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Stay Healthy, Stay Fit

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COVID-19 is a worldwide illness currently affecting millions of patients. Patients suffering from cardiovascular diseases (CVD) are especially vulnerable to respiratory tract infections, including COVID 19 and also these patients are at an elevated risk of ill health and even death from COVID 19.  However, the extent of damage in heart patients is currently uncertain.

As per evidence, patients with known CVD have a case fatality rate of 10.5% in case of a COVID 19 infection. Also, evidence suggests that 16.7% of COVID 19 patients, having CVD, develop abnormal heartbeat while 7.2% patients get acute cardiac damage. Cases of acute-onset heart failure, heart attack and other fatal cardiac symptoms have also been reported in COVID 19 patients with CVD. Heart complications in COVID 19 patients are comparable with SARS and MERS patients.

Suggested precautions for CVD patients to prevent COVID 19 infection

Following precautions are advised for CVD patients to prevent COVID 19:

  • Maintain your recommended blood sugar and blood pressure levels through regular intake of medicines. Currently, it is recommended to continue the prescribed ACE inhibitors or ARBs for hypertension, despite some reports of raised risk to COVID-19 susceptibility.
  • Frequently monitor your blood sugar and BP levels to rapidly identify any irregularities and get appropriate treatment adjustments
  • Get enough supplies related to your co-morbid testing and medications, in case of local worsening of outbreak, for at least 15 days.
  • Practice frequent handwashing with soap and water
  • Practice good respiratory hygiene by covering your mouth and nose with a tissue or bent elbow, in case of coughing or sneezing
  • Avoid touching your face, nose and eyes
  • Avoid unwanted travel and socializing
  • Stay vaccinated for each available infectious disease
  • Eat plenty of fruits and vegetables
  • Consume yogurt and probiotics for a healthy digestive system
  • Sleep for at least 8-9 hours to reduce stress and maintenance of immunity levels
  • Avoid crowd exposure
  • Avoid handshaking
  • Immediately contact your doctor if you develop any respiratory symptoms such as cold, cough, feeling difficulty in breathing or fever.
  • Last but not the least, stay hydrated.

And, of course, continue to stay active and follow an overall healthy regime. Stay connected with the people you love via phone calls, chats or emails because this kind of isolation can take a toll on your physical health and well-being. It’s important to understand that we all need to be extra vigilant in case we leave home especially people with underlying cardiovascular issues. Be mindful that every surface is a probable source of infection and everything that you bring inside your house could be affected by the virus. While this pandemic is a concern for the entire world, people with a known history of hypertension and cardiac disease have to be even more careful and nowhere is the saying “Prevention is better than Cure” more applicable than in such people.

Wearing face masks is just a part of an inclusive strategy for preventing and controlling the spread of viral infectious diseases, including COVID-19. Masks can be worn by healthy persons (for self-protection while accidentally coming in contact with an infected patient) or by an already infected patient for preventing further spread of the infection (source control). But, solely using a mask cannot provide optimum protection or source control. The WHO advises people to wear masks when unable to maintain social distancing. Compliance to other infection prevention and control (IPC) measures, such as maintaining social distancing and practicing hand hygiene are imperative to prevent human transmission of the viral disease.

Guideline for using masks in the health care settings

A) Use of medical masks (surgical or procedure masks) and respirators (N95 masks) for caring suspected or confirmed COVID-19 patients

It is recommended that health workers who directly provide care or come in direct contact with COVID-19 patients, should wear a medical mask (along with other PPE components that are a part of aerosol and contact precautions), in the absence of aerosol-generating procedures (AGPs).

In areas where AGPs are being performed, it is recommended to health care personnel that they should wear a N95 or FFP2 or FFP3 or equivalent standard respirator.

B) Targeted continuous use of medical mask by health workers in locations of known or suspected COVID-19 community transmission.

In the context of areas, where community spread of COVID-19 is suspected or an intense COVID-19 outbreak exists, following recommendations are provided:

Health workers practicing in clinical area should always wear a medical mask during their routine activities throughout the entire shift; apart from the duration when they are having their meals and changing their medical mask after caring for a patient who requires droplet/contact precautions for other reasons

It is particularly vital to adopt the strategy of continuous use of masks in areas with a potentially higher risk of transmission such as triage, waiting lounges of family physicians or OPDs, designated COVID-19 hospitals, cancer units, transplant units etc.

