COVID 19 My Thought

Dear all, I would like to express my thoughts about COVID-19(C19) regarding how serious it is? / How much importance to pay etc.,  as a close witness of the sufferings .

1. Though 80% of patients with C19 are mild to moderate  with 100% recovery, yet 20% of them progress to the severe stage and nobody knows who will progress.
2. It’s really   a Herculean task for the whole team of ICU, Infectious disease specialist team to manage such case as we don’t have exact  definite treatment to kill the virus inside the body & it replicates in millions and damage  extensively.
3. One of our young resident progressed to severe stage. A whole team of senior anesthetist, Infectious disease experts , residents and other staff  were working 24 hrs for almost 1 week  stayed inside the ICU throughout day &night  in rotation , used all investigational treatment to rescue him. Thank God ,he is now out of danger.     This is possible only because of our institute’s  dedicated team and we are at present exclusively taking care of only our staff .  Very limited number. Hence our in charge of ICU requested all of us  daily to take all precaution . Because she knows the difficulties.
4. Imagine if this happened in a covid hospital where 100s of patients are admitted??  Do we have so many senior dedicated staff to take care of even 20% severe cases?? Plus they need to take all precaution  to prevent   the disease  in whole treating staff right from ward boys!  Even in Govt aided hospital the cost of covid care in ICU  is not less than 50,000/day.

1. Kindly don’t take COVID 19 lightly , please follow GOVT rule, stay inside  as much as possible, wear mask properly, avoid talking  face to face  and  eat   healthy food  . Thank you

I heard that some people are challenging COVID 19 as ordinary flue.  Well, most of us had thought that way at some point until we faced the real situation when we & our close colleagues had to go through the whole phenomenon of COVID. I would like to mention few more points to explain how health  care workers(HCW) are under constant  mental stress  managing COVID patients  as  it is not the routine practice , here we continuously  be alert to protect  the whole team from the infection as it is highly contagious. 

1. Main aim of the management is to prevent progression from stage 1 to stage 3.  We divided cases as mild ( Stage 1 a,b,c) , Stage 2(d,e) and stage 3(f), accordingly we treat at level1, level 2 and level 3( ICU)
2. Mild( stage 1 b&c)  patients  also need close observation ,at least twice daily need to do round, check temp, O2 saturation, BP,  chest Xray at admission ( CT scan of chest if warranted), daily monitoring of inflammatory marker , Neutrophils lymphocyte ratio(N:L), renal function and many others (in patients with comorbid condition). At any red flag sign, we have to take immediate rescue treatment to prevent progression to the next level.
3. The fact of the matter  is  to do our best to prevent a patient to enter level 3 eg: ICU where we face the main challenge  as COVID icu is something different   
4. Currently we don’t know the exact life cycle of covid 19, the definite treatment. We made some treatment protocol on the basis of several publications (from China, Italy, UK, USA etc. who face the pandemic prior to us) without knowing much about the efficacy.  We pray the Almighty.

1. On the other hand, now we know how the disease spread and how to prevent it, which is not a difficult one.  3 formulas:  Wash hand thoroughly, wear face mask while going out, maintain 2 meter distance from other person, stay inside as much as possible, and maintain a hygienic environment. With these precaution we can perform  our day to day work without facing any problem from COVID

1. Until we have a definite treatment or vaccine, we need to push COVID for another few months.
2. Otherwise the health care system will be completely crushed   ; In ICU, we may have to choose whom to give attention.  We may have plenty of oxygen or ventilators or other mechanical logistics, but we won’t have enough expert manpower to run those.
3. Request you all, kindly help HCW, follow IPC protocol ( Infection Control Prevention) as advised by the Govt.
4.  

Thank you