ARTICLES ON Pandemic

Many post-Covid patients are visiting experts with various complications such as shortness of breath, fatigue, pneumonia, brain inflammation, seizures, lung fibrosis, and acute respiratory distress syndrome (ARDS). A team headed by Dr ChandraVeer Singh successfully treated an 18-year-old woman who reported a loss of taste and smell for 10 months after getting infected with Coronavirus. Ms. Amanjyot Kaur, 18-year, resident of Mira Road, exhibited symptoms such as loss of taste and smell, fever, in June 2020. The patient was admitted to the hospital. Took treatment at home for Covid. The patient was back on track after 20 days. To her dismay, even after testing negative for Covdi-19, she continued to experience loss of taste and smell. The patient earlier didn’t pay attention to it as she thought her senses may return in time. But, to her dismay, she was shocked when she could not taste or smell even after 10 months. The patient panicked and visited Wockhardt Hospitals, Mira Road wherein she received prompt treatment. Dr. ChandraVeer Sigh Consultant Otorhinolaryngologist and Head & Neck Onco Surgeon, Wockhardt Hospital Mira Road said, “Many patients who test negative for Covid-19 may exhibit some or the other symptoms. This patient came with a loss of taste and smell for around 10 months. A complete loss of taste is called ageusia, which makes a person unable to detect any tastes. Temporary loss of smell or anosmia is when a person is unable to smell or recognize the smell. Loss of taste and smell occurs due to inflammation and edema of the Olfactory nerve due to Viral infection. Usually, the patient recovers in 4 weeks. Hence, the patient was prescribed a nasal spray and systemic steroids medications, Vitamin C and D, and Vitamin A, supplements Within 10 days after medication her senses of smell and taste came back. With an increasing number of covid patients, the number of post-Covid patients with loss of smell and taste increasing. Although there is no treatment for long-lasting loss of smell and taste in patients but we have treated 5 to 6 patients successfully in our hospital. “I was aware that loss of taste and smell are the common listed symptoms of Covid-19 and the senses return in few days. But I was stressed, anxious and depressed when the senses did not return over months. Everything just tasted like sand. I would add spices to the food and even used aromatic herbs but nothing seemed to do the trick. I would constantly try to smell things, use perfumes so that I can get the fragrance, and try to smell foods. It is frustrating when people around you can smell and taste and you can’t. I thought, I permanently lost my senses. I lost interest in my daily activities like cooking, cleaning, and eating as well. I would cry alone and be restless all the time and would avoid socializing with family and friends. Do not ignore these underrated symptoms,” concluded the patient Ms. Kaur. Source: http://mediabulletins.com/health/18-year-old-post-covid-patient-with-loss-of-taste-and-smell-for-10-months-successfully-treated-at-wockhardt-hospitals-mira-road/

A harmless headache can be a symptom of the deadly covid-19 pneumonia. Stay alert and keep an eye on any unusual signs. Being forewarned is being forearmed, this idiom fits in perfectly well with the situation we are going through right now. Every single day, we are being bombarded with a lot of information around covid-19 – whether it’s new research or baseless rumors that have nothing to do with the disease. That’s why being well-informed always comes in handy. The declaration around covid-19 being air-borne has sent shock waves all over the country. Maybe, that’s the reason why cases and deaths are on the rise. But aren’t you wondering, like many others, as to why more people are losing their lives to this virus? That’s because the new mutation is causing covid-19 pneumonia. Friends, don’t make the mistake of confusing it with common pneumonia, because it’s not. The symptoms are not too different either – which makes it even more tricky to identify. That’s why we want you to know every detail about covid-19 pneumonia so that you can curb it at the initial stage. According to Dr. Bipin Jibhkate, consultant critical care medicine, and ICU director Wockhardt Hospital, Mumbai, covid-19 pneumonia is a serious and life-threatening lung infection that causes inflammation in the tiny air sacs to present inside one’s lungs. It is one of the major complications of covid-19 and can be seen in post-Covid patients. Unfortunately, a CT-Scan is the only way to figure out, whether you have it or not. Here’s what determines if you’ll get covid pneumonia or not “You may get covid-induced pneumonia, if you are severely ill with coronavirus, have poor lung function, and are on oxygen support. The coronavirus can damage your lungs, leading to the clotting of lungs and thickening of the walls of the air sacs. It is these symptoms that can cause breathing problems and pneumonia. So, people who are above 65, have asthma or an underlying lung problem, and other comorbidities like diabetes or heart problems may suffer from it. Even smokers and those with a weak immune system will get covid pneumonia,” warns Dr. Jibhkate. Symptoms of covid-19 you need to watch out for Headaches, nausea, vomiting, chills, fever, constant cough, belly pain, congestion, runny nose, diarrhoea, breathlessness, sweating, dizziness, rapid breathing, and sore throat are some of the common symptoms.  