Amid the spike in Covid-19 cases in Chandigarh and neighbouring States of Haryana, Punjab and Himachal Pradesh, Dr PVM Lakshmi, Professor of Epidemiology, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh said that the number of cases are definitely increasing, but so far, most of them have been mild. It is mostly fever, cough, cold, and sore throat. She said that first of all, no new variant of concern has been reported so far in the city. The previous results have indicated the presence of BA.2 in the tricity. India now has BA.4 and BA.5, in addition to BA.2, which have a slightly higher transmissibility as compared to the other Omicron sub-lineages. There is no need to panic, but one must remember that Covid-19 is very much around us and we need to adhere to Covid-appropriate behaviour and particularly, avoid crowded places and also make masks an integral part of our day-to-day living, Dr Lakshmi added.
While elimination of the virus is an impossibility at this point, adjustments in individual habits and communal spaces can help slow the pace of outbreaks and keep high-risk groups safer. Vaccination remains a key strategy for avoiding infection, and it has been especially effective in preventing severe disease, hospitalization, and death, she added. In an interview, Dr Lakshmi talks about current status of Covid-19 pandemic in this region, Omicron’s BA.4 and BA.5 sub-variants, post covid-19 conditions, among others. Excerpts:
Covid-19 cases are rising on a daily basis in this region. Is it a separate wave of pandemic?
The number of cases is definitely increasing, but so far most of them have been mild. It is mostly fever, cough, cold, and sore throat. The only worry is if a large number of people get infected, then there will be some — the old or co-morbid — who will land up in hospitals. We will be able to understand the trajectory a little better in the next few weeks. Hospital admissions, however, remain low. Moreover, I don’t think this is a separate wave. The numbers are going up because people aren’t masking anymore.
Is a mild case similar to a respiratory illness like the common cold or the seasonal flu?
Influenza (flu) and Covid-19 are both contagious respiratory illnesses, but they are caused by different viruses. Covid-19 is caused by infection with a coronavirus first identified in 2019. Flu is caused by infection with a flu virus. Covid-19 spreads more easily than flu. Compared to flu, Covid-19 can cause more serious illnesses in some people. Covid-19 can also take longer before people show symptoms, and people can remain contagious for longer periods of time. If a person has Covid-19, they could be contagious for a longer time than if they have flu. In case of flu, a person may experience symptoms anywhere from 1 to 4 days after infection. In case of Covid-19, a person may experience symptoms anywhere from 2 to 14 days after infection.
What separates a mild case of coronavirus from a moderate one?
Coronaviruses are a family of viruses, but this is a new coronavirus, officially called SARS-CoV-2. This novel coronavirus, also called COVID-19, first surfaced in Wuhan, China, at the end of 2019 and was transmitted to humans from an animal source. Experts have learned, and are still learning, about the different ways it affects people. It’s a fairly contagious virus that is spread through aerosols (airborne particles much smaller than droplets that linger in air) as well as droplets (the sneezes and coughs) of infected people. Touching respiratory droplets as well as touching an infected person, will also transmit the virus. This is why hand washing, social distancing, self-isolation, and vaccination are so important in slowing coronavirus transmission. Age seems to be a strong factor in who gets the sickest. Patients who have a cold and cough should isolate themselves or at least should wear a mask to prevent the infection from spreading to others. Conditions such as diabetes, lung, kidney or heart disease, high blood pressure, and obesity can make people more vulnerable to Covid-19. It’s possible to have the infection and not show any coronavirus symptoms at all. Not all fevers or coughs will be due to the coronavirus. Although more and more studies are showing that quarantine and isolation methods are indeed effective.
Cases are rising in this region. What are the arrangements made for Covid-19 patients at PGIMER?
At PGIMER, as of now, only six Covid patients are admitted. 10-20 beds have been kept reserved for Covid patients. But it would increase upto 300 depending on requirements. If patients are coming up with any kind of complaint, adequate treatment is being given. Even among those admitted, there is hardly anyone who needs oxygen or ventilator support.
What should people do if they are infected with a virus?
Everyone should watch out for symptoms of Covid-19, whether or not they are fully vaccinated. Anyone who thinks they have been exposed should get tested and stay home and away from others. Symptoms can appear anywhere between 2 to 14 days after exposure. Most people will have a mild illness and can recover at home without medical care. Seek medical attention immediately if you or a loved one is at home and experiencing emergency warning signs, including difficulty breathing, persistent pain or pressure in the chest, new confusion, inability to stay awake, or bluish lips or face.
Whether Omicron BA.4, BA.5 sub-lineages detected in this region?
Omicron’s BA.4 and BA.5 sub-variants are known to be around 13 per cent more transmissible than the previous BA.1 and BA.2 and are slowly becoming the dominant sub-strains in Europe and US. However, there is no proof of these being more dangerous. Both BA.4 and BA.5 are sub-variants of Covid-19’s Omicron variant and have been declared as variants of concern by the World Health Organisation (WHO) and the European Centre for Disease Control and Prevention because of their high transmissibility. These were first identified in South Africa in January. What we have been seeing is that it usually takes 6-8 weeks for a new variant to become the dominant one in the community. No new variant of concern has been reported so far in the city.
When can a Covid-19 patient be considered “cured” and can resume his normal life?
Adults with mild to moderate Covid-19 remain infectious no longer than 10 days after symptom onset. Most adults with more severe to critical illness or severe immunocompromised likely remain infectious no longer than 20 days after symptom onset. A patient can resume his routine activities while maintaining Covid-appropriate behaviour on the basis of the extent of damage to lungs and other tissues. The recovery period is likely to be longer for patients who suffered from more severe forms of the disease and those with pre-existing illnesses.
What are the complications experienced by a post-Covid patient?
Some people who have been infected with the virus that causes Covid-19 can experience long-term effects from their infection, known as post-COVID conditions (PCC) or long COVID. Post-Covid conditions are found more often in people who had severe Covid-19 illness, but anyone who has been infected with the virus that causes Covid-19 can experience post-Covid conditions, even people who had mild illness or no symptoms from Covid-19. People who are not vaccinated against Covid-19 and become infected may also be at higher risk of developing post-Covid conditions compared to people who were vaccinated and had breakthrough infections. Recovered patients after acute Covid-19 illness may continue to experience various signs and symptoms including fatigue, body ache, cough, sore throat, difficulty in breathing, etc. Some of the complications seen in patients include deleterious effects on lungs, kidneys, heart, and manifestation of black fungal infection, known as mucormycosis. Such patients are treated at PGIMER.
What is the Post-Covid follow up care?
Eating a balanced nutritious diet, rich in immune boosting vitamins and minerals including fruits, vegetables, eggs and safe poultry is of utmost importance to speed up recovery. Some patients experience unexplained weight loss or weight gain, hence, weight adequate calories must be provided according to the patient’s nutritional status. Drinking plenty of fluids and drinking warm water can be helpful for patients with scratchy throat or dry cough as it improves circulation and reduces nasal congestion. Taking proper rest and sleep can help your body recover faster. Covid patients are advised to practice breathing exercises to improve respiratory distress and relieve congestion.