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New Delhi, Jun 13: Loss of smell or taste has been added to the list of COVID-19 symptoms, according to the revised clinical management protocols released by the Union Health Ministry on Saturday.

The ministry said that coronavirus-infected patients reporting to various COVID-19 treatment facilities have been reporting symptoms like fever, cough, fatigue, shortness of breath, expectoration, myalgia, rhinorrhea, sore throat and diarrhea.

They have also complained of loss of smell (anosmia) or loss of taste (ageusia) preceding the onset of respiratory symptoms.

Older people and immune-suppressed patients in particular may present with atypical symptoms such as fatigue, reduced alertness, reduced mobility, diarrhoea, loss of appetite, delirium, and absence of fever, the ministry said.

Children might not have reported fever or cough as frequently as adults.

The US's national public health institute, the Centers for Disease Control and Prevention (CDC), had in early May incorporated "a new loss of taste or smell" in the list of COVID-19 symptoms.

According to the data from Integrated Health Information Platform and Integrated Disease Surveillance Programme, portal case investigation forms for COVID 19 (n=15,366), the details on the signs and symptoms reported are (as on June 11), fever (27 per cent), cough (21 pc), sore throat (10 pc), breathlessness (8 pc), Weakness (7 pc), running nose (3pc ) and others 24 pc.

According to the health ministry, people infected by the novel coronavirus are the main source of infection.

Direct person-to-person transmission occurs through close contact, mainly through respiratory droplets that are released when the infected person coughs, sneezes, or talks.

These droplets may also land on surfaces, where the virus remains viable. Infection can also occur if a person touches an infected surface and then touches his or her eyes, nose, or mouth.

The median incubation period is 5.1 days (range 2–14 days). The precise interval during which an individual with COVID-19 is infectious is uncertain.

As per the current evidence, the period of infectivity starts 2 days prior to onset of symptoms and lasts up to 8 days.

The extent and role played by pre-clinical/ asymptomatic infections in transmission still remain under investigation.

Mangaluru, May 23: Criticising the Karnataka government's fresh protocol for management of Covid-19 as expensive, a prominent physician in the city has demanded its withdrawal.

According to Dr B Srinivas Kakkilaya, the protocol released by the Health and Family Welfare Department on May 15 enlists unnecessary and unconfirmed tests and treatments. 

The protocol has classified Covid-19 cases into three categories and has provided for hospitalisation of all three categories of patients, from asymptomatic to the most severely ill.

In a letter to the government, Dr Kakkilaya said: "The protocol suggests several investigations to be done right on the day of admission, including blood counts, liver and renal function tests, chest X Ray, ECG, CT scan of the chest, and other special investigations, all of which, if done, will cost Rs 25,000 per patient."

"In the coming days when lakhs of patients are likely to be infected with SARS CoV2, is it necessary and feasible to hospitalise and test all these patients at Rs 25,000 per person," he questioned.

The treatment options suggested in the protocol are also surprising, he pointed out. "The protocol recommends choloroquine, azithromycin, oseltamivir, zinc and vitamin C for all patients, from asymptomatic to the severely ill, and also anti coagulant injections for many patients. All these would cost at least Rs 5,000 per patient. For severe cases of Covid-19, many unproven and experimental treatments have been suggested, which are very expensive and highly questionable," Dr Kakkilaya notes.

Therefore, this protocol, he asserted was not evidence based and likely to do more harm than good. He said these unnecessarily expensive tests and allowing private companies to conduct trials on Covid-19 patients is likely to be misused by vested interests and must be immediately withdrawn, and instead, a protocol that is evidence-based, simple and avoiding unnecessary expenses, must be developed.