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Battling the Covid-19 Sequelae

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The COVID-19 pandemic has already changed our collective calculus of uncertainty because there is no reference case for the COVID-19 crisis in living memory. To learn about any long-term medical problems cropping up in people who have recovered from COVID-19 might have, and whether they develop an immune response to SARS-CoV-2 that provides protection against reinfection, is the battle of the hour, writes Puja Banerjee, Assistant Editor, Elets Technomedia Pvt. Ltd.

COVID-19, the disease caused by the SARS-CoV-2 virus has been infecting the human anatomy, leading to infections like pneumonia, respiratory failure, Cardiac, Respiratory, Neurological and Endocrinological, Mental Health issues etc. in major cases, death. Researchers are learning about the effects that may persist after patients are recovering from COVID-19. Health care workers and researchers are on the front lines fighting COVID-19, hoping to slow the spread of the disease and care for the sick. Normal life has stopped for well over a billion people around the world.While models and predictions abound, no one can say with certainty what the course of the virus will be, much less the impact the pandemic is having on people and societies. Eventually, though, the crisis will end, and life will return to normal. But what if it’s not like before? What will have changed as a result of what’s happening now?

The following COVID-19 scenarios for society and healthcare explore the potential impact of the emerging global pandemic.

Scenarios are stories about what the future health system is like, created through a structured process to stretch thinking, challenge conventional wisdom, and drive better decisions today. They are not predictions about what will happen. The COVID-19 pandemic has shaken the society, but, after a slow beginning, is met with an increasingly effective health system and political response. The virus is eradicated earlier than expected due to coordinated measures by global players to spread awareness and share best practices. Their competence in the crisis renews trust in public institutions.

Covid 19: The Disease

Infections caused by the virus are an enormous global health threat. They are a major cause of death and have adverse socio-economic effects that are continually exacerbated. Therefore, potential treatment initiatives and approaches need to be developed. The incubation period before the onset of COVID-19 symptoms ranges from one to 14 days, with a median of 5–7 days. Patients suffer from fever, dry cough, and loss of smell or taste, shortness of breath chills, rigor, fatigue, myalgia, headache, sore throat, and diarrhea.

Also read: ‘Can Covid-19 vaccine cause infertility?’

COVID-19 has a broad clinical spectrum, ranging from asymptomatic infection or mild upper respiratory tract illness to multi focal pneumonia, respiratory failure, and death. Approximately 80 percent of patients experience mild to moderate disease, 15 percent has a severe course requiring intensive care, and 5 percent require mechanical ventilation. Patients may develop pneumonia towards the end of the first week of infection. The mean interval from onset of symptoms to hospitalization is between 9 and 12 days; mean duration from symptom onset to discharge from the hospital is 25 days.The most severe cases develop pneumonia and Acute Respiratory Distress Syndrome (ARDS). Vital signs predictive of a severe course include respiratory rate over 24 breaths per minute, heart rate over 125 beats per minute, and oxygen saturation over 90 percent on room air.

Post Covid Sequelae

After COVID-19 infection, most people form adequate antibodies which prevent them from contracting the virus again. Nonetheless, it’s an unknown territory for the medical practitioners across the world, as to how long can that immunity stand. Cases where patients had the novel coronavirus again have been reported too. More in this way, for individuals who are at a high risk of reinfection are either old or don’t take enough preventive measures to additionally protect their immune system which makes post-COVID care important for them. While the standard laws of staying safe suggest everyone to cover their face with a face mask, wash hands regularly and practice social distancing, a reminder of how to keep with your well-being does not cause any harm. As Doctor suggests, Dr. Ansu Sen, MD/DM, Neurology, Senior Consultant (Neurologist), Columbia Asia Hospital, Kolkata, Ramakrishna Mission Sewa Prathisthan, Government of West Bengal, informs a few points.

 

Exercising consistently: Exercising might be troublesome in case you’re recovering, and your body is weak, however, gradually bringing it to your everyday schedule will make you both physically and mentally healthy.

Having a nutritious eating routine: Another fundamental practice is to have nutrient and supplement rich meal regimen to help speeding the recovery. Coronavirus opens the body to a ton of stress and the medicines can likewise debilitate your body. A few patients additionally experience unexplained weight reduction or weight gain. Thus, try to have a well-organized eating regimen loaded with organic products, vegetables, eggs and safe poultry to compensate for the lost appetite. Attempt to have food which is cooked and simple to process for the body. Keep in mind, your body is just barely attempting to return to full power. Try not to overexert or eat undesirable.

 

Work on your memory: The virus is known to damage your memory cells. In order to regain the lost attention, cognitive thinking abilities, and memory, invest some of your days’ time in playing puzzles, memory games and activities that you make you think harder. Formulate ways in which you can invigorate the mind. Start with those activities which are feasible, and continuously challenge one to build the sharpness. The key is going slowly yet accomplishing something for your brain each day.

