Hi all, hope this post finds you in good health. Since the covid situation in India has become pretty severe, we’ve started off a medical help telegram group where doctors provide guidance to patients and common people about covid. The following set of questions have been picked from the group. Please go through them to get a better understanding about topics like vaccination, personal care, recovery, covid symptoms and treatment.

In case you have additional queries, please ask them here: https://t.me/CovidMedHelp

Vaccination queries

Last year my father tested positive for covid and he also suffered from pulmonary embolism (blood clots in lungs). This year first dose of vaccine has been administered. Seeing the reports of blood clots in are cases, should we go ahead with second dose for him?
Yes, he can take the vaccine. The risk of blood clots from the vaccine is much much lower than the risk of blood clots from covid infection itself. Hence it is definitely an acceptable risk, and is advisable to get the vaccine.

My wife is pregnant. Can she take the vaccine?
This is still a matter of consideration. As per the latest CDC guidelines overseas, they are advising pregnant women to get vaccinated. But such an advisory has not been issued in India. Keeping this in mind, we would advise for a wait and watch policy as of now.

I am senior citizen and i have to take second vaccine after 6-8 weeks. In case two or three days are over 8 weeks, can i take second vaccine or I have to repeat the course again?
You can take the second dose. No need to start a repeat course of vaccination if you are a few days late.

Both my son and daughter in law were Covid 19 +ve two weeks ago and they have recovered well. What would you suggest apart from taking covid precaution. Also need advice on vaccination for them (both are 28/29 years old).
Covid routine precautions are still to be practiced. And for vaccination our ministry of health says that after 14 days of recovery from covid one can take the vaccine. Recovering from COVID -19 confers natural immunity to an individual for a median of 3-6 months. You can delay vaccination by a month or two for them now. However, it is advisable to give them the vaccine a month or so after full recovery.

My mother is on arthritis medication right now can she take the vaccine?
She can take the vaccine, some of the drugs used in arthritis might decrease the vaccine efficiency but it’s still much better to get vaccine.

Can I take covid vaccine? I’m taking dutasteride 0.5mg daily for my prostate.
Yes, you can take the vaccine.

I have one query regarding the behaviour of the vaccine. Does the first dose of vaccine increase any sort of immunity? Or we need both the doses to get things work.
The first dose may give a small degree of immunity, but as per the trials, for most vaccines, you will need to take both doses to get the maximum protection from the shot.

Hello, my mother in law had a mild stroke in 2018. Since then she is on blood thinners (Ecosprin75/Atrova40). She is also diabetic and has high pressure problem. We are not sure if she can be vaccinated. Please advise.
She can be vaccinated. Ecosprin is not a higher category blood thinner. Patients on other drugs like warfarin, acitrom, rivaroxaban, apixaban, etc may need to seek the advice of their healthcare provider before taking the vaccine. But those on lower potency blood thinners like Ecosprin may not worry.

My wife undergone angioplasty in 2012 takes ecospirin 75 per day, can we take vaccine with such low dose of ecosprin?
Yes, can take the vaccine

My father is asthamatic from past 30 years. Is it safe to get the vaccine?
Yes, it is safe to take the vaccine.

Can you please guide me whether a feeding mother get COVID vaccination or not? My wife is a mother of 3 months old baby.
Yes. It is still being studied, but, as such there is low risk of anything happening to the baby.

Can women on their periods take the vaccine?
Women on periods can get vaccine. Nothing to worry about that. It is completely safe.

My father is under treatment for diabetes. Can he take the vaccine or not? His age is around 60 .
Yes, he can take the vaccine

Can a person with 1st dose of vaccine can get infected?
Yes. Even a patient who has taken both doses of vaccine can also get infected. Vaccines help to reduce the severity of infection. Do not hesitate getting vaccinated. Vaccination does not mean that there is a guaranteed protection against infection. It helps in preventing death and adverse effects of the infection. But there are always remote chances of anything happening even after getting the vaccine. So please take all precautions and use masks, follow social distancing etc even if you are vaccinated.

My father is 50 years old, is a smoker and has hypertension, is it safe for him to take the vaccine?
Yes, it is safe to take the vaccine.

Can a patient with MVP - mitral valve propalse condition of heart get vaccinated?
Yes, it is safe to take the vaccine.

If someone test positive after first dose, do they have to take the second dose?
Yes, both doses of the vaccine have to be taken. Take the second dose 14 days after recovering from the current infection.

Can vaccines cause infection? Can they worsen a person’s condition of they were infected in the past?
No. Vaccines act by inducing immune response and producing antibodies against the virus. It cannot make a contracted infection more severe. Make note of this, Vaccine only saves lives. Any hesitation against vaccine can prove costly.

