New Delhi: At a time when India’s dealing with the second wave of COVID-19 pandemic, there are various questions on post COVID care in people’s minds. From what should one do, eat to how much time can it take to recover completely, to even how long should a recovered COVID-19 patient wait to get the vaccine after recovery. Banega Swasth India team speaks to Dr Prashant Saxena, Associate Director, and Head, Pulmonology and Sleep Medicine; Associate Director, Critical Care, Max Smart Super Speciality Hospital to get the answers to all these frequently asked questions on Post COVID-19 management.
NDTV: What helps in post COVID recovery?
Dr Prashant Saxena: We are asked this question a lot. There are different types of COVID cases – mild, moderate and severe and the recovery depends on the type of case. Mild cases are usually recovered in 2-4 weeks, which means you will be able to return to normalcy in this period of time. Within this span, you may experience weakness, laziness, not being able to work properly, pain in body parts, and a general feeling of not feeling well.
But in severe cases, the recovery time may be 2-3 months. This is because patients have recovered from a very stressful disease, and the medicines used to treat them is of a very high level. And they can have side effects from steroids so they have to be monitored on their pulmonary function. Some patients may have a fever and other issues. So, usually, severe patients may take upto 3 months for complete recovery.
NDTV: Sometimes, people experience fever even after recovery. There have also been instances where the patient has UTI, how can the family help in such situations?
Dr Prashant Saxena: Once the first wave of COVID was over, we came to know that even after COVID is over and there is no infection, you may still have a fever. Some patients may have a mild fever like 99 for up to 6 weeks. This is known as Post COVID Syndrome or Long COVID. One should not neglect this, please inform your doctor for any fever after recovery. Because for those patients who have been on steroids, or had diabetes, or any heart problems, their doctor needs to investigate them to be sure if they have developed any complications.
It is very common for patients who have been on steroids or had diabetes to catch Urinary Tract Infection (UTI).
NDTV: For how many days after recovering from COVID-19, can a patient catch Black Fungus?
Dr Prashant Saxena: Black Fungus is not related to the time span after COVID recovery. Black Fungus is something that is already in the environment like other microorganisms and it is living among us. But in patients who have diabetes, who are on high-dose steroids, who have cancer, who are on chemotherapy, kidney patients, cardiac patients; have a tendency, where the organisms can find access to their bodies, and may actually manifest as disease. We need to be careful about these sets of population and they need to be screened. Not everyone will catch such fungal infections.
NDTV: What are the initial symptoms of Black Fungus? What is the difference between Black, White and Yellow Fungus? What is the habitat of these fungi and how can we kill them in a general way?
Dr Prashant Saxena: As I said, these fungi survive with us, they are on desktops, walls, in any place where there is moisture. To remove it, we need to maintain very good hygiene, keeping our surroundings clean, having a clean AC, cleaning dust, throwing garbage properly. It is ultimately about hygiene.
Fungus has many colours and they are named based on their colours in which they grow. All fungal diseases are dangerous to humans, they are difficult to treat, to diagnose and the drugs used in the treatment are very expensive and taken for long-term.
A lot of COVID patients who suffered from Black Fungus were because they were on high dose steroids, or uncontrolled diabetic, and many became diabetic because they were on steroids. Steroids are life-saving, but if not used wisely, this happens. If the fungus gets glucose, like with diabetic patients, it will thrive; if it gets a chronic kidney patient, it will thrive. So these are the high-risk groups, who may develop it. Normal healthy people who get COVID and recover have no risk factors to develop Black Fungus.
NDTV: I got COVID after taking first shot, who how long do I need to wait for the second shot?
Dr Prashant Saxena: As per CDC and WHO, if you contract COVID after the first dose, you should ideally wait for 3 months before getting the second jab. I would suggest people to get their antibody level tested at the end of three months. If your antibody level is very good, then you can wait more, because the additional dose may not help at the time.
NDTV: What is the good level of antibody?
Dr Prashant Saxena: Antibody reference is different for different levels, but the rough idea is to have 3-4 times of higher limit of normal is considered as a good response. Antibodies take 2-4 weeks to develop after the vaccine.
