What can you do if you are COVID-19 positive: Practical coping tips

Do you know the best ways to cope if you are affected by COVID-19?

This pandemic of COVID-19 that has set the whole world on fire, here are a few important and practical facts and tips that everyone should know:

COVID-19 is a respiratory viral infection, very similar to the previous epidemics of influenza like diseases such as the Middle East respiratory syndrome coronavirus (MERS-CoV) and severe acute respiratory syndrome coronavirus (SARS-CoV), the Spanish Flu and so on.

This virus was first named in Wuhan, China where it originated in 2019, as COVID-19. It is much more deadly than all those diseases because of its fatal consequences and its ability to spread much faster. Studies show that just 18 viral particles are enough to cause a serious infection in healthy adults.

Its effects on the old, the very young, and the people who already have other comorbidities is more serious. The viral impact on these people is more severe in nature, often leading to death or permanent impairment of the lungs.

What precautions can you take against getting COVID-19 infection?

It is very important that you make yourself aware of all the facts and facets of this COVID-19 virus. Avoid getting infected or infecting other people by following these safety tips and precautions:

The recommendations of the WHO instructs to:

• Keep a distance of at least 1 metre from other people when you go out of your home. This is called social distancing.
• A very Indian namaste with folded hands is more hygienic than a handshake or a hug when greeting people
• Wear a mask covering your nose and mouth to avoid the droplets containing the virus or fomites from the infected people, when they cough or sneeze
• Avoid touching your nose, eyes or mouth when you have previously touched surfaces that could have the fomites, such as handles, counter-tops, lift buttons, switches and so on
• Make a habit of regular hand hygiene by washing hands thoroughly for at least 20 seconds using soap and water or spreading an alcohol-based sanitiser on your hands if you are outside.
• Launder the mask before reusing
• Observe reverse quarantine by staying away from elders, children and the ill, to avoid passing the infection to these vulnerable people
• If you are not sure you have been near an infected person, have a bath and wash the clothes you wore, before moving about the house or kitchen
• If anyone you had contact with tests positive, self-isolate for 14 days at least, even from family members and the vulnerable

• Avoid large gatherings and crowded places that makes it difficult to maintain social distancing of 1 to 2 metres
• Work from home whenever possible to avoid the commute as well as the intermingling with others in the office
• Try to shop online and get goods and groceries delivered instead of going to crowded malls and markets
• Following best practices to prevent and control COVID-19 can go a long way.

What are the tests for COVID-19?

There are different types of tests for COVID-19 like the RT-PCR tests such as CB NAAT, TrueNAAT and antigen assay.

The real-time polymerase chain reaction (RT-PCR) test

The RT-PCR is the most recommended test for COVID-19. However, this takes a day to confirm as the process involves taking a swab from the inside of the person’s nose or throat. These swabs are processed by replicating the RNA strands of the virus by replicating it, then adding a primer for binding it and a fluorescent probe.

This is left for some time in the PCR apparatus. The presence of the virus is confirmed by the fluorescence of the bonded DNA. This needs the apparatus, the chemicals and has to be done in a lab. Consequently, it will take at least a day to get the results. This test is also called the CB NAAT (Cartridge Based Nucleic Acid Amplification Test).

A shorter version of this test is a recent introduction and takes one to two hours: theTrueNAT Beta Cov Test. This is in a kit form and user friendly. However, this is used only for screening a large number of people quickly and may lack the accuracy of the CB NAAT.

The antigen assay test

This is a blood test to find out if there has been a past infection – that is revealed by the antigens for the virus. When a virus or bacteria enters the body, antigens are generated by the body’s immune system to fight them.

As long as these antigens are found in the body, future infections by the same strand of germ cannot occur. However, there are differing views regarding the Corona Virus infection as there are some reported cases of re-infection within 3 months of getting a negative result for the virus.

Did you just get tested positive for Covid -19?

You washed your hands often, wore a mask when going out, maintained social distance of a metre or two when meeting other people, laundered the clothes you wore when you went out, as well as the masks. And yet, in spite of all these precautions, you learnt that the COVID-19 virus has somehow got through all your defensive strategies and entered your blood.

What should you do now?

First of all, there is no cause for panic yet. According to the WHO report, about 80% of the infected persons are asymptomatic or with the milder form of the disease. Only the other 20% are admitted in Covid facilities for treatment. 15% Covid positive patients need ICU care and 5% need ventilation too for helping the patient to breathe. Make sure to take care of your mental health during COVID-19.

How do you know which type of COVID-19 infection you have?

Make a quick self-check and list out your symptoms. Calm down and approach the problem with a positive attitude. Check if you have these signs and symptoms of COVID-19.

The COVID-19 infection manifests in 3 ways:

• Asymptomatic, with no visible symptoms such as fever, cough, cold, diarrhoea etc.. You could easily pass by even the check points in airports and other public places.
• Mild symptoms, with low grade fever, a cold maybe and small signs like tastelessness.
• Full blown infection with a cold, a racking cough, breathlessness, diarrhoea, muscular aches and a high temperature.

What should you do after you list out your symptoms?

The next step is to approach a medical practitioner – maybe your personal doctor or one from your local clinic. Any further action must be taken only under the advice of a medical authority. There are many doctors who are now available through tele-medicine. You could call them through audio or visual lines to explain your symptoms. The doctor will ask you to take a test for the virus.

