India is going through a very difficult period, because the caseload has overwhelmed our healthcare system. There are shortages of hospital beds, oxygen and some key medicines required to treat critical patients. It is important that as a medical fraternity we work closely with the government in reducing the caseload and managing patients at home effectively to reduce the pressure on hospitals.
I have also seen medical practitioners globally questioning the anecdotal evidence of the start of the second wave with the vaccination drive in various countries. In my opinion, we should recognise this and maybe modify our process till quality research emerges on this topic.
The movement from mild to moderate to critical stages of Covid in patients is driven by their immune response. A large section of Covid-infected patients tend to be either asymptomatic or have such mild symptoms that they see no reason to test. In such patients, their immune response is able to tackle the virus effectively. If such positive patients are vaccinated by adding a new vector, we can overstimulate their immune response leading to the patient becoming moderate or severe. I would advise the authorities and the public to consider taking a RT PCR or antigen test to ensure they are negative prior to vaccination. This could reduce the caseload.
I would urge patients who have tested positive for Covid to track their temperature and oxygen saturation every 6 hourly. They should also lie in the prone position (on their stomachs for 8-10 hours per day), as this helps open up the lungs and improves oxygen saturation. They should consult their physician if either temperature sustains over 100 for 4-5 days or their oxygen saturation declines by 3% from their baseline level or if they have significant other comorbidities. Their physician at that stage based on clinical examination ask for a chest CT scan and some blood tests. And start other medication if the test results warrant.
Most recover from Covid quite easily and it is important for people to not stress. They should be vigilant and track their temperature and oxygen saturation regularly and visit their physician on time. Most Covid complications arise from treatment being delayed.
(Dr Samrat D Shah is a consultant internist at Bhatia, Reliance HN, Jaslok, Saifee Hospital in Mumbai. He is also a consultant internist to the Governor of Maharashtra.)
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