May 2021 - Turtlemint

Covishield or Covaxin: Which One Should You Take?

May 19, 2021May 19, 2021 Rupanjali Mitra Basu

With the COVID-19 pandemic wreaking havoc in India, one of the most effective defence mechanisms is vaccination. Unless there is mass vaccination, the pandemic will continue to come in waves and create tremendous devastation. Thankfully, the third phase of the vaccination drive has been announced in India and everyone above the age of 18 years can now get vaccinated. There are primarily two vaccines being administered in India – Covishield and Covaxin. If you are wondering which one to choose, we have some helpful data for you. Take a look and then decide which one is better suited for you.

Covid Vaccines in India

Currently, India has two vaccines. The first one is the AstraZeneca-Oxford vaccine, Covishield. It is being manufactured in India by the Serum Institute of India. The other one is the indigenous Covaxin, manufactured by Bharat Biotech. Both vaccines have a high success rate and are given across the country. Both the vaccines are administered intramuscularly.

Properties of the vaccines

While you may not be able to choose between the two vaccines once you arrive for your jab appointment, you can choose the one you wish to go for when booking your appointment on the COWIN portal. The properties of the vaccines are as explained:

Covaxin –
According to the manufacturers, Covaxin implements the Whole-Virion Inactivated Vero Cell-derived technology. Here, an inactive virus is injected into the recipient’s body. While this virus is incapable of infecting the person, it is capable of training the immune system on how to fight an active virus, if it enters the body. Covaxin has an efficacy of over 78%, which is pretty impressive in a large country like India.
Covishield –
The Covishield vaccine works on a different mechanism – the viral vector method. Here, an active, but harmless virus is injected into the body. It mimics the main illness and the body produces pathogens that keep the body prepared to fight the active, harmful COVID viruses in the future. It has an efficacy of around 82%.

Source: The Hindu

The World Health Organisation states that any vaccine that has an efficacy of over 50% is a powerful measure to control a pandemic, and in this respect, both Covaxin, as well as Covishield, prove to be effective.

Dosage

Both the Indian vaccines, Covishield as well as Covaxin, are given in double-doses. You can get the second dose of Covaxin after 28 of receiving the first dose. However, it is preferable to wait for 8-12 weeks between the two doses of Covishield.

Side effects

Mild to moderate side effects post-vaccination have been noted in recipients receiving both the COVID vaccines in India. These side-effects include fever, fatigue, soreness around the jab area, body ache and headache. The symptoms however are mild and subside within a day or two.

The WHO informs that experiencing a vaccine side-effect is normal and you should not panic if you notice these conditions after you get vaccinated.

Production and manufacturers’ reputation

Currently, the vaccines are produced on a very large scale in India. Unfortunately, the numbers are still falling short, given the vast population of India. However, both Bharat BioTech and Serum Institute are working round the clock to ramp up the production. SII’s Adar Poonawala was recently quoted saying that SII received an order of 26 crore vaccine vials from the government. It has already delivered 15 crore vials and is working on producing the remaining 11 crore doses at the earliest. On the other hand, Bharat BioTech has received an order of 5 crore vaccine doses from the government. To fully vaccinate the entire population of the country, 60 crore doses would be needed.

The Serum Institute and Bharat BioTech are both highly reputed virology institutes in the country. They have successfully manufactured important vaccines in the past and this gives hope to the countrymen about the effectiveness of COVID vaccines too.

Table of comparison

	COVAXIN	COVISHIELD
Developed by	Bharat Biotech ICMR	Serum Institute of India
Type	Whole-Virion Inactivated Vero Cell-derived technology	Viral-Vector Technology
Dose	2 doses, at a preferred interval of 4 weeks	2 doses, at a prefered interval of between 8 and 12 weeks.
Efficacy	78%	82%
Storage requirements	To be stored between 2 degrees and 8 degrees Celsius	To be stored between 2 degrees and 8 degrees Celsius
Administration	Given on the left hand, intermuscular	Given on the left hand, intermuscular
Cost	Rs 150 for the Central Government, Rs 400 for State Government and Rs 1200 for a private hospital.	Rs 150 for the Central Government, Rs 300 for State Government and Rs 600 for a private hospital.

The takeaway

Though launched with a lot of promise, the vaccination drive in India is struggling presently. There is a massive shortage of vaccines and getting an appointment is very difficult. It, therefore, is advisable for you to opt for the vaccine that is available at the earliest slot. Both the vaccines, Covisheild as well as Covaxin, have shown positive results, and since combating the pandemic is the main issue right now, getting vaccinated is the best option.

FAQs about the vaccines in India

Can I take one dose of Covaxin and another dose of Covishield?
No, you cannot take one dose of each vaccine. As stated, Covaxin and Covishield work on two different mechanisms, so you need to take the same vaccine on both occasions.
How are the vaccines stored? Covaxin and Covishield?
Both Covaxin, as well as Covishield, need to be stored at temperatures between 2 degrees and 8 degrees celsius, which is equivalent to the temperature of a regular household fridge.
Who shouldn’t take Covaxin/Covishield?
While both the vaccines are very safe, you should speak to your doctor before taking it if you:
- Are pregnant
- A nursing mother
- Have a severe allergic condition
What is the price of each?
Covishield is charged at Rs 150 for the Central Government, Rs 300 for the State Government and Rs 600 for a private hospital while Covaxin is charged at Rs 150 for the Central Government, Rs 400 for the State Government and Rs 1200 for a private hospital.

References:

How safe is the Covid Vaccine? Can you spread Covid if you are vaccinated?

May 19, 2021May 19, 2021 Ankita Sejpal

With the availability of the COVID 19 vaccines, there is a general sense of relief. Though still a very long way to go, people have begun to see a faint light at the end of the dark tunnel. The vaccines promise to offer protection from the deadly virus which has claimed thousands and thousands of lives all across the world, with India being one of the worst-hit countries. India has two very effective COVID vaccines currently – Covishield and Covaxin. While Covishield is the globally used AstraZeneca-Oxford vaccine, Covaxin is an Indian product that is created in India by an Indian company. Both the vaccines are considered to be very safe and have the WHO approval.

