[vaibzi]

Hi doctors and experts, could you please advise about the predicament we are in.

My sister (age 35) developed minor cough symptoms 10-12 days ago which manifested to a severe cough around 5 days ago which was when my sister reached out to a doctor(she has twin kids aged 2 which she found difficult to stay away from thus delaying her in reaching out to a doc - not the greatest idea). The doc immediately suggested CT scan along with the regular covid test. The RTPCR returned negative but the doc was convinced it's a case of covid seeing her CT score.

Her CT severity score was 12/25, CORADS-5, D-dimer at 290, SpO2 levels at 93 when she was tested on 8th May. After taking the prescribed medications since 3 days now, her SpO2 has improved to 96 and she is feeling a lot better day-by-day. On the follow-up today the doc advised it would be better to get her admitted to the hospital so that she could be monitored better. Eventually doc advised to monitor her for 5 more days at home and see her progress with the same medication. Would this be prudent to do? My family is stressed out by this due to the current bed crisis in Bangalore.

Also, my mum and dad developed cough a few days after my sister visited us 12 days ago. The cough is now almost gone after taking meds except for an occasional cough two or three times a day. Are they too at any risk now? They have no other symptoms and their SpO2 levels are >97. They are vaccinated with first dose of Covishield around 50 days back.

lessons learnt:
1. We can easily get into trouble with laxity in following safe measures
2. Seek a doctor immediately once symptoms arise

[drrajasaravanan]

Originally Posted by lapis_lazuli

First of all, thanks a lot. I do understand the steps you outlined.

But since we do not have 10-15 years to wait, do you think it makes sense to not out-rightly reject findings by some of your peers worldwide, because, seemingly, it does have benefits that outweigh risks. (Or perhaps, minimal risks!) They are working to save their citizens too.!!
(NB I am not talking of any other expensive drug, but a drug whose full course is sub 100 rupees, with SOME potential benefit, probably as much as remdesivir et al)

Hi,
Trying to answer to your points
1. We do not have sufficient evidence to blanket use the drug for all. Maybe future studies will provide clarity. The studies which many of our colleagues have reviewed and discussed does not offer much evidence and are guesses of probability.
2. Govt has given a guideline and its the doctors responsibility to choose it appropriately for patients. Not all patients fit the same criteria.
3. I don't believe the govt bodies are morons too but I am being rationale to people who have trusted me to help them.
4. Pharmaceutical majors do conduct off label trials to find alternatives. Famous example is Viagra.
To sum it up I will not claim its harmful and its wrong to prescribe Ivermectin but I am yet to see strong evidence to use it and if iand when the evidence is available I will use it.

[vivek95]

Originally Posted by GTO

Doctors & experts, a few questions please.

1. I recovered from Covid around Mid-April. How long do I have anti-bodies which will protect me from Covid again? Some people are saying 3 months, some are saying 8 months!

2. Can I still be a "carrier" of Covid to my family?

3. What is the best time for me to get the vaccine?

Thanks much in advance .

Hello Admin

1. This is an unknown territory yet. The longevity of antibodies is still under study and there have been mixed results as you pointed out. From my personal observations of patients who got infected with Covid-19 twice, there was a gap of atleast 4 months.

I was reactive for IgG antibodies against Sars Cov2 for the first time in August 2020 ( very high titres ). I have never had any symptoms so far despite working in Covid ICU since more than an year, but surely I had an asymptomatic course. I tested again for IgG in October 2020 and then January 2021 and was reactive both times ( high titres in October but very low in January ). I tested myself for Sars Cov2 RTPCR for the first time on April 1st 2021 as I needed to drive from Mumbai to Gulbarga, Karnataka and RTPCR test was mandatory. Result was negative.

Yesterday I tested myself again for an even more specific Anti-Spike protein RBD of Sars Cov2 IgG ( RBD- receptor binding domain ) and by God's grace I am reactive yet again This is different from normal IgG and has more specificity, hence a costly test. Normal one costs Rs.500/- and this one costed 1600/-. This is a neutralizing antibody and more specific to Sars Cov2 virus. The intention of telling you all this is that, I am assuming the anibodies in my case have been holding up for 10 months straight now. On top of all this, there is a T-cell antibody protection. Hopefully in coming days with more research, we understand better.

