D: What brings you in?

P: Yeah, nice to meet you I, I've been having just over the last week my cough that's been getting worse and I had a fever a couple of nights and just yesterday I noticed that I started having a loss of taste and smell so that got me really worried.

D: OK, so yeah, let's rewind a little bit. The cough you said started a couple of weeks ago, so would that be about 2 weeks? Three weeks? 

P: I would say last week, so like 7 seven days ago.

D: Seven days ago, OK. So that started seven days ago and then when did the fever start?

P: The fever I hasn't been constant, but I've like had some nights where I just feel really chilly and then during the day sometimes even getting these chills I've been recorded at a temperature, but I think I've had a fever at least three times in the last week.

D: OK, so you haven't actually taken your temperature, but it you just feel like you have chills?

P: Yeah.

D: OK, we could take your temperature today. And then the loss of smell and taste. Do they both happen at the same time?

P: I think the taste happened like before, but that was just yesterday and then yesterday morning like at breakfast, I couldn't really taste anything and then continued during lunch and dinner, but smell, I kind of lost around the evening. 

D: OK.

P: Yeah, all just started yesterday.

D: OK. Um alright, so let's go back to the cough and has it been constant since it started?

P: Yeah, it's been pretty constant. It's been getting worse, especially like in the last few days. I'm mainly coughing like before I was coughing mainly at night, but now I'm coughing throughout the day.

D: OK, um so yeah, you mentioned possibly a trigger would be like time of day at night? Or did you notice any other triggers like you know, the cold air or dust or anything at home that could be potentially triggering your cough?

P: Uh no, not really. Like I've lived in the same place for awhile, no new changes and I've been barely going outside, so I don't think there are any triggers.

D: OK, and in terms of the quality of your cough is that, would you say it's harsh? Barky?

P: Uhm, I would just say it's like kind of harsh at times, but mainly it's a dry cough, like I'm not bringing anything up.

D: OK, OK. And then you said dry cough so no sputum or blood right?

P: No. 

D: OK. Have you ever experienced anything like this in the past?

P: Not the loss of taste and smell, but like the other stuff when I just had a cold or flu like symptoms previously, but the taste and smell is something completely new.

D: OK. And then, um, have you experienced any shortness of breath?

P: Um, not really, no.

D: No, OK. How about we wheeziness?

P: No.

D: Chest pain?

P: No chest pain.

D: OK. Uh, experienced any weight loss recently?

P: No, not that I know.

D: OK, how about fatigue?

P: I have been a bit tired in the last few days. The fevers at night and morning. Just feeling a little bit crummy, just not really energetic, energetic to do anything.

D: Yeah, for sure. 

P: Just been planner, just sitting on the couch.

D: OK. Any changes to your hair, nails, or skin, like rashes?

P: No, I haven't noticed anything like that. 

D: OK, you mentioned loss of smell. Do you have a runny nose or a stuffy nose?

P: I did have a runny nose earlier this week, but that's kind of subsided. Other than that, I don't really feel too much congestion. I've been taking Tylenol, the Tylenol cold so I don't know if that helped.

D: OK, how often are you taking the Tylenol cold?

P: I just took it like for four days just before going to sleep in the last week.

D: Oh, I see. OK. OK and then. Any I do have a sore throat?

P: No.

D: No, ok. How about any changes to your vision or hearing?

P: No, nothing like that.

D: Any pain or discharge in the eyes or ears?

P: No.

D: OK. Do you ever feel like your heart's racing?

P: Uh no, not really.

D: No, OK. And any swelling in your limbs?

P: Uh, no, I don't think so.

D: OK, any dizziness or fainting spells?

P: No.

D: OK. Confusion or memory loss?

P: No, not that I can tell.

D: OK, any changes in your bowel habits like constant constipation or diarrhea.

P: Oh no, not really.

D: No, no blood in the stool, right?

P: No.

D: OK, any changes to your appetite?

P: Um, just maybe in like a little bit with the loss of smell and taste, the food is not really the same in the last day, last few days?

