[ecenandu]

Originally Posted by ecenandu

True, below are the actual data from Kerala as of 29th April 2021.

Source
Active cases: 2,66,646
Hospitalized : 22,726(8.52% of active cases)
ICU: 1528 (0.57% of active cases)
Ventilator support : 535 (0.2% of active cases)

08/05/21

ICU:2505
Ventilator support:1236

64% increase in ICU admission over 10 days.
131% increase in patients needing ventilator support in the same 10 days.

As per our health experts, the peak is expected in mid-May for Kerala, really scary days. Looks like the healthcare system could get overwhelmed pretty soon at this rate.

[drrajasaravanan]

Originally Posted by CliffHanger

Hello dear doctors,

- How and when to take the oximeter reading? Is the bellow article correct?
- Should we have to walk for 5 minutes before taking the readings?
- What should be the values for older people and younger people?
- Does finger size affect the readings?

https://www.gadgetsnow.com/how-to/ho...w/82407757.cms

Hi
The answers to your questions
1. Oximeter is a good guide and measure as frequently as possible at varying intervals
2. 6mins walk test is excellent to know the threshold of your cardiopulmonary reserve. If there is a drop more than 4% it needs attention and escalation of treatment. It's preferably done with consultation with the primary physician. We routinely use it for patients prior to discharge and aim for no drop in oxygenation. It's good for screening also but I have seen patients who have fainted in attempting to do this test without guidance. It can be self monitored provided the person is careful in not to push himself and knows the limit.
3. Any saturation of less than 93% is to be taken seriously. Any drop in saturation of more than 4% with 6minute walk test or not able to complete 6 minutes needs further attention
4. Finger size don't affect reading.
Hope this helps.

[NPV]

Just sharing what I learnt/heard in the past few days, speaking to those infected and being treated as well as doctors treating them, posting here for what it's worth - I'm not a doctor!

-Do not ignore initial symptoms like first signs of fever, cough, body pain, fatigue, throat pain/irritation, loss of smell and/or taste.

-Get an RTPCR test done as soon as you experience any of the symptoms. I think there are different types/equipment used for RTPCR tests (in case you know that and are wondering which one is more accurate etc), but I'm not knowledgeable nor qualified to discuss them. Basically get the test done, these days the labs take both a throat and nasal swab and I'm told results are pretty accurate.

-If test result is positive, don't panic. Do not read too much into viral load/CT value of RTPCR if you're positive. You need to be on medication. Talk to a good physician who is currently treating Covid patients and get a Tele/online consultation done. They will put you on the right initial medication for cough, fever, some vitamins, and something like Ivermectin to treat parasitic infections.

-Around 5 days from initial symptoms get blood test investigations done. Typical important ones to find markers are CRP, D Dimer, LDH.

-Docs will know at this stage if the infection is bad and then ask to get HRCT of Chest/Thorax done a day or 2 later after blood tests (generally 7-8 days from initial symptoms). I was told that doing a HRCT test earlier can show low infection or even no infection so don't preempt it.

-By this time if things are not good, docs would have started you on an antiviral like Favipiravir.

-If HRCT results shows higher infection, start looking for a hospital bed, ideally those with Oxygen and ICU (Ventilator), because this could become a need soon.

***Also keep monitoring Saturation with an Oximeter every day at an interval of 4-6 hours.

I heard from the docs that typically if these steps aren't followed sometimes (not blaming docs), our current medical infrastructure is struggling to cope up with the magnitude of the problem so there may be delays by the patients or their inability to find the right resources to get the tests done at the right time. Those can lead to a sudden fall in patients health and become critical.

*I've tried my best to put it down in a way common people can understand, hope it makes sense and the docs on the forum can verify/validate.

Also, stay mentally strong and positive and do not succumb to fear. Stress can simply worsen the condition.

Stay safe everyone, and if you're impacted, get well soon!

*Do not take this as a prescription for medication, you need to just follow what your physician / doctor tells you, this is just a possible guideline / timeline for important tests to be done

[apachelongbow]

Originally Posted by Akshay6988

With all due respect to you, what will you do if you or one of your loved ones needs an ICU bed or Oxygen cylinder ?(I pray and hope it never comes to this) would you call the government helpline or ask your friends to arrange the cylinder? You know what you will do ! Please stop judging people who are trying to save lives of their loved ones sir. And about government taking over all oxygen plants, it was central government's responsibility to set up oxygen plants all over the country and yet here we are ! If you can't help then the least you can do is not to victimise people. Peace out.

Fully agree. This particular member has been running a nasty campaign of negativity throughout this thread. The basic theme seems to be to blame common citizens who are desperately trying to save their loved ones in this trying times.
If you can't say anything useful, it's better to keep quiet. Peace out.

[hserus]

The army has so many other things to do and you want to saddle this onto them as well?

