Author: noorali

About 80 per cent of the people with COVID-19 recover from the disease without needing special treatment. Majority of the children and young adults do well as well. But some people are not so lucky. They end up with serious illness.

Around 20 per cent of the people who are infected with COVID-19 develop difficulty in breathing and require hospital care. People who are aged over 60 years, and people who have underlying medical conditions such as diabetes, heart disease, respiratory disease or hypertension are among those who are at greater risk.

Current evidence suggests that the severity of COVID-19 disease is higher among smokers. Smoking impairs lung function, making it more difficult for the body to fight off respiratory disease due to the virus. Quite often these patients end up in ICU.

COVID-19 patients (smokers or non-smokers) who end up in ICU face many challenges. Studies have shown prolonged length of stay in ICUs is associated with long-term disability. About 25 – 80 per cent of patients admitted to an ICU will have new or worsened physical, and mental health impairments that persist beyond discharge from the hospital.

In those with a prolonged length of stay, defined as one week or longer of mechanical ventilation, patient age and length of stay in an ICU affect their mental and physical functions at one year after discharge from the ICU. Unfortunately, physical impairments after critical illness can last for years.

Long term exposure to sedation and immobility in the ICU leads to severe weakness. This prolongs the recovery time. This can affect up to 50 per cent of patients discharged from the ICU. The weakness may persist after hospital discharge, lasting more than 24 months in about 10 per cent of cases.

Fatigue, joint contractures and peripheral nerve injuries are frequently reported, affecting activities of daily living, including grooming, feeding, bathing and walking.

Many COVID-19 ICU patients have problems with memory, attention, problem solving and execution of complex tasks. This may persist one year after discharge form the ICU.

Up to 35 per cent of patients may end with mental health disorders. Even caregivers may be affected with mental health issues. Anxiety, depression and posttraumatic stress disorder can affect COVID-19 patients and their caregivers.

No robust intervention has been shown consistently to improve recovery after prolonged ICU stay.  A comprehensive multidisciplinary approach that includes rehabilitation specialists, psychiatrists and neurologists may be required and continue after hospital discharge.

What is the recovery time for the coronavirus disease?

The median time from onset to clinical recovery for mild cases is approximately two weeks and is three to six weeks for patients with severe or critical disease.

Mortality rate has improved over the last six months or so as scientists are learning more about the disease. The mortality is broadly consistent across the world; as the pandemic has progressed. ICU mortality rates have reduced from more than 50 per cent in March 2020 to close to 40 per cent at the end of May 2020. It may be better now.

Prevention is better than going to ICU. So, continue to follow prevention guidelines as they evolve as we learn more about the new virus. Wear a mask, maintain physical distance, wash your hands frequently and take care of your family and friends.

Start reading the preview of my book A Doctor's Journey for free on Amazon. Available on Kindle for $2.99!

According to WHO website, ‘herd immunity’, also known as ‘population immunity’, is a concept used for vaccination, in which a population can be protected from a certain virus if a threshold of vaccination is reached.

If 90 per cent of the population is vaccinated then the rest of the population is generally protected by the concept of herd immunity. Herd immunity is achieved by breaking the chain of transmission of the virus by immunization.

Important point is herd immunity is achieved by protecting people from a virus, not by exposing them to it.

Unfortunately, herd immunity cannot be achieved with COVID-19.

Currently, we do not have a vaccine against the virus. Vaccines train our immune systems to create proteins (antibodies) that fight disease, just as would happen when we are exposed to a disease. Vaccines work without making us sick.

The percentage of people who need to have antibodies in order to achieve herd immunity against a particular disease varies with each disease. For example, herd immunity against measles requires about 95 per cent of a population to be vaccinated. The remaining five per cent will be protected by the fact that measles will not spread among those who are vaccinated. For polio, the threshold is about 80 per cent, says WHO website.

There are two ways to herd immunity for COVID-19 – vaccines and infection.

Vaccines: Using the concept of herd immunity, vaccines have successfully controlled deadly contagious diseases such as smallpox, polio, diphtheria, rubella and many others. People who oppose vaccines do pose a real challenge to herd immunity.

Natural infection: Herd immunity can also be reached when a sufficient number of people in the population have recovered from a disease and have developed antibodies against future infection.

