POST COVID MEASURES


लेखक : लेखापढी      १० भाद्र २०७८, बिहीबार १४:४५ मा प्रकाशित     
POST COVID MEASURES
In this alarming situation of the world, the topmost priority should be given to health. Undoubtedly, it is true Health is the greatest wealth. Humans are ranked as the most civilized being on earth, so we must act with our conscious minds. The COVID pandemic is a threat to mankind and it’s a fight for life when you suffer. It is a matter of great concern to take precautions and get early prevention against this havoc. It goes beyond doubt that the spread of this Nobel Corona Virus is increasing tremendously day by day.

Monitoring blood oxygen level by a pulse oximeter, 6 hourly. If reading 94% or higher, nothing to worry about. If the reading drops 94%, start deep breathing exercises (Pranayam). Lie on your tummy (not on your back) for as long as you can; this is likely to improve your oxygen level. If oxygen level not getting better, see if you can do a six-minute walk test(see below). Please note that the period in which oxygen levels may fall is generally from day 5 to day 11 from the date of onset of the first symptom. If lying in the prone position for six minutes does not improve levels above 94%, you need to see a doctor, and you may need supplemental oxygen.

In this high time it is very essential, also to know about the post covid measures. Prevention is better than care, nonetheless, we can’t stop the inevitable part. Take a look at these post covid tips as per the 
consensus guidance of AIIMS-trained specialists  on the treatment of COVID 19:
(A) General Care
1. Strict isolation at home. 
2. Monitor your temperature six hourly.  If the temperature rises above 101, take tab paracetamol 650mg.
3. Monitoring blood oxygen level by a pulse oximeter, 6 hourly. If reading 94% or higher, nothing to worry about. If the reading drops 94%, start deep breathing exercises (Pranayam). Lie on your tummy (not on your back) for as long as you can; this is likely to improve your oxygen level. If oxygen level not getting better, see if you can do a six-minute walk test(see below). Please note that the period in which oxygen levels may fall is generally from day 5 to day 11 from the date of onset of the first symptom. If lying in the prone position for six minutes does not improve levels above 94%, you need to see a doctor, and you may need supplemental oxygen.
4. Normal diet (Patient with comorbidities need to continue to follow illness-specific dietary restrictions).
5. Drink sufficient fluids (Patients with comorbidities need to adjust fluid intake as needs to be for each specific comorbidity).

(B) Blood Tests: 
Normally no blood test is needed in mild cases. In those with severe symptoms (high fever, severe diarrhoea, severe fatigue etc.) but good oxygen levels, the following tests may be done (fasting) as a baseline:
(a) CBC, (b) CRP, (c) LFT.

(C) Treatment: 
There is no specific treatment for COVID 19 infection. Only, treatment for relief of symptoms is needed.
(a) For fever/body pains/headache: Paracetamol SOS.
(b) Sore throat: warm saline gargles.
(c) Throat irritation, sneezing or running nose: Tab Cetirizine (Zyrtec): One tab once a day 
(d) Dry Cough: Tab Montair LC; one tab per day
(e) Wet Cough (with phlegm/sputum): Bro-Zedex Syrup,  1 or 2, teaspoons thrice daily.
(f) Loose motions: 
• Take Electoral Oral Rehydration Powder, as many times as needed; 
• In severe diarrhoea, Tab Imodium 2 mg as needed.
• Also take Curd, at least once a day.
(g) General immunity boosters:
a. Tab Zinc 50 mg (Tab Zirconia) for 15 days.
E. Those with co-morbidities such as obesity, diabetes, high BP, asthma, kidney disease, smokers, chronic chest diseases, history of lung tuberculosis, etc):
Continue all medicines already being taken for chronic illnesses like high BP, diabetes, thyroid illnesses, asthma, cancer, arthritis, etc. You have to go by the advice of your treating doctor. You may be advised to do the following tests by your doctor -: Serum Ferritin, LDH, D-Dimer, Interleukin 6.
Just to repeat, those above 70, and those with diabetes and other co-morbidities, go as per your doctor’s advice.
F. Need for HRCT chest: Those with normal (>94) oxygen levels do not need HRCT of the chest. It is to be done only if oxygen consistently remains below 94, or there is severe breathlessness. CT score being done these days may have interpretation issues, and hence do not get alarmed. Abnormal blood tests alone is NOT a reason to do CT.
G. Note:
(A). Please do not give/take Fabiflu (Favipiravir) Doxycycline, Ivermectin or Azithromycin. None of these has any proven role. These may harm the patient as all medicines have side effects. The most common side effects of most drugs are nausea, vomiting, abdominal pain, loose motions.
(B) Steroids (Medrol/Dexona) is prohibited and dangerous for those with normal oximeter reading. Only those who need more than 3L/min supplemental oxygen support should receive a short course for five days. Early start of steroids (practised by some) in our opinion, can make the condition worse.
(C) Neither Inj Remdesivir nor convalescent plasma is of proven value. So do not worry too much if these cannot be arranged. Neither of these will change the outcome.
(D) The oxygen saturation level seen in the finger oximeter is much more important than blood tests or HRCT findings. This is the key to the management of Covid 19. 
This is the simplified and basic guidance for patients and their family doctors. It is based on the consensus of five AIIMS-trained specialists with over 40 years of practical experience in each. Every patient should take treatment for COVID 19 as per the instructions of a competent doctor.
How to measure oxygen level: Put the oximeter on the right (dominant) hand’s middle finger. First, cross-check the functioning of the finger oximeter by test readings on other members of the family/caregiver. Check both at rest and after walking around the room for six minutes. Those who cannot walk for six minutes should try and walk for three minutes at least. 

Summing up, these were the post covid measures that are the must regarding the world’s present situation. This situation is a global problem. Also do get vaccinated as vaccination is a mandatory method for prevention. Take on immunity boosters and a balanced diet. Consume warm fluids as much as possible. Sanitize and disinfect from time to time. Proper disposal of masks is very essential. Regular exercise and yogas are musts.
Stay Safe and healthy.


Kajol Shah
Pursuing Bachelor of Dental Surgery at BP Koirala Institute of Health Sciences.
Resource: From Covid emergency at AIMS 

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