‘Mild’ coronavirus infection is not mild


This 24 March 2020 video from the USA says about itself:

Doctor With COVID-19 Describes Symptoms As ‘Pain Everywhere’

An infectious disease specialist at the University of Alabama, Dr. Michael Saag, contracted the coronavirus and detailed his symptoms to NBC News. After monitoring how he felt for a few days, his symptoms turned from mild to extreme, in what Saag called “a horrible feeling.”

Translated from Dutch NOS radio today:

Thousands of patients with ‘mild’ corona complaints have been ill for weeks

Thousands of patients who are home with confirmed or unconfirmed covid-19 infection remain ill for weeks. Their complaints are often referred to as “mild”, but in many cases they are not. Some people have been sick for at least two months.

A RIVM [national health authority] spokesperson says it is “on the agenda to discuss”. The Dutch College of General Practitioners (NHG) says that “this is really a problem.”

About 6000 patients with long-term complaints are now members of a peer group on Facebook.

Symptoms deleted

The misguided idea that patients who are at home have mild complaints haunts them. The guideline of the National Coordination of Infectious Disease Control of RIVM states that confirmed covid-19 patients must remain in isolation at home until they are free of symptoms for 24 hours and at least seven days after the first day of illness.

All kinds of symptoms that many people in this patient group have, such as persistent fatigue, loss of smell and taste and postviral cough, are not considered covid-19 symptoms in the guideline. Those symptoms can also appear after other viral infections. Why these symptoms do not count as covid-19 symptoms is unclear.

Some patients report that their employers and occupational health and safety services pressure them to return to work by referring to information on the RIVM website. A 50-year-old patient who wants to remain anonymous because of ‘hassle’ with an employer, says that he is “stalked by the occupational health service and the employer” two or three times a week.

They appeal to RIVM, which says that “the recovery period after mild complaints is a few days. That is absolutely not true.”

The person involved has been at home being ill since the beginning of March and, despite all kinds of symptoms that indicate an infection, has never been tested. Shortness of breath and poor sleep continue. “And very tired. I can’t really take one step. Unprecedented.”

Relapse

The 47-year-old writer Esther J. Ending has been sick since March 16. Antibodies to the coronavirus have been detected in her, so she has had an infection. “I suddenly didn’t smell anymore, that’s how it started. After that, I had a severe headache for a few days and a mild fever for a few days.”

Ending calls herself “strong and sporty”. She says she “has never been so sick”. Her breathing problems were so severe that she almost went to hospital. After about three weeks it went better.

“But after a walk of half an hour it went wrong again. A severe relapse, with fever and breathing problems. Now my heart is bothering me again. That makes me anxious. When I walk up the stairs my blood pressure shoots up, it takes an hour before it returns to normal. ”

Ending suffered such recoil four times. “I was away with my daughter on King’s Day. The oxygen levels in my blood plummeted, which in turn affected my heart rate. How much exercise is good for me? My GP says five minutes, nothing at all. But I fear that five minutes is too much already.”

Condition problems

Ingrid Elferink is Ending’s GP. “Some of the patients with covid-19 or a strong suspicion have such long-term complaints. One of our doctor’s assistants has been sick for a month, another has been at home for four weeks,” says Elferink.

“We regularly see people with fitness problems who are normally in good shape. I have a colleague who always used to cycle and has not touched her bicycle for more than a month.”

Elferink says that among patients who suffer from their (probable) infection at home, there are many who are still fully working. “The impact of their complaints is therefore great.”

NHG spokesperson Jako Burgers, himself a GP in Gorinchem, also knows patients from his practice who recover very slowly. “I know two or three. If you translate that nationwide, it will soon be at least 10,000 people. Maybe we only see the tip of the iceberg.”

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