We know these look like very regular symptoms, but that’s what makes covid-19 pneumonia even more lethal. People generally tend to ignore these symptoms, and when their oxygen levels suddenly drop, it becomes too late. “If you notice chest pain due to heavy breathing and constant coughing, it is best to rush to a doctor without fail. That’s because it’s a sign that your lungs are not in the best shape. Also, if you see any of these symptoms, keep an oximeter handy and note your oxygen levels. Ensure your oxygen levels are above 90. If it’s below that, consult your doctor as soon as possible” advises Dr. Jibhkate. Here’s how covid-19 pneumonia affects your lungs “Small air sacs in the lungs called alveoli to get filled with fluid when you have pneumonia. If you have pneumonia, you won’t be able to transfer oxygen to the blood or will be unable to get rid of the carbon dioxide in the body. This can lead to respiratory failure. Lung abscesses can occur, in which one’s lungs get filled with pus,” explains Dr. Jibhkate. Dr Jibhkate shares some tips on how you can prevent it “Wash your hands thoroughly with water, and scrub them properly several times a day. Avoid touching your face, mouth, or nose. Masking, social distancing, and hand sanitizing are the need of the hour, follow cough/sneeze etiquette, opt for lung exercises, don’t be around sick people, and eat a well-balanced diet to boost your immunity,” suggests Dr. Jibhkate. The basic idea is to try and improve the functioning of your lungs by performing deep breathing exercises. So, even if you require an oxygen cylinder, you can very well delay that stage, because your lungs are strong enough to deal with it.  Another thing you should know before you step out to get an oxygen cylinder is that oxygen therapy can also be taken at home. But for that, you will have to first talk to your doctor.  Also, those of you who are planning to buy a concentrator must listen to Dr Jibhkate. “A concentrator can be kept at home after consulting your doctor. Oxygen concentrators can be helpful for patients infected with covid-19, in case the patient’s oxygen levels drop. This machine will help to filter oxygen from the atmosphere and help one to get it via a mask or cannula. Hence, it can be one of the options to boost oxygen levels. Also, I would like to advise not to stock these things up, because there are people who might need it more than you,” concludes Dr. Jibhkate. He has a piece of advice — if there are people at home with respiratory problems like asthma, you should definitely get a concentrator at home. The bottom line is: don’t take the risk of getting your lungs damaged, because covid-19 pneumonia may have long-term implications. So, as soon as you see a symptom, report it right away to get things under control in time.

What are you expected to do if you have a Covid-positive patient in the family, and are sharing your home space with them? Often, complete isolation may not be possible, and as such, you may find yourself in the same house as your parent, spouse, child, or anyone else who has tested positive for COVID-19 but does not need hospitalization. Instead of feeling overwhelmed and panicky, arm yourself with some knowledge. Remember, while it is easy to feel scared given whatever is happening at the moment, it is necessary that you keep your calm, take care of the patient, while also keeping your own health. Here is a simple home advisory and dos and don’ts for caregivers, courtesy of Dr. Behram Pardiwala — Internal Medicine, Wockhardt Hospitals Mumbai Central. Read on. Do’s: – It is extremely important for all family members to wear a mask all the time in the house.– Patients’ clothes must be washed separately, but first soaked in disinfectant.– Disinfect common washrooms all the time, in case there is no provision for separate washrooms.– Dispose of patients’ disposable material in a separate yellow bag given for biohazard material. Don’ts: – Do not enter the Covid-positive patient’s room, as it is proven to be more of an airborne disease than a contact-based disease. In addition to these, it is also expected that you sanitize your hand, and wash it with soap and water before preparing meals, before eating. etc. Make sure that the patient’s utensils are separate, and they are cleaned thoroughly. Do not step out of the house and interact with other people. Keep calm, and remember this will pass. Source: https://indianexpress.com/article/lifestyle/health/taking-care-of-covid-patients-at-home-some-simple-dos-and-donts-7283190/