While continuously using medical masks, it is also vital to:

  • Change the mask if it gets wet, soiled or damaged.
  • Not touch the mask to adjust it.
  • If you have touched it, safely remove it, perform the hand hygiene procedure and use a fresh mask.
  • Discard the mask and the PPE and use a new set after coming in contact with a patient for contact or droplet precautions.
  • Personnel not working in clinical areas need not wear a medical mask during routine activities.
  • PPEs including masks should not be shared between workers and be suitably disposed after use and not to be re-used.
  • In addition to above recommendations, precautions of social distancing and hand hygiene practices should not be avoided as they are equally important.
Table 1: Recommended type of mask for use by health workers

Considerations for using non-medical masks

The utility of medical masks by the non-affected population may lead to a shortage of this extremely important supply to the health workers, who need them the most. In settings where medical masks are in short supply, medical masks should be reserved for use by only health workers and at-risk population when need arises.

Non-medical or fabric masks are prepared from varied woven and non-woven fabrics like polypropylene. Non-medical masks may be composed from differing fabric compositions, sequences or layers and shapes. However, a non-medical mask is neither a medical or surgical device nor a PPE.

Usage Considerations

The use of non-medical masks, prepared from woven fabrics such as cloth, and/or non-woven fabrics, should only be considered for used by infected persons in unrestricted settings and not for prevention. They can be used temporarily for activities such as travelling on public transport when social distancing cannot be maintained, and their use should without fail go with frequent hand hygiene and physical distancing.

Table 2: Recommended material, source and structure of non-medical masks

Elastic materials are not preferred to prepare masks as they get stretched after each use, causing increased pore size and lower effectiveness of the mask to filter droplets.

Layers

A minimum of three layers is needed for a non-medical mask, as per the used fabric. However, cotton handkerchief masks should consist of a minimum of 4 layers. Cotton gauze is found to be very porous with a filtration efficiency of only 3%.

The ideal material combination for non-medical masks should include three layers as follows: 1) an innermost layer of a material which absorbs water (e.g. cotton or cotton blends); 2) an outermost layer made of non-water absorbing material (e.g., polypropylene, polyester, or their blends) which may restrict external impurity from penetration through to the wearer’s nose and mouth; 3) a middle non-water absorbing layer of synthetic non-woven material such as polyproplylene or a cotton layer which may enhance filtration or retain droplets.

Shape

Shape of the non-medical mask should be flat-fold, fitting closely over the nose, cheeks and chin of the wearer. If the mask’s edges are not close to the face and shift, during activities like  speaking, air penetrates through the mask’s edges rather than getting filtered through the fabric. The mask should be equipped to be held in place by the use of elastic bands or ties.

Coating

Coating the mask with materials like wax may raise the barrier and make the mask liquid-resistant, but too much coating may cause difficulty in breathing through the mask due to complete blocking of pores.

Maintenance

  • Mask should be used only by a single person and not shared by multiple individuals
  • All masks should be changed immediately, if they get wet or are visibly soiled
  • When required, masks should be removed without touching the front portion of the mask and after mask removal, do not touch the eyes and mouth
  • Discard the mask, if you wish or keep it in a sealable bag until you wash it. After washing, immediately perform hand hygiene
  • Cloth masks should be frequently washed as per the cloth’s recommended washing temperatures
  • Wash in warm hot water, 60°C, with soap or laundry detergent.
  • Non-woven polypropylene (PP) may be washed at high temperatures, up to 125°C.
  • Natural fibres may resist high temperature washes and ironing.
  • Wash the mask delicately (without too much friction, stretching or wringing) if non-woven materials are used.
  • The combination of non-woven PP and cotton can tolerate high temperatures; masks made of these combinations may be steamed or boiled.
  • Where hot water is not available, wash mask with soap/detergent at room temperature water, followed by either i) boiling mask for one minute OR ii) soak mask in 0.1% chlorine for one minute then thoroughly rinse mask with room temperature water, to avoid any toxic residual of chlorine.
Table 3: Recommendations of areas where the general public should be advised to use masks in established or suspected community transmission areas

Wearing a face mask is not a substitute for physical distancing and basic hand hygiene but in some situations where you can’t follow social distancing and other preventive measures, wearing a mask can give you some layer of protection. It is important to follow the Government’s latest guidance on safeguarding yourself during the coronavirus pandemic, including travel advice within and outside the country.

