Steps to Covid Recovery Plan

Covid-19 has been a pandaemic with a difference. Different in many ways as it continues to change faces. While to begin with, the symptoms of Covid-19 were similar to those of a patient with a common flu, with passage of time, patients started presenting with newer type of complaints which ultimately resulted in testing positive for the virus.

A unique point about this particular virus is that even if a person considers himself to have completely recovered, there is still every possibility that he may catch the infection again. This makes it extremely important for not only the recovered patient but those around him, to continue to strictly follow Covid-19 safety protocols as laid down by the health department and government.

In addition to Basic Protocols like wearing of mask, washing hands at regular intervals and maintaining a physical distance, there are certain important steps to be followed, to ensure a steady recovery from the dreaded virus.

Steps towards recovery from Covid-19

As it would happen with many patients, who would recover from various types of serious diseases, the fear of contacting the illness once again, can continue to haunt even Covid patients. Hence, it is required to formulate a methodical recovery program to ensure that start feeling confident all over again.

Taking care of emotional well-being

The very fear of having contacted Covid-19 can cause lot of anxiety to patients and their families. Hence it is extremely important for the families to ensure that the patient stays positive. It is necessary not to dwell on tough days passed by and prepare mentally towards recovery to begin with. Getting back to routine activities slowly will help in creating a fresh feeling of confidence.

Maintain a healthy diet routine

It is very important not to miss your daily meals. Include energy rich cereals in your diet like cereals, pulses, milk and milk products. Consume more of seasonal fruits and vegetables and leafy vegetables. These help in strengthening the immune system. Stay hydrated as much as possible and drink lots of water.

Regain Your Strength

Covid-19 can cause extensive damage to the lungs and respiratory system. Hence recovery would take some time. It is not a bad idea to reach out to an occupational therapist. He can help you on your road to recovery, by helping in adjusting to new energy levels. To support your recovery program, cut down on excess and strenuous activities.

Practice Breathing Exercises

Breathing Exercises can be extremely useful in helping giving momentum to the lungs. Regular sessions of Pranayama and Chest exercises can help reduce breathlessness.

Get yourself tested for Covid-19

Recovery symptoms can vary from person to person. Hence, it is advisable to have a Covid test is any symptoms persist for a long time. For those who recover, chances of getting re-infected are low for the first three months.

The Bottom Line

Covid-19 has shown itself to be a very tricky virus to deal with. The need of the hour is to continue to stay safe even after full recovery. It is extremely important to follow all safety protocols as chances of getting re-infected due to ignorance can be very high. Today, we have vaccines at our disposal which can make a huge difference. Getting vaccinated should be top priority after the scheduled period of recovery is over. How long Covid-19 will continue to keep us humans on our toes is unknown but following safety protocols should never be compromises.

Mental Preparedness before getting vaccinated

The Covid-19 virus came with no prior warning. Not only did it rattle the global healthcare sector, but also threw the global economy, completely out of gear. Exactly a year ago, researches and studies began to find out an answer to the dreaded virus. It was not impossible but a dream for sure, then. Today, thanks to the stupendous and tireless efforts of our distinguished scientists, the dream has transformed into reality, in the form of indigenously developed Covid-19 vaccinations, much to the delight of everyone.

While vaccinations have been administered in the past to prevent diseases like Cholera and Polio, the Covid-19 vaccine had to be a new discovery and tested not once but multiple times, to prove that it is completely safe and effective. Over and above this, convincing the consumer about its safety with bare minimal side effects too was a challenge for doctors. All this required getting people mentally prepared to take the vaccine.

Here, we talk about how to get mentally prepared to take the vaccine.

Vaccines and Covid-19

A cocktail of emotions, while dealing with the Covid-19 pandemic, including extreme fear, anxiety, panic, grief, guilt, loss of loved ones and uncertainty about livelihood, have all led to countless health issues. Today, with two of the most effective vaccines developed by our own country and successfully in use, citizens can breathe a bit easy with hope of surviving the effects of the deadly virus. Being the first of its kind to be developed within India, there surely will be certain doubts among citizens on its effectiveness and after effects. However, the point to be remembered here is that no vaccine is released for public use unless it is certified to be completely safe and adequate alternative medication is made available to cope up with any possible after effect. It is more to be prepared mentally and feel completely confident.

How do we prepare mentally to get vaccinated?