A lot of the problem is not oxygen production, it is states becoming selfish and not releasing oxygen stocks to other states, confiscating all oxygen produced in their borders. So if you are a place like Delhi with all your factories across the borders of Punjab, Haryana or UP, you're in trouble.

The other trouble as is being discussed in the Supreme Court, is whimsical and arbitrary allocation of oxygen to various states, without any idea of supply and demand, and then filing court cases (eg Delhi, Karnataka) to appeal any instructions by the court to supply full levels of oxygen.

Originally Posted by poloman

The moment you are asking relatives to arrange oxygen for the admitted patients, you are opening windows to huge hoarding and black marketing. Huge quantity of oxygen might have been hoarded by rich and wealthy by now anticipating infection, there by denying the same to people who are already struggling to breathe.

In highly affected places like Delhi, army should be called in and every cylinder confiscated to a central pool and distributed only via hospitals. If this is not the time for the armed forces to help the country, don't know what that be..

If required Govt should take over all oxygen plants in the country till the situation improves.

[Nishith]

Hello Doctor's,

First of all a big thank you for the front line health workers, your efforts in handling this pandemic can't be thanked enough.

My family and I have recovered from COVID recently, however I have the following queries w.r.t the vaccination and need your guidance regarding on it.

Background :-

1. Parents were administered the 1st dose of Covishield on 9th March.

2. My family and I started showing COVID symptoms on the 3rd of April and we got the RT-PCR test done on 5th of April and everyone tested "Positive" for COVID-19.

We were constantly monitoring our SPO2 levels, taking the required medication and had isolated ourselves in different rooms.

Around 19th/20th April we completed our quarantine period and felt almost recovered. On the 26th of April we got the RT-PCR re test done and fortunately all of us tested "Negative". (Had to delay this as the testing centers were extremely crowded, home sample collection facility was over priced and slots were full for the next 4 days. Hence delayed it.)

Queries:
1. As mentioned, parents had got their 1st dose of Covishield on 9th March and we're due for the 2nd dose before 9th May.
The confusion is when should they get their 2nd dose ? Few doctors suggest they can get it done now and a few doctors advise us to wait for 4 to 6 weeks after completing quarantine as the immune system would have already developed antibodies against the virus.

2. When can me and my wife get our 1st dose of vaccine? (While scheduling the appointment of vaccines for 18+ age group itself is a fight, just want to know from when should I start my efforts in this direction?)

Getting mixed responses for the above queries, tired many online consultations, yet confused..

Any guidance on this from doctors would help.

If any member has been in a similar situation please do tell what did you do?

PS: Me and my wife have registered for plasma donation, I have already received a request and will be going today for the blood donation.

[.sushilkumar]

Originally Posted by hserus

A lot of the problem is not oxygen production, it is states becoming selfish and not releasing oxygen stocks to other states, confiscating all oxygen produced in their borders. So if you are a place like Delhi with all your factories across the borders of Punjab, Haryana or UP, you're in trouble.

What you wrote did happened for a day or two in Haryana if I remember correctly but the real reason in Delhi was the lack of cryogenic cylinders to carry oxygen to the hospitals. This was the reason that local govt was seen giving ad's across India for cryogenic cylinders when HC come down heavily on them. !!!!!

[drrajasaravanan]

Originally Posted by Nishith

Hello Doctor's,

Queries:
1. As mentioned, parents had got their 1st dose of Covishield on 9th March and we're due for the 2nd dose before 9th May.
2. When can me and my wife get our 1st dose of vaccine? (While scheduling the appointment of vaccines for 18+ age group itself is a fight, just want to know from when should I start my efforts in this direction?)
PS: Me and my wife have registered for plasma donation, I have already received a request and will be going today for the blood donation.

Hi,
Vaccination after COVID is preferably done after a gap of 30 to 60 days after recovery irrespective of the first or second dose. If the person in question has immunocompromised status or at high risk of exposure he can take the vaccine after recovery and need not wait.

[hserus]

Originally Posted by .sushilkumar

what you wrote did happened for a day or two in Haryana if i remember correctly but the real reason in delhi was the lack of cryogenic cylinders to carry oxygen to the hospitals. This was the reason that local govt was seen giving ad's across india for cryogenic cylinders when HC come down heavily on them. !!!!!

This got even more complicated because the oxygen tankers and cylinders had to be completely new and not used to carry any other gas. Delhi had proposed properly cleaning these and then using them for oxygen, some companies declined to accept this.

[ZenMaster]

Originally Posted by hserus

The other trouble as is being discussed in the Supreme Court, is whimsical and arbitrary allocation of oxygen to various states, without any idea of supply and demand, and then filing court cases (eg Delhi, Karnataka) to appeal any instructions by the court to supply full levels of oxygen.