What can you expect the doctor to advise?

If you are asymptomatic or with only mild symptoms, the medical practitioners would most probably advise you to stay in home isolation and get treated. Similar to the treatment of the seasonal influenza.

However, if your symptoms are very severe – like you need oxygen support to breathe, they would advise institutional treatment. People with comorbidities like heart, kidney, lung or liver problems or have cancer are advised to get admitted to a facility with ICU and ventilation support available.

What are the expected treatments that you should follow if you are in home isolation?

• You have to remember that if you are under home isolation, then you have to take extra care not to infect the others in your family. So, stay in a separate room. If that is difficult to manage, then it is better to get admitted to a Covid facility.
• Maintain a healthy balanced diet including lots of liquids like juices and soups. Use separate utensils for eating and clean them separately in soapy water. Same with clothes, masks etc. that you have used. Don’t pass your phones and such items for others to handle. Keep them sanitised suitably.
• You can expect to be isolated for about 14 days till your test turns negative. So, get plenty of rest, keep yourself gainfully occupied and entertained and maintain a cheerful outlook.

What are the medical treatments that you should follow?

Take the medications as prescribed by the medical service provider. There is no exact drug for curing COVID-19. However, they may ask you to take some prophylactic medications like vitamin C and D, some Zinc tablets, aspirin, HCQ, or even Homeopathic and Indian Ayurvedic or Siddha medicines. These medications have to be taken only under the supervision of your doctor.

Get an Oximeter to test your oxygen levels. These meters are available in drug stores and are small clothespin-like meters that are clipped on your finger for a few seconds. The readings are digital. The SpO2 reading should be 95 to 100%. If it falls below 95, report it to your doctor immediately.

The fall in oxygen levels could indicate the inflammation caused by the released cytokines. These are small glycoproteins made by the cells for different functions. One of this function is regulating immune and inflammatory responses.

A moderate level of cytokines is beneficial in fighting the disease. However, a higher level of cytokines in the blood – called a “cytokine storm” – could cause harm to the vulnerable organs of the body. This has to be checked with suitable medication. Also, the doctor could prescribe oxygen therapy with the help of a trained nurse or health worker.

When can you expect to be cured of COVID-19?

The normal course of the treatment and recovery from COVID-19 is about 14 days. You can expect some fever and cough/cold around the 4^th day and this gets worse till about the 10^th day. Some people complain of muscular aches, or stomach upsets like vomiting and diarrhoea. After that, the symptoms wane till the 14^th day. However, keep to your room till you are tested negative.

A high viral load in the swab testing can mean that you are still infective and can transmit the virus to others. So, stay inside till the viral load shows negative for live virus. Studies have shown that those with mild and lesser symptoms are more capable of transmitting the virus if the viral load in their swab is higher.

How will you know if you need to be admitted to a hospital facility?

If you have or develop more severe symptoms, such as:

• acute breathlessness
• a distressing cough
• acute diarrhoea and vomiting
• loss of smell and taste
• higher fever
• myalgia and fatigue

However, studies have shown that certain sections of the population are more at risk for developing these distressing and sometimes fatal symptoms. These people are mostly senior citizens, those with comorbidities like cancer, heart problems, hypertension, breathing difficulties, diabetes, kidney, and liver problems. Also, pregnant women, new-born babies with medical issues and children with congenital diseases.

What happens if you are admitted to a COVID-19 facility?

According to the trends seen till now, about 18% of the infected patients need hospitalisation. And another 2% need mechanical ventilation to pump in enough oxygen to meet the needs of the body. Patients with hypoxemia (very low levels of oxygen in the blood and tissues) and dyspnoea (difficulty in breathing easily) are moved into the ICU and their conditions eased with oxygen and medications.

This is because, these conditions, if unchecked, would lead to acute respiratory distress syndrome (ARDS) in a week or so. If the oxygen levels are not increased, it would lead to multiple organ failure that could be fatal.

Studies show that this could be caused by weak immune response of the patient, especially in the older and those with comorbidities. To overcome ARDS, these patients could be given medications like methylprednisolone. Many patients are unable to breathe in enough oxygen. Mechanical ventilators are used to ease this problem. The oxygen levels and the cytokine levels are monitored regularly.

However, there is the other end of the spectrum, when the immune response is so extreme it produces ‘cytokine storms’. Overwhelming cytokine production end up attacking the body’s own organs by killing the cells/tissue that harbour the COVID-19 virus. Consequently, this damage caused to the tissues of the vital organs could lead to death.

The cytokine storm is not unique to the COVID-19 virus: it is common in many viral infections and even noticed in the reaction of the body to transplanted organs. Various antiviral medications such as Remdesivir, Favipiravir, Itolizumab are being used to treat patients with the COVID-19 cytokine storms.

However, these are not approved by other specialists who feel that the efficacy of these drugs for treating COVID-19 is still in the early stages and should not be the approved treatment drugs. Moreover, these drugs have severe side-effects that are difficult for the patients, already weakened by the virus, to bear.

The COVID-19 pandemic brought out the fact that we are unprepared for a mass infection on this scale. As viral infections do not easily respond to medical treatment, there are only two ways to tackle this scourge: prevention and building up immunity as explained earlier.

KEEP HEALTHY! BE SAFE!

TL;DR?

References

 

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