With different types of vaccines available now to choose from, the doubts in the minds of citizens about which one is most effective, is quite understandable. In many ways, Covid-19 vaccines are just like the other vaccines, you would have seen before. It is therefore necessary to plan your vaccination schedule in such a way that you give yourself sufficient time to recover from possible after effects of the vaccine, which in most of the cases, are very mild.

Here are a few suggestions.

1. Plan your appointment

It is wise to plan your appointment before any significant commitment to help you overcome any mild side effect. Choose a vaccination centre close by to your residence.

2. Maintain the same vaccine across both the dozes

It is very important to the same vaccine type till you finish both the schedules dozes. Any change of vaccine type in the intermediate period can lead to certain side effects.

3. Have pain relievers on hand

Side effects are normal after vaccination. Most people experience mild side effects like fever, pain at the vaccination site or headache. It is good to keep some pain relievers like paracetamol tablets in stock.

4. Stay hydrated

Have your routine breakfast or lunch depending upon your scheduled appointment for vaccination and stay hydrated. Some people may get nervous when they get any kid of shot. This can make them feel dizzy. Proper nutrition and hydration can combat that.

5. Avoid Alcohol and Smoking

Stay away from Alcohol and Smoking before and a couple of days after vaccination. This will help in managing after effects of the vaccine in a better way.

The Bottom Line

Intense efforts have gone into the development of vaccines for Covid-19. While vaccination is extremely important, it is also necessary to adhere to Covid-19 protocols strictly, to stay protected. The best solution to reduce anxiety is to go the nearest designated vaccination centre and get vaccinated.

For more information on Covid-19 vaccinations please get in touch with our medical experts at Sagar Hospitals in Bangalore. Stay Safe Stay Healthy.

Long COVID explained. Are you at risk?

Covid-19 has taken its toll on the healthcare infrastructure globally and nowhere is it more apparent in India. The struggles of finding oxygen cylinders, concentrators, hospital beds, and ICU beds with ventilators have made the health crisis impossible to ignore and the focus of the nation’s attention.

Accounts of recovered Covid-19 patients and various studies around the world, however, seem to signal a more drawn-out, lingering struggle. Though there isn’t an exact definition for “Long COVID,” it is synonymous with the long-term impact of Covid-19 even after a patient tests negative for it. While Covid-19 symptoms seem to pass for most people after recovery, some seem to suffer the effects of the illness weeks and even months after the initial infection. New studies show that both the elderly and the young are susceptible to Long COVID.

Here, we discuss Long COVID in detail, the risks, its symptoms, and how to manage the condition.

What is Long COVID?

Long COVID is a term that describes the post-Covid-19 symptoms experienced by patients much after they have recovered from the initial infection. While most people with mild to moderate infections recover within 2 weeks, Long COVID patients experience post-Covid-19 complications that persist for months. Though there isn’t a precise duration that is used to define Long COVID, symptoms that persist for 8-12 weeks and beyond are generally considered to qualify for Long COVID. People suffering from these symptoms are known as long-haulers.

Research from multiple studies and on-ground emerging testimony from medical professionals identify two main groups of long-term symptoms: respiratory and multi-organ. Respiratory symptoms such as breathlessness and cough are most common and also include lung fibrosis, headaches, and fatigue. The second group of symptoms affects many organ systems of the body, including the heart, the nervous system, kidneys, and more. In the study from COVID Symptom Study app (UK), 4182 people reported long-term symptoms such as cognitive impairment (or “brain fog”), anxiety, heart palpitations, numbness, and “pin and needles.”

How many people get Long COVID? Who is at most risk?

Details regarding the number or proportion of people that suffer from Long COVID are still emerging. People with comorbidities, however, are a group at risk in particular.

A study by the Stanford School of Medicine found that more than 70% of patients hospitalised for Covid-19 suffered various symptoms months after recovering from the initial infection.

In a study led by the University of Leicester of over 1000 participants who had required Covid-related hospitalisations reported that 70% patients did not make a full recovery 5 months after being discharged. Nearly 18% of those who were working before contracting Covid-19 could no longer continue working afterward. A further 19% reported having undergone a health-related change at their workplace.

According to the estimates provided by the Office for National Statistics, 20% of long-haulers in the UK found their daily activities and quality of life severely impacted by Long COVID symptoms.

