My Covid Advisory – For those who have tested positive after getting vaccination. (September)

• People who are fully vaccinated are now testing covid positive. Is there something wrong with the Indian vaccines we received ?
  • Apparently No.
• The virus will mutate. Whenever the mutation is significant, the older vaccine may not be 100% effective.

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What to do when someone who gets the infection after full vaccination ?

If any near and dear one is found Covid positive, even after fully vaccinated, Don’t panic. Follow this advisory and contact your physician SOS.

If you are vaccinated, most likely you will remain asymptomatic. But you must self monitor for 3 weeks for the following Vital Signs.

• OXYGEN >94%
• PULSE    <94/min
• TEMP    <100°F
• RESPIRATION <24/min
• URINE: Adequate

A 6 min walk test is the best method to put your breathing on stress and measure the response. Also we must rule out other causes of fever like Dengue etc. even if the Covid test are positive. It’s always better to go for an oximeter check when the patient is asleep in the night..

Here is a modification of my earlier advisory regarding drugs and precautions.

1. IVERMECTIN 12mg :  OD 3 days ( No harm)

2. DOXYCYLINE 100mg: BD 5 days ( any short course of antibiotic will do.)

4. Cetrizine OD 8pm ( BF)
(Montek LC/Allegra will do)
           
5. Paracetamol 650mg (for Fever >100°F ) One AF as and when required.

6. Vit C 500mg: OD x 10 days, BF

7. Vit D3 60K: weekly x 4 weeks

(OD -Once a Day) & (BD -Twice a Day)

( These are safe drugs with minimal side effects) Should be taken after food (AF) or before food (BF)

8. Plenty of warm water.( your normal+ 2.5 ltr)

Usually Fever comes down on Day-5.
If not consult your doctor.

Do not start steroid on your own.
Baseline investigations you require

• CBC
• CRP
• Sugar profile
• LIVER PANEL
• Renal panel
• Some special tests and radiography to be done if advised by your doctor.

( Please Don’t Self medicate, consult your doctor. this is only a ready reckoner0

1. FEVER & BODY PAINS
2. COLD & COUGH, BREATHLESSNESS
3. DIARRHOEA
4. Loss of SMELL & TASTE 
5. Red Eye, Toe
6. Rash over hands and legs 
   …

3️⃣ Observe Vital Signs 4 hourly and maintain a chart

1. OXYGEN >94%
2. PULSE    <94/min
3. TEMP    <100°F
4. RESPIRATION <24/min
5. URINE: Adequate

.. Continue your regular medication for DM, BP.

Risk Factors:

• Obesity
• Diabetes, BP
• Old age (65+ )
• 55+ with medical conditions
• Front line workers in frequent public contact

1. Breathing Exercises – Good
2. Meditation – OK
3. Steam Inhalation – OK
4. “6 min” WALKING
   ( should not have breathing difficulty after 6 min walk)
5. Warm Saline Gargling 
6. Sleep on your belly for half an hour ( Prone position)

For other General Complaints:

1. Acidity: Pantoprazole 40mg BF
2. Body pains & Fever : PCM 650mg : AF
3. Cough: Cough Syp, Allegra
4. Vomiting: Ondem 4mg : BF

1. Thermometer, 
2. Pulse Oximeter,  
3. Rotahaler ( Asthmatics)
4. Glucometer ( Diabetes)

Your Oximeter will give you pulse rate, O2 saturation levels. You can take BP measurement if you are a BP patient or sugar chart if you are diabetic. all dat should be recorded 4 hourly without fail.

Date	Time (4_hourly)	Temp	SpO2	Pulse	BP	Action taken	Remarks
						(Medicine etc)

( If fever, breathing difficulty continues > 5 days)

X-ray

1️⃣ Xray chest or HR CT Chest. ( Day-5)

BLOOD

2️⃣ *Inflammatory markers*

• CRP (q) daily
  • hs-CRP does not have any added advantage.
• D Dimer 
• PT INR
  • For Thromboembolic episodes.
• Ferritin
• LDH
• (Procalcitonin)

3️⃣ Special tests (if available)

• Cardiac marker
  • hs-Tn
  • NT-proBNP
• Covid inflammation markers
  • IL-6 
    • IL-8
    • TNF-α

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With the Vaccination, markets will be opened up. Covid Appropriate Behaviour are more essential than the past. It is more important to follow universal precaution of a respiratory virus.

👉SMS protection:

• Sanitizer/ Soap Water 
  • Mask, 
  • Safe Distance

( This is a General Advisory. Please take Doctor’s advice if any doubt)

We Advise, God Cures.

Compiled by: Dr Ramakanta Mahapatra