However, there are some major problems with relying on community infection to create herd immunity.

It isn’t yet clear if infection with the COVID-19 virus makes a person immune to future infection. Even if infection with the COVID-19 virus creates long-lasting immunity, a large number of people would have to become infected to reach the herd immunity threshold.

Experts estimate that in the U.S., 70 per cent of the population – more than 200 million people – would have to recover from COVID-19 to halt the epidemic. If many people become sick with COVID-19 at once, the health care system could quickly become overwhelmed. This amount of infection could also lead to serious complications and millions of deaths, especially among older people and those who have chronic conditions.

In most countries, less than 10 per cent of the population have been infected with COVID-19. It would be scientifically problematic and unethical to expose millions of people to the virus to achieve herd immunity. Letting COVID-19 spread through populations, of any age or health status will lead to unnecessary infections, suffering and death.

We are still learning about immunity to COVID-19. Most people who are infected with COVID-19 develop an immune response within the first few weeks, but we don’t know how strong or lasting that immune response is, or how it differs for different people. There have also been reports of people infected with COVID-19 for a second time.

Until we better understand COVID-19 immunity, it will not be possible to know how much of a population is immune and how long that immunity last for, let alone make future predictions.

It is crucial to slow the spread of COVID-19 virus and protect individuals at increased risk of severe illness. Wear a mask in public, maintain social distance, avoid big gatherings and wash your hands frequently.

Prevention is better than cure. If you have cough, fever, and difficulty breathing, seek medical care early.

Start reading the preview of my book A Doctor's Journey for free on Amazon. Available on Kindle for $2.99!

“The new realities of working from home, temporary unemployment, home-schooling of children, and lack of physical contact with other family members, friends and colleagues take time to get used to. Adapting to lifestyle changes such as these, and managing the fear of contracting the virus and worry about people close to us who are particularly vulnerable, are challenging for all of us. They can be particularly difficult for people with mental health conditions,” says World Health Organisation.

Fortunately, we can do a lot to look after our own mental and physical health and to help others who may need some extra support and care.

Here is a list of 10 things you can do to keep yourself and your family safe, healthy and happy:

1. Fear of COVID-19. It is normal to be afraid of COVID-19. But if you follow the rules laid down by the health officers then you do reduce your risk of contracting the illness. It also helps keep your family stay healthy.

2. Loneliness, anxiety and depression. Loneliness is the state of mind. You can be in a company or relationship and you may feel lonely. You may be alone and feel sorry for yourself. It’s a feeling of sadness or even anxiety that occurs when you want company. Humans are social animals. Our connection to others enables us to survive and thrive. So, stay connected with your family and friends. Talk to them frequently and laugh with them.

3. Fear of fake news. Follow trusted news channels, such as local and national TV and radio. WHO website is another place to check for facts.

4. Maintain your daily routine. Early to bed, early to rise and go for a walk, go to a gym or workout at home.

5. Control your desire to eat. That is the best way to control your weight. If you are spending more time at home due to the pandemic then organize your eating routine. Avoid snaking in between meal times. Remember, it is easy to put on weight but very difficult to get rid of it.

6. Dangers of alcohol and drugs. Do not start drinking alcohol if you have not drunk alcohol before. Avoid using alcohol and drugs as a way of dealing with fear, anxiety, boredom and social isolation.

7. Support your children. Your children need your attention with at-home learning and make sure time is set aside for play. Help children find positive ways to express feelings such as fear and sadness. Sometimes engaging in a creative activity, such as playing or drawing, can help you with this process.

8. One for all, all for one. Each individual should act for the benefit of the group, and the group should act for the benefit of each individual. Even if we cannot be close physically, we need to stay close emotionally and reach out if someone needs support.

9. Protect yourself and protect others. Wearing a face mask is becoming mandatory in many places. You must also consistently and strictly adhere to good hygiene and public health measures, including frequent hand washing and physical (social) distancing.

10. Finally, have a sense of purpose in life. Make the best use of the time you have due to the circumstances beyond your control. Be in charge of your dreams and wishes. Never lose hope. Never give up. Tough times never last but tough people do.

Take care. Be safe. We can win this battle together.

Start reading the preview of my book A Doctor's Journey for free on Amazon. Available on Kindle for $2.99!