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| Image courtesy: The New York Times article labeled 'The Coronavirus: What Scientists Have Learned So Far' |
COVID-19: An Indian Perspective
To begin with I
would like to clarify, this article is not written by an medical expert. This
article is more sort of a compilation of different dos’ and donts’ published
across press media by our respected doctors and health experts. As we
progress in time, new developments can override the existing observations. In
the meantime, the best we can do is to follow the advice of these experts.
A. Where do we stand?
A. Where do we stand?
·
A figure of 6 lac reported cases, testing
nearing to a crore, overall test positivity rate touching to 7%.
·
Reported cases does not translate to actual
cases, so be assured the actual number of infected people is much above that.
·
All the metro cities (i.e. Delhi, Mumbai,
Chennai & Kolkata) are well over the national average in terms of positivity
rate.
·
We won’t see any peak, instead there will be a high plateau (in terms of number of cases).
·
Vaccines are still in development stage; many
have reached in human trial phase. But it will take well more than a year to
have it within the reach of common man without making any special effort.
B. What we have done?
·
The government imposed lockdown, economic
activity dried up, but it was crucial though, we bought time to fight this virus.
It also, lessened the probability of death, as today we are more aware how this
virus behaves, than we were three months back. (e.g. earlier impression was
that the virus only multiplies cell in the lungs, now we are aware of its
clotting nature as well. These findings give doctors better control while
handling severe cases).
·
People of the country, by and large strictly
followed the lockdown. But instances during unlock phases haven’t been that
encouraging, it appeared as if government imposed lockdown for their own interest.
Just remember it was always for us.
·
People of the country has panicked &
overwhelmed the already fragile health care system. And this actually brings us
to the point of our next segment What we should be doing to avoid future miscarriage
of our health care.
C. What we should be doing?
·
On day to day basis we should be following the
checklist of MIDAS.
M- Wear Mask;
I- Stay Indoors if it’s not essential to go outside
D- Ensure social Distancing at populous and work place
A-
Stay Aware, updated with the developments
related to COVID-19
S- Sanitize everything you can (remember soap solution also acts
as sanitizer)
·
Taking cue from the MIDAS, this article is going
to focus on making ourselves Aware of this diseases beahviour (as experienced
till date).
·
CASE 1: Being Asymptomatic
o
On being exposed to COVID-19, if you are
infected yet not showing any symptom.
o
Treatment/ hospitalisation not required.
o
Just remember one can still infect someone else while
being asymptomatic, although contagiousness level might be less (again no concrete
proof for the same). Hence do follow MIDAS.
·
CASE 2: Pre-symptomatics or mild cases
o
This is subset of symptomatic, more of an early
phase of symptomatic but severity level being mild.
o
Symptoms like loss of smell or taste, cough,
fever & body ache.
o
Hospitalisation not required. Medication just to
manage the fever and body ache. Tele consultation can be done.
o
Duration of symptom will last for 2- 3days.
·
CASE 3: Symptomatic moderate
o
Extension of case 2 symptoms topped up with shortness
of breath brings you here.
o
Requires medical attention- not necessarily in
hospital. Intensive Care Unit (ICU) definitely not required.
o
Oxygen supply required to the patient. Portable
oxygen concentrator is one of the solution to it.
o
Practice of Pronation can be beneficial
and may avert the requirement of aggressive medical treatment. [Pronation is exercise
of lying flat on belly, which allows to open the air chambers at back of lungs,
providing more oxygen to your blood].
·
CASE 4: Symptomatic severe
o
Continued shortness of breath in symptomatic
patients turning into abrupt requirement of ventilators.
o
Requires intensive treatment, as ventilator
breathing requires direct connection with windpipe of human body & machine
operation demands expert technician.
As we have gone
through the four different cases, lets see what number speaks for them. It is
expected that for every 1000 infected cases, 3 to 4 will land up to CASE 4, 15
to 20 will experience CASE 3, while the rest will be restricted to CASE
2 & CASE 1.
So its’ prudent
for CASE 1 & 2 people to take care and preserve the limited resource of
healthcare facilities for CASE 3 & 4 people. In fact there have been
examples of Dharavi (Indias’ largest and densely populated slum) & state of
Kerala where hyper-local response and context driven strategy1 has
helped in non-escalation of the situation.
Given the population
of our country being so large it is quite natural that the absolute number of
reported cases of infection, recovery & death will be very large compared
to any other country in the world. The more prominent question should be at
what rate?
Note 1: Context driven strategy is governed by the widespread check of oxygen level saturation in the blood. Based on the results, sorting and segregation being done. People with less oxygen level in the blood (general cut off 95%, severity cut off 90%), being tested and treated accordingly.
Sources: The
Hindu,The Indian Express, BCG reports
