In clinic we are seeing Strep A and Covid in the last two months, quite a lot.
Covid is all over the map with symptoms. One person had been traveling, did not feel well, but the main symptom was dry lips. Positive covid. Another was vomiting, with no upper respiratory symptoms. Some have diarrhea and upper respiratory symptoms. It interests me that flying home to Washington last month, only about three of us on the planes wore masks. I was one of them. I know people who have taken flights knowing that they have Covid, a day or two after diagnosed, so I can’t say that I trust the other people on airplanes. We are testing for Covid for almost any symptom or just feeling sick.
We are seeing Strep A as well. I saw a small child vomiting. I asked if her nose hurt: no. Throat: yes. Tummy: yes. Toes: no. She had strep A. The oldest person with strep A this week was ninety. She said, “How did I GET it?” Streptococcus is in the environment, including our throats. We may just carry it around, but then if we get overtired or stressed (good or bad stress) or have something happen, the strep can invade. We treat strep A mostly to prevent rheumatic fever, which is where our own antibodies to strep A attack us. I have seen three cases of rheumatic fever in my career. That is called a “pseudo autoimmune” disease. The strep A has cell surface markers that sometimes are close enough to ours that our own antibodies attack our body parts.
One person in the last month has a positive strep A. I write for penicillin and send her home. We call her later because the Covid/influenza/RSV test takes longer. She also has Covid! That seems like a bit much, rather unfair, but we can have two things. An initial infection can lower our immune defenses and another virus or bacteria gets hold.
Another person had tested negative for Covid, but that was four days before. Friday afternoon, so I would not get the results at home. I asked her to retest at home. Positive.
There are Strep B and C and D and so forth. Sometimes we pick them up on throat cultures. I treat if the person is still sick and symptomatic while the culture is in the laboratory.
I am wearing a mask in airports and on airplanes. I just don’t want to pick anything up, or at least do what I can to avoid it.
The photograph is Elwha in May 2023. I figure that you would rather see his tongue than mine.
I think safety is an illusion. BUT it is also nice to feel safe and embrace the illusion.
I sleep best in tents, because as a child, I felt safest at our families “shacks on a lake” in Ontario. Cabins, but pretty much one room cabins. No electricity, outhouses, and my family lived in tents. I loved it. I was more afraid of people than bears.
The pandemic, or this pandemic, has made people feel less safe. But that safety was an illusion too. I had influenza in 2003 and was out sick for two months. I had a racing heart and it hurt to breathe. No asthma. Only rest seemed to help. My doctor and I had no idea when it would resolve. It resolved after two months. My partners accused me of malingering and lying.
A fast heart rate can come from a panic attack, but it works the other way too. If your heart rate is very fast, you may feel panicky. When I nebulize people with albuterol for the first time, I warn them that it may feel like adrenaline, it may speed their heart and they might feel panicky. A friend with Long Covid kept saying that maybe they were just anxious. I got them to have an Urgent Care test them: a resting and a walking heart rate. At rest 72 beats per minute. Normal. Walking, their heart rate jumped to 165, very abnormal! Normal is 70-100 beats per minute, though if one is out of shape, 110 or 120 can result from unaccustomed exercise. But there is no way an athlete in their 20s should jump to 165. The Long Covid heart rate was driving the anxiety, not the other way around.
After I had the 2003 influenza, I read a book of essays about the 1918-1921 influenza pandemic. And I realized that we would probably have a pandemic in my lifetime. I thought it would be influenza, not coronavirus! Hopefully the world will learn a little from this one and change a little over time and be a little more sane if (ok, when) there is another pandemic.
I saw this video today. Wow, what costumes (all 1970s) and dancing! Wonderful! And such a sad song about a broken friendship that used to feel safe.
I hope that you have places or people that you feel safe with. Elwha sometimes likes to sit in the cat tent, even if it is partly open. It feels safe.
I had covid recently AND I have been very lucky with it.
WHAT?
Ok, so when the war started I had been talking to a friend in Europe about visiting. He said nice seasons were May and September, but he and his wife have a kitchen make over planned for September.
“My son is getting married at the end of April, after two year long postponements, and so May doesn’t seem feasible. Maybe next May.”
Then the war starts. And it is affecting gasoline and causing inflation. I call my friend. “Can I come in two weeks?” March to early April.
“Yes. We have other guests a week after that.”
“Ok.” I try to get a British Airways ticket to stop in London to see an old friend from high school. British Airways has a computer attack and three days go by. To heck with it. I buy a ticket to Paris and on to my friend’s country.
