Covid-19 Knowledge [2021]

Symptoms may appear 2-14 days after exposure to the virus 🤒

• Common Symptoms

  • Fever, Cough, tired-ness, Body-pains

• Less common symptoms

  • Pink eye or conjunctivitis, Loss of taste/smell, motions, vomiting, loose motions / diarrhoea.

• Serious symptoms

  • difficulty breathing or shortness of breath. This is a emergency symptom.

  • chest pain or pressure

• Symptoms timeline (first wave 👇... but second wave is different and sometimes faster.)

  • Day-1 to Day-2 ⇒ Symptoms similar to common cold or sore throat. No fever.

  • Day-3 to Day-4 ⇒ Mild fever. Throat pain is more serious.

  • Day-5 to Day-6 ⇒ Slightly higher fever. 101 F. Occasional breathing difficulty. Easily tired.

  • Day-7 plus ⇒ Hospital treatment is must.

  • For minority of cases, depending on the body's response to the treatment:

    • Day-15 ⇒ Depending on the body condition, chances of the treatment going in the opposite direction is possible. Although for minority of cases. There are chances of acute cardiac/kidney injury also.

    • Day-18 ⇒ Blood clots are possible. Fatal. Death.

  • For majority of cases, depending on the body's response to the treatment:

    • Day-20-22 ⇒ patients recover and discharge from the hospital.

  • Managing Covid through timelines 👇

    https://youtu.be/CJzo6JIqhCw

• People with mild symptoms who are otherwise healthy should manage their symptoms at home.

• On average it takes 4–6 days from when someone is infected with the virus for symptoms to show, however it can take up to 14 days.

• Get an Oximeter and check it every 6 hours in general. Don't go to the panic mode and check every 1 hour. Panic is never useful.

Oxygen / Sp02 levels 🌬️

• level ≥ 95 is ok. Even with 95, 96, there is no life risk whatsoever.

• ≤ 94 needs attention.

• levels ≥ 90 and ≤ 93 means either body is recovering or some internal fight is happening in lungs. Need to start the Covid treatment immediately. Approach a Doctor online in Practo/mFine etc... They usually recommend a HRCT scan (Chest) + Rt-PCR test. Check this level, every 3-4 hours in this period.

  • When the body is still or not very much active (like just woke up from sleep or lying flat for a longer time) you would see readings like 94, 95. Nothing very panicky. Walk for a min and check Oximeter then. Usual rule of thumb is if the drop is 10% even after a walk of 3 mins, things are NOT good.

  • HRCT scan shouldn't be taken frequently. Frequent Radiation causes long-term risks, like Cancer in general. One CT-scan is usually equivalent of 300-400 X-rays. More scans, more radiation. Keep this in mind.

    • Report comes in an hour. Can be fetched online also. (Films usually take 3-4 hours in most hospitals). Report is more than enough to get started with treatment.

      • CT scan report contains CO-RADS score and CT-Severity Score. Both are important. Check the below table for CO-RADS score meaning.

        CO-RADS scores

      • CT-Severity score is also important. ≤8 is mild, 9-15 is moderate, >15 is severe. For example: A score of 20/25 and above pose a life risk or atleast long recovery.

      • Look for these words in HRCT scan.

        • ground-glass-opacities is ok, but crazy paving poses a life risk. Needs critical care. Like O2 concentrator to start with.

        • ground-glass-opacities 👇 (<4 days of Covid). Needs care. Life is NOT at risk immediately.

          

        • crazy-paving 👇 (4-8 days of Covid). Life at risk.

          

        • consolidation 👇 ( > 10 days of Covid). where you can't see blood vessels. Very very risky.

          

      • For more CT scan analysis watch https://youtu.be/u7pvq0eIIaY

      • For more indepth info about Covid watch : https://www.youtube.com/c/DoctorMikeHansen/videos?view=0&sort=p&shelf_id=0 This is really good source.

      • Don't go just by CO-RADS severity numbers. Seek Doctor's advice always. I personally have seen patients with 12/25 (Moderate severity) die, while patients with 19/25 (High severity) recover in a week. Multiple factors come into play in recovery.

      • Co-morbidities play a very crucial role with Covid. High BP, Cardio-vascular problems, Renal/Kidney problems, Type-2 diabetes, Hyper-tension cause problems bigger than Covid. Its like Covid becomes a catalyst for these diseases.

      • I have seen a case where Covid recovery was happening fine for 3 days without any complications, starting 4th day ECG reports showed abnormal characteristics, leading to cardiac arrest on 5th day. Its like the recovery took a U-turn suddenly.

      • There are many studies/videos on open web, by doctors who treated Covid patients or atleast studied them, and found blood clots also happen in multiple areas in our body once you caught Covid. Thats one of the many reasons why Covid medication has blood thinners in general. Blood clots in heart, brain pose life risk and eventually death.

      • Covid is lethal only if it affects lungs. That too only if severity is high in most cases. Chance of getting Covid through Food is relatively very low. But home cooked food is best always.

