COVID-19 cases rise, but symptoms are mild

Experts report an increasing number of COVID-19 patients, but while infectious, the virus is presenting fairly mild and manageable symptoms.

Though doctors expect infections to increase further, many say it’s difficult to quantify as people aren’t testing as much as they did in the past.

“It’s difficult to say that this is a wave as we don’t have a handle in terms of the quantity of infections,” said Professor Barry Schoub, chairperson of the Ministerial Advisory Committee on COVID-19 vaccines. “Certainly, anecdotally, there seem to be a lot of infections. Many individuals aren’t getting tested, or if they do get tested, it’s usually the rapid test, which isn’t done in a laboratory.”

Schoub said some parameters did indicate an increase. “Nine percent of the specimens that go to a laboratory are positive. Normally in the quiet periods, it’s about 5%.”

Schoub said wastewater surveillance was another indicator of an increase. Last month, the South African Medical Research Council called attention to increases in the concentrations of SARS-CoV-2RNA in several wastewater treatment plants in the city of Cape Town as well as several Western Cape towns.

The increase in wastewater coincides with an increase in the proportion of positive COVID-19 tests reported by the National Institute for Communicable Diseases, experts say.

South Africa experienced a mild fifth wave, which ended in June. Vaccination rates and immunity explained the mild caseload, health experts said at the time.

Schoub said the virus seemed to be more localised to the upper respiratory tract, and symptoms seemed to be a little different to the previous variants, similar to a common cold with a bit of flu.

“Previously, it might have involved the lungs with pneumonia, and a lot of people lost their sense of smell and taste. We don’t get this often now.”

Hospitalisation levels are also low, he said.

Johannesburg General Practitioner Sheri Fanaroff told the SA Jewish Report that she had witnessed an increase in COVID-19 cases over the past six weeks, but instead of a rapid uptick, it was a case of a slow, steady trickle.

“Previously, almost everyone with respiratory symptoms got a COVID-19 test, whereas now, as we’re experiencing many other respiratory viruses and influenza, only people with more severe symptoms are generally testing,” Fanaroff said. “We are probably missing many cases.”

She said the majority of positive COVID-19 patients she had seen over the past few weeks were those who had never had COVID-19 before or who had it 18 months or more ago.

“I’ve hardly seen anyone who has previously had Omicron [the prevalent strain since December 2021] testing positive again now. So, previous infection with Omicron seems to give good protection against getting infected again.”

Fanaroff said common symptoms included coughing, congestion and tight chests, severe fatigue and headaches, and body aches and pains.

“For the most part, although some people have felt quite sick for a few days, most patients haven’t battled with low oxygen levels and haven’t required hospital admission.

“However, although in general disease is mild, we have many patients suffering the effects of long COVID-19 for months after infection; some are left with debilitating fatigue, brain fog, and lingering cardiac or neurological effects. There’s a lot we’re still going to learn about the long-term effects of Omicron.”

Fanaroff encouraged those who are immunocompromised or who have underlying health risks to consider wearing masks in crowds and avoiding indoor spaces with lots of people.

More importantly, she said, people who do have respiratory symptoms (coughs/congestion/sore throats) should avoid close contact (particularly with the elderly) or at least wear a mask if it’s unavoidable.

“Those who are symptomatic and positive should still isolate at home for seven days from the onset of symptoms,” she said.

Uriel Rosen, operations manager of Hatzolah Medical Rescue, said, “Our numbers don’t reflect [overall] cases in the community as the majority of our signups are those that are more at risk of getting ill. Thankfully, there have been no COVID-19-related deaths on the programme recently, and we continue to experience milder disease than previous variants.”