Coronavirus: A Reality That Lingers…

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Tabraiz, a 30-year-old Ward Clerk, left the Isolation Intensive Care Unit for home on January 17, 2021, eager to spend time with his family after a 36-hour long shift.

However, on his way home, he felt an unusual sense of lethargy, a scratchy throat, and an instant fear of “Have I been infected?” “My worry was not just confined to having been infected with the virus; I was also concerned of the impact this will have on my family, along with those who I have been in contact with recently.”

He became even more anxious when he thought about the conditions he had been working in.

“During the early days, the Personal Protective Equipment (PPEs) for the healthcare workers were in short supply, and the healthcare personnel had to create their own masks and suits to keep themselves safe.

The lack of proper PPEs, along with a drastic increase in daily infections, created a chaotic situation in the healthcare facilities, and put everyone involved at a high risk of acquiring the virus. As he reached home, it was midnight, and the nearby clinics were closed.

He did not feel the need to visit an emergency as the symptoms were not alarming, and also because he did not want to put others at risk, if he, in fact, has come down with the COVID-19.

He isolated himself in a separate room, and received a teleconsultation through an app in his mobile phone, where he discussed all his symptoms, along with his apprehensions, with the consulting doctor.

“As discussed with the doctor, I got my PCR test done the next morning, and, unfortunately, received a positive result the day after.

My symptoms progressed over the next five days, with the initial body aches, extreme tiredness and sore throat, giving way to diarrhea, alongside a fever of 101F, and a bit of dry cough.

My cough worsened on day 3, and I also started experiencing some chest tightness. Day 4 was the hardest day of my COVID journey, as I experienced a complete loss of taste and smell, with persistent cough, and increase in chest tightness.

The feeling of not having someone to care for me was very depressing, leaving me to feel lonely and scared.” During these hard times, Tabraiz was continuously in contact with the teleclinic doctors just a click away on his phone.

He continuously discussed all his different symptoms, and any danger signs for which he may need to rush to an emergency.

The doctors were very supportive throughout the course of his COVID experience; they not only catered to his physical signs and symptoms, but also addressed his emotional and mental wellbeing.

“On the 7th day, I felt a bit better when I woke up. Some of the symptoms were still present, but they were not as bad as they had been before.

I spoke with one of the teleclinic doctors again, updated them regarding my condition, and asked them about ending my isolation.”

“I am afraid you cannot be allowed to discontinue your isolation just yet, as the guidelines recommend ten days after symptoms’ onset as a cut-off for ending the isolation, that too if the patient has been fever-free, without the use of any fever-reducing medicines, for a full 24 hours, and with improvements in other symptoms.”

The doctor also informed Tabraiz that loss of taste and smell may persist for weeks or months after recovery, which would not have any bearing on ending the isolation.

Tabraiz was not particularly content with this reply, but the thought of him still being able to infect his family made him continue his isolation for the few remaining days.

His road to recovery was smooth because he had identified his symptoms at the earliest, and sought medical care right on time.

He also took the necessary precautionary measures to ensure that he does not spread the infection to others.

One of the most daunting aspects of his work was to witness the helplessness and the loneliness of the critically ill, hospitalized COVID patients, who did not have any family member with them during their final days.

As a healthcare worker, he had always carried the fear of contracting the infection in the healthcare setting, and, unsuspectingly, transmitting it to others. However, Tabraiz was glad that his recovery had been quick and smooth.

After isolating for ten days, the moment he stepped out of the room, tears rolled down his cheeks as he hugged his family, being thankful to have been reconnected with his dear ones. He was also grateful to the teleclinic doctors of HumWell, a teleconsultation platform.

He was glad that a service like this was available where he was able to consult with registered medical practitioners 24/7, all within the comfort of his home.

“I will, forever, be thankful for the HumWell doctors, who were there to listen to my every single concern, guiding me every step of the way.

They not only helped me with the physical manifestations of the infection, but also assisted me in battling the mental and emotional impacts of isolating.

They suggested ideas like reading books, staying in touch with family and friends through video calls, and even reconnecting with my old friends with whom I have not been able to maintain contact due to life’s hustle and bustle.

All this support sincerely helped me get through those tough moments while I was unwell.

But of course, the feeling of being able to touch or just be there with your family is a blessing which all of us take for granted, until it is taken away.

It is that physical presence of a loved one which matters the most, especially during times of need.” COVID-19 might have given Tabraiz a tough time, but he came out stronger, and with a positive attitude.

