Covid Tips on 9 Days of Worshipping of Goddess Durga

By Dr Deepak Gupta
[Navratri Celebrations ongoing in India marks nine days worshipping of nine incarnations of Goddess Durga]

1.Steroids : Some benefit ( Dexamethasone/Hydrocortisone /MPA) : Useful only in patients on oxygen therapy/on ventilators. Don’t give in early first week, don’t give In mild cases ( More harm)

2. Remdesvir +/- Baricitinib : Effective if given early within first 10 days of illness in patients on NIV/HFNC/ventilatory support. It speeds up time to recovery and has no effect on mortality.

3 Anticoagulants ( LMWH) followed by Oral anticoagulants ( Apixiban for 3 weeks) useful in all {if D Dimer high} but the mild disease.

4. Plasma therapy : No Benefit …If at all then must be given within first 3 days from Plasma donor having very high antibody titres).
5. Inhaled nebuliser interferons ( useful if available), Favipiravir ( improves time to clinical cure and cessation of viral shedding by 2-3 days) in mild to moderate disease , MoAB ( Superexpensive, can be used in mild high risk cases and helps in recovery , Tocilizumab ( IL6 antagonist) not effective for preventing death in moderate or severe covid patients and has sepsis risk. If one uses, use only one dose 400mmg only in select cases.
6. What doesn’t work in Covid : Antibiotics ( azithromycin, doxycycline), Antivirals( Lopinavir), HCQS ( Chloroquine), Ivermectin, Vitamins
7. Majority improve with body immunity without any treatment. Avoid steroids if you are asymptomatic and just RTPCR+ve.
8. Oxygen therapy, HFNC/Ventilatory support if Oxygen saturation falls : Highly Recommended .

9 Vaccines : Covaxine, Covishield, Sputnik, Pfizer Moderna : 2 doses min 4 weeks recommended for all.

Remember : Covid virus is going to keep going until it infects everybody it possibly can: until it meets a vaccine or natural herd immunity … ( In India : with over 1 million cases in last 1 year and Vaccination drive at its superbest,,we are likely to achieve it soon). Just practice Covid appropriate behaviour ( Face Mask preferably N95 when outside home , Adequate hand washing, Physical distancing, Avoiding unnecessary travels outside).

The writer is dr deepak gupta, Sr Neurosurgeon, AIIMS.