Safety worries related to the COVID vaccines

A vast majority of the people have come forward to get themselves vaccinated. However, a silent fear lurks in the mind of many people regarding the safety of the COVID vaccines. Thankfully though, these worries are baseless as the WHO has ensured that every vaccine being used is safe and tested extensively to ensure maximum protection. According to the WHO, every vaccine has been tested several times, on a large group of people of different age groups, ethnicities, genders and with health conditions. Covishield and Covaxin both have WHO’s approval, so it can be said that they are very safe to use.

Who should not take the COVID vaccines?

While the WHO clearly states that the vaccines are safe for practically everyone, it does mention that certain people must take certain precautions before taking the jab. These include pregnant women, nursing mothers, people with severe allergies and HIV positive people.

Social interactions after getting vaccinated

But how safe and effective is the vaccine from preventing the spread of the coronavirus? As per the experts, the vaccine cannot exactly stop the virus from entering the body. The role of the vaccine is to strengthen the immunity system to an extent where the vaccinated person will not get affected by the virus. In other words, the severity of COVID, if injected, will be very low or marginal and the patient will not require hospitalisation or any other form of emergency care.

This is why you should limit social gatherings even after receiving your vaccine if you are unsure of the vaccination status of all the other people around you.

Can I spread the vaccine to fully vaccinated people?

But what happens if you are fully vaccinated and you interact with a small batch of people who too are fully vaccinated? In that case, the safety is much higher. It may be possible for you to interact with those people without wearing your mask. However, to do so, you must be one hundred per cent sure about what is meant by “fully vaccinated”. A person is deemed fully vaccinated two weeks after he receives his second vaccine dose. Remember, you won’t be considered to be fully vaccinated the moment you take your second shot!

Silent attack

A very important point to remember here is that you can silently get affected by COVID 19 after you get vaccinated. As stated, the virus is still capable of entering your body and infecting you. You may be completely non-symptomatic and unaware of the presence of the illness. However, the virus will keep spreading as you will be an active patient, shedding the virus. The virus, even if it spreads and circulates in vaccinated people, will retain the capacity to mutate. This is tremendously dangerous, as vaccines may not be powerful against the mutant COVID viruses. So in order to ensure you don’t play a role in this, you need to wear your mask, sanitize your hands and maintain social distancing till the time the WHO confirms the end of the pandemic.

Efficacy of the COVID vaccines in India

Another safety concern that many people have is regarding the efficacy levels of the COVID vaccines available in India. Covishield, which is the AstraZeneca-Oxford vaccine, has an efficacy of 82% after the administration of both doses. It has an efficacy of 76% after the administration of a single dose. Covaxin, on the other hand, has an efficacy of 78% after the administration of both doses.

The bottom line

After keeping all the points mentioned above in mind, it can be said that the COVID vaccines are very safe. You should therefore not hold yourself back from getting vaccinated. However, even after getting vaccinated, you won’t be 100 per cent protected against the virus. You may still get a mild version of the infection, and more importantly, you may spread the virus to others. It is thus a good idea to practice the usual pandemic norms of masking up, sanitizing hands and surfaces and maintaining social distancing and stay as safe as possible from COVID 19.

References:

How to Treat Covid at Home? When Should a Covid Patient be Admitted?

May 19, 2021October 21, 2021 Sidharth Hampanavar

With over 4 lakh people being diagnosed with Covid every day, Indian healthcare is crumbling. Hospitals and healthcare clinics are sending desperate messages that they are running out of oxygen and other necessary resources, which is putting the lives of hundreds of patients at risk. With the crisis deepening hospitals and healthcare experts are advising people with mild symptoms to treat covid at home.

With the system unprepared for such a massive disaster, treating covid at home may help in subduing the havoc created by the second wave.

Important:
Senior citizens, people with a medical history, pregnant women, children, who are at a greater risk for becoming seriously unwell, must consult their doctor as soon as the symptoms start to show, as they may require hospitalisation. These symptoms are:

Fever
Shortness of Breath
Cough
Chills/ Shivering
Muscle Pain
Headache
Loss of taste/ and smell
Congestion/runny nose
Diarrhoea
Sore Throat
Nausea/ Vomiting

What are asymptomatic cases of Covid-19?

A patient who gets a laboratory confirmation of being Covid positive but does not experience any symptoms or does not have any oxygen saturation at room air over 94% is an asymptomatic patient.

Who Can be Treated at Home?

As per experts the patients who are asymptomatic, which means a person who is laboratory-confirmed covid infected but does not experience any symptoms can take treatment at home. Along with them, people with symptoms such as cough, fever, nausea, loss of taste and smell, muscle pain also fall in this group.

The Government of India Ministry of Health & Family Welfare, consider the following patients to be eligible for treatment at home:

A medical officer should ensure that the patient is clinically assigned as an asymptomatic or mild case
These patients should have the required resources at home that allows self-isolation and also for quarantine of other family members
A 24×7 caregiver should be present on a regular basis
The caregiver should be able to monitor the patient’s health and be in touch with the hospital
Senior citizens and people with diabetes, hypertension, chronic liver/ lung disease must only be allowed self-isolation after an evaluation by a medical officer
It is recommended that HIV, Cancer patients, Transplant recipients do not undertake home isolation. However, it may be allowed after an evaluation by a medical officer
Hydroxychloroquine prophylaxis as prescribed by the treating medical officer should be taken by the caregiver as well as other members who are in contact with the patient
More guidelines are available at Ministry of Health & Family Welfare

How to Treat Covid at Home?

When you are treating coronavirus at home, you need to keep a healthy mental attitude. Dr Praveen Chandra, Medanta Hospital Gurugram said, “First of all understand, even if you have COVID – do not panic. Once you are diagnosed with COVID, do a lot of breathing exercises to keep your lungs healthy and take a lot of steam. You can do normal activities as well unless you have the warning signs like shortness of breath and low oxygen levels.”

