McXtra Care | Spl. Edition Update: COVID-19

Understanding Coronavirus Disease



The illness called COVID-19 (Coronavirus Disease) is caused by the virus designated 2019-nCoV (also called SARS-CoV-2), which is a novel strain of the Coronavirus group first seen China in December 2019.  COVID-19 is similar to Viral Flu. From the time of getting infected, it can take from 2 days to 2 weeks to manifest definite and recognizable symptoms (incubation period).

Initial symptoms include sore throat, cough and fever which may be accompanied by nasal congestion, running nose, loss of smell, sneezing, headache, fatigue, body pain and rarely vomiting or diarrhea. The virus can spread to the lower respiratory tract and lungs in about 4-5 days and can cause Bronchitis and Pneumonia which manifests as breathlessness in addition to the other symptoms.

Death occurs due to ARDS (Acute Respiratory Distress Syndrome) or respiratory failure resulting from massive inflammation and damage (fibrosis) of the lung, and sepsis leading to multi-organ failure (including Heart and Kidney failure). The overall mortality rate from COVID-19 is around 2% (<1% below 50 years of age). Risk of serious disease, complications, and death is higher and seen far more in older patients (>60 years) and those suffering from other underlying medical illnesses like Diabetes, Hypertension, Cancers, and diseases of the Airway/Lungs, Heart, Kidney, Liver or Immune system.

The 2019-nCoV is transmitted between humans through droplets emitted from infected individuals through coughing, sneezing, spitting or talking. One gets exposed to these droplets by coming in direct contact with infected persons, infected surfaces, and suspended droplets in the air when at close proximity (about 1 meter) of an infected patient. The virus can remain on metal surfaces and fabric for around 12 hours.


How to test for Coronavirus?


A cotton swab sample from the nose-throat and/or mouth-throat junction (nasopharyngeal and/or oropharyngeal swab) is taken to test for the presence of COVID-19 in an individual. A person is said to be positive for active COVID-19 if the presence of the nCoV-2019 Coronavirus is confirmed in the swab sample by a test called RTPCR (Real-time Polymerase Chain Reaction). India has over 125 designated government and over 50 private testing hospital/labs for COVID-19 with facility for collecting samples from home, and through kiosks. It usually takes 1-2 days for getting the test results, however faster / rapid tests is now approved in India to shorten average testing time to under 2.5 hours.

People in the below categories should be tested as soon they develop COVID-19 symptoms (fever with cough or breathlessness), and if asymptomatic, should be in 14-day self-quarantine to observe for symptoms.

  1. Traveled in last 14 days to a COVID-19 affected country
  2. Had contact with a symptomatic person who has traveled in last 14 days to a COVID-19 affected country.
  3. Had contact with a lab confirmed COVID-19 positive case.

In addition, hospitalized patients with severe acute respiratory symptoms, influenza like illness or pneumonia are to be tested for COVID-19. Asymptomatic people living in the same household as a COVID positive case should also be tested, as they carry high risk of contracting and transmitting infection.

Another test for testing antibodies to 2019-nCoV in blood (serological test), has been developed and approved in India. This will help in screening in high risk areas/hotspots, detect infection whether active symptomatic, or asymptomatic carriers, and also help to assess the immunity developed to the virus.


What are the treatments for COVID-19?


There is currently no specific drug/medicine available for COVID-19. All active cases should be placed in strict isolation. Mild cases recover with symptomatic treatment, maintaining hydration and nutrition, and clinical monitoring.

Some drugs which were specifically developed and approved in the past for other infections like Hydroxychloroquine (anti-Malaria) and Azithromycin (antibiotic) and in specific cases Lopinavir, Ritonavir (anti-HIV) are being used in certain COVID-19 patients in India. However large clinical trials are yet to confirm the generalized effectiveness of all these drugs in managing COVID-19, and these drugs can have side effects that need to be clinically monitored, especially when given in combination. Therefore, as of now, these drugs are being used by doctors in some of the COVID-19 cases depending on patient type, disease severity and presence of associated medical conditions. Most importantly, none of these drugs should ever be taken without the prescription and monitoring of a qualified physician. Serious cases need oxygen therapy and may also require ventilator and life support.

