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A Family of Three Gets Sick With Covid-19 Symptoms. Who Has It? A Family of Three Gets Sick With Covid-19 Symptoms. Who Has It?
(2 months later)
The 20-year-old man moved restlessly on a gurney in the emergency department at Greenwich Hospital in Greenwich, Conn., on March 14. It was hard for him to get comfortable. His head ached; his lips and mouth felt as if they were on fire. His hands were too swollen to close, and the skin and muscles all over his body felt tender and sore. Two days earlier, his mother picked him up from his university just outside Philadelphia, which had closed because of the Covid-19 pandemic. Several of his friends had been showing signs of a Covid-like sickness, and the young man and his mother were worried that he was, too.The 20-year-old man moved restlessly on a gurney in the emergency department at Greenwich Hospital in Greenwich, Conn., on March 14. It was hard for him to get comfortable. His head ached; his lips and mouth felt as if they were on fire. His hands were too swollen to close, and the skin and muscles all over his body felt tender and sore. Two days earlier, his mother picked him up from his university just outside Philadelphia, which had closed because of the Covid-19 pandemic. Several of his friends had been showing signs of a Covid-like sickness, and the young man and his mother were worried that he was, too.
As soon as she saw him, she could tell he was sick. His face was pale and sweaty. His skin was hot; his eyes were glassy with fever. She put on a mask, and then drove him home. Once he was safely in his bedroom, she called the Yale Covid-19 call center for guidance on what to do next. By then the first case of Covid-19 in Connecticut had been reported, a few days earlier on March 8. Given his likely exposure at school and his fever there and now at home, her son met the criteria of someone who should be tested, she was told. The soonest he could have the test at the local drive-through center was in three days, on March 15. In the meantime, she should assume that her son was infected with the virus and should be quarantined.As soon as she saw him, she could tell he was sick. His face was pale and sweaty. His skin was hot; his eyes were glassy with fever. She put on a mask, and then drove him home. Once he was safely in his bedroom, she called the Yale Covid-19 call center for guidance on what to do next. By then the first case of Covid-19 in Connecticut had been reported, a few days earlier on March 8. Given his likely exposure at school and his fever there and now at home, her son met the criteria of someone who should be tested, she was told. The soonest he could have the test at the local drive-through center was in three days, on March 15. In the meantime, she should assume that her son was infected with the virus and should be quarantined.
Before he could get to the drive-through, he began to get sicker. The day after he got home, March 13, he lost his appetite and developed a strange red rash around his nose, mouth and chin. The next morning, after he started vomiting, his mother took him to the hospital.Before he could get to the drive-through, he began to get sicker. The day after he got home, March 13, he lost his appetite and developed a strange red rash around his nose, mouth and chin. The next morning, after he started vomiting, his mother took him to the hospital.
In the emergency room, the young man had no fever. The rest of his exam was normal, except for the raw-looking rash on his face, hands and back. The blisters — and the round red lesions they turned into — were tender and made it hard for him to talk, eat or even use his hands. The masked nurse returned with news from the E.D. doctor: He was to be admitted. They would test him for Covid-19. The rash he had wasn’t typical of that infection, though they still had a lot to learn about it.In the emergency room, the young man had no fever. The rest of his exam was normal, except for the raw-looking rash on his face, hands and back. The blisters — and the round red lesions they turned into — were tender and made it hard for him to talk, eat or even use his hands. The masked nurse returned with news from the E.D. doctor: He was to be admitted. They would test him for Covid-19. The rash he had wasn’t typical of that infection, though they still had a lot to learn about it.
His rash looked more like a herpetic infection or hand, foot and mouth disease, an infection usually caused by the Coxsackie virus and most commonly found in young children and occasionally in adolescents. As the nurse explained this to mother and son, the mother erupted into a prolonged episode of coughing. “I’ve had this tickle in my throat for the past few days,” she explained to the nurse, apologizing for the interruption.His rash looked more like a herpetic infection or hand, foot and mouth disease, an infection usually caused by the Coxsackie virus and most commonly found in young children and occasionally in adolescents. As the nurse explained this to mother and son, the mother erupted into a prolonged episode of coughing. “I’ve had this tickle in my throat for the past few days,” she explained to the nurse, apologizing for the interruption.
“I don’t like the sound of that cough,” the nurse replied. She should really talk to her doctor about being tested for Covid-19.“I don’t like the sound of that cough,” the nurse replied. She should really talk to her doctor about being tested for Covid-19.
