If You Are Infected: Demystifying Covid-19 Care
Satchit Balsari for the Indian Express
July 2nd, 2020
Below is an excerpt from the article co-authored by Asia 21 Young Leader Dr. Satchit Balsari, originally published by the Indian Express on July 2nd, 2020.
After three months of missteps, there seems to be consensus — or rather a late realisation — that not all patients with Covid-19 need to be taken to hospitals. We have known with fair certainty since early March that Covid-19 does not spread like Ebola, and that in the absence of effective medical treatment, non-pharmaceutical interventions like hand-washing, masking and physical distancing would be the best defence. And yet, for nearly one hundred days, confirmed cases of Covid-19 in India’s cities were being admitted to hospitals, irrespective of the severity of disease.
This blunder — with no clinical justification — resulted in first paralysing, then overwhelming, and finally crushing entire health systems. The hospitals were rendered incapable of caring for tens of thousands of other patients with non-Covid-related diseases, and jeopardised the wellbeing of their overworked staff. What can other cities, towns and villages in India learn from this, as the pandemic spreads to the hinterland?
There are a finite number of permutations that can occur, when someone is exposed to Covid-19. Let’s walk through these possibilities, and the possible care pathways each situation warrants.
Asymptomatics: If exposed, one gets Covid-19 or one doesn’t. Of all who get it, most will be asymptomatic: they will show no symptoms, but will continue to spread it. It is likely that they may be less contagious than someone who is actively coughing, but there is no evidence to suggest that the asymptomatic patients do not spread the virus. They, however, need no treatment.
Presymptomatics and mild cases: Of the few that are symptomatic, all will first be pre-symptomatic. This is the roughly two-day interval in which they will be contagious, will spread the virus, but will not have developed symptoms. Eventually they will develop one or a combination of the Covid-19 symptoms we recognise: loss of smell or taste, cough, fever, and so on.
Most of these symptomatic cases will only have mild symptoms and will also need no treatment, except what physicians appropriately call “symptomatic management”, with medications to simply manage the fever and cough and bodyaches. Home remedies may help with some of this, but there is no evidence that they alter the course of the disease.