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Coronavirus Disease-19: Information for Asymptomatic, Unsure, Persons with mild symptoms and Persons with partial or complete Vaccination

This is a public Information and Education Resource. The information in this resource may change as the disease evolves. This document does not replace any national or state guidelines and does not replace any medical advice. Always consult your doctor before any treatment.

Q 1: Can I Prevent Coronavirus infection?

Medicines or tablets or injections to prevent coronavirus are not available. Vaccines have recently come out and are currently advised for adults. The Vaccine will not prevent getting the infection or spreading the infection but will help to reduce the severity of infection if you get Coronavirus.

Only strict handwashing, proper mask, and social distancing can

prevent the spread of Coronavirus.

Avoid Social Gatherings and Public Functions, group settings and minimize movement outside the house unless it is necessary.

Q 2: Can I Know if a Fever is because of Coronavirus?

It is difficult for a doctor to identify if a fever is only because of Coronavirus. It is better to consider Coronavirus as a cause if there is a fever, cold, running nose or cough especially if there is a history of contact with a person who had Coronavirus or travelled to a place where Coronavirus is common.

In the current situation, it is better to consider Coronavirus as a cause unless it is proved otherwise.

Q 3: What are the common Symptoms of Coronavirus?

The most common symptoms of coronavirus include.

  • Fever that lasts for more than 3 to 5 days,
  • Running Nose that lasts for more than 3 to 5 days.
  • Cough that can be mild or severe, dry or with sputum that lasts for more than 3 to 5 days,
  • Body Pains
  • Abdominal Pains
  • Loose or Altered Stools
  • Vomiting
  • Redness of eyes
  • Altered sensorium or loss of memory, disorientation, irritability,
  • Shortness of breath

Q 4:  When should we test for Coronavirus? (Check latest national and state guidelines)

  • If you have symptoms of Coronavirus that last for 3 to 5 days
  • If anyone in your family has Coronavirus
  • If fever continues beyond 3 to 5 days

Do not wait to test or for test results.

Isolate yourself and quarantine at home.

  • If you are asymptomatic but have been in contact with anyone who had Coronavirus
  • If you have mild symptoms and are unsure if you have contact with Coronavirus

Q 5:  What test should we do for Coronavirus?

  • Reverse transcription-polymerase chain reaction (RT-PCR) for coronavirus disease -19 (COVID-19) and PCR-based nucleic acid amplification test (NAAT) are the preferred tests.
  • Rapid antigen test (RAT) can be done, and a positive test is considered confirmatory. However, a negative test needs further confirmation by PCR.
  • Chest CT scan or Radiology Studies are not a routine test for COVID and should only be done when recommended by your doctor. Your doctor may recommend chest CT scans if you have a persisting cough, upper respiratory signs and shortness of breath

Q 6:  Are the tests for Coronavirus Accurate?

Every test or investigation can have a false positive result or a false negative result. A result is considered false positive if it identifies a person incorrectly with Coronavirus. A result is considered false negative if it identifies a person as normal when the person has Coronavirus.

The tests want to reduce false negatives so that they do not miss people with Coronavirus. In that process, it is possible that the tests may identify more people as false positives.

However, a false positive is not a major worry in the pandemic as they will be identified soon as non-coronavirus patients. A false negative is more concerning as they can spread the disease as they consider themselves unaffected.

Q 7:  Should I get a CT scan?

A computed tomography or CT scan should be done only on the recommendation of a doctor. Do not walk into a diagnostic center to get one yourself.

 The doctor will advise a CT scan only if there are moderate symptoms and if the disease is progressing clinically and based on oxygen saturation. A CT will not be advised if you are asymptomatic or have only mild symptoms.

The doctor recommends the CT scan to see if there is mild, moderate or severe lung involvement and will decide the medications you need based on that.

The ideal time for a CT is 5 to 7 days. A CT scan before 5 days is not useful (unless you are in a moderate to the severe stage already).

Q 8:  Should I take steroids?

