COVID-19
The illness that once brought cities to a halt has long since become one more winter infection, and in most people it runs like a heavy cold.
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Medicines commonly prescribed for COVID-19
For informational purposes only. Always consult a doctor before using any medicine.
Dosage form: TABLET, 1 g paracetamolActive substance: paracetamolManufacturer: Viatris Pharmaceuticals S.L.U.Prescription requiredDosage form: TABLET, 1 gActive substance: paracetamolManufacturer: Upsa S.A.S.Prescription not requiredDosage form: ORAL SOLUTION/SUSPENSION, 100 mg/mlActive substance: paracetamolManufacturer: Nutra Essential Otc S.L.Prescription not required
The illness that once brought cities to a halt has long since become one more winter infection, and in most people it runs like a heavy cold. The virus, meanwhile, keeps changing, so much of what everyone learned in the first years is now out of date: the symptoms are different, loss of smell has become uncommon, and isolation rules vary from country to country. Two things have not changed, and they are the reason to read on: in some people the illness is still severe, and for them there are medicines that only work in the first few days.
What it looks like now
You cannot tell COVID-19 apart from a cold or flu by how it feels — the list of complaints almost overlaps. What people usually get is some of the following:
- fever, chills, or simply feeling hot to the touch without ever reaching for a thermometer;
- a cough, usually dry and stubborn, which sometimes lingers for weeks after everything else has cleared;
- sore throat, blocked nose, runny nose, hoarse voice;
- headache and aching muscles and joints;
- heavy tiredness that sleep does not fix;
- breathlessness on your usual level of effort;
- loss or distortion of taste and smell, which has become rare with the current variants;
- nausea, vomiting, diarrhoea and loss of appetite, especially in children;
- in older people the only sign may be sudden confusion, marked weakness or a fall, with no cough and no fever at all.
Most people are better within one to two weeks. Cough and tiredness outlast everything else, and on their own that is not a warning sign. What should worry you is different: getting sharply worse after several days of improvement. Severe illness usually declares itself not on day one but in the second week.
What to do in the first few days
There is no specific home treatment, so it all comes down to easing symptoms and not missing a deterioration.
- Rest, and drink enough to keep your urine pale. With a fever, dehydration ruins how you feel more than the infection itself does.
- Paracetamol or ibuprofen help with fever and aches; which one suits you is worth asking a doctor or pharmacist, particularly if you take anything else.
- For a cough, a spoonful of honey helps adults and children over one year old; honey is not given below the age of one.
- If you are breathless, sit upright or lean slightly forward with your hands on your knees, breathe slowly in through the nose and out through pursed lips. Air the room: cool air is easier to tolerate.
- Do not start antibiotics: they do nothing to a virus. They are prescribed only for a proven bacterial complication, and that is the doctor's call.
- Stay at home while you have a fever and feel unwell, and during that time keep away from older people and anyone with weakened immunity. Formal isolation rules differ between countries; that one holds everywhere.
A rapid test is worth doing when the result changes something: if you are in a higher-risk group and could be given treatment, if you live with someone who needs protecting, or if your work requires it. Its weak point is worth knowing: a negative test on the first day of symptoms rules nothing out. If you have symptoms and the test is negative, repeat it the next day.
Signs that mean calling an ambulance
Call the emergency number (112 in Europe) if an adult or child develops any of these:
- breathlessness at rest: struggling to speak in full sentences, fast breathing, having to fight for air;
- pain or heavy pressure in the chest;
- lips, face or nails turning blue or grey;
- confusion, unusual drowsiness, or being hard to wake;
- fainting or a seizure;
- coughing up blood;
- a rash that does not fade when a glass is pressed against it;
- in a baby: the skin sucking in below and between the ribs with each breath, grunting on breathing out, refusing feeds, far fewer wet nappies, floppiness or an unusually high-pitched cry;
- if there is a pulse oximeter at home: oxygen saturation at or below 92 per cent. A reading of 93 to 94 per cent means contacting a doctor without delay. Bear in mind that on brown and black skin these devices often read higher than the true value, so with obvious breathlessness go by how the person is, not by the number.
Separately: if you get clearly worse after several days of improvement, do not wait for morning. That is the classic pattern of severe illness.
