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| Dr. Sanjeev Kumar |
I am pleased to share with you a small article, "Stay Safe in Covid Times". Dr. Sanjeev Kumar has written this for UPGI members and their families/friends. He would welcome comments or further questions which he has very kindly agreed to answer, finding time for us from his very very busy schedule.
We hope to share with you, from time to time, information on Covid-19 after ascertaining its authenticity from our in-house doctors.
Take good care of yourself. Regards.
--Uma Shanker
Acting President, UPGI
Stay Safe in COVID times
What is Corona Virus Disease 2019 (COVID 19)?
Corona viruses cause respiratory infections ranging from the common cold to more severe diseases. These viruses are zoonotic (from animals) in origin and spill over to humans and start transmitting from human to human to become an epidemic. The most recently discovered corona virus disease started in China is named Corona Virus Disease 2019 or COVID-19. This new virus was unknown before the outbreak began in Wuhan, China, in December 2019.
Common symptoms are fever, tiredness, and dry cough. Some patients may have aches and pains, nasal congestion, runny nose, sore throat or diarrhea. These symptoms are usually mild and begin gradually. Those who develop serious diseases become breathless and oxygen in the blood drops adversely impacting other organs such as kidney, liver, brain leading to multi organ failure which may result in death. A large proportion of the infected are asymptomatic don’t develop any symptoms.
How does it spread?
The disease spreads from person to person, like common cold and flu. When an infected person coughs, sneezes or speaks small droplets containing virus are released and others around can inhale these and get infected. Hence it helps to stay more than 6 feet away from other persons. These droplets also land on objects around the person. Other people may catch it by touching these objects, then touching their eyes, nose or mouth. COVID infected are thought to be most contagious when they are most symptomatic (the sickest), though even asymptomatic and those who have not yet developed symptoms (pre-symptomatic) do spread infection.
Population distribution of COVID 19
COVID 19 is a new disease and we still learning about it. Based on what we know so far, of those who are exposed to infection around 15-20% do not get infection due to general (innate) immunity which protects them. Of the COVID-19 infected, a large proportion remain asymptomatic. Among symptomatic, the symptoms are mild in more than 80%. Majority of the patients do not require hospitalization and can be isolated and treated at home with a modified “enforced social distancing” imposed on the household.
Recent ICMR serosurveillance study to detect antibodies as evidence of infection has shown that 0.73/1000 population has developed antibodies to COVID 19. If we extrapolate to the total population in India, about 10 million (one crore) people have been exposed to infection. The reported cases in India, at the time of survey were around 300,000 This means that about 33 times more people compared to reported have been infected. Similar picture has emerged in other countries. This has implication that actual number of those infected are much more than reported. Based on these figures if you calculated infection fatality rate among infected it would be much lower (less one per thousand infected) than case fatality rate of around 3% based on reported cases and deaths.
Whole of Population Approach to COVID: In a pandemic we need to adopt a whole population approach to address every one’s need as it directly or indirectly affects everyone. The population comprises of the following five groups:
Uninfected Population: The vast majority of population (>99%) in India is not yet infected. It is very important to educate and support them to adopt preventive practices. The health educational activities need to reach out to the whole population to practice preventive interventions to prevent new cases in the population. They should download and use Arogya Setu App. In addition to information about cases around them, it also gives messages related to COVID 19.
High Risk Groups: This group is at higher risk of mortality if they get infected. It includes those above 60 years of age and those with Hypertension, Diabetics, Cardiac conditions, Asthma, Chronic lung disease, obese, smokers etc. This group and their families need to be extra careful in observing preventive measures. Those with these conditions should ensure they are taking their medicines regularly.
Those above 60 years of age and with chronic conditions such as diabetes, high blood pressure, asthma, chronic respiratory disease, heart conditions, thyroid problems, cancers are considered high risk. Keeping these conditions under control is the best way to control the high risk of COVID19 due to these conditions
Take your medicines for the conditions you have regularly as per your doctor’s advice. Maintaining good control of medical conditions reduces the risk of adverse outcomes, if you get COVID19.
