The one thing that seems to matter to prevent significant fall in saturation is timely initiation of steroids. Early initiation harmful late initiation useless.
Saturation monitoring after6 minute walk test has to be practiced from day 1-8 post first symptom. Sats drop from day 9 to 11 typically and rapidly. Initiation of inhaled and sos oral steroid a have caused a dramatic reversal in sats in such patients PROVIDED
PROVIDED it is initiated during this rapid descent in sats. Initiation at this stage. Initiation too early is harmful late has no benefit. Hitting at sweet spot causes rapid reversal but must be monitored. Seen people we say in an hour to below 92 but pick up if started faat
So 2 hourly monitoring when awake and one 4 hour sleep gap us vital on day 9 to 11
Exercise priming huffing purse lipped breathing spirometry to improve respiratory reserve from day 1-8 is important to build respiratory reserve and training for say 9 to 11.
Idea build respiratory reserve active monitoring of sats through danger zone timely steroid a 3 things that can significantly decrease hospitalization and flooding of hospitals. Active physio is also required as these patients cough out thick white painful "bronchial casts)
Another important thing is active rest in interphysiotherapy sessions as it can be exhausting during day 9 to 11
However prevention is better than cure so sanitize mask and maintain social distance. Get vaccinated when el8gible and accessible.

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More from @Prasannasimha

2 May
Have you made your evacuation plan if you need 2 go 2 Hospital ? Large paper with SRFID(&BU number in KA) emergency contacts 2 set of clothes underwear. Phone chargerAdequate Data plan. Ready cash for emergent payment credit/debit cards etc. Dropping saturation is not time2 do it
One home quatantine family started getting aggressive when I told keep thise ready ! Do you want to be a chicken running aimlessly when the hawk is approaching. Fright Flight or **Fight**. Choice is yours. Fighters survive as you cannot Flight or be frightened here.
Never be aggressive to a care gives. Survival depends on hearing him/ her. If you antagonize you are @ loss. Difficult thing to explain but remember Mareechis advice to Ravana-its easy to find sweet talkers but difficult 2 get a person to tell & listen to bitter truth-Raghuvamsha
Read 4 tweets
30 Apr
Let this be clear viral transmission is not magical- host and recipient have to come into sufficient contact and exchange of virus has to occur for disease transmission If transmission occurs - a host recipient & conducive situation to interact and exchange has to be present
Every case that spreads is a breakdown of this . In whatever manner. Unfortunately unless you are on guard - there are many a slip between the cup and the lip.
As a fully vaccinated person with neutralizing spike protein specific antibodies I am still afraid. Really afraid - it is animalistic behaviour - eternal vigilance.
Read 4 tweets
30 Apr
See the way toolkitters are throwing dung around hoping something sticks !!
You should see the troll tweets that I get and some comments saying - he may be a Doctor but ...... (some nonsense) Sorry If medicine was so simple you would be operating looking at a YouTube video. Try learning to swim using a YouTube video for starters.
I used to try to educate but you can only put only so much lipstick on a pig. I now just ignore. If toolkitters spent half their time actually promoting safe practice encouraging vaccination of elders when it mattered(instead of crying hoarse now) we would have been far better
Read 5 tweets
30 Apr
Latest lie my Mother detected-Amma doing vaccine evaluation of her contacts-found a person who had not taken-asked why my BIL told no-Amma phones her BIL who was former student of my father-
He says-I have been advising but she is point blank refusing. Amma confronted her - sheepishly tells - I was afraid after reading so many forwards and I lied - see the way malicious information has grown vaccine hesitancy
has made people who were vaccine eligible not take the vaccine and ae now in a potentially lethal situation.
Elderly people who refused vaccination - think you may go but you will drag your Family down too
Read 5 tweets
27 Apr
The conscience of every non vaccinated person must prick because if they get severe COVID they have denied another patient an opportunity for better care.
I am repeating this because I am enraged over the fact that unvaccinated people who had opportunity to get vaccinated & get severe disease are those who are blocking beds and in effect denying care to others who could have got better treatment
Just think - if we have an inundated ICU can one possibly give quality care however much one wants to? So b responsible& its not too late to get vaccinated. Remember USis now having 4th wave in New Jersey &New York right now. If not this wave another wave- your number will be up
Read 4 tweets
27 Apr
Vaccine hesitancy has been the biggest killer in the COVID epidemic. Take Karnataka's yesterdays data 180 out of 201 deaths were those who could have taken the vaccine by now. So that many occupied beds and had avoidable deaths. Its the same story vaccinated - no why - Was afraid
People are afraid of vaccines but are not afraid of dying of COVID - the irony !! Afraid of dying of clots due to vaccine but people do not realise that they are at higher risk for dying of clots after COVID over the next 6 weeks after infection.
Now those who were not vaccine eligible could have got better care and likely did not get care in time due to blocking of beds by those whose deaths were preventable and were stuck in ventilators etc.
Read 4 tweets

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