The following points must be kept in mind when treating yourself/ a patient for Covid at home:

Patient should be isolated from all other household members and pets
One room should be allotted where he/she should stay alone. The room should be well-lit, well ventilated
The patient must always wear a triple layer mask and discard it after 6-8 hours
Respiratory etiquettes must be followed at all times
Patient and the other members in the house should wash their hand with soap and water for 40 seconds
Symptomatic management of symptoms such as fever, cough, running nose etc must be followed
Make use of a pulse oximeter and thermometer every 4 hours to monitor the patient’s health
Do not go out of the house, unless in an emergency to the hospital
You can take steam inhalation or do gargles with warm water
The patient must drink lots of fluids such as water, soups, coconut water, fresh fruit/ vegetable juice
The patient should take ample rest
The surfaces that are frequently touched must be disinfected frequently
Patients can indulge in light exercises and yoga
Allow cross ventilation in rooms, keep windows open
No sharing of utensils, drinks, bed sheets, towel and linen items must be done
If fever cannot be contained with the dose of Tab. Paracetamol 650mg, 4 times a day at an interval of 6 hours, the nearest doctor must be contacted
A Metered-dose of Inhalational Budesonide should be given if fever or cough goes beyond 5 days, best after consulting the doctor
You Must Not attempt to procure or administer Ramdev Shivir at home
Seek consultation immediately in case:

The oxygen saturation falls
Shortness of breath

Do not use an oxygen cylinder unless advised by the doctor
In case the symptoms persist for over 2 weeks or if the patient’s condition deteriorates, consult the doctor at once
The medicines must not be stopped without consulting the physician

When Can Home Isolation be Discontinued?

When 10 days pass from the first days of experiencing the Covid symptoms, and the patient does not have a fever for the past 3 consecutive days. Once the home isolation period is over, there is no need for testing.

What Precautions should be taken by the Caregivers?

Along with the patient, it is imperative that the caregiver also follows all protocols carefully’

Mask
1. Wear a triple-layer mask. When in the same room with the patient wear an N95 mask
2. Do not touch the mask when using it
3. Change the mask immediately if it gets wet or dirty with secretions
4. Dispose-off the mask in a closed dustbin after use
5. Avoid touching your face, mouth and nose
Hygiene of the Hands
1. When you are in contact with an ill person make sure to wash your hands properly afterwards
2. Be regular in washing hands before and after cooking, before and after eating, after using the washroom, and whenever your hands look dirty
3. Wash your hands with enough soap and water for 40 seconds at least
4. Try using disposable paper towels. If you can’t make sure to use clean towels to wipe your hands dry
5. Wash your hands after removing your gloves as well as your mask
When in Contact with the Patient
1. When in close contact with the patient make sure to avoid any direct contact with the body fluids of the patient, especially oral or respiratory secretions. Wear disposable gloves
2. Do not share utensils, drinks, bed sheets, towel and other linen items
3. The patient should be given food in his room. Wash the utensils separately using detergent and water. Wear gloves when washing
4. Wear a triple mask and use disposable gloves when cleaning or handling surfaces, items of clothing or linen
5. Remember hand hygiene
Disposal of Medical Waste
To prevent further expanse of the infection it is very important to dispose of the waste effectively.
1. You need to collect and store biomedical waste separately before you hand over the same to CBWTF
2. Use a dedicated collection dustbin labelled as “COVID-19 Waste” to store all the waste and keep it separately in a temporary storage room
3. For more info on Disposal of Covid-19 Medical Waste, visit Central Pollution Control Board.

When Should a Covid Patient be Admitted to a Hospital/ Healthcare Centre?

The patient’s health must be monitored regularly and under a doctor’s guidance. In case any of the following symptoms develop, you must seek medical guidance immediately:

Shortness of breath/ difficulty in breathing
When oxygen saturation dips (SpO2 < 94% on room air)
Pressure or pain in the chest that persists
Slurred speech
Inability to arouse or mental confusion
The CT Scan shows an increase in patching in the lungs
Pale or blue coloured skin, nail beds or lips

Conclusion

If you or some family member is covid positive and requires care at home, follow these guidelines and protect yourself as well as the ones around you. These guidelines should be followed when the patient may not be showing any symptoms or is a mild case. In case the symptoms persist for over 15 days or the patient experiences too much discomfort, consult a doctor as soon as possible.

Ref:

Things to Know About Covid and Pregnancy

May 19, 2021May 19, 2021 Rupanjali Mitra Basu

Being pregnant is one of the most important phases in a woman’s life. There are so many emotions that she goes through every minute of the day. There is happiness, there is nervousness, there is joy and there is doubt. Every pregnancy has its own set of challenges, heartburn, morning sickness, fatigue, anxiety and now a pandemic. So, here is all that one needs to know about Covid and Pregnancy.

In these times, if someone is expecting, it is completely understandable that they might be worried about COVID-19. In India, the second wave is already creating havoc. With over 4 lakh cases being reported each day, the situation is scary. But there is no reason to panic, as complete care can be taken to avoid pregnancy-related complications!

Most women who are carrying may find it hard to distinguish if they have a fever or are running a little hot. Feeling flushed or experiencing hot flashes is said to be common among expecting mothers. In most cases, the reason for this is the hormonal changes going inside the body. Under such circumstances, it becomes all the more difficult for an expectant mom to understand whether she is under the weather or down with COVID-19.

What are the Symptoms of COVID-19?

In confirmed COVID-19 cases, people generally experience the following symptoms:

Fever
Shortness of Breath
Cough
Chills/ Shivering
Muscle Pain
Headache
Loss of taste/ and smell
Congestion/runny nose
Diarrhoea
Sore Throat
Nausea/ Vomiting

In most cases, the symptoms can stay from 2 to 14 days. While some people experience mild illness, others may feel seriously unwell. There are also patients who are COVID positive but do not have any symptoms

What should someone do if she is pregnant and yet has Covid?

If you know of someone who has the above symptoms, it is recommended that she should monitor her body temperature and keep a tab of her overall health conditions keeping her gynaecologist in the loop. She should ideally isolate herself completely as best as possible and follow all guidelines of WHO. She should not take any medications without consulting her doctor.

