What does it mean: a person is healthy from coronavirus? It turned out to be a loose concept.
In total, on April 14, according to Rospotrebnadzor, 21,102 cases of coronavirus were registered in Russia, and the increase over the last day amounted to 2,774 new cases. With such a spread of the disease, how to understand who is infected and who is healthy, and in general, is it possible to be healthy from the coronavirus? We asked these questions to Nikolai Kryuchkov, an immunologist, an expert on public health and international health, and a candidate of medical sciences.
Nikolay, how can I understand that I am healthy and that I do not have coronavirus?
- Here you need to understand that coronavirus infection is not equal to disease. That is, a person can be infected, but he will not develop the disease, or it will develop later. We know about the incubation period, which on average lasts 6 days, but it can last from 3 days to two weeks, that is, this is the period when there is no disease, it does not manifest itself, but the person is infected. The second point, there are cases, and there are many of them: according to the literature, it is 20-40%, when a person suffers the disease in a subclinical (asymptomatic) form. That is, he has no symptoms of the disease. He is outwardly healthy, but, nevertheless, infected. In both of these cases, the person is most likely a source of infection for other people.
Therefore, if you do not have clinical manifestations of the disease, you do not cough, do not sneeze, the body temperature is not elevated, there is no discomfort in the chest area, there is no shortness of breath or difficulty in breathing, there is no confusion, there is no sore throat - that is, there is no a number of clinical manifestations typical of coronavirus, then from the point of view of the clinical condition you are healthy.
However, it is important to understand that the virus can infect the lungs early enough, causing viral bilateral pneumonia, which may not appear clinically in some people. The disease is present, it is on, but there are no clinical manifestations. How to identify? The best way is computed tomography of the lungs, which shows the presence or absence of signs of lung changes typical for COVID-19 disease.
That is, a person has bilateral pneumonia, but he does not feel anything? No discomfort at all?
- Each person has their own degree of tolerance to different manifestations of diseases. For example, if one person sneezes or coughs a little, they don't consider it to be any special manifestation of ailment, and other people will consider it a rather serious sign. This is the difficulty. When a doctor asks, “are you sneezing, are you coughing?”, A person may say “no,” because such appearances are of little significance to him. Therefore, we are talking either about the absence of clinical symptoms, or about their weak severity. But at the same time, in both of these cases, the lungs may already be affected, that is, CT will already show symptoms of bilateral viral pneumonia.
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Summing up, we can say that if a person does not have clinical symptoms of COVID-19 disease, CT scan in the lungs is clear, and PCR analysis for the "new coronavirus" is negative, then he is healthy and not infected. At the same time, I emphasize, being clinically healthy, but infected, a person can be a source of infection for other people. This is one of the insidious features of the new coronavirus SARS-CoV-2.
It turns out that it is impossible to say unequivocally "I am healthy" or "I am healthy."
- This is the main reason for the introduction of a general quarantine. If the disease had a short incubation period, bright manifestations in all infected, then perhaps a general quarantine would not be needed. But since it is impossible to be sure in the case of coronavirus, and our diagnostic tests do not have a sensitivity close to 100%, in order to interrupt the infectious chain and reduce the intensity of the epidemic in the country, we have to go to general quarantine. He becomes part of the solution to the problem.
What are the indications for discharging Kommunarka patients?
Maria Mukhina, who was being treated at an infectious diseases hospital, told how patients who recovered from coronavirus are discharged and what they are recommended to do at home:
- Recommendations of doctors at discharge are different, depending on the condition in which they are discharged. Someone is prescribed medication, some do not. Often strict self-isolation is prescribed for 14 days and a repeat CT scan (computed tomography) if there is pneumonia. They recommended me medications, antibiotics, so I finished it all and wait for the results of another coronavirus test so that there are three negative ones in a row. Then I will do another CT scan, in 10 days, probably, when I can go out. They also said that they would order blood tests. I do breathing exercises, breathe. So the criteria for a person to be healthy from coronavirus now are three negative tests in a row, plus CT. But they say that, most likely, CT will see the remnants of pneumonia in some of its manifestations for another six months. And nobody knows what the further health consequences will be. Now I am already much better, I am glad that every day there are strengths and I understand that, most likely, I was cured! Everything we did was right!
OKSANA NARALENKOVA