Patients who get completely recovered from the fatal COVID-19 disease possess chemicals (antibodies) in their blood plasma that their bodies have produced to counter the infection in their blood and get cured of the infection. The blood of recovered COVID-19 patients is termed as Convalescent Plasma. In easier terms, plasma is the yellowish liquid part of the whole blood in which the blood cells (RBC, WBC and platelets) stay suspended. It is believed that this convalescent plasma of recovered patients can be transfused into severely ill COVID-19 patients, for boosting their immunity and enabling them to fight off their infection.

Certain blood cells function as “memory cells”, remembering the pathogen against whom they have produced antibiotics. When such blood plasma possessing the antibodies against COVID-19 is isolated from the recovered patient and transfused in the existing patient, the donor’s plasma immediately recognizes the COVID-19 viral pathogen and again produces the antibiotics to fight off the organism in the transfused patient’s body to improve their condition. This therapy is known as “Convalescent Plasma Therapy” (CPT) or simply, “Plasma Therapy”. Experts believe that this therapy can also prevent moderately ill COVID-19 patients from experiencing severe symptoms and complications related to the infection. Development of passive immunity is the basis of this therapy.

Where is this therapy used?

CPT is believed to aid COVID-19 patients who do not respond expectedly to other experimental drug therapies. Such patients may develop a severe lung complication called “Acute Respiratory Distress Syndrome”, necessitating mechanical ventilation to breathe, or else their organs begin to fail.

CPT may also help patients having chronic co-morbid conditions such as diabetes or cardiovascular diseases, whose immunity is already impaired and are COVID-19 infected of becoming severely ill.

CPT might also be considered for family members of COVID-19 patients or medical staff, who get exposed to potential patients, for preventing them from getting the infection.

Probable Risks of CPT:

Blood and plasma transfusions have been used to treat multiple diseases with exceptional safety. However, CPT does carry a risk of complications such as:

  • Allergies
  • Damage to the lungs and impaired breathing
  • Infections from the donor’s plasma such as hepatitis or HIV

Although the risk of above-mentioned problems is very low, they can occur. Also, the therapy is still in the experimental phase and its effectiveness is not well-established in large clinical trials.

Who all can donate plasma?

  • People between the age of 18 to 60 years.
  • You weigh above 50 kgs.
  • You are not suffering from any transmissible or chronic diseased condition.
  • Your heart rate should be normal.
  • Your hemoglobin level is ≥ 12.5 g/dl.
  • Your blood pressure is normal.
  • You should not have got any piercing done in the last 6 months.
  • Above all, you should be completely free of COVID-19.

What is the procedure for donating plasma?

The procedure of donating plasma differs from that of donating blood. Though the initial process of blood collection is the same i.e. through the IV route, the whole blood collected from your arm for plasma donation has to pass through a dedicated machine for separating plasma and the blood components. Then, just the plasma is stored and the remaining portions are transfused back to the body with some saline. Hence, the procedure of plasma donation takes more time (approx. 90 minutes) than blood donation (which is 30 minutes).

In preliminary treatment, numerous individuals have benefited from CPT. Researchers keep on assessing the outcomes of individuals who got the treatment done. By considering the consequences of this treatment for COVID-19, specialists are drawing nearer to finding a treatment. Likewise, getting familiar with the utilization of CPT currently will assist healthcare workers to be better prepared to provide optimal patient care.

As the COVID-19 cases continue to mount and with no availability of immediate potential treatment or vaccine, it is absolutely necessary to train ourselves for living with COVID-19. In order to save the global economy, countries are now considering having certain relaxations during the lockdown in their respective countries, including India. In such circumstances, we have to prepare ourselves for living with the new “normal” by ways of introducing certain behavioral changes in our routine and implement social distancing, in order to combat the pandemic and save ourselves.

Following steps can aid in protecting us and our families during this pandemic:

1) Be aware of the local situation:

  • Stay aware of the latest information regarding the status of COVID-19 in your community and your city
  • Prepare a list of local authorities that you can get in touch immediately in case of requirement of any emergency aid such as friends, family members, drivers, family doctors, etc.

2) Be prepared for the possibility of getting ill:

  • Take due care of family members who are deemed to be at higher risk of getting infected, such as elderly members or those who suffer from co-morbidities.
  • Keep in mind which room you will select to use as a “quarantine” area if any of your family members get the infection and needed to be isolated.