Does COVID-19 cause a higher risk for Pregnant Women?

Women who are expecting, or women who have recently delivered or older women, overweight women and/or women who have had a medical history such as diabetes and hypertension may be at a higher risk of being Covid positive. As there are many respiratory and immunity changes in the body, pregnant women may get their lungs affected. In case a pregnant woman develops severe symptoms, she may require intensive care.

As per the Centres for Disease Control and Prevention (CDC), there are 7 types of coronavirus that are known to infect humans. Though many have a mild effect and cause a cold, some of the types can make one seriously ill. The CDC says the following about pregnancy and COVID-19: “Based on what we know at this time, pregnant people are at an increased risk for severe illness from COVID-19 compared to non-pregnant people. Additionally, pregnant people with COVID-19 might be at increased risk for other adverse outcomes, such as preterm birth.”

Does pregnancy increase the risk for developing Covid-19?

When a woman becomes pregnant, her immune system undergoes certain changes. It may so happen that she is at more risk for developing Covid-19.

What precautions can a pregnant lady take during the nine months of pregnancy in the pandemic?

Being a new virus, scientists are still learning about how this virus can affect pregnancy. In the meantime, it is best recommended that soon-to-be moms practise all safety norms issued by the government such as:

Practise social distancing wherever possible
Wash your hands frequently
Stay at home as much as you can
Wear a double face mask in public
Monitor your health
Avoid touching your face
Avoid being near people who are unwell
Follow all public Healthline guidelines
Staying active and fit by following the prenatal instructions

The gynaecologist would be the best person to offer prenatal care while ensuring that she stays safe. Thus, keeping the gynaecologist updated about all health conditions through phone calls or virtual appointments is necessary.

What to keep in mind when in the hospital for delivery?

The second wave of COVID has led to an acute resource shortage in hospitals. The Gynaecologist/ Obstetrician should be made aware of the birth plan. Normal delivery is different from a planned caesarean. Hence proper planning would be needed with the gynaecologist so that the other doctors, nurses and paediatricians are informed accordingly.

When at the hospital, these basic protocols would be followed, which needs to be adhered to

Doctors, nurses and staff would be following the Covid-19 protocols and wear protective gear at all times
The visitors need to be restricted
If the condition allows, she may be discharged early as well

What protocols need to be maintained after getting the newborn home?

The excitement of holding a newborn baby would be high, but the necessary precautions need to be taken as the immunity of the baby would be low at birth. Hence the risk of infection would be high. The hospital would have taken care of the basic precautions at birth, and hence the rest of the safety protocols need to be followed when the newborn child is brought home for the first time.

The mother and child need to be quarantined for a minimum of 14 days without any visitor from outside. They would be most susceptible to secondary infections at this time.
All visitors like grandparents, uncles, aunts, etc. need to be quarantined for at least 14 days before the child can be handed over to them.
All outsiders can visit the child after the initial period of 14 days but with the mask on, provided they are not sick at that point in time.
All functions and events can happen online for the time being till the pandemic settles.

There is no harm in taking an extra precaution so that the newborn child is not infected even with any secondary infections as any doctor or hospital visit can be precarious at this point in time.

Keeping in mind the second wave, should home birth be done?

In this fast-moving situation, most information becomes outdated very soon. Homebirth with the help of the gynaecologist may sound like a good idea, but it needs to be discussed and planned well with the doctor. There are pros and cons of both hospital birth as well as home birth but emergencies can be better handled at the hospital. So, it needs to be decided by the parents and the doctor in consultation.

How will a Covid positive mother take care of her newborn child?

A covid positive mother needs to keep the following protocols in mind as she would be sharing the room with a newborn whose immunity would be practically nil!

Washing hands carefully with the soap for a period of a minimum of 20 seconds right before holding the baby or using a hand sanitiser that has at least 60% of alcohol content
Wearing a double mask whenever the mother is within 6 feet of the baby
Trying as best to stay away from the newborn baby by at least 6 feet
Using physical barriers such as an incubator while the mother is infected
Taking the help of a healthy caregiver/nurse who is not at risk for severe illness.

If the mother is infected, can she pass on the Covid-19 virus to the unborn child?

Say a silent prayer! COVID-19 is reportedly uncommon in a baby born to an infected mother, even if she were infected during the time she was carrying the baby. However, a newborn baby may test positive or negative soon after birth.

But it is still not known if these babies got the virus before, during or after being born. Most of these infected babies had mild or no symptoms at all and recovered completely. Only a few were reported with severe COVID-19 illness.

Can a covid-19 positive mother breastfeed the child?

So far, there is no study that can stop a mother from enjoying this feeling of connection with the baby. There is still no evidence that this virus can infect the breastmilk. Rather, breastmilk can help to protect the baby against many illnesses.

But there is a word of caution! If a nursing mother has tested positive, she needs to follow these safety protocols:

Washing hands before touching the baby
Using a double face mask while feeding
She can also opt for `expressed milk` by following appropriate ‘breast pump’ sanitization techniques
Maintain proper respiratory hygiene for both the mother and child
A healthy caregiver or nurse, who is not tested positive, could bottle feed the expressed milk to the child
Keeping all surfaces clean and properly sanitized

Does a newborn child need to wear a face mask?

A newborn child’s face should not be covered with a mask. As per WHO guidelines, children less than two years MUST NOT wear face masks.

Precaution:

A face mask/shield can pose a threat of Sudden Infant Death Syndrome (SIDS). It can cause accidental suffocation. Bodily movements of babies can cause the shield to block their air passage like nose or mouth. The strap of the shield can cause strangulation.

What signs to look out for infection in a newborn child?

Most babies who have been infected with the COVID-19 virus show mild or no symptoms at all. Severe illness in babies is rare, however, as coronavirus is a new virus, there aren’t too many studies to support it.

Babies with an underlying medical condition or babies who were born earlier than 37 weeks are more prone to severe illness from COVID-19. In case the baby shows symptoms or the baby has been exposed to this virus, then the paediatrician needs to be contacted at the earliest.

