[shashank.nk]

Had a bit of a scare the last two weeks with me showing all symptoms of a asymptomatic COVID infection which luckily turned out to be a regular viral infection and not COVID-19.

On October 3rd when I checked the Arogya Setu app it told me i'd come in contact with a infected person the previous day (October 2) near my home. However, I ignored it as I'd taken my parents for their quarterly health check up during which time my phone was connected to the car bluetooth and the only time I stepped out of the car was to open and shut the gates to my home and wore a N95 mask all through using 3m avagard and dettol disinfectant spray adequately.

I waited two days and as I had no symptoms I resumed my workouts after nearly a month and got a moderate HIIT session done on Monday October 5th. Later that night around 3am I woke up feeling feverish and cold though I was under a comforter, so checked the temperature and I had a 101F fever. Took a pill and somehow managed to sleep. The following morning I went to my regular doctor who suggested some medicines and asked to go in for a COVID test 2 days later if there was no improvement in my condition and advised me to completely isolate myself from family members.

Within two courses of the medicine, the fever vanished and I felt normal. So on October 7th I had no fever, tiredness or cold. I continued the course of medicine and decided to skip the COVID test (thanks to scary quarantine center stories) much to the disappointment of my doc wanted me to go just to be absolutely sure.

The next 4 days were uneventful, but on 11th Sunday, when my mom had prepared some tasty Biryani for lunch I ask her why there's no salt, spice and food tastes so bland. Lo and behold I'd lost sense of taste and smell.

I called up doc again and he suggested I go in for a COVID test but also suspected it may just be a severe viral infection and not COVID. I managed to get a test done twice this week (first at a private lab and second time from BBMP) and both turned turned out negative which was a huge relief. I still haven't got sense of smell or taste though! So even if you have a lot of symptoms, it might not be COVID but do ensure you get tested to rule it out.

[guptavis]

Originally Posted by SoumenD

Hows the situation now? Purely from published numbers POV on Covid-19 website looks like we are off the peak(90k+/-) now to 60k levels for 10-11L tests per day . Is that so in real sense as well? News channels are full of garbage news so prefer hearing it directly from the doctors on forum who are seeing it real-time.

I can't say for the entire country but i can tell you for sure that the hospital load around chandigarh and punjab has gone down considerably. I and my father got infected towards the end of september and hospitals were overflowing. We could only manage a hospital bed due to my cousin being a doctor. But now things are much better, there is availability of beds in hospitals. Another of my cousins who is a doctor, works in a large ludhiana hospital and while in september end he was finding it difficult to arrange a bed even for family members, he says the now number of covid patients in his hospital have less than halved.
So testing may have reduced or not. But the number of hospitalisations has gone down considerably and that I think is a very good indicator of the prevalence and spread of virus.

Originally Posted by vivek95

On August 8th 2020, I had first done my Total Antibody (IgM+IgG) level that was highly reactive at 46.2 AU/mL ( Arbitrary units/mililitre ). Remember, the cut off value stands at 1.0 AU/mL.

Yesterday on 16th October, 2020, I repeated the test and here are my results ( very very reactive ) -
1. Total Antibody level (IgM+IgG) = 68.8 AU/mL
2. Only IgG in isolation ( more important ) = 69.3 AU/mL

By God's grace, after working in Covid ICU in Mumbai for straight 8 months, I am myself protected and able to protect others as well I believe. Two visits to hometown in last 2 months (Belgaum) and probably my antibody levels have kept my parents and friends safe. Thanking Almighty, and I have already signed up for plasma donation

Hello Dr. Vivek,
I got fever on 25th September and was tested positive for covid-19 on 27th September. Though I have been declared recovered now, i still have some fatigue and cough. Is it recommended to get a test for antibodies done?

Is plasma therapy being used now? I remember reading that it was not as helpful as thought earlier. If it is when can I donate plasma?