Studies are showing that it is not only the hospitalised patients with moderate to severe COVID that are susceptible to Long COVID, but non-hospitalised patients with milder cases as well. As per a survey conducted by the US CDC (Centers for Disease Control and Prevention), 35% of non-hospitalised patients with mild Covid-19 suffered various symptoms well after 21 days. This includes patients in the 18-34 age group where 20% reported ongoing symptoms.

Overall, research shows that nearly 33% of non-hospitalised Covid-19 patients will be experiencing Long COVID symptoms up to 3 months later, and some for even 6 months or longer. In comparison, only 10% of flu patients are still sick after 14 days.

What are the symptoms of Long COVID?

Many Long COVID patients experience the same Covid-19 symptoms from their initial infection, albeit for months. Post-Covid-19 symptoms can range from 4-12 weeks for most long-haulers and longer (up to 6 months or more) in rarer cases. Some people can develop new symptoms also, such as hair loss, and undergo cycles of improving and then getting worse.

Symptoms of Long COVID include:

● Fatigue: Severe fatigue and tiredness is a common Covid-19 symptom that, according to researchers, is prevalent in recovered patients weeks after testing negative for the initial illness. Covid-19 severely affects the immune system and the body as a whole, and it is apparent from patient testimonies. Long-haulers complain of long-term fatigue and an inability to resume physical/ daily activities at pre-illness levels for months.

● Anxiety and depression: Covid-19 can put an immense mental strain on patients with the possibility of health levels plummeting in a short span of time. This is worsened in the backdrop of health services under duress with necessary medical resources in short supply—all while isolating or quarantining. This toll on mental health can continue much after the initial recovery (as PTSD in extreme cases) and be exacerbated by other physical post-Covid-19 symptoms.

● Brain fog/ cognitive impairment: Brain fog is a common post-COVID symptom that can severely disrupt the functioning of the central nervous system. Covid-19 can have a direct impact on the brain and when it affects other organ systems as well, this effect is compounded.

Brain fog can interrupt cognitive abilities, resulting in confusion and mental fatigue. It can make it very hard for people to concentrate effectively and focus on tasks.

● Shortness of breath/ dyspnea: Patients can still suffer from an inability to breathe smoothly weeks after recovering from their initial Covid-19 infection. This can indicate fatigue and low oxygen levels in the body and can lead to chest pain if not managed in time.

● Heart palpitations: The immune response to fight the coronavirus infection can cause high inflammation in the body that can damage healthy tissue, including the heart and lungs. Post-Covid-19, this can manifest as rapid or irregular heart rates or palpitations.

● Chest pain: Chest pain post-Covid-19 can happen due to myalgia (muscle pain or soreness) from a severe bout of COVID. This can make the area sore to the touch and movements such as turning or twisting the chest can be painful. Long-haulers can also suffer from non-cardiac or non-specific chest pain that can be sharp or dull. These symptoms can ail recovered patients for weeks.

● Joint or muscle pain

Treatment and support to manage Long COVID

Considering that Long COVID can impact many organ systems, health experts from across the globe and at Sagar Hospitals suggest a multi-disciplinary approach for dealing with Long COVID. Doctors from various disciplines such as infectious diseases, cardiology, pulmonology, and others must work together to focus on increasing the lung capacity and physical strength of Long COVID patients.

Our doctors at Sagar Hospitals suggest pacing yourself, taking adequate breaks, and gradually increasing the amount of exercise to manage breathlessness and fatigue. Flexibility exercises and controlled strength training can help relieve joint and muscular pain. Finally, our experts advise you to not ignore your mental health and to be kind to yourself during recovery.

In light of recent research and numerous testimonies from recovering Covid-19 patients, post-Covid-19 symptoms that stay with people for months after the initial infection may be the next global healthcare challenge. Long COVID has proven to affect not just hospitalised patients but patients suffering mild COVID as well. These lingering post-Covid-19 symptoms can severely impact the daily lives of patients and even affect employment. As more studies are conducted on Long COVID, more information on its impact on recovering patients will come to light.

To find out about multi-specialty and multi-expertise medical teams that focus on providing holistic care to rehabilitate recovering Covid-19 patients, reach out to our experts at Sagar Hospitals.

Mucormycosis: what is the “black fungus?”

As the second wave of the Covid-19 pandemic rages across India, a fungal infection known as mucormycosis (or commonly as the "black fungus") is being reported in increasingly high numbers amongst recovering and recently recovered Covid-19 patients. The country now faces the prospect of multiple health crises with the "black fungus" being declared a pandemic by many states. The rampant mucormycosis infections have added yet another dangerous complexity to the recovery of Covid-19 patients and created more panic amongst the citizenry.