Conclusion

Everything that you do and everything that happens to you has an effect on you and the baby growing inside you. This consciousness can often make dealing with an illness all the more complicated, and the worry of bringing your baby into this virus-stricken world can be overwhelming.

The virus is new, a lot more research is required to understand its effects on expecting moms, new moms and their babies. There is very little data that can offer accurate guidance. Being pregnant in the pandemic has brought unique challenges, but not to worry much. Just take all the necessary precautions, surround the pregnant woman or the new mother with happy and positive thoughts, read good books and keep her happily engaged. Yes, the challenges would be there, but it would all be worth the effort!

Ref:

What are the Possible Complications of Covid-19?

May 19, 2021May 19, 2021 Ankita Sejpal

In the past few months, millions of people have been affected by a coronavirus, all over the globe. So far saving themselves from this virus was the only concern of the majority of people all across the world. But the situation and its dynamics have changed drastically over the past eight months. Doctors and other health experts are now realising that this virus can cause havoc even after the patient has ‘recovered’.

It has become extremely important to understand how this virus transmits and what effect it has on the body. Along with many factors which have turned it into a pandemic.

COVID-19 is a member of the coronavirus family. The other members of this family with whom we are familiar are SARS (Severe Acute Respiratory Syndrome) and MERS (Middle East Respiratory Symptoms) virus. The strains of coronavirus cause common cold and flu as well.

Primarily, COVID-19 infects the respiratory tract in humans. The effect can be as simple as mild flu or no symptoms at all. But it can lead to severe symptoms which can turn out to be fatal.

The Complications

COVID-19 and ARDS are directly related. The severity of covid-19 infection normally leads to ARDS and pneumonia. These problems can prove to be fatal for the patient. Acute Respiratory Distress Syndrome (ARDS) can lead to breathing difficulties, dry cough and an increase in heart rate. Covid-19 shows mild symptoms in a person who is otherwise healthy and doesn’t have any underlying medical conditions. These signs and symptoms can be taken care of with medication till the patient recovers.

But in cases where the person has low immunity due to underlying health issues, the infection from coronavirus can progress to ARDS, which ultimately causes pneumonia.

Besides the lungs, this virus impacts the functioning of the heart as well as the brain of the infected person. This can further increase the risk of long term medical issues and can prove to be life-threatening.

The most common symptoms of this virus are-

Fatigue
Breathlessness or shortness of breath
Cough
Headache
Weakness
Joint and muscle pain
Depression or anxiety
Increased heartbeat rate
Sleep-related issues
Loss of taste and smell

Organs that are Affected by COVID-19

Lungs
When infected, the air sacs inside the lungs of the patients can get damaged, which can cause breathing-related issues.
Heart
Certain patients who experienced only mild symptoms have also shown damage to the heart muscle, months after recovering. This may pose a threat to the heart and can cause heart-related complications.
Brain
The virus can cause seizures and strokes can even cause temporary paralysis in the infected person. Development of Parkinson’s and Alzheimer’s has also been reported in some cases.
Blood
Covid can make blood cells gather in dense groups. When such clots are formed in the blood, it can cause strokes, heart attack or other damage to the heart. Big and small blood clots can affect organs like the legs, kidney, liver and lungs.
Mood Disorders
Having survived this infection, a person is likely to develop depression, anxiety and post-traumatic stress disorder.

Does Every Patient Face the Side Effects?

Though the effects of Covid seem to be rather grim, it is not all bad news. The silver lining is that many people who were infected with this new coronavirus have recovered completely within a short period of time. As discussed earlier, some people, including the ones who exhibited mild symptoms of the infection, experience symptoms even after they have experienced initial recovery. Nevertheless, it should be kept in mind that asymptomatic patients are not immune to the long term effects of this disease.

It becomes important here to understand the factors which make this virus fatal. These factors include underlying medical conditions like diabetes, respiratory complications, cardiac problems and hypertension. Individuals who are advised of immune-suppressing medication need to be more vigilant about their health parameters.

Though mostly it is the senior citizens or people with comorbidities who may suffer from long term effects of this virus, few children and young adults with mild versions of this virus have reported a few of the above-mentioned symptoms

Different Categories of COVID-19 Infection

To understand the other complications that may arise from Covid, it is also important to understand how it affects different people, who have been affected:

Asymptomatic Cases
The individuals who have been infected but may not exhibit any symptoms. They act as a carrier of this disease without even realising it because they themselves may be oblivious of their infection. They are at great risk of spreading this virus.
Mild Cases
Individuals who suffer from mild symptoms like fever, headache, cough or even conjunctivitis, as these are infections of the upper respiratory tract.
Moderate Cases
Here the symptoms suffered by the individual are more pronounced. Such individuals might need medical assistance and hospitalisation. Timely medical help can prevent the risk of fatality.
Severe Cases
People in this category may have severe conditions. Their infection may lead to ARDS and pneumonia. If a person reaches this stage, Covid-19 becomes life-threatening and fatal.

Covid-19 and the Side Effects of the Vaccine

Just like for covid-19, all vaccines are introduced only after their safety is proven. But side effects of vaccines cannot be ruled out altogether. In most cases, side effects are found to vary from person to person. The most common complaints of Covid vaccines so far have been mild fever and pain at the site of injection. Let us take a look at the side effects in detail.

Covishield may have some mild symptoms like:

Fatigue
Mild fever
Chills
Injection site pain or tenderness,
Nausea
Malaise or uneasiness
Myalgia or muscle pain
In very few cases, demyelinating disorders have been seen where the myelin of the nerve tissue is destroyed.

Covaxin also has its own set of mild symptoms such as:

Pain in the Injection site
Fatigue
Fever
Abdominal pain
Body ache
Giddiness
Vomiting and nausea

Trembling
Cough and cold
Excessive sweating
Swelling at the injection site

No other vaccine-related severe complication has been reported so far

Conclusion

While the studies and experiments are ongoing for finding a life-saving vaccine for coronavirus, which is tested and certified by medical associations, the most judicious way to be safe from this virus is to stay safe, avoid public places and get vaccinated. Simple precautions like wearing masks, maintaining hygiene and maintaining a social distance would surely go a long way in curbing the spread of this COVID-19 virus.