The mother couldn’t believe that she might have this viral infection. She had been very careful. She started wearing masks and gloves whenever she left the house at the end of February. People had looked at her as if she were crazy for wearing that kind of protection, but she didn’t care. She wiped everything down with disinfectant before she brought it into the house and left her coat and shoes in the foyer. She washed her hands dozens of times a day and scrubbed her counters and keyboards before and after every use. She was caring for her 91-year-old mother, who lived just a block away, and was terrified that the family matriarch would get sick. Her mother had isolated herself when the first cases hit New York City and depended on her daughter for anything she needed from the outside world.The mother couldn’t believe that she might have this viral infection. She had been very careful. She started wearing masks and gloves whenever she left the house at the end of February. People had looked at her as if she were crazy for wearing that kind of protection, but she didn’t care. She wiped everything down with disinfectant before she brought it into the house and left her coat and shoes in the foyer. She washed her hands dozens of times a day and scrubbed her counters and keyboards before and after every use. She was caring for her 91-year-old mother, who lived just a block away, and was terrified that the family matriarch would get sick. Her mother had isolated herself when the first cases hit New York City and depended on her daughter for anything she needed from the outside world.
The woman suspected that her husband wasn’t quite as careful as she was. He was commuting on the Metro North train to New York for work. He didn’t wear a face mask, but he said he washed his hands frequently and wore gloves when he was outside his home or office. But he had been coughing for the past week or so. He didn’t have a fever and didn’t feel short of breath. He just had this little cough that, he said, was nothing.The woman suspected that her husband wasn’t quite as careful as she was. He was commuting on the Metro North train to New York for work. He didn’t wear a face mask, but he said he washed his hands frequently and wore gloves when he was outside his home or office. But he had been coughing for the past week or so. He didn’t have a fever and didn’t feel short of breath. He just had this little cough that, he said, was nothing.
She had a cough, too, which started a few days before her visit with her son to the E.D. on March 14. A week earlier, she had a headache that felt like sinusitis. She went to a walk-in clinic on March 10, and the doctor there gave her azithromycin, an antibiotic. When that didn’t help, and with her son at home in bed, she went back to urgent care and was given a second antibiotic. That didn’t do much, either. Now the nurse who took care of her son in the E.D. suggested that she should be tested for Covid-19 — confirming her worst fears.She had a cough, too, which started a few days before her visit with her son to the E.D. on March 14. A week earlier, she had a headache that felt like sinusitis. She went to a walk-in clinic on March 10, and the doctor there gave her azithromycin, an antibiotic. When that didn’t help, and with her son at home in bed, she went back to urgent care and was given a second antibiotic. That didn’t do much, either. Now the nurse who took care of her son in the E.D. suggested that she should be tested for Covid-19 — confirming her worst fears.
The next morning, March 15, the woman dialed the number for the Yale call center again. She explained about her headache, her cough and her sick son. A voice on the phone patiently explained that she didn’t meet their criteria for testing, even though her son might have Covid-19. She should just assume that she had it and isolate herself for 14 days.The next morning, March 15, the woman dialed the number for the Yale call center again. She explained about her headache, her cough and her sick son. A voice on the phone patiently explained that she didn’t meet their criteria for testing, even though her son might have Covid-19. She should just assume that she had it and isolate herself for 14 days.
Updated June 30, 2020
Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.
Scientists around the country have tried to identify everyday materials that do a good job of filtering microscopic particles. In recent tests, HEPA furnace filters scored high, as did vacuum cleaner bags, fabric similar to flannel pajamas and those of 600-count pillowcases. Other materials tested included layered coffee filters and scarves and bandannas. These scored lower, but still captured a small percentage of particles.
A commentary published this month on the website of the British Journal of Sports Medicine points out that covering your face during exercise “comes with issues of potential breathing restriction and discomfort” and requires “balancing benefits versus possible adverse events.” Masks do alter exercise, says Cedric X. Bryant, the president and chief science officer of the American Council on Exercise, a nonprofit organization that funds exercise research and certifies fitness professionals. “In my personal experience,” he says, “heart rates are higher at the same relative intensity when you wear a mask.” Some people also could experience lightheadedness during familiar workouts while masked, says Len Kravitz, a professor of exercise science at the University of New Mexico.
The steroid, dexamethasone, is the first treatment shown to reduce mortality in severely ill patients, according to scientists in Britain. The drug appears to reduce inflammation caused by the immune system, protecting the tissues. In the study, dexamethasone reduced deaths of patients on ventilators by one-third, and deaths of patients on oxygen by one-fifth.
The coronavirus emergency relief package gives many American workers paid leave if they need to take time off because of the virus. It gives qualified workers two weeks of paid sick leave if they are ill, quarantined or seeking diagnosis or preventive care for coronavirus, or if they are caring for sick family members. It gives 12 weeks of paid leave to people caring for children whose schools are closed or whose child care provider is unavailable because of the coronavirus. It is the first time the United States has had widespread federally mandated paid leave, and includes people who don’t typically get such benefits, like part-time and gig economy workers. But the measure excludes at least half of private-sector workers, including those at the country’s largest employers, and gives small employers significant leeway to deny leave.