Get adequate sleep (6-7 hours).
Take balanced diet as per doctors advise
Continue light physical exercise as per medical advice. Try indoor options. If you do Yoga, continue with it. This helps you boost immunity.
Procure and keep medicines you take regularly for about 90 in consultation with your doctor.
If you develop fever, cough or difficulty in breathing, please contact you doctor or call helpline number given at end.
Population with Early Symptoms: This group needs to identify and report symptoms early to health care providers or program staff including reporting on Arogya Setu App and/or call the helpline number. These cases must be screened early and isolated immediately if found positive to prevent further spread of infection.
Care of the Sick: Those who tested positive need to be screened by a doctor to identify those who need care in the hospital. Those found asymptomatic or mild disease may be treated at home with clear instructions when and whom to contact and where to go if breathing difficulties or any other symptom of severe or critical disease are noticed for prompt hospitalization and treatment. Those put in home for care and their family members must strictly follow isolation practices to prevent any spread of infection within the family. Those with moderate to severe disease will need immediate hospitalization and appropriate treatment.
Contacts of COVID cases: This group is at a high risk of infection, hence completeness of contact tracing determines the success or failure of the containment measures and further spread on infection
Prevention of COVID: As there is no vaccine yet against COVID 19, one can prevent infection by following the preventive measures:
Stay at home and do not go out unless it is really necessary.
Frequently wash your hands with soap and water or clean your hands with an alcohol-based hand rub.
Maintain at least 6 feet distance from anyone.
Avoid touching your eyes, nose and mouth.
Cover your mouth and nose with your bent elbow or tissue when you cough or sneeze. Then dispose of the used tissue immediately.
Use face Cover or mask when you go out or any one visits you
Take regular medications as prescribed by your doctor if you have diabetes, hypertension, asthma, chronic Obstructive Lung Disease, heart problems etc.
Strictly follow guidelines if any family member is put quarantine and isolation as a large proportion of cases now are from family contact
Download and regularly update Arogya Setu.
Misinformation on COVID
There is a virulent epidemic of misinformation during the current COVID19 pandemic. According to U.N. Secretary-General Antonio Guterres, the world is not only fighting the “common enemy” of the coronavirus “but our enemy is also the growing surge of misinformation” about COVID-19 disease. It is important to identify and ignore misinformation. Infodemic (Information epidemic) has emerged as an area being addressed by WHO and other organization dealing with COVID19. Today, anybody can write anything on social media such as Twitter, WhatsApp, Facebook, TikTok, YouTube etc without any evidence or falsely attribute the wrong information to a well-known expert or a renowned institution. 24X7 coverage by electronic media contributes to spreading fear and at times misinformation, adversely impacting the epidemic containment measures. Infodemic contributes to, Fear and paralysis; Lose faith in scientific evidence based interventions; False sense of security; Promote interventions that may increase the risk of spread of disease andDivert attention of authorities debunking myths and clarifying false information.
You can take the following five steps to identify misinformation: Check the Source and their expertise, If in media, check if any other reputed media house has reported this, Examine the Evidence, Look for Fake Images or fake research and Does It Sounds Plausible. For more details you may read https://drsanjivkumar.wordpress.com/2020/04/02/prevent-infodemic-from-turning-public-into-covidiots/
Where to look for authentic information on COVID19
https://www.mohfw.gov.in/ on the website useful pages are Awareness, Frequently asked questions, current status of COVID 19 in the country and states and all , helpline numbers and COVID19 related government circulars and guidelines on COVID
Dash board at https://covid19.who.int/ for latest number of cases in the world, by WHO regions and by countries. It is updated every day. For other COVID elated information https://www.who.int/emergencies/diseases/novel-coronavirus-2019. Another useful link is on COVID myth busters https://www.who.int/emergencies/diseases/novel-coronavirus-2019/advice-for-public/myth-busters
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