3) Strictly follow the preventive steps:

  • Frequently wash your hands with soap and water
  • Avoid frequently touching your eyes, nose and mouth
  • Stay in your room if you are sick
  • While sneezing or coughing, cover your nose and mouth with a cloth or tissue and dispose of in a covered bin after use
  • Clean and disinfect the surfaces in your home, which are frequently touched
  • Be prepared for creating ample room for every family member, in case the children and/or other members have to stay at home due to shutdown

4) Be alert in case of witnessing any symptoms:

  • Stay at home and consult your doctor, if any family member, including yourself, develop symptoms such as   fever, cough or difficulty in breathing
  • Other family members should stay away from the symptomatic patient

5) If any family member gets sick:

  • Continue the following hand hygiene
  • Isolate the sick member
  • While caring for the sick family member, follow all recommended protocols (PPE kits and face mask) and be aware of your own health
  • Keep the surfaces disinfected
  • Take care of the emotional well-being of all your family members

6) Care of children and co-morbid family members:

  • Remain at home and avoid venturing into crowded places
  • Pileup the stocks of the medicines, you require in case you need to stay home
  • Strictly follow hand hygiene practices
  • If at all you need to go out, maintain at least 6 feet distance with others
  • If any child in your family gets infected, notify the school authorities so that they can alert others

7) Take care while going to buy supplies:

  • Family members who are not sick and are at least risk of getting infected should run the necessary errands.
  • Always wear a face mask, avoid gatherings and follow social distancing norms while going out
  • Don’t go for public transportation or shared cab services
  • If at all you need to go through public transport, maintain social distancing and avoid touching handrails and frequently wash your hands with a hand sanitizer.
  • Once you return home, immediately wash your hands with soap and water and then perform any tasks.

8) Coping with stress:

  • Avoid watching, reading or listening to news related to the pandemic for a prolonged period.
  • Take deep breaths and meditate to cope with the stress
  • Eat nutritious meals
  • Regularly engage yourself in exercises
  • Avoid alcohol, tobacco or consumption of drugs
  • Talk with your friends through telephone, regarding any bothersome issues.
  • Consult your psychiatrist, if you are feeling too anxious
  • Take care of the elderly and co-morbid patients, as they are more prone to get extra stress due to COVID-19
  • Keep a watch on children and teenagers as they may get excessively stressful due to being confined at home
  • Avoid the spread of false news and stigmatizing healthcare workers working with COVID-19 patients

The ongoing pandemic is exerting the whole world both physically and mentally but there’s no doubt that this pandemic will come to an end one day. Sooner or later there are going to be vaccines and treatment that will bail us out. However, what’s also for sure is that, life after this pandemic is going be significantly different than before and full of precautionary measures. So, if you want to get back your previous lives then a lot will depend on our actions and only then we will experience a normal world after the COVID-19 pandemic. 

Condition of COVID 19 pandemic in the USA

When the dreadful novel coronavirus reached the USA, it granted the USA an exclusive luxury of “perception after the fact”. The virus’s biological character and course were already revealed in China, and its genome had also been charted. It was already established that it was a novel virus corona without known treatment or prophylactic means. It was known that only non-drug-based interventions like quarantine, isolation, and social distancing could aid in containing its spread.

Still, the USA turned out to be the epicenter of the COVID-19 pandemic and as of now, suffers the highest death toll. As of April 10th, it possessed 30% of confirmed cases and 18% of COVID-19 deaths in the world.

As the USA is a superpower, there was even no lack of commitment, skill or financial means to counter the pandemic. The first confirmed case of COVID-19 in the USA was detected on January 21st.

Reasons of non-containment of coronavirus in USA

The reasons are as much cultural as these are political:

  1. Higher Air Traffic with China
  2. Preference for Personal Freedom: Politicians in the USA are seriously afraid to do anything that can be demonstrated to violate citizen’s rights. Their individual freedom is given foremost importance which makes, essential limitations on public activities, hard. However, unexpected times need unexpected solutions. Before the above realization, thousands of citizens were already infected and dead in the community.
  3. Private Healthcare System: The healthcare system in the USA is largely private which makes organizations among different hospitals and public health officials more challenging as compared to a centralized healthcare system. Any well-meant reform in the healthcare sector by the government is perceived as communist and is violently opposed. Also, profit drive in the healthcare industry gave slight respite for dealing with crises of such nature. Consequently, poor American minorities, forced out of the medical insurance net, and forced to work through the crisis are being increasingly affected by the disease and related fatalities.
  4. Disjointed Central and State Response: US bodies such as CDC had substantial problems initially in developing and introducing COVID-19 testing, which made it increasingly tough to ascertain the range of the disease outbreak. Also, state authorities did not co-operate with the federal government in policy implementation.