Doctors on why it’s essential to give your body the time to heal, rest and recover before you get going again This is probably one of those rare times when ‘being positive’ may be all that we hoped against. After all, testing positive for Covid-19 comes with much anxiety and trepidation, apart from the challenges in dealing with the standard symptoms. And considering that a vaccine for the condition is yet to be found, most have to fall back on their body’s natural defenses to sail us through. Luckily, there are antibodies formed in the body post-Covid-19 which may ensure you develop a time-bound immunity. But it is necessary to take precautions to ensure that the patient gets back on their feet steadily. The adequate time is given to the body to heal and recover, regularly monitoring temperature and sugar levels, routine consultation with doctors, exercising, and eating nutritious food, go a long way in ensuring overall good health. In September this year, Hurlene Kharbanda’s husband tested positive for coronavirus and five days later, the PR professional, too, contracted the virus. “It started with a slight fever and joint pain. I tested negative after a week but we were both homes quarantined for around three weeks in total,” says Kharbanda. She admits to feeling “miserable from within” — punctuated by severe weakness. “There were no hunger pangs, but we motivated each other to eat every two hours. Thankfully, with our faith in Buddhism and the positivity we share as a couple, we bounced back to good health pretty quickly,” she says. Being discharged from the hospital post-testing negative does not mean you are fit to be out and about. Andheri-resident Joginder Singh Thakur, who spent 11 days in the hospital, was advised a week’s home quarantine on discharge. His antibody test came out fine after another week, post which he resumed work. Home quarantine for at least a week post-testing negative is something Dr. Manjusha Agarwal, consultant-Internal Medicine, Global Hospital Mumbai advises all her patients. “Depending on the gravity of their condition, I would schedule a follow-up after 15 days to readjust the medicines. Patients with mild symptoms require a single follow-up, while those who had been in the ICU or were on a ventilator, require visits depending on the severity of their condition,” she says. Dr. Kedar Toraskar, chief of critical care, Wockhardt Hospital, South Bombay, says that there are a couple of things to keep in mind once the patient has been discharged or tested negative. “Their oxygen levels need to be monitored for at least two weeks post-testing negative. If they are diabetic, then their blood sugar also has to be monitored. The third thing is to keep a track of their body temperature at least twice a day. If there are any symptoms such as acute weakness or diarrhea, it should be conveyed to the doctor,” he says. Many assume that they are absolutely fit to resume exercise immediately post-recovery. However, Dr. Agarwal suggests simple walking for a few minutes before moving on to a full-fledged fitness regimen. “After doing nothing for 10-15 days, if they suddenly decide to go for a 5 km walk, they are bound to feel fatigued,” she says. The doctor suggests a 15-minute stroll for the first few days, slowly progressing to longer durations is ideal. “Always listen to your body,” she says. “Some exercise is necessary for the body. Even in the hospital, I tell my patients to stroll inside the room at least thrice a day. It builds their stamina and lung capacity,” she shares. Most doctors have stressed the importance of breathing exercises. Dr. Toraskar also suggests going for a respiratory rehabilitation program if the patient had been on a ventilator. Kharbandra, who had faced difficulty in breathing, shares that she relied much on kaada or hot water mixed with ajwain during her post-recovery phase. “We would also perform breathing exercises thrice a day and monitor our body temperatures and oxygen levels,” she adds. Just like any other illness, it’s essential to try and get eight hours of good sleep and consume a diet rich in leafy greens, whole grains, nuts and seeds, veggies, and fruits. Doctors also recommend multi-vitamins for building immunity and strengthening the body from within. The 11 days that Thakur spent in the hospital were probably the most challenging. “Although I was in a ward with three beds, I was mostly on my own. There was no human activity outside my window and nobody to meet or talk to,” he shares. Anxiety over the illness and social distancing can take a toll on the patient’s mind, says Dr. Toraskar, adding that there is the possibility of being inflicted by depression post-Covid. “It’s always better to be in touch with a counselor at the hospital. Social and family support also play a major role in such times,” he suggests. Being locked up inside the house for extended periods can take a toll on mental health. So it’s also a good idea to get out and bask in the sunlight early in the morning, suggests Dr. Toraskar. In Kharbanda’s case, apart from chanting, her support system included her family and friends who rallied around the couple and motivated them during the difficult time. “We have made small changes in our lifestyles now, adding exercise and eating healthy,” she says. Oxygen levels need to be monitored for at least two weeks post-testing negative. If there are any symptoms such as acute weakness or diarrhea, they should be conveyed to the doctor. Source: https://mumbaimirror.indiatimes.com/others/health-lifestyle/life-after-covid/articleshow/78753487.cms