2. If you are asymptomatic at present , there is a very less chance that you are a carrier to others. Since masks and sanitization has become a norm now, worry less about being a carrier especially when you have recovered and have no symptoms now whatsoever.

3. Best time for you to get the vaccine is 12 weeks from the 17th day after you tested positive. That should be in total about 15 weeks from the date of you getting the first symptom. You recovered in mid-April, so take your first vaccine shot in mid-July. Hope I did not confuse you here.

--Dr. Vivek

[Thad E Ginathom]

Some friends of my wife's had covid, and have admitted themselves in a siddha hospital. I do not know what kind of facilities such a hospital has?

At first, despite long interests in and acceptance of "alternative" medicines, I was sceptical. Then I thought, "Wait: IF they are lucky enough not to need more than support, then that is all they would get from mainline medicine anyway."

It's not what I would do. It probably is what my wife would do, because she is, essentially, prejudiced against "English" medicine.

Dreading that I might start flames, for or against any medicine, I still wonder what people here think?

[ZenMaster]

A very disturbing article that I read in "The Wire" magazine today. I goes into detail about the possible origins of the Covid-19 pandemic that has turned the world upside down. The piece was researched and done by Nicholas Wade. Its republished by the magazine in India.

As it goes more and more into detail, its paints a picture of how there is a very high probability that Covid-19 is man-made and accidentally leaked out of the lab in Wuhan as opposed the popularly accepted probable cause i.e. natural transmission.

The more and more I read in detail, it really gave me the chills. It Talks about how trying to get ahead of the virus and trying to fast forward its evolution and mixing and matching diff. viruses to "Study it" might have landed us all in the soup we are in.

I'm not writing down too much of the contents of the article because I would like people to read it themselves and make up their own minds.

Its and exhaustive piece, but will be well worth your time.

https://thewire.in/health/origins-of...na-coronavirus

The Wire is usually a very reliable source of news (maybe a bit politically biased at times but overall trustworthy source). But I would never think they'd republish something this serious without doing their homework.

Please give it a read.

[Zen2001]

WHO Warns Against Use Of Ivermectin For COVID-19 Treatment.

https://www.ndtv.com/india-news/coro...sher=newsstand

This time, even the original manufacturer of the drug has cautioned against its use without adequate efficacy and safety data.

https://www.merck.com/news/merck-sta...d-19-pandemic/

Especially in a country like India, where parasitic infestations are endemic, especially in rural areas and even across entire states, the potential of causing serious anaphylactic reactions (lethal) cannot be overlooked. We might have bodies floating in rivers due to mass drug induced reactions. Besides, the drug is contraindicated in pregnancy and lactation - I wonder if any authorities have even bothered mentioning about this before making it a blanket therapy.

Steroids causing mucormycosis, with 40–60% mortality rate.

https://www.deccanchronicle.com/scie...lity-rate.html

Steroids are like magic bullets - equally liable to kill as able to protect. In the long run, safer to stay away than use unwanted artillery that has potential to self destruct. Quick in and quick out with short acting derivatives rather than prolonged dosing with long acting agents could be the lesser evil.
After all, any treatment that could land up with a 40-60% mortality for a disease that has barely 1.5% mortality cannot be justified.

[drrajasaravanan]

Originally Posted by vaibzi

Hi doctors and experts, could you please advise about the predicament we are in.
My sister (age 35) developed minor cough symptoms 10-12 days ago which manifested to a severe cough around 5 days ago which was when my sister reached out to a doctor(she has twin kids aged 2 which she found difficult to stay away from thus delaying her in reaching out to a doc - not the greatest idea).
Also, my mum and dad developed cough a few days after my sister visited us 12 days ago. They are vaccinated with first dose of Covishield around 50 days back.

