Allergies? Nope! Covid

[Ioreth, ADN, RN]

I always get allergies this time of year, like clockwork. It is even worse when the heaters get turned on since all the crud in the ducts set off my allergies like no other.

On Monday, I woke up with allergy symptoms (itchy eyes, post nasal drip, sore throat) and no fever. I took an antihistamine and went to work. I felt cruddy, but it was also a rough day. Went home at the end of the day, checked again, no fever. Next day rinse, repeat. Wednesday, my husband suggested I get a free covid test in my community. I thought it was silly, but sure I'll do my due diligence. I got one, mostly to prove my husband wrong. Friday I worked again, and still had the same allergy symptoms (though slightly better) and no fever. 

Well today I got my result back and it is positive. Now I'm really worried because I've been around patients and my coworkers. I called Oc Health and I'm still waiting to hear back from them. I've been very good about keeping my mask on at work, hand hygiene and not getting unnecessarily close. But it is still nursing and I still have to get close to take care of my patients. I'm worried that I've infected someone. I'm worried that I'll be "in trouble" for not calling Oc Health earlier. And I'm worried that now my family will get sick.

What is most frustrating is I have no identified vector. None of my patients I've cared for recently have been identified covid. One is recovering from an ICU stay for covid, but was cleared by infectious disease for standard precautions. We have another nurse out with covid on my unit, but I haven't worked closely with her in weeks. I've also not done much of anything besides work and be home. Even grocery shopping has been on low volume hours and not much of that either.

Also I thought I had it already. I was sick in early July with flu-like symptoms. Tested twice negative and negative antibodies, but short of breath and couldn't smell anything for a month. The doc I saw said it was very, very likely I had it based on symptoms but also that I might not have had a great immune response and didn't produce antibodies. I thought I was free and clear from covid at least for a while longer. This is one of the reasons why I dragged my feet on calling Oc Health since I had already been out for 3 weeks in July with a fever that took forever to go away. I already felt like I was being reactionary from the first time since I tested negative. (Though it occurs to me now that if I did have it the first time and didn't produce antibodies, then of course I'm still susceptible. Argh.)

I'm so frustrated, and I'm angry with myself for not going through proper channels.

[amoLucia]

OP - be easy  on yourself. All your rationales sound reasonable to me, but then I'm not on the front lines. Nor do I have the extended circle to worry about. But your 'guilties' will prob only serve to depress you more and inhibit your immuno responses.

Take solace in that thru all you WERE doing, you were trying to do your best for your pts. That's BIG! You WERE NOT being deliberately stupid or ignorant re C19. Like so many others out there.

Thank you for your continued first-line 'essential-ness' for what you do. YOU and all the others are often under-appreciated & under-recognized for your work and the assoc risks. 

[Ioreth, ADN, RN]

Thank you! I do tend to be a worrywart and not hearing back from Oc Heath after 3 hours has me busy worrying. So of course I come here to put my worries out there on AllNurses to get some levelheaded perspective. Thank you again!

[Ioreth, ADN, RN]

Update.

Oc Health finally got back to me. They've been totally swamped by hundreds of calls a day. Covid is heating up fast in mid-America.

The Oc Health RN told me that this wave has been different than previous waves. She said that 2/3 of cases are presenting without fever and that the majority of calls have gotten tests out of an abundance of caution thinking it was allergies. So maybe the virus is changing?

[NRSKarenRN, BSN, RN]

Hope your on the mend soon.

[JKL33]

On 10/31/2020 at 5:40 PM, Ioreth said:

None of my patients I've cared for recently have been identified covid.

That's a big part of the problem and it isn't your fault: That ^ is practically meaningless as far as I can tell.

[Olypen Nursing Student]

I get those exact symptoms all the time from my allergies. I tell myself to be rational, those aren't covid symptoms. I was seen by an NP who told me I didn't need a covid test because I didn't have symptoms. I can imagine how you must be feeling, but I don't think you had a reason to suspect these symptoms since they were part of your usual allergy pattern. I hope that you make a full recovery, and that your family and patients are okay. 

