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PICTURE SHOWING COVID-19 INFECTION OF LUNGS
The Covid19 pandemic

Living with COVID-19 pandemic- How to Reshape our Lives Now and Lead a Happy Healthy Life

The COVID-19 PANDEMIC-

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]HRCT image of lungs in COVID-19 pnuemonia

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-
    Pulse Oximeter
    Pulse Oximeter-Click here to purchase

    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%.

  • X-ray chest shows changes of typical pneumonia called Ground glass pneumonia.
  • HRCT[ discussed above] also shows changes in Ground glass pneumonia.

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.”

To know more about Cytokine storm, click on this link- link

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

 

 

 

Lockdown Effect In India
10 Days of The CoVid-19 Twenty One Days Total Lockdown in India
These days they say'Hope is greater than Fear, So, today, let's Hope more and Fear less, And Pray that the CoVid-19 Fades away. Click To Tweet

10 out of Twenty-one days Covid-19 India Lockdown

It has been 10 days already of the twenty-one days of the CoVid-19 lockdown. I think we have had enough of this disease dominating our lives and it is getting boring by the day.

In these 10 out of 21 days of the lockdown, we are already feeling the brunt of what to expect in the coming days if the CoVid-19 spread continues.

Just before I get to what we should do now, let’s have a look at the total number of cases so far.

Before I touch on the Dos, I would like to talk about the Donts because they are far more important than the Dos.

Here’s what you should not do

  1. The CoVid-19 lockdown has been imposed so that we break the chain of coronavirus infection thereby curbing it. We should follow the government’s initiative by virtually locking ourselves from the outside world by strictly staying indoors. So, don’t venture outside your home unless it is absolutely necessary.
  2. Do not spread or forward false news or Whatsapp messages. Some anti-social elements are defying the government orders and are spreading rumors that whatever the authorities concerned are doing is all sham. This is not so. Consider ourselves fortunate that our country has very less number of cases compared to other larger and developed countries.
  3. Don’t remain glued to your TV for the latest news on CoVid-19 updates. It will only make you depressed. Instead, watch some cartoon movies or family-based movies to make you happy.
  4. Senior citizens should not step out of the house. As such, most of them have health problems,  sometimes multiple. They are the most vulnerable people.
  5. Do not gather or move as a group- even with your family members. Research shows that gatherings- be it religious or a family function such as marriage, funerals helps in the spread of the disease. So, avoid social gatherings totally. Read this to know the impact-TOI News.

Things that I do and what you can also do

Ten days of the total 21 days of the total lockdown are already over. Many of you must be wondering what to do in the remaining 11 days.

As you all may be knowing by now, I am an active practicing doctor. I have my duties cut out for each day and that routine I am going to share with you all.

1. Get Up Early-

From my school days, I have been an early riser. I have the habit of getting up around 4.30 a.m. The first thing which I do is to boil water and put it in a filter coffee decanter. I use milk in the coffee, so I boil that as well.

During the interim period, I have the habit of meditating. I pray and thank my creator for everything he has given me- a fairly good life, a good family, good friends, and finally the followers of my blogs.

After making my coffee, I drink it in my favorite stainless steel glass[shown below]. What is the purpose of showing this glass? Well, it has been my companion for the past 35 years and gives me a feeling of being awake every day. It also gives me the motivation to start my day.

My Favorite Coffee Glass
My Favorite Coffee Glass

Next, I sit on my favorite rocking chair[ gifted by one of my friends] and start reading a book while sipping my coffee. At present, I am reading a book named The Miracle Morning by Hal Elrod.

Miracle Morning book
The Miracle Morning book

I advise everybody to read some motivating books like the one I am reading now. You can purchase this ebook on Amazon Kindle or read it for free on the Anybooks app which you can download from Google Playstore. Books like this one engage your mind and motivate you to do something good to yourself and to others. I have 2 glasses of the coffee and this stimulates my bowels.

2] Do Some Exercise-

During this lockdown period, our movements have been severely hampered. I have the habit of going for regular walks for at least 5 days a week. As going out for walks has been put on hold presently, I make it a point to walk in the balcony of my home. Take a look at the screenshot shown below-

Total number of steps I walked today
Total number of steps I walked on the 4th April 2020

As you can see, I have walked almost 4201 steps i.e. approximately 2.81 km. Previously, I used to walk around 8500 steps or approximately 5 km.

