Fresh COVID-19 surge: What are the symptoms, how long do they last, should you get a booster?

Yes, there has been an increase in cases of Covid-19 over the last couple of weeks. The number of cases is going up as we have ramped up testing again. Before that, we were mostly seeing cases of flu but not many among them were getting tested for COVID-19.

Most of the cases at present are not severe. They come in mostly with cough, runny nose and fever – all symptoms similar to flu. Very few people need hospitalisation and they are people who are very old or have severe co-morbidities like uncontrolled diabetes, chronic kidney disease, or obesity.

Of course, if the number of cases shoots up, then as a proportion, the number of people who need hospitalisation will also go up. But, at present, it doesn’t seem like a big worry.

Are there any differences in the presentation of COVID-19 and flu, both of which are in circulation?

On the face of it, the symptoms don’t really differ. Most of the people with COVID-19 have very mild symptoms that last for three to five days. When it comes to flu, however, this year we are seeing a persistent cough that can last for three to five weeks. We have to sometimes give anti-allergy medicines, cough syrups and steroids to control the cough in flu patients.

Now that more and more people are getting tested, we are also able to offer the antiviral therapy, Paxlovid, which when given early in the course of the disease has been shown to reduce hospitalisation and deaths.

At present, generic versions of the medicine are available only through hospitals. The medicine is not meant for everyone and has to be given only to those at a higher risk of severe disease and hospitalisation. Although people cannot purchase it from a pharmacy, there is a need to be careful while prescribing it at hospitals as well. The drug is known to have a lot of interactions with blood pressure or heart medication.

Is COVID-19 becoming a seasonal illness?

That is the direction we see it going. For now, COVID-19 hasn’t decided on a season unlike seasonal flu has (India sees two flu peaks in a year – January through March and August through October). But it keeps happening every few months.

It will be one of the viruses that we just have to live with. These keep coming and going, causing an increase in cases from time to time. We just have to watch the trends and follow precautions like masking and hand hygiene to protect ourselves. We might also look for newer vaccines that have the variants in circulation, maybe something like yearly flu shots for those at the highest risk of severe disease.

How important is the vaccine or booster dose at present?

So, if you talk about the COVID-19 cases at present, I cannot tell you whether it is the vaccinated or unvaccinated that are getting more severe symptoms – the number of cases is still too small right now. Anyway, almost everyone has had their first two shots.

The booster dose coverage is low but I don’t think it is very important at the moment. All of us have had at least one or two clinical or sub-clinical COVID-19 infection – some of us more than two times – and this seems to be protecting most people against severe disease.

Why Dr Gogia? Dr Gogia is a renowned internal medicine specialist at one of Delhi’s biggest tertiary care centres, Sir Ganga Ram Hospital. Practising for over 24 years, his area of interest lies in diabetes and infectious diseases.