RESUMEN
COVID-19 is not the world's first pandemic, not its worst, or likely to be its last. In fact, there have been many pandemics throughout history with lessons for the current one. The most destructive pandemic of all time, at least in terms of the number of people killed in the shortest time, was the "Spanish flu" pandemic of 1918/1919. Why did it happen? What lessons did it teach us? And could it happen again? These questions are addressed in the context of the current COVID-19 pandemic and several other nearly equally devastating pandemics of earlier times.
RESUMEN
Coronavirus disease 2019 screening can evaluate large numbers of patients while reducing healthcare exposures and limiting further spread of the virus. Temperature screening has been a focal point of case detection during the pandemic because it is one of the earliest and most frequently reported manifestations of the illness. We describe important factors to consider of screened individuals as well as the measurement process and current outcomes. Optimal temperature-based screening involves both individual and environmental factors as well as reconsideration of the current fever threshold.
RESUMEN
OBJECTIVES: Fever is the single most frequently reported manifestation of COVID-19 and is a critical element of screening persons for COVID-19. The meaning of "fever" varies depending on the cutoff temperature used, the type of thermometer, the time of the day, the site of measurements, and the person's gender and race. The absence of a universally accepted definition for fever has been especially problematic during the current COVID-19 pandemic. METHODS: This investigation determined the extent to which fever is defined in COVID-19 publications, with special attention to those associated with pregnancy. RESULTS: Of 53 publications identified in which "fever" is reported as a manifestation of COVID-19 illness, none described the method used to measure patient's temperatures. Only 10 (19%) publications specified the minimum temperature used to define a fever with values that varied from a 37.3 °C (99.1 °F) to 38.1 °C (100.6 °F). CONCLUSIONS: There is a disturbing lack of precision in defining fever in COVID-19 publications. Given the many factors influencing temperature measurements in humans, there can never be a single, universally accepted temperature cut-off defining a fever. This clinical reality should not prevent precision in reporting fever. To achieve the precision and improve scientific and clinical communication, when fever is reported in clinical investigations, at a minimum the cut-off temperature used in determining the presence of fever, the anatomical site at which temperatures are taken, and the instrument used to measure temperatures should each be described. In the absence of such information, what is meant by the term "fever" is uncertain.