(And if my allergies come on, I will get tested -  thank you for posting.)

[turtlesRcool]

It's also possible to have COVID and allergies.  I don't think COVID gives the itchy eyes, so that symptom is probably the allergies. You could even have basically asymptomatic COVID, but have it at the same time as your allergy symptoms.  I'm sure we'll be seeing patients test positive for both COVID and flu this year.

[ruby_jane, BSN, RN]

On 11/1/2020 at 12:44 PM, Ioreth said:

 

The Oc Health RN told me that this wave has been different than previous waves. She said that 2/3 of cases are presenting without fever and that the majority of calls have gotten tests out of an abundance of caution thinking it was allergies. So maybe the virus is changing?

OY. As a school nurse I can say that the above (if true) is going to flatten us.

You did every darn thing you could. I am sitting here with my allergies kicking (and I did get swabbed this weekend, waiting for result).

[JKL33]

On 11/3/2020 at 10:58 PM, Olypen Nursing Student said:

I was seen by an NP who told me I didn't need a covid test because I didn't have symptoms.

I understand the spirit of your post and agree the OP doesn't need to lose sleep over this, but just need to say that ^ this doesn't represent brilliant thinking on the part of that NP. Covid manifestations are all over the place and there is more than one possibility for a lot of things in diagnosing patients, like the classic "did you fall because you tripped on the kitchen rug or because you passed out or because one of your leg bones spontaneously snapped...?"

Does a patient have a sore throat, itchy eyes and post-nasal drainage because of allergies or because of covid + allergies or because of ??? any of several other possibilities. Just blowing off allergy sx and saying that they are not covid sx is not great; there is overlap.

On 11/1/2020 at 1:44 PM, Ioreth said:

The Oc Health RN told me that this wave has been different than previous waves. She said that 2/3 of cases are presenting without fever and that the majority of calls have gotten tests out of an abundance of caution thinking it was allergies. So maybe the virus is changing?

Maybe there are simply a lot of people walking around with (asymptomatic) covid from day to day and some of them now also have seasonal allergies. 

All sorts of possibilities.

[ruby_jane, BSN, RN]

27 minutes ago, JKL33 said:

I understand the spirit of your post and agree the OP doesn't need to lose sleep over this, but just need to say that ^ this doesn't represent brilliant thinking on the part of that NP. Covid manifestations are all over the place and there is more than one possibility for a lot of things in diagnosing patients, like the classic "did you fall because you tripped on the kitchen rug or because you passed out or because one of your leg bones spontaneously snapped...?"

I started working with our health department's epidemiology team in March. A lot of our local providers are struggling with the differentials on this.... 

[JenTheSchoolRN, BSN, RN]

On 11/4/2020 at 11:59 AM, ruby_jane said:

I started working with our health department's epidemiology team in March. A lot of our local providers are struggling with the differentials on this.... 

Same here in the northeast. I'm also a school nurse and have referred staff and students out to check in with their provider with allergy symptoms. Every single provider has sent them for testing. (No positives yet, thankfully). 

But part of this is also because sick visits are mostly virtual in many PCP offices. You just can't assess a person as well virtually so you have to be over cautious here. If COVID test is negative, then offices move forward with in person sick visits it seems like. My school doc works in a pedi ED and basically says she is getting way more "less sick" visits than usual because family needs COVID testing and help and their pedi won't schedule an in person sick visit...

(Of note, for me the sore throat has been the more common factor here and I wonder if that will be more of a trend we will see. All the folks with allergies, strep, AND COVID. I hope not!)

OP, your thinking was sound. And you were taking all the pre-cautions, including getting tested just in case. It is so hard to say "don't feel guilty" because we are all human here. So ::hugs:: to you right now.