What is the "black fungus?"

Mucormycosis is a rare but serious fungal infection caused by a group of moulds known as mucormycetes. These moulds are prevalent in our natural environment as spores in the air and in places such as the soil, plants, manure, and decaying vegetables and fruits. It is so ubiquitous that it can be found even in the nose and mucus of a healthy person.

Mucormycosis generally affects immunocompromised individuals (people with a compromised ability to fight viruses, germs, and other environmental pathogens). Patients recovering or recently recovered from Covid-19 typically suffer from a weakened immune system, and are being found to be susceptible to mucormycosis infection. The infection affects the sinuses, the lungs, and the brain.

With an overall mortality rate of 50%, it can easily be life-threatening in immunocompromised people.

What are the risk factors for contracting this infection?

In spite of the seemingly close association with Covid-19 recently, "black fungus" does not spread by direct contact - neither by person-to-person contact nor by droplet spread. This fungal infection also does not spread through oxygenation, humidifiers, or water. The fungal spores are found indoors as well as outdoors and enter the respiratory tract via inhalation.

Though there are some linkages cited by doctors with overuse of zinc and iron supplements, the main risk factors for contracting mucormycosis infections are believed to be the following:

● Drug-related compromised immunity from steroid overuse, immunosuppressant drugs, or chemotherapy.

● Diabetes or hyperglycemia (high blood sugar levels).

● Immunocompromised patients suffering from conditions such as cancers and HIV/AIDS.

What is the link between Mucormycosis and Covid-19?

In spite of the seemingly close association with Covid-19 recently, there is no direct link or causation between Covid-19 and mucormycosis.

There are, however, many factors that are closely connected to Covid-19 cases that increase a patient's susceptibility to contract the infection:

● Diabetes: Uncontrolled diabetes contributes to weakening the immune system. With an already compromised immune system, a Covid-19 patient has an additional complication with diabetes. A history of uncontrolled blood sugar levels not only exposes these patients to the risk of contracting more severe illnesses but also encourages the "black fungus" infection to thrive in the body.

● Steroids: Steroids are used to reduce inflammation in the lungs of Covid-19 patients and help control lung damage when there is an overly strong reaction from the immune system to fight the coronavirus. These drugs, however, can in addition to controlling the immune response also weaken it severely. They also push up blood sugar levels in diabetic as well as non-diabetic patients.

This sets upon a cycle of conditions that can leave a Covid-19 patient severely immunocompromised. First, diabetes (or poor sugar control) reduces the body's immune defences, then Covid-19 worsens it, and finally, non-judicious use of steroids cripples the immune system. This plummet in the immune response of Covid-19 patients leaves them vulnerable to a mucormycosis infection.

● Comorbidities, immunodeficiencies, and immunosuppressants: Patients suffering from comorbidities (such as diabetes) or immunodeficient conditions (such as HIV/AIDs) already have a weak immune system to protect them. Patients taking immunosuppressive medications (such as chemotherapy, corticosteroids) to fight severe diseases and environmental pathogens are in a similarly vulnerable situation. Such patients are at a high risk of contracting fungal infections. Ailing Covid-19 patients, whether diabetic or surviving with immunosuppressant drugs have low defenses against fungal infections such as mucormycosis.

What are the early symptoms to watch out for?

Mucormycosis, with a mortality rate of 50%, can be life-threatening. Though controlled mainly with antifungal medication, it is not uncommon for patients to require surgery and lose an eye or the upper jaw.

It is important that you pay attention to early signs of a possible mucormycosis infection to prevent severe complications:

● Pain and redness around the eyes and nose, accompanied by fever.

● Swelling of the forehead and headaches.

● Local pain and swelling in the one side of the face or cheekbone.

● Loosening of teeth and reduced jaw involvement.

● Blackish discolouration or crusts around the bridge of the nose or palate.

● Blurred or double vision, accompanied by pain.

● Pulmonary symptoms such as nasal blockage/ discharge (bloody or black in colour), nosebleeds, reduction in facial sensations.

● Respiratory symptoms such as trouble with breathing, chest pain, and coughing.

How do you prevent or minimise "black fungus" infection?

Mucormycosis remains a rare infection amongst non-immunocompromised people.

