Doctor’s guide for Covid-19 patients recovering at home

Doctor’s guide for Covid-19 patients recovering at home

With Scarcity Of Hospital Beds, Telemedicine Consultations On The Rise

Kamini.Mathai@timesgroup.com

06.05.2021

Don’t start on steroids too soon as it may worsen the infection ... No, antibiotics will not help with Covid-19 ... All day long, Dr Subramanian Swaminathan, director, Infectious Diseases and Infection Control, Gleneagles Global Hospitals, fields phone calls from anxious Covid positive patients.

With cases mounting and hospitals running out of beds, several of those infected by the virus have no option but to stay at home. “At least 90% of those who are positive do not require hospitalisation. A teleconsultation with a doctor can help identify the 10% who require further management,” says professor K Ganapathy, past president of Telemedicine Society of India.

In the past couple of months, the number of 1800 helplines, government and private telemedicine facilities, and at-home care services have increased exponentially to deal with the rising number of cases. At virtual medical consulting service Myhealthcare, the average number of calls received in a day is 2,000 — most of them related to Covid. The demand is such that they just launched a “virtual central command centre”, from where patients in home isolation across the country can be monitored through their smart phones. “Patients have access to a panic alert button, which triggers an immediate mobile consult,” says Shyatto Raha, founder of Myhealthcare.

Dr Subramanian’s first word of caution to those at home with Covid19 is: “Unless you are a considered a high risk individual (someone with comorbidities such as diabetes) it is better to wait for three or four days before you seek medical help. Until then, just take paracetamol and multivitamins.”

He also does not recommend administering steroids in the first few days. “If steroids are given in the phase when the virus is multiplying, it will stimulate the virus.” Inappropriate use of steroids in the early phase, he adds, may convert someone with a mild version of Covid into someone with a more severe infection. “We are sometimes forced to start steroids for people at home with borderline oxygen saturation and no hope of a hospital bed, but it is critical that the right dose is given,” says Dr Subramanian.

It is imperative that teleconsultation facilities follow recommended protocols from the Union health ministry and institutions like the Indian Council of Medical Research, says Dr Ganapathy. “The protocol that was in place a few months ago is not the same now. Patients shouldn't be afraid to question and clarify.”

In the case of antivirals and antibiotics which are being recommended, Dr Subramanian says, “None of the antivirals have been proven to save lives and there is no role for antibiotics in the treatment of Covid.” Monoclonal antibodies, which can help limit the progression of the infection, have to be administered within 48 hours of its onset, he says. The vaccine, he says, is the best armour against the virus.