Pressure is mounting on the NHS to change its official list of Covid symptoms after a government-run study found fever and loss of taste or smell are not the most common signs of the disease.
Smears and questionnaires carried out on more than a million people in England found that infected patients were equally likely to experience headaches, muscle aches, chills, or loss of appetite.
However, the current NHS test and trace rules mean that people who have only these symptoms will not be able to get access to a test and therefore may not self-isolate. Swabs are reserved for people with a fever, persistent cough or loss of smell or taste.
Professor Paul Elliott, who led the REACT study, said the results suggest that many infected people slide through the cracks due to the tight guidance.
He added, “I hope that our results on the most informative symptoms will allow the testing program to use the most current evidence to identify more infected people.”
It is based on another official yesterday’s study by the Office of National Statistics that also linked headaches and muscle aches to Covid infection.
The UK has been repeatedly accused of keeping pace with the rest of the world when it comes to discovering Covid-19 during the crisis.
In the US, the Center for Disease Control and Prevention (CDC) warns of eleven primary symptoms, including fatigue, body aches, headaches, sore throats, and shortness of breath. However, the virus can cause a number of other side effects.
Results from swabs and questionnaires conducted between last June and December when the original Covid strain was the dominant version in the UK

The results of swabs and questionnaires were done in January this year when the Kent strain accounted for 86 percent of infections

The UK has been accused of missing “the majority” of Covid-19 cases as it still only sees three tell-tale signs of infection (see NHS website).
The REACT program, run by Imperial College London, examined nearly a million random swabs sent to households in England from June to January and compared them to people’s self-reported symptoms.
It found that up to a quarter of adults had any of the three official symptoms currently listed by the NHS.
Up to 26 percent of adults who tested positive also complained of headaches, while up to 18 percent had muscle pain.
One in ten infected patients reported chills and approximately the same number experienced loss of appetite.
The REACT study also found differences in symptoms between different ages.
While chills were associated with positive tests in all age groups, headaches were more likely to be reported in young people ages five to 17.
Loss of appetite was more common in the elderly and middle-aged, and muscle pain was most common in patients between the ages of 18 and 54.
Infected five- to 17-year-olds also reported fewer fever, persistent cough, and loss of appetite compared to adults.
The program, funded by the Department of Health and Welfare, also found that 60 percent of people with Covid have no symptoms at all.
Doctors and experts have called for the UK’s coronavirus testing criteria to be repeatedly expanded as the pandemic progresses.
However, policy makers need to weigh the benefit of capturing more positive cases that would otherwise have been missed against the risk of overwhelming the testing system with people with symptoms that are unlikely to be coronaviruses.
Even a small percentage of people with the three main symptoms actually have coronavirus – currently only about 5.5 percent of tests done by members of the public are positive, according to Public Health England.
At the height of the second wave over Christmas and New Years, that number rose to 18 percent, but that still meant that eight out of ten people who believed they had the virus didn’t.
Scientists at King’s College London, who run the ZOE Covid Symptom Study app, have repeatedly urged ministers to add to their list.
Their app allows users to log symptoms whenever they are suffering, and then see if they test positive for the virus and uncover other warning signs.
The team has made a push to get the NHS to add anosmia – or loss of taste and smell – to the symptom list after it was previously ruled out at the start of the pandemic.
The REACT study also looked at whether the emergence of the new British coronavirus variant, first identified in Kent, was related to a different symptom profile.
The team compared symptoms in November and December, when the Kent variant made up less than 20 percent of cases, and in January when it made up 86 percent of infections.

Tests by the Office for National Statistics show that less than half of people who tested positive for coronavirus had symptoms at all, with coughing being the most common in England at almost 30%
They found that people with the mutated strain were more likely to experience coughs and less likely to experience loss or change in their sense of smell.
Dr. Joshua Elliott of the School of Public Health at Imperial College London said, “As the epidemic continues and new varieties emerge, it is important that we continue to monitor how the virus affects people so that testing programs can meet changing needs .
“We hope that our data will help educate test guidance and systems development to help identify people who should take a COVID-19 test based on their symptoms.”
An ONS report, based on random community testing of around 9,000 people rather than people who signed up for swabs, found that 47 percent of positive cases had symptoms.
It was similar in other parts of the UK with 55 percent in Wales, 47 percent in Scotland and 38 percent in Northern Ireland.
The most common symptoms for those who got them were cough, fatigue, weakness, and headache.
These symptoms each affected more than 25 percent of those who tested positive.
For comparison: In England, 19 percent of people developed a fever and 22 percent said they had lost either their sense of taste or smell.
Swab tests were done by people across the UK between October 1st and January 30th and were asked to describe any symptoms they had within seven days of the test.