Many states in India are witnessing a rise in upper respiratory tract illnesses, with symptoms like cough, cold, sore throat, and fever. The surge has been noticed in Delhi and the National Capital Region covering Gurgaon and Faridabad, as well as Kolkata, Mumbai, Kochi and Bengaluru.
However, the dilemma lies in the similarity of these symptoms to those of Covid-19, with many wondering if the uptick is indicative of a mild coronavirus variant or merely another flu-like illness.
While INSACOG has not identified anything alarming, its co-chair, Dr NK Arora, told News18 that the Covid-19 virus undergoes rapid mutations, with Omicron sub-variants currently in circulation.
INSACOG is a national multi-agency consortium of Genome Sequencing Laboratories (RGSLs) laboratories which were established to expand whole genome sequencing of the SARS-CoV-2 virus across the nation. It monitors and aids the country’s understanding of how the virus spreads and evolves.
“There is no evidence that any increase in serious illness and hospitalisation has occurred. But Covid-19 is part of the several circulating viruses, and mild common cold-like illness occurs. XBB subvariants are the dominants, including JN.1 lineages,” Arora said.
As I spoke to more general physicians and pulmonologists, the trend was found to be more pronounced. In this edition of Health Matters, let’s explore what doctors across India are noticing.
No surprise if it is Covid-19: Experts
Dr Manoj Goel, director and unit head, pulmonology, at Fortis Memorial Research Institute in Delhi-NCR, Gurgaon, told News18 that there is a rise in Covid-19 patients. However, Goel clarified “it’s not alarming”.
“It is difficult to figure out the exact numbers because patients with mild symptoms mostly avoid Covid-19 tests. But in some patients who come to a hospital with pneumonia, the Covid-19 test is positive.”
Patients who are testing positive usually have co-morbid conditions and are elderly. “Such patients are being presented with fever, cough, breathing difficulty, and low oxygen. So high-risk people should continue to follow Covid-19 prevention practices. We are looking at two to three patients every week with a recovery time of two to three weeks.”
In Bengaluru’s Fortis, Dr Vivek Anand Padegal, director of pulmonology, has spotted a similar trend. “This trend has been ongoing for a few months. It involves rises and falls, with at least 10-20 occurrences per week.”
Padegal said some patients experience longer periods of post-viral fatigue and cough, with people with pre-existing conditions experiencing worsening symptoms of wheezing and breathlessness.
“I would not be surprised if many cases were Covid-related,” he said, adding that “we are finding Covid-19 cases when we test periodically. Treatment mainly involves supportive care for symptoms, and most patients recover”.
In West Bengal’s Mukundapur, Dr Aratrika Das, consultant-pulmonology at Narayana Health RN Tagore Hospital, spotted the same trend.
“There is a definite rise in both upper and lower respiratory tract infections to the extent of 8-10 patients per week with about one-fourth of them serious enough to require hospitalisation.”
The top symptoms, Das said, are throat pain, runny nose, and nasal blockage accompanied by nocturnal cough mainly with difficulty in expectoration. Generally, there is pain in the full body and sometimes shortness of breath too.
Das said usually such patients start recovery by the end of the fifth day and take about 10 days to recover fully. However, weakness may persist for a long time.
Mumbai-based Dr Hemalata Arora, who is a senior consultant, internal medicine, at Nanavati Max Super Speciality Hospital, echoed similar observations.
She said the city is witnessing a surge in upper respiratory tract infections, coinciding with an unusual spike in temperatures. “Over the past week, we have experienced the temperatures soaring to 38°C. This abrupt climate variation appears to have impacted people’s health. We are observing an average of 10-12 patients daily with similar complaints.”
As is usually seen in the cases of flu or respiratory infections, Arora said, she is finding younger individuals, both men and women, aged between 20-40 years, as the most common patients. “It could be because of them being the working population and most at risk of catching the infection while travelling or at work.”
According to a post by Dr Rajeev Jayadevan on social media platform X, dated April 17, the positivity rate in Kochi for the same week stood at 6.7-7.3 per cent — which means of every 100 Covid-19 tests, more than 6-7 samples turned positive, compared to nil a month before.
Jayadevan, who is co-chairman of the National Indian Medical Association’s Covid-19 Task Force and also past president of IMA Kochi, wrote “COVID returns sooner than expected” in the post. “Cases mild or asymptomatic (screening), severe disease not yet reported.”
As per his analysis, Covid-19 is in circulation in Kochi. “The last wave collapsed December 21. While the return of COVID is only expected (cyclical), the short duration (3 months) of case-free gap is surprising. This coincides with Bangalore waste water surveillance (@TIGS_India) showing viral load in all samples tested,” his post read. “This means COVID is in circulation.”
Delhi-NCR spotting the same trend
Doctors in Delhi are witnessing the same trend.
Dr Vikas Maurya, director and head of department, pulmonology, at Fortis Hospital, Shalimar Bagh, told News18 that he is seeing about 30-40 patients per week.
“In fact, in April, we used to see fewer URTIs, but this time, compared to last year, we are seeing more. Recovery typically takes seven to 10 days, with some recovering in five days.”
Additionally, some patients are being admitted with H1N1, also known as swine flu, requiring ICU care and some with Covid-19 infections, necessitating ICU care.
“Mild symptoms include throat pain, irritation, fever, cold, mild cough and body aches,” Maurya said, adding that individuals must remain vigilant for persistent fever, cough, or the onset of breathlessness and seek medical evaluation promptly.
Dr Arjun Khanna, head of department, pulmonary medicine, at Amrita Hospital in Faridabad also noticed a surge in such cases. “It seems clinically like influenza-like illness (ILI).”
He said while he has not noticed many hospital admissions, a bout of incessant cough can be distressing for some patients.
Avoid antibiotics, recovery in a week
Many of these patients initially started self-medication with antipyretics and antibiotics, experts said.
However, doctors advise to not stretch the consumption of medicines on their own and take advice from a doctor on call if symptoms persist for a long stretch.
“In case you don’t feel better in a couple of days, it is best to see a doctor. Antibiotics usually do not work in such cases unless bacterial infection is proven. Mostly such affected individuals respond to rest, plenty of warm fluids orally, analgesics, antihistamines and antipyretics,” Das from Narayana Health RN Tagore Hospital said.
While analgesics are used for the management of pain, antihistamines relieve the symptoms of allergies and antipyretics are used to reduce fever.
Generally, only those patients who are breathless or have less oxygen in their blood require hospitalisation. “Most recover by domiciliary management,” Das said.
The good news is that most patients are recovering within 4-5 days with just symptomatic supportive care. Generally, the use of antibiotics or antivirals is strictly reserved.
“We only used antiviral Oseltamivir for patients diagnosed with flu,” Arora from Nanavati Max Super Speciality Hospital.
Doctors advise the public to focus on their fitness and diet for better immunity. Also, preventive measures such as wearing masks outdoors, avoiding outside food, and maintaining general flu prevention protocols are recommended, once again.
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