Hi,
If your sisters and parents oxygen levels are consistently more than 93 and 6 minute walk test the oxygen levels stays above 93 and fever has subsided without any difficulty in breathing they should be safe. CT score is a guide and the clinical progress determines the decision for escalation of treatment. I feel they are recovering. Take the opinion of the primary doctor.

Originally Posted by vivek95

Hello Admin
, I am assuming the anibodies in my case have been holding up for 10 months straight now. On top of all this, there is a T-cell antibody protection. Hopefully in coming days with more research, we understand better.

Hi,
Isn't it possible you are having repeated exposure to COVID due to nature of work. However careful we are there could be breaches and we are exposed to the virus. We still don't know how much our memory cells coerce the fight against this.

Originally Posted by Thad E Ginathom

Some friends of my wife's had covid, and have admitted themselves in a siddha hospital. I do not know what kind of facilities such a hospital has.

Hi,
Siddha or Ayurvedic medicine cannot deal with this virus with the rapidity of changes it brings in an individual's body. If the hospital provides isolation areas and oxygen by all means utilize them but regarding treatment there is no possibility Alternative medicine can dent it. Do not hesitate or look for appropriate support if the situation demands.

[akshay380]

I was tested positive for COVID-19 towards end of April and when Oxygen Saturation dropped to around 91-92%, decided to find myself a bed and got admitted to ESI hospital Margao Goa on 8th day which was an absolutely right thing to do in hindsight as same night my Saturation dropped to 86%. I don't know what could have happened if I had waited at home and wouldn't have got oxygen when needed. Thankfully I am recovering now.

I am writing this post to make all aware of a very important and simple technique doctors here taught us to stabilise those needing immediate oxygen. We successfully increased this patients saturation from 89% to 94% by doing this procedure for 10 minutes. Let the patient lie FULLY flat on bed with neck on one side. Pat lightly on his back. Let him be like that for couple of hours ignoring the neck pain

Please remember 10 minutes of Oxygen time can and will save a life. Also it is very important to behave calmly with affected patient. Any agitation shown by you will affect the patient even more.
Also strictly monitor your vital parameters. Pulse/Spo2/Temperature thrice a day. Those are your first markers of any impending danger. In my case, I started dropping Oxygen levels from 7th day. Please stay in touch with your doctor and please do not hesitate in shifting to COVID hospital if your doctor says so. REMEMBER, a COVID care facility is your only hope if things turn for the worse.

[drrajasaravanan]

Originally Posted by akshay380

I was tested positive for COVID-19 towards end of April and when Oxygen Saturation dropped to around 91-92%, decided to find myself a bed and got admitted to ESI hospital Margao Goa on 8th day which was an absolutely right thing to do in hindsight as same night my Saturation dropped to 86%. I don't know what could have happened if I had waited at home and wouldn't have got oxygen when needed. Thankfully I am recovering now.

Hi,
Thank you for pointing out the effect of proning. Just to caution if any person has reached a stage of proning to keep his oxygen levels up please do not delay getting to a COVID facility. This is a tipping point where initiating intensive care can reverse the impact. Do not continue proning at home and expect total recovery. Yes it beneficial but it's not the treatment and only a stop gap till you get the right resources.

[akshay380]

Originally Posted by drrajasaravanan

Hi,
Thank you for pointing out the effect of proning. Just to caution if any person has reached a stage of proning to keep his oxygen levels up please do not delay getting to a COVID facility. This is a tipping point where initiating intensive care can reverse the impact. Do not continue proning at home and expect total recovery. Yes it beneficial but it's not the treatment and only a stop gap till you get the right resources.

Absolutely doctor. I was lucky that the doctor managing me was the same person who set-up Goa's initial COVID response last year. I did this video per his guidance directly from hospital. Hope it helps in encouraging more people. https://m.facebook.com/story.php?sto...7&id=726756256

[itwasntme]

A 14 year old male nephew has been down with low grade fever (99-99.7) for the last 11 days with eye ache & fatigue, but with consistent SpO2 97-100, reasonable appetite and normal bowel movements.

RAT & RTPCR (done ~7th day) are negative but has tested 'weakly positive' for Dengue NS1 antigen & 'weakly reactive' for Typhidot - IgM. CRP well within limits.

