Running temperature in the midst of the pandemic is cause for worry. But in the advent of winter, that itself has come after a prolonged monsoon, it can also be confusing. Should one rush for a Covid test or brush it off as a viral flu owing to season change? Or could it be dengue that has already claimed many a victim this year?
“I got drenched in the rains before Jagadhatri puja and since then am getting fever off and on. I’ve run full courses of paracetamols and done a series of tests to detect everything from dengue to allergy but doctors still can’t put their finger on why I’m unwell,” says a BL Block resident, who has now been asked to do an allergy test.
In any other year this may have been normal but with coronavirus and its ever-mutating strains and variants still looming, panic is in the air.
“Fever is like Pandora’s box,” says Dr Rajesh Kumar Chel, who is attached to several Salt Lake hospitals. “A few months ago, 18 out of 20 fever cases were due to Covid, but now dengue, malaria, UTI (urinary tract infection), typhoid, flu and pharyngitis are all back. Just because Covid is around, doesn’t mean these have disappeared.”
Diagnostic centres are doing multiple tests on the same samples. “Blood samples are being tested for Covid, dengue, malaria and typhoid. Out of every 10 samples we are testing, three or four are coming positive for dengue. The positivity rate for Covid is slightly less now,” said Dr Bibekananda Panda, a microbiologist who owns SP Diagnostics & Polyclinic, located behind Uniworld City.
Dr Chel mentions how some fever patients are opting for only Covid tests and upon testing positive, are popping paracetamols on their own and isolating themselves, hoping to get better in 14 days. “It’s only when their symptoms get worse that they test themselves for other diseases and realise that along with Covid they also have, say, dengue. By then, their platelet count has dipped alarmingly low,” says the HB Block-based doctor who goes out on house visits too.
Vector-borne diseases are a worry this year, confirms Dr Arpit Kapoor. “Usually we see cases of dengue and malaria at the end of monsoon and it is highly unusual to get them in December but the extended rains this year have caused this anomaly,” says the Karunamoyee resident attached with Apollo Gleneagles Hospital and who also does house visits. He too has seen patients getting dengue and Covid together.
Dr Panda, who became a familiar figure in New Town being one of the few doctors who was doing home visits during the lockdown, is himself currently treating four dengue patients and three Covid patients. “I had got a Covid case who had also got typhoid. The latter is a bacterial infection which people eating out a lot or drinking contaminated water are prone to while Covid is a viral disease,” he added.
Dr Adrija Rahman Mukherjee does not discount winter allergies either. “In the dry season dust and pollen cause allergies in many. Since people are wearing masks and maintaining social distancing, along with Covid, other diseases like flu are also being transmitted less, to an extent,” notes the doctor attached to Apollo Clinic City Centre. “After many years I’m also seeing cases of malaria this year.”
Not to forget Covid
Dr Rahman Mukherjee says that in the midst of a pandemic any fever, unless otherwise proven, must be tested for Covid. “Even if a patient seeks hospitalisation he is being tested for Covid before being admitted,” says the BB Block resident.
Of the types of diseases causing fever, Bidhannagar Subdivisional Hospital is facing a dengue spurt. But there is no let-up in Covid tests. “We are being directed to send samples for sentinel surveillance every six or eight weeks to Nilratan Sircar Medical College and Hospital. The latest batch of 99 yielded 1 Covid positive case. In the earlier batches of 155 and 150, there was just one positive case in one and none in the other,” said Bidhannagar Subdivisional Hospital superintendent Dr Partha Pratim Guha.
But Covid is a taboo among patients, says Dr Atanu Banerjee. “Patients panic if we so much as tell them we suspect Covid. There is also a matter of money as the tests are expensive,” says the doctor who renders service at a charitable clinic at New Town’s CC Block. “On the first day of fever a Covid test will not yield accurate results anyway so we are prescribing anti-allergy pills or paracetamol and asking them to get tested for Covid if symptoms do not fade away.”
Then again the pandemic has made hypochondriacs out of others.
Spot the disease
Flu- sneezing, coughing, fever, sore throat, itchy throat, head and body ache
Allergy- sneezing, watering eyes, coughing, ashtma, skin rash
Dengue- high fever, joint pain, measles-like rash, head ache
Malaria- fever after intervals (could be eight or 12 or even 48 hours) and shivers and copious sweating
Typhoid- low grade fever, stomach ache
Covid- fever, loss of smell
“A colleague of mine is always on the edge. He’s got Covid once and now he’s getting tested almost every 15 days on the pretext of a sneeze or even if he’s feeling low,” says the BL Block resident down with a mystery fever himself.
“Of late I have been getting patients walking in with flu-like symptoms but many are afraid they have got Covid. Although some symptoms overlap, the main tell-tale signs like loss of smell and diarrhoea are missing. Still, many are getting themselves tested for Covid,” said Dr Bimal Chandra Kundu, who sits in AH Block.
Dr Rahman Mukherjee is now worried about the Omicron variant. “In the beginning of the pandemic, the typical Covid symptoms were loss of taste and smell. Later we were getting fevers with stomach problems. But now unless the Covid testing kits are updated Omicron may not get caught,” she says.
Dr Kapoor is relieved that vaccine hesitancy has been low in Salt Lake and that most people here are double-dosed. “It’s good for the entire population. Even if one gets Covid after the vaccine, the severity will be less and the patient will have a fighting chance against the virus,” he says, adding that patients are even enquiring about booster doses now. “Several patients are doing antibody tests and comparing their results with that of six months back. If the levels are less, they are seeking boosters as and when they become available.”
Covid notwithstanding, doctors have been advising patients to get vaccines for flu. “It’s foolish not to get this jab when it is available,” says Chel. “It’s like people complaining that cancer has no treatment but getting a heart attack as they didn’t care to pop something as simple as blood pressure controlling pills.”
But Dr Rahman Mukherjee says the optimum time to get the flu jab is September. “Vaccines inject a tiny bit of a germ into the body so the latter learns to recognise it and prepares soldiers to fight it. But this must happen before being exposed to the full- blown disease. So the flu vaccine is recommended before the advent of winter.”
She also advises a month’s gap between Covid vaccine and most others. “The other day I got a patient who had taken a rabies shot after being bitten by a dog. Her second shot of Covid vaccine was due as well but she would have to wait a while before getting it.”
Tips to follow
Shanoli Majumder, who runs Shefali Medical Hall in BF Block, confirms that many people this season are asking for vitamins. “While it shows they are concerned about their health, it’s sad that many are still coming with masks dangling at their necks instead of noses. And many of the multi-vitamins people are having are self-prescribed that they may not even require,” she says.
Dr Kapoor says that while Vitamin C tablets are fine, the nutrient is absorbed best when received from natural sources like oranges and amla.
Dr Rahman Mukherjee in fact discourages patients from having multivitamins for prolonged periods. “Excess Vitamin B and C in the body can be passed through urine but excess Vitamin D, for instance, gets deposited in the liver. Calcium and zinc in multivitamin tablets can leave deposits in the kidney too,” she says.
Many are resorting to good old ayurveda to steer clear of colds — tulsi leaves, basab leaves, clove, misri, honey — and doctors too recommend them. “Simply inhaling the vapour of boiled water before going to bed works wonders. One should also gurgle at bedtime with about half teaspoon salt in a glass,” Dr Banerjee says.
Additional reporting by Sudeshna Banerjee