Why do I get infected even if I don't go out? How many days does it take to recover the sense of taste and smell? Experts answer ten hot questions

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With this wave of Omicron BF.7 variant infected patients passing through the infection period, some questions related to “Yang over” and “Yang Kang” also troubled the recovered patients. With these questions, the Yangtze Daily reporter interviewed Wen Daning, director of the Infectious Diseases Department at Wuhan Jinyintan Hospital, on December 22. Wen Daning is also a member of the provincial and municipal joint expert group on Newcastle pneumonia, and has been engaged in clinical work on infectious diseases for more than 20 years, participating in the treatment of major epidemics such as SARS, bird flu and Newcastle pneumonia. He has participated in the treatment of major epidemics such as SARS, avian flu and neoconiosis.

Why do you get infected even if you don’t go out? How many days does it take to recover the sense of taste and smell? Experts answer ten hot questions

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Which strain of Omicron is now prevalent in Wuhan? How is it different from other mutated strains?

Wen Danning: Since February 2022, the strains of viruses that we have been treating patients with are all variant strains of Omicron. Over time, we have gone through BA.1, BA.2, BA.5, and up to the current BF.7, with some minor mutations and different symptoms.

Many people have developed symptoms after this infection, mainly fever, cough, muscle aches, dry throat, nasal congestion, diarrhea and other related symptoms, but more focused on the upper respiratory tract, with cases of pneumonia, but less, which is different from the previous strains.

The duration of the disease is shorter than that of the original strain and the Delta virus strain, and full recovery is estimated to take more than 10 days for patients with Omicron infection who have been admitted since February. From my clinical experience, recovery is basically better in 10 to 14 days.

Wuhan’s current dominant strain, BF.7, is actually more symptomatic, but this symptom is limited to the upper respiratory tract more. Some people have fragile respiratory systems and are particularly prone to coughing, while others are particularly prone to diarrhea. In general, people with normal immune function gradually recover in 7 to 10 days, but for elderly people with underlying diseases and various complications, a few people may still have some pneumonia and some critical illnesses.

After the 7-10 days of the disease course, many people still have symptoms such as cough, diarrhea, dry and sore throat, night sweats, etc. Are these symptoms the continuation of the disease or the sequelae brought by the infection?

Wen Danning: Since February this year, we have been clinically exposed to Omicron infection, from BA.1, BA.2 to BA.5, and now the dominant viral strain BF.7. The symptoms of BF.7 infection are indeed somewhat different. These symptoms that appear during the recovery period are actually a process of recovery from an infection. Symptoms such as cough, diarrhea, dry throat, coughing, and night sweats that appear 7 to 10 days after infection, it is not called a sequelae.

The medical term for sequelae is that we call them symptoms that are still present 3 to 6 months after the disease has been completely stabilized. Symptoms such as cough, diarrhea, dry throat and sore throat, and coughing up sputum (including some people coughing up bloody sputum), which are present in this wave of Omicron infected people, will gradually improve and recover as this disease progresses and time passes.

For example, for diarrhea, anti-diarrheal medicine is needed, as well as some dietary adjustments; for cough, expectorant medicine can be used to stop coughing, and if coughing up blood is more frequent, some medicine to stop bleeding is also needed. The principle of medication is symptomatic treatment.

Should we carry these disease symptoms or not? This also needs to be based on each person’s own situation. For example, some people have some chronic diseases in their lungs, and they are prone to lung infections in winter and spring, so they should not just carry on, but actively treat the symptoms. If you cough up thick sputum, it may be secondary to other infections, at this time, you may use antibiotics for 3 to 5 days, and after eating for two or three days, it is obvious that the volume of sputum is decreasing, and the color of sputum is becoming lighter, from thick sputum to white bubble sputum, which means that anti-inflammatory is effective.

Why do you get infected even if you don’t go out? How many days does it take to recover the sense of taste and smell? Experts answer ten hot questions

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Many infected people have lost their sense of taste and smell, is this because the virus has damaged the relevant nerves? Is it possible to recover?

Wen Danning: The number of patients who have lost their sense of taste and smell is still relatively high, around 10%, especially in the case of BF.7 infection, which seems to be more frequent. But the ones I saw in the clinic were all one-offs, and they all gradually recovered after 3 to 5 days. I don’t think it is the central nervous system that is affected, but maybe the peripheral neurons that perceive taste and smell are damaged once and for all, that’s why I see patients who lose their sense of taste and smell gradually start to recover in 3 to 5 days. There are basically no patients who do not recover continuously, so this damage should not be permanent.

Most of the infected patients are significantly better by the 5th day, but some have fever for 5 or 6 days, how is the course of Omicron infection?

Wen Danning: This wave of Omicron BF.7 infections is different from the ones admitted before October, which are more contagious and mostly mild, but we are not saying that all of them should be mild.

The general feeling is that the symptoms are more severe at four or five days and start to recover by about a week. But in clinical practice, we have encountered patients who have not recovered for a week or whose fever has not come down for 5 days, then this group of patients should be careful, the disease may have progressed, it is better to go to the hospital to do a comprehensive examination, so that the doctor can assess the disease.