Shaista Pathan, 47, a native of Palghar, is suffering from memory loss and brain fog after testing positive for COVID-19. According to a report in Times Of India (TOI), Pathan was rushed to Mumbai’s Wockhardt Hospital on August 14 after she complained of abdominal pain and headache. When she arrived at the hospital, she was reportedly restless, drifting in and out of consciousness and disturbed. “When she arrived, even five nurses couldn’t calm her down or draw blood. However, the next morning, we noticed neck stiffness that suggested an infection in the central nervous system” neurologist Pavan Pai, was quoted as saying by TOI. On August 19, she was diagnosed with viral encephalitis, an inflammation of the brain, and also tested positive for COVID-19. Now, even after two months, Pathan still has moments of “difficulties”. “My sons tell me not to think hard as I get a headache and a bit of confusion,” said Pathan. “She cannot remember eight days of the infection, but is otherwise healthy,” said neurologist Pavan Pai, who treated her. In the US, news reports stated that patients complained of forgetfulness or brain fog after being diagnosed with COVID-19. Source: https://odishabytes.com/covid-19-positive-woman-suffers-memory-loss-brain-fog/

Looking after your own mental health is even more important now given the uncertainty surrounding the outbreak of the novel coronavirus. Perhaps, we’re still trying to adjust to the new realities of working from home, home-schooling of children, a lack of physical contact with our family members, colleagues and friends – all these changes to our routines can be challenging for all of us. Yet, for some people, especially those with mental health conditions, adapting to lifestyle changes brought on by the COVID-19 and managing the fear of being infected with the virus can be particularly difficult. While not all mental health conditions can’t be prevented, there are a lot of things that we can do to take care of our own mental health and help others who may need help and support. In fact, there are many ways in which families can support each other and make the most of this new normal. How to protect your family’s mental health amid COVID-19 Treatment for mental health disorders may vary from person-to-person depending on the underlying condition. Fortunately, there are a many step you can take to improve your emotional health on your own. Ahead of World Mental Health Day, Dr Sonal Anand, Psychiatrist, Wockhardt Hospital, Mira Road, Mumbai, suggests a few tips that will help you and your family re-balance and thrive amid the pandemic: Eat right and exercise daily: You must green leafy vegetables, berries, walnuts, fatty fish with omega-3 fatty acids, turmeric, broccoli, pumpkin seeds, nuts, oranges, eggs and have green tea that is good for the brain. Drink water and stay hydrated. Say ‘NO’ to smoking and alcohol. Stay physically active and exercise as that will enable you to release feel-good chemicals like dopamine, serotonin, oxytocin, and endorphins. Ta da, you will be able to stay happy and reduce stress. You may also opt for swimming, cycling, walking, jogging, aerobics, or any other activity that you like. To de-stress do yoga or meditation.Stay away from self-criticism: Uplift your spirits. Do not criticize your behavior. Just respect yourself, be kind, and patient. You can do what you like for example – painting, dancing, gardening, or cooking. Stick to a proper schedule and lead a healthy life. Also, do not let people treat you badly. You deserve love and respect.Be positive: Accept the situation and be optimistic about life. Try to battle the illness with the help of your family members. Surround yourself with people who care for me and can guide you. Open up about your feelings and communicate with people. Journaling can be a good idea to write down your thoughts or triggers and then overcome them. You can also volunteer and help others who are struggling with the same problems.Have simple conversations: Do not roast the person who is feeling sick. Instead, ask him/her about why they are feeling low. Let them open up to you confidently. Encourage the person to live a healthy life. Be understanding and listen to their worries and concerns. Help them overcome their fears and offer them emotional support.Don’t assume things: Avoid assuming things on your own. Do not make any diagnosis by yourself. See to it that you help your loved one to cope with the problems. Allow them to discuss at their own pace. Help them become courageous and this will, in turn, build their trust in you. Avoid pressuring the person as this will worsen his condition. Be kind and compassionate towards your loved one who is trying to cope. Additionally, look for warning signs – if you notice symptoms such as anger, frustration, behavioral changes, or injuries then the person will need immediate attention. Ask them about the things that are bothering them and take them for counseling. Take immediate action to ensure that the person is safe. Source: https://www.timesnownews.com/health/article/5-ways-to-protect-your-family-s-mental-health-amid-covid-19-crisis/664495

