If a covid patient at home has a dip in oxygen levels (<94%) despite a 6 min walk test that means they need to get admitted in a covid bed with at least oxygen.
If a bed is available, public or private, get them admitted without DELAY
No If No But
.....
After reaching hospital, hospital says only bed with O2 available, no ventilator
Mistake that people do this travel around looking for bed with ventilator (just in case)
My suggestion would be to get admitted if a bed with O2 is available esp in these times.
...
At home, monitor O2 every two-four hours using a pulse oximeter. DO NOT take this lightly.
*O2 - oxygen
Covid-19 management guidance AIIMS New Delhi Apr 2021
If having mild symptoms, oxygen saturation is maintained, no comorbidity, isolate at home
There is no point doing CT scans and other investigations as long as your saturation is maintained and symptoms are mild
This reduces a lot of panic
I say this with full responsibility
Do NOT take unnecessary medications while on home isolation for mild COVID19 🙏🏻
Plenty of fluids, lemon juice (normal diet)
Paracetamol if required
Follow a routine even when on home isolation
Be in touch with someone who is knowledgeable, has a calming influence and provides realistic advice
At Community level (for civil society, political/rel/spiritual groups
Organise for access to portable pulse oximeter
Every family may not have but especially one ward must have
Community action for health for home isolation has an untapped potential to destress hospitals
We as Indian public, media as well as the Govt lose the plot when we start talking about absolute numbers and vaccinating entire population, at least for now
1/n
For immediate reduction in hospitalisation and deaths (within 4-6 wks), we should ensure a rapid and wide coverage of COVID-19 vaccines in >45y population.
So
Ask data for coverage among these vulnerable pop.
Ask, is the current CoWin dependent strategy appropriate?
2/n
>45 are roughly one-fifth of the population. We should cover these using our public health vacc system thru decentralised approach (no need for CoWin). If vacc supply is the issue use sectoral approach. By spreading out thin we are not denting admissions and deaths.
3/n
Thread 🧵
India should urgently change its COVID-19 vaccination strategy - why and how? @MoHFW_INDIA@NITIAayog
(1/25)
Change in strategy is not as simple as making vaccination open to all (vacc criteria).
Still after 35 days of phase II, the numbers suggest that the coverage among elderly is abysmal and this needs immediate correction
(2/25)
Opening the vaccination to all will spread thin the already available doses. And it will also be an implementation nightmare.
This sounds fine at individual level but impractical and not correct at population level.
Again context specific exceptions could be made
@BWDDPH @BWDDPG @janisfrayer@pash
I watched the video with interest. I have been following the COVID-19 numbers and here is my take esp on the deaths.
To infer the extent of COVID-19 mortality in India using ‘reported’ COVID-19 deaths is not correct. Let me explain.
(1/n)
@BWDDPH@janisfrayer@pash In a scenario of very high seroprevalence (20%), very low covid case detection rate (3.6%), very poor coverage and quality of routine death surveillance (18% coverage), and low % of deaths in hospitals (34%), for me the reported covid deaths are waay lower
(2/n)
@BWDDPH@janisfrayer@pash Also, There is limited excess deaths data in public domain, there are no post mortem COVID-19 studies (testing all deaths post-mortem in a study area / period for COVID-19), we are not reconciling data from routine death surveillance (however good or bad it is)
(3/n)
I will share death registration and medical certification of cause of death coverage in India-state by state. One tweet per day.
In the absence of reliable cause of death data, how can we effectively plan to reduce cause specific deaths? (1/n) #CRS#MCCD#RoutineDeathSurveillance
In India,
86% of estimated deaths are registered (CRS report 2018)
21.1% of registered deaths undergo cause of death certification (MCCD report 2018)
Therefore
18.1% (86%*21.1%) of all estimated deaths undergo registration along with cause of death certification
(2/n)
In Andhra Pradesh,
100% of estimated deaths are registered (CRS report 2018)
14.9% registered deaths undergo cause of death certification (MCCD report 2018)
Therefore
14.9% (100%*14.9%) of estimated deaths undergo registration along with cause of death certification
(3/n)