Novel Corona Virus / COVID 19
Novel Corona Virus (COVID - 19)
Notorious Inflammatory Vascular Virus Disease
Highly contagious virus
Understanding the virus and learning to live through the pandemic
The Covid 19 pandemic has been the biggest crisis to hit humanity since world war 2 It has already cost over 17 crore cases and 37 lakhs deaths and countless livelihoods. The impact on the economy has been extremely sharp.
The Novel Corona Virus or COVID 19 : Its a flu virus. It effects lungs, heart, kidney, liver and brain. It also emerged that some of those recovered after been ill enough to be hospitalized will bear the physical and psychological scars of their ordeal for months, perhaps years (and in some cases for ever) The good news is that its mortality rate is 2%.
Corona virus which emerged in China in December 2019, and has spread around the world, halting industries, bringing flights to standstill, closing schools and forcing the postponement of sporting events and concerts. Pope Francis held his weekly general audience via live streams for the first time as the Vatican implemented Italy,s drastic corona virus lock down measures and barred general public from St. Peter,s Square.
Wuhan corona virus, is a contagious virus that causes respiratory infection, can transfer from human to human. Nagaland government has issued a memorandum urging people to stay away from activities like hunting since it increases chances of contact with wild animals. It is clear, however, that the virus mainly causes infection through respiratory droplets from an infected person. So quarantining a sick person is not enough if precautions are not taken to decontaminate surfaces that a patient comes in contact with and on which corona viruses can survive for days. Children are not at high risk of getting infected. The people most vulnerable to COVID -19 seem to be those above the age of 50 years. Fliers from abroad now need medical certificates. Covid 19 triggers inflammation in the body
Around 81% of COVID -19 cases have mild disease and recover on their own. Around 14% people have severe disease including Pneumonia and shortness of breath , while the virus causes critical disease including respiratory failure, septic shock and multi organ failure in about 5% of cases. People with pre-existing medical conditions (such as asthma, diabetes, heart disease) are more vulnerable.
As time passes in a pandemic there’s a greater chance of survival for those getting infected later. The reason for this is that Doctors and scientists know more about Covid-19 now than few months ago and hence are able to treat patients better.
Corona virus attacks the throat and lungs. . SARS-CoV-2 is presented to human cells by ACE2, a key enzyme involved in inflammatory and cardiovascular homeostasis. The virus induces direct cytotoxic damage along with a potent inflammatory and cardiovascular reaction., possibly resulting in fatal outcomes even in previously healthy people.
Corona virus are Zoonotic, meaning they are transmitted between animals and people. Protecting our natural ecosystem is vital to staying alive and preventing future pandemics. Virus can jump from human to animals and then from animals back to humans.The Mink relative of otter is also spread corona virus.
infected humans.
"Corona virus spread by air born infection."
- Loss of taste
- Loss of smell
- Redness in left eye.
- Diarrhea
- Rashes in the skin
- Sore Throat
- Cough
- Breathlessness
- Obesity :B.M.I more than 25
- Hypertension
- Diabetes
- Smoking
Gender :
I When the symptoms starts appearing.
II When the lungs start getting affected
III When the condition deteriorates.
Contact Time
- Half an hour face to face communication. Contact time last 48 hours.
"A person is highly contagious 2 days before the appearance of symptoms"
Who is at risk?
Diabetic patients, who have recovered from COVID-19 need to pay extra attention since they have a higher risk of developing skin infection, suffer from bleeds and cuts.
- Sars-CoV-2 spreads through contact , and longer range transmission via aerosols, especially in conditions where ventilation is poor. : That it spreads rapidly across communities., that the fatality rate of Covid 19 is higher than that of other Flu's., that there is such a thing as long Covid. It is unclear how long protective immunity last.
- 5 day after exposure, within 2-14 days.
Covid Day -1 and -2 PRESYMPTOMATIC Phase
Covid Day 1 - 7 ISOLATION Phase
Covid Day 10-14 QUARANTINE Phase
Covid Day 14 -120 MONITORING Phase. )
AntibodiesThe only way your body "protects" you from COVID is by building up antibodies. Antibodies develop when a body battles the virus, recognizes its proteins and creates infection-fighting antibodies that give you immunity against the illness. The only way, right now, to confirm this would be to get an antibody test, which can detect the level of COVID fighting antibodies in the system.
However, since studies have emerged that antibodies start to wane in patients 2-3 months after illness, it might not give the most accurate results.
However, since studies have emerged that antibodies start to wane in patients 2-3 months after illness, it might not give the most accurate results.
Acute - Symptoms less than one month
Sub- Acute - Symptoms less than six months
Chronic - Symptoms more than six months
- Difficulty in breathing, persistent cough
- Persistent high fever
- Dip in oxygen saturation (SpO2,95%)
- Persistent pain / pressure in the chest
- Slurred speech / seizures
- Mental confusion or lack of alertness
- Weakness or numbness anywhere on the body
- Any bluish discoloration of the limbs or face
- Gastritis : Rule out the cardiac cause. Covid gastritis is a possibility. Drugs like analgesics, or anti-inflammatory or steroids can cause gastritis.
- Gastro-enteritis.
REPORT IMMEDIATELY TO HOSPITAL
Symptoms
A . Single symptom : Sudden redness or irritation of left eye. Sudden partial or total loss of altered taste, Sudden partial or total loss of smell. Any new first time of unexplained symptom, after positive or suspected contact. All the symptoms irrespective of RT PCR Test. are Corona illness.
B. Two Symptoms : Low grade fever on walking or exertion or evening fever.. or Feverish. Throat pain, dry cough, and or Breathlessness, (URI, UTI or Loose motions.)
Three Symptoms : Any one of the B and two of the C
C . Headache, Right lower abdominal pain, nausea, vomiting, anorexia, Urinary symptoms , Pain legs below knee, Ear pain, Tiredness,Weakness, Exhaustion, Constipation , Exertion high pulse, nasal discharge, Sneezing, Rash, Myalgia.
6 Minutes walk test : (Enhance SpO2, Cough, Fever, Breathlessness.)
- Difficulty in breathing, persistent cough
- Persistent high fever
- Dip in oxygen saturation (SpO2,95%)
- Persistent pain / pressure in the chest
- Slurred speech / seizures
- Mental confusion or lack of alertness
- Weakness or numbness anywhere on the body
- Any bluish discoloration of the limbs or face
- Gastritis : Rule out the cardiac cause. Covid gastritis is a possibility. Drugs like analgesics, or anti-inflammatory or steroids can cause gastritis.
- Gastro-enteritis.
MAJOR CRITERIA
- Anosmia (Loss of smell), loss of taste, left eye redness.
- Dry Cough, throat pain, fever, loose motion
MINOR CRITERIA
- Mild chest pain, jaw pain, ear discomfort, abdominal pain, urinary symptom, rash, headache, any first time symptom.
MULTIPLE MEMBERS - In family with common symptoms.
MULTIPLE MEMBERS - Of the family with atypical unrelated symptoms.
- Dry Cough, : Although a dry cough is a fairly prominent symptom of the COVID virus, medical authorities are now alerting people about another type of cough which could be an early sign of the viral infection- continuous cough. Cough and headache can be there for three months.
- Exertion Fever : Check fever at 6 PM., i f there is 1 degree rise of fever between 6 AM and 6 PM. This is called the evening rise of temp. Covid Fever is generally low grade. There is a rise of degree.There will be an evening rise of fever. Fever will increase on exertion.Sometimes Covid fever may not respond to Paracetamol. If Fever is more than 103 F that indicates inflammation is high.There may be body ache, headache along with fever. Exertion fever is also present.Fever is prolonged in corona.If Post Covid Fever persists, do ESR & C.R.P. Fever can come off and on.
- Shortness of Breath or Breathlessness or Dyspnea :Breathlessness can be a sign of oxygen saturation dipping low, and require medical support.If after walking Breathlessness improves nothing has to be done. If the breathlessness increases then contact the doctor.20-30% patients have breathlessness in between 5th to 8th day after the onset of symptoms. For those with a severe infection, blue lips, discomfort, confusion Progress from Dyspnea to Acute Respiratory Distress Syndrome (A.R.D.S)
- Temporary Chest Pain : Persistent pain and pressure in chest :
- Hypoxia : Dip in oxygen saturation Spo2 Less than 95% .Hypoxia after walking.
- Sore throat : A rash in the throat is a sign of corona.
- Burning in throat : can be corona, may be due to acidity or allergy.
- Post corona throat pain : can be there. Tonsillitis and fever can be corona.
- Fatigue : Difficulty in initiating action. Patient says , I am not able to walk, Reduced capacity to maintain activity, Easy fatigability. Difficulty with concentration, forgetfulness. Emotional instability. Patient falls sleepy and doesn't feel like getting up.Uncontrollable need to sleep.
- Diarrhea : 50 % people have Gastrointestinal symptoms.
- Costocondritis : Joint pain can remain for three months.
Headache:
Body ache : can be corona symptoms.
- Costochondritis : Joint pain of rib can remain for three months.
Swelling and redness of the left eye can be the symptoms of Covid.
Diarrhea : 50 % people have Gastrointestinal symptoms.
- Increased Pulse Rate : It signifies inflammation.
Headache:
Body ache : can be corona symptoms.
- Costochondritis : Joint pain of rib can remain for three months.
Swelling and redness of the left eye can be the symptoms of Covid.
Diarrhea : 50 % people have Gastrointestinal symptoms.
- Post Covid diabetes : Raised uric acid in women means an increase of Obesity. Or increased Triglyceride. Low HDL. BP high.Can lead to Diabetes.
- Post Covid Anxiety : Heart palpitation
- Multi organ inflammatory disease : Sometimes Multi organ inflammatory disease can come. Inflammation can be precipitated for 2 people in one lac cases.
- Skin Changes :
Skin inflammation and rashes, a sudden change in your skin could also lead to a COVID diagnosis. Findings also suggest that this symptom could be more likely experienced by young people, with no pre-existing conditions or typical symptoms. Itchiness, redness, COVID toes, itchy lesions and chilblains could also be experienced in certain cases. These are atypical symptoms and may not be experienced in all cases.
- Running nose : can be a sign of corona.
- COVID toes can cause swelling, lesions and discoloration in the fingers and toes. Covid toes, seen especially in young kids are the newest
- Covid thyroid : Immunological Reaction : After 43 days feverish, pain in legs. Pulse rate high, increased heart beat. It is called immunological reactions. Do Thyroid test. Sometimes Covid thyroid is activated by Covid. It will be alright after 2 months.
- Conjunctivitis or Pink Eye :Swelling and redness of the left eye can be the symptoms of Covid. Experiencing a scratchy, runny, pink eye can feel unpleasant, and can also be a sign of mild conjunctivitis fueled by the SARS-COV-2 virus. It can be a possible way the virus could transmit when you constantly touch your eyes and skin around the face with dirty hands or come in contact with the virus through aerosol transmission
- Mental Fog or Confusion / or lack of alertness & Delirium : COVID-19 can lead to psychological distress and impair nerve functioning, to an extent, impacting your brain health as well. However, these symptoms were only noticed in patients who complained of post COVID symptoms only. However, NHS findings have observed that some nervous issues, such as confusion, delirium could be accompanied by a headache and fatigue. Again, these symptoms have only been noticed in patients who complained of severe illness or had to be hospitalized.A Lancet study, done back in May also pointed out that confusion, anxiety and agitated behavior was noticed in at least 60 per cent of patients who had to undergo intensive care post hospitalization
- Vision Problem : While the virus can settle in the upper tract and mucous membranes, newer findings have found people complaining of red, itchy, swollen eyes as well. The symptoms can be very minor, and go unnoticed. In some cases, the inflammation can also lead to enlarged blood vessels near the eyes, swelling, excessive watering and discharge. Sensitivity and irritation can also be experienced.
Dry Lips
- Dry lips can also happen when you are dehydrated, or not getting ample nutrition during recovery. Another sneaky sign, bluish tint on the lips, caused by oxygen deprivation- can also act as a warning sign of attention. Developing dry, scaly lips during the infection phase can be common and the soreness can also spread inside the mouth. It is most likely a cause of skin dryness and blisters which happen with the infection.
Hair loss
Kawasaki is the delayed post Covid. seen in Europe. We have inflammation in hearts arteries.IV, IG , treatment is given. It is found in children. Rarely found in Indians.
Covid Gastritis :
- Red spot on hand
- Vertigo, dizziness
- Slurred Speech seizures
- Ringing in the ear
- Pain in ear :
Irritability
- Pain in leg
- Urinary pain can be Covid.
Post corona pain in the throat can be there.
- Hiccups :
- Hiccups are the newest, and perhaps the strangest symptom of Covid. it could last for more than 48 hours.
- Myalgia and intense back pain :
Muscle pain or myalgia becomes a common factor of rapid viral multiplication in the body, which can sadly lead to shooting pains, muscles and chills in the joints and muscles. Back pain, joint ache and inflammation can be quite prevalent during the peak days of infection swelling and cause a lot of discomforts. Pain and inflammation can be experienced in a lot of sensitive, blood vessel rich areas as the virus can spread through the bloodstream and cause infections in vital tissues. Nerves, tendons, joints and ligaments can also undergo stress. Excruciating back pain and headaches can also be experienced in cases where the fever doesn't go down and causes acute inflammation. Nerves, tendons, joints and ligaments can also undergo stress. Excruciating back pain and headaches can also be experienced in cases where the fever doesn't go down and causes acute inflammation.
- Physical degeneration and weight loss :
- A COVID-19 infection can leave you drained, fatigued and make you undergo appetite loss. For patients who suffer from severe COVID-19 symptoms, weight loss is a common side-effect of the illness. The body loses out on its stamina and muscle mass, food intake is drastically reduced and in many cases, extreme weakness can also be experienced. Unusual weight loss is also a symptom of rapid inflammation or chronic infection present in the body. Gastrointestinal problems, such as diarrhea, nausea can also affect gut functioning. Therefore, it's important to follow a healthy diet and balance your diet during the recovery period.
- Symptoms Of Low Oxygen Level :
Difficulty in Breathing, Confusion, Difficulty in Walking up, and bluish lips or face. Adults may develop chest pain. Children May develop a flare up of nostrils, grunting while breathing, inability to drink or eat.
- Mucormycosis : Mucormycosis, is a black fungus infection, is a rare infection, caused by a group of moulds called mucormycetes. It mainly affects people with health problems . And its symptoms include nose obstructions , swelling in eyes, cheeks, and black dry crust in the nose. It is generally noticed post Covid 19. If left untreated it can cause blindness, infarction and death.
- Spike in blood pressure :
- Profuse blood clotting and hypertension : It can be two signs of your COVID battle getting more serious since they often go unnoticed until the last moments. This is one of the reasons why even those with a mild or moderate form of infection are asked to check readings often-even if they are feeling good.
- Thrombosis and limb numbness :
Blood clotting can lead to yet another dangerous complication-deep vein thrombosis in the legs and limb trouble, which can cause problems over the long run. This strange symptom can be more commonly experienced by those who are older, and prone to chronic inflammatory problems. On the other hand, many also complain of limb numbness, skin twitching.
- Teeth problems of weakened gums, tooth loss and dental infections : After recovering from a bout of COVID-19. losing out a tooth due to the decay, tooth discoloration, break and gum weakening. Evidence suggests that the SARS-COV-2 virus can disrupt vital blood flow in the body, causing a number of clots, and patchy blood flow. This, in turn, causes problems in the transportation of blood flow and nutrients to various vital organs in the body. In some cases, it may also cause consequential damage, such as to the heart, chest, brain and your jaws, since our oral cavity is filled with a rich supply of blood vessels which could be impacted by lower than usual or compromised blood flow. This, in turn, could be a possible theory, as to how the virus causes so much damage and weakens the foundation of our oral cavities, leading to tooth decay, gum weakening, bleeding as well. Gum infections, decay, tooth loss, loosening of other teeth and sizable vasculature damage from the infection.
Hair loss
Kawasaki is the delayed post Covid. seen in Europe. We have inflammation in hearts arteries.IV, IG , treatment is given. It is found in children. Rarely found in Indians.
