The Call-On-Doc Guide to Covid-19

Similar to other viruses that cause upper respiratory infections, Covid-19 spreads primarily through air, close contact, and when a surface has been contaminated by the droplets carrying the virus. (1) More specifically, the best environment for Covid-19 has proven to be lower temperatures in relatively dry environments. The virus has been viewed to remain longer in environments with a temperature around 24°C or 75°F and below, with the lower temperature leading to a longer lifespan of Covid-19 outside of the human body. (2) The opposite can be said for warmer climates, with the virus breaking down faster in temperatures at 24°C or 75°F and above.

For the vast majority of cases, Covid-19 is spread through breathing in infected particles or by interacting with infected surfaces and touching your face. Masks prove to be an effective way to lower transmission when those who are infected wear them because instead of having around a two-meter or six-foot range to spread the virus when talking, coughing, or sneezing, the mask stops the particles just in front of the mouth. This applies only if the mask stays on those who are infected and masks are replaced or washed frequently.

COVID-19 is considered a highly contagious virus, as it spreads aggressively through populations that remain indoors and is suspected to be common during the winter months. Similar to influenza, there are also variants of the virus that can prove to be more or less contagious depending on its genetic makeup. When considering its genetic makeup, Covid-19 evolved to be as transmissible as possible, with it not only being effective by respiratory spread but also by fecal matter. (3) Not only that, but the virus has features that interact easily with cells in the human body, including: 

• Spike Protein Mutations: The spike protein of the virus plays a crucial role in its ability to enter human cells. Mutations in the spike protein can enhance the virus's ability to bind to and enter human cells, making it more infectious. Variants like Delta and Omicron had mutations in the spike protein that increased their affinity for the ACE2 receptor in human cells.
• Increased Replicative Fitness: Some mutations in the viral genome can enhance the virus's ability to replicate more efficiently within the human body. This increased replication can lead to higher viral loads in the respiratory secretions of infected individuals, making them more contagious.
• Enhanced Immune Evasion: Certain mutations in the virus's genetic makeup may help it evade the immune response, including neutralizing antibodies generated through previous infections or vaccination. This can allow the virus to persist in the population and continue spreading.
• Faster Transmission: Variants with genetic changes that lead to faster transmission between individuals can increase the overall transmissibility of the virus. The Delta variant, for example, was associated with a faster rate of spread compared to earlier strains.
• Altered Binding Affinities: Changes in the spike protein's binding affinities can affect how tightly the virus attaches to the host cells. Variants with mutations that result in stronger binding can more efficiently infect host cells.

Like strep throat, the risk of getting Covid-19 if someone in your household has it is relatively high if the proper precautions are not taken. The virus is highly contagious and primarily spreads through close contact and respiratory droplets. Living in close proximity to an infected individual increases the likelihood of transmission. However, the risk of exposure depends on the infected person's viral load, the duration of exposure, and the preventive measures in place (such as mask-wearing, proper ventilation, and vaccination status). Additionally, those who are vaccinated and live a healthy life tend to get minimal symptoms, if any at all, when infected. 

Covid symptoms have remained steady throughout the various mutations, even with new variants at the time of writing (October 2023). (4) However, severity from person to person varies with the most common factors including: 

• Individual personal health 
• Immuno response strength
• Underlying health conditions
• Vaccination status
• Viral load spread
• The age of those who are infected 

In many cases, the virus is asymptomatic, but general cases feature Covid-19 symptoms like:

• Fever or chills
• Cough
• Shortness of breath 
• Fatigue
• Muscle or body aches
• Headache
• Loss of taste or smell 
• Sore throat
• Congestion or runny nose
• Nausea or vomiting
• Diarrhea

For many with minor Covid-19 symptoms, it can also be easily mistaken for seasonal allergies. While many can cope with or ignore symptoms and warning signs of Covid, doing so may result in spreading the virus to someone who is at higher risk of developing more severe complications. In such instances where you might be unsure, Covid-19 symptoms not shared with seasonal allergies include a fever of 100.4 or higher, a sore throat, and digestive issues that can result in vomiting or diarrhea. (5) It is recommended that those who have such Covid-19 symptoms get tested to avoid unnecessary spread. 