Pace down: First off, don’t hope to jump back to your normal life routine right after you get back home or test negative for the virus. Henceforth, give yourself enough time to gradually transition into your old everyday practice, taking each day at a time. Keep in mind, you have quite recently battled an illness that severely attacked your immune system and it is smart to get into your old exercises gradually, instead of simply taking a plunge.

Focus on alarming signals: Whether it is a pestering headache or an episode of fatigue, it is essential to focus on any noticeable signs that your body isn’t approving the post COVID situation. Stay in constant touch with your primary care physician if any such issues crop up in the post-recuperation period.

Make space for others in your recovery journey: Understand that you do require rest to feel like yourself once you’re COVID negative. Consequently, look for help at whatever point you need as it will assist you with rationing your energy levels and fight exhaustion. Regardless of whether it is shopping for food or preparing it, acknowledge that your body needs enough opportunity to recover. So, by taking help or involving someone close while you are on your recovery route is rather beneficial for you.

While normally, a COVID-19 patient for the most part takes 3 weeks to recover; new researches have called attention towards those individuals who may have experienced impact on their kidney, lungs and heart, long after they recovered. Other conceivable long-haul effects of COVID-19 are neurological conditions and mental health issues as studies suggest that the infection can likewise attack the brain cells and the nervous system.

Mental Health

Dr. Sudipta Roy, Clinical Psychologist, Founder and Director of Psy Lens Centre, Surat, Gujarat explains, mental health concerns and treatment usually take a backseat when the limited resources are geared for pandemic containment. In this global humanitarian crisis of the COVID-19 pandemic, mental health issues have been reported from all over the world. The major mental health issues reported were stress, anxiety, depression, insomnia, denial, anger and fear. Children and older people, frontline workers, people with existing mental health illnesses were among the vulnerable in this context. COVID-19 related suicides have also been increasingly common. Globally, measures have been taken to address mental health issues through the use of guidelines and intervention strategies. The role of social media has also been immense in this context. State-specific intervention strategies, telepsychiatry consultations, toll free number specific for psychological and behavioural issues have been issued by the Government of India. Keeping a positive approach, developing vulnerable-group specific need-based interventions with proper risk communication strategies and keeping at par with the evolving epidemiology of COVID-19 would be instrumental in guiding the planning and prioritization of mental health care resources to serve the most vulnerable.

In-patients and Outpatients

During the COVID-19 pandemic, healthcare systems have adjusted their standard approaches of delivering healthcare services to reduce the need to provide in person care to minimize risk to patients. Telehealth services are optimized in India and are available and appropriate. The federal government has made telehealth services easier to implement and access.

 

Dr. Narayan Chakravarty, Medical Officer, Kolkata Municipal Corporation, Government of West Bengal suggests

  • Provide urgent care for non COVID-19 conditions, identify higher acuity care needs, and refer patients as appropriate.
  • Access primary care providers and specialists, including mental and behavioural health care providers, for chronic health conditions and medication management.
  • Participate in physical therapy, occupational therapy, and other modalities as a hybrid approach to in-person care for optimal health.
  • Monitor clinical signs of certain medical conditions remotely (like blood pressure and blood glucose levels).
  • Engage in case management for patients who have difficulty accessing care, including those who live in rural settings, older adults, or those with limited mobility.
  • Follow-up with patients after they are discharged from the hospital.

For Out-Patients

  • Assess the patient’s ability to safely self-isolate and monitor their symptoms at home and assess the risk of the virus spreading to others in the patient’s home environment.
  • Provide clear instructions to caregivers and people who are sick regarding home care, including when and how to access the healthcare system for in-person care or urgent/ emergent conditions.
  • Identify staff to monitor patients at home with daily check-ins using telephone calls, texts, patient portals, or other means, if possible.
  • Engage local public health resources, home health services, and community organizations to assist with support services (such as delivery of food, medication, and other goods) for patients isolating at home.

 

Future Perspectives

India is taking necessary preventive measures to reduce viral transmission. Along with the Government of India, State Governments, ICMR and the Ministry of AYUSH provided guidelines to use conventional preventive and treatment strategies to increase immunity against COVID-19. These guidelines could help reduce the severity of the viral infection in elderly patients and increase life expectancy. In addition, the Serum Institute of India has developed a vaccine against SARS-CoV-2 infection. Until every individual obtains a vaccine, it is highly recommended to stop further transmission of the virus.

India has attempted to broaden its research facilities and shift toward testing the mass population, as recommended by medical experts in India and worldwide. So far, total 19.36 crore samples have been tested for Covid-19. India crossed a crucial milestone in its fight against Covid-19 with over 20 lakh beneficiaries vaccinated against SARS-CoV2 since the national drive was launched on January 16. Daily new cases of infection as well as deaths are at their lowest in around eight months. If there is one thing that the pandemic have taught us, it must be to wait in line, patiently, with at least six feet in between. No matter when you get the vaccine shot, victory is assured.

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