Experts at the Sagar Hospital advise the following to prevent a black fungus infection in immunocompromised patients:

● The fungi spores thrive in damp, high moisture environments. Unsanitary environments where patients are being treated or oxygenated can become a source of infection in the absence of proper ventilation and cleanliness. All environments of recovering patients, whether medical or home, must be kept as sanitary as possible.

● Unsystematic and overuse of steroids can push down immunity and raise blood sugar levels. The prevalence of both these conditions increases the chances of contracting a mucormycosis infection. One way to stall the possibility of the fungal infection is ensuring that Covid-19 patients, in treatment as well as after recovery, are administered the right dose of steroids at the right time and for the right duration. Patients should avoid self-medication and treatment should be strictly under a doctor's guidance.

● It is strongly recommended that hyperglycemia be monitored and controlled. Blood sugar levels of diabetic as well as non-diabetic patients being treated for Covid-19 must be kept in check. Doctors should also monitor patients discharged from Covid-19 treatment for blood glucose levels, especially in diabetics.

Treatment

Management of Covid-19 patients is an interdepartmental effort of internal medicine specialists, ENT specialists, microbiologists, ophthalmologists, dentists, and maxillofacial surgeons. At Sagar Hospitals, our interdisciplinary team of experts handles mucor infections in our patients with utmost care and efficacy.

For Covid-19 patients being treated for mucormycosis, our experts strongly recommend controlling diabetes and hyperglycemia, reducing steroid use, and discontinuing the use of immunosuppressant drugs. Following medication and procedures, intravenous antifungal treatment may be required.

While primarily treated with antifungal medication, a mucormycosis infection may eventually necessitate surgery.

The "black fungus" has become a pandemic in India in its own right and naturally created worry in a population already reeling from the pandemic. While not a common infection at all, mucormycosis is a high risk for the immunocompromised such as Covid-19 patients. Overuse of steroids and uncontrolled blood sugar levels further makes patients even more vulnerable to this fungal infection. However, infection can be prevented and treated with monitoring of hyperglycemia, strict control of steroid use, and control of immunosuppressant conditions. For more information on mucormycosis and its control reach out to our experts at Sagar Hospital.

Covid-19 is confirmed airborne. Now what?

With the clamour of scientists growing louder and evidence piling every day, the discussion of airborne transmission of Covid-19 has finally come to a consensus with the CDC and WHO both making the announcement official. The medical bodies have updated their guidelines nearly a month after a report in the medical journal Lancet backed by many scientists claimed that there is strong and consistent proof that the SARS-CoV-2 virus is transmitted predominantly through the air.

What does “airborne” mean, exactly?

Clarifying the meaning of the word “airborne” is a great place to begin considering the amount of panic and misconception this single word has created in the general public—especially in India. The scientific meaning of the word isn’t the same as its commonly used or understood meaning.

“Airborne” does not mean that the SARS-CoV-2 virus spreads in the open air, that outdoor air is dangerous, and that the virus is potentially everywhere around us. No, you also do not need to wear N-95 masks at all times to protect yourself. What it does mean is that the previously accepted theory that the SARS-CoV-2 virus spreads primarily through large droplets that travel only short distances (less than 2m) has been discarded. It is now believed that the virus can travel much farther (close to 10m) and can collect in the air of a closed space in the form of aerosols.

As panic-inducing as it can be to read a news headline that the coronavirus is airborne with the implication that there is seemingly no safe distance between the virus and you, and that risk is nearly unavoidable, it is actually a call-to-action to open your windows instead of closing them.

Droplets or aerosols?

Since the pandemic began, the question of how the coronavirus transmits has been the subject of greatest importance in the effort to curb the virus. It was earlier suggested that the SARS-Cov-2 virus spreads mainly through large droplets that are produced when a person sneezes, coughs, or talks loudly. It was believed that these droplets, since they were of large size, could only travel short distances and fell to the ground. With this understanding, a person standing 2m (6 feet) away was considered safe from viral transmission.

However, by studying contact tracing data over the world, researchers found that the “super-spreader” events tended to occur in venues and events where people tended to linger longer: in offices, conferences, retail stores, indoor restaurants, and most importantly, homes. Transmission was found to be more likely when people spent more time together in a closed environment. Over time, the evidence for aerosol-based airborne transmission became overwhelming, and that for droplet transmission hard to find.

