“Mild” Covid-19 infection may not be as mild as it sounds, doctors say

Many people hear their doctors say they have a “mild” Covid-19 infection amid an advance of the highly contagious Ômicron variant. But the illness may not seem as mild as it may seem.

That’s what happened to Michelle Cordes, a nutritionist at a Chicago-area hospital. She is vaccinated, received a booster dose and says she has done everything possible to avoid the virus infection, such as wearing a mask and avoiding agglomerations. So when she got sick on December 30th, she thought it was a cold or maybe an allergy to the cat her daughter brought home from college.

To be sure, she took a test at home and was surprised to find it positive for Covid-19. Her husband, son and father-in-law also tested positive.

“We all develop coughs. We all had a runny nose. My throat itched, and my husband and I had night sweats for four nights in a row,” Cordes said.

What does a “mild” illness entail?

“Smooth” is a word that seems to fit Cordes’s symptoms compared to those she sees in her patients at the hospital, she said. But her illness didn’t feel like a small cold either.

The actual feel during Covid-19 can vary dramatically. Studies have shown that illness caused by the Ômicron variant is generally milder than that caused by the Delta variant of the coronavirus, and some people have no symptoms or only a brief cold. But it can still cause serious illness, especially among unvaccinated people.

There are currently 126,410 people hospitalized with Covid-19 in the US, about 89% from last year’s peak, according to the US Department of Health and Human Services (HHS).

But even “mild” illness can be uncomfortable and prolonged.

The National Institutes of Health (NIH) definition of Covid-19 “mild” includes symptoms that people are very familiar with today, such as fever, cough, sore throat, and fatigue. These are symptoms that Dr. Shira Doron realized are not worth noting.

The use of the word “mild” “is not intended to minimize your experience,” said Doron, a hospital epidemiologist and infectious disease physician at Tufts Medical Center in Boston.

Even people with mild illness can develop what is called a “long covid,” with symptoms that persist for six months or more. The doctor believes that the term “soft” used by experts may need to be reworded.

“When we, or the CDC or the NIH, say ‘mild,’ we really mean you didn’t get sick enough to go to the hospital,” said Doron. “But when you have a flu-like illness that takes you to bed, it’s not mild for you.”

Cordes ended up on bed rest for three days, something she says she has never done before.

“We feel bad and tired,” Cordes said. This week she is feeling better, but she hasn’t returned to work yet.

Dave Juday was also shocked when a routine test of Covid-19 came back positive on December 8th. The Arizona high school radio and audio instructor undergoes weekly tests and is very careful about wearing his mask as he doesn’t want to take the disease to his wife, who has lupus. His school’s vice principal even told him that his positive test scared people.

“They told me if I can get Covid, anyone can, I’m very careful,” Juday said.

The vaccines and boosters worked, he said. He never had to go to the hospital, but a slight headache turned into what appeared to be one of the worst sinus headaches he’s ever had.

“My head felt like a bowling ball, and my sense of smell and taste were disappearing,” said Juday.

He felt good enough to teach virtually. “Even if I blew my nose 500 times because I looked like Rudolph at Zoom with my classes,” said Juday. “I don’t even want to know what it would have been like if I hadn’t been vaccinated.”

When your body has these symptoms, it’s doing what it should, Doron said: neutralizing the virus.

“That’s good, but it doesn’t feel right,” said Doron. “The symptoms themselves are not dangerous and you don’t need to seek medical attention.”

Disadvantages

With a “light” Covid, it is not necessary to go to the emergency room, especially at a time when health resources are scarce.

Calling the disease “mild” can have another downside: it can make some people not take it seriously enough.

“There has been so much fatigue with Covid, and this is associated with the desire to get back to normal, or as close to normal, that people can trivialize their symptoms and decide not to get a Covid or flu test,” said Dr. William Schaffner, Professor of Infectious Diseases at Vanderbilt University Medical Center.

Even with mild symptoms, people should be tested for Covid-19, he said, to see if symptoms are getting worse and need medical attention. A test will also tell you if they need to isolate themselves so as not to spread the coronavirus to others.

“Your case may be mild, but you can infect Aunt Susie, who has diabetes, and she can get a lot more serious,” Schaffner said.

And while the Ômicron variant may be causing more cases of mild illness than previous variants, people shouldn’t use that as an excuse to forgo vaccines or boosters.

“People are still hospitalized with it, and the vast majority remain unvaccinated,” Schaffner said. “A hospital is not a vacation hotel.”

Dr. Claudia Hoyen, Director of Pediatric Infection Control at Rainbow Babies University Hospital and Children’s Hospital in Cleveland, has also been encouraging everyone she knows to get vaccinated and get a booster.

Hospitals are good at helping people with Covid-19, he said, but symptoms and complications can persist long after a hospital stay.

“We’re recording data that sometimes show up to 30% of patients who end up in the intensive care unit never get back to life as it was before,” Hoyen said. “Unvaccinated people may think that ‘someone will save me and everything will be fine’, but not everyone regains their baseline level and normal life.”