So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement.
Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.
A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study.
The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April.
If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)
If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.
The woman hung up, discouraged. She told me that it felt important to know for sure whether she had the illness. She called the number again, and a different voice answered. She again described her symptoms and her sick son. The voice asked if she’d had any fevers. The woman hesitated. She hadn’t had a fever but suspected that if she said that again, she wouldn’t get tested. Yes, she told the woman on the phone. She spoke to a doctor who told her she would need to be tested. She could go to the testing facility in Waterbury. But the results wouldn’t be available for another few days.The woman hung up, discouraged. She told me that it felt important to know for sure whether she had the illness. She called the number again, and a different voice answered. She again described her symptoms and her sick son. The voice asked if she’d had any fevers. The woman hesitated. She hadn’t had a fever but suspected that if she said that again, she wouldn’t get tested. Yes, she told the woman on the phone. She spoke to a doctor who told her she would need to be tested. She could go to the testing facility in Waterbury. But the results wouldn’t be available for another few days.
Her son stayed in the hospital for three days. His Covid-19 test still hadn’t come back by the time he was discharged on March 17, but the doctors suspected that he probably had hand, foot and mouth disease. It’s an infection consisting of a low-grade fever and a rash of small blisters that break open and then heal over the course of a few days. They are usually limited to the mouth but can spread to the hands and feet, and sometimes to the torso and buttocks. It’s quite contagious, but for reasons that are not well understood, adults rarely get it. A few days later, their hypothesis was confirmed: The patient’s Covid test was negative, and the test for the Coxsackie virus was positive.Her son stayed in the hospital for three days. His Covid-19 test still hadn’t come back by the time he was discharged on March 17, but the doctors suspected that he probably had hand, foot and mouth disease. It’s an infection consisting of a low-grade fever and a rash of small blisters that break open and then heal over the course of a few days. They are usually limited to the mouth but can spread to the hands and feet, and sometimes to the torso and buttocks. It’s quite contagious, but for reasons that are not well understood, adults rarely get it. A few days later, their hypothesis was confirmed: The patient’s Covid test was negative, and the test for the Coxsackie virus was positive.
Now that her son was home, the mother’s goal was to stay away from him until she knew for certain whether she had Covid-19. She’d also moved into a different bedroom to separate herself from her husband. But the day after she brought her son home from the hospital, her husband told her he was going to the emergency room. He felt terrible, he said, really short of breath. He’d packed a small suitcase, just in case he had to stay.Now that her son was home, the mother’s goal was to stay away from him until she knew for certain whether she had Covid-19. She’d also moved into a different bedroom to separate herself from her husband. But the day after she brought her son home from the hospital, her husband told her he was going to the emergency room. He felt terrible, he said, really short of breath. He’d packed a small suitcase, just in case he had to stay.
He did have to stay. His oxygen level was low, and a chest X-ray showed that he had pneumonia in both lungs. He probably had Covid-19, he was told. He was put in an isolation room. Occasionally one of his doctors came in, though mostly he spoke to them on the phone. The results of his Covid-19 test and his wife’s test came back the same day — on March 19. Both were positive. He stayed in the hospital for nearly a week. And when it was time for him to come home, his wife was so worried that he might infect their son that he moved instead into the small apartment they had in the city.He did have to stay. His oxygen level was low, and a chest X-ray showed that he had pneumonia in both lungs. He probably had Covid-19, he was told. He was put in an isolation room. Occasionally one of his doctors came in, though mostly he spoke to them on the phone. The results of his Covid-19 test and his wife’s test came back the same day — on March 19. Both were positive. He stayed in the hospital for nearly a week. And when it was time for him to come home, his wife was so worried that he might infect their son that he moved instead into the small apartment they had in the city.
The wife’s headache slowly got better, as did her cough. She never had a fever. She is certain she got the virus from her husband. He wonders if he got it from her; he thinks his cough started well after hers. They will probably never know where it came from. As for their son, had he presented with the same rash and history at just about any other time, the diagnosis of hand, foot and mouth disease would have been obvious. But in this epidemic, with a bug we still know so little about and one that is moving so quickly, everything can look, at least at first, a lot like Covid-19.The wife’s headache slowly got better, as did her cough. She never had a fever. She is certain she got the virus from her husband. He wonders if he got it from her; he thinks his cough started well after hers. They will probably never know where it came from. As for their son, had he presented with the same rash and history at just about any other time, the diagnosis of hand, foot and mouth disease would have been obvious. But in this epidemic, with a bug we still know so little about and one that is moving so quickly, everything can look, at least at first, a lot like Covid-19.