Exclusive The Government has indicated that it has no current plans to update its official list of Covid symptoms, despite research indicating the now-dominant Delta variant has more cold-like symptoms.
The Department of Health and Social Care did admit that Covid-19 has a ‘much longer list of symptoms than the ones initially used in the case definition’ and said that it keeps symptoms ‘under review’.
Last month, new research revealed that the Delta variant, which now accounts for the vast majority of the Covid-19 cases in the UK, is not presenting with classic symptoms but is more like a bad cold.
Data from the ZOE COVID study at King’s College London said the top symptoms are headache, followed by a runny nose and sore throat.
But the DHSC has failed to confirm any planned updates to official Covid symptoms used for isolation and testing purposes, although it said that data on symptoms is continuously gathered.
A spokesperson told Pulse: ‘Since the start of the pandemic we have acknowledged that Covid-19 has a much longer list of symptoms than the ones initially used in the case definition and our experts keep the list of symptoms under review.’
They stressed the importance of regular rapid lateral flow testing, adding that ‘around one in three people’ do not show symptoms of Covid.
‘Over 100 million LFDs have been carried out so far with over 200,000 cases identified that would not have been detected otherwise’, they said.
Under current guidance, anyone experiencing the ‘main symptoms’ of a high temperature, new continuous cough or loss or change to sense of smell or taste must get a PCR test and self-isolate immediately.
A WHO spokesperson told Pulse that it has not conducted any research on symptoms specific to the Delta variant.
They said: ‘WHO is aware of media reports of changing symptoms, however the scientific data on this is not yet conclusive. Covid-19 can have varied symptoms, ranging from respiratory symptoms to neurological to gastrointestinal and other symptoms.’
Professor Iain Buchan, executive dean at the Institute of Population Health and chair of public health and clinical informatics at the University of Liverpool, told Pulse that it is ‘very clear’ the Covid case definition should be expanded and that the Delta variant makes this more pressing.
He said: ‘You’ve got a more transmissible virus that is affecting younger people because of vaccination status – and those younger people tend to display a broader range of symptoms earlier in their infection anyway – and early infection is when you’re more likely to pass the virus.
‘So it’s very complex, it’s almost a perfect storm for [the Delta variant’s] effects in younger people and the need to consider a broader symptom definition because of that – it’s not just its absolute level.’
However, he said that amid a lack of PCR test capacity, lateral flow testing for those with ‘even vague symptoms’ is ‘the only way we’re going to reach people in time’.
Professor Buchan said: ‘The ideal situation is you use the lateral flow to gain time with isolation but have a follow-up PCR [for those with positive LFT] so that we’ve got variant surveillance and proper confirmation.
‘There isn’t enough capacity in the system for everyone with aches and pains or runny noses to have a PCR – it would be very wasteful. But there is a lot of lateral flow capacity in the system.’
But while awaiting policy change, GPs should work closely with local directors of public health to ensure communications ‘raise awareness’ of unofficial symptoms and encourage those who have them to take LFTs, he said.
He added: ‘My colleagues in public health and scientific communities have put the case quite clearly, so it’s being considered. The evidence is there and it has been put to policymakers – we should expect some changes but there’s no need to wait. Communication actions can be taken right now.’
However, former GP and chair of the BMA Public Health Committee Dr Peter English said that updating the case definition would only have a ‘marginal’ benefit.
He told Pulse: ‘[Social distancing and lockdown are] what was doing the heavy lifting. Test and trace was set up in a way that it was going to make practically no difference – at vast cost.
‘So in that sense, tweaking it slightly to amend the symptoms, it’s logical if you think that Test and Trace is worth it in the first place, but probably it didn’t contribute very much in any case.’
He added: ‘Given that the range of symptoms is now so much wider and so much less specific – it would mean telling a vast number of people to isolate on the basis of very common symptoms.’
GPs have been calling for the Government to include more symptoms in the official case definition of Covid, including a runny nose and a cold, since February.
It comes legal Covid-19 restrictions ended in England earlier this week (19 July), with the Government stating that it does not believe the current rise in infection rates will put unsustainable pressure on the NHS.
The latest daily reported infections stood at more than 46,500 – a 41% increase over the course of the last week. There was also a 38% rise in Covid hospital admissions and a 61% rise in the number of deaths.