Advised monitoring and home care with lot of fluids. Doctors, can you advise please?

[Zen2001]

Jugaad breathes its last: Why this Indian principle serenaded by Harvard heavyweights deserves to die.

https://timesofindia.indiatimes.com/...serves-to-die/

Mods could seriously consider starting a separate thread on the covid "jugaads" of India, as we are seeing these much more than actual scientific practice - whether it is the flawed flip flop testing policy, creation of robust hospital infrastructure, running behind therapies of questionable benefit (Remdesivir, Plasma, Ivermectin etc), resource shortages (OXYGEN!!), vaccination policy (that has been ripped right through) and in general, the (mis)management by politicians becoming jugaad doctors and endorsing certain beliefs for obvious non medical benefits.

Originally Posted by itwasntme

A 14 year old male nephew has been down with low grade fever (99-99.7) for the last 11 days with eye ache & fatigue, but with consistent SpO2 97-100, reasonable appetite and normal bowel movements.

RAT & RTPCR (done ~7th day) are negative but has tested 'weakly positive' for Dengue NS1 antigen & 'weakly reactive' for Typhidot - IgM. CRP well within limits.

Advised monitoring and home care with lot of fluids. Doctors, can you advise please?

Treat as per the clinical suspicion. Plenty of fluids, balanced heathy diet and paracetamol if fever >100.5°F. Monitor CBC (for platelets), LFT and RFT (bi weekly or as directed by your physician - depending on the baseline and trends). There is no specific treatment for dengue (other than supportive), but typhoid will need appropriate antibiotics. Repeating the serological tests to confirm increasing titres (of antibody) sometimes confirms a previously weak/negative test. There are several other causes causes of fever, headache, bodyache, cough, breathlessness, loss of taste, diarrhoea - which are potentially dangerous as well. These should not be forgotten/brushed aside simply assuming and ascribing everything to covid.

[itwasntme]

Originally Posted by Zen2001

Treat as per the clinical suspicion. These should not be forgotten/brushed aside simply assuming and ascribing everything to covid.

Well put, thank you. We have forgotten about the many diseases like malaria, dengue, chikungunya, typhoid which anyway strikes BLR with the ongoing unseasonal rains.

[drrajasaravanan]

Originally Posted by itwasntme

A 14 year old male nephew has been down with low grade fever (99-99.7) for the last 11 days with eye ache & fatigue, but with consistent SpO2 97-100, reasonable appetite and normal bowel movements.
RAT & RTPCR (done ~7th day) are negative but has tested 'weakly positive' for Dengue NS1 antigen & 'weakly reactive' for Typhidot - IgM. CRP well within limits.
Advised monitoring and home care with lot of fluids. Doctors, can you advise please?

Hi,
Just so you are aware RTPCR kits used in India often shows weak positive for Dengue and Typhoid in endemic zones. Unlikely for your cousin to actually suffer from either dengue or typhoid. It would be prudent to wait and observe, rest, fluids, close watch on his vitals, bowel habits, oxygen levels and fever. If he remains asymptomatic I don't foresee a problem. Keep his primary physician in the loop. Your primary physician will most likely redo the labs within a week to ensure progress and safety.

[Gansan]

Originally Posted by Thad E Ginathom

Some friends of my wife's had covid, and have admitted themselves in a siddha hospital. I do not know what kind of facilities such a hospital has?

There is one person famous in Chennai for running a Siddha covid facility. During the first wave I know many people who sought out that place and stayed there. All of them had good outcomes and went home.

As per my understanding, they took only asymptomatic or moderately symptomatic patients. They were given a couple of herbal preparations to boost immunity, citrus and other fruits and taught some breathing exercises; mild but nourishing food thrice a day. That was all, and the patients went home after a peaceful isolation of ten days. Mostly a case of the body healing itself.

But if any patient seemed to get serious he was immediately shifted to a proper government hospital by them. Those facilities saved a lot of regular hospital beds from unnecessary occupation. In that sense they were good.