it is a reality that we are facing a very serious second wave of coronavirus infection all over India and particularly in Maharashtra. The situation is getting from bad to worse in spite of sincere efforts by all concerned. Survival and reduced hospitalisation are important. By taking some simple precautions we can address this issue of survival and not getting on a ventilatory mode of treatment. It is a reality that we are facing a very serious second wave of coronavirus infection all over India and particularly in Maharashtra. The situation is getting from bad to worse in spite of sincere efforts by all concerned. Survival and reduced hospitalisation are important. By taking some simple precautions we can address this issue of survival and not getting on a ventilatory mode of treatment.

Which patients become serious?

The current experience suggests that those who had uncontrolled hypertension, diabetes and COPD and moderate astluna are the one’s getting into a serious mode of illness. Those who had undergone bypass surgery or renal transplant are also getting serious. Those who are obese and with a history of heart failure are also associated with a serious form of Covid disease.

What about the younger population?

Most in the age group of 20 to 40 years do well. However, those who have diabetes or a history of heavy smoking get a serious form of viral pneumonia.

What precautions need to be taken to prevent a serious outcome in a Covid patient?

Very early medical treatment is the key. The treatment should not be delayed even if the symptoms are mild, particularly in the elderly. Initiation of antiviral drugs, steroids, prophylactic antibacterial drugs in selected cases is an important factor in reducing mortality.

What are the simple means-uses to be taken at home to assess the severity of illness?

Maintenance of temperature and oxygen saturation 4 times a day is strongly recommended. Continuous fever for more than 4 days or a drop in oxygen saturation below 94% should make you think about hospitalisation. Hence a thermometer and pulse oxime. it is necessary to monitor these parameters. However, in the elderly early hospitalisation is suggested.

How can we prevent deaths due to coronavirus infections?

Early and prompt treatment is the key to preventing serious illness. Early introduction of steroids Remdisvir and tocilizumab may help in selected patients What about vitamins, zinc and other forms of therapies in case you are Covid positive? These drugs have no role in the acute phase of illness. Their role is supplementary. Non-conventional treatment only delays the correct guidelines directed treatment.

What about home quarantine?

The second wave coronavirus is extremely contagious. We are finding almost all family members getting infected in a span of very few days. Hence a very dedicated and sincere approach should be made to quarantine the first family member to be infected. Using an N 95 mask and another mask, that is two masks by all remaining family members even at home is strongly recommended. All non-infected individuals should get vaccinated as early as possible as per the present protocols. In your experience what can be done by home caretakers to prevent a serious form of infection in funny members? Early institution of treatment, close monitoring at home and early hospitalisation in high-risk coronavirus infection are important.

What is happy hypoxia?

This is a misnomer This is known as silent hypoxia. Many patients do not have major symptoms of breathlessness even if their oxygen saturation is below 90%. Their major symptoms being fever, cough or loss of taste and smell by that time. By the time they reach the hospital, their oxygen levels drop below 80% and this is also associated with significant viral pneumonia with more than 90% of lungs being involved. Even at these poor oxygen levels, patients do not look sick in spite of severe dis-ease. Hence monitoring of oxygen saturation at home and reporting to the hospital if saturation is below 95% is important.

What is the solution for fewer beds that are available to treat coronavirus patients as compared to the requirements?

Many patients want to get hospitalised at centres that are known to them. This may not be always possible and this delays treatment. As of today get hospitalised wherever there is a vacant bed and let the treatment be initiated as early as possible. The second wave is affecting us very badly. The deaths due to coronavirus need to be minimised as far as possible. Vaccination for non-infected and home quarantine and health vigilance at home is necessary for infected individuals.