  • Rt-PCR test can be done at home. 80883 72009 (Chetan Home Blood collection team, Bengaluru).

    • Reports can be fetched online. Aware that a Negative test won't totally rule out Covid. It just means Covid cells are not there in your nose/mouth. They can be there somewhere else. So don't be negligent and still quarantine yourself for sometime. Let all symptoms subside.

    • Rt-PCR test gives you SRF number. This is really important.

    • If RT-PCR test comes out as Postive, then BBMP (Bengaluru) Aptamitra team will automatically call you (in a day) and will share the BU number with you. BU number is important for bed allocation.

• levels ≤ 90 require 0xygen(O2) bed treatment. This is a case where home care is no longer enough. Prolonged <90 level, can start causing multiple organ damage. So better move to a hospital.

• There are many fake oximeters these days, even ones that get broken very easily. Soldering the wire joints is usually the issue. If you can fix it or get it fixed, do it. I have 4 oximeters in my home and all of them got broken for the same reason recently. Went to a near by Tv mechanic and got them fixed for Rs 50. https://youtu.be/BDCQaGaZC_g video can come handy.

• Double mask. Use N95 and wear surgical ontop of that. I have seen doctors recommending this. If the surgical mask is exposed frequently to crowd, change it daily. Like you end up being an attender for someone close and you have to go to a Covid hospital everyday.

Home Care 🏡

• Ideally after the first symptom, like 103-104 fever or body-pains etc.. manage for 1-2 days at home.

  • Usually already healthy younger people (<40 years) recover inside a couple of days and shouldn't be an issue. Keep monitoring O2 levels.

  • If you are older, based on "Oxygen levels" mentioned above, make a decision to go for hospitalization or not.

• Ideally at the end of the 3rd day, symptoms should subside and body should start recovering. Keep monitoring O2 levels.

• By 3rd day morning, if the O2 levels are not right and you feel heaviness in breathing, start searching for beds right away. Hospitalization is required here.

• If you see anytime O2 levels are going down, don't panic. Take deep breaths and start doing the medically approved Proning technique 👇 to build up O2 levels. Seek medical care if required.

  

  

  

  

• Get an online consultation from Practo/mFine etc...on 3rd day of symptoms. Its mostly via audio call or video call. So can be done at the comfort of your home (isolation).

Reaching out for beds 📱

• Bengaluru Helpline numbers:

  • 1912

    • Yes this works and they are doing a great job in routing patients to hospitals. Bed availability is their primary service in these days. Dedicate one of your family persons to dial 1912 repeatedly if its NOT connecting. There will be a long queue and thats perfectly ok.

  • Use https://bbmpgov.com/chbms/ and https://searchmybed.com/#/p/public-portal to check bed status and dedicated covid healthcare center names.

  • Use this format for mentioning patient details:

      Name: 
      Age: 
      Home area / Address: 
      RT-PCR test : Done or not done. what is the result.
      SRF ID : (You will get this from RT-PCR test)
      BU number: Will be given only if the test is positive. Can be fetched by quoting SRF number to 1912 BBMP helpline.
      SPO2: (number with last recorded time)
      Co-morbidities: (if any)
      Aadhar: 
      State Patient Code: 
      Aptamitra registration number: 
      Current Hopsital name: (if any)
      Current Hospital address: (if any)
      Patient attendee: 
      Attendee contact: 
      Preferred Hospital: Pvt / Govt.
      Type of Bed required: General/ICU/Ventilator.
    

  • Zonal Control Room Numbers

    To Know which zone you belong to https://bbmp.gov.in/zonalclassification.html

    ZONAL WAR ROOM NUMBERS

    Yelahanka Zone - 9480685964 Nodal Officer - Dr. Rashmi 9632819836

    Mahadevpura Zone - 08023010101 , 08023010102 Nodal Officer - Dr. Pragyan 9502322032

    Bommanahalli Zone - 8884666670 Nodal Officer - Dr. Kumaraswamy 7349552658

    RR Nagar Zone - 08028601050 / 08028600954 Nodal Officer - Dr. Murali 9482224474

    South Zone - 8431816718 Nodal Officer - Dr. Rehan 9535586578

    East Zone - 7411038024 Nodal Officer - Dr. Akash 9886959900 Alterntate No: 08028601050

    West Zone - 08068248454 Nodal Officer - Dr. Yogesh 9448550159

    Dasarahalli Zone - 08028394909 Nodal Officer - 7204869787

  • Bengaluru: Any COVID-19 patient, who is struggling to get a hospital bed, can walk into any of these triage centers

    

    

  • https://karnatakafightscorona.org/#/resources

• Sprinklr doc.

• Twitter. Tag #Covid #Bengaluru and other related tags. Mention peakbengaluru, indiacares_2020, covidhelpblore names in the tweet threads.

