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Keep calm and maintain Covid appropriate behavior, say Dr PVM Lakshmi, Prof of Epidemiology, PGIMER amid rise in COVID cases

INDIAEPOST CHANDIGARH JULY 05, 2022

With the recent rise in COVID-19 cases in Chandigarh, Haryana, Punjab, Himachal Pradesh and other NCR and other parts of the country, Dr PVM Lakshmi, Professor of Epidemiology, Post Graduate Institute of Medical Education and Research (PGIMER) cautioned that one should neither panic, nor let their guard down. Instead, it is essential to keep wearing mask and to follow all COVID Appropriate Behaviour (CAB).

Dr Lakshmi told the reporters that as per the available evidence, BA.2 (sub-lineage of Omicron) has cross immunity with the Omicron variant but the cross immunity is poor with BA.4 and BA.5. The genome surveillance results will clear the picture about whether the BA.4 and BA.5 variants have a presence in this region. The previous results have indicated the presence of BA.2 in the Chandigarh and tricity areas. She cautioned that patients with mild symptoms need to take precautions so that they do not cause the spread.

Moreover, cases are increasing in this region because no Covid-related restrictions are in place, allowing people to attend large indoor and outdoor gatherings, without wearing face masks and maintaining social distance.

While elimination of the virus is an impossibility at this point, adjustments in individual habits and communal spaces can help slow the pace of outbreaks and keep high-risk groups safer. Vaccination remains a key strategy for avoiding infection, and it has been especially effective in preventing severe disease, hospitalization, and death, she added.

Dr Lakshmi said that at PGIMER, as of now, only six Covid patients are admitted. 10-20 beds have been kept reserved for Covid patients. But it would increase upto 300 depending on requirements. If patients are coming up with any kind of complaint, adequate treatment is being given. Even among those admitted, there is hardly anyone who needs oxygen or ventilator support. Even as the number of Covid cases continues to increase, the most patients are coming to the hospital with fever, cough, sore throat, and body ache. Almost everyone is recovering within three-five days of getting the symptoms.

She said that everyone should watch out for symptoms of Covid-19, whether or not they are fully vaccinated. Anyone who thinks they have been exposed should get tested and stay home and away from others. Symptoms can appear anywhere between 2 to 14 days after exposure. Most people will have a mild illness and can recover at home without medical care. Seek medical attention immediately if you or a loved one is at home and experiencing emergency warning signs, including difficulty breathing, persistent pain or pressure in the chest, new confusion, inability to stay awake, or bluish lips or face.

Omicron’s BA.4 and BA.5 sub-variants are known to be around 13 per cent more transmissible than the previous BA.1 and BA.2 and are slowly becoming the dominant sub-strains in Europe and US. However, there is no proof of these being more dangerous. Both BA.4 and BA.5 are sub-variants of Covid-19’s on Omicron BA.4, BA.5 sub-lineages, she said that omicron variant and have been declared as variants of concern by the World Health Organisation (WHO) and the European Centre for Disease Control and Prevention because of their high transmissibility. These were first identified in South Africa in January. What we have been seeing is that it usually takes 6-8 weeks for a new variant to become the dominant one in the community. No new variant of concern has been reported so far in the city, Dr Lakshmi added.

She said that adults with mild to moderate Covid-19 remain infectious no longer than 10 days after symptom onset. Most adults with more severe to critical illness or severe immunocompromised likely remain infectious no longer than 20 days after symptom onset. A patient can resume his routine activities while maintaining Covid-appropriate behaviour on the basis of the extent of damage to lungs and other tissues. The recovery period is likely to be longer for patients who suffered from more severe forms of the disease and those with pre-existing illnesses.

Some people who have been infected with the virus that causes Covid-19 can experience long-term effects from their infection, known as post-COVID conditions (PCC) or long COVID. Post-Covid conditions are found more often in people who had severe Covid-19 illness, but anyone who has been infected with the virus that causes Covid-19 can experience post-Covid conditions, even people who had mild illness or no symptoms from Covid-19. People who are not vaccinated against Covid-19 and become infected may also be at higher risk of developing post-Covid conditions compared to people who were vaccinated and had breakthrough infections.  Recovered patients after acute Covid-19 illness may continue to experience various signs and symptoms including fatigue, body ache, cough, sore throat, difficulty in breathing, etc. Some of the complications seen in patients include deleterious effects on lungs, kidneys, heart, and manifestation of black fungal infection, known as mucormycosis. Such patients are treated at PGIMER.

On post-Covid symptoms, she said that general symptoms are tiredness or fatigue that interferes with daily life, symptoms that get worse after physical or mental effort (also known as “post-exertional malaise”), fever; Respiratory and heart symptoms are difficulty breathing or shortness of breath, cough, chest pain, fast-beating or pounding heart (also known as heart palpitations); Neurological symptoms are difficulty thinking or concentrating (sometimes referred to as “brain fog”), headache, sleep problems, dizziness when you stand up (lightheadedness), pins-and-needles feelings, change in smell or taste, depression or anxiety; Digestive symptoms are diarrhea, stomach pain; Other symptoms are ioint or muscle pain, rash and changes in menstrual cycles.

On Post-Covid follow up care, Dr Lakshmi said that eating a balanced nutritious diet, rich in immune boosting vitamins and minerals including fruits, vegetables, eggs and safe poultry is of utmost importance to speed up recovery. Some patients experience unexplained weight loss or weight gain, hence, weight adequate calories must be provided according to the patient’s nutritional status.  Drinking plenty of fluids and drinking warm water can be helpful for patients with scratchy throat or dry cough as it improves circulation and reduces nasal congestion. Taking proper rest and sleep can help your body recover faster. Covid patients are advised to practice breathing exercises to improve respiratory distress and relieve congestion, she added.