DO NOT take steroids unless a doctor advises you to. Steroids are useful only if they are given at the right time and the right doses. More than necessary doses of steroids can lead to complications and increase severity of the condition. Taking steroids before necessary or later will also increase severity of the condition.

Talk to your doctor if you feel any shortness of breath, difficulty in breathing, chest pain or if symptoms do not subside in 3 to 5 days.

Your doctor may advise steroid inhalation, or as tablets or injections based on your condition.

DO NOT SELF MEDICATE

Q 9:  Should I take Remdesivir?

DO NOT take Remdesivir unless a doctor advises you to.

Remdesivir is recommended as an investigational and experimental medication only in certain conditions.

Remdesivir is to be given only in a hospital setting and is not meant for home use.

Remdesivir is an antiviral medication that has limited use in the management of Coronavirus. The medication can help reduce the number of days of hospitalization by a few days but does not impact on mortality, and other important outcomes of the disease

DO NOT SELF MEDICATE

Q 10:  Should I take Oxygen at home as a precuation?

DO NOT take Oxygen unless a doctor advises you to.

Only a small percentage of patients will need Oxygen. About 85 to 90% of persons with COVID will be asymptomatic or have only mild symptoms.

Your doctor will advise you oxygen if your symptoms are worsening and oxygen saturation is falling. They will remove you from oxygen supplementation when your oxygen saturation improves.

DO NOT SELF MEDICATE. DO NOT TAKE OXYGEN ON YOUR OWN WITHOUT MEDICAL ADVICE

Q 11:  Are there serious problems with Coronavirus?

We must understand that Coronavirus can lead to serious complications. However, only a small percentage of people develop serious complications. 1 to 5 of 100 people with Coronavirus may develop serious complications and need intensive care admission.

Some groups of people are more at risk for severe complications.

  • People with co-existing diseases like heart, liver, kidney diseases
  • People with low immunity due to immune diseases, medications, cancers
  • Obesity and Metabolic Syndromes including diabetes, high cholesterol, hypertension that can alter immune states and defence mechanisms of the body.

Q 12:  Can I self- medicate if I have Coronavirus?

  • NO
  • Do not take any prescription medicine by purchasing from a medical shop.
  • Take a paracetamol 500 mg if you have a fever.
  • Steam inhalation if you have a running nose or cough. Avoid any high-pressure methods for steam inhalation. Make sure you inhale only for short periods.
  • Take cetirizine if you have a running nose or cough.

AVOID the temptation to self-medicate yourself with steroids or antibiotics.

Q 13:  What should I do about Coronavirus?

  • Take it seriously.
  • Anyone may get Coronavirus.
  • Do not panic or become afraid.
  • You may not be able to avoid getting Coronavirus, but you can do things to help your body adapt to Coronavirus or minimize effects of Coronavirus on your body.

Remember:  

Your body has natural defence mechanisms to protect you. They have protected you for as long as you have lived. Trust your body.

Fear reduces immunity and reduces the ability of your body to fight back.

Only a small percentage of people progress to severe disease, so remain positive.

Q 14:  Do I have to wear a Mask?

  • YES.
  • Choose an N95 or medical grade mask. If you do not have this mask, use two masks (double mask).
  • Wash your hands with soap and water before and after you wear the mask.
  • Touch only the ties (the part that you wear on your ears) of the mask.
  • The mask should cover your mouth and nose.
  • Make sure you can breathe through your mask.
  • Do NOT remove your mask to talk.
  • Lower your mask while eating or drinking.

Q 15:  Do I have to maintain Social Distancing?

  • YES.
  • The virus spreads through the air. Keeping enough distance reduces the chance for the virus to come from another person through air and droplets.
  • Small droplets are released into the air when we speak, laugh, cough, sneeze and breathe.
  • Keeping distance and wearing a mask can help reduce the chance for these droplets to infect you

Q 16:  Do I have to wash hands often?

  • YES.
  • Wash your hands, feet, face with soap and water.
  • A sanitiser is good to use, however, a good wash with soap and water can also affect the virus.
  • Wash your mask after you go out with soap and water.
  • Take a bath with soap and water after you go out.
  • Do not touch your face or nose before you wash your hands.

