Updated on: June 15, 2020

COVID-19: Do you have “thinkihadititis?”

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Original story posted on: June 12, 2020

There is no ICD-10-CM code for it.

 EDITOR’S NOTE: The following article by Dr. Remer is from her recent “TalkBack” segment on the Talk Ten Tuesdays broadcast.

Thinkihadittis is a condition that afflicts people who have experienced COVID-like illness, making them think they had it already. They fluctuate between exhilaration, presuming that they have beaten the disease, and the anxiety of possibly having been a vector, giving it to other people unknowingly.

Until May 14, I suffered from this condition.

I flew to Maui from Cleveland on March 3 and found myself ill upon arrival. I felt like I had been run over by a truck for five days, and had bronchitis-type symptoms. I tried to isolate. I didn’t shake hands or hug anyone. We really didn’t do any activities for the first week, because I was not feeling up to it. My infectious disease doctor friend pooh-poohed it, saying it was the flu.

We flew to Oahu at the end of the week. Have you ever been to Pearl Harbor? You move through the exhibits with huge masses of people, many of whom are masked, because they know better. There are buttons to push and knobs to turn. I used hand sanitizer the same as I always do, but in retrospect, I worry. Did I do enough?

Fortunately, Hawaii seems to have been relatively spared from the worst of the pandemic. They have had fewer than a thousand cases. So I guess I wasn’t COVID-19 Typhoid Mary, like you suggested, Ron Hirsch!

We returned home on March 13, and the world imploded on March 15. My older son came back home from New York City suffering from thinkihadititis. In February, he went on a vacation to Spain and had a febrile respiratory illness, with loss of taste and smell. He knows he has been exposed multiple times since then. My younger son had four weeks of GI symptoms, which the gastroenterologist said was likely COVID-19.

On May 14, the results of my antibody test came back positive. It affirmed what I already knew – I had it. I am grateful that I did. The stress of life right now – dealing with the pandemic, unprecedented economic turmoil, worrying about all loved ones (I haven’t seen my father in his assisted living since mid-March) was more than enough for me, without the uncertainty of waiting for the COVID-19 shoe to drop. I sympathize with those of you who haven’t recovered from it yet.

Unfortunately, the rest of my family’s serology results came back negative. There are some major concerns about the accuracy of antibody tests, so I’m not sure what this means.

However, I had been doing all of the shopping, cooking, cleaning, and interacting with the outside world for my household, and I will continue to do so. I firmly believe that social distancing and hygienic practices flattened the curve.

I hope there is some degree of immunity, but the duration is unknown, so I know it is possible I could get it again someday. But even if I had permanent immunity, have you seen the Japanese video simulating a man spreading germs under fluorescent lighting? They say the transmission is most common via person-to-person aerosol and not from objects, but I think it is similar to other viruses.

If I went to the grocery store and got contaminated with viral particles, I might not contract the illness again, but I could spread the virus to my family if I didn’t practice good handwashing. It is incumbent upon all of us to be responsible and act as though we could be the vector, even if we are immune.

I was petrified when I watched the news this week. I understand the need to protest, and everyone wants to get back to work. Wearing a mask and adhering to social distancing is not an affront to your freedom; it is caring for others. We are morally responsible for each other. I am paraphrasing Hillel, who said, “If I am not for myself, then who will be for me? If I am only for myself, what kind of person am I?”

Please be safe and take care of each other and yourselves.

https://www.cnn.com/2020/05/13/health/japan-black-light-experiment-coronavirus-trnd-wellness/index.html

https://www.fda.gov/news-events/fda-voices/insight-fdas-revised-policy-antibody-tests-prioritizing-access-and-accuracy

Erica E. Remer, MD, FACEP, CCDS

Erica Remer, MD, FACEP, CCDS has a unique perspective as a practicing emergency physician for 25 years, with extensive coding, clinical documentation improvement (CDI), and ICD-10 expertise. As a physician advisor for University Hospitals Health System in Cleveland, Ohio for four years, she has trained 2,700 providers in ICD-10, closed hundreds of queries, fought numerous DRG clinical determination and medical necessity denials, and educated CDI specialists and healthcare providers with engaging, case-based presentations. She transitioned to independent consulting in July 2016. Dr. Remer is a member of the ICD10monitor editorial board and the co-host of Talk-Ten-Tuesdays. She is also on the board of directors of the American College of Physician Advisors.

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