Experts over the world are now of a collective opinion that public health measures that fail to treat the virus propagation predominantly through airborne transmission leave the public unsafe and allow the virus to spread.

What is the new advisory?

The US Centers for Disease Control and Prevention (CDC), the World Health Organization (WHO), and Union Health Ministry (India) have recognised that SARS-Cov-2 is airborne and can be transmitted through respiratory fluids, which are fine droplets or aerosols that are released during respiration. This means that the SARS-CoV-2 virus can be transmitted when an individual inhales respiratory aerosols produced when a COVID-infected person exhales (including quiet breathing), talks, sneezes, coughs, sings, or shouts. Public guidelines now include “airborne transmission” as a possible mode of coronavirus transmission.

These aerosols or respiratory droplets that carry the SARS-CoV-2 virus and transmit infect exist across a spectrum of sizes. The virus can travel on very small particles that can build up indoors but disperse quickly and easily outdoors. Indoors, these particles can travel much farther than the stipulated social distance of 2m (6 feet). These exhaled respiratory fluids can settle on surfaces or remain suspended in the air, building up. Although large droplets settle down to the ground within seconds to minutes, the very small droplets and aerosols can remain suspended for minutes to hours in a poorly ventilated space.

This is why the straightforward public health messaging in Japan is to avoid the 3 Cs—closed spaces, close contact, and crowds.

What should you do, especially regarding indoor ventilation?

The risk of transmission increases greatly in closed, poorly/ unventilated spaces because respiratory fluids and aerosols can quickly spread and concentrate in such areas. You should keep your indoors well-ventilated by keeping windows and doors open to ensure good air circulation and by using exhaust systems.

It is repeatedly stressed that the risk of coronavirus transmission is markedly lower outdoors because virus-carrying aerosols dissipate quickly in the open air. It is advised that you take measures to improve ventilation in homes, offices, and public spaces. Simple and strategic placement of fans, open windows and doors, and exhaust systems introduce outdoor air and improve the quality of air inside. Creating cross-ventilation goes a long way in curbing the transmission of Covid-19.

Therefore, indoor spaces such as indoor restaurants where mask protection is compromised while eating and have plexiglass separators to create a physical barrier between diners don’t actually provide much protection against viral transmission. We have also enjoyed a false sense of security with a social distance of 6 feet and the “sanitisation theatre” in airports, public offices, and other public spaces. A focus on ensuring good ventilation and should be a much bigger priority than the manic disinfection of all surfaces and store-bought items.

These precautions are underpinned, of course, by continued use of face masks and hand washing/ sanitisation.

In the face of it, the new advisory may seem contradictory to earlier precautions. But digging deeper into the CDC and the Indian government advisory, we see that the breadth of precautions has only been expanded, and they do not contradict earlier guidelines. Transmission of Covid-19 being considered airborne does not indicate in any way that outside/ open air and ventilation are the new public enemy. In fact, it only reiterates the knowledge that closed spaces and close contact are where the SARS-Cov-2 virus is transmitted most easily, and that good ventilation and open spaces combined with mask wearing and vaccination are the most potent weapons against Covid-19.

5 Benefits of preventive healthcare that could save your life

The age-old proverb “prevention is better than cure” though overused, holds true. The proverbial cure is usually expensive, painful, and not convenient in the least. To put things in perspective, consider the use of seatbelts—they are affordable, easy to use, and provide a robust prevention capability against injury. The consequence or price of not using seatbelts can be quite serious and regrettably dire. The same principle of prevention works with our personal health as well.

Preventive healthcare mostly revolves around 3 things:

• Maintaining a balanced and healthy diet.

• Keeping physically and mentally fit.

• Regular health checks for early detection of diseases.

Your chances of getting cured or being able to successfully manage a non-communicable disease (NCD) are much slimmer after being diagnosed with it. In fact, as reported by WHO in 2018, non-communicable diseases are responsible for 70% of global mortality. Regular health checks are the kind of preventive measures that can help you stay a step ahead of diseases.

The following are the 5 benefits of preventive healthcare:

1. Detecting diseases early can be life-saving

The top four global causes of death are chronic diseases that are preventable and manageable with regular access to basic healthcare.

They are:

• Heart disease: Heart conditions are usually caused by obesity, bad diet, and a lack of cardiovascular exercise.

• Cancer: The most common kind of cancer, lung cancer, is caused by smoking and genetic factors.

