A Guide to Coughs During Coronavirus
By Maja Husaric and Vasso Apostolopoulos
For centuries, doctors and care givers have listened to the different types of cough in search of clues to help diagnose underlying disease.
Coughs are a valuable diagnostic tool, but how do you know if you've got a relatively harmless cough, a coronavirus cough – or something else altogether?
An occasional cough is healthy, but one that persists for weeks, produces bloody mucus, causes changes in phlegm color or comes with fever, dizziness or fatigue may be a sign you need to see a doctor.
If you've gone to see a doctor about a cough, he or she will want to know:
- how long has the cough lasted? Days, weeks, months?
- when is the cough most intense? Night, morning, intermittently throughout the day?
- how does the cough sound? Dry, wet, barking, hacking, loud, soft?
- does the cough produce symptoms such as vomiting, dizziness, sleeplessness or something else?
- how bad is your cough? Does it interfere with daily activities, is it debilitating, annoying, persistent, intermittent?
COVID-19 cough: dry, persistent and leaves you short of breath
The most prominent symptoms of COVID-19 are fever and fatigue, and you may feel like you have a cold or flu. Cough is present in about half of infected patients.
Considering that COVID-19 irritates lung tissue, the cough is dry and persistent. It is accompanied with shortness of breath and muscle pain.
As disease progresses, the lung tissue is filled with fluid and you may feel even more short of breath as your body struggles to get enough oxygen.
Wet and phlegmy or dry and hacking?
A wet cough brings up phlegm from the lower respiratory tract (the lungs and lower airways, as opposed to your nose and throat) into the mouth.
The "wet" sound is caused by the fluid in the airways and can be accompanied by a wheezing sound when breathing in. The lower airways have more secretory glands than your throat, which is why lower respiratory tract infections cause a wet cough.
A dry cough doesn't produce phlegm. It usually starts at the back of the throat and produces a barking or coarse sound. A dry cough does not clear your airways so sufferers often describe it as an unsatisfactory cough.
Nose and throat infections cause irritation to those areas and produce a hacking dry cough with sore throat. These types of cough are often seen in flu or cold.
Sometimes a cough can start off dry but eventually turn wet.
For example, the lung infection pneumonia often begins with a dry cough that's sometimes painful and can cause progressive shortness of breath. As infection progresses, the lung air sacs (alveoli) can fill up with inflammatory secretions such as lung tissue fluid and blood, and then the cough will become wet. At this stage, sputum becomes frothy and blood-tinged.
What about whooping cough?
Whooping cough is caused by bacterial infection that affects cells in the airways and causes irritation and secretion.
Symptoms include coughing fits that end in a loud, "breathing in" noise that often sounds like a long "whoop" and leaves you gasping for air. Mucus is often expelled.
Prolonged, forceful coughing can damage your airways, or cause rib fractures or muscle tears – so it's important to know when medical help is required.
So whatever your cough sounds like, keep an eye on it and see a doctor (either in person or via a telehealth appointment) if it doesn't go away or gets worse.
Maja Husaric is a Lecturer at Victoria University.
Vasso Apostolopoulos is an Adjunct Professor and Sessional Academic at Victoria University.
Disclosure statement: Vasso Apostolopoulos has received funding and fellowships in the past from the NHMRC. Maja Husaric does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.
Reposted with permission from The Conversation.
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The speed and scale of the response to COVID-19 by governments, businesses and individuals seems to provide hope that we can react to the climate change crisis in a similarly decisive manner - but history tells us that humans do not react to slow-moving and distant threats.
A Game of Jenga<p>Think of it as a game of Jenga and the planet's climate system as the tower. For generations, we have been slowly removing blocks. But at some point, we will remove a pivotal block, such as the collapse of one of the major global ocean circulation systems, for example the Atlantic Meridional Overturning Circulation (AMOC), that will cause all or part of the global climate system to fall into a planetary emergency.</p><p>But worse still, it could cause runaway damage: Where the tipping points form a domino-like cascade, where breaching one triggers breaches of others, creating an unstoppable shift to a radically and swiftly changing climate.</p><p>One of the most concerning tipping points is mass methane release. Methane can be found in deep freeze storage within permafrost and at the bottom of the deepest oceans in the form of methane hydrates. But rising sea and air temperatures are beginning to thaw these stores of methane.</p><p>This would release a powerful greenhouse gas into the atmosphere, 30-times more potent than carbon dioxide as a global warming agent. This would drastically increase temperatures and rush us towards the breach of other tipping points.</p><p>This could include the acceleration of ice thaw on all three of the globe's large, land-based ice sheets – Greenland, West Antarctica and the Wilkes Basin in East Antarctica. The potential collapse of the West Antarctic ice sheet is seen as a key tipping point, as its loss could eventually <a href="https://science.sciencemag.org/content/324/5929/901" target="_blank">raise global sea levels by 3.3 meters</a> with important regional variations.</p><p>More than that, we would be on the irreversible path to full land-ice melt, causing sea levels to rise by up to 30 meters, roughly at the rate of two meters per century, or maybe faster. Just look at the raised beaches around the world, at the last high stand of global sea level, at the end of the Pleistocene period around 120,0000 years ago, to see the evidence of such a warm world, which was just 2°C warmer than the present day.</p>
Cutting Off Circulation<p>As well as devastating low-lying and coastal areas around the world, melting polar ice could set off another tipping point: a disablement to the AMOC.</p><p>This circulation system drives a northward flow of warm, salty water on the upper layers of the ocean from the tropics to the northeast Atlantic region, and a southward flow of cold water deep in the ocean.</p><p>The ocean conveyor belt has a major effect on the climate, seasonal cycles and temperature in western and northern Europe. It means the region is warmer than other areas of similar latitude.</p><p>But melting ice from the Greenland ice sheet could threaten the AMOC system. It would dilute the salty sea water in the north Atlantic, making the water lighter and less able or unable to sink. This would slow the engine that drives this ocean circulation.</p><p><a href="https://www.carbonbrief.org/atlantic-conveyor-belt-has-slowed-15-per-cent-since-mid-twentieth-century" target="_blank">Recent research</a> suggests the AMOC has already weakened by around 15% since the middle of the 20th century. If this continues, it could have a major impact on the climate of the northern hemisphere, but particularly Europe. It may even lead to the <a href="https://ore.exeter.ac.uk/repository/handle/10871/39731?show=full" target="_blank" rel="noopener noreferrer">cessation of arable farming</a> in the UK, for instance.</p><p>It may also reduce rainfall over the Amazon basin, impact the monsoon systems in Asia and, by bringing warm waters into the Southern Ocean, further destabilize ice in Antarctica and accelerate global sea level rise.</p>
The Atlantic Meridional Overturning Circulation has a major effect on the climate. Praetorius (2018)