Condition of India as compared to  the USA amid global COVID 19 crisis

India is still a lower-middle-income country. It witnessed her first case on January 30th, 2020. India with almost 430% of the US population and just 14% of US GDP has seen far fewer infections and deaths due to COVID 19. There are several learning here related to India’s success story.

  1. Strong Leadership: Prime minister of India understood the magnitude of the situation early and was swift to seek faith of the countrymen on the need for compulsory strict measures needed to preserve lives. Early lockdown implementation at the national level prevented the pandemic to spread without control. Currently, India stands unified regardless of political affiliations at state levels.
  2. Effective Policy Implementation at Grass-root Levels: Reflecting the urgency at the capital level, district and rural bodies, also understood the seriousness of the problem at hand and contributed to an already motivated bureaucracy in curbing the pandemic. Its outcomes can be witnessed in the significantly lesser numbers of COVID 19 cases seen in the rural and semi-urban areas of India.
  3. Disaster preparedness: India’s frequent encounter with natural disasters has facilitated the countrymen to develop a seamless response system where hundreds of workers are organized rapidly. These acts and rules of disaster management are traditionally verified, effective, and devoid of political interference. Such freedom to take spot assessments and act peculiarly to unique ground situations is the strength of the Indian system of governance.
  4. Full Supply of Empirical HCQ: Due to the inherent Indian policy of helping its partners, India was generous in supplying Hydroxychloroquine tablets to countries including the USA and the entire world, which bore good outcomes in terms of exchanging ideas, apart from saving lives at home.

However, there is a caution to this analysis. The USA consists of significantly higher air traffic than India and containment would have always been comparatively tough in the USA.

The COVID-19 pandemic continues challenging healthcare systems globally. As per an estimate, we are yet to experience the complete impact of the outbreak, despite practicing social distancing. Surgeons also require to aid in policy implementation for helping to tackle the potential rise in COVID-19 patients at their respective hospitals. Regarding this fact, it is recommended that surgeons and hospitals cut down the number of “elective” surgical procedures to reduce patient traffic. However, owing to the uncertainties in defining the surgeries, elective surgeries can realistically be classified into essential or non-essential procedures, which means that there is an elevated risk of adverse results by delaying the “essential” elective surgery compared to a non-essential elective procedure, which is purely not time-sensitive as far as medical emergencies are concerned.

Why are elective surgeries on hold?

Surgical patient’s stratification will help in accurate decision-making and reduce patient-burden in each hospital and also aid in proper resource allocation. As per this stratification, essential elective procedures bear an urgency of carrying out the surgery in 1 to 3 months and include cancer surgeries, cardiac valve surgeries, hernia repair, hysterectomy, reconstructive surgeries, etc. Contrary to the above procedures, discretionary elective procedures can be delayed by 3 months or more, such as cosmetic, bariatric, joint replacement surgeries, or others. Elective surgeries should preferably be postponed before it seems necessary. Postponing surgeries will cut needless patient movement in the hospital and lessen the likelihood and the spread of disease between symptomatic and asymptomatic patients and hospital staff. Also, the reduction in surgeries saves healthcare assets including hospital beds, personal protective equipment, along with maintaining the health of surgical staff.

The need for postponing “elective” surgeries is vital because:

1. Elective surgeries need “personal protective equipment” which is in short supply presently and is badly needed by health care providers in the areas worst affected by the pandemic for caring for COVID-19 patients.

2. Surgical patients or their caretakers may be an undiagnosed case of COVID-19, which may be spread to the health care staff and others in the hospital.

3. Operating rooms require ventilators that may be needed to support COVID-19 patients rather than being utilized for elective surgeries.

If your “elective” surgery is delayed, you need to follow certain precautions until your surgery is rescheduled:

  1. Change your activities to avoid positions that may cause pain and discomfort
  2. In some extreme cases, injection of a heavy dose painkiller may be given by your doctor
  3. Use NSAID to control your pain or swelling
  4. Apply ice or heat pads to the affected area, depending on your comfort levels
  5. Try restricting your movement levels and avoid lifting heavy loads
  6. Try conservative treatments such as physical therapy if you have been a patient of arthritis
  7. Immediately consult your doctor if your condition becomes unbearable and you need an emergency operation

When an infectious disease outbreak begins, the ultimate response is for public health officials to begin testing for it early. Without any doubt, one can say that testing is one of the principal factors responsible for countering COVID-19’s spread around the world. More testing leads to more identification of positive cases and helps in responding faster to those who are suffering. It does not only help in understanding who needs complete isolation and needs immediate attention but also helps in stopping the transmission of the virus from one region to another. 

