Covid: Scientists call for expanded list of symptoms

A group of leading scientists is calling for the UK’s official list of Covid symptoms to be expanded to ensure cases are not missed.

They point out the World Health Organization and US guidance include many other symptoms – such as a sore throat and runny nose.

Others warn this needs to be balanced against the risk of needlessly testing those who have other common illnesses.

Government officials say they keep the symptom list under constant review.

“With around one in three people not showing symptoms of Covid, we have made regular, rapid testing available twice a week for free for everyone in England.”

Younger people

Current NHS advice states people should self-isolate and get a test if they have a high fever, a new continuous cough or a loss or change to their sense of smell or taste.

But the group of experts – including Prof Calum Semple, of the government’s Scientific Advisory Group for Emergencies (Sage) – points out not everyone who catches Covid displays these classic symptoms.

Writing in The BMJ, they say “unofficial” symptoms such as a runny nose, headaches and muscle aches are more commonly seen in younger people, who are now more likely than older people to be infected.

Recent analysis by the Zoe Covid Symptom study, for example, suggests headache, sore throat and runny nose are now the most commonly reported symptoms linked to Covid infection in the UK.

Researchers, including Dr Alex Crozier from University College London, say the situation in the UK is a very different one to when the list was first published, with greater testing capacity and more knowledge about the disease.

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They acknowledge the approach could increase the demand on testing centres and increase the number of people isolating.

But they argue that, with careful implementation, there would be important gains – including reducing transmission at a time when new variants are emerging.

The current “narrow” list could miss contagious people, particularly at the start of their illness when they are more likely have non-classical symptoms but are most likely to spread the disease.

Dr Alexander Edwards, at the University of Reading, said the group raised valid points about spotting infection.

But he added: “The big difficulty is in accurately finding people who are infected, without needlessly testing other people with other symptoms.

“Many are very common – and the best way to judge the likelihood of someone having Covid is a combination of symptoms, their risk of exposure, plus testing.”

And Dr Edwards said spotting people who are infected was just part of the story, adding: “Unless you can effectively support infected individuals to isolate from others and thereby break the chain of infection, testing alone doesn’t reduce the burden of this disease.”

Meanwhile a spokesperson for the Department of Health and Social Care said: “Since the start of the pandemic we have acknowledged Covid has a much longer list of symptoms than the ones initially used in the case definition and our experts keep the list of symptoms under review.

The spokesperson added: “With around one in three people not showing symptoms of Covid, we have made regular, rapid testing available twice a week for free for everyone in England.”

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