D: Yeah yeah, that makes sense. Any nausea or vomiting?

P: No. 

D: No, OK. And any changes in terms of urine?

P: No, I've been peeing alright.

D: OK, good. Any major or a longstanding medical conditions, or are you otherwise healthy?

P: No, I've been fortunate otherwise healthy. I had asthma as a kid, but like I haven't had to use the puffers for more than a decade.

D: Oh ok. OK. And what triggers your asthma?

P: I think back then it was just when I did sports and I was running around a lot. I've been fine for the last 10 years at least. 

D: OK. OK, that's good. And any surgeries or hospitalizations in the past? 

P: No.

D: No, OK. Any are you on any medications?

P: Currently just the other thing, Tylenol cold, but other than that no other medications.

D: OK, not even other over the counter medications or herbal supplements?

P: No, nothing like that.

D: OK. Do you have any allergies?

P: Um, sometimes in the fall like I get a bit sniffly and, but other than that, I don't know of any allergies to any foods or medications.

D: OK. And how about immunizations? Are you up to date?

P: Yeah, they're all up to date.

D: Any lung conditions or heart conditions that run in the family?

P: Uh, my father did recently have a heart attack at age of 58 I think he was, he, he's fine though, but that's that's about it.

D: OK, um any cancers that run in the family?

P: Um, no, I don't think so.

D: OK. And, and do you smoke?

P: Uh, yeah, yeah I do.

D: OK, how much do you smoke?

P: Probably, I would say a pack a day.

D: Pack a day, OK. For how long?

P: Ah, probably since in my 20s, so at least 10 years now.

D: OK, have you ever thought about cutting down?

P: Yeah, especially with this pandemic going on, it's been, I've been trying to cut down just because like I don't want to get the, get COVID and then you know my lungs are probably already weaker because of the smoking. So I've been trying to cut down.

D: Yeah, for sure it's good that you're trying to cut down. We have resources to help you if you ever need them. 

P: Yeah, for sure. 

D: Do you do marijuana?

P: No, no, I've never tried marijuana.

D: OK, how about other recreational drugs?

P: No, um, besides alcohol, nothing else.

D: OK, and then um, I guess I'll ask you about the alcohol, uhm, how much do you drink?

P: Um, um, not that much. I'd probably say like a few times a week when there's a game on. I just grab a couple of beers, but that's about it. 

D: OK. Uhm, and where do you live right now?

P: Yes, I just live just outside of London with my wife and daughter in a small townhouse.

D: OK and anyone else at home sick?

P: No. I I've kind of stayed away once I noticed some symptoms. I'm just kind of just staying in my room, not getting out. I don't wanna make any of my families like.

D: Yeah, that makes sense. And have you traveled to anywhere recently?

P: No, umm, I haven't really traveled. I do I do go to work though I haven't in the last last week. I've told them that I've been having these symptoms, but other than that, no traveling.

D: OK. Uhm, OK, that's good. Those were all the questions I had for you today. Was there anything that you wanted to ask me or anything else that you wanted to discuss that I may have missed?

P: Uh, yeah, I I that I'm just wondering like I could it be COVID I I don't know. I don't know if someone in the office had it or yeah, it was just basically worried about, if I had COVID.

D: Yeah for sure. that's definitely something that we need to rule out, so we will be doing a COVID swab on you and and you will hear back in about 24 to 48 hours with the results. But regardless, because your symptoms overlap with symptoms of COVID especially umm, the loss of smell and taste, we do recommend that you isolate for 14 days and that includes trying to isolate from family members as well. So we'll, that's where we'll start. If it's not COVID, it could be another viral illness that's going around at this time of year. But, we'll start with, we'll start with these COVID swabs. How does that sound?

P: Yeah, that sounds good. I'll, I'll let my work know and yeah, hopefully it comes back negative, but I'll stay away from everyone till then. 

D: OK, sounds great, thank you.

P: Alright, thank you so much.