Testing also helps in identifying the precise rates of infection and survival. Let us now understand the working of these tests in particular and who all are required to get one done. 

How does the test work? Currently, two kinds of tests are available to detect COVID-19 infection in suspected patients. The most widely used test type to detect the SARS-CoV2 (COVID-19 virus) is the RT-PCR (Reverse Transcription-Polymerase Chain Reaction) test which targets the RNA of the virus (organ of the virus responsible for its replication). This type of test can identify even a single virus particle present in swabs taken from a suspected patient’s mouth or nostrils. Another test quantifies the immune (antibody) response against the virus in the blood serum of the patient. In this test, a test tube is coated with the virus components and then a minor quantity of diluted blood sample from the patient is added in the test tube. If any antibodies are present in the blood, they will bind to the coated virus components.

Who should take the test? Because of the limited amount of test kits, the medical authorities and the doctors are taking a final call on who needs one and who doesn’t need a test at all. The main objective behind this approach is only to identify as many cases as they can with whatever resources they have available. Hence, we’ve have highlighted a few points that can help you understand if you need to get yourself tested or no.

  • All patients having symptoms of the disease and have traveled internationally in the last 14 days
  • All persons who have been in contact with patients having symptoms of the disease
  • All healthcare workers who show the disease symptoms
  • All patients having symptoms of severe acute respiratory disease/Flu
  • Persons who don’t show symptoms but have been in direct and high-risk contacts of a confirmed case should be tested once between day 5 and day 14 of coming in his/her contact 

According to research, the ongoing uncertainty over whether hydroxychloroquine can successfully treat COVID-19 appears to have eroded demand considerably among hospitals and across the globe. Hydroxychloroquine is a drug that is approved to treat malaria, analogous to chloroquine. However, it is associated with less significant side-effects. It is also used for treating certain auto-immune disorders like rheumatoid arthritis and lupus. It is considerably inexpensive and is an over-the-counter medication. Let us now move deeper into understanding more about what this drug is and how it works.

Mechanism of action of Hydroxychloroquine: Hydroxychloroquine is termed as an interferon blocker and functions by minimizing the response of the immune system against a virus. This mechanism of action of hydroxychloroquine has scientists globally and is currently at the center of investigation for its effectiveness against the dreadful COVID-19 infection. An overactive reaction by the immune system is believed to be predominantly responsible for consequent pneumonia, a severe manifestation of SARS-CoV-2 infection.

Clinical outcomes with HCQ in COVID-19 patients: Initial reports from China discovered that chloroquine could stop SARS-CoV-2 in-vitro, and demonstrated seeming efficacy in treating COVID-19 in humans. However, it has yielded mixed results in the initial trials conducted in humans to test its efficacy in treating COVID 19 patients.

The experts who favor the drug’s use opine that Hydroxychloroquine (HCQ) reduces the recovery time significantly and also improved pneumonia in trials involving patients with relatively mild COVID-19 symptoms. Also, a combination of HCQ and azithromycin resulted in clinical improvement in 78/80 COVID 19 patients. However, the researchers opposing the HCQ use argue that HCQ in addition to standard care was not more effective versus only standard care in a trial carried out in 30 patients with COVID-19 in China. So, at present, one cannot confirm the effectiveness of HCQ in treating COVID 19 patients.

Concerns with the widespread use of HCQ in COVID 19 patients: Presently, whether HCQ works in vivo against any virus is not definitely proven, and actually, it is not effective at all as per outcomes of randomized controlled trials against several viruses, including influenza. However, despite the lack of strong evidence, some people are now trying to self-medicate with the drug, with fatal outcomes. Hydroxychloroquine can have hazardous side-effects related to heart rhythm irregularities, in cases of improper dose control, and cases of chloroquine poisoning have already emerged in some parts around the globe.

Hence, currently “A Wait-and-Watch Strategy” is the only way forward till reliable data favoring HCQ in COVID 19 emerges. Till then, HCQ can be used as empirical treatment, strictly under doctor’s recommendations, to ease symptoms in COVID 19 patients.

