COVID-19 Update: Signs and Symptoms

Welcome back, everyone. So today I would just like to review a recent article published from data from the World Health Organization in the Lancet. The Lancet is one of the premier medical journals in the world that's based out of England. And it's just basically reviewing signs and symptoms of COVID 19 based on a summary of data from China. The reason I want to go over this is because a lot of people are having some concerns about symptoms and signs and what to look for. And there's a confusion as far as far as what would constitute someone having COVID 19. And so the first thing I'd say about this data is that it is Chinese data. It's not based on Italian or American data. But if you, if you've been following information, you'll see there's a very strong correlation between the data there, European data, as well as the American data. Having said that, I'm all, especially now, I'm a little hesitant to look at information coming out of China just because it's been spotted from the beginning. And now supposedly there are no more cases where the cases have greatly diminished in China. We have secondary sources saying there's still some stuff going on there. But I think this is useful just for us to kind of wrap our brains around who has COVID 19 and what we should do about. Something else that's interesting in the literature is that COVID 19 has basically taken up all the air in the room. So what do I mean by that? I mean that the cases of normal influenza, the cases of usual infections, have greatly diminished in the United States and hospitals and ERs and what's taken their place is COVID 19. So it's as if COVID 19 has come to town and everything else is getting out of the way and it's kind of doing its deeds. So that's a very interesting phenomena as well. But we must remember is 80%, roughly, of people that get COVID 19 will have minimal symptoms and will not need any kind of interaction with the healthcare system. About 20% of people will need interactions with the healthcare system. 15% will need hospitalization. 5% will end up in the intensive care unit or some type of intensive care system. So again, this is a very serious thing. So fever, 88% of people have fever. Fever is defined as a temperature above 100.4. The caveat to that is if you're someone who's older who has a baseline temperature of, say, 97.2, then a fever for you might be 100, you know, might be 99.8. So the way I tend to define a fever is anything that is a elevation equivalent to a 98.6 going up to 100.4. So if you have a 98.6, go up to 99.6. So a 1.8 degree temperature rise, that's probably a clinical fever for you. Some people do run a little low. Averages are averages, which means they don't apply to individual people. So if someone who runs 97.0 comes in with a 99.8, I'm going to call that a fever. And 88% of people have a fever. Dry cough. Now, the dry cough is interesting because initially we were told that it was just a dry cough. And if you produce sputum, then it wasn't. Covid 1968% of people with this will have a dry cough. The interesting thing is 33% will have a cough with sputum. So we learned a lot, and we've learned to change our view on things a little bit. 38% will have fatigue. So basically between the cough, fever, dry cough, or sputum cough, you'll get between 88% of people and 33% of people having any one of these. The thing to remember as well about these characteristics is that you might present just with loss of smell or anosmia, which anywhere from 33 to 60% of people are getting just the single symptom of losing the smell. And some people are getting the loss of smell after they get better from this infection. So it's not as if you have to have all of these. You might have one, two or three. Some that actually are pretty specific right now are actually loss of smell. Some that may not be as specific are cough and fever. Because there's a lot of different things can cause that shortness of breath. About 19% of people have shortness of breath. So those of you have been following us this whole time have also learned that a lot of people will present with COVID 19 without shortness of breath and a fluid pneumonia. Some people will have mild shortness of breath and have fluoride pneumonia. So unfortunately, it's now typical pneumonia. By the time you have shortness of breath, it's pretty significant. I actually had a case of a pneumonia early this week with someone who was pretty sick off, probably had COVID 19 fever, you know, et cetera, et cetera. And shortness of breath was a significant symptom that they had. But you have to remember, the young, healthy people that are getting this, a lot of them are presenting without significant shortness of breath. Joint pain. 15% of people have joint pain. Any fever can give you joint pain. So again, nice specific symptoms. Sore throat, 14%, headache, 14%, chills. Only 11% of people with COVID 