References

What is the Official Line of Treatment for Covid Patients in India?

May 19, 2021May 19, 2021 Rupanjali Mitra Basu

The way coronavirus has upended our lives, it is difficult to imagine if life would be normal again. The surge of this disastrous disease has been so massive, that it has made even the most developed nations’ healthcare come crumbling down. However, man continues to fight the pandemic with all his might.

The challenges faced by the Indian government are many. The vast population, the lack of resources, the ignorance among people, the newness of the pandemic have been big hurdles in containing the adverse situation. In lieu of the emerging pieces of evidence, the government has been revising its treatment protocols from time to time.

Recently, new guidelines have been issued by the All India Institute of Medical Sciences (AIIMS), to treat Covid-19 among adults. The course of treatment has been classified into three categories, on the basis of the seriousness of the patient:

Mild Case
Moderate Case
Severe Case

In this article, we will discuss the official line of treatment in all three categories.

Treatment for Mild Cases of Covid-19

The patient who has mild covid-19 has upper respiratory tract symptoms such as cough, sore throat, tiredness, with or without fever. There is no shortness of breath or hypoxia in these patients. Such patients are recommended home isolation and care. Let us take a look at the Dos and Don’ts for these patients.

Do’s

For a patient who is a mild case of Covid-19:

Maintain a physical distance of 6 feet from all members at home, and pets
Strict hand hygiene must be maintained
Double/ N-95 mask must be worn at all times
Be in regular contact with your doctor
Keep a thermometer and oximeter to monitor your temperature and oxygen levels
Follow the symptomatic treatment that includes antitussive, multivitamins, hydration, antipyretics, as recommended by your physician

Can Also Do:

Tab Ivermectin Dose 200 mcg/kg can be taken once a day for 3 days
Hydroxychloroquine Dose 400mg BD – for 1 day, which has to be followed by 200mg BD for 4 days
These medicines should be taken only after consulting your physician
Metered-dose of Inhalational Budesonide can be given if fever or cough continues beyond 5 days, after consulting the doctor

Treatment for Moderate Cases of Covid-19

Confirmed cases of covid-19 who have a respiratory rate of more than 24 per minute have shortness of breath and their SpO2 is below 90% or are categorised as moderate cases of Covid-19. It is recommended that such patients are admitted to a hospital.

Recommendations:
Oxygen Support

The targeted SpO2, i.e. the oxygen saturation is a minimum of 92% to about 96%. The higher the better.
For COPD (Chronic Obstructive Pulmonary Disease) patients the oxygen saturation is considered normal for 88% to 92%
The preferred tool for oxygenation is a non-rebreathing face mask
Patients are to be encouraged to practise awake proning

Anti-inflammatory or Immunomodulatory Therapy

Injection Methylprednisolone to be given from 0.5 to 1 mg/kg in divided doses
If a patient is unstable, he/ she may be switched to oral route

Anticoagulation

Conventional dose prophylactic unfractionated heparin or Low Molecular Weight Heparin can be given if there is no risk of bleeding

Clinical Monitoring

Breathing, change in the requirement of oxygen, hemodynamic instability to be monitored
If in case the patient’s condition worsens, Serial CXR; HRCT chest may be done
CRP and D-dimer should be monitored every 48 to 72 hours

Treatment for Severe Cases of Covid-19

The patients who show signs of a respiratory rate above 30 per minute, shortness of breath or a SpO2 that is less than 90% are regarded to be severe cases of Covid-19. It is recommended that such patients are admitted to the Intensive Care Unit (ICU) of a hospital.

Recommendations:

Respiratory Support
- Depending on the availability, NIV (Face mask or helmet interface) should be used for patients who have an increasing requirement of oxygen or their breathing is low
- If the patient cannot tolerate NIV, intubation can be carried out with high work breathing
- Patients who have an increasing requirement of oxygen can also be given HFNC
- For management of ventilator, conventional ARDSnet protocol should be used
Anti-inflammatory or Immunomodulatory Therapy
- Injection of Methylprednisolone from 1 to 2mg/kg IV in divided doses, for 5 to 10 days
Anticoagulation
- Intermediate dose prophylactic unfractionated heparin which should be weight-based
- Heparin can be given if there is no risk of bleeding
Other Measures
- Sepsis or septic shock should be managed according to the protocols and local antibiogram
- Euvolemia should be maintained
Clinical Monitoring
- In case the patient’s condition worsens, Serial CXR; HRCT chest may be done

Guidelines About Remdesivir

According to the recent guidelines issued by AIIMS, the use of Remdesivir should be done only in rare cases. The Emergency Use Authorisation, of the medicine, is on the basis of limited available evidence and only in specific circumstances”.

Remdesivir should be considered only for the following:

Patients who fall under the category of Moderate to Severe cases
Patients who do not have any renal or hepatic dysfunction
Patients who experienced the initial Covid-19 symptoms less than 10 days ago
Patients who are not on oxygen support or are in a home setting must NOT be given Remdesivir

Guidelines About Tocilizumab (Off-label)

Tocilizumab (Off-label) should be given only when all the following criteria are fulfilled:

The patient is severely ill
There are significant inflammatory markers
The patient’s condition does not improve even after steroids
There is no fungal/ tubercular/ bacterial infection

Guidelines About Convalescent plasma (Off label)

Convalescent plasma (Off label) should be given when the following criteria are fulfilled:

When the disease is within 7 days of the onset of symptoms
There is high availability of high titre donor plasma

Conclusion

With the health infrastructure on its knees, the government has been urging the public to stay at home, wear masks and maintain social distancing norms. The citizens need to empower themselves and prevent the further spreading of this deadly virus. While it is important that you stay updated about the covid-related information, it is also necessary to stay from negativity and rumours. Follow the government-issued guidelines and stay safe.

References:

What is the normal reading for Pulse Oximeter and what does it indicate?