Currently all COVID positive cases were being hospitalized in India in designated government hospitals and apex institutes, along with some private hospitals also being commissioned recently. However going further, to prevent overwhelming and overloading of healthcare workers and facilities, a triple level of isolation will be seen coming into play in India, with patients having mild symptoms and no risk factors or pre-existing medical illness, isolated in COVID-Care Centers, (self-care/basic care repurposed stay centers like hostels, lodges, stadia, guest houses, etc.) and Moderate and Severe cases having breathlessness in COVID isolation wards in Dedicated COVID Health Centers or Hospital blocks/Hospitals with oxygen and life support/ventilator availability. Severe high-risk cases will be kept in COVID hospital ICU.  Patients will be discharged once they test COVID negative, asymptomatic and stable.


Important precautionary-preventive measures for the Public for COVID-19


Here are important points of care for COVID-19 caused by the novel strain of Coronavirus 2019-nCoV (also called SARS-CoV-2):



  1. Clean hands frequently- Wash hands with soap for 20 seconds or use alcohol (at least 70%) based disinfectant hand rub or sanitizer.
  2. Cover nose and mouth with disposable tissues, napkins, handkerchief or elbow/sleeve while coughing/sneezing (after that wash hands or use sanitizer immediately). Discard tissues in a closed bin.
  3. If using handkerchiefs or non-disposable cloth, wash after use in warm water and detergent.
  4. Avoid touching your face, eyes, nose or mouth as much as possible.
  5. Mask is to be compulsorily worn if suffering from cough or fever, while visiting a healthcare facility, caring for an ill or symptomatic person, and by close family contacts of suspect/confirmed COVID-19 cases. A triple layer mask (changed 6 hourly and immediately when wet) with colored side out should be used.  All others can use a homemade/cloth mask (washable/re-usable) when unavoidably going out.
  6. Avoid unprotected contact with wild/farm animals. Preferably consume all meat only after cooking.

Social Distancing:

  1. Avoid contact with cases suffering from fever, cold or cough.
  2. Avoid contact with people who have returned from COVID-19 countries, for 14 days.
  3. Avoid shaking hands or hugging socially.
  4. Stay home as much as possible. Avoid all non-essential travel, social visits and being in large groups or crowded places.
  5. While outside for essential work, try to keep a distance of 1 meter from other people. Do not spit on the road.

Community Responsibility:

  1. If you have come back from overseas travel from any country where cases of COVID-19 are present, a 2-week self-quarantine to observe for symptoms is a must. If symptoms appear, inform your country’s health-line number for getting tested.
  2. Do not panic, or spread panic or fear. Do not forward or share medically non-validated or unconfirmed news, articles or guidance on COVID-19
  3. Always follow and adhere to your government’s health advisory and recommendations.
  4. Respect and Cooperate with Health Care Workers and ensure their smooth functioning and duty execution not only in hospitals, health centers, and labs but also in your premises, residential complexes and locality during sanitization, quarantining implementation or contact tracing activities and collecting swab/blood for testing.

Self & Family Care:

    1. Maintain a nutritious and healthy diet, for maintaining optima immunity.
    2. Drink water regularly (a glass every half hour or so). Be well hydrated at all times.
    3. Put in place a regular daily indoor exercise regimen for at least half-hour like stretching exercises, walking on treadmill, cycling, yoga, or aerobics. Every morning take a few deep breaths and hold for 10-15 seconds and release.
    4. Spend time with family members especially children and guide them on hygiene, social responsibility, and care.
    5. Get 8 hours of regular sleep on most nights
    6. Indulge in relaxing and destressing hobbies like music, dance, reading, crafts, painting, and indoor games
    7. Take special care of the elderly in the house, and those with medical issues. Keep emergency and health-line numbers handy, and ensure they are getting their medication on time.
    8. Keep the home clean and well ventilated.



Dr Varsha's blog link


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