UKH

I know that this is a question that is impossible to answer, but I wouldn't mind people's thoughts.

I have not been ill at all over the last few months, but I have felt a little short of breath at times and I have really struggled with my running, really struggling to get my breath at speeds which would normally be very, very easy.

A month or so ago, I bought a peak flow metre. I was recording scores or around 530. I am asthmatic, so have my peak flow measured every six months as part of monitoring my asthma, it is typically between 630 and 650.

I have been doing a little running over the last few weeks, but much more walking. The running is starting to feel a little easier, but not back to normal, even accepting a certain amount of loss of fitness. I measured my peak flow this morning and I was 600.

Could it be that I have had Covid 19, been more or less asymptomatic, but that it has had a 20% or impact on my lungs, which I am in the process of recovering from. Speaking to a friend who has had it, whilst he had clear symptoms and it was quite unpleasant, be reported even when he was well again, his lungs seemed to be recovering quite slowly.

If your peak flow was reduced by about 15% from baseline then it's much more likely that your asthma wasn't as well controlled as it has been previously.

I've wondered something similar myself after what I would call mild flu symptoms in March. I'm back training 4 or 5 days a week, but when working hard uphill my breathing is maxed out but heart rate barely above 140, when previously on the same hills it would be 160-170. It's as though my lungs are at capacity long before my heart and this wasn't the case before March, there wasn't a gradual change. I've also been coughing up the odd bit of phlegm. All odd, but certainly not anything I'd trouble a doctor over until things are quieter. 

Not really impossible, just will cost you £69 to be about 97.5% sure

https://onlinedoctor.superdrug.com/coronavirus-antibody-test-kits.html

I had considered that, but It seems unlikely as treatment has been consistent and my asthma is only mild and it hasn’t been this bad in the past even when I have been without an inhaler for a few weeks. Also feels different.

I meant that it would be impossible to answer on UKC. I think the Superdrug tests are sold out, but to be honest knowing now probably isn’t all that important.

You'll be a lot less than 97.5 % sure because of the low rate of Covid in the population. You have to think of Baysian statistics:

Imagine a test that is 99 % accurate for Covid 19 but only 1 % of the population has Covid. You test positive. Your chances of having Covid are only 50 % because either of these two things can be the case:

1) You are in the 1 % who have Covid and the test is correctly positive (1% x 99%)

2) You are in the 99 % who have not had Covid and the test is incorrectly positive (99 % x 1 %)

The exact numbers will vary for antibody testing and you also have the Baysian prior of having had symptoms, but your chances of having had covid after a positive test are still significantly lower than the accuracy of the test.

This probably explains it better https://brownmath.com/stat/falsepos.htm

Are you sure? They state:

Chance of a false negative: 0.25%

Chance of a false positive: 0%

Take your reliever inhaler just before you test your peak flow- that will tell you if it is asthma.

OK if chance of false positive really is 0 % then it's fine. When I read 97.5 % accurate I thought it meant that it was symmetrical in that a chance of any error was 2.5 %. It's still a good point about medical testing though and I suspect it's why doctors send you for more than one test if one is positive. 

Yes, I tried that early on, it didn’t make any difference.

Could be COVID, could be something else.  I got a chest infection of some kind, probably viral, back in 2017, it gave me breathing difficulties that never went away other than with asthma treatment (and it's still not 100%).

Only way you'll know is an antibody test.

It's very easy to retro-fit your symptoms into a covid 19 frame isn't it? I spent a lot of the late Feb half term break in London. Stayed with my cousin (an ITU nurse) and her family - they all had it by the end of March. We went to tourist attractions like the Natural History Museum, so stood in queues surrounded by tourists from around the world etc. etc. The next week when I was back at work I felt lousy, headaches, weakness, tiredness. I didn't get the muscle aches I normally get with flu though, nor did I get a temperature. Felt a bit  better after a week, but started coughing - not very bad but the cough went on for weeks. I don't often get coughs. When the lockdown started and I was cycling most days I thought it felt hard work riding up the longer hills - harder than normal anyway.

It's very easy to tell yourself a story like that and join all the dots to get "covid 19". But I'm a teacher, so have been surrounded for hours each day by kids coughing and sneezing - so the illness and the cough could just be various bugs and viruses that are around every winter. The cough just a cough! The weakness when cycling could have been I don't normally ride up those longer hills as normally I'm commuting to work and back 2 to 3 times a week and that's the bulk of my riding. So who knows!

Hearing from people who have been tested +ve and have been ill with it, it sounds pretty horrible so that might lead to wishful thinking of having had and got over it without to much trauma. But I suppose also we hear less from people with minor cases because its simply not so newsworthy.

I agree with what you are saying. I do tend to get chest infections, so I thought that if I got Covid, I might get it relatively badly, although I have got other health factors in my favour. Funny that you should mention the Natural History Museum. Dippy the Dinosaur is on a national tour and is currently sat in my office, it has been there since mid February. Between the exhibition opening to the pubic in February and being suspended in March, we had 120,000 visitors. I passed through hundreds of people every day and thousands on the couple of days when I was a volunteer guide.