I spend an hour on the phone trying to change to a layover in Paris for three days. I manage that. I fly to Paris and then take the train to London. Three wonderful days with my friend in London. I mask on planes, metros and trains. I double mask on the airplane, with my oxygen, and use a ceramic straw to drink liquids.
After three days I take the train back to Paris, the local train to the airport, and fly to my old friend’s. I arrive at midnight and we take the metro.
We do lots of sightseeing and take a memory trip to his parents’ graves and the town we lived in when I was 17 and he was 18.5. I was an exchange student. The language comes back. I can read but listening is more difficult. My brain won’t process it fast enough.
Four days before I am due to fly back, I get an email from AirFrance. I need a negative PCR covid test within 24 hours of flying to return to the US.
Well. I have a mild headache and muscle aches. Probably not covid, BUT. I go online, register in the country for a test and go to the testing site. Positive. I read about covid. The muscle aches of this strain usually happen at day 4-5. I did notice that going from London to Paris to my destination four days earlier, I feel a little off balance. Not bad, not spinning, just slightly weird. So my guess is that I am at day 4 or 5 of covid.
My hosts have both had covid within the last month, so I am not confined to my room. I read the rules for being allowed on the airplane once you HAVE covid. I have to wait 11 days, have a certificate of the test and then the eleven day certificate saying cleared. I isolate for 5 days, spend about 8 hours rescheduling the flight with Air France and Delta, and contact my doctor. My doc wants me to take medicine, but the local medical people where I am say I am not sick enough. I agree with the local people. The headache is gone the next day, I have mild sniffles, and my lungs are fine. Well, at least, they are no worse.
When I am out of isolation, I take a train to another town masked and stay at a hotel for four days. In that country, 80% of the people are vaccinated and 80% have had covid. They are no longer masking, except a few. I am feeling good. I mask when I am around other people and in all public spaces in the hotel.
The trip home is rather more exciting than I would like. At the airport I am informed that I need a doctor clearance ALSO. They say retest. I say “I AM a doctor.” and pull out a copy of my license. I brought it just in case the war spread and I needed to help out. They let me on the plane. In Paris I nearly miss my connection, but am one of the last 8 people on the plane. I am very relieved once we take off.
The silver lining is that at my son’s wedding I am now very unlikely to get covid or give anyone covid and mine was very mild. The Omicron BA2.12.1 that is circulating in Europe is milder than the previous strains AND ten times more contagious or more. So the covid is morphing towards a cold, which is what coronaviruses used to do to us. There are some strains that I read about that are going in a more virulent direction, so I would prefer to have the mild one and be protected from the nasty ones.
I am hoping that it’s more and more Omicron BA2.12.1, since it seems to be milder. I am reassured that covid did not make my lungs worse. Within a week I am better from covid and then get what seems like a normal cold. Covid testing negative. I am feeling well for the wedding and reassured that a normal cold does not force me on to continuous oxygen. I am feeling lucky about the version of covid that I have but I am NOT recommending that people get it on purpose, because even with mild covid, some people go on to develop long covid. Here is an article that I got yesterday through the American Academy of Family Practice:
Long covid is very worrisome and we don’t know what it will look like after a year or more. Many of the present studies are on unimmunized people, from the first year of covid, so the studies of immunized are still evolving. There is hope that there is less risk of long covid with immunization but there is still a risk.
Covid will continue to morph into different strains. We continue to get “colds” or “upper respiratory infections” because the viruses are very very good and fast at changing and avoiding our immune systems. Consider checking the CDC data tracker above regularly to see if your county or your destination has a high covid level and if so, mask back up.
One caveat: my local health department says we have a high level of transmission right now, here:
Remember that all of these sites have to exchange data and update everything. My best guess is that the local has the best numbers, but that is a guess.
Discover and re-discover Mexico’s cuisine, culture and history through the recipes, backyard stories and other interesting findings of an expatriate in Canada
Engaging in some lyrical athletics whilst painting pictures with words and pounding the pavement. I run; blog; write poetry; chase after my kids & drink coffee.
Refugees welcome - Flüchtlinge willkommen I am teaching German to refugees. Ich unterrichte geflüchtete Menschen in der deutschen Sprache. I am writing this blog in English and German because my friends speak English and German. Ich schreibe auf Deutsch und Englisch, weil meine Freunde Deutsch und Englisch sprechen.
KO Rural Mad As Hell Blog 