The Covid-19 Pandemic

The Covid19 Pandemic:How to Adapt our Lives Now and Lead a Happy Healthy Life

Would you like to lead a healthy, fit, and useful life in this COVID-19 pandemic? That’s a question everyone wants an answer to because the pandemic never seems to be letting up.

For the last 12 months, we all have been bombarded with the same word-COVID-19- over and over again on all the media channels. Today, we are all really ‘Sick’  of-

• Hearing about COVID-19
• Listening to the loss of our near and dear ones, including friends, due to the disease
• The fear with which we are living our day-to-day life

Is it ever going to end, or are we being compelled to being living with COVID-19 forever?  These questions linger in the minds of almost all the patients that I see daily in my clinic.

What has been the situation so far due to the COVID-19 pandemic in the city where I am living?

I live in Navi Mumbai, a place named Vashi. In the early days of the COVID-19 pandemic, there were a few cases and much fewer deaths. In the past 6 months, the situation changed drastically- the number of positive cases just shot up. And the number of deaths also shot up.

What has been my experience so far?

As the days progressed from January 2020, the number of cases all over India started spurting to unprecedented levels. Initially, in the early days of COVID-19, I had written 2 articles{ read here-1, 2 }.

Those were early days, and I had assumed that this disease would peter out like its other cousins- SARS-1 and MERS. But I [and the whole world, for that matter] was wrong. The disease, instead of declining, started climbing with unprecedented speed causing immense damage to the economy as well as the lives of the family who had patients amongst them. You can also say that this is the worst ever pandemic of the century, after the Great Spanish Flu of 1918, where millions had lost their lives.

Here, in this article, I am going to share my experience with one of my patients. This will help you to understand what happens when you suffer from a Covid-19 infection.

Case study of COVID-19:-

Mrs.SS, a 56-year-old lady, visited my Clinic in the first week of September 2020. At that time, it was raining very heavily in Navi Mumbai.

This lady had-

• High temperature-102.5°F
• Cold
• Sore throat
• Cough
• Pulse Oximetry reading-SpO2-98%

At this stage, her chest examination was found to be normal. With 2 days of treatment with paracetamol, anti-cold medicines, and an antibiotic, her temperature was back to normal. But, on the third day, she started complaining of-

• Severe weakness
• Breathlessness
• Pulse Oximetry reading -SpO2-had dropped to 85%
• Dry hacking cough which was making her feel very sick

I ordered the following investigations-

A] Fever Panel-

This investigation consists of the following tests-

• Complete Blood Checkup-this showed a high total white blood cell count with reduced lymphocytes. 
• C- reactive protein[ a marker of inflammation] very high- it was 45( normal range 0 to 6). This suggested a severe infection in the body.
• Increased levels of liver enzymes- Again, signs of severe infection, mostly of the liver.
• Widal test – negative for typhoid
• Malaria parasites- absent in the smear.

B] RT- PCR test

This the test which determines whether one is infected with the Coronavirus. The full form of RT-PCR is the Reverse Transcriptase Polymer Chain Reaction test. You can watch this short video to know more about the test- click here

In this patient, it was negative.

C] Pulse Oximetry-[discussed below]

The oxygen level- SpO2- of this patient when she visited for the first time was 98%. Gradually, by the 3rd day, her SpO2 level came down to 85% and appeared as if she was gasping for oxygen.

D] Chest  X-ray

This showed changes of pneumonia.

E] HRCT of Chest

This test is a high-resolution CT- scan of the lungs and the chest. It showed the presence of round glass pneumonia [similar to the image shown below]

After proper assessment,  this patient was referred to a COVID-19 Center, where she was admitted for approximately 14 days and treated with medication 💊 for Coronavirus.

F]The  After- effect of treatment –

This patient was admitted to the hospital, and she received treatment and attention for about 14 days. There she was treated for ‘cytokine storm'( discussed below). She was administered these medications-

1. Antiviral injection Remedesvir by intravenous route- 1 dose per day for 6 days.
2. Injection Sepsivac- an immunomodulator to neutralise the excess antibodies in the body and tackle the cytokine storm. This was given subcutaneous( underneath the skin) at 3 places for 3 consecutive days.
3. Steroid injections – to reduce swelling inside the lungs.
4. Antibiotics
5. Cough syrup.

The side-effects-

Now, these medicines have their own side- effects. This patient developed-

1. High blood pressure – the blood pressure had shot to 200/ 120 mm of Hg when she visited my clinic again after discharge from the hospital.
2. Hyperglycemia- her random blood sugar was 245 mg/ dl.
3. She had developed a moon face due to steroids used to treat her.

However, after a few days of medications, she was back to normal.

What about the present COVID-19 situation in India?