May 19, 2021May 19, 2021 Ankita Sejpal

With cases of covid-19 setting new records daily, the healthcare system of the country is bending backwards. Doctors and health experts have been appealing to people to keep themselves safe and seek medical people in case their symptoms worsen. A drop in the oxygen level in a patient is a severe symptom. Over the past few days, there have been numerous reports where patients have been seriously ill due to lack of oxygen. In such a scenario, it has become extremely important to keep your health parameters under check.

Till a few months ago, the device ‘pulse oximeter’ was new to many. People with lung or heart conditions may have used it periodically to monitor their condition. Others may have seen it on their visit to a hospital. Regardless of one’s familiarity with them in the past, one must have lately heard of it in news or in social circles, in conversation with family and friends, all due to Covid-19.

What is an Oximeter and How Does it Work?

A pulse oximeter is a reliable and painless way to monitor a person’s blood oxygen levels. It is a small device that is quite similar to a cloth clip. The oximeter is put on a person’s finger (nail side up) and within a few seconds, it displays the numbers which indicate the person’s oxygen saturation level in the body.

When a person breathes, the oxygen enters the lungs and eventually enters the blood. The blood cells then carry this oxygen to various organs of the body. An oximeter helps in measuring the amount of oxygen that is sent to different parts of the body from the heart. It uses infrared light refraction to measure how well the oxygen is being mixed with your red blood cells. It indicates the amount by flashing different wavelengths of light through the stream of blood that flows inside the finger on which the oximeter is placed.

Why do I Need an Oximeter?

The fear of pandemic has made everyone overly conscious about their health. It is important to keep a regular check on our temperature because a fever is one of the first indicators of COVID-19. However, a new study by medical scholars has suggested the use of pulse oximeters instead. One of the concerning symptoms of Covid-19 is a drop in the oxygen levels in the patient’s body. An oximeter helps by alerting the person about such a situation, early.

So, it is advisable to keep a pulse oximeter at home. It will help to keep a tab on your oxygen levels regularly. In case the oxygen levels fall below normal, you should seek medical help without delay.

What is the normal reading for Pulse Oximeter and what does it indicate?

As explained earlier, the blood oxygen level is a measurement done to check how much oxygen, O2, is being carried by the blood cells. A SpO2 displays the percentage of Oxygen concentration in the patient’s blood. As per experts, 92% or higher is a normal level of oxygen. An oximeter thus becomes very helpful in alerting the patient/ the caregiver about such a situation.

Below Normal

A SpO2 reading when below 92%, is considered to be alarming. When the blood oxygen level is below the normal level it is called hypoxemia. Hypoxemia is indeed a matter of concern as it can lead to complications in the tissues and organs of the patient’s body. This can prevent the lungs from inhaling adequate oxygen from the air and exhaling carbon-di-oxide. The next effect would be disorders and problems in the circulatory system, preventing the blood to pick oxygen and transport it across the body.

The patient may experience the following symptoms:

Shortness of breath
Pain/ Pressure in the chest
Mental Confusion
Headache
Fast heartbeat
Blue discolouration of nails, lips, skin

Keep in mind that if someone’s SpO2 falls to 90 or lower and/or experiences any of the above symptoms, it is best to consult a doctor at the earliest.

Things to Remember Before Using an Oximeter:

The way our hospitals are crowded, doctors are advising the infected people to keep a regular check on their oxygen level and visit the hospital only if there is a fall in the level below 92-93%. Doctors are also claiming that a lot of people can be cured if they follow the medical advice appropriately while in self-isolation at home.

Pulse oximeters can prove to be very helpful in monitoring the oxygen levels without any medical assistance by the patient himself or a caregiver. But before using it, one should keep in mind a few things.

Before taking the reading, it is important that the patient rests or relaxes for 10 to 15 minutes
If you are laying down, keep a hand (left or right would not make a difference) on your chest and keep it still
If you are sitting keep your hand on the armrest and take the reading while keeping it still
Place and set the oximeter either on the middle finger or the index finger of your hand
Don’t change the position of your hand till the reading on the device becomes stable
Record the highest result after the reading on the device has stabilised
Record the reading correctly
Start to record the reading from the baseline. Record it thrice or four times a day unless you notice a difference in health
Call your medical care provider and seek help in case there is shortness of breath or a fall in the oxygen level to 92% or less.

How to correctly use Pulse Oximeters?

SpO2 oximeters indicate the percentage of oxygen level in the blood of the patient. There are a few tips to consider before one starts using the device.

Ensure that your finger is not covered with Heena
As your finger is inserted into the oximeter nail side up, make sure that your nail does not have nail paint on it.
Rest and relax for a few minutes before you put your finger into the device
Once the oximeter is placed on the finger, the movement of the hand should be restricted
The pulse oximeter should be worn on the finger for at least a minute, till the reading on it stabilizes.
Make sure that the device fits well onto the finger. Too loose a probe, it may fall off. It should not be too tight as it would then constrict the blood circulation.

In these covid-stricken times, it is essential to keep a check on your oxygen levels and a pulse oximeter is a useful and convenient way to do so. The margin of error is slight, and most oximeters are accurate enough. Remember that when in doubt relying on the oximeter alone, is not enough. If you or any family member is experiencing any Hypoxia symptoms, they need emergency treatment as hypoxia can worsen very rapidly.

References:

Why an e-Insurance Account is a Must in Today’s Age?

May 10, 2021May 10, 2021 Ankita Sejpal

The wave of technological development has been sweeping the nation far and wide. Fat wallets have slimmed down due to mobile wallets and e-payment gateways, physical shopping has given way to e-commerce and the world has shrunk down to your computer and mobile screens.

Even when it comes to insurance, buying it has been simplified through online insurance marketplaces. Moreover, storing the insurance policy has also become easier with e-insurance accounts.

What is an e-insurance account?

An e-insurance account is a short for electronic insurance account. It is an electronic or digital account wherein you can store all your insurance policies. Thus, an e-insurance account is like an online locker or safe for your insurance policies, both life and general.

