**Disclaimer: This is an observational opinion piece.**
Do I have COVID?
Do you think I have COVID?
Could this be COVID?
These are all questions most of us have heard over the past 12 months from patients.
My answer? Maybe you do, maybe you don’t… Let me get my magic COVID detector wand out of my pocket and check.
Seriously, this virus has made the jobs of many healthcare providers even more tedious then what it was before… Why? Because anything from a headache to a runny nose to full blown flu like symptoms to nothing at all, could be COVID.
I still pick up urgent care shifts and a day has not gone by in the last 6 months where every single cough, runny nose, sore throat, or cold like symptom could very well be a mild COVID case. Without testing people, I honestly just don’t know.
With strep throat, it is obvious.
With flu, usually it is obvious.
With sinusitis, it is obvious.
With a migraine, usually it is obvious.
With gastroenteritis, usually it is obvious.
With allergic rhinitis, it is obvious.
And so on and so on.
With COVID though? Anything from a little nausea to a fever of 104 and a severe cough could be COVID, regardless if they lose their sense of smell or taste or not. While losing your senses can be a common symptom, it is not present in all patients…
It absolutely astonishes me what I have seen pop up positive for COVID:
I have seen a family of 3 with nothing more than a mild sore throat test positive.
I have seen nausea and diarrhea test positive.
I have seen rhinorrhea and congestion test positive.
I have seen multiple totally asymptomatic people test positive.
I had a patient that presented for evaluation of a sprained ankle who also just wanted to be tested to “be on the safe side” test positive. This guy was completely asymptomatic and I would have never even tested him if he had not asked…
Granted, there are false positives, but surely to God not this many… Many of these people are even positive on confirmatory PCR, so these are not isolated events…
I am getting to the point that when a patient asks me if their symptoms could be from COVID or not, I just shrug my shoulders and say “Maybe. I don’t know…” and offer to test them. If they accept, then great. If their runny nose is in fact COVID, I scratch my head and tell them to quarantine, monitor their symptoms, and chances are that they will be just fine. If they refuse to take the test and then proceed to walk out the door with a clinical diagnosis of URI, the question in my mind remains “Did I just let this person who could have COVID leave and now continue the spread of this virus?” It is a difficult situation, but one that is affecting thousands of providers…
This virus has made the practice of acute sick visits daunting. As medical providers, it is our job to try to decrease the spread of COVID, but at the same time, it is becoming an impossible task when non-specific and mild symptoms could be COVID. It is just a mild cold in the majority of people after all…
The main question for me is this: Do we just test every person walking through the door for COVID? Maybe we should. It might not be the most practical thing in the world to do, but I am at a loss anymore. How else can I just diagnose a good old fashion cold or sinus infection? Is that even possible now? Not for the foreseeable future without testing everyone from my point of view, but this would only increase our numbers as we continue to be the “country with the highest COVID rates” in the world… Or just the country who is testing everyone… that is for you to decide.
Additionally, everything is not COVID, yet it is being blamed for so many symptoms from a majority of the population and everyone wants a test… you know:
Normal cold is still circulating around.
Influenza is still out there.
Strep throat is still present.
GI bugs are still affecting people.
People are still having heart attacks. Chest pain does not = COVID…
Yet, people still want to be tested for every little symptom. And when their test comes back positive, I just stand there in disbelief.
So, is it COVID? My answer is still, “I don’t know… Lets swab you and see” and let the dice roll.