Q 17:  What other Precautions can I Take?

  • There are many precautions you can do with material that is often available in many houses and at low cost.
  • These precautions will not prevent you from getting infected with Coronavirus. However, they will help the natural defence systems of your body to fight back.
  • The most important precaution you can do is to use your common sense and avoid risky behaviour saying: “Nothing will happen or chalega, it is only a short time or once”.

STOP THE FEAR

  • It is natural to be afraid when all the news about Coronavirus is about death, funeral pyres and ventilators, lack of oxygen and lack of hospital beds and care.
  • However, remember that ONLY a small percentage of people with Coronavirus need admission to a hospital or intensive care.
  • Most people are asymptomatic or have mild symptoms and recover.
  • THIS DOES NOT MEAN THAT WE TAKE THE VIRUS LIGHTLY. ACKNOWLEDGE THE VIRUS. RESPECT IT. BUT DO NOT BE AFRAID OF IT.
  • Fear reduces the ability of your body to protect itself.

IMPROVE THE DEFENSE MECHANISM OF YOUR BODY

  • You can improve the natural defence mechanisms of your body without any additional cost through some lifestyle changes.
  • Each of these changes is low cost, easily doable, can be done at the comfort of your home and do not take much time.
  • These changes will work on the natural defence mechanisms of your body and help it to fight back.

THINGS YOU CAN DO- BUILD A DAILY ROUTINE

  • Wake up early and at a regular time.
  • Watch the Sunrise
  • Listen to the birds or the sounds of nature,
  • Stand near a window and breathe some fresh air,
  • Listen to some soft music, chants, hymns.
  • Relax. Breathe in and out gently without any effort or count. Let it flow and settle into a natural rhythm.
  • Do some light exercises- Yoga stretches, walking, cycling
  • Meditate if you follow any particular form or just sit calmly and watch around.
  • Keep all windows open. Let the air flow freely. Avoid/Minimize AC.

Remember: Your phone or computer does not crave your attention as much as you crave for its attention. Let them be.

THINGS YOU CAN DO- DIET

  • Eat Smart, at fixed intervals and in moderation.
  • Drink enough water.
  • Your diet can help your body fight back. Eat in moderation.
  • Avoid oily, deep-fried, salty, very sweet food, aerated drinks, processed foods.
  • Reduce Salt and Sugar if you cannot avoid them.
  • Use Turmeric- add crushed black or green pepper when you use turmeric (Pepper helps the absorption of turmeric)
  • Use Neem Powder. Can mix with a drop of Honey, or a jaggery piece and Turmeric.
  • Common Kitchen spices like Jeera, Methi, Cinnamon, Clove, ginger, garlic are useful to boost immunity.
  • Eat Green leafy vegetables and seasonal fruits.
  • Eat locally available, locally grown food and eat freshly cooked homemade food.

THINGS YOU CAN DO- DIET

  • You can take dry fruits if you wish but can replace them with pumpkin seeds, melon seeds, sunflower seeds. Take Guava.
  • Take Gooseberries if they are available, Gooseberries soaked overnight in Honey and Pepper are very useful. If honey or pepper are not available, raw fresh or dried gooseberries are also useful.
  • If gooseberries are not available, consider consuming Chavanyaprash. There are plenty of brands of Chavanyaprash available and choose a brand carefully.
  • Ragi and Millets provide plenty of nutrients and fibre.
  • Buttermilk and Curd provide probiotics and healthy bacteria and help the gut.
  • Fermented Foods help improve the health of the gut.
  • Sprouts help antioxidant status.

THINGS YOU CAN DO- DIET

  • Eat an early Dinner. Preferably between 6 and 7 pm or latest by 730 pm.
  • An early, balanced light dinner of fruits, salads, seeds, nuts, lentils, vegetables give your body enough time and material to repair your body. This provides the body with all the vitamins and minerals needed like vitamin A, E, B, Zinc, Selenium, Calcium etc
  • Your body repairs itself while you sleep and if we provide the body with material and time, it will work to heal itself.
  • Most Hormones work optimally around midnight to early morning. Give them a chance.
  • Eat breakfast around 730 am. That gives you nearly 12 hours of fasting as well.