Why is the e-insurance account important?

There are various reasons which make an e-insurance account a must have in today’s age. Let’s have a look –

Convenience and safety
First and foremost, the e-insurance account provides you complete convenience in keeping a track of all your insurance policies. Since the policies are stored in the account, you can access them whenever you need. As the account is online, you don’t face the threat of misplacing or losing your insurance policies. They are protected from physical damage and theft and, so, the e-insurance account provides convenience with the added advantage of safety of your policy documents.
Ease of servicing
If you want to service your existing insurance policies, you can do so through the e-insurance account. Payment of renewal premiums, updating your details on an existing policy, porting, etc. can be done from one central database which is the e-insurance account. So, you don’t have to search for your policy papers, look through them and check what is needed to be done with each policy. You can simply log into your e-insurance account and get every details right at your fingertips.
Ease of opening
The e-insurance account is free of cost. You don’t need to pay any money for opening or maintaining the account. You can open an e-insurance account with any insurance company whose policy you have or you can pick any insurance repository, like CAMSRep, NIR-NSDL, Karvy, etc. and open the account. The account can be opened online and you just need to submit your KYC documents for verification.

How to convert your existing insurance policies into e-policies?

After you have successfully opened and registered your e-Insurance Account, you can request all your insurance companies to convert your existing policies to e-policies so that the policies get stored in the e-insurance account. To convert your existing policies you would have to fill up a conversion form available with the insurance repository with whom you have opened the account or with the insurance company. Fill up the conversion form stating your name, e-insurance account number, policy number, insurer’s name, etc. Submit the form with the repository or the insurance company and your physical policy would be converted to an e-policy and sent to your e-insurance account.

The pandemic and the need of the e-insurance account

The concept of e-insurance account is slowly gaining popularity as policyholders are opting to collate their policies in an e-insurance account for its ease and convenience. Moreover, the COVID pandemic has heightened the importance of having an e-insurance account. As the pandemic is wreaking havoc and causing increased lockdowns and reduced office hours, it becomes easier to service your policy through an e-insurance account. If you have an e-insurance account you would not have to step out of your home to pay renewal premiums, make claims, or make changes in your policy. Moreover, you would not have to visit the offices of the insurance companies to check your policy details if you have misplaced your policy bond. You can check your details online where your policies would be stored.

As the e-insurance account is a central account for both life and general insurance policies, you can check all the plans without having the need to go through your records or physical documents.

So, if you have not yet opted for the e-insurance account, don’t delay. Open the account free of cost and convert your physical policies to digital ones. The process is online and you can track your insurance plans from the safety and comfort of your home.

What Factors Affect your Bike Insurance IDV?

May 10, 2021August 24, 2021 Rupanjali Mitra Basu

When you buy a comprehensive bike insurance policy, the coverage amount of the policy is called the Insured Declared Value (IDV). This value is calculated after deducting the depreciation of the bike from its market value. Depreciation of the bike is based on its age. The depreciation rate has been specified for calculation of IDV and it is as follows –

Age of your bike	Applicable depreciation rate	IDV (as a % of the bike’s market value)
Up to 6 months	5%	95%
More than 6 months but below one year	15%	85%
More than a year but below 2 years	20%	80%
More than 2 years but below 3 years	30%	70%
More than 3 years but below 4 years	40%	60%
More than 4 years but below 5 years	50%	50%

For bikes that are aged more than 5 years, the IDV is calculated on a mutual agreement between you and the insurance company.

So, if the value of your bike is INR 80, 000 and you just drive it out of the showroom, the value, for insurance purposes would reduce by 5%!

Factors affecting the IDV

The IDV of your bike is affected by various factors. Let’s find out what these factors are –

Age of the bike
This is an obvious factor. As your bike ages, its depreciation increases and, so, the IDV goes down. If you check the table, you would see the IDV gradually reducing with the age of the bike. So, for older bikes the IDV is lower compared to newer ones.
The make, model and variant
Your bike’s make, model and variant (MMV) determines its market value. Different bikes are priced differently and so, when you buy bike insurance, the make and model of the bike is required to determine the IDV. Based on the MMV, the market value of the bike is determined and then the applicable depreciation is deducted to arrive at the IDV.
Accessories added
If you add accessories to your bike, which are not factory fitted, the value of such accessories would be included in IDV calculation. In such cases, IDV would be calculated using the following formula –
IDV = (market value of the bike – age-based depreciation of the bike) + (market value of the accessories – depreciation on such accessories)
So, if you add accessories to the bike and intimate the insurance company about the same, the IDV would be increased.
Underwriting policies of the insurer
Though there is a formula for calculating the IDV of the bike, you would find different insurance companies offering different IDV values when you compare bike insurance plans available in the market. This variation is because of the underwriting principles of the insurance company. Based on its underwriting policies, some insurers might offer you a higher IDV while others might restrict the coverage. You should, therefore, compare different bike insurance plans to find the IDVs offered by different insurance companies.

Choosing the IDV

Thankfully, you have the option to customize your bike’s IDV as per your requirement. You are allowed a maximum and minimum range of IDV and you can select the IDV within this range. You can also negotiate with the insurer to offer you the most optimal IDV in your bike insurance policy.

The IDV also determines the premium payable for the bike insurance plan. Higher the IDV, higher would be the premium that you would have to pay. That is why many individuals prefer a lower IDV so that their premium outgo is reduced. This, however, is a mistake. The IDV is the maximum claim liability that the insurer bears. If your bike is totalled or stolen, the IDV would be paid as claim under the bike insurance policy. In such cases, if your IDV is low, you would suffer a considerable financial loss.

So, for saving a few bucks on the premium payment, don’t compromise with the IDV. Do your IDV calculation using the above-mentioned factors and find out the most optimal IDV for your bike. Then, look for policies that offer the IDV closest to the optimal level and choose them. If there is a contingency, the claim payment would compensate you for the loss that you suffer.

Do a little homework when you buy bike insurance, especially when it comes to the policy’s IDV. Choose a suitable IDV so that your bike is insured at its actual value.