The second wave of Covid-19 has been brutal on us all. With the rising number of cases and increasing worry among the citizens, Consultant Pulmonologist, Narayana Multispeciality Hospital in Jaipur, Dr. Shivani Swami gives us a better understanding of the second strain, use of certain medicines and drugs for treatment, the significance of vaccine and post-Covid recovery.
Among other things, she says: “We just wake up, dress up and show up. When a sick patient gets well and goes home and the family is very thankful, that is where we draw our inspiration.”
In the past, Dr. Swami has worked in some of the most prestigious hospitals in the country like the Medanta: The MediCity in Gurgaon and the Fortis Hospital in New Delhi. She specialises in pulmonology, sleep medicine, allergy and immunology as well as critical care.
Q. How is the second strain of Covid-19 different from the others?
A – It is way more contagious than the first one. Many young people are getting very sick. Most importantly, there is a lot of severe lung involvement. Patients are requiring oxygen sometimes as early as the 5th or 6th day which was not the case in the first wave.
Q. Medicines like Azithromycin and Hydroxychloroquine are not being recommended by the doctors. So what is the new change in the treatment for Covid-19?
A- Drugs like Azithromycin and Hydroxychloroquine are almost on their way out. As per evidence and studies, the new guidelines do not support their effectiveness. However, many continue to use it because of results from their personal experiences. Similarly, as per the new guidelines, plasma has no role but still a lot of doctors are using it in the early stages. Most of the guidelines are based on studies done overseas not looking at the Indian strain or the Indian patient. So every doctor here is deciding as per their own experience.
Q. What do you recommend for a patient who has just got afflicted?
A – Someone who has just gotten afflicted should contact their doctor and if advised get tested. Secondly, during the course of illness a lot of doctors will advise you repeated blood tests to decide the further course of treatment. These are genuinely advised and not to make money out of the patient. Thirdly, many patients rush to get CT scan done by themselves in the early stages which is not recommended. You are unnecessarily exposing your body to radiation. The diagnostic test still remains the RT-PCR test.
Q. What precautions should the patient follow in the second week? When should the steroids be recommended?
A – In the second week you need to keep a close watch on fever and oxygen levels. You need to eat well and lie prone (on your stomach) multiple times a day lasting 45 minutes to 1 hour each time. This will help with breathing. If you experience any kind of chest pain or your oxygen level drops below 92 you must consult your doctor.
Each doctor makes a call for their patient when it comes to steroids depending on the blood tests and their clinical condition. But for steroids to be given in the initial 4-5 days is counterproductive. It should not be taken without medical supervision.
Q. Are vaccines and the Covid protocols the answer to current Covid wave?
A – Vaccines are the only answer to the Covid wave. Those who have gotten both shots their disease severity is much milder and they recover easily. It may not be 100% effective which it is not even claiming to be. But, it certainly has an effect in preventing moderate to severe disease.
Q. Do you agree that doctors in private hospitals are not getting enough publicity even though they are doing a herculean job?
A – I do not think anyone is looking for publicity right now. Nevertheless, the Government could be more supportive of private hospitals. Sometimes we have a problem in obtaining medicines for the patients.
Q. Would you like to comment on the overwhelmed medical infrastructure in the country presently?
A – No country can provide healthcare for all their citizens at one go, as is the present situation. However, we could have been better prepared considering we have gone through this for almost a year and everybody expected this wave to come back in March.
Q. What are the post-recovery Covid protocols?
A- Post-recovery a person should really focus on their diet and lifestyle. If they have diabetes they should control their sugar. They should do a lot of deep breathing exercises or respiratory physiotherapy as advised by their doctor. This is the time they need to work on themselves to get better and not just lie in bed.
Q. How have you coped with the stress and work pressure of the second wave?
A – We just wake up, dress up and show up. When a sick patient gets well and goes home and the family is very thankful, that is where we draw our inspiration.
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