Covid is not a specific disease

When people say: "I had Covid," what do they mean?

They mean they had a positive test for the SARS-CoV-2 virus.

Very often, they had no clinical symptoms whatsoever – they "had" asymptomatic Covid.

They may have suffered from the well-known symptoms of a common cold or a "flu" – fever, chills, shortness of breath, cough, sore throat, aching muscles. They may have felt a loss of smell and taste (anosmia, ageusia) without nasal obstruction – the only characteristic clinical symptom of an infection with SARS-CoV-2. That is to say, it was relatively characteristic with the early variants, but since the emergence of Omicron, it no longer is. Characteristic does not mean specific, however – many Covid "cases" did not lose their smell or taste, and the symptom can be caused by other pathogens too.

Sometimes, their cold or flu may have progressed to pneumonia (chest infection) – the severe form of a respiratory infection that can be life-threatening, above all in the elderly or in immune-compromised patients with comorbidities. The clinical and radiological presentation of these severe forms is that of a non-specific, "atypical" pneumonia. There are no unequivocally distinctive signs that would differentiate them from the severe respiratory infections caused by a plethora of other viruses.

Some people complain of persistent non-specific symptoms (e.g. brain fog, fatigue, decreased exercise capacity) months after they had their original illness with a positive test – "Long Covid."

The government of Queensland, Australia, has recently reported the results of an observational study that found that the frequency and severity of "Long Covid" symptoms mirrored those of post-infection syndromes after other viral illnesses. This result led a number of researchers and clinicians to conclude that it "was time to stop using the term 'Long Covid.' The lead author of the study, the state's Chief Health Officer Dr. John Gerrard, stated: "Terms like 'Long Covid' wrongly imply there is something unique and exceptional about longer-term symptoms associated with this virus. This terminology can cause unnecessary fear, and in some cases, hypervigilance to longer symptoms that can impede recovery."

Along the same lines of reasoning, one would naturally have to argue that the term "Covid-19" wrongly implies that there is something unique and exceptional about the acute symptoms associated with this virus – which clearly there is not. As we all know, this terminology has caused plenty of unnecessary fear. Over more than three years, it has also caused societal hypervigilance and political hysteria which not only impeded recovery in patients, but resulted in enormous damage to freedom, the economy, the health systems, and the lives of many people around the world.

Despite the now widespread use of the expression everywhere, "Covid-19" is not a nosological entity of its own; that is to say, it is not a specific disease. The diagnosis depends only and entirely on the presence of a positive lab test for SARS-CoV-2. Without that test, "Covid-19" is a non-specific viral rhinitis, laryngitis, bronchitis, pneumonia. In some rare cases, it may also become a non-specific viral myocarditis and/or it may involve other organs – like other respiratory viruses. Virtually every respiratory virus strain can cause dangerous complications.

The enormous amount of biological research on SARS-CoV-2 notwithstanding – clinically, this virus was and is nothing new. Our immune systems need to confront fresh mutants of such respiratory pathogens every year.

However, has Covid been particularly and unusually dangerous, has it been particularly deadly?

We have been trying to separate "true" influenza from other viral respiratory infections ("common colds"), because it is generally more severe. Nevertheless, as the clinical symptoms are hardly discriminatory, we use the term "flu" (or "Grippe" in many other languages) rather indistinctively: By "flu season" we mean the high frequency of respiratory infections (due to many different viruses) during the winter months, with its accompanying rise of "excess deaths" – a rise whose importance varies from year to year.