Now he uses the experience of his illness to emotionally support his patients, colleagues, friends, and family suffering from the disease.

“I just want them to know that they can count on me for the support, as someone who they can speak with at any moment they feel depressed, scared or upset.

I want people to know that ‘staying home’ means ‘staying safe’, and that in an era of technology, being able to stay connected with those who are physically distanced is extremely easy.

It is the least we can do to show our support and solidarity with the fallen ones, the frontline workers, and the unsung heroes who always show up at work so that our day-to-day necessities can be met, whether it is a shopkeeper at a grocery store, a driver of a public transport or a doctor at the hospital.”

Teleconsultation: Teleconsultation is the interaction between a patient and a clinician “for the purpose of providing diagnostic or therapeutic advice through electronic means.”

Even though it has been around for quite some time, it was not until the pandemic that its significance was greatly realized, and greater strides made towards attempting to shape it as one of the mainstream health-rendering media.

Teleconsultations: have the ability to not only reduce the workload of the healthcare facilities, but to also ensure the safety of the healthcare personnel and the patients by reducing the need for in-person visits, and thus slowing the spread of the virus.

HumWell is one such platform, offering on-demand teleconsultations, 24 hours a day.

Despite having round-the-clock availability, the service is highly affordable, with user-friendly application, which is currently available in both English and Urdu.

It is a comprehensive telehealth solution, which, in addition to teleconsultations, also provides medical record keeping, along with the ability to access the prescription for each consultation.

It also has a patient education library, and a directory of nearby healthcare facilities. COVID-19: Coronavirus Disease-2019 is an infectious disease caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), a highly pathogenic type of Coronavirus.

It was first reported in Wuhan, China in December 2019, and has, since, spread worldwide.

Spread: COVID-19 most commonly spreads by having a close contact with a person infected with the disease.

When an infected person coughs, sneezes, sings, talks, or breathes, respiratory droplets are produced.

These droplets range in size, with some larger droplets even being visible. These droplets can either be inhaled or deposited on mucous membranes, lining the inside of the nose and mouth, causing infection.

Sometimes, infection can also occur via airborne transmission, which is when the smaller droplets linger in the air for minutes to hours, infecting others who are further than six feet away or even after the infected person has left the space. This kind of transmission occurs within enclosed spaces with inadequate ventilation.

However, it is important to note that the amount of infectious virus in the respiratory droplets decreases with time.

The least common way of spread is through coming into contact with contaminated surfaces or objects, where infective droplets had landed.

A person may contract the virus by touching these surfaces or objects, and then touching their own mouth, nose, or eyes.

Staying Safe: Taking the following precautionary measures will reduce the likelihood of getting infected as well preventing the spread of COVID: ●Staying at least six feet away from others, whenever possible ●Covering mouth and nose with a mask when around others, which will reduce spread by close contact as well as by airborne transmission ●Washing hands frequently with soap and water, or using a hand sanitizer, containing at least 60% alcohol ●Avoiding crowded indoor spaces, lacking adequate ventilation ●Staying home and self-isolating when sick ●Cleaning and disinfecting frequently touched surfaces Symptoms: Since the virus can cause a varying range of disease, from mild to severe, the reported symptoms are also widely variable.

They can appear from any time between two days to two weeks after being exposed. However, it is best to note that older adults, pregnant females, and those with any of the following preexisting medical conditions are at a greater risk of having a severe illness, requiring hospitalization, or of dying: ●Cancer ●Chronic kidney diseases ●Chronic liver diseases ●Chronic lung diseases ●Diabetes Mellitus (Types I and II) ●Down Syndrome ●Heart conditions ●Hemoglobin blood disorders ●HIV infection ● Immunocompromised state (weakened immune system) ●Neurological conditions ●Obesity (BMI 30+) ●Smoking ●Solid organ or blood stem cell transplant ●Stroke ●Substance use disorders The most common symptoms include: ●Sore throat ●Muscle or body aches ● Fever ● Headache ● Fatigue ●Cough ●Loss of taste or smell ●Nausea ●Diarrhea Some symptoms are considered as ‘Danger Signs’, and should prompt immediate medical attention: ●Trouble breathing ●Persistent pain or pressure in the chest ●Confusion ●Inability to wake or stay awake ●Pale, gray, or blue-colored skin, lips, or nail beds, depending on the skin tone Testing: Diagnostic Test confirms current infection.