My 2nd vaccine dose is coming up. I am anxious to go out. Is it safe to take the vaccine now?
Yes take the vaccine. Wear an n95 mask or double mask if you’re feeling apprehensive.

If a person of age above 18 years is COVID positive, how long should he/she wait for getting vaccinated?
As per MoHFW guidelines, one can take the vaccine 14 days after recovering from covid infection.

Is it alright for a person with high sugar levels to take the vaccine? My relative is afraid to take vaccination out of fear that she may face reaction or complications.
One need not wait for control of sugar to take vaccine. Take the vaccine while simultaneously focusing on controlling diabetes. Those with diabetes are in high risk group with respect to Covid19 and they should get vaccinated on priority basis.

Can I take vaccine for covid19. I am facing allergic reaction when I took pencilin and antibiotics.
In case you have a history of severe life threatening allergies, avoid taking the vaccine for now. In case you have a history of mild allergic reactions, you may take the vaccine after getting a test dose as per protocol. Inform the staff at the vaccination center about your history of allergies when you go to get vaccinated. Patients with mild allergies should not delay getting vaccintated out of fears allergic reaction. Such a patient can be closely monitored for adverse reactions after being administered the vaccine.

Medical queries

Our family tested positive in September, now again we are having slight symptoms like headache, body pains, fever (99.6F), but tested negative in rapid test, please suggest the appropriate steps to take.
Book an RTPCR just to be on the safe side. Isolate yourselves till you get the report. Take multivitamins with Zinc and vitamin C and vitamin D on a daily basis. Take paracetamol 650mg for fever and body pain and monitor your blood oxygen levels. As long as oxygen saturation stays in the normal range (96-100%), no need to worry.

I tested positive on 4th Nov and negative on 14th Nov Can I donate plasma now?
I would recommend against it as it has been more than 3 months now, so the level of antibodies in your plasma will not be enough to make a difference. As a general rule, you can donate convalescent plasma 14 to 90 days after recovering from the virus. It is best to donate plasma as soon as you are eligible, as the level of antibodies slowly goes down over time.

From last night, I felt that my smellling sense is going. No other problem. Could it be covid symptoms. If yes so what shoud I do?
Sudden loss of sense of smell is not a common thing. The only common cause right now is covid-19. Isolate yourself, monitor your pulse and oxygen saturation and get RT-PCR and rapid test done.

I got infected on the 13th of April . Experienced loss of smell, loss of taste, fever and loss of appetite, Now I regained all, but mild cough is there. What should I do?
The cough will resolve over time. You can do steam inhalation and gargles with turmeric & salty water thrice a day for now, as you are already on the road to recovery. You will need to stay in isolation for 14 days and then gradually go to back to your routine, some dry cough and fatigue might might continue for a few days.

Is Fabiflu (Favipiravir) recommend to a covid+ve person?
It has been given permission by the drug regulatory authorities for use in trial mode. As of now its effectiveness is still under investigation, but it is being prescribed by many doctors for treatment of mild-moderate infections.

My brothers oxygen level is 89 to 90% and no hospital is ready to take him in, what should I do?
Please make him lie in prone position, and keep monitoring oxygen saturation. Try to consult a doctor in person and arrange a bed, or at least oxygen at home as per the advice of your local physician.

Hello doctor from last two days I am getting fever body pains for sometimes and stop than again coming next day this is Corona or viral fever
Kindly self isolate yourself and monitor your symptoms closely. If they persist, get an RT-PCR and an antigen test done. In the meanwhile, you may take tablet paracetamol 500 as needed for contolling the fever.

Dear doctors, my father is diabetic. His antigen test is negative. His SPO2 level is 86. Please suggest what we should do.
If SpO2 is 86% persistently, plan to get an HRCT done and take him to a hospital. Meanwhile, ask him to lie on his stomach in prone position as long as possible.

Is 96% oxygen saturation good for my father? He is 55 and is diabetic.
Yes, it is normal

Can CT scan be used as a diagnostic tool for Covid19?
CT scan along with symptoms and other lab reports can be decided upon by your doctor for hospitalisation. Consult a doctor so they can use a combination of clinical signs, symptoms and tests to make the diagnosis

Is it safe to get a CT scan, do they allow wearing masks and clothes while doing so?
Yes. They allow to wear mask and clothes while doing CT scan. However, please know that CT scan also brings with itself some radiation which can have harmful side effects in the long term. Many physicians and patients are insiting on getting early CT scans these days. Please get a CT only if it is clinically indicated.

Hello doctor, I am having cough, fever since last 3 days, suspecting covid. RT-PCR facility is not available in my town, but HRCT is available. After how many days from first symptom, should I get HRCT done for myself?
CT scan is not mandatory if RT PCR is not available. Given the current pandemic, these symptoms should be treated as presumptive COVID unless proven otherwise. At least try getting the basic lab investigations like CBC with ESR, CRP, D dimer, serum creatinine, serum bilirubin and SGOT done. Also most importantly, please isolate yourself and make sure you do not transmit the infection to your loved ones. Keep a watch on oxygen saturation, pulse, blood pressure and temperature.

