Covid - 19 now into 21 : First Aid and Tips

Do whatever we can to avoid getting infected & if infected, minimize adverse consequences to ourselves & others, Stay away from uninfected contacts.

For all:

Remember The 3 Ws – Wear a mask, Watch your distance, Wash your hands. Wear masks (whenever you are not at home and not alone), physical distancing to the extent possible, and washing hands frequently.

Masks work, and are probably the most important precaution given our current understanding that aerosols are the predominant mechanism of spread. The best is a well-fitting N95 mask, which is now widely available & not too expensive – you could re-use them too.

Physically distance, “the more the better”. 6 feet preferable, but a minimum of 3 feet. Better still, avoid crowds as much as you can. Meet others only if absolutely necessary – most meetings can be done virtually. Good to have outdoor air, and avoid AC and large gathering. 

Wash your hands and use steam inhalers. 

Get your vaccine as early as you can. It gives you 70-80% chance of avoiding getting infected and 95% chance of serious illness. That’s as good as it can get.

Make preparations even before you get infected. Buy a thermometer and a pulse oximeter to keep at home.  These are two important instruments you need in case you get infected in addition to the steam inhaler which you should definitely have.

When to test for Covid

Covid Test can be done at the nearest PHC, private clinic or by calling a diagnostic lab for home visit. 

If you exhibit Covid symptoms: cough, fever, shortness of breath, sore throat, congestion, headaches, body aches, sudden loss of smell and taste, gastric disorders etc.

If you are a primary contact of a Covid-positive person. 

In addition to a Covid Test, consult a doctor (tele-consult if possible) for a clinical diagnosis. 

Note: A contact is a person who is likely to acquire infection from a positive case:

Anyone exposed to a symptomatic Covid case, 2 days before to 14 days after the onset of symptoms.

If exposed to an asymptomatic case, 2 days before to 14 days after the test date.

Once a person tests positive, the rest of the members in the household and those they were in close contact with, are considered Primary Contacts and have to maintain quarantine. If a primary / high-risk contact is asymptomatic, they have to be tested twice — once immediately (Day 0) and after a week (Day 7) after high-risk exposure to a Covid Positive case. If test results are negative, this person must be in a self-reporting period for another 7 days. 

https://m.youtube.com/watch?v=fCIkF6tlKUU&feature=youtu.be

If Tested Positive:

First, don’t panic on getting a #COVID_19 positive report – 98% get through without major issues. Isolate yourself from others. You can do this at home if possible.

Chart your temperature using the thermometer, & your oxygen saturation with the pulse oximeter. Check both 2-3 times/day, the latter before & after a brisk 6-min walk. Make sure you drink enough fluids and keep yourself hydrated. Stay positive – you’ll get through this.

If your baseline saturation falls under 94% or if your fall in saturation before and after the 6-minute walk is 4% or more. Contact a hospital, and start proning yourself (lie chest down, back up)

If your oxygen saturation is fine & you have no symptoms other than fever, all you need is Paracetamol

Home care situation

Asymptomatic, without any clinical symptoms and if the chest scan is normal.

Low to moderate Symptoms – mild fever, fatigue, dry cough tiredness, aches and pains, sore throat, diarrhoea, conjunctivitis, headache, loss of taste or smell a rash on skin, or discolouration of fingers or toes.

If symptoms are not present or are mild, the patient can remain in home isolation under a physician’s care. The patient has to be in a room with an attached bathroom with the door closed, for a period of 10 days.

Hospitalisation

Severe Symptoms – Shortness of breath, loss of appetite, confusion, persistent pain or pressure in the chest, high temperature.

Hospitalisation is required for severe symptoms — frequent fever, cough, Chest CT scan showing lesions. Keep checking Blood oxygen saturation levels (SpO2) with a pulse oximeter – SpO2 level below 90% needs urgent treatment.

There is no evidence to suggest that anything helps – including Favipiravir/ Ivermectin. Don’t waste your time desperately trying to procure them. What definitely works is proning and oxygen (when saturation is low), and steroids (Dexamethasone) for moderate to severe disease. Some are allergic or will have side effects with Dexamethasone, check with doctor, if you have terrible headache, unable to sleep etc. 

Please allow your physician to decide when Remdesivir/ Tocilizumab & ConvalescentPlasma is required – there are very limited situations when they are beneficial & please don’t pressurize them to prescribe it – much of the shortage today is because of unnecessary prescriptions.

If you have severe breathing problem, you would be given oxygen, and based on severity moved to ICU. When in ICU if the condition deteriorate, you are moved to Ventilator and put on IV or NIV

Pronal or Ventilator breathing, help increase the oxygen level in couple of minutes. Its done by lying down on your abdoman, keeping a pillow below your chin, and with head slightly head high, and another pillow under your leg if needed. This is the most important first aid.

Ensure you have sufficient Vitamin C and Zinc. You can get it from Egg, Milk, and Gooseberry. Those who are diabetic/sugar, are low in zinc and so it's dangerous. Drink plenty of hot water and hot milk.  

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Just saw Doctor’s round table on India Today Channel having 4 highly reputed Doctors panel. It was very informative & I would like to pen down few important points made by these qualified Doctors :

1) Plasma therapy is not at all recommended in the 2nd wave by WHO or any other Organisations around the World. It is waste of time & money.

2) If needed, CT scan of lungs to be done between 5th to 7th day, otherwise report may be misguiding.

3) No need of any Medication in the 1st week of infection, except Paracetamol (if fever persists) along with Multivitamins & Zinc. In case of Fever Paracetamol should not be taken SOS but regularly in 6 hourly interval.

4) If symptoms continue, Condition worsens in 2nd week between 7th & 10th day, so pl. keep close monitoring on Oxygen level, Coughing frequency, Pulse & Temperature.

5) If Condition worsens in 2nd week, without wasting time start treatment with Steroids in consultation with Doctor. Steroid treatment is the most effective way of treating Lungs infection.

6) Oxygen concentrator of 5L is not suitable, as they probably cannot bring back Oxygen saturation above 94 continuously. 

7) Proning is now officially approved method for improving Oxygen level.

8) Positive persons after becoming negative are safe from infection for next 90-180 days.

9) Positive persons should take their 1st or 2nd Jab after 90 days of becoming negative, as they have sufficient antibody for next 90 days at least.

10) Condition of young people in the age group of 30-45 yrs. worsens suddenly as they have strong capacity to hold back till a point and thereafter collapses suddenly. Close monitoring is essential and each passing day is crucial.

* Good points to be taken care by everyone * 

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