The “gold-standard” test for diagnosing COVID-19 is the Polymerase Chain Reaction (PCR) test.

It detects the presence of the viral ribonucleic acid (RNA) sequences that comprise its genetic material, or its fragments as it breaks down.

A person should only get tested if they have symptoms of COVID, have recently been within six feet of a COVID-positive individual for 15 minutes or more within a 24-hour period, or have taken part in activities that put them at a higher risk because of limitations on physical distancing.

The test is done using a swab, which has a soft tip on a long, flexible stick, to collect the respiratory material lining the inside of the nasal cavity.

The results are available as early as within 24 hours. Positive Result: Stay home, preferably in a separate room, away from other family members.

if isolating is not possible, then wear a mask, and maintain a distance of at least six feet from others.

Do not share personal household items, like towels, cups, and utensils. Do not leave home, except to get medical care; opting for teleconsultations will ensure that others are not inadvertently exposed.

Inform those who may have had come into contact with an infected individual recently, as an infected person can spread the virus starting two days before exhibiting any symptoms or testing positive; this will help protect others, and slow the spread of the virus.

Since the majority experiences only a mild illness, recovering at home by resting, staying hydrated, and taking over-the-counter (OTC) medicines to relieve symptoms is the best way to manage; monitor symptoms to recognize any danger signs requiring immediate medical care.

Negative result: The individual was probably not infected at the time of the sampling, or that the individual was infected, but the sample was collected too early in the infection to get a positive result.

Antibody Test confirms past infection by detecting antibodies created due to exposure to the virus.

Antibodies are proteins created by the body’s immune system to help fight off infections, and protect from reinfection. The protection offered by the antibodies varies from person to person. There have been rare reports of reinfection, which are being studied.

Vaccine: COVID vaccines are safe and effective. There are currently three types of vaccines, depending on the type of viral material that is being used; however, they all teach the body’s immune system to safely recognize and block the SARS-CoV-2 by creating antibodies.

Herd immunity: (Population immunity) The “indirect protection from an infectious disease that occurs when a population is immune either through vaccination or immunity developed through previous infection.”

The percentage of population required to acquire resistance to COVID was initially estimated to be about 60-70%; however, that number has gone up to 70-90% in recent months, based on the new available data. Vaccination Registration Procedure in Pakistan:

  • Free of cost Sinopharm vaccine-two dosages ● Age: 50+
  1. Send CNIC # to 1166 to receive the vaccination center, date, and PIN code
  2. Arrive at the vaccination center on the date, as mentioned in the SMS
  3. Get vaccinated
  4. Second dose due after 21 days Private Vaccinations As of April 2, 2021,

Russia’s Sputnik V vaccine has been made available to the public, 18 years and above. It costs Rs. 12, 268 for the two doses, given 21 days apart.

Side Effects: Most are mild, and should not last longer than a week. Those after the second dose may be more intense, but are still considered normal.

OTC medicines can be taken to alleviate the post-vaccination side effects. ●Pain, redness, or swelling at the injection site ●Headache ●Muscle pain ●Fever ●Chills ●Fatigue ●Nausea Immunity is not achieved until two weeks after either the second dose of a two-dose vaccine or the one-dose vaccine.

Fully-vaccinated individuals can start doing some of the activities that were stopped due to the pandemic.

However, continue to follow the safety precautions of wearing a mask and maintaining at least six feet of distance when around people who are not from your household, and avoiding large gatherings.

CONCLUSION: COVID-19 has proven to be a challenge, from its emergence back in December 2019, until the present day.

It continues to baffle the entire world with its changing behavior, different strains springing up throughout the planet. It is proving to be an enigma requiring a concerted effort from the global community to join forces to triumph over it.

However, even in this period of uncertainty, what is certain is that the human species, as a whole, has the power to overcome the most adverse of thecircumstances together as a global community.

We all have acted as one family to keep each other safe, by taking heed of the precautions laid down by our governments and health institutions.

We all have shed tears for those who have lost dear ones to this battle against COVID, and in solidarity, have made progress to overcome this disease.

Yes, much is still left to be done, but it will be accomplished in the times to come, only if we all continue to pledge ourselves to upholding the safety of ourselves, our families, our friends, our neighbors, and everyone else near and far, and across the oceans.

This planet, along with everyone and everything on it, is our responsibility, and, no one, besides us, can bring the life back to this “standing-still” world!