HOW THE PANDEMIC EXPOSED OUR INHERENT FOLLIES

As the pandemic rages on in our country, the misery and hopelessness unleashed by the disease are matched equally by our complete lack of common sense in tackling it.

A short story will illustrate the situation – 

A young patient called me from Dwarka, South Delhi to state that she is Covid -19 positive and that she is sharing a prescription with me to see whether it is ok.

The prescription was a handwritten note on a plain piece of paper – no doctor’s name or signature. It contained two antiviral agents, two antibiotics, one antacid, paracetamol 650 mg, one combination of an antihistamine with montelukast, and three vitamin supplements. 

So I asked her who wrote this?

“Doctor uncle I got this from the security guard bhaiya in the Society. The aunty in another flat was Covid positive so she gave the security guard bhaiya this list of medicines to get for her. He has passed this list to all of us who are positive- so we are all taking these medicines.

End of story

A large majority of patients who develop this disease will have mild to moderate symptoms and will be treated at home. 

WHO, AIIMS, and many such reputed organizations have made protocols for home care.

There is only one common message- symptomatic care and monitoring Oxygen levels.

Persons at high risk (elderly, obese, diabetic, heart disease, serious liver, lung or kidney disease, immune-compromised) may take a prophylactic antibiotic and an antiviral.

In spite of this, we are consuming drugs of unknown value without any medical guidance or prescription – we are letting messages of unknown provenance via WhatsApp determine our treatment. I was treating a patient who was taking 80 mg of a systemic steroid in a day – because she was told that is what hospitals are prescribing. 

Healthy persons want to start Ivermectin or Doxycycline even in the absence of disease- as a preventive.

As a human species, where are we going wrong?

The Follies

• Fear – the fear of catching the disease has created such a panic that we are ordering and hoarding precious medical items like life-saving drugs and Oxygen cylinders even when we do not need them- creating an acute shortage and denying the same to our fellow citizens who are in dire need.

• Irrationality – As per medical reports many patients who have succumbed to this disease in the second wave or are struggling to breathe in crowded hospitals were eligible to take the Vaccine but did not take it on account of some irrational thought and belief in conspiracy theories. We have lost many loved ones because they did not get vaccinated when they had the chance.

• Superstition – We throng Melas in large numbers under the superstitious belief that our Gods will protect us – at the time of writing a prominent Seer, unfortunately, succumbed to the disease waiting for a hospital bed in Rishikesh. God does not protect us from the disease – our own responsible behavior does.

• Blind belief – Our blind belief in ‘Tall Claims’ and ‘Miracle Cures’ has caused untold suffering. As an ENT specialist, I see nearly daily cases where patients are coming with a burnt oral cavity after drinking burning hot ‘Kadha’ because they thought this will keep the virus away- a damaged mucosal surface makes it all that much easier for the virus to enter. The same goes for doing steam inhalation all through the day with boiling hot water.

• Civic disregard – Our reluctance to wear masks in public places, gathering in large numbers in religious and other functions, defiance of simple public health measures like keeping a distance of six feet from others has led to the sudden resurgence of the disease.

And as for us – the medical fraternity – the arrogance and easy confidence with which we have prescribed medicines of no known value, with complete disregard to practical and credible protocols established by reputed institutes like the WHO, AIIMS, ICMR belies belief.

Please read this carefully

1. For home care of a Covid-19 patient there is only symptomatic treatment  

2. Signs of Deterioration – when to go to the hospital

• Falling SPO2
• Rising respiratory rate
• Breathing difficulty, heaviness in the chest
• Severe persistent cough
• Persistent high fever
• Mental confusion
• Dehydration due to diarrhea or vomiting

3. Wear masks in public, go out only if you have to

4. Seek credible medical advice – do not self-medicate

5. Avoid taking drugs on your own except for symptomatic relief. 

6. Eat healthy, sleep well, do moderate physical activity

7. Think positive – do not let all the bad news around getting to you.

8. Please, please get Vaccinated when your turn comes- Vaccines save you, save your loved ones at home, and keeps the community safe.

Dr (Major) Rajesh Bhardwaj