I am 4 months pregnant. My husband tested COVID positive 4 days back. And I am having fever, cough, body ache for two days. I am self isolating currently. Please advise me what to do ?
Please remain in isolation and consult your obstetrician as well. Monitor your symptoms and vital signs like oxygen saturation closely, get blood tests done as advised by your physician and obstetrician, and do breathing exercises, steam inhalation etc in the meanwhile.

What is cytokine storm?
An immune system reaction caused by many infections, including covid-19.

Hello doctor. If one has been diagnosed positive in RT PCR, does he need to have a CT Scan?
You don’t need to get HRCT just because you are positive. The decision to get a CT scan should be taken if the patient is high risk or if they are not maintaining oxygen saturation. In some cases, HRCT is also used to rule out false negatives, but that is a clinical judgement that should be made by a doctor after examining the specific patient.

I am having fever from the last 4 days, no other symptoms except body ache. SpO2, pulse rate are normal. Should I go for test or not?
Yes, please get an RTPCR test. Please isolate yourself at home till the test results come. Consult a doctor if symptoms increase over the course of time.

My fever is going away in the morning. But in the evening it’s coming back again upto 99.5. Report has not come yet. But smell gone. What should I do?
Fever is a common symptom of covid-19 infection. You can take tablet paracetamol 500 as needed to bring down the fever. Isolate yourself till you get the results. Monitor your pulse, BP and oxygen saturation and consult a doctor if you start having additional symptoms.

I had fever yesterday. I had taken Dolo - 650, Azithromycin-500 & B Complex. No fever since then till now. Got very little cough. But nothing else I have. Any suggestions on what should I do?
Kindly self isolate and get an RT-PCR test done. Monitor your oxygen saturation and get checked by a doctor in person if your symptoms worsen.

My 6 year old brother is suffering from 101 fever and cough from yesterday. Can he be at risk?
Yes, fever and cough are part of the symptoms of covid-19 infection. Please don’t ignore fever in children, as they can deteriorate rapidly. Consult a paediatrician.

My wife who is 9 months pregnant is Covid positive. She is having heavy dry cough and fever. What can be done?
Give steam inhalation. Make sure she is checked by a physician and a gynecologist if her symptoms worsen. Monitor pulse, blood pressure and saturation and if saturation falls below 92%, please take her to a hospital.

My husband is 46 year old he has covid,now fever is normal but oxygen level goes down till 85 generally in night or in morning. When he is doing proning it will increase till 95,96 and also he is having pain in chest. Does he need to be hospitalized?
Saturation of 85% is not healthy. Please get this patient checked by a doctor in person. He may need to be administered oxygen, inhaled corticosteroids and other medications, depending on his condition as judged by the attending doctor. In the meanwhile please ask him to maintain prone position

Post Recovery

How long does it take to fully recover from covid? Been 18 days now for me and I have body and joint aches in my entire body. Plus weakness is crazy, focusing anywhere is a challenge.
Depends on severity, some symptoms may go on for weeks. A few patients report having symptoms months after the infection, which is known as Long Covid syndrome. Such a patient may not be infective but may have persistent, low grade symptoms. There is no specific treatment for this, except taking symptomatic medication like paracetamol, cough syrup as needed, breathing exercises etc. Recovery takes time. Check oxygen saturation and if it’s normal than no need to worry. The body takes some time to recover from infection.

When do we consider someone recovered from Covid?
Consider the patient to be recovered around 14 days after the diagnosis is made.

I have tested negative for covid now but I have still not recovered my sense of taste and smell. Is it normal?
Yes, it is normal. You should get your sense of smell and taste back slowly over a period of time.

Is an RT-PCR test required after 14 days of home isolation and recovery?
As per protocol no need to repeat RT-PCR after 14 days of home isolation.

I want to know what are the signs of recovery from COVID. I am on my 6th day of isolation, no fever, no cough, but lost smell/taste. O2 level is 98-99
Generally if you are without any symptoms for 3 continuous days, with normal oxygen saturation, no difficulty in walking for three minutes without dropping saturation you are on the path to good recovery. 10 days from the onset of symptoms your infectivity decreases to minimal. Two weeks from the onset of symptoms you are considered recovered and can move out of isolation.

