New Ways to Handle Corona

Most are scared of the rising number of corona positive cases in the community. Now approximately 60000 cases are daily added in the list of positive cases in our country. Same time, there is a remarkable recovery rate of 18,000 to 20,000 per day with the overall death rate is at 1.9%.

Medical experts across the globe have had some time to understand the biology and aggressiveness of covid virus, which has benefited the community at large.

There are 4 factors that are helping all medical experts to give the best treatment to all clinically affected persons.

· In the beginning, the cause of death following corona infection was severe lung infection (pneumonia), so an artificial breathing machine (ventilator) was used as a rescue for recovery from pneumonia along with other supportive therapy with dismal results.

Now the most critical medical event following this infection is the formation of blood clots in small blood vessels of the lung by a corona virus. In normal circumstances, the oxygen exchange happens between small blood vessels and lung alveoli.

The blocked vessels simply mean that there is an inadequate oxygenation process is happening in the lung and ultimately person will have a low oxygen level.

Blood thinner has improved blood circulation by preventing the process of blood clotting. So ventilators are not needed in most of covid cases in the current treatment algorithm.

· Earlier, there was a sudden deterioration in the condition, and the healthcare system was unable to salvage the patient.

This phenomenon was different from other types of lung infections. Now it has been learned that following corona virus infection, the affected person will have low levels of oxygen level in the body.

Corona virus has hampered/blunted the activation of bodily response, so people will not have symptoms till oxygen level drops significantly below 70%, in contrast to normal people who feel breathing difficulty if oxygen level drops below 90%.

Earlier, in a conventional way, the person is admitted only if they develop breathing symptoms. Now the person is actively monitored at the hospital or at home for oxygen level by pulse oximeter, an affordable and portable device, without keeping patients in ICU. The proactive institution of oxygen therapy has helped to active better results.

· There is an over-active response of own immune system against virus, medically labeled as Cytokine Storm.

In the usual situation, such a response of the immune system help to kill virus or bacteria. But over-response is good at one end to kill a virus but its high severity also creating a physiological insult and damage to other organs.

Now such a cascade of event had improved the understating that such over-response should be proactively terminated before it can be lethal. Many surviving doctors have shared the doomed to death experience because of cytokine storm.

Now doctors are using steroids, old-time, well tested, effective, and affordable medicine to control over-activation of the immune system.

The newer drugs (Remdesivir and Tocilizumab) are being also used to decrease the severity of cytokine storm. The newer medicines are not only help to alleviate the severity of the symptoms but also to maintain the oxygen level at an acceptable safe range.

· Special position to improve Oxygen level:

In an attempt to improve oxygen levels with the use of medications, critical care experts have added time tasted physiotherapy in the prone positions (face-down and back upside).

As the patient is getting stabilizing, doctors are getting more time to add supportive therapy of lung position, overall results are getting better.

Now a large number of cases are increase wing, so home care and home quarantine have become an integral part of the care.

Vaccinations against corona is a major process that takes it time: need a product with sustainable efficacy, safety in human and then mass production to meet the need of all global human being.

In such a scenario, early access to covid center, monitoring of oxygen level, and lying down at a prone position will help to tide over the crisis.