Could damage residual Pneumonia
Post Covid persistent inflammation / fever
Loose motion
C.R.P
Inflammatory drug
Post Covid - Hyper Coagublity state D'Dimer
Heart -- heart attack
Brain - Stroke
Lungs - Pulmonary Embolism
Post Covid - Cytokine crises.
Post Covid cough can persist for two months. Inhalers will help.
Antigen negative
Antibody positive (Humeral antibodies are formed)
Eligible to donate plasma
Chances of clot formation reduced
Stop blood thinners / or adjust the dose of blood thinners
Diagnosis
Get your test after exposure of 48 hour or after 5 days or after symptoms appear.
- RT - P.C.R Test with CT Cycle : Which is considered the gold standard of Covid 19 testing. Pre test counseling of the patient should be done. Get RT PCR test done on the very first day of the fever. First 3-4 days are very crucial.
- Rapid Antigen detection test (RAT)
- Antibody Test can be done after 28 days.
- Pool Test :If one person is positive, any one of the member of the family can be tested for corona to confirm. If one person in the family has corona , presume other family members also have contracted corona illness.
6 min walk test and check the reading at rest and after walk? Check
- Watch the Distance : 500 meter walk, Is the walking distance reduced..
- S p o 2 level
- Breathlessness
- Cough
- Difficulty in talking
- Heart rate, temp, pulse rate.
- 6 Minutes walk for breathlessness : If positive than a patient might have started the symptoms of Pneumonia, S.P.O.2 level At rest and after walking 6 minutes. if it falls to 5 there is a catch. S.p.o.2 97 good. it is important to detect Pneumonia, .(Normal range - More than 100 % measure by pulse Oximeter.) Oxygen saturation between 90% and 94% . Silent Hypoxia. - Oxygen saturation will decrease in blood in Corona. To know the saturation of oxygen in blood. Resting S.P.O.2 level has no significance. After walking if it is less is important. Walking Test : In 50 feet distance, if one can walk 17 times , it is normal. If the distance is decreasing then the virus has entered the lungs.
- Pulse Oximeter :
Oximeter Reading : Our oximeter reading (SPO2 level) was always in the range from 96 to 99 and even after six minute walk tests, SPO2 level never came down below 95.It measures Fall in Spo2 level or oxygen saturation in the blood. The use of Oximeter alerts the patients of a drop in oxygen levels. which is an early sign of deteriorating health. SpO2, also known as oxygen saturation, is a measure of the amount of oxygen-carrying hemoglobin in the blood relative to the amount of hemoglobin not carrying oxygen. The body needs there to be a certain level of oxygen in the blood or it will not function as efficiently. Oxygen- Blood gasses -Hypoxia - if oxygenation is inadequate SPO2 is Less than 10 k poc
- Peak expiratory flow rate (P.E.F.R) is the maximum flow rate generated during a forceful exhalation, starting from full lung inflation. P.E.F.R primarily reflects large airway flow and depends on the voluntary effort and muscular strength of the patient.The peak expiratory flow, also called peak expiratory flow rate, is a person's maximum speed of expiration, as measured with a peak flow meter, a small, hand-held device used to monitor a person's ability to breathe out air. It measures the airflow through the bronchi and thus the degree of obstruction in the airways
- X- Ray Chest P/A and lateral view. To detect Pneumonia. Generally lower lobes are affected.
- H.R..CT OF Chest : To diagnose pneumonia. stage I,II,III & IV .It is used to evaluate the structure of the lung for fibrosis, emphysema, or similar conditions. A CT scan severity score ranges from 0 to 25 below 7 indicates mild infection.7 to 12 moderate infection. above 12 indicates severe infection. And 5/25 means about 20% Lung infection.
- SGOT AND SGPT till 80 is normal :
Thyroid test : For weakness do the
Urine Routine :
- Post Covid Antibody Test : If Antibodies are not formed in the body, that means immunological reaction is still going on in the body. Relapse which can occur for 3 months.
- Antibody Test : Antibody test do not identify current infections but are good measure of past ones and therefore ideal to measure prevalence or immunity. Serological - Survey Done to know the extend of the spread of the virus. 70 % of population needs to have had exposure to the infection to develop herd immunity.
Increasing Lymphocytes is a good sign.
Blood test NO Eosinophil, Reduced Lymphocytes, C.R.P more than 26, or ESR more than age or + 20 in women.
- Baseline C.B.C, E.S.R, C.R.P, Urine R.E, Fasting sugar, Hb1ce, Urea, creatinine, S.G.O.T, ,S.G.P.T, for tissue damage. L.D.H, Tissue damage, Ferritin level,IL6, for Anemia, hemoglobin.
- Blood sugar Fasting , Post Prandial (PP) and HbA1c After meals is important 140 mg/dL normal value. And fasting blood glucose 70 to 110 mg/dl.
- Clot retraction test (C.R.T) : Clot is formed or it is diluted.
- SGOT AND SGPT till 80 is normal : The normal range of values for AST (SGOT) is about 5 to 40 units per liter of serum (the liquid part of the blood). The normal range of values for ALT (SGPT) is about 7 to 56 units per liter of serum.
- Prothrombin Time : This test measures how long it takes your blood to clot. If it takes a long time, that could be a sign of liver damage. Medications that thin your blood, such as warfarin can also lead to a longer PT.
- Clotting time (C.T) and Bleeding (B.T) time :
Creatinine Kinase Protein (C.K.P) : For muscles
- Ferritin :
Cholesterol : Decreases In Covid illness.
- E.C.G : For heart.
- Lung diffusion test :
- Raised uric acid in women means an increase of Obesity. Or increased Triglyceride. Low HDL., BP high. Can lead to Diabetes.
ESR : Raised ESR means damage in the body.
CRP : Raised CRP means inflammation in the body. CRP can double in 8 hours. For raised CRP anti-inflammatory drugs are prescribed. It will reduce CRP
Inflammation cured or not? On the 9th and 14th day. If your
ESR and C R P are raised you need to continue medicines.
High pulse rate check for Thyroid.
"Pulse Oximeter is helpful in detecting Happy Hypoxia."
COVID 19 MARKERS
Subject NORMAL ALERT
Spo2 ( (Post 6 minutes walk) > 95 <90
TEMP (Post 6 minutes walk)
97.6 F 4-6 P.M OR 6 AM AND 6 PM Post 6 minutes walk
Pulse 72/ minutes Pulse rate high
BLOOD TEST
COMPLETE BLOOD COUNT (C.B.C)
HB
RBC 5 million/cumm ?
M.C.V
Eosinophil 1-4 cells /micro lit < 1
E.S.R According to age in males,+20 in females More indicates infection
Absolute Leukocyte count 1000 - 7700 mcg <800 /mc/L
BLOOD SUGAR fasting, P.P
HEART
D'Dimer <500mg/ml >1000mg/ml
Troponin 0-14 mg / lit
L.D.H 110-210 Unit / lit >245 unit / lit
IL6 on 5-8 day Any rise in upto 7.0
LIVER FUNCTION TEST
S.G.O.T < than 80
S.G.P.T < than 80
Alkaline Phosphate
KIDNEY FUNCTION TEST
C.P.K 40 -150 UNIT/LIT >2
Urea 20-40
INFLAMMATION
C.R.P <1mg / lit > 100 mg / ml
Serum Ferritin 10 - 200 mcg / lit High Ferritin >500 mcg / lit low ferritin iron deficiency Anemia
When CRP is reduced that means you are recovering.
- C Reactive Protein ( C.R.P) : Raised C.R.P means inflammation in the body. C.R.P can double in 8 hours. For raised C,R,P anti-inflammatory drugs are prescribed. It will reduce C.R.P. C.R.P should not cross 26.
- D'Dimer': It increases in inflammation (Covid 19). It can be reduced by anticoagulant/ blood Thinners. 800 normal for 80 years. Negative D'Dimer rules out clot formation.
- Cholesterol decreases In Covid illness.
- E.S.R : Raised ESR means damage in the body.
- Kidney Function Test : Urea and creatinine
- Respiratory rate per minute : A respiratory rate of 24 or more ( Normal is 12 to 20) breaths per minute and a progressive increases the requirement for oxygen despite the use of steroid.
- For loss of taste & loss of smell : Keep these two things at your home: Jaggery and Gulab Ark ( rose essence) : To know if you have Corona there will no taste of sweetness in Jaggery and a person won't be able to feel the smell of rose.
1st Stage : Imported cases.
2nd Stage : local transmission of contacts of imported cases.
3rd Stage : Community transmission. (to general public and every one.) Once community transmission starts people who are not bothered, will get infection first. Outbreak of infection in community.
The Pattern
It is clear that the Corona virus disease (Covid 19) starts slow, build up momentum, rises to a peak, then starts plateauing and finally falls. We know that Sars-CoV 2 virus does not infect everybody. We also know that not everyone who is infected spreads the disease. A lot of the spreading is caused by super spreaders, perhaps explaining the clusters of infection that emerge. The redeeming feature is the high percentage of recoveries.
For every symptomatic case, there could be several undetected asymptomatic cases.
India's strength lies in its strong communities, who should be mobilized in full strength to take the country ahead of the pandemic curve and control its spread.. For children aged below 14 years corona is not serious, but high risk group has to be taken care of.
"The virus has proved strangely resilient --- not weakening. Summer/or winter has no effect on it."
Cause
Corona- Virus
CORONA Virus (SARC-CoV-2 Virus.). is an RNA virus 0.1 microns. It has a covering called membrane (बनियान ). Which is again covered with an envelop of lipid sheet. (शर्ट ) And above it are spikes (फरकोट ) which helps in holding it to the host. . So the virus has three coverings.This virus is similar to AIDS virus, as it affects T cells, lymphocytes. Which is the part of immune system.
Corona virus is NOT dangerous but it’s complications are life threatening. Inflammation and mucus cause complications like pneumonia. Take measures to keep it under control. Acidic environment escalates bacterial growth and inflammation. Energy in your body is limited and low during the illness. So let it be available for the Healing Process to the maximum possible extent. 6. Stress pulls down your immunity further. Be calm, patient and alert.
Most crucial and important Keep Calm but be alert !! Take some urgent steps. Eat light and less. Only breath meditation and deep breathing exercise. . Do Pranayam and warm up and back stretching exercises to relieve back pain
Start eating protein rich diet.
Pathogenesis : As it is a multi system inflammatory diseases.It ignites slow fire in the body. So organs are on fire, Sometimes this slow fire is flared up. Sometimes these viruses can be seen at the time of flare up of inflammation. Then ESR and CRP may be raised.
ESR AND CRP signifies the damage done in the body. What is damaged depends upon which part of the body virus has entered. This damage is caused due to fighting between viruses and (fighting cells) police inside the body. Different enzymes and proteins increase in my body. If after 14 days they are raised then (Our Body) Municipal people take time to remove them. If this garbage is still left after 14 days, then some medicines are prescribed to lower the values.
Sometimes only ESR is raised.
Or only CRP is raised. Generally both are raised.
Along with it Ferritin also increases.
LDH also increases.
Lymphocytes are decreased in Covid.
IL6 is raised It is a sensitive parameter for Cytokines.IL6 are treated with cortisone.If it is very high in the first week then it is serious.
Original virus and the variants,. Mutation. Double Mutation. Triple mutation
Vaccines teach our body to recognize spike proteins and this is the outer coating of the virus. But when the virus mutates, the spike protein changes and makes it difficult for your body to identify the virus. Difficult but not impossible.
Pathogenesis : As it is a multi system inflammatory diseases.It ignites slow fire in the body. So organs are on fire, Sometimes this slow fire is flared up. Sometimes these viruses can be seen at the time of flare up of inflammation. Then ESR and CRP may be raised.
ESR AND CRP signifies the damage done in the body. What is damaged depends upon which part of the body virus has entered. This damage is caused due to fighting between viruses and (fighting cells) police inside the body. Different enzymes and proteins increase in my body. If after 14 days they are raised then (Our Body) Municipal people take time to remove them. If this garbage is still left after 14 days, then some medicines are prescribed to lower the values.
Sometimes only ESR is raised.
Or only CRP is raised. Generally both are raised.
Along with it Ferritin also increases.
LDH also increases.
Lymphocytes are decreased in Covid.
IL6 is raised It is a sensitive parameter for Cytokines.IL6 are treated with cortisone.If it is very high in the first week then it is serious.
Vaccines teach our body to recognize spike proteins and this is the outer coating of the virus. But when the virus mutates, the spike protein changes and makes it difficult for your body to identify the virus. Difficult but not impossible.
"Incubation period is infectious.
"Many infected people suffer from mild infections, do not require hospitalization, and recover often even without any any sort of medical intervention."
Incubation Period:
- 14 days Asymptomatic.
- The high infectivity of the virus during the incubation period suggests that quarantining asymptomatic contact may help preventing transmission
- 14 days Asymptomatic.
- The high infectivity of the virus during the incubation period suggests that quarantining asymptomatic contact may help preventing transmission
- Corona virus is an air born disease.
- Via respiratory droplets from an infected person' s cough or sneeze enter through your nose, mouth or eyes or from touching a contaminated surface and touching your face, nose, mouth or eyes. It can be in air for 3-4 hours.
- Fomite transmission is another mode of its spread.
- The virus moves through the nasal passages to the mucous membranes in the back of your throat.
- Symptoms appear in a median period of five days, but could appear between 2-14 days, after exposure.
- One may develop a sore throats and dry cough.
- One may develop a fever (usually around 100 degrees F)
- The virus then moves down the airway passages to the lungs and inflames the lung membranes, making it harder to breath causing breathlessness.
- Your chest begins to feel tight, you have difficulty in breathing or start breathing rapidly.
- Severe Pneumonia may require oxygenation and ventilator support to help your breath
- The household and the family clusters are the primary source of infection. The more virus you are exposed to, the more you are likely to get infected, and in high density housing, where large families live together infected respiratory droplets can stay suspended in air and infect other.
- The corona virus disease (Covid 19) spreads easily among people living together even when an infected person is asymptomatic or pre-symptomatic (in incubation period).
- People with Covid 19 are as infectious before they develop symptoms as later in their illness..
- With people who are 80 years older being most susceptible to infection. Breaking the chain of transmission within households, timely tracing and quarantine of close contacts could reduce new infections during the incubation period.
- You may experience extreme fatigue.
- Those over 65 or with more than two pre- existing conditions like diabetes, hypertension or kidney disease are likely to have more severe symptoms.
- Severe pneumonia may progress to acute respiratory distress syndrome. (A.R.D.S)
Happy Hypoxia
Previously patients used to drop dead on the road or even before reaching a hospital due to reduced oxygen in their blood- OXYGEN SATURATION. This was because of HAPPY HYPOXIA- where even though the oxygen saturation was gradually reducing the COVID-19 patients did not have symptoms until it became critically less, like sometimes even 70%. *Normally we become breathless if oxygen saturation reduces below 90%. **This breathlessness is not triggered in Covid patients and so we we’re getting the sick patients very late to the hospitals in February 2020. Now since knowing about happy hypoxia we are monitoring oxygen saturation of all Covid patients *with a simple home use pulse oxymeter and getting them to hospital if their oxygen saturation drops to 93% or less. This gives more time for doctors to correct the oxygen deficiency in the blood and a better survival chance in July 2020.In such a situation, one should be hospitalized & should be under proper medical supervision. Happy Hypoxia is dangerous. And ideally one must take a walk for 6 minutes & again check his SPO2. Resting SP02 may be deceiving.
Blood clots: Blood clots can be caused due to a condition called disseminated intravascular coagulation (DIC). Due to this condition, the body’s blood clotting response will work differently than it should; unusual clots will begin to form around major organs of the body and it will lead to internal bleeding and organ failure, if not treated at the earliest.
The onset and severity of Acute Respiratory distress syndrome (ARDS) in infected individuals:
- Hypoxia – Low oxygen levels in the blood, due to damage to the alveolus
- Breathing difficulties and shortness of breath
- Chest x-rays of the lungs exhibit an opaque and glassy look against the black background
- Worsening symptoms over the course of time, from the day of detection of the virus
The virus can cause a secondary bacterial infection , may lead to disease severity. Broad spectrum antibiotics to prevent secondary bacterial infection. Strep and staph infections are common culprits. If the infections are not treated immediately. They can be serious enough to risk death.
