WHEN TO TEST
On having symptoms| Usual symptoms are fever, body ache, loss of smell and taste, chills, breathlessness. New symptoms are pink eyes, loose motions and hearing impairment.
Close contact | In case you were close to 6 feet for a total of 15 minutes or more with confirmed Covid-19 patient.
WHEN NOT TO TEST
Fully vaccinated people | If 2 weeks have passed after taking both doses of vaccine, and there are no symptoms, no need of test after coming in contact with Covid patient.
WHICH TEST TO BE DONE
RT-PCR is gold standard. Rapid antigen test (RAT) gives instant report. If RAT is positive, Covid confirmed. But if RAT is negative and there are symptoms, go for RT-PCR test.
CT VALUE & CT SCORE ARE DIFFERENT THINGS
CT value in RT-PCR is Cycle Threshold Value, a marker for the viral load in patient. The lower the CT value, the higher the severity.
Doctors ask for CT scan of chest of some patients. Here, higher the CT score, higher the severity of infection.
STAGES OF COVID 19
Stage I | Home quarantine or isolation wards Asymptomatic | Without any clinical symptoms and chest scan is normal Condition | Mild fever, fatigue, myalgia, cough, sore throat, runny nose, sneezing, nausea, vomiting, abdominal pain or diarrhoea
Stage II (a) | Isolation wards/Hospital/ICU Condition | Moderate but frequent fever, cough, chest CT with lesions.
Stage II (b) | ICU Condition | Severe pneumonia with SpO2
Stage III | ICU Condition | Critical, acute respiratory distress syndrome, shock, heart failure, coagulation dysfunction and acute kidney injury.
MEDICINES AND THERAPIES IN USE
REMDESIVIR
Emergency use approval, experimental, doesn’t prevent death.
CRITERIA
RT-PCR confirmed positive case.
SpO2 ≤ 94% on room air, requiring mechanical ventilation and/or supplemental oxygen.
Chest x-ray/ CT scan shows infection.
Note | Early use recommended in first 9 days when virus is replicative and patient is hospitalized. Does not impact mortality but may hasten recover.
FAVIPIRAVIR
Emergency use approval, experimental, data on viral clearance, not deaths.
CRITERIA
Fever/cough/ breathlessness + Covid-19 RT-PCR +ve
Age 18 to 75 years
Note | Not recommended by national guidelines. Doctor may find it useful in the first 72 hours only to achieve better viral clearance
CONVALESCENT PLASMA
Emergency use approval, experimental, compassionate use only
CRITERIA
Covid-19 positive in RT-PCR; age above 18 years.
Fever/cough/breathlessness and respiratory rate > 30/min or SPO2
Note | Plasma may improve clinical outcomes in patients with mild to moderate Covid-19 infection if given early but needs data generation. Use is strictly off-label.
PREVENTION IS BETTER
- Therapies for Covid experimental only
- No medicine on Covid, hence prevention is the best way
- Wear masks, wash hands and maintain physical distancing