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By Mary Carpenter
When I tested positive for Covid last month and kept testing positive for 16 days, I had managed to avoid the virus for so many years—since its beginning—that I thought I might be immune; also my blood type O has been suspected to confer some protection. But I worried that never having the infection made me more vulnerable, despite having obtained each vaccine almost as soon as it became available. For the first week or so my only symptom was such mild sniffles—along with fatigue, albeit hard to distinguish from the jet lag following travel to Europe—that my first positive test result was a surprise; later I developed the hacking cough that has followed previous infections such as flu, along with startling pink pink eye—a common symptom of the latest Covid variants.
“A COVID SUMMER UPTICK” read an early July Washington Post headline on recent infection rates. The prevalent JN.1 variants—one dubbed FLiRT for the locations of its mutations—are “significantly different from the dominant variant that preceded it,” according to the Post. While the currently available vaccine “still confers some protection… nearly two thirds of current infections caused by JN.1 descendants can more efficiently infect people who have been vaccinated.”
Meanwhile, across the United States, precautions taken during the recent Covid surge differ widely—from places like Massachusetts beach resorts, where people with active infections continue to socialize unmasked; to the DC metro area, where people stay away from friends like me as long as the tests results are positive.
The CDC’s updated Covid quarantine advice eliminates altogether the reliance on retesting: “People who test positive for COVID-19 should follow CDC guidance for preventing spread of respiratory viruses… stay away from others until at least 24 hours after both symptoms are improving overall and they have not had a fever without the use of fever-reducing medication. For 5 additional days, people should consider added precautions such as hygiene, use of masks, physical distancing, and steps for cleaner air.”
Symptoms of currently circulating variants—especially conjunctivitis, or pink eye, as well as a bad cough—can make it difficult to hide signs of infection. And for some people, unfamiliar symptoms accompany Covid that make it appear “more like they have food poisoning than anything else,” according to the New York Times. University of Pennsylvania medicine professor Ken Cadwell compared Covid infection to “throwing a bomb in your body…You’re going to feel that in multiple different organs, not just the lungs.”
In my case, the Paxlovid I had on hand for my travels—motivated in part by the drug’s record in possibly preventing Long Covid—tamped down symptoms for the five days I took it. After stopping Paxlovid, I felt more tired—a resurgence of symptoms that researchers now believe to be ongoing Covid infection that reemerges following cessation of Paxlovid, rather than caused by the antiviral drug as some had worried.
“People may avoid Paxlovid out of a fear of COVID rebound,” said Yale infectious disease specialist Scott Roberts. “But for high-risk patients, the benefits of Paxlovid in preventing severe disease, hospitalization, and death far outweigh the downsides of a rebound, which is usually mild, and, in most instances, will do nothing more than prolong the isolation period.”
After my 16 days of positive Covid tests, only the cough remained, but it kept me awake at night and contributed to lingering fatigue. On a call with my doctor’s office, I expected to receive the usual recommendations: Mucinex and an antihistamine, such as Benadryl. Along with advising both of those, however, my doctor suggested two prescription medications—creating a multi-drug regimen that I started gratefully, despite my usual reluctance to take so many drugs.
What motivated me above all was the two cracked ribs caused by a similar cough after a bout of flu several years earlier, which had also erupted in unstoppable bursts all day and night and could be calmed only with a steady ingestion of cough drops. Now, along with Benadryl at night, my regimen included Mucinex three times a day as well as the prescription nasal spray ipratropium bromide, a bronchodilator designed to open air passages in the lungs.
The most surprisingly effective was the prescription cough medicine, benzonatate (common brand names, Tessalon or Tessalon Perles), also three times a day, which reduces the urge to cough by numbing areas in the lungs and airways to dampen the cough reflex. As to how effectively benzonatate stopped my cough, as soon as I tried cutting back to one dose before bed, the daytime cough returned in full force—so I continued the full regimen for a few more days. Having never heard of this drug before, I have since heard from friends—with coughing following asthma as well as other infections—who received the same prescription.
Next came pink eye, or conjunctivitis—in my case, most likely viral, based on my positive Covid tests. First came puffiness that narrowed my eyes, then an itching and burning that made my eyes feel exhausted starting first thing in the morning, and finally the unmistakable pink coloring. What helped was applying cold compresses many times a day: I couldn’t use the lubricating eye drops as advised because of difficulty keeping the tip of the drops dispenser from touching my eyes—a serious issue in the case of extremely contagious conjunctivitis.
The best healer of pink eye in most cases is time. According to the CDC, whether viral or bacterial, most mild pink eye clears up without medical treatment in two days to two weeks. For bacterial pink eye, antibiotics can help shorten the length of infection and prevent the spread to others. My doctor assured me that pink eye looks obviously bacterial when the discharge, or pus, is thick and colored yellow and green.
With such an array of symptoms—each of which seemed mild in my case, but altogether lasted almost four weeks—Covid remains unpredictable, compared to other infections such as the flu, with which it is often compared. But contracting Covid should have the advantage of conferring some protection for the next few months—at least until the arrival of the next new vaccine, designed to better protect against currently circulating variants. And if that Covid shot includes the latest flu vaccine, as reported, putting off the jab until at least late September may offer the best protection against both throughout the flu season.
—Mary Carpenter regularly reports on topical subjects in health and medicine.
