Ministers are finally acknowledging what has been patently obvious since the beginning of the pandemic: Covid is associated with far more than the oft-cited symptoms of high temperature, persistent cough and loss of sense of smell and taste.
With little fanfare, a further nine potential symptoms have now been added to the official list on the NHS website, including diarrhoea, loss of appetite, sore throat and tiredness.
The US Centers for Disease Control and Prevention (CDC) has recognised many of these symptoms since April 2020, as have numerous other governments. So why has the UK taken so long – and will anyone take any notice?
British scientists have long called for a broadening of the official symptoms list. According to research published in February 2021, the inclusion of fatigue, sore throat, headache and diarrhoea in the criteria to qualify for a PCR test could have enabled 96% of symptomatic cases to be detected – a third more than relying on the “classic” three symptoms alone.
Indeed, some scientists suspect it’s precisely because access to free testing has been scrapped for most people in England that the government has updated the list.
“We were always told that the barrier to expanding the list was that adding more symptoms could overwhelm the testing capacity, so it makes sense that since free testing has now stopped, the list has been updated,” said Prof Tim Spector, lead researcher of the Zoe Covid symptom study app, who has been lobbying for this change for two years.
Although the addition of more symptoms “is definitely a step in the right direction and it could help reduce infections as we go forward”, Spector would also have liked to seen them reordered – fever, a new continuous cough, and a loss or change to your sense of smell are still listed in positions one to three – yet they are much less common in the Omicron variant era.
“According to the Zoe Covid study, the top five symptoms being reported by contributors with a positive Covid test are; runny nose (83%), fatigue (71%), sore throat (69%), headache (69%) and sneezing (68%),” Spector said.
Others question how helpful it is to expand the symptoms list, now that the majority of people cannot access tests without paying for them.
“Better late than never, one might say, but the problem is that none of this is much help if you can’t test to make more certain whether you have Covid or not,” said Prof Stephen Reicher, a psychologist at the University of St Andrews and member of the now disbanded Sage subcommittee advising on behavioural science.
“Indeed, precisely because Omicron presents more like a cold, it is more important than ever to test in order to see what the symptoms mean.”
Presumably, the change is designed to encourage people to behave responsibly, and limit contact with other people if they develop any of these symptoms. But you only have to walk down your local high street to see that the public mood has shifted.
On the other hand, what are people supposed to do? Asking everyone with any of the listed symptoms to isolate as if they have Covid would be overkill, and only increase the number of teachers, healthcare staff and other essential workers who are off sick – and many essential and non-essential workers can’t afford to take time off work “just in case”.
Neither are many prepared to waste concert or theatre tickets, miss out on parties or forgo weekend shopping trips, in case their runny nose is Covid. Far easier to assume it isn’t.
Reicher said: “Yet again, this is ‘rearranging the deckchairs’ stuff from a government which refuses to do the obvious thing and restore free testing, as well as restoring or extending support for self-isolation, so people can do the right thing if they are Covid positive.
“The government has sent out so many messages that ‘it’s all over’ and so ‘infections don’t really matter’ that it is difficult for anyone to think it matters.”