• Stroke: Like heart disease, stroke is mostly caused by obesity and poor nutrition.

• Chronic lower respiratory disease: Smoking is by far the greatest risk factor, causing 80% of the cases.

In India alone, NCDs are responsible for 61% of all deaths. Preventable diseases caught early increases the chances of surviving them. Breast cancer and prostate cancer can be detected in women and men in early stages with regular health screens such as mammograms and prostate cancer screening (check-ups are advised starting at the ages of 40). The chances of early detection, in turn, are much higher if you have a preventive mindset with a willingness to get regular health check-ups done.

2. Timely prevention can save you from crippling medical bills in the future

As per the National Health Accounts, 2013-14, only 9.6% of the overall medical expenditure in India is on preventive healthcare. Simply put, over 90% of overall healthcare expenses are towards treating diseases and their various complications. This translates to a staggering national bill of Rs. 3.6 lakh crore per year. With skyrocketing costs of medical care, most people from the poorer sections of society end up selling property and personal possessions to keep up with the burgeoning medical expenses.

The management and treatment of chronic diseases such as heart disease and cancer is exorbitant and can easily run into lakhs. Being covered under health insurance (according to reports by RedSeer, only 25% of the Indian population has health insurance) in the present can prevent hefty out-of-pocket (OOP) payments in the future. Investing in preventive healthcare allows chronic diseases to be discovered early and for you to avoid expensive medical treatment for conditions that have progressed past regular management.

3. Early diagnosis = early treatment

Knowledge is power—and regularly checking for high cholesterol levels, blood sugar, and blood pressure helps you catch chronic diseases early even if you don’t have symptoms. Preventive health checks let you know what’s going on in your body and what needs to be addressed immediately. This information that can be gleaned from simple and inexpensive blood tests can provide you the necessary insight to make adequate changes in your lifestyle and diet for early treatment of the condition. In many cases, it can minimise the necessity of seeking specialist care from specialist doctors such as cardiologists, endocrinologists, and neurologists.

4. Avoid or reduce symptoms of illness

Sometimes, avoiding a non-communicable disease altogether is not an option due to genetic factors and constraints related to ability. In such cases, the easy management of symptoms becomes important for reduced risk and better quality of everyday life. One of the biggest advantages of working with a proactive and preventive mindset is that NCDs such as cardiac disease, type 2 diabetes, hypertension, and conditions caused by smoking or alcohol consumption are targeted first. The management of these diseases beyond regular stages can be lengthy and difficult. Their early detection plays an important role in effectively managing or avoiding their symptoms.

5. Improved quality of life

Timely preventive screenings such as mammograms can lower health costs, introduce an early intervention, and invariably improve the quality of life. NCDs can have debilitating effects on your ability to be productive and your career. Dealing with advanced stages of NCDs impacts your everyday activities and mental health. Detection of serious illnesses in the early stages can help you prevent not just symptoms but chronic inconvenience as well.

Much like the seatbelt, the cost of which is only a fraction of the overall cost of accident care, preventive healthcare is one of the most efficient methods of maintaining long-term good health. Regular check-ups provide you early markers of worsening conditions for you to make timely and inexpensive lifestyle changes to not just mitigate an illness but improve your overall health and longevity as well. Detecting illnesses and non-communicable diseases in the early stages allows you to seek treatment when it is most likely to work best. With the life-changing and life-saving potential of preventive healthcare, it should be seen as a compulsory part of your overall health. For more information on preventive measures against chronic and life-threatening diseases, book an appointment with our experts at the Department of Preventive Healthcare at Sagar Hospitals.

How can pregnant women protect themselves from COVID-19?

As the pandemic rages on, everyone has reason to be anxious and afraid¬—COVID-19 has claimed more than a million lives worldwide. If you are pregnant, it is natural to be afraid for the health of your baby. Since COVID-19 is a new disease, many risks and threats to particular demographic groups are still unknown. Some answers may still not be clear yet, but with the help of new research and studies, guidelines for pregnant women are getting clearer.

This blog answers some of the burning questions you might have as an expecting mother. These recommendations are based on the latest guidelines from international health organisations like the WHO, CDC, and ICMR - National Institute for Research in Reproductive Health. The links to these guidelines are available at the end of the blog for your reference.

Do pregnant women have a higher chance of getting the coronavirus (COVID-19)?

Pregnant women are not particularly susceptible as a group to the SARS-CoV-2 virus (the virus that causes COVID-19) any more than the general population is.