bananas: Balking at Banana flowers: Indians are rediscovering old ways of cooking food during Covid-19 lockdown – The Economic Times 100Cleaning banana flowers takes time. You must first oil your hands to prevent staining. Then the dark red outer bracts are peeled off to reveal rows of delicate blooms. These must be individually picked and the inedible parts, a stiff sheath and long stamen, painstakingly picked out from each one. Each flower head has many such blooms and cleaning them is an ideal job for those stuck at home thanks to Covid. Just as people across the world are using this enforced leisure to enjoy the extended process of sourdough bread making, right from fermenting their own starter, many Indians have been using the time to rediscover old ways of cooking and eating that were being pushed aside due to lack of time. bananas: Balking at Banana flowers: Indians are rediscovering old ways of cooking food during Covid-19 lockdown – The Economic Times 114Now there is time to clean and cook banana flower or shevla, vibrantly coloured yam shoots from the Western Ghats that need careful soaking and cooking to prevent it constricting the throat when consumed. Now is the time to dig out old cookbooks, like the Tamil classic Samaithu Paar, with its ingredients given in old measures like ollocks and seers (Wikipedia has conversion formulae) and minutely detailed instructions on how to grind and ferment idli batter. Now is the time to exercise arm muscles by rescuing that grinding stone from being used as a door-stop, and making chutneys with that slightly grainy texture which you never get with the pulverising power of an electric grinder. bananas: Balking at Banana flowers: Indians are rediscovering old ways of cooking food during Covid-19 lockdown – The Economic Times 124Now is the time to unearth those heavy metal cooking utensils we had abandoned in favour of less wrist straining options made of aluminium and other lighter materials. It all makes for satisfying effort and good pictures to post on social media, especially since evoking nostalgia is sure-fire way to get likes. But will it lead to a revival of these recipes post-Covid? Their proponents certainly hope so, talking about the need to educate current generations, and bewailing an obsession with modernity that deems these older traditions uncool. We need to learn from our grandmothers and make masalas from scratch, stop buying only ‘English’ vegetables and using shortcuts like readymade idli batter. bananas: Balking at Banana flowers: Indians are rediscovering old ways of cooking food during Covid-19 lockdown – The Economic Times 133No one should object to being educated about the range of ingredients at our disposal, and the many different cooking techniques used in Indian food. But it is simplistic to assume that the only reason people don’t use them is ignorance, and rather stereotyping to put our grandmothers into a box of pure tradition. Cooking is the most practical of arts and recipes that don’t fit the routines of regular cooks, with all the demands on their time and energy when not confined by Covid, is unlikely to be used often. bananas: Balking at Banana flowers: Indians are rediscovering old ways of cooking food during Covid-19 lockdown – The Economic Times 142What no one points out while extolling banana flowers is that when finally cooked they tend to taste rather like well-cooked red cabbage. Not exactly, of course, and people may well prefer the former – but are they the ones who also have to do the cleaning and cooking? India has a wide variety of unusual tubers, but when well cooked in a spicy dish do they really differ all that much from potatoes? And while hand ground chutneys and pastes do taste different, perhaps even better than machine blended ones, does that really justify the knuckle scraping effort of wielding a stone grinder every time you want to have them. The truth is that what we think of traditional Indian food depends on the generally undervalued labour of wives, daughters-in-law and servants. And when given an option most of them readily picked the less traditional, but less labourious one. bananas: Balking at Banana flowers: Indians are rediscovering old ways of cooking food during Covid-19 lockdown – The Economic Times 151Pressure cookers, for example, cook dals into mush rather than the more textured versions you can taste when slow-cooked, for example in temple kitchens which still simmer dishes in huge vats over wood fires. It is a real and enjoyable difference, but when safe pressure cookers became available, from the 1960s onwards, most cooks happily swapped slow cooking for their speed, which shortened the time they had to spend in hot and steamy kitchens. (It is remarkable how badly ventilated many Indian kitchens still are, often without even a decent electric fan). Old cookbooks also tend to be misunderstood. When you read beyond their yellowing pages and archaic terms, you often find views that were quite modern for their time. S.Meenakshi Ammal, who write Samaithu Paar, has become a paragon of Tamil Brahmin tradition, yet she was a woman who refused to let early widowhood hold her back, and took the unusual step of transforming her skills into a best-selling book. bananas: Balking at Banana flowers: Indians are rediscovering old ways of cooking food during Covid-19 lockdown – The Economic Times 163And after thoroughly documenting the basics in her first book, the next two included more diverse recipes from other communities, including cakes and biscuits. This is not to claim her as a radical, but just to suggest she combined appreciation of tradition with a practical readiness to accept useful innovations – much as most of us are today. Stainless steel, which has been much extolled on social media recently as an example of undervalued ‘real’ Indian style, offers a slight variation on this story. Its use in India is hardly traditional, dating only from the 1960s when the metal became available for kitchen use. And many traditional

