Bracing up for 2nd wave, state releases updated treatment norms

Manav Mander

Tribune News Service

Ludhiana, November 24

The state government has released several updates for the treatment of Covid patients ahead of the expected second wave in mid-December. This is the third amendment made by the state since the pandemic spread. The guidelines have been revised according to the regional updates and have been sent to all districts.

Dr Bishav Mohan, senior cardiologist from Dayanand Medical College and Hospital (DMCH), who is also a member of the Covid-19 task force formed by the state government, shared the revised guidelines for treating mild, moderate and serious patients. He said there were some important points to remember while treating Covid patients, like low dose of steroids have a good outcome when patients are on oxygen support. However, giving steroids with normal saturation and on the basis of CT scan can cause more harm.

“Ramdesivir injection has not shown benefit in reducing death rate. However, in some cases of moderate severity, when given in early phase, it can help in reducing stay in the hospital. In addition to this, blood thinners like Heparin, given in required dose, help. HCQ Prophylaxis for high-risk contacts and frontline healthcare workers should be considered. Mental health issue should be managed in consultation with psychiatrist/ psychologist and voluntary organisations,” Dr Mohan maintained.

He further said that current evidence supporting the use of Ivermectin /Doxycycline was limited. Few preliminary studies had shown clinical benefits.

For moderately ill patients, plasma therapy could be considered while for severely ill patients, a single dose of Injection Tocilizumab for cytokine storm after the team meeting could be considered, Dr Mohan stated.

Patients with high risk factors included those above 60 years of age or having compromised immune system, those suffering from cardio vascular disease, diabetes, obesity, chronic lung, liver and kidney disease, pregnant woman and cerebro-vascular disease.

The moderately ill patients should be shifted to a Dedicated Covid Hospital (DCH) / Intensive Care Unit (ICU) Level III if there is increased work of breathing (use of accessary muscles), hemodynamic instability and increase in oxygen requirement, he said.

“The major set-back for Punjab has been late testing. Rumours that were spread in June-July affected the mindsets of the people. As a result, many did not come for testing. Had testing been done as we had planned, Covid would not have spread in Punjab to this extent,” Dr Mohan added.

BOX

Warning symptoms/signs for home isolation patients:

-Difficulty in breathing.

-Persistent pain/pressure in the chest.

-Mental confusion

-Bluish discoloration of lips/face.

-Decreased urine output.