A reminder to everybody about COVID-19 symptoms: they are nonspecific and not distinguishable from the common cold or flu.
Yes: even mild cold symptoms could represent an infection, especially in the young and healthy (this was well studied in exposed individuals in Germany).
Even if your symptoms are mild, you could go on to infect others, particularly high-risk individuals, leading to potentially serious disease.
So no, you do NOT “need to have a fever”. In fact, in a February 2020 study in China, less than 50% of patients admitted to the hospital had fever initially! These were patients who ended up getting quite sick (nearly all developed fever eventually).
- Cough can be seen in ~70% infected
- Fatigue in ~40%
- Sputum production in ~30%
- Sore throat, nasal congestion in <20%
THIS nonspecific symptomology is one of our greatest problems, because quarantining anybody with even mild symptoms is the safest approach, but is also the most alarmist. Thus, specific recommendations will depend on your community rate of spread.
Reference: Guan W-J et al. Clinical characteristics of coronavirus disease 2019 in China. N Engl J Med 2020 Feb 28
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