When covid symptoms start, people who feel them relate it to a common cold or mild flu. (6) Early signs often include a combination of symptoms such as: 

• fever or chills 
• cough 
• fatigue 
• headaches 
• Mild sore throat. 
• Loss of taste or smell (anosmia)

It’s exceedingly important to state that for many, the case will be asymptomatic or that Covid symptoms that may arise are not felt. The capacity for spread, in this case, tends to be minimal, if any at all, as the virus has been shown to be driven out of the individual’s body relatively quickly. (7)

Covid symptoms are known to go from mild to severe in the event that the virus enters the lungs and the body overreacts to defend itself. Often resulting in inflammation of the lungs; these can appear as a patient getting sick, appearing to recover, and then getting worse. When this complication occurs, the result is partly due to the virus, but mostly because of the overreaction produced by the body itself. (8) In such circumstances, Covid symptoms will appear as: 

• Difficulty Breathing: Characterized by a feeling of breathlessness or air hunger, with those at this stage potentially needing medical intervention to get enough air for normal function. 
• Chest pain or pressure: Manifests as a tight, uncomfortable sensation in the chest that makes certain movements and breathing difficult. 
• Confusion: An altered mental status, with individuals experiencing disorientation, difficulty concentrating, or an inability to think clearly. 
• Inability to Wake or Stay Awake: Indicating lack of oxygen to the brain and heart, those with Covid having difficulty staying conscious should seek medical attention when combined with other severe Covid symptoms. 
• Discolored Skin: Manifests as a bluish tint to the lips, face, or extremities, known as cyanosis, which is a sign of oxygen deprivation and requires urgent medical evaluation.

While it should be noted that the vast majority of Covid patients do not have these symptoms, those that do should seek out immediate medical attention by calling 911 or getting to the nearest hospital. 

The duration of COVID-19 symptoms can vary widely from person to person. For many individuals, symptoms are mild and resolve within a week or two. However, some people, especially those with more severe cases, may experience symptoms for several weeks or even months. Long COVID, also known as post-acute sequelae of SARS-CoV-2 infection (PASC), refers to a condition where symptoms persist for an extended period, often beyond four weeks. (6)

Distinguishing between Covid vs cold symptoms can be difficult in the moment because they can feel similar. Both illnesses can cause symptoms like a sore throat, runny or congested nose, cough, and fatigue. However, there are some differences that can help you differentiate between the two:

• Fever: COVID-19 is more likely to cause a fever, although not everyone with COVID-19 will have one. A fever is less common with a cold.
• Loss of Taste or Smell: An abrupt loss of taste or smell (anosmia) is a symptom that is more commonly associated with COVID-19 and is rare in a typical cold.
• Muscle and Body Aches: Muscle and body aches are more common with COVID-19, but they can occur with a cold as well.
• Shortness of Breath: COVID-19 can lead to respiratory symptoms like shortness of breath, which is rare in a cold.
• Sore Throat and Headache: These symptoms are common in both COVID-19 and colds. They are not very specific for either illness.
• Onset and Progression: COVID-19 symptoms tend to develop more gradually, and severe symptoms can appear 2-14 days after exposure. A cold usually comes on gradually and typically peaks in a few days.
• Congestion and Runny Nose: These symptoms can occur in both COVID-19 and colds. However, a cold is more likely to cause significant nasal symptoms.
• Seasonal Factors: Colds are more common in certain seasons, such as fall and winter. While COVID-19 can occur at any time, it was initially more prevalent in the winter months.

It’s important to note that when it comes to getting a confirmation of whether you have covid or cold, the best method is getting tested. If you have Covid symptoms, you should get tested, especially if you have been in contact with someone who has tested positive for the virus.

Covid-19 and the flu (influenza) can have overlapping symptoms, making it challenging to differentiate between the two based on symptoms alone. Both illnesses can cause fever, cough, body aches, fatigue, and respiratory symptoms. (9) However, there are some differences and considerations to keep in mind:

• Loss of Taste or Smell: Anosmia (loss of taste or smell) is a symptom more commonly associated with COVID-19.
• Shortness of Breath: Severe shortness of breath is more frequently seen in COVID-19 cases, especially in those with severe illness.
• Gastrointestinal Symptoms: COVID-19 can sometimes cause gastrointestinal symptoms like diarrhea, which are less common in the flu.
• Onset and Incubation: COVID-19 symptoms can take longer to appear after exposure (up to 14 days), whereas flu symptoms typically appear 1-4 days after infection.

Looking for more information? Call-On-Doc has covered this subject in a past article titled Flu or COVID-19: What Do I Have?