Septic shock:
- Post Covid complication of severely ill hospitalized Covid patient.
- It occurs if the T.L.C does not increase after 7 day.
- CD4 (helper cells) AND CD8 (cyto toxic cells) decrease. CD4 and CD8 count should become normal after 7 days.
- It occurs in immuno compromised patient.
- Uncontrolled blood sugar.
- When there is low immunity in body. H.I.V patient.
- If the patient does not recover within 7 days.
- Persistent lymphopenia for 7 days.
- Cellular immunity of the body is very low.
Covid is known to create Silent Hypoxia - Oxygen level decrease, but the patient is not symptomatic till the level falls to critical value. Normally the oxygen saturation in our blood is 99-100%. If it falls to a level below 92%, you need oxygen support to prevent possible damage to your organs. Normally when the saturation falls below 92% there are symptoms like difficulty breathing, restlessness, drowsiness. But in Covid patients, the saturation can fall to 80% (this is also called Air Hunger) without the patient showing any symptoms. That's Silent Hypoxia, that what makes this disease so dangerous. So one of our main job is to constantly monitor saturation levels.
- Travel together 79.3%
- Community 27.9%
- Household 9%
- Other settings 4.2%
- Health care 1.3%
Positive attitude will bring you back on track. Focus on health & fitness.Try to go “au naturel ” . the most difficult part of being diagnosed with the viral infection is to stay away from people for 14 days. It gives you “strange and weird feelings.”
If you are asymptomatic , then it is fine, you have no symptoms. But if you have symptoms. It's a huge challenge because you have to take care.
Be vigilant in terms of making sure your vitals are fine.
You are eating right.
Stay hydrated.
Getting enough rest.
Taking medications.
It is not something you can deal with two or three days. The time period is 14 days. Which is a long time.
But it is important to stay calm and be positive.
unless you test you cannot know the actual disease prevalence
- Loss of smell and taste (to sweet and salty only. Khatta taste remains) occurs in 30--32% of patients and in current times is as accurate as a Covid RT PCR test to diagnose Covid infection. This is associated with excellent survival and fast recovery so don't make a patient waste money on tests. Just quarantine, treat oral drugs and monitor Spo2.
- ZERO LYMHOCYTE SYNDROME. Whenever zero or less than 5% lymhocyte count, means AIDS like response to the virus so anti-retroviral drugs Lopinavir and Ritonavir used for aggressive treatment.
- If CRP more than 100 or fall in Spo2 after a 6 minutes walk, methylprednisolone 40 mg BD, IV or oral, saved a lot of patients from ventilator in Mumbai.
- Inhaled steroid added on 7th day helped in reducing dyspnea.(difficulty in breathing)
- Since thymus gland is active, children below 10 years never get a severe disease and recovery is fast.
- Fever can last up to 21 days. However patient is non infective to others after 10th day even if Covid test is positive (shows Covid particles) as virus does not replicate after 10 days. Fever is positive due to post infective inflammation. However after 14 days look for a secondary infection and treat with second antibiotic if procalcitonin positive or C.R.P rises even if leucocytes not increased.
- Sleeping for 8 hours daily during the infection was found to be associated with faster response due to slowed viral replication hence prescribe sedatives for sleeping and reducing anxiety.(Melatonin) before 8 PM
- In patients with moderate to severe disease prescribe atorvastatin 10 mg and Aspirin 75 mg even on discharge to reduce thrombotic and cardiac events. 24% patients have echo change of cardiac involvement.
- Low molecular weight heparin is standard of care in hospitalized critical cases.
- In highest specificity was with loss of smell and taste. Next was HRCT finding of ground glass appearance.
- Pharyngeal swab for RT PCR is best done on days 5--10 of infection.
- In people living in flats chance of family members getting infection is 40---50% . In Bungalows or spacious houses 5---10% chances of transmission to family members. Density infects.
- In 1918 Spanish flu led to mass scale implementation of burkha in Muslim and ghoonghat in Hindu communities. Now Covid is leading to face mask--- probably part of our lives for at least a year more.
India's case fatality rate (C.F.R)- defined as the proportion of deaths to the total number of cases .
Immunity :
Innate immunity : It is a unique case of Innate immunity (pre-existing, passed on by the mother since birth). Innate host resistance leading to significant reduction in expected mortality. It can be explained by large degree of regional variation observed in sero prevalence and cumulative deaths.
Herd Immunity : Is herd immunity possible without a vaccine?
When people refer to a herd immunity strategy to manage pandemic, there are two issues they are not addressing.- The first is that letting people get sick until most are immune and the disease no longer spreads easily will lead to many millions of deaths.
- The second is that herd immunity is always temporary, because children are born without immunity and eventually there will be enough susceptible people that the disease can start spreading easily again..
- For both reasons, a vaccine is critical. It will save lives now and protect future generations from reliving this experience.
Overall population infection rate is called heard immunity. A high prevalence isn't necessarily a bad thing. The herd immunity can be achieved in two ways :A. By vaccinating enough number of people or , (PREFERRED)
B . If enough people are infected and develop immunity against the disease.
The heard immunity level is lower when immunity is caused by disease spreading then when immunity comes from vaccination.
None of the Sero-prevalence studies suggested that any country was close to achieving herd immunity. An antibodies found in recovered Covid 19 patient fell sharply in 2-3 months after infection.
Immunity Passport : Passports would be issued on the basis of antibody test.. With anyone with antibodies for Covid-19 being eligible for one. These people could move around, work travel and help cities and countries get back their feet, because they couldn't get infected.
Cross-immunity to Sars-CoV-2. Even though the antibodies may fade within months, the all protective army of T cells can stay in circulation for years.or may have been infected with Sars -CoV-1 in 2003 could still have T cells that could actually help protect them from Sars-CoV-2. This cross immunity could explain why some people are, either immune already, or react differently from others.( For instance , they might not infect others or the intensity of infection could be lower.)
Loss of Antibody immunity : Sars-CoV-2 antibodies peak three weeks after infection, and then decline. with levels almost the baseline., in some cases as little as two months. A "Potent" antibody response that peaked three weeks after they developed symptoms. They fell down to 17% three months later. In facts some individuals no longer had any trace of antibodies. After 90 days after infection.Vanishing antibodies are a reminder that their presence in Covid 19 does not mean guaranteed protection. Therefore Germany and China dampen hopes of long term immunity in those recovering from the infection. They also have implications for the development of a vaccine and the question about reinfection. Do depleting antibodies signify that the person doesn't have immunity anymore? YES.
T cell mediated in immunity : T cells, which fight infected cells and have long memories, are therein roughly twice the number of people in whom anti bodies are found. These cells play a pivotal role in protection. Cell -mediated immunity involving killer T cells often referred to as immune warriors : These cells are a part of the human immune response against viral infections due to their ability to kill infected cells. All the recovered Covid 19 patients were found to have Sars-CoV-2 specific T cells, which suggest that these play an important role in this infection. Second,patients recovered 17 years after the 2003 outbreak still possessed long lasting memory T cells that displayed The infected T cells are emerging as the real heroes of the pandemic. Sarc CoV 2 generates specific T cells with long lasting memory. Twice as many people who have antibodies have T cells that target cells infected with Covid 19- which means the actual immunity in a population is higher than that measured by antibody test. As 56% of Delhi population are sero positive. Inference is that one can expect actual level of immunity may be more which is herd immunity baseline for Covid 19.
Cross-immunity to Sars-CoV-2.
Even though the antibodies may fade within months, the all protective army of T cells can stay in circulation for years.
Vaccine should be "Double defensive" ,it should stimulate the body to produce both "antibodies" and "Killer T cells,"
Where do we stand?
There is 56% infection in community according to latest sero survey is far away from the 60 to 65% of the population that needs to be infected before we can reach heard immunity.
Vaccine Can Covid 19 end without a vaccine?
After all a vaccine won't be available before end of 2020.and chances are the first vaccine are either not be the very effective, or will require multiple booster shots.. It is also clear that not everyone is going to get the vaccine immediately. Vaccine should be "Double defensive" ,it should stimulate the body to produce both "antibodies" and "Killer T cells
Herd Immunity : Is herd immunity possible without a vaccine?
When people refer to a herd immunity strategy to manage pandemic, there are two issues they are not addressing.
- The first is that letting people get sick until most are immune and the disease no longer spreads easily will lead to many millions of deaths.
- The second is that herd immunity is always temporary, because children are born without immunity and eventually there will be enough susceptible people that the disease can start spreading easily again..
- For both reasons, a vaccine is critical. It will save lives now and protect future generations from reliving this experience.
B . If enough people are infected and develop immunity against the disease.
The heard immunity level is lower when immunity is caused by disease spreading then when immunity comes from vaccination.
None of the Sero-prevalence studies suggested that any country was close to achieving herd immunity. An antibodies found in recovered Covid 19 patient fell sharply in 2-3 months after infection.
Immunity Passport : Passports would be issued on the basis of antibody test.. With anyone with antibodies for Covid-19 being eligible for one. These people could move around, work travel and help cities and countries get back their feet, because they couldn't get infected.
Cross-immunity to Sars-CoV-2. Even though the antibodies may fade within months, the all protective army of T cells can stay in circulation for years.
T cell mediated in immunity : T cells, which fight infected cells and have long memories, are therein roughly twice the number of people in whom anti bodies are found. These cells play a pivotal role in protection. Cell -mediated immunity involving killer T cells often referred to as immune warriors : These cells are a part of the human immune response against viral infections due to their ability to kill infected cells. All the recovered Covid 19 patients were found to have Sars-CoV-2 specific T cells, which suggest that these play an important role in this infection. Second,patients recovered 17 years after the 2003 outbreak still possessed long lasting memory T cells that displayed
Even though the antibodies may fade within months, the all protective army of T cells can stay in circulation for years.
Vaccine should be "Double defensive" ,it should stimulate the body to produce both "antibodies" and "Killer T cells,"
There is 56% infection in community according to latest sero survey is far away from the 60 to 65% of the population that needs to be infected before we can reach heard immunity.
Vaccine Can Covid 19 end without a vaccine?
After all a vaccine won't be available before end of 2020.and chances are the first vaccine are either not be the very effective, or will require multiple booster shots.. It is also clear that not everyone is going to get the vaccine immediately. Vaccine should be "Double defensive" ,it should stimulate the body to produce both "antibodies" and "Killer T cells
- Pregnancy
- Lactating mothers
- Pulmonary embolism
- Immuno-compromised patient
- C.R.P more than 1
- Allergy
By Vaccination we are introducing Muscle Covid which in turn produces antibodies and T cells.
Vaccination or Corona choice is yours....
For fever Tab Mefenic acid
If C.R.P above 10 Tab Colchicine .5 mg daily
LDL should be below 70
If diabetic control the sugar
Allergy is not a contraindication for vaccination
Tab Montair LC is prescribed for 3 days. One before the day of vaccination, next on vaccination day followed by next day. Montair LC is a combination of 2 tablets. 1 . Montelukast , and 2 . Levocetrizine. H1 Blocker. It blocks the production of chemicals responsible for production of allergic response.
In addition H2 blocker Tab Rhinitidine is also added.
For age 95 Micobacterium W is prescribed ti increases the immunity.
Tab Panadol sos
have lock down violators shot.
- Avoid participating in large gathering. Like movies, concert, matches, swimming etc.
- Working from home instead of at the office
- Closing schools or switching to online classes
- Visiting loved ones by electronic devices instead of in person
- Cancelling or postponing conferences and large meetings
- Do not go to the Cinema, Mall, Crowded Market . If possible, Park, Party, etc. should also be avoided..
- Avoid Unnecessary Meetings,
PEAK
On a graph, the curve showing the daily count of new cases has gone from rising sharply to moving sideways — the curve has flattened — and even begun to move downward.That is one corner being turned: The rate of the spread of the virus has slowed down. But even when those curves flatten, the epidemic still has not “peaked” by another crucial measure: the number of active cases. That figure continues to rise until the number of patients who either die or recover each day is larger than the number of new infections.To ease the staggering load on health care systems, the active cases curve must also flatten and then fall.
Post Peak Period
Post Peak : Period signifies that pandemic activity appears to be decreasing, but countries need to be prepared for 'Additional waves', according to W.H.O . Pandemic waves can be separated by months and an immediate 'at ease' signal can be premature. Therefore it is important to maintain surveillance and update pandemic preparedness and response plans accordingly. In United States where the authorities thought they had a hold on the pandemic when cases fell after the 'New York' peak and opened up too soon, leading to a second wave of infection. The same happened
in 'India ', where cases rose after falling because the state opened up and people became complacent.
Before allowing people to gather in groups, more testing need to be done. People who are infected need to be quarantined, and their contacts must be tracked down and isolated for two weeks. Wearing mask in public will likely remain necessary.To relax preventive measures THE LONGER YOU WAIT IS BETTER. The experts pointed to the 1918 pandemic of flu, which infected a quarter of the world’s population and killed 50 million people. Months after the first surge, there were several spikes in cases, with the second surge being the deadliest.
“If we pull off the public health measures too early, the virus is still circulating and can infect more people,” We want that circulation to be among as few people as possible. So when new cases do erupt, the public health departments can test and isolate people.
The Harvard researchers, in their article this week in the journal Science, said their model suggested that a resurgence of the virus “could occur as late as 2025 even after a prolonged period of apparent elimination The virus is likely to re-erupt next winter, similar to what happens with the flu, said a lecturer in the University of Florida Department of Epidemiology.Without a vaccine, people’s risk doesn’t change, she said.“Someone who is susceptible now is susceptible in the future,”
"W.H.O states that Covid is one big wave, not seasonal".
Children less than 15 years usually do not have corona unless some family member is positive
Work From Home (W.F.H)
It is a luxury that takes away more than it gives.
Time to prepare for stage 3
Be careful, be united. Stage 3 which is community transmission. This occurs when a person with no travel history to an affected country or direct contact with a confirmed case test positive for Covid 19. It is an indication that the undiagnosed and likely asymptomatic carriers are spreading it , and makes breaking the chain of transmission increasingly tough.
Various states have imposed a lock down. Various states have imposed 144, which restricts gathering of more than 5 persons. There will be more extended periods of the people,s curfew. If self quarantine measures are not implemented, legal consequences may follow. Economic activity will get even more adversely affected, hitting the poorest the hardest. Stage 3 will require citizens to exercise a great degree of responsibility. Social distancing will have to be accompanied by social solidarity and care for the more vulnerable sections. Employers will need to be more sensitive towards their staff. Patient will need empathy, not stigmatization. And the government, even as it is held accountable will need support, as it introduces more measures to both battle the virus and introduce measures to minimize the distress.
At Risk
- Elderly above 65 years of age are vulnerable.
- People 80 years or older had a 20 fold increased risk of death.
- Infants below 1 years.
- Persons taking blood thinners. i.e. Aspirin
- Persons with organ transplant.
- Persons taking immuno-suppresents because of medical conditions.
- Autoimmune disease
- Pregnancy
- living in nursing homes or long term care facilities and with underlying medical conditions , such as chronic lung diseases, asthma, heart conditions , obesity, asthma, diabetes, chronic kidney diseases and liver diseases..
- Compromised immunity because of cancer.
- Smoking,
- Immunodeficiency, prolong use of corticosteroids
- Gender : Men carries 3 times higher risk of death from Covid 19 than women. (Due to smoking factor)
Isolation 1-7 days
4th Day : If symptoms of Pneumonia are suspected like breathlessness, shortness of breath. C.T.scan of chest will show patch of Pneumonia. A patient is having a respiratory COVID..If negative than it is non respiratory COVID .Treatment : Antiviral, Anti - Inflammatory, Steroid and Oxygen is given. Therefore 4,5 th and 6 th Day is very crucial.
