Disclaimer: The views and opinions expressed by this author are their own and do not represent the official position of the Barbados Today Inc.
For years the standard of care for primary care in the Caribbean was to diagnose persons who presented with aches and pains, feeling weak and tired, perhaps a little fever, cough, with or without a sore throat as having some sort of viral illness (or a malingerer looking
for some unwarranted time off from work].
Lots of rest, lots of fluids with Vit C, e.g. orange juice, and paracetamol (or some sort
of multi-symptom combination) was the mainstays of treatment.
Some advocated mild to moderate physical activity, to help “sweat it out”, although a slightly older generation added a “shot of brandy” for good measure.
Those seeking time-off from work chose
the “rest and relaxation” approach to get past their symptoms.
It was rarely necessary to identify the actual virus involved, or even try. From the patient’s point of view, this would entail having two blood tests two weeks apart, called acute and convalescent serum samples to identify a specific immune response to a specific virus.
Patients “hated” one blood test, much less having to find time to come back to the doctor’s office for a second ‘injection’. Most times, patients felt much better two weeks later; why should I have to go back to the doctor’s office, and to get stuck at that.
Apart for the rare individual who had unexplained symptoms, public health officials were primarily concerned with viral illnesses that had epidemic potential, like Dengue fever and Zika so focused on “virus testing” when the mosquitoes were on the rampage, and the potential epidemic needed to be both documented and contained. The vector i.e. the mosquito, rather than the virus, was the main focus of their attention.
From the doctor’s point of view, since virus identification was not done in Barbados but were sent off to the Public Health laboratory
in Trinidad, results came back in six months or not at all. In many cases, both doctor and patient had long forgotten about the illness in the first place.
So for Caribbean people, whether one had a bad cold (common cold) or the flu (influenza) the approach was generally the same, with little thought about attempting to determine ‘which was which’.
But then came COVID-19.
Because this is a killer virus whose initial symptoms resemble both the common cold
and the flu, it is necessary to identify the specific virus early.
To their credit, public health officials moved at great speed to upgrade our COVID-19 testing and identification facilities, and initiated other public health measures
Symptoms of COVID-19
One of the challenges of COVID-19 is that its symptom overlaps both the common cold and the flu, the latter two being endemic in the Caribbean, and rarely attracting any attention by anyone apart from the affected individual. COVID-19 demanded and attracted the attention of the whole world.
Most people who contract covid-19 will have at least one of the symptoms:
• Fever: a temperature of 37.8 C or more.
A common cold is not usually associated
with fever.
However, there are many other causes of a fever, but if COVID-19 is even a remote possibility, through possible contact with a covid positive patient or if other COVID-19 symptoms are present, then the person should have a COVID-19 screening test. Many patients who contract the flu have a fever.
• Coughing: The coronovirus associated cough is a persistent cough, or a number of coughing fits. In patients with asthma, who generally cough a lot anyway when their asthma is “acting up”; the coughing is worse than usual, and may not respond to the usual inhaler therapy.
The flu comes on suddenly with aches & pains, chills, headache, loss of energy, along with a sore throat and a runny or stuffy nose, along with a mild cough.
• Loss of taste or smell: While these may occur with a common cold, their prominence
on the list of COVID-19 symptoms suggests that if either (or both) of these occur then a COVID-19 test is recommended.
• Sneezing: sneezing is not a common symptom of COVID-19 and unless accompanied by a fever, cough or loss of smell or taste, then a COVID-19 test is not needed.
• There is no guarantee that an individual can only have one of these diseases at any one time. With the flu season approaching (corresponding to fall and winter in “cold countries’), accelerated spread of COVID-19 is possible as more people have coughing, sneezing and runny noses, precisely the features that promote the viral spread.
It is also the time when visitors flock to Caribbean countries to embrace our sun, sand and liquor.
Caribbean adults have not generally embraced immunizations – it’s the old “fear of injections thing” except when they get a “nail-juck”; and realize that they have not had a tetanus injection for a very long time.
It will be interesting to see if/how our public health officials promote the flu vaccine, followed by whichever coronavirus vaccine is eventually adopted for widespread distribution.
See Table 1
There is no doubt that the un-invited presence of covid-19 to our shores has caused us to look at these upper respiratory illnesses differently.
Stay home if you feel sick. Whether sick or well, remember the 3 Ws (no, not Weekes, Worrell and Walcott)
• Wash (sanitize) your hands
• Wear your mask
• Watch your distance (from your
fellow man)
In addition, follow the advice of our public health officials. They will presumably soon be advising us on the flu and COVID-19 vaccines: stay tuned.
Dr. C. V. Alert
MB BS, DM (Family Physician).
The Wellness Clinic, Barbados.
