Ronald Keister late last month started feeling muscle and joint aches and developed a low-grade fever, making him wonder if he somehow contracted COVID-19.
The Laurelton resident, worried that his wife who has health problems was in danger, called his doctor to ask if he should be tested for the novel coronavirus. He was told to wait two days to see if the fever would go up; in the meantime, he and his wife noticed a big red welt on his shoulder. Keister had Lyme disease.
"We have woods out back, and I'm out there all the time," said Keister. "I've had ticks before, and had no problems. I never saw the tick on this one."
The state Department of Health last month put out a media release reminding Pennsylvanians to take proper steps to prevent tick bites and recognize the symptoms of Lyme disease, as some symptoms of Lyme disease are similar to those of COVID-19. Ticks can carry Lyme disease, among other dangerous diseases, that can be severe if not treated properly.
Keister is now on his second round of antibiotics and said he has no more symptoms, but symptoms can often be much more severe and longlasting.
Symptoms of Lyme disease can include a red, swollen bulls-eye shape rash, fever, chills, headache, fatigue, muscle and joint aches and swollen lymph nodes. These early stage symptoms of Lyme may appear in as few as two days or as long as 30 days after exposure. Later stage symptoms like arthritis, heart and neurological issues may appear months later. Reported illnesses have ranged from people with few to no symptoms to people being severely ill and dying, according to the state Department of Health.
Some symptoms of Lyme disease are similar to COVID-19. Symptoms of COVID-19 can include, fever, cough, shortness of breath or difficulty breathing, diarrhea, chills, repeated shaking with chills, muscle pain, headache, sore throat and new loss of taste or smell, according to the DOH.
“Over the past several months, we have seen an increase in the number of emergency department visits related to tick bites,” Secretary of Health Dr. Rachel Levine said in a statement. “Some symptoms of Lyme disease, such as fever, chills and headache, are similar to symptoms of COVID-19. It is essential that all residents know the proper ways to protect themselves against ticks and are aware of the dangerous diseases they can carry. We want all Pennsylvanians to get outside and be healthy but do so in the safest way possible.”
Preliminary data show that more than 8,500 cases of Lyme disease were reported in Pennsylvania in 2019. The department is continuing to compile complete Lyme disease data, and final numbers for 2019 should be available within the next month. Over time, if not treated, Lyme disease can lead to severe symptoms that affect the heart, nervous system and joints, according to the DOH.
Dr. Stanley Martin, the director of infectious diseases at Geisinger in Danville, said early symptoms of both Lyme and COVID-19 are similar. Given enough time, it becomes easier to distinguish the two: COVID becomes more of a respiratory illness, he said.
"I've seen more patients tested for both simultaneously; they have a COVID and a Lyme test at the same time," said Martin. "I've seen this a couple of times this summer."
Martin said the cases for Lyme are not noticeably up this year, but it's too early for state data. Pennsylvania is usually one of the states with the top number of cases due to its size and rural nature, he said.
Amateur disc golf player Gary Daddario III said disc golf is a sport that intentionally has you playing in wooded areas and grassy fields, so players are being told to take extra precaution for ticks. The community and tournament directors are really emphasizing the use of sprays before playing and careful self-inspection after completing rounds, he said.
"One of the things I've noticed is that it used to be all about being careful in known tick areas," said Daddario. "Now, it's being encouraged to be cautious no matter where you're at. I've personally taken about three or four ticks off of me this season. When it comes to disc golf, a lot of this was brought to life when Ricky Wysocki, the second highest ranked disc golfer in the world at the time, almost had his career end due to the disease."
The general weakness and fatigue that both Lyme and COVID-19 share is "scary to say the least," he said.
"Two weekends ago, I was playing in a tournament with some heavily wooded areas, and we were discussing how Lyme and COVID were a double threat for disc golfers these days," said Daddario.
Many indoor activities have been canceled, so many people are spending their time outside in parks or hiking. Martin said anyone spending time outside should take precautions.
"Regardless of what's happening with a viral pandemic, the ticks don't care. They're always there," said Martin. "Every summer, they're looking for a host. If you're spending time outdoors, prevention is the key."
Wear pants and long sleeves, put on tick repellant and do tick checks on your body when you return indoors, especially in the deep, dark places of the body where they like to reside, said Martin.
Preventing Lyme disease is important, but preventing the spread of COVID-19 is even more important, he said.
"We in Pennsylvania have done a great job in bringing down cases. As we reopen, I'm concerned that our counties will shut down again as the cases increase," he said. "We have to be responsible for that. The single most important thing a person can do to help stop the spread is to wear a mask."