Dr Clive Fernandes, Group Clinical Director, Wockhardt Group Hospitals, Consultant, Joint Commission International Expert at ISQua, RPI Certified Yellow Belt shares insights on how hospitals can successfully deal with challenges that they encounter during the COVID-19 crisis Today, COVID-19 is the most searched for term on google. The daily number of invitations sent out by anyone and everyone on LinkedIn, Zoom and other mass conferencing platforms regarding education and webinars on all aspects related to COVID-19 would seem to indicate that we have mastered all aspects of the disease. But the stark reality on the ground is different.  There are many challenges that healthcare organisations are facing due to the ongoing COVID-19 pandemic. Below are a few of the challenges and how we at Wockhardt hospitals are dealing with them  Lockdown and Shutting Down of Public Transport Since most staff use public transport to commute to the hospital they were left with no mode of transport. Our HR department responded quickly, liaised with the local municipal authorities and arranged for buses from major routes ensuring that staff were able to reach the hospital. Staff using their personal vehicles had their hospital ID cards as well as an official letter on the company letterhead stating that they were part of essential services.  Focus On Infection Prevention and Control at Hospital Entry Points Screening and triage, an effective screening process helps in identifying and mitigating risks. Every person entering the hospital had to undergo the thermal scanning for temperature and were asked six screening questions (which were based on the symptoms of COVID-19). If the answer to any question was yes, they had to see a medical officer before they were cleared to enter the hospital. Everyone had to practice hand hygiene at the entrance gate of the hospital and had to wear a 3-ply mask before they entered the hospital.  Segregating COVID / Suspected COVID Patients From Routine Patients Wockhardt established a dedicated COVID-19 unit to prevent cross infections among patients with COVID symptoms /diagnosis and other patients. The dedicated COVID-19 unit had a separate entrance and exit. This unit had its own air handling unit that ensured that the airflow did not mix with the airflow with the other parts of the hospital. We identified dedicated staff for this unit and defined additional safety protocols for all clinical processes like medication ordering and administration, food handling, waste handling and clearance etc.  Personal Protective Equipment and Its Related Challenges Personal Protective Equipment, PPE, is essential to prevent the spread of infection from one person to another. PPE requirements were defined and were provided by the hospital daily to all level of associates as per their exposure risk (from the security guard, cash handlers in the billing department, to clinical staff). We had defined and provided an elaborate PPE kit to all associates working in the COVID-19 unit.  Donning and Doffing Process The process of sequentially wearing the PPE is known as donning and the process of sequentially removing the PPE is known as doffing. We identified rooms with a separate air handling unit for donning and doffing. Since these processes are very important, all associates were individually trained in both. Greater emphasis was laid on training staff on the doffing process as if not done correctly there would be a risk of infecting fellow associates. Staff were assigned a buddy to help them familiarize themselves with the processes until they became comfortable. In the donning and doffing rooms, we posted posters on the wall that illustrated sequentially the steps to be followed for the processes and included a demonstration video on donning and doffing that was available on an iPad. There was an assigned showering room adjacent to the doffing room and we made showering post doffing mandatory. This step was taken to eliminate any risks of contamination being transferred out of the unit.  Addressing Staff Issues This was the most important challenge that most healthcare organizations faced and continue to face and have to deal with on a daily basis. These are divided into two main categories  Fear of working in a COVID-19 unit: This was a genuine fear as we encouraged social distancing and highlighted the contagious nature of this virus while at the same time had our staff assess patients, administer medications and do procedures if required. We were able to overcome this challenge to an extent by training staff on how the disease was transmitted and how it could be prevented by properly donning and doffing the provided PPE. The showering protocol that we defined post duty actually helped ease most of the staff’s apprehensions. The initial challenge was designing showering facilities in the vicinity of the doffing rooms but our maintenance department did a wonderful job in overcoming that challenge.  