Important points from the panel discussion of Dr.Sanjay Oak, Chairman Covid Task Force, Maharashtra and Dr.Shashank Joshi, Dean ,Indian college of Physicians.
1. Covid 19 positive patient if symptomatic and having co-morbidities should only be admitted to hospital.
2. Initial line of treatment
Vit C 1000 mg per day plus
Zinc 50 mg per day plus
Tab HCQ 400 mg BD for day 1,followed by 400 mg OD for 4 days
plus Tab. Azithromycin 500 mg OD for 5 days .
3. If HCQ plus Azee contraindicated, then Cap Doxy for 5 days plus Tab Ivermectin for 3 days.
4. Drop in spo2 is mostly seen in day 8 to 10 of illness
5.Most lives are lost during day 7 to day 14 , when febrile stage already over.
6. Death rate has come down from 7.7 to 3% in Mumbai.
7. Doubling rate of cases has improved from 3.5 days to 16 days.
8. Putting patients on invasive ventilator has not helped much as 88 % of those on ventilator died.
9. High flow Nasal Cannula Oxygen is the only and only way of treating patients.
10. Antibody tests are not to be done for diagnosis of cases.
Quantitative titre of IgG can only tell us about the amount of resistance a person has developed against virus.
Also individuals with high titre of IgG are appropriate candidates as plasma donars. It is something like having immunity passport if IgG titres are high.
11. By now 5 to 10% of population must have developed antibodies against the virus.
12. After 10 days of illness virus is no longer replicating, hence though person is symptomatic he is not infectious to others.
13. It may take few weeks for the test to become negative in some individuals.
14. HCQ is a protective and well tolerated drug for Indians. Police people who received HCQ prophylaxis had milder illness and lesser deaths as compared to the group that didn't receive HCQ prophylaxis. Can be safely use in person below 55 years of age .A baseline ECG is recommended.
15. Doctors should not start treatment for Covid only on clinical suspicion.
Better get the test done. If ECG and Chest Xray are normal,then can start Tab Azee and Tab HCQ till reports of test awaited.
16. Xrays and HRCT have significant role in diagnosis of Covid19.
17. Close contacts of covid positive patient should also take HCQ prophylaxis if asymptomatic.
18. There are already 11 variants of corona virus found in India.
19. Peak of epidemic is over in Mumbai may be in next week. But number of cases will increase again after lockdown is over, may be a second spike will come.
20. Other red zones will reach their peak in next 2 to 3 months.
21. In the month of November,December we may get a second peak, but with less mutated form of virus may be with vaccine and herd immunity.
22. We have to live with corona virus for the next 2 years.
23. Specific advice for home quarantine people to improve their immune status is as follows:
Eat healthy, eat on time, eat little less (as lesser activity)
Take good protein supplements .
Vit C 500 mg BD
Zinc 50 mg daily
Vit D daily 60000 for 3 days and then once a week
2 drops of virgin coconut oil daily
Minimum 8 hours sleep.
Yoga, Pranayam, Exercise.
Avoid oily, spicy food, fast foods, cold drinks, ice-cream which make you vulnerable for sore throat.
24. Avoid alcohol as it makes you vulnerable, each drink increases your chances of getting infection 6 times.
25. Follow SMS i.e.
*Masking (even at home if having cough, cold) and
26. Uncontrolled emotions are equally bad as uncontrolled diabetes.
Don’t be Coronised mentally.
27. Be self disciplined and don't try to oversmart Corona!!
Dr Shashank Joshi is a renounced physician worldwide and is known for his work in the field of medical science.
Dr Sanjay Oak is well known pediatric surgeon of Mumbai, was dean of KEM and then, DME of maharashtra and VC of medical university.