It has been more than a year now since we were introduced to the Covid-19 virus, and since then, we have come a long way in the diagnosis, treatment, and management of the virus and infected persons. The last few months have been particularly traumatic for us as a nation and will last as some of the most horrifying times we experienced. Presently, even though the infections seem to have lowered down, we are still in the pandemic stage. It might be another month before we can shift into a relatively comfortable endemic stage of the disease.
As a treating doctor, I have seen the trends in the infections and the public fear fall after the first wave and rise with the second wave. During the first wave, we had established guidelines and the cases were easier to handle because of access to resources and relatively low rates of infection. However, the sudden spike in cases has posed multiple difficulties for patients and doctors alike. People are visibly panicked and afraid of the disease. They need to steer clear of all misinformation and consult their doctors on every new information they come across before believing it.
The new COVID-19 strain is different not in the treatment it requires but in how it shows itself and creeps up on the patients. Patients whose symptoms initially look like a case of mild infection go on to develop serious complications on the 5th -7th day of disease. The symptoms range from sore throat, cough, fever, vomiting, and pain-abdomen to atypical symptoms like simple muscle pain and body ache, indigestion, and reddening of eyes. Persistent fever and cough in the second week of illness, shortness of breath, fall in oxygen saturation (< 94%) are all indicators of the patient requiring the need of supervised care in a health facility to avoid the development of any complications. It is, thus, important for people to stay in touch with doctors regularly and report any discomfort instead of opting for self-treatment and home remedies.
I spend >15 hours daily with COVID-19 patients. There is an undeniable increase in anxiety and general panic. But there is also a rise in people shifting into denial of their infection or falling prey to misinformation. Most patients who get tested and contact us in the early stages of infection, when the symptoms are just beginning to show, pass through the disease rather comfortably with fewer complications. The problem arises where the patients refuse to get tested and continue to believe it isn’t COVID-19 but seasonal cold. This is brought upon by both, extreme panic states and the social stigma of being an infected individual and works against their best interest, who then approach doctors after the complications have arisen. In this meantime, not only do such patients harm their health but pass the infection onto their family and other society members.
In the second wave, we saw many patients referring to the prescriptions of their friends and relatives, instead of consulting a physician first-hand. This has led to increased complications because such patients take medicines they either did not need or would need in a further week of the illness. The intake of steroids and blood thinning agents in the early phase of disease by such patients aggravates their illness instead. The COVID-19 virus might seem like a common flu virus but behaves in peculiar ways and thus, self-treatment and negligence are dangerous and might prove to be life-threatening.
About Fungal infections and Mucormycosis in the second wave, these complications were present during the first wave as well, but have become more visible with the rising number of infected patients and the proportionate rise in complications. Additionally, the new strain might be involved in causing more immunosuppression than the old virus, leading to more extreme cases.
Some suggestions I have for the public, are to stay connected with your physician and not ignore any unusual symptoms along with fever and cough. Currently, doctors are heavily burdened, and it is extremely hard for us to stay on top of all incoming calls. So, I suggest that you prepare a list of all questions you have about the virus, disease, and information you receive about it and ask the same during scheduled appointments itself. We cannot answer calls in PPE kits and so, such an arrangement would benefit people the most.
Lastly, I would encourage people to receive their vaccinations and remind them that the risk has not surpassed us yet. We need to stay alert and take adequate precautions and stay at home as much as possible. Office gatherings during lunch, mini family gatherings, small event celebrations, etc. should be avoided at all costs as the virus does not differentiate between strangers and family. We are in this together and a collective effort to tackle the virus will bring us closer to the end of this pandemic.
(The author is Senior Physician and Covid Care Specialist, Yashoda Super Speciality Hospital Kaushambi, Ghaziabad)