[DCEite]

Originally Posted by SoumenD

Hows the situation now? Purely from published numbers POV on Covid-19 website looks like we are off the peak(90k+/-) now to 60k levels for 10-11L tests per day . Is that so in real sense as well? News channels are full of garbage news so prefer hearing it directly from the doctors on forum who are seeing it real-time.

Not a doctor but number of reported cases indeed are going down in my locality. And if i extrapolate to my city the cases are way less reported then what was couple of months ago.

Definitely there is a downturn in the real sense. However, it can't be explained. Its a similar case with Pakistan and Bangladesh, they too are on a downward spiral, without achieving herd immunity.

[vivek95]

Originally Posted by Thad E Ginathom

Excellent. Do you think that there is a chance that continued exposure may be keeping your antibodies high? Just wondering.

It is highly possible that my continued exposure to Covid patients until date might have increased the antibody level in my body. However, it is more to do with normal immunological response where the antibodies tend to keep growing over a period of time after the primary exposure itself. Levels will plateau at some point. Honestly, I too need to go back and read more on this, will get back here if I find something worthy to share.

Originally Posted by guptavis

Hello Dr. Vivek,
I got fever on 25th September and was tested positive for covid-19 on 27th September. Though I have been declared recovered now, i still have some fatigue and cough. Is it recommended to get a test for antibodies done?

Is plasma therapy being used now? I remember reading that it was not as helpful as thought earlier. If it is when can I donate plasma?

Hello

Glad to know you recovered from Covid. As such, antibody test is not recommended at all. We only advice antigen tests when we suspect and want to treat covid patients. Once symptomatically recovered, we never advise antibody test to anyone as it is rather understood that antibodies would have developed. Anyone can get it done though without prescription because of easy availability, usually to alleviate some apprehensions or out of curiosity. That said, if interested, get your antibody level tested after another week. No, plasma therapy is not standard and practiced much. Infact not many encouraging results or studies. I signed up just in case, it's contemplated for any patient by my chief. When God has graced me with so much antibody levels, I would wish some needy to get benefitted out of it, that's all.

Your cough and fatigue will subside for sure, however keep a close watch on how bad the cough is and don't delay in consulting a physician.

Fresh Covid cases are definitely decreasing in Bombay.

[Thad E Ginathom]

Oh yes! How nice it is to see some downward movement in the graphs.

Everybody stresses, though, that passing the peak (if there is one peak) can only be maintained by keeping up the precautions. Onam seems to have set Kerala back, now we have Durga Puja (I see the courts have stepped in) and Navaratri. And Diwali to come. In this part of India, it is the pre-festive shopping that seems to pose the greatest threat --- and I saw a depressing picture of heavy crowding in a Chennai silk shop today. The caustic caption was to the effect of "Quite safe: there isn't any room for Corona!"

Late in the day to say it, and I think they may be cutting back now, but I appreciate that Chennai corporation has been doing house-to-house checks. Our lady calls early morning, and I'm never awake. It seems they suffer a lot of abuse, which is a great shame. Even my wife politely asked her not to call daily, and took her phone number.

Also, mild cases have been advised to quarantine and rest at home for a while. Now the local authority has introduced a care package of medicines and medical-advice contacts. Hope this turns out to be effective. Nobody wants to go to hospital unless they have to.

I read about a new nasal vaccine recently. It seems that that is now going to be made in India and may start tests soon.

Just... it's good to read about all the vaccines and research, but the testing makes it an interminable (seems like it) long way away. I'm not complaining: the last thing we want is rushing to give millions a vaccine that may have bad side effects. Better to wait.

[DigitalOne]

Originally Posted by Thad E Ginathom

Oh yes! How nice it is to see some downward movement in the graphs.

These days Chennai-ites are more concerned about their team (non-) performance in IPL

[Gansan]

Originally Posted by Thad E Ginathom

and I saw a depressing picture of heavy crowding in a Chennai silk shop today. The caustic caption was to the effect of "Quite safe: there isn't any room for Corona!"

Also, mild cases have been advised to quarantine and rest at home for a while.

