Yes to Proning, No to Hoarding: A Handy Guide for COVID-19 Care at Home

Coronavirus

Yes to Proning, No to Hoarding: A Handy Guide for COVID-19 Care at Home

Illustration: Arati Gujar

On May 9, the Maharashtra government announced a programme called “Majha Doctor”. The new initiative aims to encourage family doctors and general practitioners to advise patients on treatment for coronavirus cases at home. Together with the state’s COVID-19 task force, some 700 participating doctors have been consulted in order to establish guidelines and protocols for home treatments. Already, doctors have been invaluable in advising isolated patients and their families who are trying to provide care; many who have fallen prey to the mammoth second wave.

“Majha Doctor”, however, connects its doctors with municipal ward officials for monitoring and updates on quarantined patients, and throws official support behind a process that, until now, has been informal. Governments want to keep people at home as much as possible, and out of the overburdened hospital systems. Families, too, are desperate to avoid shutting their loved ones in facilities where the resources are stretched thin and the contagion runs rampant, precluding them from visitations.

Families, too, are desperate to avoid shutting their loved ones in facilities where the resources are stretched thin and the contagion runs rampant, precluding them from visitations.

The situation is grim, and if you’re lucky enough to have a comfortable home where you can self-isolate and your symptoms are mild, the chances are slim that you would want to leave it behind for a frenetic general ward (private rooms now being a rare luxury.) And yet, even though we might all feel like battle-hardened experts after so many months of getting to know unfamiliar names of medicines and official-sounding breathing techniques, ordinary people struggle to care for their COVID-19-positive family members. So how do we go about it when nearly all of us are trying to help the sick of our own households, not sure where to start?

Luckily, a lot of resources are out there to give us a clue. Health professionals have put out several strategies and tips for managing mild to moderate COVID-19 symptoms before approaching hospitals. Keeping track of the situation several times a day is vital, so a home oximeter and thermometer are a must.

When fevers shoot above 100.4º F despite taking paracetamol, or oxygen drops rapidly, caregivers will know it’s time to take strong measures right away. SpO2 (Oxygen saturation) levels between 100 and 94 are considered healthy, but readings fall consistently below 90, you need to get medical aid. Small oxygen canisters are easier to come by than cylinders, and might prove a useful stopgap breathing aid while waiting to access proper healthcare. However, hoarding cylinders or canisters if you don’t have a patient at home is not a good idea; you might be depriving someone who is really in need.

One key procedure that has been super effective for patients whose oxygen levels are dipping is proning: a posture in which the affected person lies on their front with their head raised, allowing them to breathe more freely without feeling stifled. Along with prescribed expectorants, steams several times a day are a simple remedy for chest congestion. Hot, nourishing soups, fruit juices, and fluids enriched with electral provide much-need energy when food is hard to get down and many doctors now prescribe steroids like prednisone or dexamethasone for lung recovery, which have the added benefit of spurring on appetites. However, don’t self-medicate.

Hoarding cylinders or canisters if you don’t have a patient at home is not a good idea; you might be depriving someone who is really in need.

Even if WhatsApp forwards and recipes from mom tempt you to try out all kinds of kadhas, make sure you check with a doctor before using any herbal or ayurvedic treatment for a patient who is already on prescription medicines. A harmless home remedy can turn damaging if it interacts badly with something else in your body – a fact that we often overlook in our zeal to provide relief for COVID-19 sufferers. After all, anything with a positive effect can have undesirable side effects, too.

This also means that drugs such as Remdesivir, which is so hotly in demand that it costs lakhs in the Mumbai black market, are not necessarily a solution unless a doctor gives the go-ahead. Due to the hype around such medicines, many believe they are suitable for all patients, when they can in fact do more harm than good. Same with innocuous-seeming pranayama and breathing exercises that are fine if patients can easily perform them, but detrimental if they force their lungs to struggle even more.

To stop the spread, caregivers should be cautious about keeping laundry and dishes of the COVID-19 patient separate from the rest of the household.

To stop the spread, caregivers should be cautious about keeping laundry and dishes of the COVID-19 patient separate from the rest of the household. Using disinfectant wipes on surfaces and getting fresh air and sunshine into sickrooms are good for hygiene, both for those recovering from the infection and shedding the virus, and those who interact with them.

And of course, caregivers themselves must keep up their health by wearing clean double masks, getting proper rest and food, and washing their hands whenever they come in contact with a sick person. While being vigilant over patients is necessary, mental breaks are important, so take it in turns to tend to patients and take pauses to breathe. Even for mild cases, keeping ambulance and medical resource helplines in your area on standby can give you peace of mind – something we all sorely need right now.

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