Listen while you walk-

As I walk along, I put on my headphones and listen to Podcasts on my Player FM app. Once again, you can download this app from Google Playstore for free and listen to different podcasts on a variety of subjects. Have a look at this screenshot-

Screenshot of Player FM app
Player FM podcast app

 

The topics to which I listen are mostly health-related, lifestyle changes or simply motivational ones. They energize me for the rest of the day.

After downloading this app on your phone, try to listen to some useful podcasts and report to me your feelings or changes which you experience. I can assure you that you will feel that this lockdown has been a blessing in disguise apart from preventing you from getting infected by the CoVid-19 virus. It has allowed you to do something new in your life.

You will also feel that your walk, which you find boring, is not so boring after all. Again, it will motivate you to walk the extra mile because you will be very much engrossed in hearing your podcast.

While walking, do some swinging of your arms also well as legs so that almost the whole body gets exercise.

3. After the morning chores-

After my routine walk and listening to podcasts, I finish my morning rituals like bath, pooja, etc., and reach my clinic by 11.00 a.m. Due to the lockdown, patient attendance is minimal. So, I reduced my timings which were from 11.00 a.m to 1.00 p.m. and 7.30 p.m. to 10.00 p.m., by 30 minutes each in both sessions.

In the afternoon after my clinic hours, I have lunch and a short nap. A nap is necessary as it recharges me again and after this, I take time to either read or write articles or follow my hobby.

4. Develop a hobby-

During this lockout period, try and develop a new hobby, a hobby which you were yearning for but were unable to do so due to time constraints.

My latest hobby, other than reading and watching movies on the TV, is Gardening. In my spare time, I used to read a book called The All New Squarefoot Gardening by Mel Bartholomew-

All new squarefoot gardening book
The gardening book

I purchased the physical copy of this book on Amazon and have also downloaded the same on my Anybooks app. After reading the book, I built a 4′×4′ square foot garden on my terrace and have recently planted some vegetable seeds in it. This hobby keeps me engrossed-I try to learn how to make it better. Have a look at what I have built-

My Squarefoot Garden
My Sqarefoot Garden

Taking a cue from this picture, you can also develop some hobby which is not only useful to you but also something which you will love doing. So go out there[literally, staying indoors] and do something- you can learn to cook or draw or to make your own website. There are plenty of free tutorials available on Google or you can buy one from Udemy. I recently received a message on my LinkedIn account which appears to be inline with my thoughts mentioned above. Take a look-

Motivational Message
The Truth

5. Sit and talk with your Family members-

These 21 days of total lockdown in India gives us an opportunity like never before to sit with the members of our family -to talk and discuss many things.

How many days has it been since you all had quality time together as a family?

Be it your spouse, your working son/daughter/daughter-in-law, the quality time that you have spent with them must have been either a Sunday or some public holiday or some vacation.

Today, this lockdown- with work-from-home advice given by almost all the companies- has given you the chance to have quality as well as quantity[of] time with your loved ones. Utilize this period to-

  • have breakfast/ lunch/dinner together
  • sit and watch your favorite shows on TV
  • play the games which you have enjoyed playing together
  • discuss your plans for the future like going on a vacation, purchasing a new car or a house

I have been doing all these things in the last 8 days of the lockdown in my country. This has helped me develop a positive attitude towards the forced curfew rather than getting depressed. I am sure that all of you must also be doing the same and I would like to learn from my readers what they have been doing all these days.

The takeaways of this Lockdown-

There are a few positive effects or takeaways of this forced lockdown. They are-

  1. Improvement in  Air Quality– The last few days of the lockdown has seen vehicular traffic reduced substantially thereby reducing the air pollution bringing down the particulate matter in the air drastically-air seems to have become breathable. The smog created by the exhausts of the vehicle has diminished. Patients with allergies related to pollution like sneezing, cold etc., have reduced a lot.
  2. The Discipline in the Attitude of people– 95% of the Indian population is backing the government’s call for total lockdown by staying indoors, queuing up for supplies, wearing a mask maintaining social distancing, etc., to mention a few.
  3. Increased Health Awareness– As a doctor, I have been witnessing the changing attitude of my patients towards personal health. They are visiting their respective doctors even for minor ailments like cold, sore throat, etc., which in the past they used to self-treat by taking medicines over the counter without a valid prescription.

To know more about health issues in general and that related to CoVid-19 disease, you can visit this site.

Be sure to drop in a line or two regarding your views on this CoVid-19 Lockdown. Adios.