It’s been a while that the World Health Organization (WHO) declared COVID-19 as a global pandemic but unfortunately, the world is yet to see a successful antidote that can fight the virus and save lives. With more than 100 countries being affected by the virus and non-availability of any treatment, it becomes very important for you to adhere to the guidelines issued by medical authorities to stay protected.

One of the key factors in preventing yourself from the virus is by improving your immune system along with maintaining the required hygiene standards. The stronger the immune system, the greater are the chances to resist the virus. Your immune system is known for doing a remarkable job when it comes to fighting off foreign cells to protect against illnesses. Various factors play a part, such as age and lifestyle that determines how resilient the defense system will be. Naturally, when something massive like COVID-19 strikes the globe, we’re bound to feel more concerned than usual about staying strong and healthy. Hence, boosting your immunity through the following steps can aid in preventing COVID-19.

1) Consume a healthy diet:  Food is one of the principal aspects in deciding your general immunity status and health. Consumption of diet, low in carbohydrates is advisable, as it aids in controlling high blood sugar, blood pressure, and body weight. Hence, you should take green vegetables and fruits, rich in Vitamins (B and C). You can prefer consuming diets rich in good bacteria such as yogurt, curd, etc. which aids in preserving gut immunity.

2) Get ample sleep: Prefer taking sound sleep of 8 to 9 hours as it is termed as the ideal way to aid your body in boosting your immunity.

3) Stay Hydrated: Drink around 8 to 10 glasses of water preferably warm and any form of fluids daily to maintain hydration, as it helps your body to remove any toxins and decreases the risk of getting any sort of flu, even COVID-19.

4) Exercise regularly: Regular exercise for 30 to 45 minutes along with a good diet is recommended for improving metabolism which directly impacts our immune system. A mix of free weight exercises like push-ups, jumping squats or burpees can be added to the regime and performed from the comfort of your home.

5) Avoid any sort of stress: Undue stress releases stress chemicals in the body (hormone cortisol), which makes your body prone to getting infected. Meditation, avoiding self-criticism, doing your favorite hobby, or even a video call with friends can help take down stress and indirectly make you feel stronger.

6) Avoid unwanted or leisure traveling: Though travel and leisure are something that everyone should experience for recreation but not during a pandemic. Especially, when there’s a high risk to your life. Staying home is the safest option to stay protected. 

It would be hard to deny the fact that lockdown has seriously taken a big toll on the mental health of a lot of people.  While it is important to stay informed and follow all the necessary measures shared by the respective authorities, it’s even more important to manage your mental health during this isolation period. And, with lockdown getting extended again and uncertainty of the situation getting better, it is necessary to identify ways that can keep your mind stable. Factors like losing jobs, low availability of food and groceries, loneliness and uncertainties of the future are just adding to the overall stress and anxiety levels.  Following are a few tips that can help in maintaining sound mental health during this tough hour.

1) Exercise at home: Exercising every day for 30-40 minutes or even doing yoga can be a great way to take down stress. It is said that regular participation in any physical exercise helps in decreasing overall levels of tension, stress, stabilize mood and improve sleep.

2) Consume a healthy diet: Though it is easy to binge eat any food during such times, however, eating veggies, fruits and homemade items can help keep your gut health on top.

3) Get ample sleep: Adequate sleep cycle can help your mind and body to recharge and react positively to almost all kinds of situations. Also, it is great for muscle recovery and development.

4) Stop watching negative updates: While it’s important to stay updated & informed, consuming constant content on coronavirus can stress you up. Watch news related to the disease in moderation and be selective of the content you consume on TV or social media. Instead, you may follow people that inspire you or read books/articles that help you stay positive.

5) Create a balanced daily routine: A balanced work-life routine that’s aimed towards building good physical and mental health can help in increasing the overall productivity, decrease overthinking and the negative mindset. We must take short breaks at regular intervals to rewind your mind.

6) Walking in your home space after regular intervals: Like any other cardiovascular exercise, walking also can boost endorphins, which can reduce stress hormones and alleviate mild depression.

7) Get enough oxygen/fresh air: Standing in your balcony and enjoying the fresh air is a great way to switch off your mind and soak in the goodness. This way you not only breathe in some fresh air but also helps in feel light-hearted.

8) Conversation with friends: Talk to your friends or relatives if anything bothers you because sharing what you feel with your loved ones can make you feel relaxed and give a feeling of extra support.