A year after the Coronavirus pandemic wrecked our collective lives, our society has been grappling with fear and insecurity. As a result, we have seen misinformation spread like wildfire, and many resorting to bizarre and incorrect methods of dealing with the virus. With this column, which will be published every Sunday, we aim to address any health or vaccine-related question our readers might have about the coronavirus pandemic.

In this week’s column, Dr Parul Vadgama, Head of Department, Respiratory Medicine, Government Medical College, Surat has answered queries. She is also Vice president, IMA GSB (Indian Medical Association Gujarat State Branch).

When will the second wave peak in India?

Though every city is at a different stage of the peak. On average, we are expecting to reach around May 2nd or 3rd week for most of the country. In June, we may see a decline in the cases.

What is being done to deal with oxygen shortage?

There is a severe shortage of oxygen in the country. We surely need more oxygen supply but until that reaches us, we as a doctor are doing whatever we can to use the existing supply as judiciously as possible. At Surat Medical College, we are trying to find ways to reduce oxygen wastage and to use the available oxygen as judiciously as possible. We are taking some important steps: We targeted a patient’s oxygen saturation above 92 %. When we give oxygen to a patient, at times a small amount of oxygen leaks at the oxygen port, or at times there is leakage in the ventilator. So, we activated our biomedical team and formed an oxygen audit committee which comprises a doctor, a nurse and, a biomedical engineer. This team takes rounds to look for leakage and resolve it. We have started switching off the patient’s oxygen supply when the patient is eating food or goes to the washroom.

We have started actively weaning the patient off the oxygen. As soon as the patient stabilizes, we try to taper down its oxygen dependence. For patients who need 5-7 litres of oxygen, we shift them on an oxygen concentrator. Then we are using a small device called ventipip, an instrument with a bi-pap mask. This is not a ventilator, but it is a small instrument that gives oxygen with pressure which helps in opening the patient’s lungs cell. So, a patient who requires say 15 lt/ min now needs 10 lt/min, enabling us to treat a patient with lesser oxygen more efficiently.

With all these small innovations, we are able to save 7-8 metric tons of oxygen every day which can be used to stabilise another 100 patients.

If Maharashtra really likely to see the third wave in July-August and how to deter that?

I think Maharashtra may see the third wave a little later by September -October. But we need to prepare ourselves from now. See, we need to learn from the bad days. We need to augment our healthcare infrastructure. We definitely need more oxygen beds, more oxygen plants, more ventilators.

Besides, we will be needing trained manpower. We have already begun training our nursing students and paramedic staff in life-saving procedures such as bi-pap, setting up a ventilator, setting up an oxygen cylinder, etc. Covid is here to stay, we would be needing trained medical manpower to be able to tackle the rising number of cases.

What happens when a person’s Covid-19 test results are negative but he still has every symptom of the virus?

If your symptoms are mild such as you have fever, myalgia, body ache, cough congestion please isolate yourself and take medicines to relieve the symptoms. Keep yourself hydrated. And keep track of your oxygen saturation. If your oxygen level dips, whether or not your RTPCR is positive, consult a doctor and seek admission at a hospital.

What tests should a person who has recovered from COVID 19 do to check the well-being of his organs?

We don’t recommend any follow-up test. In case of severe pneumonia, with more than 35-40 percent lung involvement, then we may advise patients to get a CT scan of the chest and pulmonary function test after a month. Yes, at the end of treatment we check other markers such as CRP, D-Dimer, IL6 to rule out the possibility of any residual symptom or secondary infection.

Does the vaccine affect those who have Cirrhosis of liver?

If your LFT is normal and there is no recent infection or inflammation, you can safely take your Covid-19 vaccine.

What is the first thing a person should do if his or her oxygen level dips and he or she cannot access any hospital ?

If your oxygen saturation dips beyond 94 %, you may try to stabilise a patient with an oxygen concentrator till the time you get a bed. Any healthcare facility where you have an oxygen supply will be helpful.

If my Spo2 is normal but I am feeling short of breath, what should I do (Covid positive since 14 days, no fever since 5 days and normal spo2)

If you are feeling breathless, please consult a doctor. Please recheck your oxygen saturation using another oximeter as it is possible that your oximeter is not giving you an accurate reading. Check your respiration rate. For that lie down straight, put one of your hands on your abdomen, and count the number of breaths you take in one minute. If it is more than 20 breaths / minutes, pls consult a doctor.

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