When it comes to diagnosing Covid-19, healthcare providers will typically conduct a clinical evaluation to examine the Covid symptoms, if anyone around you has had the virus, and may conduct the following tests to get the best diagnosis: 

• Polymerase Chain Reaction (PCR) Test: PCR tests are the most common and reliable diagnostic tests for Covid-19. They detect the presence of the virus's genetic material (RNA) in respiratory samples, typically collected through a nasopharyngeal or throat swab. Results can take a few hours to several days, depending on testing capacity and location.
• Antigen Test: Antigen tests, also known as rapid tests, detect specific proteins on the virus's surface. They provide quicker results (usually within 15-30 minutes) and are often used for rapid screening. However, they may be less sensitive than PCR tests and can produce false negatives, especially in people with lower viral loads.
• Serology Test: Serology tests detect antibodies produced by the immune system in response to the virus. These tests are useful for determining past infections but are not typically used for diagnosing acute cases. They are more relevant for understanding the prevalence of the virus in a population over time.

A positive Covid test is the most accurate way to get a covid diagnosis in addition to being in direct contact with someone who has been infected. For certain forms of treatment, a positive Covid test will be required for using medications like Paxlovid as it will result in side effects in uninfected individuals. 

For most patients, rest, hydration, and isolation will be the best Covid treatment due to the majority of cases being successfully fought off by the body’s immune system. (10) Forms of treatment are often restricted to specific individuals. For example, the CDC recommends Paxlovid requiring infected individuals to be over thirty or have underlying risk factors. In the event you do not qualify for treatment that includes medication, those with Covid-19 will typically be prescribed a vitamin and mineral regimen that includes vitamin C, vitamin D, and zinc alongside herbal supplements, probiotics, and other supplements that enhance the body’s natural immunity. 

Considered the best Covid treatment for at-risk individuals, Paxlovid is an antiviral medication developed by Pfizer for the treatment of Covid-19. While there are newer forms of treatment being studied and released for Covid, Paxlovid still provides the most effective form of treatment at the time of writing. (12)

Similar to measures discussed in the CallonDoc Guide to the Flu, management of Covid-19 will typically be limited to rest, hydration, home remedies, and monitoring symptoms. Much of the time, Covid symptoms will resolve themselves when the body is provided a regimen of vitamins and naturally rids itself of the virus. Additionally, some over-the-counter medications, including acetaminophen or ibuprofen, can be taken for symptoms like aches and soreness throughout the body. When it comes to having a sore throat commonly associated with Covid-19, cough drops, tea with honey and lemon, and gargling salt water will help reduce irritation in the throat. (13)

When you have Covid-19, it's essential to focus on a well-balanced and nutritious diet that supports your immune system and aids in your recovery. Here are some foods and dietary guidelines that may help you during recovery:

• Hydration: Staying hydrated is crucial. Drink plenty of water, herbal teas, and clear broths to prevent dehydration, which can be a common symptom of Covid-19.
• Nutrient-Rich Foods: Incorporate foods rich in essential nutrients, such as:
  • Fruits and Vegetables: These provide vitamins, minerals, and antioxidants that support your immune system. Citrus fruits, berries, leafy greens, and colorful vegetables are good choices.
  • Protein: Lean sources of protein, like poultry, fish, beans, lentils, and tofu, can help with muscle strength and recovery.
  • Whole Grains: Foods like brown rice, whole wheat pasta, and oats can provide energy and fiber.
• Healthy Fats: Include foods with healthy fats, such as avocados, nuts, and olive oil, which can help reduce inflammation.
• Spices and Herbs: Garlic, ginger, and turmeric are known for their potential anti-inflammatory and immune-boosting properties. Incorporate them into your meals.
• Bone Broth: Some people find relief from symptoms by consuming warm, soothing bone broth, which can also provide nutrients.
• Probiotic Foods: Yogurt, kefir, and fermented foods like sauerkraut and kimchi contain probiotics that support gut health and may benefit your immune system.
• Easy-to-Digest Foods: If you have digestive issues, opt for bland, easily digestible foods like rice, plain toast, bananas, applesauce, and plain boiled chicken.
• Avoid or Limit Processed Foods: Stay away from highly processed and sugary foods, as they can be inflammatory and may weaken the immune system.
• Vitamin and Mineral Supplements: Consult with a healthcare provider before taking any supplements. In some cases, vitamin D, vitamin C, and zinc supplements may be recommended, especially if you have deficiencies.