I have not had any symptoms, except for the measurable shortness of breath, but I am struggling to explain it as something else at the moment. That of course doesn't mean that there isn't another reason.

It’s certainly possible. In the state’s antibody tests are showing about 10 times the number of infections than we knew about. Sometimes as high as 50x.

I had a cold and slight discomfort swallowing in March and my wife had similar. But she was an MD around sick patients, in teaching around kids all day and our daughter was in daycare so colds are common. 

but it’s also allergy season here. It really is impossibly to know without an antibody test. We’ll have one at some point. It would be nice to know.

That’s true but with antibody testing we’re now hearing about those who had few symptoms or were asymptomatic. Most known infections were from people with strong symptoms.

"Have I had Covid 19?"

People often ask this 

The only way to know is to have a test 

I keen not to use any NHS resources, unless me having a test would assist in understanding how prevalent the virus has been. I would be happy to volunteer for such testing, but I don't think we are at a point where widespread antibody testing is happening. Or have I got that wrong?

I thought that too with my shortness of breath, but the brown inhaler didn;t make any difference over several weeks and the blue inhaler made very very little difference at the time.

Hi, sorry to hijack, but I suspect I have mild asthma (my brother has it and my Dad has more severe asthma). The doctor prescribed me an inhaler to see how I got on without checking my peak flow. I didn't like the inhaler as it seemed to make my heart palpitate a little, so stopped using it.

Would a peak flow metre help me understand whether I may genuinely have mild asthma (i.e. is there a normal range I should be in and the metre will show whether I'm in it)?

The reason I ask, apart from the tickly cough I've had most of my adult life, is that I seem to run out of oxygen when pushing my running (e.g. intervals) rather than my HR being at the limiting factor. All rather unscientific I know!

Also, if a metre would be useful, can you recommend the one you have?

(As an aside, my brother has had COVID-19 and is still recovering, unable to run but can walk a few miles now, after 10+ weeks! Long road back for him unfortunately, but last couple of weeks have been promising)

To be honest, I don't know. I guess you need to have a baseline, treatment for asthma increased my peak flow, so they concluded that I had mild asthma. Hard exercise also brought on symptoms.

Peak flow meters can be useful in diagnosis/monitoring. There is a normal value depending on your height and age and regular monitoring several times a day showing a reduction in peak flow in the morning is suggestive of asthma

It is something to go back to a doctor about as a normal peak flow doesn't mean you don't have asthma.

Ok, good to know thank you. I also get hay fever (not terribly) but I don't think this limits my running, just fuzzy head, tiredness bit of sneezing etc. Again, I don't take anything for it as it's nowhere near as bad as my brother's but maybe I should.

Great, thanks. I might have a different doctor now so might be a good idea. The last one wasn't very interested (she wasn't a runner so couldn't get why I was that bothered about it as normal life was unaffected other than some tickly coughing!).

I think many of us are in the same boat. We live in Spain and just before the lock-down here, my wife had a high fever and very strong flu-like symptoms for 4 days, followed by 3 weeks of dry coughing by both of us. Absolutely no way to get tested during that time, as it was just madness here. We were told to stay put and only people that actually got admitted to hospital at that time got a test. The number of unrecorded cases must be massive. But in our personal case, there is no way of knowing until we can do an antibody test.

On the other side, a family member of my wife is a nurse and worked on a Covid ward in emergency admission. She got extremely strong symptoms and did not even get tested because they were so sure it was a case. Went back to work after recovering and isolating the required time and had several negative antibody tests. So even in what seems to be a clear cut case, you cannot get assurance in retrospect. 

So anyway, not an extremely useful reply, just stating that it might impossible to be sure either way.

Yes, here at least (Spain) you only hear about the really bad cases, because they are the only ones that get tested. At least that's what it was like at the peak of the outbreak here. If you only do tests to people that are on the brink of going into an ICU, the disease suddenly sounds much worse (not saying that it is not bad or serious). Now, that there have been some studies with random testing, there seem to be two main findings:

1. A lot of people that thought they have had it, don't have antibodies.

2. A lot of people have antibodies and have not had a single symptom.

My asthma has been noticeably worse for the last 5-6 weeks. There is a fractional chance this is covid related but as we seem to be in a period of ridiculously good and consistent warm weather, I've assumed this is all pollen/hayfever related.  

The air has been like pollen soup for pretty much the whole of May. As my hayfever recedes - once the hawthorn has done flowering I'm past my peak - grass pollen kicks in and my wife starts suffering, so she thinks the air remains like pollen soup.

Hayfever can make you feel fairly rough while it lasts. I'd put covid 19 lower on the list of probable causes of feeling dreadful than hayfever at the moment.

T.

Yes, I'd approximate that it's about 0.25% Covid and about 99.75% chance it's hayfever

It's entirely possible. I've had very similar symptoms to you, actually almost identical in every respect.  In Jan my better half spent 2 weeks in hospital on oxygen with what we then thought was Dengue fever, and still could have been. We have both been tested recently and both have has Covid19. 

My shortness in breath has been quite sporadic. Every 2 or 3 weeks it feels a bit worse, then improves for a similar time. However exercise doesn't seem to have any impact.