Society and neighbourhood issues: The fear created by this pandemic has been such that the very people who came out in their balcony and flashed lights and banged plates to appreciate healthcare professionals acted very differently in reality. Many healthcare professionals were informed by their landlords/societies that they would not be allowed to return home if they went to the hospital. We dealt with this by allowing our staff to stay at the hospital but then this actually decreased the hospital’s available capacity to admit patients.  Reinforcing social distancing: Many times once associates moved back to the hostel post duty they tended to relax safety protocols especially the ones dealing with social distancing. We continuously kept educating staff to follow this 24*7. We identified “marshals” who moved from one department to another enforcing the social distancing norms, especially at tea breaks/meal times where we had witnessed maximum violations. We also instructed staff to prepare a daily line list of all associates with whom they came in close contact with and instructed department heads to check the lists periodically. This helped us to reinforce the social distancing protocol and if any staff tested positive for COVID-19 we were able to easily identify, quarantine and observe their contacts for

Patients who were diagnosed with COVID-19 and seemingly recovered have been readmitted to the hospital after testing positive for the virus again. South Korean officials announced seems to be hitting the news. The novel coronavirus that causes COVID-19, was only discovered a few months ago, scientists are still trying answer questions. The World Health Organization (WHO) is investigating the reports of patients testing positive after being released from treatment, but said it has no findings yet. The most daunting question is whether you can get re-infected or not. Experts say the body’s antibody response, triggered by the onset of a virus, means it is unlikely that patients who have been infected with virus can get re-infected so soon after contracting the virus. Instead, testing positive after recovery could just mean the tests resulted in a false negative and that the patient is still infected. A positive test after recovery could also be detecting the residual viral RNA that has remained in the body, but not in high enough amounts to cause disease. Even after the virus is dead, the nucleic acid (RNA) fragments still remain in the cells is what scientists are stating .The patients generally were not symptomatic at the time of their second positive test. Does recovering from COVID-19 make you immune is another question. With other coronavirus strains, experts say the antibodies that patients produce during infection give them immunity to the specific virus for months or even years, but researchers are still figuring out if and how that works with COVID-19. Time will tell on coronavirus strain its evolutions and body reaction towards the disease. We can only hope that a vaccine will come out soon so as to build immunity against this infection.

While it is crucial to mention hygiene standards like washing your hands frequently and maintain social distancing as precaution ,marinating a good immunity is also vital in order to defend against  getting the disease or act as a tool to fight it. There are also certain methods to improve your immunity which is paramount in these critical times Individuals in certain pre-existing illnesses like diabetes, hypertension, cardio vascular disease, and respiratory issues are at a higher risk of having Covid 19 complications, it also aggravates with age as the general immunity reduces as you get older. In the younger generation with no underlying illnesses, Covid 19 can result in a minor infection, provided you have a robust immunity and do not engage in activities like smoking or vaping to combat the onslaught of the virus. Here is a list of measures you can undertake to improve your immunity. Balanced Diet: A diet rich in antioxidants has been linked to a host of health-promoting, disease-fighting activities in the body Antioxidant-rich foods include: Along with a healthy diet and adequate nutrition, there are healthy activities that can re-enforce your immune health too. Exercise Moderate exercise has been shown to improve the flu-fighting power . Solo exercises include jogging, jumping rope, and a variety of at-home workouts from and yoga. Stress Reduction Moreover, chronic stress has been shown in some studies to leave us more vulnerable to infections. These are testing times, and a prolonged period of staying indoors has its implications on your mental wellbeing. Being stressed out leads to increased levels of suppressor T cells, which suppress the immune system. When this branch of the immune system is impaired, you are more susceptible to viral illnesses including respiratory conditions like colds, flu, and the novel coronavirus infection. You can reduce stress through breathing exercises, meditation, working out, talking to a therapist, and getting out into nature, along with many other ways. Sleep Getting the right amount of quality sleep can help your natural infection resistance, too. Several studies confirm the link between sleep and a healthy immune system. For most adults, that means 7 to 9 hours of uninterrupted slumber. Stay Hydrated Drink up to 8-10 glasses of water every day, to stay hydrated. Hydration will help flush out the toxins from the body and lower the chances of flu. Other alternatives include juices made of citrus fruits and coconut water, to beat the heat.