Let us learn to live with COVID-19
By;Prof. Dr. Narayan Mishra
COVID-19 is a new pandemic disease due to a new or novel CORONA virus which is highly infectious, originated at China in Nov 2019 and imported by more than 212 countries including India. At present we don’t have definite specific treatment and vaccine for it. Researchers across the world working on it and are not able to recognize it properly and the virus is changing its property from time to time. Usuallyit spreads through droplet infection while coughing and by settled viruses (fomite) on various surfaces. Few studies also indicates about faeco-oral transmission which is not well established. Resurgence of this infection is also anticipated globally.
If 100 persons are infected with Novel Corona Virus, 80 persons remain asymptomatic or use to have minimal symptoms (mild) which do not need any specific treatment or hospitalization. The rest 20 persons (Moderate to Severe) need hospitalization and out of which approximately 15 get cure and rest 5 those are critically ill needs ICU care and ventilator and are likely to face death. It is found that elderly persons and persons having comorbidities like COPD, Asthma, Cardio vascular diseases, Diabetes, Hypertension, HIV, Cancer and many other condition where the general immunity and the local immunity of airways and lungs is reduced, are more prone for this infection and severity.It is very difficult to check this disease till some specific drugs and vaccine comes out in view of resurgence.
Today in our country or in our state, even if it is a untold story, in reality we are probably entering or already have entered in some places to the stage 3 i.e Community spread which is not a good sign. We have tried our best till now with our national lock down along with local strategic policies. Presently due to migratory population everywhere with special reference to daily laborers or skilled laborers such thing is likely to happen. Without blaming anybody, now in current situation we will have to learn to live with this virus till we develop a Herd Immunity i.e about 60 to 70% of our population get infected and curedwith antibody formation in their body to fight against the future exposures. It will take quite some time and if specific drugs and vaccine comes out we will be in a comfortable position. Now it is a collective work and we all have to think how to come out of it with minimum death.
In the present context, Elderly and young persons with comorbidities are most vulnerable and at stake.Though with a population of 1.35 billon where 80% are bellow 45yrs, we are in a very critical situation. In this population of 45yrs- 20% HTN, 4% Diabetes, 83% out of all patients of HIV are included. Again 3% & 4.2% of entire population suffering from Asthma & other chronic lung disease respectively. One third of our adult population smoke. Apart from these, young persons are also suffering from many other diseases with low immunity status.
Calculate the risk of young people those are likely to suffer from severe diseasenecessitating hospital admission& critical care in our country or state. Are we having such quantity of facilities & quality of care? Data suggests that in general we are having only 0.55 bed in hospital per 1000 persons. As a result not only our 20% elderly but a major chunk of young people are also going to suffer.
In our state Odisha the condition was excellent before migration of worker, but now the situation is different due to inflow from Surat& WB in big number. Even though during long journey of bus and train they are using mask & maintaining distance, the spread of infection to majority is inevitable due to droplets, fomites and even through faeco-oral contamination. There is a sudden great rise of positive cases found from quarantine patients only. Tests are not done for all in view of large numbers and as such many asymptomatic healthy carriers are left behind to spread it. Many unruly returnees have escaped quarantine and those are in quarantine centre are likely to get infected because of inadequate hygienic facilities. Now inview of a vast number of returnees, strategically ourState has planned for home quarantine for asymptomatic healthy carriers in urban areas if they are having facilities along with health care supervision. Now we should look for the strain of the virus we are having & more testing facilities in affected areas like Ganjam District by shifting testing machines from less affected areas.
“LEARN THE ART OF LIVING WITH CORONA”
Universal precautions: while coming out of house, think that any person you are meeting outside is infected with COVID-19
1. Keep elderly & persons with risk factors( even if young) isolated and take care including medicine.
2. Mask: is a must for everybody when going out. Clean/disinfect it after coming back to house.
3. Personal hygiene& cleanliness: Frequent hand wash with soap/sanitizer, Cough etiquette, strictly don’t touch your nose, mouth & eye; Don’t spit out side
4. Social distancing:maintain always 6 ft distance from a person, no social function, careful in bazar/fish market etc.
5. Keep your immunity intact: Exercise (minimum 30 min), Adequate sleep, Good diet (less SOS-salt, oil, sugar), Say no to alcohol & tobacco
6. Don’t visit hospital unless it is highly essential. Use Tele Medicine
7. Don’t allow any body to your house.
Entire world is waiting for a specific drug and Vaccine. Only time will say when this disease will come to an end. Though it is a critical moment for all of us and let us not be worried about it.At this juncture with patience & courage we will have to fight against this deadly disease basing on only scientific evidences and obeying strictly the rules of the land. Universal precaution, Social Distancing, repeated hand washing with personal hygiene, Quarantine and Isolation are the magic wand. Stay at home – stay safe.
Prof. Dr. Narayan Mishra
MD, FIAB, FNCCP, FICS,FIAMS, FIRD;FICAAI,FRCP(Glasgo) FCCP (USA)
Former Prof & HOD Pulmonary Medicine. Nationalpast President of Indian Chest Society, Past President National College of Chest Physicians of India.