Self Imposed Home Isolation For 14 days Guidelines:
More than 80% Corona Positive Patients can recover easily at home
- A team of health workers from district surveillance office will visit your home. They will examine your health parameters and living conditions and inform you if you can be home isolated.
- If your found to be fit for home isolation, you will receive a home isolation training call from the health department. They will train you on the best practices for home isolation. You will receive daily calls to monitor your health for next 17 days.
- Patient can end their home- isolation after 17 days of onset of symptoms.If they don.t have fever or any other symptoms for at least 10 days of isolation period. The team of health workers will call you to inform you of the end of home isolation period after 17 days, if no symptoms persists.There is no need for testing after the home isolation period is over.
- Practice frequent hand washing with soap and water or use an alcohol based hand sanitizer,
- Follow respiratory etiquette - cover your mouth with tissue or handkerchief while coughing.
- Avoid touching your eyes, nose and mouth.
Avoid close contact with people who are unwell or showing symptoms of illness, such as cough, difficulty in breathing etc.
- Wear a mask if you have symptoms such as cough, fever, or difficulty in breathing.
- Contact local doctor immediately if you have cough, fever or difficulty in breathing.
Quarantine 7-14 days
Day 14 look for residual inflammation or thrombosis.?
Look for Hypoxia.?
"It is worth changing our behavior and lifestyle".
Day 14 to 120 Monitoring
Between 14-21 days RT P.C.R will become negative.
Day 120 independence from Post Covid complications. (
( independence from slow fire of corona).)
After one is cured one can marry and have children after 3 months.(after 120 days) after independence from Covid
Dead viruses can stay in a body for 40 days.
Lifestyle
NEW LIFE MODEL
- Hydrate well : Have warm water as it relieves nasal congestion, aids digestion, calms the central nervous system and helps relieve constipation. Make sure you carry water with you while going for a jog or walk.
- Cover your nose and mouth with disposable tissue or handkerchief while coughing or sneezing
- Frequently wash your hands with soap and water
- All central air conditioners should be shut down to prevent the virus from aerosolizing in the central ducts. Instead coolers can be used.
- Person suffering from Influenza like illness (ILI) must be confined at home
- Stay 6 FEET distance from persons sick with flu
- Take adequate sleep and rest
- Disposal of used napkin or tissue paper in open areas
- Try to maintain your immunity level high by healthy diet and lifestyle.
- Saline gargles : Gargle with warm saline water at least once a day.
- Steam inhalation : Take a steam regularly if Asthmatic.
- Start your day with lemon in Luke worm water
- Doing Yoga Regularly to boost your immunity.
- Diabetic patient should maintain their blood sugar levels.
- Cut down on calories if cannot exercise
- Sodium Hypochlorite wash for surfaces.
- Sunlight exposure is always good
- Wash the vegetables in hot salt water followed by running water. Dry them and preserve them.
- Fruits can be washed in soda water.
- Postpone travel abroad
- Be very careful while at Barber shop or at beauty Salon parlor..
- Clean your hands & legs when you come home from outside.
- When you feel you have come nearer to a suspected patient take a thorough bath.
It opens the posterior and lateral part of lungs for respiration. However, improved oxygenation by more advantageous gas exchange in the lungs seems to take place in the prone position as compared to the supine position. Benefit : 1) to improve oxygenation; 2) to improve respiratory mechanics; 3) to homogenize the plural pressure gradient, the alveolar inflation and the ventilation distribution; 4) to increase lung volume and reduce the amount of atelectatic regions;
- Avoid common touch points: If you are stepping out of your homes, it's important that you don;t touch anything at all. From park gate, lift buttons, plants, trees to benches, anything and everything outdoors must be in your "DO NOT TOUCH" list to avoid contamination.
- Touching surfaces usually used by public (Railing,door gates etc).If you do touch something by accident,sanitize your hands with an alcohol based hand sanitizer thoroughly
- Electrolyte for body balance : It is good to keep your body balance. Intake the intake of vitamin C, D and Zinc during these times, especially if you are stepping out.
- Touching eyes nose or mouth with unwashed hands.
- Hugging, kissing and shaking hands with greeting sitting in public spaces.
- Disposal of used napkin or tissue paper openly (Railing door gates,etc).
- Smoking in public places.
- Avoid close contact with anyone with cold or flu like symptoms.
- Avoid frozen meet.
- Avoid spitting: Which is still common
- Do not eat outside food
- Do not go to unnecessary marriage or other similar ceremony..
- Don,t wear belt, rings, wrist watch, when you go out. Watch is not required. Your mobile has got time.No hand kerchief. Take sanitizer & tissue if required
- Don't bring the shoes into your house. Leave them outside.
Make Your Respiratory System Strong.
- Blowing balloon by mouth three times a day is a good respiratory exercise. Its a good lung exercise. Beneficial uses of balloons in therapy - related goals could be an increase in lung capacity for those with asthma and related illnesses,.
- Take a glass of water, along with straw bring bubbles in water is good respiratory exercise.
- Blowing air pillow .
- Playing musical instrument like flute or mouth organ.
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| Playing Mouth organ |
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| Playing Flute |
Meditation can put our body into a state of deep rest , which can lower our blood pressure.
Exercise
Go for a walk in the morning or post 4 P.M. Post 4 P.M.is a good time , as lung health is better at that time. Try and complete 8000 steps a day
"After you have tested positive, other persons who have come in contact with you in past few days to get themselves tested. for Corona .And if positive should be isolated."
Pranayama
Cooling Pranayama
* Sheetali Pranayama (शीतली प्राणायाम)
Apart from keeping the body cool, regular practice of Sheetali
Pranayama reduces hypertension and hyper- acidity. It is calming to mind. Sheetali is ideally practiced in summer months to cool the body and refresh the mind. It should be practiced only on empty stomach.
Sit in a comfortable place, either on a mat spread on the ground or on a chair. Place the tongue between the two rows of teeth and open the mouth wide. Now close your eyes and breath in through the mouth and out of the nostrils. While breathing in , the air rushes in through the sides of the mouth, between the two rows of teeth. Perform this practice up to five times.
● Alternate Nostril Breathing / Nadi shodhana or Anuloma - Viloma (अनुलोम विलोम )
Technique :
- Sit comfortably in an erect position. Keep the head, neck and the spine straight.
- Rest the left hand on the left knee.
- Close the right nostril with the tip of right thumb.
- Now breath out slowly through the left nostril.
- Keeping the right nostril closed breathe in slowly and deeply through the left nostril.
- Now close the left nostril with ring finger and little finger of the right hand and slowly breathe out through the right nostril.
- Now keeping the right nostril still closed, breathe in through the right nostril.
- This completes one entire round of Anuloma - Viloma.
- Repeat the entire process
- Remember that breathing in and breathing out should be done very slowly without any noise
- Infuses the body with oxygen
- Clears and releases toxins
- Reduces stress and anxiety
- Calms and rejuvenates the nervous system
- Helps to balance hormones
- Supports clear and balanced respiratory channels
- Helps to alleviate respiratory allergies that cause hay fever, sneezing, or wheezing
- Balances solar and lunar, masculine and feminine energies
- Fosters mental clarity and an alert mind
- Enhances the ability to concentrate
- Brings balance to the left and right hemispheres of the brain
Bhastrika is done through the chest and engages the lungs. Bhastrika Pranayama is the process of rapid inhalation and exhalation which gives a boost to the body, and helps in sinus, bronchitis and other respiratory issues.
Avoid going to crowded places : like matches, movies, concerts etc.
Cleansing Procedures / Kriya (क्रिया)
● The shining forehead,' Kapal bhati
Avoid going to crowded places : like matches, movies, concerts etc.
Jal Neti (जल नेति )
Jala neti is beneficial for upper respiratory health. It would well become a part of one’s daily morning routine. The Sanskrit word, Jala, means “water”. The original meaning of neti is “to guide”. It has also come to mean “nasal cleansing”. Therefore, Jala neti means guiding water through the nasal passages to cleanse them..Jala neti is a traditional Ayurvedic and Yogic practice that clears the nose and sinus passages through nasal irrigation. Sea salt along with Betadine (an antiseptic) is dissolved into warm, pure water in a Neti pot, a tool specifically designed for this purpose. The head is tilted forward and to the side and the solution is poured into one nostril and allowed to pour out the other, thereby clearing the nasal passages and sinuses of excess mucous, toxins and debris along the way. Neti allows for fuller, freer breathing, which increases the amount of Prana, or vital life energy, that we absorb.
Hold your Breath
Face wash
Splashing water over the face
- Washing eyes with fresh clean water daily.
- Wash eyes with Triphala water every day. Triphala eye wash -¼ tsp. in 1 cup water, boil for 10 minutes, cool and strain.
- Boric acid is a good eyewash. It prevents conjunctivitis when there is an epidemic in the city.
- Freshly prepared rose water can also be used
Oral Hygiene
Brushing twice a day is recommended morning and night. Scrape the tongue. Clean the tongue with the scraper (or with three fingers) to remove excess mucous. It activates the taste buds to maintain the sense of taste in the receptors. Scraper helps to remove the toxins which get accumulated overnight. This will prevent diseases of the oral cavity. This is beneficial for removing bad taste and odor of mouth. It also provides strength and enhances taste perception. This should be followed by gargling with normal water. Rinse your mouth with warm water and hold the liquid in mouth for 45-90 seconds this will completely clean your oral cavity.
Steam Inhalation
This technique involves holding substances in the mouth. As daily routine practice plain sesame oil (Tila taila) is advised for Gandusha ) for 3-8 minutes in the mouth.. This treatment will strengthen the teeth and gums, and more importantly, improve the sensitivity of the taste buds and freshness in your mouth. Gandush prevents excess thirst, improves taste and maintains oral hygiene. Gundush with lukewarm water will make the mouth clean and cheerful.
* Wishing or Greeting each others with NAMASTE.
* Washing hands and legs before entering home.
* Worshiping animal, plants, trees and forest as Gods & Goddesses
* Burnt Camphor as an Aarti (आरती )
* Primarily having veg diet
* Doing Yoga & Pranayama
* Burning the dead
* Bathing after attending a funeral
* Quarantined themselves for 13 days after funeral
* Removed dirty Slippers / Shoes before entering home
* Without a reason don't touch your own sense organs. indriyas. (Eyes, nose, ears, etc.)
* Wash your hands, feet, mouth before you eat.
* Salt, ghee, oil, cereals and other food should not be served with bare hand. Use spoons to serve.
* Don't use clothes already worn by you & dry yourself after a bath.
* Don't wear clothes worn by others.
* Clothes once worn should not be worn again before washing.
Keep virus away with healthy habits
"The biggest immunity booster is the mindset of a person.
Immunity Booster
Have a turmeric immunity shot every day (empty stomach if possible). Take 1 tsf of turmeric ,black pepper powder,apple cedar vinegar or lemon juice, add some Luke worm water and drink it
Nutritious Diet
* All 7 color of food to be eaten.
* All 6 types of tastes should be consumed. Bitter and astringent taste is preferred , as the virus of Corona is wet. To make it dry we need astringent taste. i.e. radish,(मूली ), turnip (शलगम), garlic, Giloy (Tinospora cardifolia) and Aswagandha.
* Antiinflammatory food : Cinnamon. bitter guard, Giloy, Fenugreek seeds, Jamun (blue berry). are good for corona virus.
* Extra 500 calories should be consumed by Corona patient.
* Proteins veg pulses, non veg egg,chicken,meat etc.
* Chawanprash as immunity booster.
* Make sure your consume food that is rich in vitamin C such as amla, orange and kinnoe.
* Green leafy vegetables helps ward off infections as they are high on fiber and also boost immunity.. You can make a salad with spinach, broccoli. Prepare smoothie with green vegetables and seeds or make a green juice with Amla, lemon and ginger.
* Berries are great as they are high on antioxidant and vitamin C and hence help to curb infection. You can even make a smoothie bowl, add berries, yogurt, almond and seeds such as Chia,flex and sunflower.
* Almonds are great source of vitamin E, fiber, protein and omega 3, so you should eat them everyday after soaking overnight.
* Onion and garlic should be added while cooking food as they posses antimicrobial capabilities.
Covid 19 Diet
Eat
Water : Drink 30 ml per kg body weight. Suppose your weight is 60 kg then 1800ml. if Covid is positive (fever) add 500 ml extra. That is 2300 ml.
High Protein diet in Covid times.: For weakness eat lots of proteins. Protein has 4, Carbohydrates have 4 and fat has 9 cal per gram.or per ml. Your requirement is 30 cal /kg.
Pulses or Dal Rajma chawal or dal rice it provides all essential amino acids.
200 -250 gram dal can be consumed. 1 katori (100 gms) or bowl in the morning and evening one can eat Rajma, lobia, chana, moong, urad, masoor, arhar etc.
MILK & its products : All milk products like Paneer. If cough avoid due to mucus formation.
Soya Bean : Soya Milk can be consumed. Soya paneer can be consumed. Or Soyabean, soak overnight in water .And make its milk in the morning, and drink it. Soybean nutri nuggets can be eaten in the form of vegetables.
Egg white of 2-3 eggs can be taken. Make omelet, scrambled egg or boiled egg.
For weakness eat lots of proteins. Protein has 4, Carbohydrates have 4 and fat has 9 cal per gram.or per ml. Your requirement is 30 cal /kg.
Dry Fruits have Proteins.
Threptin Biscuits.: These are high protein biscuits
The diet which should not thicken the blood.
Food is to heat it, boil it, cook it, peel it or forget it, otherwise don’t eat it.
Consume 7 colors of food items : Eat the food which has all seven colors. Eat colored foods. Red, yellow, green capsicum, brinjal,(egg plant)
Eat all six tastes in your food. 6 Taste : Sweet, sour and salt, increases your body mass, and astringent, pungent and bitter reduces your weight. Keep a balance of all six tastes. Sweet (rice or roti), Sour (curd), Salt in vegetable, Astringent (onion, garlic, radish and dal), Bitter (Bitter gourd or karela, Bathua, Green vegetables), Pungent (green ,red or black chilli and garam masala.)
Eat in Moderation : Eat in moderation, not very less or more. Normally eat the amount which your hand can hold.
Eat a different Variety of food : In one meal all varieties of food are present.
Food should come from Tree or Plant origin : Whatever comes from the tree it does not have bad cholesterol (LDH) .When ever we eat food ask whether it is of plant origin or animal origin? If of animal origin it will have bad cholesterol (LDH). You can eat fruits, but cannot eat non-veg the whole day, Non veg can be one item but non veg cannot be your lunch or dinner.
Dry fruits : are good for your health.If you eat 50 grams dry fruit daily, good cholesterol will increase. It will be good for Covid illness also. Soak the dry fruits overnight in water. In the morning put it in a GRINDER , add water and drink it. It can also be taken in a boiled form.
The leaves on the upper part of the tree can be eaten. It constitute satvik food.
Satvic Food above, very high on the tree like leaves is satvic
Rajsik
Tamsic food :Food below the ground.
Seasonal vegetables and locally grown vegetables can be eaten. Vegetables which are cheap in the morning, and they are in abundance that means they are covid friendly. They are Antioxidant, immunity boosting.
Milk : Drink it alone or leave it alone. Do not eat non-veg along with it. Milk should not be drunk along with fruits. Do not add salt in milk.
Watermelon eats it alone or leaves it alone. Watermelon should not be eaten along with other fruits.
Coffee, tea, chocolates, cocoa: They are Antioxidants. It can be taken.
Black Tea is good.
Black coffee is good.
Black Tea is good : If you are adding milk and sugar in the tea the beneficial effect of tea is finished. As tea is an astringent , the advantage of astringent is finished after adding sugar and milk.
Alcohol : For relaxation 18 ml Whisky + 42 ml soda. whisky’s. (2 pegs of 60 ml will be ready ) You can enjoy it for one hour. For the person who drinks alcohol. Persons who drink whisky should reduce their amount. The people who do not drink ,should not start.
Turmeric : Turmeric contains TNF blocker, which reduces inflammation. Persons taking an inflammatory diet should use more turmeric
Anardana, Amchur and Tamarind (Imli) : You can eat it. In covid times the more you take it will be better. Sour taste does not go in Covid.