The shop was "Kumaran Silks" and the occasion was clearance sale! I read the shop was sealed today by Corporation officials for non compliance with Covid 19 SOP.

They are indeed recommending home quarantine for mild cases. There are two cases in our apartment complex, one of them (my relative whom I mentioned earlier) about to complete his quarantine in a few days.

In another part of the city, my cousin's husband and her daughter-in-law tested positive, while she and her son tested negative. They have allowed home quarantine for only one - either one - of them, though both are very mild cases. The other has to go to some hospital of their choice, because it is a two bedroom apartment and the bathrooms are attached to the bedrooms. The negative people have no bathroom to use. If they had a third one, both could have remained in home quarantine. So the daughter-in-law chose to go to a corporate hospital (she has very good cover from her employer) and the father-in-law remains home.

[am1m]

The wife just got off the phone with a friend who wanted to invite us for lunch over the weekend. When we suggested that it might be better to meet somewhere outdoors, order some food and eat outdoors, that friend first gets offended and then mentions not being comfortable because "eating outside food is risky"! (But apparently spending hours indoors with people who are not from the same household is absolutely safe!)

Seen this right from the start, each of us will find some way to rationalize the activities we think are necessary and use 'covid risk' as an excuse to sanction those activities we don't want to do or that are not important to us. This is the sort of thinking that sees neighborhood parks being closed 'because of virus spreading risk' but wedding halls being allowed to function!

[vivek95]

It's official now. Remdesivir finally gets US-FDA approval as the first and only drug to be used in the treatment of Covid-19 patients. The approval is backed up the results of three Randomised controlled trials -
1. NIAID USA ACTT-3 phase 3 trial
2. SIMPLE-Severe trial
3. SIMPLE-Moderate trial

"Veklury" ( trademark name for Remdesivir, developed by Gilead life sciences, USA ) is the only drug now FDA approved. Remember that just last week WHO released its interim results of "Solidarity trial" that was conducted across more than 400 hospitals in 30 countries. Solidarity trial had dismissed the effectiveness of Remdesivir as it showed to have no benefit. However, the Solidarity trial structure was questioned and criticised. And here we now realise that things are not over yet. In my experience, yes, the drug couldn't have been written off so soon. I have personally seen improvements. However, Oxygenation and steroids are of most paramount importance for us in treating patients.

Anyways, Remdesivir it is now !!

Source of info - Its all over the internet

[ObsessedByFIAT]

I feel people have now got used to Corona staying finding its place around us. The fear is all gone.

Not blaming any particular party or trying to be politically influenced; however, look at the poll rallies being conducted in Bihar.
Step out to any near by market in your area. It's again the same chock-a-block situation. Masks are either missing or are worn everywhere except for covering what they are supposed to cover.
Even the vloggers who are followed by quite a large number of people are hitting the road and not one vlog mentions anything about the corona and care thats needed.

[Thad E Ginathom]

Originally Posted by ObsessedByFIAT

I feel people have now got used to Corona staying finding its place around us. The fear is all gone.

It's a bit like drivers slowing down when they know there is a police speed check. Once past, then back to normal.

This social behaviour with corvid is terrifying.

[sumeethaldankar]

The government is planning to distribute the vaccine free of charge to all Indians once it is made available. While this is a nice initiative on part of the government when it happens, a part of me is telling that nothing is free and we would most probably be seeing some "Covid-cess" etc on products like "petrol" and "diesel" to "pay" for what we were led to believe was given to us for free .

[Zen2001]

Originally Posted by vivek95

It's official now. Remdesivir finally gets US-FDA approval as the first and only drug to be used in the treatment of Covid-19 patients. The approval is backed up the results of three Randomised controlled trials -
1. NIAID USA ACTT-3 phase 3 trial
2. SIMPLE-Severe trial
3. SIMPLE-Moderate trial

Anyways, Remdesivir it is now !!

