We fought Covid. It’s real, it’s scary but it’s beatable!

Most of the information available on COVID focuses on the precautions people should take to protect themselves from getting infected, but not much is being talked about the big elephant in the room. …what if your loved ones catch the dreaded Virus? Through this blog, I am going to share my first-person experience of encountering Covid that infected all of my family members, three different generations living under one roof.

We were taking all possible precautions but seems they weren’t enough. 4 members of my family, my Grandmother (88 years), my parents (65+) and my wife were infected of Covid on October 3rd. Almost after three weeks of treatment and following a rigorous medical and recovery regime, they all are doing fine now. God has been kind to us!

The virus is deadly and incurable, you won’t think much about it until you are literally looking at a RT-PCR report of a loved one that reads POSITIVE, that’s when the reality hits hard. Because you feel helpless and weak, all you can do is provide them with best supportive treatment and hope that their body will get strong enough to fight the virus on its own. You Pray!

That’s what happened with me in early October, when my entire family was tested positive. I started to gather as much information as possible to figure out how to deal with this devil. Read hundreds of research papers and talked to dozens of doctors, all of whom had different opinions on the course of treatment we should be following, which was scary. We finally relied on advice of a doctor who was known to us and was heading the Covid ICU unit of a public health facility in Delhi. There are lots of new things I learned, here are few important ones, some of this information might be new for you too and might help you keep your loved ones safe.

THE SINGLE MOST IMPORTANT LEARNING:

If you observe any Covid related symptom. Do not delay a Doctor’s consultation. Timely diagnosis, by day 2 or 3 after onset of symptoms, is the key to avoid hospitalization and further complications.

Early Symptoms

All my family members suddenly lost their sense of smell or taste, which prompted us to get our tests done. They weren’t even able to smell strong odors, like camphor. These symptoms appeared abruptly. They did not have fever. My Grandmother could not tell the difference between the taste of salt and sugar, everything was tasting bitter to her. Even before losing the sense of smell, my Mother had developed a harmless looking rash on her right elbow and had reddish eyes. Which we ignored, thinking it might be because of some pollutant.

My Father had a sudden episode of diarrhea, only once, a day before he lost his sense of smell. Which we ignored too, thinking that it must be because something that he would have eaten. We were wrong!

Note: WHO has replaced ‘persistent dry cough’ as a symptom of Covid with ‘persistent cough’, which means it could be either of dry or wet progressive cough, that produces phlegm. My Father and Grandmother had a productive wet cough, whereas my mother had dry cough and irritation in her throat.

How does the illness progress, especially from the elderly viewpoint?

From what I learnt through my experience and after reading hundreds of research papers from the scientific community, the effect of Covid is measured in the number of days after the first symptom appears in the patient.

The first symptom could be a loss of smell or taste or fever or a rash or diarrhea or sudden extreme fatigue or blurring of vision, red left eye, nausea, stomach pain, etc. Something everyone should keep a close watch on.

This is marked as the ‘Day 1’ of the Covid infection (1), after this the virus starts to replicate in the body. By day 3 the pulmonary system could start to manifest along with fever. This is a very important day, even if the treatment starts from the third day, there is a fighting chance the person will recover without hospitalization without further complications. If left untreated, the disease mostly hits the lungs by day 4–5. These are important days to monitor SPO2 using an oximeter. Reading below 94 should be notified to the consulting doctor immediately and the patient should be put on oxygen support as soon as possible, especially if the SPO2 drops below 92.

If the body fails to stop the virus from replicating, the virus can cause severe respiratory issues by day 7–9. If by Day 9, someone is not experiencing respiratory symptoms, this would typically mean that the person on his way to recovery. Most of the patients with severe respiratory symptoms get hospitalized by day 7 or 8, when they need supplemental oxygen. It seems my Grandmother got infected a couple of days before the others, because 3 days after the test results, her SPO2 plummeted to below 90, which meant her lungs were severely infected and it was her day 7 already.

Notes: (1)Watch this video and from Dr. KK Aggarwal, Padam Shri Awardee. All his other videos are also quite informative.

Incubation period: You might have contacted the virus anywhere between 2–14 days before the ‘Day 1’ of the infection when your symptoms show up. This period of 2–14 days, after contact and before the symptoms show up, is called incubation period.

Why is early diagnosis important?

Elderly patients and people with co-morbidities (a health issue as simple as diabetes is also considered a comorbid condition) are at high risk. Why? Because their bodies are immunocompromised, not only because their immunity is low but also because their immune system can behave erratically.

Have you ever encountered someone developing severe allergy symptoms after eating shellfish or peanut butter? Within a matter of hours the person might need hospitalization. Ever wondered why it happens?

Simply put, the body tries to fight the allergen by releasing immunity boosters, certain proteins, which sometimes are released in excess and the body starts to attack itself, leading to rapid inflammation in organs. Something similar might happen when one has Covid too, the situation could get worse in a matter of hours if the patient’s immune system overreacts — this is called cytokine storm. Older individuals, immunosenescence and comorbid disorders are more likely to promote viral-induced cytokine storm resulting in life-threatening respiratory failure and multi organ involvement.

Timely intervention with steroids and anticoagulants (like aspirin) has potential to save lives.