My advice is that if the fever is more than 5 days old and still above 39°C, this is definitely a case that needs to be seen. In normal people, the fever starts to go down in about 5 days. 5 days should be a limit for us to observe at home. If it starts to recover in 5 days, you can continue to observe it at home. If it is still getting worse after 5 days, you must go to the hospital at this time, so that the doctor can judge it. If you need to be hospitalized, the doctor will arrange for hospitalization, and if it is not serious, you will be instructed to continue taking oral medication at home.

Many people feel weak after infection, so should we emphasize “rest and recuperation”?

Dennis Wen: We recommend that the exercise after recovery should be appropriate. In the early stage of recovery, fatigue and tiredness are certainly common, so it is important not to be overly tired in activities or work after infection with Omicron BF.7. Self-perception of activity or work after special fatigue, physical exercise after the heart rate, breathing increased to feel very uncomfortable, this is too much.

The overall trend after infection with Omicron BF.7 is a slow recovery. However, each person has a different constitution, age and condition, and some people have a long recovery time, while others have a short recovery time. Whether to recuperate or to resume normal work depends on your body condition and usual work life habits.

The degree of return to work and exercise should be gradual, according to each person’s recovery state, to start work and exercise. The intensity should be judged by not feeling fatigue.

Why do you get infected even if you don’t go out? How many days does it take to recover the sense of taste and smell? Experts answer ten hot questions

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After the infection some men show pain all over the body, including genital pain, so they worry that it will affect the reproductive function. Is there any effect?

Wen Daning: Omicron is still a kind of new coronavirus, which has some effects on many organs of the human body. However, we now believe that Omicron is more likely to affect the upper respiratory tract and has very little effect on other organs. Omicron is less virulent than the previous delta or the original strain. Omicron now mainly affects the upper respiratory tract, then again it is very unlikely to affect multi-organ function, so I don’t think it will have an effect on reproductive function.

In addition, heat does have an effect on male reproductive function. The testicles of sperm-producing men are affected by prolonged exposure to high temperatures, but there are basically no reports of ordinary fever like this affecting reproductive function.

Nowadays, some elderly people around us are very sick after infection, so is it true that elderly people will definitely go to serious and critical illness after infection?

Wen Danning: The ninth edition of the guidelines says that the first high-risk group is the elderly over 60 years old. For the elderly, the older they are, the greater the risk of having underlying disease. However, it is not the case that the elderly should be hospitalized as soon as they are infected, a risk assessment is needed here. The elderly can relax the assessment index a little bit. For example, we ordinary people say that it takes 5 days to go to the hospital with high fever, then elderly people are still recommended to go to the hospital promptly if their body temperature exceeds 39℃ for 3 days, or if they have panic, shortness of breath, chest tightness after activities, or if their underlying diseases such as hypertension, hyperglycemia and heart failure are not well controlled.

Diabetic patients are more prone to secondary infections because of diabetes, and it is particularly difficult to control infections after they occur. When a person’s blood sugar rises, the blood is like a culture medium for pathogens. So diabetics are prone to secondary infections. We are now encountering serious illness, diabetics will be a little more.

Therefore, when elderly people or young and middle-aged people with underlying diseases such as diabetes are infected with Omicron, it is important to closely observe the changes in their condition and not just carry on.

Why do you get infected even if you don’t go out? How many days does the sense of taste and smell take to recover? Experts answer ten hot questions

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Many infected elderly people have not been out of the house, why are they still infected?

Wen Danning: Many elderly people, if you ask carefully, do not go out at all. He is mostly downstairs, just not far from home.

Some elderly people do not go out, but there are always visitors to their homes, such as children and relatives who visit them, caregivers, etc.

Seniors who don’t leave their homes also receive outside items, such as bought food and daily necessities. All of these can be sources of infection.

How can we deal with aerosol-borne viruses?

Tannin Wen: Not only Omicron, but many viruses of the respiratory tract are aerosol-borne. Aerosols are best understood like the smoke from smoking. A person smoking in a room, after he leaves, people coming in can smell the smoke, which is actually an aerosol, which can float in the air for a long time, it does not sink. You encounter it, you sucked in.

But if you open the windows in time to ventilate, you will soon not smell the smoke, indicating that this thing will spread out. This is the reason why we need to keep offices, living rooms and other places ventilated. Compared to the smell of smoke, the aerosols that spread viruses are colorless and odorless, and are a bit more insidious. Keeping windows open and ventilated should become a good habit to live by.

I have turned negative, but my family members or colleagues are “positive” again, will I be infected again?

Wen Danning: Everyone is asking this question. There is no such cross-infection between family members and colleagues.

In a family or a certain area, people are basically infected with the same strain of the virus, and there is no recurrence of the same strain in the short term. Because after infection, the body’s immune function will produce antibodies against the strain, and these antibodies will last for 3 to 6 months.