Telling people that you are a “zero” may not get much attention. Telling people that you are a “patient zero”? That’s a different story.
Apple co-founder Steve Wozniak, who also goes by the nickname Woz, momentarily caused a stir with the following tweet:
Yeah, that’s not going to get zero reaction with the ongoing COVID-19 causing coronavirus (SARS-CoV2) outbreak occurring. The possible suggestion that he and his wife, Janet, may have been the “patient zeros” who brought the new coronavirus to the U.S. got all kinds of responses, ranging from people tweeting that Macs don’t get viruses to those wondering angrily why the Wozniaks took so long to see doctors.
A patient zero is the first human to get infected by a pathogen like a virus and then subsequently spread it to others. There can be a patient zero for the overall SARS-CoV2 outbreak, that is the first human to have contracted the virus from a non-human source such as another animal. There can also be patient zeros for outbreaks in different locations, such as the persons who first introduced the virus to each country. It can be very, very difficult to identify who really was the patient zero in each of these cases because that person may have had very non-specific symptoms or even no symptoms at all.
It turns out that all of this patient zero talk Woz probably a false alarm. As Carlie Porterfield reported for Forbes, Janet Wozniak sent USA Today an email indicating that she actually had a sinus infection, presumably a run-of-the-mill sinus infection that was not caused by the SARS-CoV2. So perhaps there is zero concern, or rather zero zero concern about the Wozniaks.
All of this shows how easy it is to mistake something else for a SARS-CoV2 infection, and vice versa. According to the Centers for Disease Control and Prevention (CDC) website, the potential symptoms of “coronavirus disease 2019” include fever, cough, and shortness of breath. That’s pretty darn non-specific.
The World Health Organization (WHO) website does add “breathing difficulties” to the list of potential symptoms. It also says that “infection can cause pneumonia, severe acute respiratory syndrome, kidney failure and even death.”
OK, so death is always pretty serious and would certainly merit attention. But the other symptoms may not be quite as clear. After all, lots of things can cause a fever, cough, and shortness of breath, including many different types of bacterial and viral infections and a BTS appearance. Just because you have these symptoms, does not mean that you should automatically suspect SARS-CoV2. Instead, ask yourself the following questions:
Are your symptoms severe? If so, contact a doctor as soon as possible. This includes having a temperature of over 102.5° F (39.2° C) or a cough that significantly interferes with your daily life. The prescription for a fever that high is not just more cowbell. It is medical attention. Very frequent or very severe coughing should raise concerns as well. The words “coughed up a lung,” typically shouldn’t be followed by “but everything is cool.” Similarly, distinguish between the love-is-in-the-air type of shortness of breath and real difficulty breathing. The latter calls for a call to the doctor.
Do you have any symptoms of pneumonia, severe acute respiratory syndrome, or kidney failure? Chest pain could be a sign of a pneumonia or other type of severe respiratory disease. So could night sweats, assuming that you aren’t actively doing burpees in your bed, or coughing up blood. Be concerned about any significant decrease in urination or change in the color of your urine when you didn’t just eat a bucket of beets, as these could be signs of kidney damage. Keep in mind though that you can have pneumonia, severe acute respiratory syndrome, or kidney failure without having obvious symptoms.
How long have you had these symptoms? No symptoms should last for more than week without medical attention. Not a fever. Not coughing. Not shortness of breath. In fact, anything that isn’t love and lasts for more than a week should give you pause. Also, track the course of your symptoms. If you find yourself getting better and then suddenly getting worse, contact your doctor.
Do you have any risk factors for a SARS-CoV2 infection? No, seeing someone of East Asian-descent and eating Asian food are not risk factors. We’re talking about real risk factors. Of course, the biggest one is coming into close contact with someone known to have COVID-19. So if your roommate made the news for having COVID-19, take any possible COVID-19 symptoms very seriously. In fact, if you were that close to someone who definitely had COVID-19, it’s good idea to notify your doctor even if you don’t have symptoms. Similarly, if you’ve been in a location where there’s active transmission of the virus such as Wuhan, China, contact your doctor as soon as you develop any kind of fever or respiratory symptoms. Symptoms typically begin anywhere from two to 14 days after being exposed to the virus.
You can see how recognizing COVID-19 can be very difficult without formal medical testing. You can also see how identifying a patient zero before he or she has spread the new coronavirus can be very challenging. The person could even have zero symptoms, so to speak. In the end, we may never find out who the zeros were. Nevertheless, always let your doctor know if you are worried in any way about having a new type of infection. For example, if you hear of a new infectious disease in a place that you have just visited, have a low threshold for seeking medical advice. After all, you want to make sure that you have as close to zero chances as possible of spreading that infection to others.
I am a writer, journalist, professor, systems modeler, computational and digital health expert, avocado-eater, and entrepreneur, not always in that order. Currently, I am a Professor of Health Policy and Management at the City University of New York (CUNY), Executive Director of PHICOR (@PHICORteam), Associate Professor at the Johns Hopkins Carey Business School, and founder and CEO of Symsilico. My previous positions include serving as Executive Director of the Global Obesity Prevention Center (GOPC) at Johns Hopkins University, Associate Professor of International Health at the Johns Hopkins Bloomberg School of Public Health, Associate Professor of Medicine and Biomedical Informatics at the University of Pittsburgh, and Senior Manager at Quintiles Transnational, working in biotechnology equity research at Montgomery Securities, and co-founding a biotechnology/bioinformatics company. My work involves developing computational approaches, models, and tools to help health and healthcare decision makers in all continents (except for Antarctica) and has been supported by a wide variety of sponsors such as the Bill and Melinda Gates Foundation, the NIH, AHRQ, CDC, UNICEF, USAID and the Global Fund. I have authored over 200 scientific publications and three books. Follow me on Twitter (@bruce_y_lee) but don’t ask me if I know martial arts.