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What is Covid?

9/6/2022

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No, I’m serious… what is Covid? I hear it all the time. Someone coughs, is it Covid? Someone sneezes, is it Covid? Some say they feel a bit under the weather, is it Covid? I even had the discussion with my parents at the weekend… ECIC (aka my wife) has a bit of a cold and they say, “has she got Covid?”
 
So, what is Covid?
To start with, “Covid” isn’t anything. The actual name for the disease cause by the Severe Acute Respiratory Coronavirus type 2 (SARS CoV2) was Covid-19; it was an acronym for COronaVirus Infectious Disease 2019. But now it has been reduced to a snappier “Covid”.
 
I have also been asked if someone has “caught covid”…NO! You cannot catch Covid-19, you can catch SARS CoV2, that is the name of the virus. It is so reminiscent of the horror show that was HIV back in the 1980s… even senior health professionals thought you could catch AIDS (Acquired Immune Deficiency Syndrome) …NO! You cannot catch AIDS, you can catch Human Immunodeficiency Virus (HIV). Covid-19 and AIDS are the names of the clinical diseases, not the causative viruses.
 
So, when we think about Covid-19 being a disease, a group of symptoms if you like, then the question “what is Covid-19?” actually starts to make more sense. 
last covid-19 blog
​What is Covid-19?
The original Covid-19 was a severe infection with SARS CoV2 characterised by high fever, cough, severe shortness of breath and hypoxia often requiring hospitalisation for respiratory support.
 
But we rarely see this pattern of infection with SARS CoV2 anymore. It has been a while since I have seen someone sick enough with SARS CoV2 infection to end up on ITU. Yet there are still about 80 patients a day with positive SARS CoV2 tests around the hospital, so what has happened?
 
The increase in immunity to SARS CoV2 from previous infection or vaccination has changed the symptoms of infection with SARS CoV2. In fact, the NHS website lists lots of symptoms of Covid-19 now… but are they all Covid-19?
  • a high temperature or shivering (chills) – a high temperature means you feel hot to touch on your chest or back (you do not need to measure your temperature)
  • a new, continuous cough – this means coughing a lot for more than an hour, or 3 or more coughing episodes in 24 hours
  • a loss or change to your sense of smell or taste
  • shortness of breath
  • feeling tired or exhausted
  • an aching body
  • a headache
  • a sore throat
  • a blocked or runny nose
  • loss of appetite
  • diarrhoea
  • feeling sick or being sick
 
It seems to me that the list of possible symptoms from infection with SARS CoV2 has become so broad that the term Covid-19 has probably become obsolete. ECIC has tested negative, but she has a new cough, shortness of breath, feels tired, has a sore throat, blocked nose blah blah blah… but she hasn’t got Covid-19 she has one of the many other “cold-like” illnesses we don’t name… she also didn’t get too much mollie-codling or sympathy either! Donuts, ice cream are allowed, and to just watch daytime TV and snooze in the afternoon… she is getting better… it’s probably an unnamed virus… it will pass.
 
Think about it. We don’t normally have a single name for all infections caused by a specific bacterium. We wouldn’t say a patient had “Staphylococciitis” (okay, I have just made that up), we would say they had had cellulitis, or septic arthritis, or osteomyelitis, or endocarditis, or one of the other infections caused by Staphylococcus aureus. The name of the infection is dependent on the symptoms… not the causative microorganism.
 
And we don’t call the other coronavirus related infections by any specific name; we don’t have Covid-92 for what was thought to be the cause of “Russian Flu” back in 1892.
 
I think we need to move on. I think still talking about Covid-19 is damaging. It is damaging because it dilutes our understanding of how severe the infection can be in non-immune people, and it increases the anxiety for those who have a mild or asymptomatic upper respiratory tract infection; some people still think everyone with COVID-19 dies!!!!!!!!
 
Personally, I think it is time to stop using the term Covid-19 EXCEPT as the name for the severe life-threatening acute respiratory infection that leads to people ending up on intensive care units. For everyone else we should use the term for their actual infection; upper respiratory tract infection (URTI), pharyngitis, pneumonia, acute coryzal illness (a cold).
 
To this we can then add the causative virus if we really, really, really, want to:
  • URTI caused by SARS CoV2
  • Pharyngitis caused by SARS CoV2
  • Pneumonia caused by SARS CoV2
  • Cold… no, just a cold, eat chicken soup, donuts, ice cream, whatever you like… it’s a cold and as “old housewives” say…you “feed a cold”…
 
But what do you think? Do you think the name Covid-19 still has a wider value? Or do you think it should be restricted to specific patients?
 
Or do you not care… it’s just pedantic Microbiologists who think about these things and everyone else has something better to do? 😊 Okay, fair enough…
 
That’s it, I’m not going to write another blog about Covid-19!
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    David Garner
    Consultant Microbiologist
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