THINGS YOU CAN DO- EXERCISE

  • Do some light exercises.
  • You want the body to move and to produce some sweat.
  • You do not have to do a lot of gym stuff or heavy duty lifting.
  • Yoga gives you a perfect blend of stretches, movements, resistance, flexibility in a self-paced slow and steady manner that allows you to listen to each part of your body.
  • Listen to your breath and breathe naturally.
  • Practice a few basic pranayama techniques including deep inhalations and exhalations.,
  • Build hobbies to engage your mind. Less of TV, digital devices, more of observing and enjoying nature.
  • Help in household chores-Sweeping, Mopping, Cutting Vegetables, Washing Utensils are all good and light exercises that make your spouse smile as well.

What do I need if I am doing Home Care?

  • Pulse oximeter
  • Thermometer
  • Nebulizer- if possible
  • Gloves (for anyone helping you)
  • Masks (for everyone at home)
  • Hand sanitizer
  • Disposable garbage bags
  • Well-ventilated room – windows open, fans on
  • Separate bathroom
  • (Remember: clean your thermometer and pulse oximeter after every use)

How do I know my symptoms are worsening?

  • If Oxygen Saturation is > 94%, you do not need admission. Keep Checking Pulse and Temperature every 6 hours. Take Paracetamol Tablet 500 mg (1-2 tablets) every 6-8 hours.
  • If Oxygen Saturation is 92% to 94%, keep checking pulse and temperature every 4 hours. Take Paracetamol 500mg 2 tablets every 6 hours. Minimize activity and avoid heavy activity. Rest and move around. Be in a prone position when you lie down and change sides every 2 to 3 hours. Do not always lie down, move around. Steam inhalation. Drink plenty of fluids (consult a doctor if you have kidney or cardiac problems)
  • Respiratory rate <24/ min, Saturation >92-96%, Patient does not feel breathless indicate improvement.
  • If Oxygen saturation <90%, respiratory rate >24/minute, the patient feels breathless, CONSULT DOCTOR WITHOUT DELAY. DO NOT SELF MEDICATE. FOLLOW THE ADVICE OF THE DOCTOR

I am Vaccinated. Am I protected?

  • The current vaccines only reduce your chance of getting a severe disease.
  • You can still get Coronavirus even if you are vaccinated.
  • You may still transmit the disease even if you are vaccinated.
  • You must maintain social distancing even if you are vaccinated.
  • You must wear a mask even if vaccinated.
  • You must wash with soap and water even if vaccinated.

STAY SAFE. STAY HEALTHY

  • Listen to your body and work with it to help you. After all, it has helped you all these years, so give it the tools to help you.
  • Change lifestyles.
  • Do not panic or fear. Most people recover although they may have some discomfort.
  • Do not be afraid of quarantine. Use the chance to become friends with your body again.

WE CAN IMPROVE OUR PROTECTION WITH A LITTLE SELF EFFORT AND LET THE HEALTHCARE RESOURCES BE AVAILABLE FOR THE SEVERE OR VERY SEVERE PEOPLE WHO NEED IT.  THAT ITSELF IS A GREAT HELP TO THE OVER STRETCHED MEDICAL RESOURCES.

Dr Praveen Nirmalan

Written by Dr Praveen Nirmalan

Dr. Nirmalan did his basic medical education from Thrissur, Kerala and followed it with a PG Diploma in Ophthalmology from Aravind Eye Care System, Madurai and a Vitreo-retinal Fellowship from Mumbai. Subsequently, he completed his MPH and a Public Health Ophthalmology Fellowship from the Johns Hopkins School of Public Health in the USA. He has led community-based and clinical research in some of the top eye care institutes of India and led a clinical research program at a top tier obstetric and neonate institute as well. He has experience chairing Ethics Committees and has helped with the setting up of Institutional Review Boards. Besides mentoring clinical faculty, he has mentored DNB and PhD students through their dissertation work and research methods.

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