Source of info - Its all over the internet

Source

The SOLIDARITY study spans over 400 hospitals in more than 30 countries and looks into the effects of these treatments on various indicators, including their ability to prevent deaths and shorten hospital stays. The trial involved more than 11,300 participants. It's IRONIC how such a diverse and robust, (hence most likely unbiased) trial is challenged by smaller single institute based selective trials.

The main aim was to help determine whether any of these repurposed therapies could at least moderately affect in-hospital mortality, and whether any effects differed between moderate and severe disease, said Dr Sheela Godbole, national coordinator of the Solidarity Trial in India. The initiative included 26 trials in parts of India with a high burden of cases. As of October 15, 937 hospitalised Covid patients were participating, Dr Godbole said.

None of the drugs was able to prove benefits across the parameters studied, especially in reducing mortality among hospitalised patients. The interim results, made available on a pre-print server, said these drugs had “little or no effect” on hospitalised Covid-19 patients “as indicated by overall mortality, initiation of ventilation and duration of hospital stay.

Drugs like hyrdoxychloroquine and lopinavir, in fact, had already been dropped over the course of the last six months for not showing much promise.

What are the findings on remdesivir?

“The mortality findings contain most of the randomized evidence on Remdesivir and Interferon, and are consistent with meta-analyses of mortality in all major trials,” the paper stated. Interferon was dropped from the trial on Friday.

The findings struck a nerve with American biopharmaceutical firm Gilead Sciences, which developed and patented remdesivir. In a statement, it said the emerging data “appear inconsistent” with the “more robust” evidence from “multiple” other studies on remdesivir’s clinical benefits that have been published in peer-reviewed journals. It said at least three randomised, controlled clinical trials have demonstrated remdesivir’s “benefits”. (The ones you mentioned)

Other experts have questioned the findings of the trials cited by Gilead Sciences. Dr Srinath Reddy, president of the Public Health Foundation of India and a member of the executive group of the Solidarity Trial’s steering committee, referred to a trial on over 1,000 patients in the US. “The numbers were relatively small for a clinical trial — and it turned out that the remdesivir group had better prognostic indicators than the control arm. So, in a sense, we can’t say time to recovery was because of remdesivir and not due to the other factors.

“Personal experiences are valuable. However, that does not help to compare in the clinical setting. The Solidarity Trial has commented on the value of remdesivir in hospitalised patients,” said Dr Soumya Swaminathan, WHO Chief Scientist.

[whitewing]

Originally Posted by am1m

... This is the sort of thinking that sees neighborhood parks being closed 'because of virus spreading risk' but wedding halls being allowed to function!

In the end I guess economic activity is paramount, and as humans we also need to show that some action is being taken to control the situation. So, we find/invent petty measures to retain sanity.

Originally Posted by ObsessedByFIAT

I feel people have now got used to Corona staying finding its place around us. The fear is all gone.

So true, and that coupled with the false sense that measuring temperature, a mask dangling somewhere around the face and a hand rub with the sanitizer- every thing is safe and under control!

Originally Posted by Thad E Ginathom

It's a bit like drivers slowing down when they know there is a police speed check. Once past, then back to normal.

This social behaviour with corvid is terrifying.

Tell me about it ! One of our maids insisted to travel back to her native to attend the annual festival at her village temple. This, when her kids refused to travel citing the risks.
Now, I want the lady to take a week off, post her return. Home ministry is not happy with the additional workload that will befalls on us as a consequence.
Ah! The dilemmas we have to face.

[V.Narayan]

While the brouhaha over covid19 has abated a bit the deadliness or contagiousness of the disease has not . Yesterday, sadly, I clocked my third person well known to me who died due to Covid19. He was a cousin of roughly the same age as me and just retired from State Bank of India. The other two were in their forties. The cousin was admitted for treatment at a good hospital and was recovering well when all of a sudden he had a collapse {I'm using layman's language here} of his lungs and went within a few hours in the ICU. Which ever way you cut the cloth it is still necessary to keep the precautions on and be sensible about it.