 

 

 

 

Corona virus and you
Covid19 scare- How it is affecting our lives and What should we do.
All the media say that Covid19 is here to stay But we all pray that it should go away! Click To Tweet

How does the Coronavirus pandemic affect our routine life

Open any news channel or newspaper- the first thing which you notice is the latest update on Covid19 and it’s aftermath or progress all over the world.

When I wrote my first article on 7th February 2020, the cases were restricted mainly to China and a few surrounding countries. It was then thought to be an epidemic in China and the rest of the world sighed with relief.

Even as I am writing this article, I find that what was a mere epidemic has become a pandemic. People are moving about wearing face masks. A mask costing Rs. 2/- is quoting anywhere between Rs.20/- to 40/- in Mumbai.

Such is the fear of the disease created by TRP hungry media that patients nowadays are talking about nothing else but the Coronavirus.

What about Public places?

Public places like malls and parks in Mumbai are temporarily closed to avoid contamination and spread of the disease. I guess the same is true for cities in other countries as well. However, hospitals, clinics are open to all concerned.

Some hospitals in other countries are reporting the fate of ER physicians and nursing staff as they are getting overworked and the resources inadequate. ( Read Here)

The situation in India-

In the last 2 months, starting January 2020, in Navi Mumbai ( an extension of the old Mumbai) we have been treating cases of upper respiratory tract infection( URTI)with fever.

Cases with fever have risen more than ten folds as compared to previous months. But recovery has been very good with proper advice and treatment.

Patients have been reporting with a runny nose, sore throat, and fever- signs and symptoms of the common flu or Influenza. But now, with India reporting an increase in the number of Covid19 positive cases, panic has started to set in.

According to the latest news, about 125 confirmed cases with 3 reported deaths and 4 cases seems to have recovered- click here for the latest information.

In India, in most places, spring has set in with the arrival of the Holi festival. It is a matter of a few months when the summer season makes its appearance felt. As of today(17/3/2020), the temperature in Mumbai is already 34° C.

The Coronavirus is known to be sensitive to high temperatures. So hopefully, the death march of the deadly disease will be halted by Mother Nature.

What about the rest of the world?

Countries having colder climates are more susceptible to the Covid19 disease and its spread. This link shows how many countries are affected and the progress and mayhem caused by the disease- ( click here) as of 18/3/2020 7.00 a.m. IST.

If you observe carefully, you will notice that countries above the equator have been affected much more than those below the equator.

What do I advise patients visiting my Clinic?

Most of the patients attending my clinic are suffering from cold, cough, sore throat (URTI) and mild fever. I have been advising them to-

  1. Drink plenty of fluids-  warm fluids like vegetable soups, tea, coffee, etc., help a lot.
  2. Gargle- with lukewarm saltwater[salt contains iodine], povidone-iodine solution
  3. Avoid dusty places
  4. Total bed rest till symptoms subside
  5. Have medication sincerely prescribed to treat the URTI.

Should we wear a face mask or not?

This is the most common question I am asked when my patients with fever visit me every day. What I tell them is this-

  • If you are using a bike for traveling to work, you should.
  • Working in a dusty place? You have to use it.
  • If you are working in a hospital or in its vicinity, it is a must.
  • If you are traveling in public transport, you can consider using one.

Why should one wear a mask?

I would recommend wearing a face mask for all patients having a cough or cold. Patients having Covid 19 disease may transmit it if they are coughing, through microdroplets.’

These microdroplets, if inhaled, can infect anyone, especially those who are immuno-compromised because of HIV, Aids, Tuberculosis, etc. These patients would be better off wearing a mask.

A face mask helps you block unwanted dust from being inhaled.  Research has shown that the Coronavirus is found on the floor or the ground and gets transmitted through the dust.

What are the medicines or vaccines available to treat Covid 19 disease?

So far, none. Scientists and doctors all over the world are working hard to develop a vaccine. But according to the news heard, it may take months to develop one.

In the meantime, some news channel have come out with information that an antimalarial drug-chloroquine and Hydroxychloroquine might be worth trying.

Having said all this, I also advise all my readers that they should follow the protocol set by the World Health Organization-click here.

They also have a video to teach people all about Covid19. Click here to see it.

Here are some more sites which can be useful to all-

  1. Kevin MD Blog
  2. WebMD
  3. Dr.Mercola.com
  4. Wikipedia

 

We are all hoping for a solution to end this pandemic. As in the past, when there was SARS-Cov(2003) and MERS-Cov(2012) scare, physicians all over the world are confident that this Covid19 scare will also pass away.

 

 

Dr. K. P. V. Rao's Health Blogs
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