Who is at greater risk, and what that changes
The risk of severe illness is higher in older people and in anyone with weakened immunity: after an organ transplant, during and after cancer treatment, while taking medicines that suppress the immune system, or with HIV and a low count of protective cells. The same group includes people with advanced kidney or liver disease, chronic lung and heart conditions, poorly controlled diabetes, sickle cell disease, Down syndrome, and serious neurological or neuromuscular conditions, as well as pregnant women and anyone who has never been vaccinated.
The practical consequence is this: antiviral medicines exist for these people, and with them timing is everything. They are given in the first days of illness, as a rule no later than the fifth day from the start of symptoms; after that they are of little use. So if you are in a higher-risk group, it is sensible to find out from your doctor in advance whether such treatment applies to you and where to go for it, rather than searching for it once you are already ill.
Two warnings that are often forgotten. The main antiviral tablet combines very badly with a long list of ordinary medicines — from cholesterol-lowering drugs to those for heart rhythm, blood thinners and immune suppressants; some of them have to be paused or swapped for a while. The doctor needs to see the full list of what you take, including anything bought without a prescription and any herbal products. And the second: never take tablets left over from someone you know. The monoclonal antibodies used so widely in the early years have largely lost their effect against current variants and are no substitute for antivirals.
Vaccination: what it gives you now
Vaccination does not protect against catching the virus at all, because it changes too fast, and that disappointment is worth stating plainly. It protects against something else: severe illness, hospital admission and death, and there its effect has held up.
Protection fades over a few months, so booster doses are offered seasonally and first of all to those for whom the illness is more dangerous: older people, people with weakened immunity or chronic conditions, pregnant women, and those who live with or care for them. Vaccine composition is updated to follow the virus, exactly as has long been done for flu. Who is eligible and when is best checked with your doctor: recommendations differ between countries and change over time.
How it spreads and how not to pass it on
Infection happens mainly through the air: someone who is ill breathes out tiny particles carrying virus, and those hang in the room for a while. The simple conclusion is that what matters is not the surface of the table but what you are breathing. The worst setting is an enclosed, crowded, unventilated space; outdoors the risk is incomparably lower. You can catch it and pass it on without symptoms, after vaccination, and having had it before.
- Ventilate: an open window or fresh-air ventilation cuts the risk far more than wiping surfaces does.
- If you have to go out or meet someone at higher risk, wear a mask — a well-fitting filtering respirator works noticeably better than an ordinary surgical mask.
- Cover your mouth and nose when coughing, using your elbow or a tissue, and wash your hands afterwards.
- Tell anyone due to come into your home, and anyone about to see you at an appointment, that you are ill.
- At home, try to sleep separately and keep a window ajar in shared rooms.
When you do not get better afterwards
In some people the symptoms drag on for months after the acute phase is over. Most commonly this is tiredness, breathlessness during everyday tasks, brain fog and trouble concentrating, palpitations, dizziness on standing, disturbed sleep and lost sense of smell. The identifying feature is deterioration some hours later or the next day after exertion, physical or mental. It is more likely after severe illness, but it also follows mild illness.
What actually works is not pushing through by willpower but spacing effort out and always leaving something in reserve, increasing it very gradually and stepping back whenever things worsen. Trying to snap back to the old pace usually costs ground. And do get seen rather than putting everything down to after-effects: the same tiredness and breathlessness can hide anaemia, a thyroid disorder, iron deficiency, or a heart or lung problem — all treatable, and all worth ruling out.
Online consultation
A remote appointment settles the commonest question: whether this is an ordinary course that can be seen through at home, or whether it is time for an examination in person. The doctor will go through which day of the illness you are on, how your breathing is changing and what the pulse oximeter shows if you have one, will fit any medicine around everything else you take, and will explain what to watch for over the next twenty-four hours. The most urgent topic is people at higher risk: there the point is not to lose the few days in which an antiviral still helps, and to sort out drug interactions in advance. Online is also the place to discuss a cough that will not go, lingering tiredness and other after-effects, and to decide which tests are needed. The emergency signs listed above are not assessed remotely — those mean calling an ambulance straight away.
This material is for information only and does not replace medical advice.
Consult with a doctor about COVID-19
Discuss your symptoms and possible next steps with a doctor online.
Online doctors for COVID-19
Discuss your symptoms and possible next steps for COVID-19 with a doctor online.