Keth Phal (wood apple) :
Keth phal is good to eat.It reduces the inflammation side of our body. It also reduces diabetes.The scientific name of Kaitha is Feronia limonia. It is a good source of vitamin B-12. Catha strengthens immunity, maintains good digestion, it regulates body temperature as well as cholesterol and blood pressure. Kaitha is helpful in preventing scurvy. Kaitha is anti-inflammatory, antipyretic, analgesic, anticancer, anti-diabetic, wounding, diabetic, anti-biotic.
Jamun is good to eat : Jamun l is good to eat. It reduces the inflammation side of our body. It also reduces diabetes.
Substances which are bitter and green reduce diabetes.
Things which can be divided into two parts like pulses (dal), Lobia, rajma, almond, Walnut (Akhrot). After soaking it in water it should be eaten. Or after boiling them in low flame then eat.
Sprouts : In this Vitamin B 12, folic acid and Zinc is increased. Eat sprouts good for your health.
Wheat Grass or / Barley Grass Juice : It is also called green blood. Eat one grass surely. Whether it is wheat grass or barley grass. You can grow wheat and barley at home. And drink the juice of wheat / barley grass.It is Antioxidant, Anti cancerous and it is very good for health. Kusha Grass is also good. Druva grass is also good. So make use of these grasses in your eating habit.
Clarified Butter (Ghee) , Oil and Butter : It should be consumed ½ kg per person per month. Oil liquid or solid will decide its quality. Any oil which is liquid at room temperature is good for health.
Rice and Pulses (Dal +Chawal) : You get full Amino Acids that are proteins.
1 . Diet should not be inflammatory.
We should not take inflammatory diets in times of Covid.
Refined food : White sugar, white rice and white maida are inflammatory food. Instead of sugar, khand. Instead of khand take jaggery. Instead of jaggery, take honey.
You have to add one bitter item along with sweet substance. I.e instead of aloo matar , eat aloo + Methi or .Aloo + palak. Aloo mungree (radish legume). Aloo+Bhindi. Aloo+phalli (legume)
Do not add two sweet items.
Brown rice instead of white rice.
Take wheat (Chokar wala wheat ) instead of Maida.
Blood thickening food : Tomatoes, cabbage, broccoli, they have vitamin K. It should not be taken in covid times.
2 . It should not be coagulatory.
Banana Shake : Fruits and milk should not be mixed according to Ayurveda.So not recommended. It should be consumed separately..
Milk should not be taken with salt, Fish, meat and fruits according to Ayurveda.
Trans Fat : It is also called Vanaspati . (Saturated Hydrogenated oil) It should be avoided.
Any oil which is solid at room temp, is not good for the health.It will also get solidified inside the body. It will increase the bad cholesterol (LDH)
Non Vegetarian food
Meat / Mutton : (Red Meat) if taken in large amounts can increase cholesterol, uric acid. Meat should be well cooked. It should not be seen as red.
Chicken : (White Meat) Chicken is a better choice to eat.
Fish : 6o grams of fish is beneficial to eat for the people who are consuming fish.If you are consuming more than 60 grams of fish , make sure that fish do not have mercury in it.
Sea food : Sea food is good for the heart provided you are non vegetarian.
.Ice cream : You can eat but not daily.
Soft Drinks : Dilute it with 50% Soda so that its sugar content is reduced.
Water : Drink 30 ml per kg body weight.Suppose your weight is 60 kg then 1800ml.if Covid is positive (fever) add 500 ml extra.That is 2300 ml.
Meals
Dal : Mix or plane Dal, Rajma or chole.
Avoid all fermented items at night. Pre Fermented items can be taken before sunset. Dinner Time in America is 5-7 PM. It can be consumed before sunset.
Do not take curd at night. : When chapati and curd are eaten together , after chapati reaches the stomach and gets sour, curd becomes bitter.It is fermented and causes gas formation.
As curd is sour inside the stomach it becomes more sour .As curd is pre fermented. In the night as the digestive power is slow it will lead to gas formation. Person can have Belching (dakaar), therefore one has to walk. If you want to eat it, then eat it alone.
Curd : If sour then mixed with Methi, chana, bottle gourd, or potato)
Do not eat Curd and cucumber as both are sweet.
Chapati : Makka, bajra,
Rice : Vegetable Pulav without potato. (As rice and potato will become sweet) Both items should not be of the same taste.
Post Digestive effects (VIPAKA) When we eat food, after chewing and after mixing with saliva Amylase enzyme, it becomes sweet. When food enters the stomach it becomes sour after it is mixed with acid. When food travels down it will become bitter.(in stool form)
Alcohol : Best time to consume alcohol is before sunset. Timing 4-6 PM. As it is also a fermented product. Anybody who consumes alcohol at night lands up in trouble.
Which food to be eaten when?
Light food should be eaten at night.
Our body has a circadian cycle or a rhythm.
Morning from 6-10 AM digestion is weak therefore breakfast should be taken light.
From 10-2 PM Our digestion is strongest. One should take a full meal.
In the afternoon from 2-6 PM digestion is a bit less strong and my mental activity is more, I should take light snacks.
In the evening 6-10 PM our digestion is weak. If you take heavy meals during this period ,you won't be able to digest, therefore there will be a problem.
Here's what you can inculcate in your diet to have a strong immune system.
- Ashwagandha : Improves antibody production that plays an essential role in fighting bacteria viruses and other pathogens.
- Tulsi : It act as an immuno-modulator, which refers to agents that improve the immune system.. Helps to restore balance for healthy physiological and psychological functioning. It also contains anti-oxidants and micro nutrients, which increase the body capacity to fight against disease. Take tulsi tea in the morning.
- Giloy : An anti-pyre-tic in nature, giloy can prevent the onset of recurrent fever. Strengthens immunity and is a source of biologically active compounds such as alkaloids and lac tones. Helps reduce respiratory problems such as frequent cough and coil and tackle respiratory problems. Helps to fight off free radicals and disease causing germs.
- Amla : Rich in vitamin C which is a nutrient known to help boost immunity.It helps repair the body and keep the risk of disease away. It boost the production of white blood cells (W.B.C) in the body that help in fighting several infections. Amla juice,neem and giloy works beautifully with warm water, and should be taken regularly ro boost the immune system.
- Turmeric : Corcumin present in the turmeric has anti-oxidant properties that neutralize free radicals, stimulates the body's antioxidant enzymes. It also inhibits inflammation relieves congestion and improves breathing. Turmeric Latte to boost immunity. A nutritional powerhouse, it is a cup full of antioxidant rich spices that have also anti-inflammatory properties. Have one glass of this at night before sleeping and you can considerably reduce the odds of falling sick.
- Neem : Its leaves and fruits.
- Fenugreek seeds are immune boosters.
- Cinnamom : It is anti-inflammatory.
- Ginger : Good for respiratory problems.
Relatively few cases of babies with Covid 19 have been reported and and those who are infected have experienced mild illness, according to WHO. Children are 56% less likely than adult to get infected when in contact with an infected person, but how easily they pass on the infection to others is unclear. In the US and China, children under 18 years account for around 2% of diagnosed cases.
What happens if you have mild or no symptoms?
Around four in five people have mild illness and can recover at home without medical care. They need to stay isolated at home for two weeks to prevent spreading infections to others around them.
When shall you seek medical attention?
Emergency warning signs for Covid 19 trouble breathing, persistent pain, or pressure in the chest, confusion, inability to wake or stay awake and bluish lips or face.
"Covid spreads easily within families, symptom less spread common."
Around 5% of population. In Delhi it would be translated into million test which should be done.
Do lock down hampers immunity ?
Isolation or lock down is not one to aspire to go back to because that does set up the condition for a new virus to come in and find a totally immunologic ally naive population and wreck havoc just as the flu did in 1918. lock down will prevent the buildup of immunity in sectors of population who are not vulnerable. In that sense, that is also a cost according to an epidemiologist.
First Aid Box
- Should have have an Oximeter, thermometer, PEFR,BP instrument?
Prevention
- Being home is the best self defense.
- Get fully vaccinated.
- After public dealing when you come home, dispose of your clothes, and take a bath
- Am I wearing a contact lens ? Take it out. Dentures, take proper care and wash them.
- Work from home (W.F.T- Video - conferencing _ should, and those of us who cannot should take adequate precautions.
- Exhaust fan working in the common toilet
- Install Air purifier to reduce the risk.
- Avoid using contact lens
For Using Taxi : If using a cab use a mask along with a face shield.Sit at the rear seat. Instruct the driver not to look at the back.
- Open hair saloon for hair cut.
- Avoid servants.
- Keep yourself fit by walking, exercising regularly, doing Yoga, Pranayama and sunlight exposure..
- Avoid cigarettes, alcohol or drugs risk will reduce.
- Travel by auto-rickshaw or non a/c car. Avoid public transport.
Kadha should be taken once a day.
In prevention of Covid 19.Yes for personal protection. The virus enters in my body through the nose or through the oral cavity.Therefore nasopharynx and oropharynx is the route of entry, 0.5% solution of Povidone iodine can disinfect the oropharynx and nasopharynx.within 20-30 seconds. And the action can last for at least 20 minutes.The low viral load will be associated with less severe covid infection therefore regular use of Povidone iodine mouthwash every 1 to 3 hours may reduce the chances of infection specifically in a situation of high viral load doctors clinic,hospitals, dental departments, surgeries,high risk individuals,everywhere this may have a role. It should be used in addition to PPE and Masking.0.5% PDPI solution as gargles.
How do you gargle with Povidone iodine? Pour Povidone-Iodine (BETADINE®) Gargle & Mouthwash into the cup. Dilute with an equal amount of warm water if taste is an issue. Swish part of the solution briefly in the mouth and spit it out. Tilt your head backwards and gargle for a total of 30 seconds via swirling the liquid at the throat.Repeat up to four times daily, for up to 14 days in a row, or as directed by your doctor or pharmacist. Do not use it for more than 14 days.
- Turmeric gargles.
Oil Pulling : with Sesame oil or Coconut oil
Prevention: No face to face meeting. Only one angle to avoid. In our Indian tradition it is followed not to talk to elders with eye contact. We talk to them by looking down. Yes chachaji, yes Mamaji. If you talk face down your virus will go down and elders virus will pass from upwards. When Sudama went to meet his childhood friend Krishna . Krishna welcomed him “ATITHI DEVO BHAVA.” His feets were cleaned with water ,his hands were washed, Sudama's mouth was rinsed with water, and then he was made to sit at a higher level.
You will inform all members of the society you have met in the last 48 hours. That you were exposed, and you have isolated yourself ,when ypur report comes ypur will inform. Inform by S.M.S.
Make sure that you are Isolated. And your family is quarantined, which means they use masking.
You will follow good hygiene and nutritious diet.
Vegetables and fruits should be washed in potassium permanganate solution.
How does washing hands help?
Hand washing 6-10 times a day lower the risk by 36%. When water is not available clean hands with alcohol based hand rub (with over 70% alcohol content). It does not offer complete protection.
HAND HYGIENE SANITIZERS
Do mask and face shield help?
Yes . The primary source of infection is through infected droplets when people speak, cough or sneeze. Wearing a mask- even a non medical face covering - reduces the possibility of inhaling the infected droplets quite significantly.. Mask with an exhalation valve- something anti-pollution mask usually not that effective.
W.H.O recommends that vulnerable people should wear a medical grade mask and doctors should wear Face shield since they are prone to being exposed to the virus, which can also be by the body through the membrane in the eyes.
WEAR PROPER FACE MASK
Government warns against in- appropriate use of N-95 masks with valved respirators. As valve used for exhalation- could act as an easy passage for germs and endanger those in close proximate, if the user has an infection.
Mask must fit the face perfectly and that no gaps are left on the sides. People to wash hand thoroughly before wearing the face cover, switching to another fresh one if the face cover becomes damp or humid and never reusing it after single use without cleaning it. Never share the face cover with any one. Every member in a family should have separate face cover.
Every body need to wear mask all the time. Most people take off their mask inside the homes because they feel safe and protected, but given the density of population in India indoor containment will be a challenge.
Face covers must be washed and cleaned daily and recommended the use of cotton cloth to make these covers. The fabric is washed well in boiling water for 5 minutes and dried in sunlight well before use. Adding salt to this water is recommended.
HAND HYGIENE SANITIZERS
When you are running or jogging your oxygen requirement goes up and you need to inhale that much more air to deliver the required oxygen to the body. Mask block free flow of oxygen to the lungs so they are not recommended while exercising. However if you are brisk walking , or see people around , make sure you wear the mask.
FACE SHIELD
Protected Goggles
GLOVES
P.P.E KIT FOR DOCTORS
Maintain 6 feet social distancingNasal drops: .Anu taila - Put two drops of oil in each nostril.
Benefits : - ANU OIL improves the sense of smell.
- It improves eye sight and prevents eye diseases.
- It helps clearing sinuses and prevents sinusitis.
- It improves voice and the vocal chord.
- It provides strength to the facial muscle, jaw joints and other facial structures.
- It helps relieving neck stiffness and prevents cervical spondylosis.
- It helps curing hair falls and baldness. It also prevents early graying of hair.
P.P.E KIT FOR DOCTORS
Maintain 6 feet social distancing
- ANU OIL improves the sense of smell.
- It improves eye sight and prevents eye diseases.
- It helps clearing sinuses and prevents sinusitis.
- It improves voice and the vocal chord.
- It provides strength to the facial muscle, jaw joints and other facial structures.
- It helps relieving neck stiffness and prevents cervical spondylosis.
- It helps curing hair falls and baldness. It also prevents early graying of hair.
"Avoid handshake, greet others with Namaste "
Cough antiquates
VENTILATION
-
Ventilation: It is the key to mitigating risk. : Keep all doors and windows open. Cross ventilation of room. The entry of fresh air and stale air exhaust and filtration are the two key elements. Indoor spaces like workplaces, restaurants, parties, shopping centers, and transports. In the lab we increase the exhaust with the maximum fresh air and don,t have crowding.
- Air purifiers : Cleaning the air, High efficiency particulate air (H.E.P.A) filters used in aircraft and in health care settings have demonstrated good performance with particles of SARS- CoV-2 virus size ( around 70-120) . A NASA study documented H.E.P.A. filters stopped particles as small as 0.1 microns., which is approximate size of corona virus.Installing high performance air- purification systems. Cheaper options for air flow management are through the use of a vertical laminar for slow steady air flow in a straight path to push out potentially contaminated air. Vertical laminar is used to minimize contamination, so that the air flow systems direct air from the ceilings to the floor.
- Aerosols : To restrict the spread of infection. No use of room perfumes etc.An increasing number of outbreaks implicate the role of aerosols in the spread of infection, which can be spread by symptomatic and asymptotic people.
- Use of Washroom : After 15 minutes of previous user. As corona virus acts as an aerosol and spreads in air. Diarrhea being a symptom of corona can be prevented in families.
- Exhaust fans : Instillation in laboratories, kitchens, washrooms and toilets.
- No central air conditioners. Re-modelling and re-modifying heating, ventilation and air conditioning (HVAC) systems can help owner the risk of infection.
- Smoking prohibited in public spaces.
- Ventilation: It is the key to mitigating risk. : Keep all doors and windows open. Cross ventilation of room. The entry of fresh air and stale air exhaust and filtration are the two key elements. Indoor spaces like workplaces, restaurants, parties, shopping centers, and transports. In the lab we increase the exhaust with the maximum fresh air and don,t have crowding.
- Air purifiers : Cleaning the air, High efficiency particulate air (H.E.P.A) filters used in aircraft and in health care settings have demonstrated good performance with particles of SARS- CoV-2 virus size ( around 70-120) . A NASA study documented H.E.P.A. filters stopped particles as small as 0.1 microns., which is approximate size of corona virus.Installing high performance air- purification systems. Cheaper options for air flow management are through the use of a vertical laminar for slow steady air flow in a straight path to push out potentially contaminated air. Vertical laminar is used to minimize contamination, so that the air flow systems direct air from the ceilings to the floor.
