Only one in five coronavirus-positive Victorians have fever

Coughs, sore throats and runny noses are the most common symptoms being detected in Victorians testing positive to coronavirus, with only one in five people presenting with a fever.

While fever is often thought to be a distinctive feature of the virus, data compiled by the state's public health team shows only about 20 per cent of people found to have coronavirus in recent weeks had a high temperature.

The severity of COVID-19 differs greatly between people tested in the community and patients sick enough to present to emergency departments.Credit:Getty Images

Infectious disease physicians suspect this is due to young people, who have been over-represented in the state's second surge of cases, experiencing milder bouts of COVID-19.

"What it suggests to me is that we are seeing a lot more younger people with more milder illness, so a fever may not be as prominent a symptom as it was in the first wave of cases," Australian National University infectious disease expert Professor Sanjaya Senanayake said.

"It also highlights that even if you don't have a fever but you have any kind of acute respiratory infections symptom like sore throat, cough, runny nose, then you should be getting tested."

Medical director for infection prevention and epidemiology at Monash Health, Professor Rhonda Stuart, said the severity of COVID-19 differed greatly between people tested in the community and patients sick enough to present to an emergency department.

"When we are ringing through positive results for people in the community, a lot of people only have really mild symptoms, so just a bit of a fever, a sore throat, or a bit of sniffle," she said.

Only 10 to 15 per cent of people with COVID-19 require hospitalisation – a figure that has remained largely unchanged throughout the pandemic.

"What brings people to hospital is shortness of breath, that's the main thing people get concerned about, and feeling short of breath with a cough that is getting progressively worse," Professor Stuart said. "Often they will come into hospital with a fever."

Professor Stuart has noted striking differences between age groups struck down with the virus.

While children were more likely to present with a fever and milder symptoms such as loss of appetite, elderly patients often came to hospital confused or after falling and injuring themselves.

"The elderly can present with things that are not classically coronavirus," she said. "Things like increased falls, increased confusion and delirium – they're the things we need to be careful of and watching out for in the elderly.

"It's a very tricky virus and it presents in so many different ways, so we have always got to be thinking, 'Could this be COVID?' no matter what presentations we are seeing to the hospital."

Delirium is an acute condition characterised by an abrupt change in the brain that causes confusion and reduced awareness.

Professor Stuart said Monash Health had treated an increasing number of elderly patients in recent months, whereas the first surge of infections largely involved returned travellers.

"We've had so much more transmission this time around that we are seeing more cases and then … we have a whole range of people having no symptoms right through to people needing intensive care," Professor Stuart said.

She said the good news was the virus did not appear to be making people sicker.

"From what I have seen there is no worsening sort of strain from presentations – it's just the pure numbers of people being infected increasing," she said.

A breakdown of Victorians being tested, which was obtained by The Age and The Sydney Morning Herald, shows that of the more than 2.4 million people tested for the virus across the state, people aged in their 20s and 30s made up almost 40 per cent.

Those in the 30 to 39 bracket made up the highest proportion of people tested, at 19.8 per cent of all tests, followed by Victorians aged 20 to 29 (17.7 per cent), 40 to 49 (14.8 per cent), 50 to 59 (12.8 per cent) and 60 to 69 (9.5 per cent).

Children aged nine and under made up of almost 7 per cent, followed by those aged 10 to 19 (6.5 per cent). People aged 70 to 79 made up 6 per cent of all those tested.

Victorians aged 80 to 89 made up just 4 per cent, followed by people aged over 90 at less than 2 per cent of people tested.

A health data snapshot released by NSW last week showed stark differences in virus symptoms across age groups, with young children and the elderly more likely than other cohorts to have diarrhoea, nausea and vomiting.

Emergency doctors nationwide have previously reported increasingly seeing certain types of skin rash or sore and discoloured fingers or toes that appear to be a manifestation of coronavirus. Temporary loss of taste and smell is also a common symptom.

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