Today is 3rd January 2021, 3 days after I started writing this article. So far, as per the daily news about COVID-19 Infection spread in India, it is –

1. Total No. of active COVID-19 cases as of today-2.5 lakhs
2. No. of deaths due to COVID-19 reported so far-1.5 lakhs
3. Recovered cases from COVID-19 as of today-9.9 lakhs

But the cases are not declining. The recovery rate is quite slow, and the number of deaths is increasing by the day, even though it is just 1.5% of the total. It remains to be seen how we will fare in the coming days. In the past 11 months since the first case was detected in India, the total no of cases are as follows-

1. 10.3 million
2. 9.98 million recovered
3. 1.49 lakh dead

You can have a look at the real-time statistics of the COVID-19 situation in India by clicking this link.

What should we do in such a situation?

What is heartening news is that the percentage of recovered cases of COVID-19 is quite satisfactory. Now imagine a situation where you yourself or your near and dear one gets affected by the Coronavirus. In most cases, people first rush to their family physician [if he/she is available, as most of them are not].

What are the likely questions that you may be asking your family physician about COVID-19 infection?

My experience in the past 10 months of the ongoing pandemic is that patients who visit my Clinic are very anxious and more and more worried about getting infected by the COVID-19 virus.

To allay the fear of all concerned, I am going to put up some frequently asked questions by my patients and the answers I give-

Q1. What is this COVID-19 infection? And How do we get it?

Answer:- COVID-19 infection is a viral infection just like the seasonal flu; the only catch is it is more severe and dangerous. You can get it in several ways-

• Through a person who has already been exposed to the virus. This virus has been imported to our country by people who had traveled to places like China, where it was reported first.
• By inhalation of air that has been contaminated by droplets containing the virus by a patient who has a cough, cold, or sneezing.
• Touching things like metals[ copper, steel of door handles], wooden surfaces like that of tables, chairs, etc.
•  Direct contact with an asymptomatic person[one who does not show any signs/symptoms] like kissing, hugging, etc.

2] What is the course of progressing disease in a Covid-19 pandemic?

Answer:- To begin with, the COVID-19 infection presents as a common cold with –

• Sneezing
• Runny nose
• Sore throat
• Cough
• Fever which may be as high as 102° F.
• Loss of sense of smell and taste( read this article to know more about these symptoms)

As the disease progresses, the cold and fever may disappear with the patient feeling better. Then suddenly, after 2 to 3 days, the patient presents with-

• Mild to severe breathlessness
• His or her oxygen level drops. This can be seen by using a Pulse Oximeter-

The normal oxygen level, read as SpO2 on the Pulse Oximeter, ranges from 95 to 100%. This drops down below 90 and may range anywhere between 65 to 85%.

3] What is Cytokine storm

This is a condition that occurs a few days or even months after the initial Coronavirus infection. When we suffer from the disease, our body produces antibodies to fight the infection. If these antibodies are in excess, they attack parts of our own body such as the lungs[most common], the brain, the eyes, the joints causing post-COVID complications. This collective complication is called the “Cytokine Storm.”

4] Will I recover fully if I get affected by the COVID-19 pandemic?

This is a tricky question. Most cases that do not have any other comorbid conditions like old age diabetes, hypertension, heart disease, arthritis recover fully. Provided proper treatment is given.

For those having the above-mentioned comorbid conditions, there is a chance they might not survive. For instance, consider this case which came to me for cold, cough, and fever- a lady who was

• 68 years old,
• had hypertension
• as well as diabetes.

She got infected by the disease and was admitted to the hospital with severe breathlessness, where she was diagnosed as RT-PCR positive, and her HRCT showed signs of a Cytokine Storm. This lady underwent the treatment as per COVID-19 protocol but could not survive due to her other co-morbid conditions.

Recently, an anti-inflammatory drug called piroxicam has been shown to reverse the Cytokine storm. Here is a interesting short video by Meyer Organics, the manufacturer of Ugesic, a sublingual anti-inflammatory  medicine piroxicam,  that can reverse the cytokine storm- click this link  Cytokine storm reversal medicine- piroxicam .

I hope I have explained most of the queries regarding the Covid-19 pandemic. In case anyone has any doubts regarding the COVID-19 infection, you can put up a query in the comments section. I will surely answer them to the best of my knowledge. All said and done ✔, we have to take care of ourselves whether we are in a pandemic or not. Here is one article which can help you to do so- read here.

For more details on COVID-19, I recommend you to read this article- link.

This is the latest take on the news of the new variant of COVID-19 which is prevalent in the United Kingdom- link

Conclusion-

I hope this article has taught you many things about Covid-19 that can unsettle you if you get it. The best course of action is to prevent it in the first place. Now different countries have come out with vaccines to prevent and stop the progress of this pandemic.