Updated on: Wednesday, January 05, 2022, 09:15 AM IST

Mumbai: Viral or COVID-19? It's hard to tell

A medical staff takes a swab sample of a man for a reverse transcription polymerase chain reaction (RT-PCR) test during a Covid-19 coronavirus screening as passengers arrive at a railway platform in Mumbai on January 4, 2022.  | (Photo by INDRANIL MUKHERJEE / AFP)

A medical staff takes a swab sample of a man for a reverse transcription polymerase chain reaction (RT-PCR) test during a Covid-19 coronavirus screening as passengers arrive at a railway platform in Mumbai on January 4, 2022. | (Photo by INDRANIL MUKHERJEE / AFP)


Doctors in Mumbai are noticing a rash of viral infections along with the surge in Covid cases, over the last 10 days, especially those causing upper respiratory tract infection problems. During the first and second wave of Covid-19, most patients displayed similar symptoms for viral flu and corona, but now, every patient has to mandatorily undergo RT-PCR or CRP tests. Doctors said at least 8-9 of their daily patients were testing Covid-positive on RT-PCR testing, or every second person was contracting Covid. Health experts have attributed this to the change in pattern of the infection’s attack on the respiratory tract. In the first and second wave, it was observed that the virus attacked the lower respiratory tract, but now the upper respiratory tract is seen to be infected, due to which transmission increases if Covid protocols are not followed.

Dr Mala Kaneria, Consultant, Department of Infectious Diseases at Jaslok Hospital & Research Centre, said that with the onset of winter, there has been a spate of viral fever cases, which have now coincided with the pandemic. The viral fever caused by the flu virus and Covid caused by SARS-CoV-2, have predominantly upper respiratory symptoms such as a runny nose, sore throat, headache, cough, bodyache and fever.

“The Delta variant and its derivatives, in addition, caused lower respiratory symptoms and anosmia. However, the new variant Omicron, causes symptoms similar to the common cold or the flu virus, which are mainly upper respiratory. Clinically, it is difficult to distinguish between viral fever due to other viruses (including H1N1, flu virus, etc) and Covid. Unfortunately, even the RT-PCR test, the gold standard for the diagnosis of Covid-19, may be false negative, thus precluding necessary isolation and quarantine,” said Dr Kaneria. However, the treatment for both viral fevers and mild Covid in non-vulnerable patients is symptomatic. In addition, Covid application behaviour (masking, hand hygiene and avoiding closed, crowded places) can prevent both.

The outpatient departments (OPDs) of the four major civic hospitals -- King Edward Memorial (KEM), Lokmanya Tilak Municipal General, Dr R N Cooper Municipal General and B Y L Nair Hospitals -- have reported a 50-60 per cent rise in viral infection cases.

“In the past few days, the number of patients visiting our OPDs has increased owing to the change in the weather. Most of them are children and senior citizens and many are complaining about allergies and viral fever,” said Dr Ramesh Bharmal, medical director of the four hospitals.

Health experts said that the virus thrives in fluctuating temperatures, due to which cases have increased. “We are getting at least ten patients every day in the hospital’s out-patient department and we are asking them to undergo RT-PCR testing. Not everyone requires hospitalisation but in a situation where there is high fever, usually above 100 degrees, patients seek admission and require intravenous antibiotics,” said a doctor from KEM Hospital.

Most patients, both adults and paediatric patients, are made to undergo an RT-PCR test to rule out Covid before being treated for symptoms such as fever, cough and cold. Due to the lockdown last year, there seemed to be a lull in non-Covid ailments. But with the third wave officially underway, doctors have noticed a trend of rising fever cases.

“While Covid cases in Mumbai are increasing, with the higher test positivity rate (TPR), we are seeing more adults with fever and cough, leading to breathing problems because of Respiratory Syncytial Virus (RSV), which generally affects children. Patients with Covid symptoms testing negative are now checked for RSV ,” said a doctor.

Dr Vikrant Shah, infectious diseases expert, said the current pattern of viral fever was completely different, as it was directly affecting the upper respiratory tract, causing most patients with viral fever to test Covid-positive after RT-PCR tests.It was also highly transmissible.

“People need to take great care, as now viral fever and Covid are going hand-in-hand, so it is difficult to differentiate between the two. People need to adhere to Covid norms and should get vaccinated as soon as possible,” he said.

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Published on: Tuesday, January 04, 2022, 11:22 PM IST