In the current situation ( April 2021), it is presumed you have Covid 19 infection. Treat accordingly. If available, get RT-PCR test done for COVID 19. Only if RT-PCR test facility is not there, Rapid Antigen Test or CBNAAT may be done.

A. General Care

Strict isolation at home. All positive patients in the same house do not have remain in different rooms.

Monitor your temperature six hourly. If temperature rises above 101, take tab paracetamol 650mg.

Monitoring blood oxygen level by pulse oximeter, 6 hourly. If reading 94 or higher, nothing to worry. If reading drops < 94, start deep breathing exercises (Pranayam). Lie on your tummy (not on your back) for as long as you can; this will make your oxygen level better. If not getting better, see if you can do a six minute walk test.
* Please note that the period in which oxygen level may fall is generally from day 5 to day 11 from the date of onset of first symptom. If lying in prone position for six minutes does not improve level above 94%, then supplemental oxygen is needed.

Normal diet (Patient with comorbidities need to continue to follow illness specific dietary restrictions).

Drink sufficient fluids (Patient with comorbidities need to adjust fluid intake as needs to be for each specific comorbidity).

B. Blood Tests: Normally no blood test is needed in mild cases. In those with severe symptoms (high fever, severe diarrhoea, severe fatigue etc.), the following tests may be done (fasting) as baseline:

a. CBC

b. CRP

c. LFT

C. Treatment: There is no specific treatment for COVID 19 (Corona virus infection). Only treatment for relief of symptoms is needed.

• For fever/body pains/headache: Paracetamol SOS.
• Sore throat: warm saline gargles.
• Throat irritation, sneezing or running nose: Tab Cetirizine (Zyrtec): One tab once a day
• Dry Cough: Tab Montair LC; one tab per day
• Wet Cough (with phlegm/sputum): Bro-Zedex Syrup, 1 or 2, teaspoons thrice daily.
• Loose motions:
  • Take Electral Oral Rehydration Powder, as many times as needed;
  • In severe diarrhoea, Tab Imodium 2 mg as needed.
  • Also take Curd, at-least once a day.
  • Eat light meals.
• General immunity boosters: a. Tab Zinc 50 mg (Tab Zinconia) for 15 days.

Those with co-morbidities such as obesity, diabetes, high BP, asthma, kidney disease, smokers, chronic chest diseases, history of lung tuberculosis, etc): Continue all medicines already being taken for chronic illnesses like high BP, diabetes, thyroid illnesses, asthma, cancer, arthritis, etc They may also do the following tests, in addition (on advise of your doctor): Serum Ferritin, LDH, D-Dimer, Interleukin 6. These tests are NOT a must. Those above 70 years of age or who have had diabetes, hypertension or kidney disease, also do: KFT.

Need for HRCT chest: Those with normal (>94) oxygen level do not need HRCT of the chest. It is to be done only if oxygen consistently remains below 94, or there is severe breathlessness. CT score being done these days may have interpretation issues, and hence do not get alarmed.

Note:

Please do not give/take Fabiflu (Favipiravir) Doxycycline, Ivermectin or Azithromycin as none of these has any proven role. These may harm the patient as all medicines have side effects. Most common side effects of most of these drugs are nausea, vomiting, abdominal pain, loose motions. These unfortunately are also symptoms of the illness.

Steroids (Medrol/Dexona) are prohibited and dangerous for those having normal oximeter reading. Only those who need more than 3L/min supplemental oxygen support should receive a short course for five days. Early start of steroids can make the condition worse and even cause death.

Neither Inj Remdesivir nor convalescent Plasma is of proven value. So do not worry too much if these cannot be arranged. Neither of these will change the final outcome.

Much more important than blood tests or HRCT findings is the oxygen saturation level as seen in the finger oximeter. This is the key to management of Covid 19.