Cytokine storm is an aggressive inflammatory response of the body to fight the virus by release of a large amount of pro-inflammatory cytokines, which happens when the body’s immune system becomes hyper-active. This is a serious condition that can be tamed if the patient’s immunity is kept under check by administration of steroids and other supportive medicines. This is a tricky situation to be in, because one you are already low on immunity and second you will now be on steroids which will further lower the immunity, while letting the antibiotics do their work. That’s why most patients need hospitalization and intensive care, if the illness is diagnosed at a late stage. In the ICUs doctors carefully keep the immunity at balance. As lungs get infected and inflamed, the patient might need supplemental oxygen, or ventilation, while doctors try to recover the patient with medicines or plasma therapy.

My parents and my Grandmother were put on steroids and anticoagulants on day 3, possibly because of this timely intervention none of them needed hospitalization and we are able to successfully treat them at home. But treating them at home meant keeping a 24x7 eye on their vitals, checking their BP, sugar, SPO2, pulse, etc. every two-three hours. I barely slept for weeks and was in regular touch with the consulting doctor. There were complications but we were able to manage them by ensuring intensive care at our home itself. We used a rented oxygen concentrator to administer oxygen to my Grandmother, who had severe symptoms and was facing breathing difficulties.

What tests were done and how?

We were told that the RT-PCR test is the gold standard test to diagnose Covid. Along with it the doctors also ordered few blood tests, like liver functioning (LFT), CBC and malaria.

Throughout this time, we were on online consultation. The doctor shared the number of the lab and within a few hours a guy, dressed in normal clothes visited us at our residence to pick samples. He wore the PPE kit just before taking our samples. The swabs were collected from the nose and throat. I wouldn’t say it was painful, but it was uncomfortable. At this stage, the anxiety kicked in, everyone was suddenly tense, like many of you, we never thought this would ever happen to us. The results would be shared with us after 24 hours. We were already on day 2.

Covid tests available:

RT-PCR: Gold standard test. Samples collected from throat and nose. Antigen : As good as tossing a coin, 50% sensitivity. Sample collected from nose only. Antibody: Will only tell if the person has had Covid in the past by checking the presence of antibodies in blood. It’s a blood test. These antibodies develop mostly after 20–21 days of infection, so within the first 51 days, the test might give a negative result. TrueNAT: The chip-based test works by detecting the SARS-CoV-2 E-gene, gives a result within 30 minutes but still needs to be followed with RT-PCR. Sample collected from nose or throat. I haven’t heard of anyone talking about this so far.

You can read about them in detail here

RT-PCR test also shares a CT value. There is a correlation between the CT value and how many days have passed since you got infected. Read more about it here and here

What was the first line of treatment?

Ivermectin 12 mg — 5 Days — to be taken on an empty stomach. Doxycycline twice — a day for three days. Zinc and Vitamins. Steam 4–5 times a day. This line of treatment is also known as Bangladesh Protocol.

When are you discharged from home isolation?

As per the WHO guidelines a Covid patient can be discharged after 10 days from the appearance of the first symptom, if the person does not have fever or respiratory symptoms for the last three consecutive days. Plus there is an additional 7 day quarantine period. That’s what we were told by the government authorities. No further testing was required. If by the end of the 17th day you are feeling healthy, then you are cured.

Checklist for treating your loved one at home (keeping this ready will help)

(1) Oximeter : Buy a good one. I used Omron, pretty accurate and long battery life. (2) BP Monitor: Steroids sometimes push the BP off the charts, regularly monitoring BP is very important. (3) Glucometer : Steroids also affect production of insulin, which can temporarily raise sugar levels in the body. Tracking sugar levels 30 minutes before meal and 120 minutes after meal is important. The sugar level should be less than 180 after a meal, else it will impact the self healing capability of the body. Doctors might add insulin if your sugar is consistently getting high. (4) Steamer: We got a separate steamer for everybody. TIP: Use tap water and do not add salt. (5) Oxygen Concentrator (Optional): Timely administration of Oxygen can save life. When the SPO2 drops below 92, the heart has to beat faster, and the BP rises, this could be life threatening for heart patients. Hence, keeping SPO2 level above 94 is critical. Oxygen concentrator is such a life saving machine that makes high quality oxygen (upto 98% pure) from room air (those bulky oxygen cylinders are not required). I rented it from curodoc at INR 7500 per month. Having this machine handy was very useful, because I now knew if any of my family members’ condition got severe, I could at least start oxygen immediately while I am waiting for the ambulance. (Consult your doctor before using it) (6) Rapid Ambulance Number: Nowadays private ambulance services are readily available, have a number ready. Do some homework and ask them about their response time. Save the number of couple of ambulances that can reach your place within 15 minutes max. (7) Decide on the hospital in advance: Be ready for the worst, talk to hospitals in advance. Ask them about the ICU availability and charges. Most probably you might not need it, but there is no harm to be prepared. When our tests came back positive, I called 5 hospitals in my city, ICUs were full in 4 of them, our usual hospital also declined. Fortunately the need did not arise.

I pray to the almighty none of you reading this blog ever face such a situation. But God forbid, if you do, keep calm and know that you can beat it too.

Happy to answer more of your questions, please feel free to watsapp me on +8377880468 or simply inbox me on linkedin.

Disclaimer: Please consult your doctor, if you face any such situation. The information shared here is my own understanding from my personal experience. Treatment might vary from case to case.