NDTV: I delivered a baby 13 days ago, when I can take my vaccine’s first dose?
Dr Prashant Saxena: When vaccines were launched the recommendation was that pregnant women and lactating women shouldn’t take vaccines. Now the recommendation has changed, even pregnant women and lactating mothers can get vaccinated.
NDTV: How long should one take blood thinners after COVID-19 recovery?
Dr Prashant Saxena: In COVID, blood tends to become thick and clots. Important thing is to hydrate yourself, take all your prescribed medication. We start blood thinners from Day 1 because the disease can become severe or moderately severe. So, it is advised to start immediately and we continue this for 3-4 weeks after the recovery. One has to be careful with blood thinners because it has a bleeding tendency.
NDTV: How to be safe from COVID and what is the recommended diet during the pandemic?
Dr Prashant Saxena: No matter what disease it is, a very good diet has a good role to play. Antioxidants can benefit greatly. I am a believer in nutrition and I believe our community is deprived of nutrition. We need to restrict on carbohydrates and fat and focus on high protein. There are many supplements available that can be taken. Please do not take protein powders randomly, this can lead to blood clots, kidney issues, digestive issues, etc. You need to consult with your doctor about the protein powders first.
NDTV: After recovering from COVID six months ago, I can’t taste things as it used to be. Is that normal?
Dr Prashant Saxena: Losing taste and smell happens to only 3-5 per cent of people. It is a rare symptom, it may take up to 6-8 weeks for the taste or smell to come back. This takes time. It is very unusual to get it in 6 months, one should consult their doctor in such a scenario.
NDTV: What is ‘Antibody Dependence Enhancement’?
Dr Prashant Saxena: There is a lot of research on this going on. When you take a vaccine and antibodies are produced, sometimes, these antibodies can harm you instead of benefitting you. This is called antibody dependence enhancement. This phenomenon is responsible for why we don’t have vaccines for dengue. Because the antibody was harming more than it was benefitting. This phenomenon hasn’t been seen in a lot of the population and is being investigated. We don’t want this to happen and it hasn’t happened in the case of COVID vaccines as yet.
NDTV: Can vaccine prevent Black Fungus as well?
Dr Prashant Saxena: Vaccines can help protect you from COVID infection. Before COVID, Black Fungus used to happen with patients who’re uncontrolled diabetic, or had kidney issues, or have cancer. It wasn’t a concern among the healthy patients.
NDTV: Are steroids essential for every COVID patient?
Dr Prashant Saxena: The last wave, I didn’t use steroids at all. This wave, research has come up that steroids are useful for patients who have low oxygen, patients who have moderate to severe infection and are on oxygen support. Steroids are recommended to only these sets of patients. However, all the mild patients also started taking steroids because of the fear. So this over-usage is not required, there are only limited cases that need steroids. 80 per cent of patients don’t require steroids for treatment.
NDTV – Dettol Banega Swasth India campaign is an extension of the five-year-old Banega Swachh India initiative helmed by Campaign Ambassador Amitabh Bachchan. It aims to spread awareness about critical health issues facing the country. In wake of the current COVID-19 pandemic, the need for WASH (Water, Sanitation and Hygiene) is reaffirmed as handwashing is one of the ways to prevent Coronavirus infection and other diseases. The campaign highlights the importance of nutrition and healthcare for women and children to prevent maternal and child mortality, fight malnutrition, stunting, wasting, anaemia and disease prevention through vaccines. Importance of programmes like Public Distribution System (PDS), Mid-day Meal Scheme, POSHAN Abhiyan and the role of Aganwadis and ASHA workers are also covered. Only a Swachh or clean India where toilets are used and open defecation free (ODF) status achieved as part of the Swachh Bharat Abhiyan launched by Prime Minister Narendra Modi in 2014, can eradicate diseases like diahorrea and become a Swasth or healthy India. The campaign will continue to cover issues like air pollution, waste management, plastic ban, manual scavenging and sanitation workers and menstrual hygiene.
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