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.

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.

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 30^th, 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.

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