GPs have called for the Government to include more symptoms in the official case definition of Covid, including a runny nose and a cold.
The symptoms, with the technical term coryza, should be added to the list of symptoms that prompt people to get a Covid test, they said.
Currently, Covid tests are available for those who have a high temperature, a new, continuous cough or have lost or noticed a change in their sense of smell or taste.
In an open letter to the chief medical officer Professor Chris Whitty, primary care academic Dr Alex Sohal said it is ‘vital’ to include runny nose and cold in the UK’s testing criteria in line with World Health Organisation (WHO) guidance.
The letter, published by the BMJ today and supported by 140 east London GPs and healthcare professionals, said patients with mild symptoms such as a blocked nose, sore throat and headache ‘regularly’ turn out to be Covid positive.
Dr Sohal, Tower Hamlets GP and honorary clinical senior lecturer in primary care at Queen Mary University of London, said: ‘These patients have frequently not even considered that they may have Covid-19 and have not self-isolated in the crucial early days when they were most infectious.’
She added that GPs ‘have to advise patients to be dishonest to get a Covid-19 test’.
The letter said: ‘Tell the public, especially those who have to go out to work and their employers, that even those with mild symptoms (not only a cough, high temperature, and a loss of smell or taste) should not go out, prioritising the first five days of self-isolation when they are most likely to be infectious.
‘This will help to get—and keep—us out of this indefinite lockdown, as Covid-19 becomes increasingly endemic globally. Ignoring this will be at our peril.’
The WHO’s case definition of ‘suspected’ Covid cases includes symptoms such as fatigue, headache, runny nose, difficulty breathing, diarrhoea and vomiting.
It comes as a recent report has shown that cough, fatigue, sore throat and muscle pain may be more common in those testing positive for the new variant of coronavirus.
Meanwhile, a study revealed in September that just 18% of patients self-isolate with Covid symptoms.
READERS' COMMENTS [6]
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why? runny nose is hardly diagnostic–so why are gps pushing this?
Exactly – we need to be very careful.
Nursery children would spend more time waiting for test results than actually in nursery.
Several points to demonstrate once again politics colliding with ‘science’; reality against ideology :
(1) The percentage of people with government-defined Covid symptoms who isolated , was very low (18%). The implications of isolation in employments are perhaps underestimated with no impact assessment for various sectors. Working from home , so often , is easy said than done . Has the government done enough and cared enough ?
(2) Including coryzal symptoms on the list of Covid 19 is understandable but carries a caveat of increasing more burden on the already ‘misused’ PCR testing system for those with ‘symptoms’ . I can easily tell you how many of my friends who had lied to get themselves tested with PCR on GOV. UK website. Consequently , the waiting time for results to come back is prolonged jeopardising those with typical Covid 19 symptoms to verify whether they should resume daily activities or isolate . Of course , one cannot underestimate the difficulties in implementing this PCR testing policy and indeed , it is a dilemma so often .
(3) Then we have the lateral flow test . It carried a poor reputation of being ‘crap’ particularly on sensitivity in picking up positive cases ( BMJ’s previous article). Nevertheless, the latest report from Oxford University and PHE supported the arguments that (a) only those with high enough viral load ( I think 25 in certain units was the threshold ) will pass the virus on after being infected (b)if LFT is done regularly , at least twice a week , the sensitivity will reach 83-91% in picking up at least these patients with viral loads high enough to be infectious. (c) LFT result is available in about 30 minutes
I was testing myself in lateral flow test centre daily（with GOV.UK text message reporting results) for running vaccination days in my PCN site last 3 weeks .
Hence , LFT may be yet to be declared as the missing piece of this jigsaw of testing more people with ‘atypical’ symptoms like runny nose ??
We need academics to be more realistic and pragmatic ; politicians to be more in touch with the frontline and real world .
It is important that for primary care to remain sustainable and operational, that some GPs reconsider their roles and exposure in Hot Clinics and whimsically entertaining trap doors set by politicians – remember, some doors are one way. Also, I have learnt over the 10 months that there is nothing wrong with self-care, doing nothing, saying no, self-respect and protecting yourself from harm. The world continues to spin. Do no harm – (to yourself) – that old mantra. Remember, you are a patient to some surgery also. Learn quickly from the legacy of colleagues.
Atchoo! OMG, I sneezed.
See you in 2 weeks , then
Stop testing snotty children…..