- Aerosols : To restrict the spread of infection. No use of room perfumes etc.An increasing number of outbreaks implicate the role of aerosols in the spread of infection, which can be spread by symptomatic and asymptotic people.
- Use of Washroom : After 15 minutes of previous user. As corona virus acts as an aerosol and spreads in air. Diarrhea being a symptom of corona can be prevented in families.
- Exhaust fans : Instillation in laboratories, kitchens, washrooms and toilets.
- No central air conditioners. Re-modelling and re-modifying heating, ventilation and air conditioning (HVAC) systems can help owner the risk of infection.
- Smoking prohibited in public spaces.
- First manifestation of Covid
- Heart Attack
- Stroke
- Rapid rise in C..RP increased inflammation can precipitate heart attack by replurging plaque - Cytokines are produced, interleukin 6. Acute rise of inflammation can produce heart attack or stroke due to clot.
Warning Signs
- Fever above 103 not responding to Meftal
- Fall in Spo2 more than 5 on exertion
- Respiratory rate more than 25 or breathlessness
- Unable to speak
- Mental alteration
- Semi-consciousness
- Unconsciousness
- Sleepiness
- Absolute lymphocyte count <1000
- Absent Eosinophil
- Difficulty in talking
- Development of cough
- Breathlessness
- Fever
- 6 months may require for recovery.
- Antibody test after 28 days is positive in Covid patient.
- Look for residual or recurrent inflammation .Thrombosis.
- Day 14 to day 21 most serology will become negative. Delayed clots and hypoxia can develop.
- Day 120 Full body check up.
- XXXX
Post Covid
- Loss of smell : Not to worry
- Red eye on left side : Not to worry
- Diarrhea : Not to worry.
- Dry Cough : Codeine linctus 2 tsf three times a day. It suppress cough. For dry cough. As it is uncomfortable and will spread the infection also.Take some hot tea or beverage or sip a glass of warm water.
- 6 months brisk walking, check for SpO2 level, breathlessness, fever, tachycardia.
- Running nose anti allergic tab
- How to prevent hyper coagulate (clot formation) state in Covid 19.
- Blood Thinners : Tab Eliquis 5 mg daily. Attention can also be paid to preventing detecting and treating blood clots. Low molecular weight Heparin . Inj Heparin ,(Inj Clavin) . 6ml subcutenous to be given. After 10 days oral blood thinner that is Tab Aspirin 150 mg (for elderly) for 40 days. Tab Rivaroxaban
- Caution : To be used judicially. Anti -coagulant should be used in all at risk patients who do not have any risk factors of bleeding.
- Diabetes : Novonorm 0.5 mg Tablet is used to lower blood sugar levels in adults with type 2 diabetes mellitus
- Steroids : Caution : To be used judicially
- Pnemonia : LINOX / Luminox 600 mg Tab T.D.S is used in the treatment of bacterial infections such as pneumonia, skin infections or blood infections.
- Bony chest pain : Tab Meftal Twice a day.
- Fever : Tab Paracetamol / or Dolo 650
- Bronchitis : Inhalors.
- Oxygen Therapy : First supply oxygen through a non-rebreather mask. If that didn't work well, then the technique called "Awake Proning". Low Oxygen levels in blood that can be monitored by a simple Pulse Oximeter. If this is done. If this is done, patients likely to become more ill can get necessary care in time- Oxygen supplementation with face down position (proning) and ventilator support , if needed preferably non-invasive. Highflow / low flow oxygen is administered to the patient by non invasive method.Caution : To be used judicially
- Awake Proning : Put the patient on the stomach while continuing oxygen therapy. This opens up the lungs more. This is a technique used for Acute respiratory distress syndrome (A.R.D.S.) patients, which is a critical illness of lung .
- Therapeutic vomiting (वमन): It is done to eliminate the Kapha which is a cause of excess mucous and toxins in the respiratory tract.
- Post Covid Bronchitis: If breathlessness
- Pain in throat : If lots of hot water or kadha is taken.It will be alright.
- Heart patient : Low dose Tab Ecosprin 150 mg Aspirin 150 mg for 40 days. as preventive for heart patient.Control BP by medication.
- Headache : Headache can only or the first manifestation of Covid.
- Covid Cystitis: Covid Cystitis : No pus cells present .Culture sterile (or negetive) . It is cured by itself after infection is gone. No Antibiotic prescribed.
- CRP Quantitative number
- Spo2 level 95, 96
- If LDH (Normal -80) is increased no non veg. Ghee,oil and butter 1/2 kg per person per month.Eat raw turmeric one piece daily. it has to be controlled by medicine and diet (.Evabred 5m
- Constipation : Isabgol
- Anxiety : Melatonin (anti anxiety) has a curative effect in corona, so should be prescribed.
- Fatigue : Tab Mankind L Carnitine (LC). Tab Folic acid vit B12 .Also helpful in loss of smell and loss of taste.
- Gas in Abdomen : Digene gel
- Heart attack patient : Day 1 Blood thinners are prescribed. Tab Aspirin and Statin are prescribed. Do not stop the medication.
- Mainly supportive treatment for the lungs, heart and kidneys.
* Oxygen therapy : A mask or high flow nasal canula that provides humidified oxygen.
* Non invasive oxygen administered using C.P.A.P / B.I.P.A.P machines.
* Medical ventilation with a tube down the throat for critically ill patients who cannot breath on their own.
* Extra corporeal Membrane Oxygenation (E.C.M.O) that works like a heart lung by-pass machine. - No dehydration should be there. Patient should urinate regularly.Capillary permeability increases, blood becomes thick. Therefore blood thinners are prescribed on day 1
- How much is Covid fever? It is low grade fever, there is rise of 1 degree. There will be evening rise. exertion will be there. If it is more than 103 then inflammation is high. Therefore we say check the temp 6 pm. If there is 1 degree rise of fever between 6AM AND 6PM .Exertion will come Wont response to Paracetamol. There can be body ache, headache due to fever. Corona fever does not response to paracetamol. Tab Mefenic acid or Tab Nimusulide will be effective.
- Ventilator : If oxygen saturation does not improve.
- (LC) can also be levo citrazine which is the medicine for allergy so do not confuse.
- Loss of taste : Not to worry. Varuna Mudra
- Pneumonia
- Lung fibrosis
- Age below 12 years.
- Antibodies present
- RT.P.C.R Negative
- 9 days Covid infection over
- Using tight face mask
- Maintaining social distance of 6 feet
- Max Hospital Saket
- Indraprastha Apollo Hospital
- Batra Hospital
- Sir Ganga Ram Hospital
- Fortis Hospital Vasant Kunj
- Fortis Hospital in Gurugram
At an epidemiological level, this severely hampers the process of TEST-TRACE-ISOLATE a mechanism that works to end an outbreak if at least 90% of contacts of an infected person are isolated.
But with an estimated 30% of infections due to asymptomatic or pre-symptomatic carriers , achieving this efficiency of contact tracing is next to impossible.
Why is it spilling in some region?
Everyone who comes in close contact of a positive case must quarantine themselves even if you don,t feel ill as you may be pre-symptomatic or asymptomatic, If you don,t do that you become the part of chain (that spreads infection).
What threat do we face in future in terms of disease ?
* We need to be very vigilant as infectious diseases are not going to go anywhere. Infectious diseases will emerge and will keep continuing.
* We have to protect not just ourselves but work in tandem with our neighbors to achieve larger protection.
* We need to work across borders.
Worst affected countries are China and Italy. One of the biggest economies China, came to a halt when the corona virus detected.
Till date it has affected more than 100 countries.
Insidious Virus : Australia was free from Covid 19 for 2 months again on June 5th 2020 it registered 5 new cases. It is almost as if it was alive. when it comes to viruses , lulling people and countries, into a false sense of security, and then striking.
Sars-CoV-2 virus which causes the corona virus disease is air borne, especially in closed spaces. The W.H.O finally accepted earlier this week that the virus may be transmitted in air. (Crowded, closed poorly ventilated settings). It means the virus can stay for hours in the air in closed environment.
Sweden P.M. Stefan Lofven refuse to impose the lockdown in his country because it was too high an economic price to pay, Result was the death rate was high. U.S. ignored the safety precautions and tarnish the image of progressive society.
In France first confirm case of a newborn infected in the womb with Covid-19 by the mother. The baby born boy, born in March 2020, suffered brain swelling and neurological symptoms but has recovered.
In India first case was reported in Kerala. WHO has finally declared the corona virus disease (Covid-19) a PANDEMIC on 11th March 2020.
24th March 2020 complete lock down of the country for 21 days as announced by honorable prime minister to check the spread of disease.
Lock down 1 Started in March 2020 for 6 weeks, Lock down 4 extended till 31st May 2020
Lock down 2 is extended till 3rd May 2020
Lock down 3 is extended till 17th May 2020 (Scraping a night time curfew)
Unlock 2 will end on 31 st July 2020
Unlock 3 will end on 31 st August 2020
Death rate
Expert said rising recoveries may suggest that the outbreak was stabilizing. When the number of those infected in a day is the same as number of people recovering then it usually highlights the fact that the disease outbreak is going to stabilize and start declining in some time.Unless some other variable comes such as floating population or new births that change the entire dynamics.
"The virus has proved strangely resilient --- not weakening. Summer has no effect on it."
Everybody have insurance in the family.
Genome Sequencing
Lambda C.37 Per Dec 2020 June 14 2021 Have several mutations found in significant number
Dropped as V O I
Epsilon
Zeta
Theta
A previously unknown Sars-Cov-2 variant has now started to emerge in samples analyzed in India by scientists to check for mutations, according to experts and new analyses that show one of these changes. It is the same one found in Brazilian and South African variants of the Corona virus.
This particular change is known as E484K, and it has been strongly linked with the virus becoming more resistant to antibodies created by vaccines or a past infection. It has been found in a variant now labeled as B.1.618 which has been reported in West Bengal
Details about its spread came days after genome sequencing data indicated a large presence of another known variant first found in India, the B.1.617 often referred to as “double mutant virus“
Both these variants are now considered variants of interest (VOI). and scientists are studying whether it can make the Coronavirus more transmissible, more lethal or more resistant, clues that are crucial to determine whether the intensity of India's current wave of infections is because of this?
B.1.618 is 12% and is the third most common variant sequenced in the last 60 days. The B.1.617 at 28% is the most common among sequences. Followed by B.1.17 (the UK variant) the India mutation report by Scripps Research showed, citing the GISAID data.
The particular variant had appeared some time ago in West Bengal, however we did not study the mutations and its clinical significance in detail as the so-called double mutant variant (B.1.617) out completed it.
The B1.618 variant has plateaued at about 25% of the total mutations reported from West Bengal.
B1.617 has become predominant. Across the country there are some districts in states such as Maharashtra where the prevalence of the variant is as much as 80% samples. What the impact of this variant or B1.617 would be on the vaccine efficacy etc. is all a matter of predictions. It is thought to evade the immune response because it contains the E484K mutation. We will be able to tell the clinical significance of these mutations only when we test them in the animal system.
The institute is currently in the process of collecting and growing laboratory samples of the mutated. Variants of the virus to establish whether they actually aid the virus in escaping the immune response from vaccines and previous natural infections.
A variant can contain multiple mutations, which are not unusual _ particularly for RNA viruses such as Sars-Cov2 but since late last year some of them have made the virus “fitter” _ particularly UK variant, which spreads much more readily than its ancestors - and the South African variant,which appears to cause more repeat infections and make vaccine less effective.
According to the analysis at outbreak info, 129 of the 130 B1.618 sequences in India were in samples from West Bengal. India accounts for 62.5% of the B1.618 variants reported in the world. The variant was first found in a sample outside of India in April 2020.
Experts tracking India’s genomic surveillance said that while specific tests are required to determine the impactions of the virus, India needs to sequence and share details of more samples.
India has 8,455 publicly available genomes and around 14 millions cases so far . This is 0.06% of cases sequenced.. Ideally we want the number to be between 2%-5% which is in line with successful genomic surveillance programs in other countries.
* Antibody test started in Delhi in April but were put on hold after allegations over quality of Chinese kits.
* From Friday Delhi will test 20,000 people from a cross section of the population in the 11 district to check disease prevalence within a community. Maharashtra is the only other state conducting antibody test.
* Antibody test are prohibited for diagnosis. as they cannot detect a current infection.
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VACCINE
Localities color coded as per threat level : The move has come after the central government allowed states to demarcate zones in the forth phase of lockdown
No of zones
GREEN : Areas where containment measures have been scaled down due to no new case in 21 days.
ORANGE : Areas where no case has been reported for at least 14 days.
RED : Area where Covid cases are surfacing frequently.
"A fall in daily deaths over 10 consecutive days is a more stable indicator."
COVID 19 Hospital's of Delhi
2 Rajiv Gandhi Super speciality hospital 500 Beds
3 Deep Chand Bandhu Hospital 200 Beds
4 Satyavadi Raja Harishchand Hosspital 200 Beds
"The virus has proved strangely resilient --- not weakening. Summer has no effect on it. "
- Do I have communication apps on my mobile
- Do I have enough bleaching powder, sanitizers and soaps
Do I have a first Aid box?
Do I have an Oximeter, thermometer, PEFR,BP instrument?
Did I prepare an electronic summary of my medical records?
Did I check my Arogya Setu App or not?
Is the isolation room in my house ready or not?
Does everybody have insurance in my family or not?
If after taking medicine I have diarrhea, or cough I assume it is a covid? Like Amoxicillin causes diarrhea and Tab Envas causes cough.
Hydrate yourself well.
Hydration : Proper fluid intake.
High Protein diet.
Cross ventilation.
Make arrangements for the Oxygen concentrator, or oxygen cylinder.
HOME ISOLATION
For asymptomatic patients or those with mild symptoms who have a separate room to isolate themselves. Keep the isolation room in the house ready.Get yourself locked and isolated in a room with an attached bathroom. Arrange a Pulse Oximeter and digital thermometer.
COVID CARE CENTER
If you have mild symptoms , but do not have a separate room than arrange for your admission into a Covid care center.
HOSPITALS
If you have severe symptoms or co-morbidity go to the nearest government or private Covid 19 hospital.
Revised D.G.H.S Guidelines for Covid
It added stress to a healthy balanced diet with proper hydration, and asked patients and their families to stay connected and engage in positive talks through phone, video-calls, etc.
The Union health ministry’s directorate general of health services (DGHS) has overhauled Covid-19 treatment guidelines and removed all medicines, except antipyretic (fever) and antitussive (cold), for asymptomatic and mild cases.
The revised guidelines, issued on May 27, effectively dropped all drugs that doctors have been prescribing even to asymptomatic or mildly symptomatic Covid-19 patients such as hydroxychloroquine, ivermectin, doxycycline, zinc, multivitamins etc. The guidelines also dissuade medical practitioners from prescribing unnecessary tests such as CT scan.
For asymptomatic cases, the guidelines said, no medication is required, while medications for other co-morbid conditions should be continued. “Patients are advised to seek tele consultation; and Covid-19 appropriate behavior must be observed such as mask, strict hand hygiene and physical distancing,” the guidelines said.
It added stress to a healthy balanced diet with proper hydration, and asked patients and their families to stay connected and engage in positive talks through phone, video-calls, etc.
For tests, the advisory said, “Usually, no investigation is required at this stage.”
In mild cases, the guidelines recommended self-monitoring for fever, breathlessness, oxygen saturation (SpO2) or worsening of any symptoms. People may take antipyretic and antitussive for symptomatic relief, and inhalation budesonide (given via metered dose inhaler with spacer device) at a dose of 800 mcg twice a day for 5 days for cough, the guidelines said. “No other Covid-19 specific medication is required. Patients may have to be investigated further if symptoms persist or deteriorate,” it recommended.
Managing Covid 19 : Govt’s New Guidelines for Adults
In home isolation
No medication required except for existing illness
Consult doctor regularly over phone or / video calls
Have a healthy and balanced diet with adequate hydration
Isolate wear a mask
Test Recommended
Usually none as long as the patient's condition remains unchanged.
