‘Mild’ Covid-19 doesn’t always feel that way

Many people are hearing from their doctors that they have a “mild” Covid-19 infection amid a surge of the highly contagious Omicron variant of the coronavirus, but your illness may not feel as minor as “mild” sounds.

It was true for Michelle Cordes, a dietitian at a Chicago-area hospital. She’s vaccinated and boosted, and she says she has done everything she can to avoid catching the virus, like wearing a mask and avoiding crowds.So when she didn’t feel great on December 30, she thought it was a cold or maybe allergies to the cat her daughter brought home from college.

Just to be on the safe side, she took a home test and was surprised to find that she was positive for Covid-19. Her husband, son and father-in-law also tested positive.

Linsey Jones, a medical assistant working at a drive-up COVID-19 testing clinic, hands a nose swab to a person in a car, Tuesday, Jan. 4, 2022, in Puyallup, Wash., south of Seattle. People using the facility, which is being run by the Pierce County Dept. of Emergency Management, faced waits of several hours Tuesday for testing. (AP Photo/Ted S. Warren)

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“We all developed a cough. We all had post-nasal drip. I had the itchy kind of throat, and my husband and I both had night sweats for like four nights in a row,” Cordes said.

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

What Covid-19 actually feels like can vary dramatically. Studies have shown that disease from Omicron is generally milder than from the Delta coronavirus variant, and some people have no symptoms or only brief, minor sniffles. But it can still cause serious disease, especially among the unvaccinated. There are 126,410 people currently hospitalized with Covid-19, about 89% of the way to last year’s peak, according to US Department of Health and Human Services.

But even disease considered “mild” can still be uncomfortable and prolonged.

The National Institutes of Health’s definition of “mild” Covid-19 includes symptoms that people are all too familiar with these days, like fever, cough, sore throat, and fatigue. They’re symptoms that Dr. Shira Doron has realized are nothing to, well, sneeze at.

Use of the word “mild” “isn’t meant 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’s called long Covid, with symptoms that stick around for six months or more. She thinks the “mild” term that experts prefer may need to be reframed.

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

Gael Rojas attends a computer science class at the Escalerillas neighborhood in Chimalhuacan, Mexico state, Mexico, on February 24, 2021. - The COVID-19 pandemic made schools close down but also allowed low-income children living in front of a municipal garbage dump in Mexico get to learn computer science with the help of an NGO. (Photo by ALFREDO ESTRELLA / AFP) (Photo by ALFREDO ESTRELLA/AFP via Getty Images)

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Cordes ended up sitting in her pajamas for three days, something she says she has never done before.

“We’ve felt crappy and tired,” Cordes said. “On Monday, we took our tree down, and by one o’clock, we were all exhausted.”

She feels better this week and is up to taking on a paper-shredding project, but she’s not back at work yet.

Dave Juday was also shocked when a routine Covid-19 test turned up positive December 8. The Arizona high school radio and audio instructor tests weekly and is extra careful to wear a mask because he doesn’t want to bring the disease home to his spouse, who has lupus. His school’s assistant principal even told him that his positive test scared people.

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

Vaccines and boosters worked, he said. He never had to go to the hospital, but a slight headache turned into what felt like one of the worst sinus headaches he had ever had.

“My head felt like a 16-pound bowling ball, and I could feel my sense of smell and taste fading,” Juday said.

He felt OK enough to teach class virtually. “Although I was blowing my nose 500 times because I looked like Rudolph on Zoom with my classes,” Juday said. “I don’t even want to know what it would have been like had I not been vaccinated.”

Worcester, MA - December 29: A healthcare worker at UMass Memorial Medical Center tends to a patient while working in the COVID-19 Intensive Care Unit in Worcester, MA on Dec. 29, 2021. As COVID-19 cases spike and the pandemic ravages on, hospitals are faced once again with a shortage of ICU beds. (Photo by Erin Clark/The Boston Globe via Getty Images)

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

“That is good, but it doesn’t feel good,” Doron said. “The symptoms in and of themselves aren’t dangerous, and you don’t need to seek medical care.”

With mild Covid, there’s no need to go to the ER, particularly during a time when health care resources are scarce.

Calling the disease “mild” may have another disadvantage: It may prompt some people to not take Covid-19 seriously enough.

“There’s been so much Covid fatigue – and that’s associated with a desire to get back into the normal, or as close to normal, swing of things as possible – that people may actually trivialize their symptoms and choose not to get tested for either Covid or influenza,” said Dr. William Schaffner, professor of infectious diseases at Vanderbilt University Medical Center.

HOUSTON, TEXAS - AUGUST 23: Children participate in an activity in class at the Xavier Academy on August 23, 2021 in Houston, Texas. In-person classroom sessions are resuming and schools around Houston are requiring mask mandates, keeping in accordance with CDC guidelines. Harris County Judge Lina Hidalgo has gone against Gov. Greg Abbott's statewide ban on mask mandates and has issued an order that requires face coverings to be worn in schools. All staff and faculty at Xavier Academy have been vaccinated and 90% of students in attendance have also been vaccinated. (Photo by Brandon Bell/Getty Images)

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Even with mild symptoms, people should get tested for Covid-19, he said, so they know to watch for worsening symptoms that need medical care. A test will also tell them if they need to isolate themselves so they don’t spread the coronavirus to others.

“Your case could be mild, but you could give it to Aunt Susie, who’s got diabetes, and she may wind up being much more seriously ill,” Schaffner said.

And even though Omicron may be causing more cases of mild disease than previous variants, people shouldn’t use that as an excuse to forgo vaccines or boosters.

“People are still hospitalized with this, and the vast majority continue to be unvaccinated,” Schaffner said. “A hospital is not a resort hotel.”

Dr. Claudia Hoyen, director of pediatric infection control at UH Rainbow Babies and Children’s Hospital in Cleveland, has also been encouraging everyone she knows to get vaccinated and boosted. Hospitals are good at helping people with Covid-19, she said, but symptoms and complications could stick around long after a hospital stay.

“We are seeing data that shows sometimes, up to 30% of patients who end up in the ICU never get back their lives,” Hoyen said. “The unvaccinated may think ‘somebody is going to save me, and it’ll be fine,’ but you know, not everyone gets back to baseline and back to their normal lives.”

Correction: An earlier version of this story incorrectly spelled Dr. Shira Doron’s name.