot avoid busy places, wear an N95 standard face mask. I even avoid elevators, and take the stairs.

WEAR A MASK AT ALL TIMES OUTSIDE YOUR HOME


To protect yourself, assume that every other person is infected - even if they seem well.

To protect others, assume that YOU are infected.

This will break the chain.


Coronavirus symptomsBe the one who breaks the chain!

Symptoms of COVID 19 -
Is it safe to visit your dentist?

A dental office is normally a place you would think would be on top of infection control procedures - and that is true. But covid-19 is different.

For example, if a person infected with covid19 coughs or sneezes into their hand, and then uses the door handle into the dental office, touches the reception desk, uses the restrooms, and touches a magazine in the waiting room, these surfaces are sources of infection with the virus. And there will be airborne aerosols with the virus for several hours.

Inside the dentist's room, disinfection procedures will already cover virus contamination. BUT now there is a need to minimize the spread of the virus in the first place. How is that done?

  • ALL staff (including reception) wearing eye protection, proper high-filtration face masks, a visor, a head covering,  and gloves.
  • Limiting use of dental equipment that generates aerosols, such as high-speed drills and ultra-sonic scalers.
  • Using a 30-second disinfectant mouthwash before any contact with the dentist.
  • The dentist may use a 'rubber dam' (like a little surgical drape) over your teeth during treatment.
  • Minimizing use of intra-oral X-rays; Panoramic (external) X-rays are preferred.
  • Only allow the patient into the treatment room. Accompanying friends and relations should wait outside, preferably outside the entire office.
  • Remove all magazines and newspapers from the waiting room.
  • Moving waiting room chairs further apart - minimum 6 feet.
  • Limiting waiting time in the waiting room to less than 5 minutes - if the dentist is running late, the patient should leave the premises until the dentist is ready.

Remember, if you are having a dental problem, and cannot get to see a dentist for whatever reason, you can read some of my tips for home remedies HERE.

WEAR A MASK AT ALL TIMES OUTSIDE YOUR HOME

I hope my guide to the symptoms of COVID and protection has been helpful. I am updating it regularly as the worldwide situation evolves, so check back to find out the current recommendations.

HERE is the link to the American Dental Association Covid-19 page again.

Best wishes.

Dr. Richard

MARCH 2021


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