In self isolation or Covid care center
Self monitor for fever and breathlessness
Use drugs for fever, cough for symptom relief
Take inhaled budesonide (8oo mcg twice a day for 5 days)
Test Recommended
Doctor to investigate further if symptoms persist or deteriorate
Admit in Covid hospital
Oxygen support if spo2 is at 92-95%
Steroids may be needed if Spo2 is below 92%
Strength of steroids and anticoagulants used to be determined by change in diagnostic markers.
Test Recommended
Carry out baseline investigations such as :
Blood test - CBC, BLOOD GLUCOSE, Blood glucose, KFT, CRP, FERRITIN, D DIMER, LDH.
Serial chest X Ray 48 hours apart
CT scan only if symptoms worsen
In ICU or Covid hospital
Begin Oxygen therapy to target reaching Spo2 above 90% (target 92-96% in pregnant women)
Use high flow nasal cannula or mechanical ventilation if patient does not improve
Start steroid therapy
Begin prophylactic anticoagulants.
Test Recommended
Carry out investigations such as :
Blood test - CBC, BLOOD GLUCOSE, Blood glucose, KFT, CRP, FERRITIN, D DIMER, LDH.
Serial chest X Ray 48 hours apart
CT scan only if symptoms worsen
Ventilator is required for 3% cases
* After the patient is discharged from the hospital 7 days home quarantine is advised.
* Co- morbid patient are at risk i.e leukemia, brain tumor, stroke, diabetes, heart disease, kidney diseases, and immune-comprised patients.
What to do if case is :ASYMPTOMATIC HOME ISOLATION
- Stay under immediate care of parents
- No specific medication needed
- 6 minute walk test for children above 12 years
MILD CASESHOME ISOLATION
- For fever paracetamol of 10-15mg/kg/dose every 4-6 hours
- Counting of respiratory rate 2-3 times a day
- Look for chest in drawing bluish discoloration of body.
MODERATE CASESCOVID HOSPITAL
- Immediate oxygen therapy
- For fever paracetamol may be repeated every 4-6 hours
- Test. H.R..CT scan needed
SEVERE CASESICU OF COVID HOSPITAL
- Immediate oxygen therapy
- Check if acute respiratory distress Syndrome develops
- May need oxygen support in case of oxygen disfuntion.
USING MASK- No mask for 5 years and under
- 6-11 years may wear depending on ability to use it safely
- 12 years and above must use as adults
- Stay under immediate care of parents
- No specific medication needed
- 6 minute walk test for children above 12 years
- For fever paracetamol of 10-15mg/kg/dose every 4-6 hours
- Counting of respiratory rate 2-3 times a day
- Look for chest in drawing bluish discoloration of body.
- Immediate oxygen therapy
- For fever paracetamol may be repeated every 4-6 hours
- Test. H.R..CT scan needed
- Immediate oxygen therapy
- Check if acute respiratory distress Syndrome develops
- May need oxygen support in case of oxygen disfuntion.
- No mask for 5 years and under
- 6-11 years may wear depending on ability to use it safely
- 12 years and above must use as adults
Children infected with Sars-Cov-2 should not be given remdesvir and steroids or anticoagulants.If requires, should only be given in a hospital
HRCT of chest to be done only if there is worsening of symptoms.
Routine treatment should include no more that typical antipyretics (fever medicines) and antitussives (drugs for cold and cough)
overuse of drugs, which could lead to worsening of symptoms.
Mild symptoms as low grade fever,cough,rhinorrhoea,sore throat, body and headache,malaise or weakness,diarrhea,nausea or vomiting,loss of smell or taste.
Moderate disease includes pneumonia and a high respiratory rate and oxygen saturation between 90-93% on room air.
Severe has been defined when oxygen saturation (or Spo2 level) dropped below 90% and child showing symptoms of Pneumonia. Acute respiratory distress syndrome,septic shock, or multi organ dysfunction syndrome.
There is no point in over prescribing medicines or tests as children by and large recover with symptomatic treatment.But what is important is to accurately categorize mild,moderate and severely ill children
Asymptomatic cases
The guideline recommend infants and younger children stay under immediate care of parents or guardians in home isolation. No specific medication is required but any ongoing medication for other illnesses should be continued. The child infected must follow Covid precautions.The guidelines advise adequate intake of fluids to maintain hydration and a nutritious diet, and advice older children and family to stay connected and "engage in positive talk through phone,video calls etc." Should any symptoms worsen, the family must immediately consult a doctor. No routine investigations (tests) are needed.
Mildly Asymptomatic
They should also remain in home isolation and must follow Covid appropriate behavior. For fever, they can be given paracetamol. This dose can be repeated every 4-6 hours if needed. For cough,throat soothing agents and warm saline gargles in older children and adolescent is recommended or other Covid 19 specific medication is needed especially antimicrobial drugs. Parents or attendants need to maintain a monitoring chart and keeping a lookout for symptoms : like chest in drawing (inward movement of lower chest wall), blueish discoloration of body, any abnormality in urination, oxygen saturation change etc. Parents or care givers must contact a doctor in case of deterioration of symptoms.
Moderately Sick
Such children must be taken to a hospital or a Covid care facility, where they must be put on oxygen therapy and their fluid and electrolyte balance, especially oral fluids (breast feeds in infants) must be maintained by initiating intravenous fluid therapy if oral intake is poor. Corticosteroids are not required in all children with moderate illness. They may be administered in rapidly progressive disease and anticoagulants may also be indicated, the guideline advise. For fever (temperature >38 degrees or 100 F) a child should be given paracetamol 10-15 mg/kg/dose that may be repeated every 4-6 hours. Antimicrobial need to be administered if there is evidence or strong suspetian of bacterial infection. And supportive care of co-morbid condition, if any must be initiated.The guidelines prescribe a set of tests but suggest that HRCT scans must be done only in a rational manner.
Severe cases
They should be immediately put on oxygen therapy in a facility and fluid and electrolyte balance must be maintained. They will also need to start on corticosteroids and anticoagulants as indicated. In case there is acute respiratory distress syndrome(ARDS) or shock necessary management to be initiated. Antimicrobial should be administered if there is evidence or strong suspicion or super added bacterial infection.The child may need organ support in case of organ disfunction such as renal replacement therapy etc.
Guide for using masksChildren age 5 years or under not be required to wear masks.Children aged 6-11 years may wear a mask depending on their ability to use it safely and appropriately under direct supervision of parent or guardians. Those aged 12 years and over should wear a mask under the same conditions as adults and should ensure hands are kept clean with soap and water or an alcohol based hand rub while handling masks.
Red Flag : Patients should immediately inform :
Co-morbid precautions :Uncontrolled BP, Uncontrolled sugar, any internal disease,
Or after a 6 min walk test any 6 parameters affected.
Blood test IF NO Eosinophil, Reduced Lymphocytes, CRP more than 26,Or ESR more than age or +20 in woman.
Talk to your doctor immediately.
Breathlessness or Dyspnea
Loss of taste is a good sign recovery is good.Eat ginger + honey for restoration of taste.Switch over to sour taste after some times. Later on you can try Amchoor, anardana or tamarind.Loss of taste can be tested by eating jaggery / gur.
Loss of smell is also a good sign. It can be tested by gulab ark / or rose essence.
Loss of Smell : Treatment - Take out Orange peel, Take out its juice, Try to practice smelling it for 4 times a day.Fatigue : or Weakness eat protein you will be alright. L Carnitine is advised. Mankind LC is L Carnitine.
HRCT of chest to be done only if there is worsening of symptoms.
Routine treatment should include no more that typical antipyretics (fever medicines) and antitussives (drugs for cold and cough)
overuse of drugs, which could lead to worsening of symptoms.
Mild symptoms as low grade fever,cough,rhinorrhoea,sore throat, body and headache,malaise or weakness,diarrhea,nausea or vomiting,loss of smell or taste.
Moderate disease includes pneumonia and a high respiratory rate and oxygen saturation between 90-93% on room air.
Severe has been defined when oxygen saturation (or Spo2 level) dropped below 90% and child showing symptoms of Pneumonia. Acute respiratory distress syndrome,septic shock, or multi organ dysfunction syndrome.
There is no point in over prescribing medicines or tests as children by and large recover with symptomatic treatment.But what is important is to accurately categorize mild,moderate and severely ill children
Asymptomatic cases
The guideline recommend infants and younger children stay under immediate care of parents or guardians in home isolation. No specific medication is required but any ongoing medication for other illnesses should be continued. The child infected must follow Covid precautions.The guidelines advise adequate intake of fluids to maintain hydration and a nutritious diet, and advice older children and family to stay connected and "engage in positive talk through phone,video calls etc." Should any symptoms worsen, the family must immediately consult a doctor. No routine investigations (tests) are needed.
Mildly Asymptomatic
They should also remain in home isolation and must follow Covid appropriate behavior. For fever, they can be given paracetamol. This dose can be repeated every 4-6 hours if needed. For cough,throat soothing agents and warm saline gargles in older children and adolescent is recommended or other Covid 19 specific medication is needed especially antimicrobial drugs. Parents or attendants need to maintain a monitoring chart and keeping a lookout for symptoms : like chest in drawing (inward movement of lower chest wall), blueish discoloration of body, any abnormality in urination, oxygen saturation change etc. Parents or care givers must contact a doctor in case of deterioration of symptoms.
Moderately Sick
Such children must be taken to a hospital or a Covid care facility, where they must be put on oxygen therapy and their fluid and electrolyte balance, especially oral fluids (breast feeds in infants) must be maintained by initiating intravenous fluid therapy if oral intake is poor. Corticosteroids are not required in all children with moderate illness. They may be administered in rapidly progressive disease and anticoagulants may also be indicated, the guideline advise. For fever (temperature >38 degrees or 100 F) a child should be given paracetamol 10-15 mg/kg/dose that may be repeated every 4-6 hours. Antimicrobial need to be administered if there is evidence or strong suspetian of bacterial infection. And supportive care of co-morbid condition, if any must be initiated.The guidelines prescribe a set of tests but suggest that HRCT scans must be done only in a rational manner.
They should be immediately put on oxygen therapy in a facility and fluid and electrolyte balance must be maintained. They will also need to start on corticosteroids and anticoagulants as indicated. In case there is acute respiratory distress syndrome(ARDS) or shock necessary management to be initiated. Antimicrobial should be administered if there is evidence or strong suspicion or super added bacterial infection.The child may need organ support in case of organ disfunction such as renal replacement therapy etc.
Red Flag : Patients should immediately inform :
Co-morbid precautions :Uncontrolled BP, Uncontrolled sugar, any internal disease,
Or after a 6 min walk test any 6 parameters affected.
Blood test IF NO Eosinophil, Reduced Lymphocytes, CRP more than 26,Or ESR more than age or +20 in woman.
Talk to your doctor immediately.
Breathlessness or Dyspnea
Loss of taste is a good sign recovery is good.Eat ginger + honey for restoration of taste.Switch over to sour taste after some times. Later on you can try Amchoor, anardana or tamarind.Loss of taste can be tested by eating jaggery / gur.
Loss of smell is also a good sign. It can be tested by gulab ark / or rose essence.
Diarrhea : Prepro can take twice a day PROBIOTICS , Can eat curd.twice Because inflammation is there in the small intestine ,it will take time to cure you come to quarantine. Diarrhea : Prepro, Mankind LC, Levo carbitol.Helps in Diarrhoea and weakness.
Fever : Tab Paracetamol 500 mg or Tab Dolo 650 mg.Tab Meftal 500 mg.
- Insomnia : If due to Anxiety for sleeplessness take Tab Melatonin 3 mg for insomnia.
- Pulse rate high :
Snoring people : Should sleep in a prone position. That is upside down.It increases the oxygen intake.
Bloating & Gas : Take Antacids. Digene Gel or Gelusil MPS Gel
Dry cough : Varuna Mudra ..
Post covid cough can persist for two months.Inhalers will help.
For coughs, get treated for Bronchitis.Take Bronchodilators. Tab Deriphyllin may be prescribed.
Honey is good for the throat. It acts as a soothing agent, and will heal faster.
After recovery, start doing Pranayama.
Nose block do Jal Neti. Take Naturopath. Take Anti allergic medicine. Tab Cetrizine.
Post covid bronchitis: Lots of expectorant is coming.Inhalers will help.Take medicine to dilute the expectorant.or loosen it.Honitus cough syrup. Azithromycin for 5 days, and Tab L'Dio M Ldio 1 M 5mg/10mg Tablet is a combination medicine used in the treatment of allergic symptoms such as runny nose, stuffy nose, sneezing,
Betadine Mouth Wash :- Povidone Iodine used as an oral antiseptic (As oral rinse) :: Povidone iodine is a broad spectrum antimicrobial , virucidal drug, which has been effective in Sars-2 infection.The use of Povidone iodine nasal spray and Mouthwash in the current pandemic may reduce cross infection and protect healthcare workers.
Gastritis will be alright.
Mouth ulcers or oral stomatitis : Tab Folic acid 5 mg daily
Breathlessness : .Patient is advised to sleep in a prone position, or laterally. Arrange for Oxygen. LMWH Low molecular weight Heparin is given.
Black spots on the tongue, Tab Aspirin may be prescribed.
Post Covid Costochondritis : Pain over left chest. Can remain for 3 months. Walking is the best treatment
Post Covid Bone Pain : will be there for three months.
Pain below the knees : Or Leg pain is Vit B12 deficiency. There is a deficiency of Vit B12 from the small intestine in covid.
Headache : : Tab Maftal 500mg ( Mefenamic acid) or Nimesulide.
Fever :
Tab P OR Dolo 620 mg aracetamol then take tab Maftal. Tab nimusulide, tab Neprocin, tab Indomethacin.
Black spots on the tongue, Tab Aspirin may be prescribed.
Post Covid Costochondritis : Pain over left chest. Can remain for 3 months. Walking is the best treatment .
Pneumonia will take a couple of weeks to go.
Pain in Throat : Betadine Gargles.
Allergic Asthma in children will cope as well. 6yrs. They don't spread disease.Child will not become serious in allergic asthma. Budesonide inhaler.
Gas in the stomach : Digene .
Post Covid Anxiety : Heart palpitation.Write down I am stronger than the virus.
High Pulse rate : Tab Ivabrad 5mg for 15 days is prescribed.IVABRAD 5MG contains Ivabradine. It works by reducing the heart rate by a few beats per minute and helps to
improve the functioning of the heart. Tab is tapered of.i.e.½ tab then withdraw it.Do Chanting also : i.e. lam,vam,ram, jam,ham,om..
Inhaler Seroflo : 50,125,250 Each actuation delivers:, Salmeterol (as Salmeterol Xinafoate IP).................25 mcg, Fluticasone Propionate IP………….........................50 mcg, Suspended in propellant HFA 134a…….................q.s. SEROFLO INHALER is indicated in the regular treatment of asthma, where use of a combination (long-acting beta2-agonist and inhaled corticosteroid) has been found to be appropriate, and in patients with COPD. Taken twice a day.
Loss of Smell : Treatment - Take out Orange peel, Take out its juice, Try to practice smelling it for 4 times a day.
Tiredness : High Protein diet. Take vitamins.
Post covid Bone Pain : will be there for three months.
If Post Covid Fever persists, do ESR & CRP. Fever can come off and on.
Post covid loose motion : Take probiotic,curd.
Continue your vitamins for 3 months.
Tab Dexamethasone for 10 days.Because ESR is increasing. And Novanorm for 10 days.This medication is a corticosteroid hormone (glucocorticoid).If you take this medication once daily, take it in the morning before 9 AM. adjunct therapy for COVID-19 requiring oxygen or ventilatory support.
Tab Novonorm 0.5mg Tablet is used to lower blood sugar levels in adults with type 2 diabetes mellitus. It is usually prescribed along with others .
Post covid loose motion : Take probiotic,curd.
Post Covid Anxiety : Heart palpitation.Write down I am stronger than the virus.
Carnitine for muscle weakness.It is an immunomodulator.Carnitine plays a critical role in energy production.It reduces general fatigue.
ESR : Raised ESR means damage in the body.
