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Did you already have COVID-19?
And does that mean you still need to be careful?
Welcome to Not a Doctor, the only (free!) newsletter about health and science that tells you to please stop reading this if you’re already way too stressed about the coronavirus.
Take a break, archive or delete this without reading — whatever you need to do. My only goal here is to help you take care of you, by doing my best to explain what’s going on.
I’m Melody Schreiber, a journalist and the editor of What We Didn’t Expect (Nov. 2020). I’m not a doctor, or a scientist, or really an expert of any kind. (Unless you count Googling “is it a panic attack or coronavirus?” I am pretty much an expert at that.)
Today, I want to talk about that nasty virus you had a few weeks ago.
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Wait, did I already go through this?
It was Thanksgiving, or it was Christmas, or it was right after New Year’s Eve. You woke up one day feeling like you’d been hit by a truck. High fever, no energy, a pounding headache, a cough that rattled like a machine gun. You stayed in bed for days, which was really unlike you; usually you’re able to push through an illness.
When the symptoms finally ebbed, you breathed a sigh of relief and life returned to normal.
But now you’re wondering: Was it the coronavirus?
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Before we talk about the coronavirus, let’s talk about flu.
First of all: They are not the same thing — not by a long shot.
Note: If you’re already stressed about severity and fatality rates, please skip this next part. But if you’re still not sure how they stack up, here are a few numbers:
The flu kills about 0.1 percent of the people who get it, whereas COVID-19* has a fatality rate right now of about 3.4 percent. That’s thirty times deadlier. And it can be even worse if hospitals are overwhelmed and unable to care for an influx of patients.
However, symptoms for the coronavirus can be very similar to the flu. And for many people, that’s very likely what they had this fall and winter — not the coronavirus.
The U.S. has seen another busy flu season. From October 1 until February 22, there were about 32 million cases of influenza-like illnesses.* More than 300,000 people were hospitalized, and 18,000 died from influenza this season. Kids were especially hard-hit this year. The flu shot has been about 45 percent effective in preventing flu cases.
It’s possible, of course, for an illness to be both COVID-19 and another respiratory virus, so it’s possible that people who tested positive for the flu could have had both. We won’t know for sure until we’re able to conduct blood tests to see if people have gained immunity — and these tests are still being developed right now.
There is another, grimmer way to tell that the virus has been circling for a few weeks: an increase in deaths.
Because the coronavirus is much more fatal than the other respiratory illnesses already floating around your community, experts would expect to see a higher death rate in your area if widespread community transmission* is at work.
The good news is: If you fought off your illness a few months ago and everyone in your town seemed fine, you probably didn’t have the coronavirus.
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When the virus appeared
So: how likely were you to be infected with the coronavirus a few weeks or months ago? To answer that, let’s look at a quick timeline of the virus’s emergence in China.
The earliest known case of the coronavirus in China has now been traced to November 17, although it could have been spreading earlier than that. (It’s important to note that our understanding of events can and likely will change as scientists race to understand this new virus.)
By the end of the year, at least 266 people in China were confirmed with the mystery virus.
Here are a few possible ways that you could have come into contact with the virus in the United States before New Year’s Day:
You or someone you’re in close contact with traveled to Hubei province.
Someone from Hubei traveled to your area and came into close contact with you.
It’s not impossible? But unless we start to see an uptick in newly confirmed cases before the end of 2019, it doesn’t seem very likely that you would have had the virus last fall or in the early winter.
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The more recent, the more likely
In the U.S., the situation seems to have changed around mid-January or so.
The first U.S. case was confirmed in a traveler who returned to Seattle on January 15. Months later, community spread in Washington state was confirmed. Trevor Bedford, a scientist in Seattle, later found that nearly all of the early cases found in the community linked back to a single introduction of the virus in January or so.
There’s no reason to think this was unique to Washington, though, so it stands to reason that other cases throughout the United States could have begun early in the year as well.
Going back to that illness you fought off: the more recently it happened, the more likely it was COVID-19. If it was November — not very likely. January — more likely. Last week? Call your doctor, please.
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How do we know it’s not the flu now?
Looking at this year’s flu-like illnesses compared to recent years, the rates don’t seem that unusual. That means influenza was circulating about the same as it usually does.
Until you get to recent weeks.
There’s been a rise in people reporting flu-like illnesses to their doctors — but there’s been a drop in positive flu tests. That means whatever they’re feeling isn’t the flu.
It takes a little bit for community spread to happen, and then it takes a little while longer for people to become sick enough to see a doctor.
If these rates continue to climb, even as the flu season is supposed to wind down, it shows the prevalence of other respiratory viruses — including the coronavirus — in a given state.
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What this means for you
Okay, so, why does all of this matter?
If you think you already had COVID-19, you might think you’re immune now. You might think, okay, it wasn’t so bad, actually, and now I’m fine! You might not be as careful as you go out and about.
Please don’t think that!
First of all, if you did have the coronavirus, especially within the past two weeks or so, it’s possible you’re still contagious. Even after your symptoms begin to disappear, the virus is still circulating in your body, and it’s not clear how long you’re still able to pass the virus on to others.
And secondly, we can’t know for sure until you’ve had a blood test (technically, it’s called a serological test) to see if you have antibodies. Maybe what you had was the flu, or strep, or RSV, or some other virus that you’re now thankfully immune to.
But until you have a positive coronavirus test, you can’t know for sure. So, your best bet is to act as though you haven’t had it, and continue to protect yourself and others.
If what you went through was COVID-19 — what a wonder that you came out of it just fine.
Please, please keep it from spreading to those who wouldn’t be so lucky.
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community spread or transmission: when a virus is spread locally, without travel to an affected area; often, this term is used when a person tests positive for COVID-19 but had no contact with a known case
COVID-19: an illness, caused by the virus SARS-CoV-19, that can include symptoms (like a high fever, coughing, shortness of breath, a loss of smell and taste, or others) but can have no symptoms at all
influenza-like illnesses: a term that covers the flu and other illnesses that have similar symptoms, including a fever of at least 100 degrees Fahrenheit and a cough or sore throat
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