Is it normal to have occasional cough, even after 2 weeks of testing positive for Covid19?
Some symptoms might persist for few days or weeks depending upon how severe disease one had, but if oxygen saturation is maintained above 92%, there’s no need for worry

Doctor, I am in the moddle of covid-19 recovery, its been 7 days since I am on isolation, taking medicine. Is it common to feel weakness with a slight sensation of fever, during 6th-7th days of isolation, I did not feel this during during the initial days of isolation. Now I feel tired and feel like sleeping all the time.
Yes it is normal to feel weakness as the body recovers from the infection. Keep monitoring your symptoms and take prescribed medicines. Keep a watch on your pulse, blood pressure and oxygen saturation and maintain good hydration.

What can hospitalised COVID patients be given for dehydration ? Hospital is allowing us to send eatable / drinkable as patient is very dehydrated but what is safe ?
Home cooked fresh food. Vegetables and fruits. Fresh juices. Lemonade with sugar and salt. All this can be given to ensure good hydration.

Personal care

I got Covid19 earlier. If I get the infection again, will it be more severe?
There are a few reports of reinfection, but there is no indication if reinfection will be mild or severe. And with the existence of multiple variants and the constant evolution of the virus, there is no way to predict for sure. There is an old credo: Prevention is the best cure. It is best is to take all precautions to ensure that you are not infected again, use masks properly always, distancing and santitisers.

Have a small query can we take any medicine even though we don’t have any symptoms? As a matter of precaution?
You can take multivitamins with Zinc and vitamin C and vitamin D for precautionary measure. You can wear an n95 mask in public, practice physical distancing and frequent handwashing with soap or sanitizer. Prevention is the best cure.

Can we take Fabiflu (Favipiravir) per day as safety measures?
No. All medicines have side effects. Favipiravir only has emergency approval for covid because there are few alternatives. It is not advisable to take experimental medicines like this by yourself.

How can we isolate someone at home?
Confine them to a dedicated room and bathroom, they should not come out and interact with others at home, give food and water to the person in room without coming into direct contact, like by keeping it near the door, give them a pulse oximeter to monitor, if person is elderly and can’t take care of themselves, or have difficulty doing so, a dedicated caregiver with N95 mask, distancing as much as possible, and frequently sanitizing hands may look after them.

What precautions do you need to take if someone in your building has come positive and you have a common pathway of going in and out of the building?
Wear a mask (preferebly an N95 mask) properly at all times while in the public areas. Avoid touching common surfaces unnecessarily and wash hands with soap or sanitise them with alcohol based sanitizer after coming into contact with such surfaces.

Should eating egg and fish be avoided during Covid19 recovery?
Any home cooked food can be given.

A Covid +ve person is not eating properly. What can be done?
Adequate food and water intake is necessary for the body to be able to fight any infection. If the patient is not tolerating solid food, they can be given semi-solid food like dal-rice, mashed vegetables, etc. Take care to see that the patient has adequate water intake. You can give them some lemonade with salt and sugar in it as well. Keep a watch on their food intake, if doesn’t improve, take them to the nearest hospital. Monitor pulse, blood pressure and oxygen saturation.

If one of our family members are positive, but the rest of us haven’t tested positive… what precautions must we take?
Please keep the family member who tested positive in isolation. Others should take appropriate precaution - maintain distance from each other, wear a mask inside the home and monitor symptoms/saturation. Go for a test if anyone develops symptoms.

If an old person above 70 years is showing symptoms What are thing he should eat to keep himself fit and healthy?
If anyone is showing symptoms of covid, please get them tested with RT-PCR and rapid tests. Other than that, there are no covid specific foods. The patient should be given normal home cooked food along with fresh fruits and vegetables They should maintain adequate water intake to ensure good hydration

Can I do betadine (2% povidone iodine) gargles to maintain throat hygine? How many times a day betadine gargle can be used and for how many days? Can we do it regularly for a few months to prevent covid?
Betadine is not recommended for prevention of covid. Gargles with turmeric and salt water can be done for normal hygiene purposes. But there is no evidence that these gargles can prevent covid infection.

Are there any medicines for children which can be given as a preventive measure/immunity booster to protect from coronavirus which can be given before they catch covid?
There are no such preventive medicines. Take home cooked food, fresh fruits and vegetables and good hydration. Maintain appropriate hygeine. Kindly follow all the covid related precautions. Please feed the child home cooked food, a balanced diet of grains, green leafy vegetables, fruits and sources of protein like dal, eggs, chicken etc. No additional multivitamins will be required if this is done.

I have a 1.5 year old kid. My wife is isolated due to symptoms. Is it safe to breastfeed the kid in this scenario?
Yes you can breastfeed but need to follow all the precautions carefully - washing hands and wearing mask etc. As it does not spread through milk but by contact. Wash hands properly before feeding. Try to minimize contact time. You can also try expressed/extracted milk if feeding is absolutely necessary.

A big thank you to all the healthcare workers, frontline workers and volunteer initiatives who are helping each other out.
Regards,
Team covid19india.org