CRP : Raised CRP means inflammation in the body. CRP can double in 8 hours. For raised CRP antiinflammatory drugs are prescribed. It will reduce CRP. Steroids are prescribed.
.
- Budesonide inhaler
Gas in the stomach : Digene .
Rash in the skin : No need to worry.
Pain in Throat : Betadine GarglesHigh Pulse rate :
Increased Pulse signifies inflammation.Anti inflammatory drugs prescribed.
Tab Ivabrad 5mg for 15 days is prescribed.IVABRAD 5MG contains Ivabradine. It works by reducing the heart rate by a few beats per minute and helps to
improve the functioning of the heart. Tab is tapered of.i.e.½ tab then withdraw it.Do Chanting also : i.e. lam,vam,ram, jam,ham,om..
- Heparin or Aspirin with Statin may be prescribed
- Inhaler Seroflo : 50,125,250 Each actuation delivers:, Salmeterol (as Salmeterol Xinafoate IP).................25 mcg, Fluticasone Propionate IP………….........................50 mcg, Suspended in propellant HFA 134a…….................q.s. SEROFLO INHALER is indicated in the regular treatment of asthma, where use of a combination (long-acting beta2-agonist and inhaled corticosteroid) has been found to be appropriate, and in patients with COPD. Taken twice a day.
- Post Covid Vertigo
Epley Manoeuvre : https://youtu.be/9SLm76jQg3g
SteroidsSteroid Side Effect Bone death due to a vascular necrosis.Children infected by Sarc Cov-2 should not be given ramdesivir These help control a hyperactive immune response to Covid 19 that causes inflammation and organ damage.
Steroids ChildrenChildren infected by Sarc Cov-2 should not be given randesivir Steroids are generally prescribed for 10 days. These help control a hyperactive immune response to Covid 19 that causes inflammation and organ damage.
Dexona is not prescribed after 9 days. It is given on day 3,4,5, When there is a crisis. Side effect :One can have secondary Pneumonia due to Dexona.Antibiotics are prescribed accordingly.
Immuno-modulators.These can regulate how the immune system works, often helping spur or reducing the intensity or some immune reactions.Modulating the immune response of infected person such that it is strong enough to clear the virus, but not so much that it kills the host. Increasing natural immunity through vaccine appears distant at the moment and externally providing antibodies via plasma of recovered patients (Plasma Therapy) is neither risk free nor easy to do at scale.Steroid Dexamethasone, it has to be used correctly. Steroid will dampen excessive immune response, limit damage and promote recovery.. However they also suppress immunity and should not be used early in the disease.. More sophisticated immune modulator like the Tocillizumab that can selectively block Cytokine Storm without compromising immunity.
Traditional remedies that boost immunity can be another approach.
Caution : To be used judicially DEXAMETHASONEResult : Very Promising.This inexpensive steroid has offered the best hope yet to curb fatalities. It reduced motality at 28 days by over 10%. And reduce ventilator need by nearly 27%.Category : CorticosteroidStatus in India : , Approved to treat rheumatoid arthritis, allergies.What it does : Modulates immune -mediated lung injury and slows progression to respiratory failure and death. It cut the risk of death by third for patients on ventilators.SIDE EFFECT : Several serious bacterial infections Caution : To be used judicially
REMDESIVIRResult : not effective.Category : AntiviralStatus in India : ApprovedWhat it does : Speeds recovery by shutting down viral replication in the body. Hospitalized patients given Remdesvir were discharged within 11 days on average, compared to 15 days for patients on the standared care.When Should It Be Used : Given to hospitalized patients on oxygen with moderate Covid 19.Mode Of Delivery : Intravenously in I.C.U, Gilead Sciences working on an inhaler.
Dose : Taken for total five days. Loading dose 200 mg (shot) on day 1, will now be followed by 100 mg (shot) daily for four days.Caution : To be used judicially
TOCILIZUMABResults : Mixed.Tocilizumab blocks an inflammatory protein called IL-6. Category : Monoclonal antibodyStatus in India : ApprovedWhat it does : Calms the aberrant hyper immune response called cytokine storm by acting against inflammatory chemicals to fight infection.When Should It Be Used : Moderate to severe disease.Mode Of Delivery : Intravenous Drip.
Regeneron's Regn- Cov2Result : Promising.A cocktail of Antibodies that was given to U.S president Donald Trump.This has shown to reduce viral load and improve recovery times.
Caution ; For patients with blood thinners like ASPIRIN the dose of the medicine has to be adjusted, as virus causes Pneumonia and blood clot formation. Caution : To be used judicially
Now we have 2 important medicines FAVIPIRAVIR & REMDESIVIRWhich are ANTIVIRALS that can kill the corona virus . By using these two medicines we can prevent patients from becoming severely infected and therefore cure them
Steroids are generally prescribed for 10 days. These help control a hyperactive immune response to Covid 19 that causes inflammation and organ damage.
Dexona is not prescribed after 9 days. It is given on day 3,4,5, When there is a crisis. Side effect :One can have secondary Pneumonia due to Dexona.Antibiotics are prescribed accordingly.
Traditional remedies that boost immunity can be another approach.
Dose : Taken for total five days. Loading dose 200 mg (shot) on day 1, will now be followed by 100 mg (shot) daily for four days.
It also urged clinicians to be judicious in recommending CT scans
The guidelines lay down specific precautions that need to be taken into account for use of remdesivir and tocilizumab
ED Symptoms and what they say about severity
If CRP Positive
Having fever doctor we will start:
Patient put on Anti -Coagulant
Colchicine
Mephanic acid
If CRP Increasing next day immediately on steroids
CRP on Day 0,1 and 2. If the doubling time
If CRP doubles in 24 hours treat him aggressively.
Inflammation 4 pathways
PLA 2 pathway Corticosteroids.
NLRP Block by mefenamic acid
NFKB Pathway by Colchicine
KNLF Pathway Blockage
All fevers in Covid 19 will response to Mephanic acid
Mafenic acid is steroid sparing Anti inflammatory.
Tab Colchicine 1 tab daily till the CRP comes to normal
Colchicine is for low grade fever (It is approved for post heart attack.) So ALL PATIENT AFTER HEART ATTACK should be given Colchicine. It can be given for a year for low grade inflammation.
Ddimer' : Tab Revoxaban can reduce D'Dimer Rivaroxaban, sold under the brand name Xarelto among others, is an anticoagulant medication (blood thinner) used to treat and prevent blood clots.
Do the olfactory training : Smelling of orange peel juice 3-4 times a day.
- Vomit sensation post covid : Tab Rhinitidine 150 mg BD for 4 weeks
The biggest challenge will be to achieve the balance between industrial impact Verses health impact of Covid 19.
It is important to identify the reasons associated with this unprecedented rise in numbers and examining measures that must be taken to halt the upsurge.
The steady fall of Covid 19 numbers since the beginning of 2021 coupled with the news about the availability of two reasonably effective ingenuously manufactured vaccines in India and the possibility that at least three more equally effective vaccines were in the pipeline made the people let down their gourd, relax and act as if life was back to normal.
As businesses educational institutions, malls restaurants and the entertainment industry opened most people abandoned observing Covid 10 appropriate behavior. Home quarantine and social distancing measures coupled with business losses that people had experienced over several months had brought in an element of fatigue and they suddenly started to enjoy uninhibited freedom.
RNA viruses keep undergoing duplication and adding mutations to their parental strain because of pressure from host immunity. Due to its recent association with humans, the Sarc-Cov-2 that causes Covid 19 may not yet have been fully adapted to the human host.This has led to the speculation that the virus may be evolving continuously towards higher transmissibility. It has already accumulated novel mutations leading to the patterns of genomic diversity and behavior, specific to different regions of the world.
Although the majority of mutations are inconsequential, the three reasonable concerns are those detected in the United Kingdom (B1.1.7), South Africa ((1.351) and Brazil (P1). The U.K variant with the potential of high transmissibility has been detected in over 10% of the sequenced samples in India with the most concentrated in Maharashtra and Punjab It is possible that these could be additional as yet unrecognized, India specific mutations whose behavior need to be identified. The emergence of multiple variants of concern of Sarc-Cov-2 raises the possibility of the immune escape mechanism adopted by the virus.This means that the host immunity may eventually lose its ability to attack a particular variant (or strain) and eliminate its effectiveness. Current data indicates that the existing vaccines are equally effective with the known new variants . While this is good news, it is important to be on guard since higher infectiousness could lead to the development of viral resistance to both natural and vaccine induced immunity.
What must be done to deny an opportunity for the virus to spread?
A combination of scientific and administrative strategies can be considered. First, besides vaccines, it is important to give equal attention to developing novel therapeutic options through genomic approaches. India has already up scaled its infrastructure in at least half a dozen centers of international standards that can perform highly efficient sequencing of the genome of Corona virus isolates, obtained from the infected individuals. Viral cloning technology could help in designing more effective therapeutic options against Covid 19, particularly of those who get hospitalized and develop severe disease.
The second scientific approach is to develop new strategies to create designer therapeutic antibodies,with efficient neutralizing ability for the virus just like it was done successfully for treating Ebola virus infection Regeneron pharmaceuticals in the United States has already developed an investigation product. REGN-Cov2 on similar lines for Covid 19 which was successfully used to treat Donald Trump. More research is needed to develop new products on similar lines that are equally effective against new variants and more importantly, are affordable
The third is to further increase the vaccination drive to cover, on an average, 5-6 million people a day and perhaps adopt a staggered roll out according to containment zones. Robust data on sero-surveillance using the more sensitive chemiluminescence immuno-assay (CLIA), is needed to identify hotspots, just as it was done earlier with tangible results.
Vaccinating every susceptible individual in these areas, irrespective of age group and banning all social activities there could go a long way in halting the second wave. The critical question is whether the faster spread of the infection in younger age groups will lead to faster herd immunity and thus contraction of the pandemic faster.
Fourth it is clear that human behavior has played a key role in driving the second wave. A more administrative approach will be to adopt strict measures, round up and fine those who violate Covid stipulated behavior. All establishments would be made more responsible and routinely test their personnel, track the positives and treat them as per protocol. The authorities may close their establishments even if one person is not tested or the positive person is not quarantined.
While India has to successfully battle the second wave , it is important not to create panic and stay calm.The surge will settle soon and what worked before during the first will surely work again - but for that a mix of scientific, administrative and behavioral changes are essential.
"EVERY CRISIS IS AN OPPORTUNITY TO REBUILD BETTER."
Any personal gear used by a Covid 19 patient is potentially hazardous waste, and must be treated as such - for the safety of the family, and those collecting and treating the waste itself.
What constitutes such waste
Virologist say all Covid 19 related personal protective gear is potential biomedical waste and can remain infective for days, even if it is been used by an asymptomatic patient. So even if you are not in home quarantine, haven't tested positive or haven't had a test yet because you don't have any symptoms, segregate all the Personal Protective Equipment (PPE) you use. Its better to be safe, as they say, than sorry.
FACE SHIELD Plastic
MASKS Plastic
USED TISSUES Plastic
GLOVES Plastic
SHOE COVERS Plastic
WHAT TO DO WITH IT : Segregate, Segregate,Segregate
According to the government's Solid Waste Management Rules 2016, there are three types of household waste :
BLUE : NON BIODEGRADABLE or dry waste is further shifted for recyclable items like certain kinds of plastic and glass, with the rest sent to a waste-to -energy plant
GREEN : BIODEGRADABLE or wet waste is ideally sent for composting.
RED : BIOMEDICAL WASTE : Domestic hazardous or biomedical waste typically includes items such as discarded pesticide, cans, bulbs, exopired medicines, used needles and syringes. This waste must be incinerated at a treatment plant, Storage and disposal facility (TSDK)
WHAT HAPPENS IF IT IS NOT TREATED RIGHT
PPE waste can remain infective for days. This means that waste workers are at high risk of contracting Covid -19, if the waste is not properly segregated. Your Covid 19 related waste could also infect others if not disposed of properly or left as litter in public spaces.
The best way to dispose of Covid - 19 - related waste
- Pack it away carefully in a separate carton or bag.
- Inform the waste collector mark this is Covid 10 related hazardous waste so that your local government body can process it accordingly,
- Use a red/yellow bag when handling it over, to ensure it doesn't get mixed in with other dry waste.
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| Domestic Hazardous Waste |
Pankaj Mudra
Pankaj means lotus. It grows in water and is considered very sacred in India. A number of Gods and Goddess like Brahma, Laxmi and Saraswati have lotus in their seat. We form Pankaj mudra as a symbol of purity and offering. It is a part of worship.Formation :Join the two palms facing each other. Join the thumbs and the little fingers.Form the other fingers like a blooming lotus.Effects :The thumbs represents fire and the little finger represents water. Joining these fingers means purifying the body and mind.Benefits :- The mind becomes calm and pure.The body also becomes cool.
- This mudra pacifies fever in a short time.
- The beauty of the face is enhanced by this mudra.
Pankaj means lotus. It grows in water and is considered very sacred in India. A number of Gods and Goddess like Brahma, Laxmi and Saraswati have lotus in their seat. We form Pankaj mudra as a symbol of purity and offering. It is a part of worship.
- The mind becomes calm and pure.The body also becomes cool.
- This mudra pacifies fever in a short time.
- The beauty of the face is enhanced by this mudra.
Shankha Mudra
- Feverish feeling in the body. as it subdued the fire element in the body.
- Feverish feeling in the body.
- Burning in the body and body parts.
- Allergic disorders specially skin rashes.
- Voice, larynx and throat pharynx problems
- Flabbiness
- Weakness , paralysis of muscles.
- This mudra puts pressure on the point of thyroid gland thus making it active to remove illnesses related to thyroid glands, so obesity is regulated.
- This mudra purifies 72,000 nerves connected to the navel center there by rejuvenating the whole body.
- This mudra relieves allergies, caused by dust and smoke , so throat becomes clean, also pacifies skin rashes.
- Tonsillitis and other throat infections are cured.
Understanding Reproduction rate
Key lessons for India
Enforce the wearing of masks, Hand Hygiene, and Social Distancing. Draft a vaccine plan. Appoint a chief Scientist- or a Covid Commissioner. Appoint a data czar. Reintroduce Daily briefing on how India is doing. Frame rules for focused lock downs. Give children enrolled in a school under the right to education scheme. Announced another Stimulus : funds, businesses, and put the cash in hands of people. Convene parliament and parliamentary committee.
What pandemic has taught India several painful lessons.
PROTECT NATURE : We can no longer continue with the ruthless exploitation of nature. The climate crisis, erratic weather phenomena, pollution of air, land and ocean have pushed the country, and the world to the dangerous brink. Unless this is reversed immediately, we are in for the serious trouble by the end of the century. It is extraordinary that the lock down period has lead to nature regenerating. We saw blue skies again after many decades, pollution level dropped, and several species of animals, birds and insects staged a comeback. We must try to ensure that these positive developments are sustained so that we do not revert to the old normal, but adopt a new normal vis-a vis nature,
* Second lesson
THE WORLD IS ONE FAMILY : Despite efforts of leader such as the US president Donald Trump to trash the concept of globalization, the fact remains that international collaboration in crisis like this is essential. This applies to the quest for a vaccine as well as the availability of medicines and personal protective equipment. As our ancient concept of (वसुधैव कुटुम्बकम ) The world is one family, tell us in the final analysis, no nation, however great, can be an island unto itself. The human race will ultimately sink or swim together. We have some of the best scientists and researchers in the world, and several of India's laboratories are working overtime to find a vaccine against Corona virus .Here again cooperation with the laboratories in other countries will be of great value.
despite W.H.O coming in for criticism recently, we must continue to cooperate with it fully and take advantage of its organisational expertise.
* Fourth lesson
* Fifth Lesson
FAMILY VALUES : The virus has forced us to revisit family relationship and to extend support and affection particularly to elderly, Reports of increased domestic violence during the lockdown are disturbing. This is the opposite of what is needed. Existing law need to be strictly enforced, because any improper behavior towards women, children or the elderly is unacceptable and against the tenets of Indian culture.
* Sixth lesson
great info about this corona virus. very helpful. Thanks.
ReplyDeleteThanks a Lot.
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