The novel coronavirus is rapidly spreading globally and has put the entire planet on standby. Despite following strict measures of hand washing and social distancing, the SARS-CoV-2 virus causing COVID-19 has been impossible to contain. Nearly 80% of people infected by coronavirus will develop mild to moderate respiratory illness which will usually recover without any treatment. However, this disease can cause serious complications in elderly people and people with underlying medical problems such as cardiovascular disease, diabetes, respiratory diseases, and cancer.
With time, we are learning more about the virus as it continues to evolve. Earlier it was thought that only people showing symptoms such as cough, high fever, or breathing difficulty was possibly infected by SARS-CoV-2 and could spread the disease through contact. But this has been proved wrong by recent studies. Even people showing no symptoms may spread the virus through contact transmission. Hence, while we have to maintain a safe distance from people showing flu-like symptoms, we also have to be aware of asymptomatic carriers who can spread the disease.
Classifying people based on the severity of the disease symptoms
Classifying people based on their symptoms is not an exact science. You may not fit anyone classification exactly or may shift from mild to moderate symptoms or vice-versa during the course of illness. With so many people that are affected, everyone may not fit perfectly into the simple groups of classification. If your symptoms are predominantly mild, with one or two moderate symptoms, you may be classified as one with mild to moderate symptoms. People with COVID-19 are classified broadly as follows:
- Silent carriers
- Patients with mild to moderate symptoms
- Patients with moderate to severe symptoms
- Critically ill patients with multi-organ dysfunction
Who is a silent carrier?
There is recent evidence that COVID-19 can spread through silent carriers. These silent carriers or spreaders are people who are infected with coronavirus but show little or no symptoms of the disease. As a result, these people carry on with their daily lives, meeting family and friends, going to work, and spreading the disease without their own knowledge. It appears that most asymptomatic carriers are healthy young adults and children. If you come to contact with people who are positive for COVID-19, you may be positive despite not showing any symptoms of the disease.
Types of Silent Carriers
The terms that are used to classify the silent carriers are:
- Mildly symptomatic carriers
People who display very mild symptoms like a mild cough or may just be feeling a little low come in this category. The virus mainly affects the upper respiratory tract and may cause mild cough or mild breathlessness on exertion. Your fever may not reach 37.8℃. You may lose your sense of smell, have mild headaches, or develop a runny nose. These symptoms usually last for seven to ten days. It has been seen that some people showing mild symptoms can rapidly deteriorate, more often among people in the high-risk group.
- Pre-symptomatic carriers
Some people do not develop any symptoms for up to a week after contracting the disease. They may later on experience cough, fever, or breathing difficulty.
- Asymptomatic carriers
These are people who do not show any signs or symptoms of the disease on contracting it for the entire duration of the incubation period. This can last for around 14 days. As a result, they end up transmitting the virus to a lot of people. This fuels the pandemic in a rapid and dangerous manner.
Unusual symptoms to look out for
Some people may develop symptoms that are not typical to COVID-19. These include symptoms such as loss of smell, loss of taste, and diarrhea. This means that some of the people placed in the category of asymptomatic carriers could be shifted to the mildly symptomatic category keeping these symptoms in mind. Until these symptoms have been categorized, it is best to follow strict personal hygiene practices and Government protocols for quarantine and lockdown.
What you can do:
Protect yourself at all times. Practice hand and respiratory hygiene at all times. Always maintain a distance of 6 feet from other people, especially if someone is coughing or sneezing near you. If you live in an area with rampant malaria or dengue cases, do not ignore a high fever. Visit a hospital or clinic and avoid touching any surface or coming in close contact with other patients.
If you ever find out that you have been in close contact with an asymptomatic carrier, it is essential that you should self-quarantine for fourteen days even if you are not showing any symptoms of the disease yourself. Close contact is when you live with someone or have been in settings of less than a distance of 1 meter or 6 feet from someone who has the disease. Always cover your face and mouth properly when outdoors and do not leave your house unless it is absolutely essential. Always maintain a distance of 6 feet from other people. You are more likely to infect others in the early stages of the disease when you have only mild symptoms, hence it is very important to self-isolate.
How to self-quarantine?
To self-quarantine means to separate yourself from others because you have been exposed to someone who possibly has COVID-19, even though you yourself are not showing any signs or symptoms of the disease. This helps prevent transmission of the disease. How to achieve this in your own home:
- Stay within a room that is well-ventilated and has facilities for a toilet and hand hygiene.
- If that is not possible, keep a distance of 1 meter between beds.
- Keep a safe distance from your family members at all times.
- Monitor your symptoms daily
- Self-quarantine for 14 days even if you feel healthy
- Stay positive and keep in touch with friends and family through phone calls or online.
- If your symptoms worsen, call a health provider, or COVID helpline immediately.
People in the high-risk category need to be extra cautious and need to seek medical attention as soon as they develop symptoms of COVID-19. These include people who are:
- Over 60 years of age
- Have significant heart, lung, or kidney disease or have immune dysfunction.
- Are on oral steroids
- Have had a solid organ or bone marrow transplant
- Patients on chemotherapy
- Patients with uncontrolled diabetes
Dr. Harish MM, Consultant Anaesthesia & Critical Care, Mazumdar Shaw Medical Center, Bommasandra, Bangalore