Hospitalization 🏥

• Cabs for Covid+ and Others: Customized Services from RideAlly at Bengaluru (Reduced Prices)* We understand that ambulance charges are very high nowadays for Covid patients e.g. Visits to Hospital for CT scan etc. At RideAlly, we have reduced our prices and is quite lower compared to Ambulance. Our prices are Rs 1500 upto 10 kms (Covers nearby Hospitals). Every extra km is Rs 75. Waiting charges is Rs 250 per hour. 5% GST is applicable. Above price covers operational costs, like, PPE kit, sanitization for each trip, to manage empty km from/to patients location (at times, 25-30 kms one way) etc. You may call our 24/7 customer care at 0804600 4600 to avail the service. Pls note following points:

1. The vehicle is normal Sedan car and no way, can replace an ambulance. It has NO medical equipments.

2. Safety Measures: Driver will have PPE kit, Sanitizers and cars have a partition between driver and back seat. Passengers are allowed only on back seats. Vehicle is sanitized after every trip.

3. All payments need to be online and NOT to be settled with driver to avoid physical contact.

4. Min lead time to get the cab is 1 hour. Thank you for your support and do share your feedback. ~ RideAlly Team8th May 2021Https://rideally.com/apps

• These days every pneumonia case is given Covid level focus. Anyway Chest-CT scan can eliminate this confusion.

• Ensure Complete Blood Count (CBC) blood test, Complete Metabolic Panel (CMP) is done as soon as you join the hospital. This pretty much predicts which patient will die vs recover sooner or later. More on this: https://youtu.be/nqNxSRcIQPY?t=164

• ICU beds vs O2 beds. If the patient's oxygen levels are going down (<94 or worst a little less than 90) prefer an O2 bed compared to ICU bed. Reason being... ICUs are usually closed rooms and most of the times BiPAP machines will be there and there is a very high chance you would find other critical patients coughing. Since ICU rooms circulate air internally, there is a very high chance patient or anyone close can catch more Covid from air. Yes, within 1 meter distance Covid can be treated as Airborne disease. Hence the need for social-distancing in the first place. Thats one of the very reasons Covid cases are high in summers (where AC runs more) and also cab drivers won't put AC these days.

• Always prefer hospitals that are Covid Care Centers already. (https://bbmpgov.com/chbms/ gives you that list.) Because injections like Remedisivir (for all good reasons) are directly given to hospitals that are registered as Covid Care Centers, by Drug Control Department. (No middleman involved). So if you don't get a bed in these hospitals, go even with a small hospital that can give you O2 bed and start the treatment first. You can shift the patient in a day or two once you get a bed in one registered hospital.

• Remedisivir is only useful for a Covid patient, for the first 2-3 days. It won't cut mortality.

• If a bed with O2 supply (i.e.. O2 bed) is not sufficient and patient need to be put on BiPAP or Ventilator, go with ICU. As a last resort. Its always risk vs benefit calculation.

Recovery 👍

• Ensure Rt-PCR test is done and is negative for the discharge to happen. If its too early to see negative, (as dead cells will still make the report come as positive, speak to Doctor first.)

• The patient will feel very weak and this has to be specially focused for the next 1-2 weeks atleast. Its ok.

• Lot of hydration, ginger tea, hot-water to drink, fruits (or juice without ice) need to be given. Atleast twice a day. Along with normal food.

• Medication related to BP control, zinc, vitamin-C will usually be recommended by the doctor. Ensure you follow this strictly.

• BP Fluctuations will surely come post covid and thats ok with medication. Keep a BP machine handy and check it every 6 hours. BP control medication, don't forget to take.

• Monitor SP02 levels closely, every 4 hours. They will slowly build up. ≥ 95 is ok. Nothing alarming.

• Quarantine of 2 weeks from date of discharge is more than enough. Dedicate a room with attached bathroom for the recovered person. Keep disposable plates handy always. Air ventilation has to be there for the room.

• If the patient is having Fever or Cough still, attenders should wear mask definitely while interacting with patient. They don't need to wear mask inside the home, while away from the patient.

• Unless the patient has Fever or Cough, Covid is not contagious. So relax. Adequate use of sanitizer is must, nevertheless.

• After the discharge from the hospital, usually 5 days of isolation is recommended by doctors.

• Immunity usually takes a hit with Covid. Hence post-covid, one has to be careful for atleast a couple of months. Especially patients treated with O2 supply for prolonged time, may get black-fungus infection in rare circumstances. Also this is usually with patients with comorbidities.

Vaccination

• Registration : https://selfregistration.cowin.gov.in/

• If you're going out to get vaccinated, make sure you wear an N95 mask. I cannot tell you how many people have come back after their vaccination and got the illness. So I'm pretty sure that they've got it at the vaccination centre by being in a closed place for that half hour or whatever, and not wearing a proper mask. So, it has to be an N95 mask if you are going for your vaccination. Best is double mask.

Covid in Kids

• Yes. In 2nd wave, percentage of cases in kids is also high.

• But its not deadly for kids... atleast not like that of adults. watch the below video from May 2021.

• https://www.youtube.com/watch?v=pvqUmPzQL8Y