These Whimsical allocation might have another reason behind it. These states that seem to be arbitrarily given more oxygen by the centre actually need that much oxygen but cannot request more because they have been fudging their numbers and the centre/ruling party knows it and could be prioritizing them over "the other states". We all know which states these are.

[Zen2001]

Doctors flag indiscriminate use of steroids, antibiotics in Covid-l19 treatment.

https://www.hindustantimes.com/citie...414781884.html

Indiscriminate use of drugs with questionable effects, but known serious toxicities is already making this (Indian method of) covid 19 treatment cocktail a full blown disaster.

[msdivy]

Need advice on the situation at a friend's place. She was tested +ve in March end, home isolated and got -ve in RT-PCR in 3rd weeks of April, test repeated after 21 days. Now her parents, in a different city have tested positive. They are yet to take to the 1st dose of vaccine. Her parents (are trying to) have isolated themselves. But they need help in cooking. My friend feels obliged to help them and she has reached their place. She is concerned her parents are not following strict isolation and she might be at risk.
Now, what are her chances of contracting again? What precautions should she take to mitigate the risk?

[ecenandu]

Originally Posted by Zen2001

Indiscriminate use of drugs with questionable effects, but known serious toxicities is already making this (Indian method of) covid 19 treatment cocktail a full blown disaster.

DCGI approves anti-COVID drug developed by DRDO for emergency use
It said clinical trials of the drug 2-deoxy-D-glucose (2-DG) showed that it helps in faster recovery of hospitalised patients and reduces supplemental oxygen dependence.

What about this drug, doc.

Source

[nareshov]

Originally Posted by Zen2001

Doctors flag indiscriminate use of steroids, antibiotics in Covid-l19 treatment.

https://www.hindustantimes.com/citie...414781884.html

Indiscriminate use of drugs with questionable effects, but known serious toxicities is already making this (Indian method of) covid 19 treatment cocktail a full blown disaster.

Quoting from the article:

According to Rajan, unwarranted high doses of steroids, often coupled with unnecessary high-generation antibiotics, present the perfect soil for invasive and life-threatening fungal infections, which can be independently a major risk factor for mortality. Cases of mucormycosis, a stubborn fungal infection are now widely being reported from the city. Also referred to as black fungus, it commonly affects sinuses or the lungs. While the disease is tackled with medication at a very early stage, cutting away the infected tissue is the only option when it spreads. Doctors in the city have had to operate out tissues of the eyes, nose and jaw in many patients.

Gory, scary, unfortunate.

[aashishnb]

Originally Posted by Zen2001

The Indian way of unscientific medicine - from unnecessary tests to unproven and even potentially hazardous treatments - not to mention additional costs and waste of resources. This is particularly sad to see when ample evidence on these issues exists everywhere in the world. I guess it's our mindset to only adopt and follow that which "suits our convenience". I wouldn't be surprised to see an emergence of new drug related complications, antibiotic resistant infections, reactivation of latent TB, flare-ups of pre existing immune disorders, to mention a few.
The reason? Psychological! DABDA - read in the article below.

Lack of Definitive COVID-19 Treatment Guidelines Is Leading To Chaotic Medicine.

Originally Posted by Zen2001

Doctors in India are under pressure to prescribe drugs that are considered ineffective.

Unnecessary, unproven, prescriptions - either for psychological benefit or out of pressure to be seen "doing something" must stop. Have been saying this all along, based on the general inefficacy, potential (& most definitive side effects), not to mention the shortages caused by rampant prescription and agony to relatives who have been made to run helter skelter in the belief that these drugs are going to be miracle live savers.

With regards to testing, I think generally (not covid specific), we as a country test much lower than say in US, Canada; where the doctors would not prescribe any medication without a slew of tests to confirm their diagnosis. Seem to recollect reading a good article on this a few years ago, but don't remember.
Maybe I am completely wrong!

There is a hindi saying, 'marta kya na karta'. Rough translation, when you are dying, you'll try everything.
Since there is no confirmed treatment protocol for this, everyone is trying their best to use whatever means/medicines at hand. For e.g. I know of one person who got cured using 'Methylene Blue' by his physician. It is some really cheap & widely available drug/medicine. So for that person, it worked. Would it work for everyone, nobody can say. Will others doctors also prescribe it, unlikely. Will the same physician prescribe it, most likely yes given his positive experience.

Originally Posted by AltoLXI

A breath test to detect Corona in 45 seconds? Reliance signs deal with Israel firm. Move over RT PCR tests and CT scans

Now, let's hope they do a Jio kind of disruptive pricing for this as well!!


A question to the doctors, there was some talk about a nasal spray medication as well, which will supposedly be the game changer. Heard some MNC pharma company and Bharat Biotech trying to produce these. Any idea/update on that one.