The best way to prevent Covid-19 will mirror the prevention of other diseases affecting the respiratory system. Depending on where you live, there may be public and governmental guidelines to assist in curbing the spread, but individual steps you can take include: 

• Vaccination: Getting vaccinated with a COVID-19 vaccine is one of the most effective ways to protect yourself and others from the virus. 
• Mask-Wearing: Wearing masks, especially in indoor and crowded settings, can help reduce the transmission of the virus. 
• Hand Hygiene: Wash your hands regularly with soap and water for at least 20 seconds, especially after being in public places or touching surfaces. If soap and water are not available, use hand sanitizer with at least 60% alcohol.
• Taking Daily Vitamins: Vitamin use, especially for individuals who are not able to get a regular intake of normal nutrients, has been proven to help the body resist and fight off Covid-19. Making sure to get your daily amount of zinc, vitamin C, and vitamin D keeps your body healthy enough to fight Covid and other diseases. 
• Staying Home When Sick: If you're feeling unwell, with symptoms like fever, cough, or loss of taste or smell, stay at home to prevent potential spread to others.
• Avoid those who are Sick: Those who are sick and not wearing a mask can spread the condition up to two meters or six feet away from themselves when not wearing a mask. 
• Ventilation: Ensure good ventilation in indoor spaces by opening windows and doors when possible to increase air circulation.

While the global and national pandemic is considered over, Covid-19 can still make you sick and require treatment. For symptom relief and quick recovery, Call-On-Doc can prescribe Covid-19 treatment online 7 days a week in a matter of hours. Stay safe and get better faster with instant online visits from home - no video or phone visits needed.

1. “COVID-19 Overview and Infection Prevention and Control Priorities in non-U.S. Healthcare Settings.” CDC, https://www.cdc.gov/coronavirus/2019-ncov/hcp/non-us-settings/overview/index.html.
2. Valsamatzi-Panagiotou A, Penchovsky R. Environmental factors influencing the transmission of the coronavirus 2019: a review. Environ Chem Lett. 2022;20(3):1603-1610. doi: 10.1007/s10311-022-01418-9. Epub 2022 Feb 21, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8859930/. 
3. Elrashdy F, Redwan EM, Uversky VN. Why COVID-19 Transmission Is More Efficient and Aggressive Than Viral Transmission in Previous Coronavirus Epidemics? Biomolecules. 2020 Sep 11, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7565143/. 
4. Blumberg, Dean. “New COVID variants and a rise in cases: The latest on symptoms and at-home tests.” UC Davis Health, 1 September 2023, https://health.ucdavis.edu/blog/cultivating-health/what-you-should-know-about-covid-symptoms-and-at-home-tests-with-new-variants/2023/09. 
5. “Is It Fall Allergies or COVID-19? How to Tell the Difference.” Allergy & Asthma Network, https://allergyasthmanetwork.org/news/is-it-fall-allergies-or-covid-19/.
6. “Symptoms of COVID-19.” CDC, https://www.cdc.gov/coronavirus/2019-ncov/symptoms-testing/symptoms.html.
7. Ravindra K, Malik VS, Padhi BK, Goel S, Gupta M. Asymptomatic infection and transmission of COVID-19 among clusters: systematic review and meta-analysis. Public Health. 2022 Feb, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8654597/.
8. Gray, Dan. “Mild COVID-19 Symptoms Can Quickly Turn Serious.” Healthline, 23 April 2020, https://www.healthline.com/health-news/mild-covid-19-symptoms-can-quickly-turn-serious.
9. “Similarities and Differences between Flu and COVID-19​.” CDC, 28 September 2022, https://www.cdc.gov/flu/symptoms/flu-vs-covid19.htm.
10. “If You Are Sick or Caring for Someone.” CDC, https://www.cdc.gov/coronavirus/2019-ncov/symptoms-testing/symptoms.html.
11. “Office of Dietary Supplements - Dietary Supplements in the Time of COVID-19.” NIH Office of Dietary Supplements, 14 February 2023, https://ods.od.nih.gov/factsheets/DietarySupplementsInTheTimeOfCOVID19-Consumer/.
12. Ellis, Ralph. “Paxlovid Weaker Against Current COVID-19 Variants.” WebMD, 22 September 2023, https://www.webmd.com/covid/news/20230922/paxlovid-weaker-against-current-covid-variants.
13. “9 Tips to Recover Faster from COVID-19 or Flu.” UnityPoint Health, https://www.unitypoint.org/news-and-articles/9-tips-to-recover-faster-from-covid-19-or-flu.