19 will have chills. So the fever at 88% is much more specific than chills. Now, fever is not you feeling chillish. That's the difference. A lot of people say, oh, I had a fever. What was your temperature? I don't know, I felt feverish. They're describing chills. They're not describing an actual fever. Fever is boom. What's your temperature? Nausea and vomiting. About 5% of people will get GI symptoms specific to nausea and vomiting. And this was something that we didn't quite realize initially. Kind of harks back to H1N1, where a lot of people were having GI symptoms and diarrhea with their flu like illness. So about 5% will have nausea, 4% of people will have diarrhea. So roughly 9% of people will have some kind of GI tract symptom. A stuffy nose. I mean, what does that mean? It's allergy season right now in central Virginia. A little stuffy right now, myself coughing up blood. 1% of people will cough up blood. So that's a symptom that's not quite as strong. And there are some unusual symptoms and sides. And the biggest unusual one is the loss of smell. We talked about this several episodes ago and we already published the article from England based on that. Other things to think about with this is the low blood oxygenation without shortness of breath. And that's one of the things that's very characteristic of this illness is that people are having low blood oxygen levels. They come in and they're really low and they're not having a shortness of breath that is as severe as the oxygen level would look. Their oxygen level might be 82, 83%, and they're mildly short of breath, or it might be 88 to 89% and they don't feel short of breath at all. So that is something that is actually quite unique to this disease. So right now, the overall case fatality from this Chinese data is 1.38%, much, much less than the 5.4 and the 3.8. So I mean, as time's going on, time is going on. We're seeing the case fatality come down, come down, come down. And now from the Chinese data, which originally I was telling you all two months ago, looked like 5.4% in the Wuhan province and the rest of China looked like 3.8%. Now, with this summary of data of the compilation from China, we're looking at 1.38%. So what does that mean? For me, that means, you know, maybe Dr. Fauci is right, maybe some of these experts are right. We're going to be looking closer at a 1% mortality, maybe even. There's an article I mentioned this past week, a 0.67% mortality. But you have to take that in mind that, you know, 1% of, you know, 80% of 380 million people is still 250 to 500,000 people. So it's still a lot, a lot of people. So, yeah, so that's. I already mentioned that. So currently, based on The Chinese data, 0.0016% of people less than 10 who get this will die. So that's a minuscule math. If you're a kid and you get this, you're pretty okay. I know there's cases out there of kids getting this. The first child dying was about a week and Change ago, but 0.0016%, pretty low chance. If you're over 80, the number has come down now. The number of the chance of mortality is 7.8%. That's a far cry from the 15% I was telling you all about several weeks ago. So that's actually encouraging. If you're less than 30, your chance of dying is 0.3%, 0.03%. Now, to keep that in mind, a typical flu season has a 0.1% chance of mortality. So if you're less than 30, pretty low. Those age from 10 to 20, about 0.04% were admitted to the hospital between 40 and 50. This is where it starts kind of going up. 4% of hospital admissions were in this age range. And between 50 and 60, about 8% of hospital admissions were in this age range. So if you're less than 80, that accounts for about 18% of admissions. So again, this is just basically solidifying. The young are not getting this really severely. It's mainly the old, especially those over 80. The next group is over 60, especially with other morbidities. But if you're young, less than 50, you know, it's basically less than 40, then less than 50, then less than 60. Your risk for serious illness from this is quite low. I will be posting this, the article that goes along with this on where this is getting posted now. Well, as well, going forward, I will be doing like, shorter updates just to keep people informed. I've been told the longer ones of 15 to 20 minutes are a little, a little much, so I'm going to try to keep them a little shorter just to give people a little more digestible pieces of information. If this is helpful, please like us on Instagram and Facebook as well give us a five star rating. That will just help our information to be more available to people. And as well, you can sign up for our newsletter. We'll be putting out actually a COVID 19 survival guide here in the next several days or week. And so if you want to be one of the first people to get that, if you're already on our newsletter list, you'll get that promptly. So everybody take care, be safe, and stay well.