Home Care For A Patient Of Covid-19!
A large majority of patients who are infected by the Coronavirus are either asymptomatic or mildly symptomatic.
Most of them are managed at home. This has multiple benefits- you prevent passing on the infection to multiple other persons, you are in the comfort of your house and can enjoy home food, and most important you do not overwhelm hospitals that need beds to treat seriously ill patients.
Credible and respected organizations like WHO, CDC, AIIMS have set up and continue to update protocols for home care of a patient diagnosed with Covid-19.
Medication
1. Tab Paracetamol SOS for fever or body ache
2. Simple over-the-counter antacid, empty stomach - for acidity
3. Simple antitussive cough syrup/cough suppressant for a simple cough
Steam inhalation at night - for productive cough
Points to Note-
1. Consult with the treating physician once a day.
2. Monitor SPO2 (Use Pulse Oximeter)- above 94 is ok. Check Twice a day
3. Check respiratory rate – less than 24 is ok – see how many times the chest moves to breathe per minute.
4. Isolate from other family members (especially elderly) - separate room and bathroom.
Wash utensils thoroughly.
Use disposables if possible.
Hand hygiene – wash hands before and after touching common surfaces.
Discard disposables with care.
5. Eat healthy nutritious food, hydrate well.
6. Wear a mask as far as possible (inside the house – in case other members live with you)
7. Pets are safe.
8. Ventilate the room well, prevent the spread of droplet infection.
9. Test again on day 14 of first symptom or date since positive - not mandatory
10. The RT-PCR test is a qualitative test. It is the gold standard for the diagnosis of Covid-19. There are many variables in the testing process – do not read too much into the CT score mentioned in the report.
Signs of Deterioration
- Falling SPO2·
- Rising respiratory rate
- Breathing difficulty, heaviness in the chest
- Severe persistent cough
- Persistent high fever
- Mental confusion
- Dehydration due to diarrhoea or vomiting
High-risk patient
- Obese·
- Elderly –60 years and beyond ·
- Diabetic·
- Heart disease, Hypertension·
- Systemicorgan disease – Lung, Kidney etc·
- Immunocompromised- on steroids, Transplant recipients, cancer patients on Chemo
For high-risk patients - need to start a prophylactic Antibiotic and sometimes Ivermectin early in the onset of the disease- 200mcg/Kg body weight per day for 3-5 days.
APPROVED MEDICINES FOR COVID-19
There is currently NO CURE for Covid-19.
Some drugs have been given EUA (Emergency Use Authorization) - given the nature of the pandemic and our obvious helplessness in fighting it.
These are only for patients admitted to hospitals with moderate to severe disease.
For home care WHO recommends only symptomatic treatment.
1. Remdesivir- given Intra Venous– in a hospital setting.
2. Monoclonal Antibodies – very expensive, not easily available.
3. Dexamethasone- given in the hospital, usually in ICU settings, to prevent a Cytokine storm
4. Anticoagulant therapy – if required
5. Oxygen/ High flow ventilation
6. Other supportive therapy on a case-to-case basis.
When the medical fraternity is moving so cautiously in managing this disease, we are aghast to see and read prescriptions that patients with mild symptoms are following at home- Up to 2Antibiotics, Antivirals, Three to Four supplements and other unnecessary drugs.
In a country with lax drug rules- where practically anyone can walk into a chemist shop and pick up practically any drug without a prescription – the outcome can be catastrophic.
Remember – all the superfluous medicines and supplements that you take must be digested, metabolized and excreted by your body.
Carry home message -
- Please follow sensible medical advice
- Avoid self-medication
- Avoid taking so many drugs for mild cases – there is no evidence for their use
- Do not send or forward frightening messages or doomsday scenarios- be positive
Get well soon!
Dr (Major) Rajesh Bhardwaj
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