Pregnancy is known to alter the immune system and the way your body responds to viral infections. This may result in more severe symptoms of any infection in general and holds true for COVID-19 as well. For this reason, it is advisable that you be more cautious and reduce social contact during the pandemic.

Does COVID-19 pose an additional and higher risk to pregnant women?

Pregnant women who are older, obese, or suffering from pre-existing medical conditions such as diabetes, hypertension, and heart disease (congenital or acquired) are at a greater risk of developing severe symptoms of COVID-19. Statistically, when pregnant women acquire severe illnesses, they are more likely to require healthcare in intensive care units (ICU) than non-pregnant women of reproductive age.

With an altered immune response due to pregnancy, women may be affected more acutely by respiratory diseases. This is evidenced by the increased risk to pregnant women during the last trimester of pregnancy from other coronavirus infections like SARS and MERS. It is therefore strongly advised that you report any flu-like symptoms (cough, fever, or difficulty in breathing) to your doctor.

The coronavirus pandemic has also increased the risk of perinatal anxiety and instances of domestic violence. It is critical that support to the expecting mother and her mental health is strengthened and checked at every contact.

What effect does COVID-19 have on my pregnancy?

Currently, there is no data or reported cases that indicate an increased risk of miscarriage or pregnancy loss due to COVID-19. There is also no evidence to suggest that COVID-19 causes physical or functional abnormalities in the human embryo or foetus. Evidence regarding such instances will require long-term observations and data collection.

Overall, COVID-19 is not currently considered an indication for medical termination of pregnancy.

Can COVID-19 be passed from the mother to the foetus or a newborn baby?

Emerging evidence suggests that transmission of COVID-19 during the pregnancy or birth is probable. Newborn babies whose mothers have COVID-19 have been found to test positive for the novel coronavirus in some cases; however, this may be a correlation and not evidence of transmission during pregnancy or birth.

The proportion of pregnancies affected by COVID-19 is yet to be determined. At present, there are no recorded cases of COVID-19 being present in breast milk, amniotic fluids, or vaginal secretions.

A newborn baby can, however, catch the infection after birth. This is why doctors recommend temporarily separating the baby from mothers who test positive for COVID-19 at the time of delivery in addition to testing the baby.

What are the precautionary steps for pregnant women against COVID-19?

1. Wash your hands regularly. This is a message you may have heard over and over since the pandemic began, but it is sound advice. Hand hygiene really goes a long way in protecting you from COVID-19.

2. Adhere to social distancing norms. Avoid social contact outside of your family as much as possible. Maintain a distance of 6 feet or 2 meters from other people when you are in any public area.

3. Work from home if the option is available to you.

4. Avoid close contact with anyone showing flu-like symptoms such as coughing, sneezing, or fever. Symptoms of COVID-19 vary in intensity and it is very hard to differentiate non-Covid viral and bacterial respiratory diseases from COVID-19 without proper testing.

5. Get the recommended vaccines. The influenza/ flu vaccine will make you less susceptible to the flu, a respiratory illness that can cause complications during pregnancy. The whooping cough vaccine will protect your baby against whooping cough, which can be very dangerous in newborns.

6. Employ proper sneezing etiquette. Use a tissue or the inside of your arm when you sneeze or cough. Dispose of the tissue safely and wash your hands thoroughly.

7. Seek medical attention if you display any flu-like or respiratory symptoms. If you develop trouble breathing, fever, or a cough, talk to your doctor immediately. Your doctor will recommend you a COVID-19 test based on your medical history.

8. Seek virtual consultations with your gynaecologist instead of in-person prenatal visits. Minimizing your time in your doctor’s or the hospital’s waiting room is advisable. However, do not deny yourself any healthcare that you may need; necessary tests like blood tests, ultrasounds, and foetal tests will require you to make a visit in person.

9. Reduce everyday stress as much as possible. Do things that make you happy, calm, and put you at ease. Maintain social contact virtually with friends and your support network. Do Kegel and squat exercises as recommended by your doctor.

Is it safe to go to a hospital to deliver my baby?

Yes. It is safer to deliver in a hospital, even during the COVID-19 pandemic.

Do not delay getting any emergency care because you are afraid of getting COVID-19; the benefits outweigh the risks. Planned deliveries in hospitals are safe—hospitals take necessary precautions and have systems in place to ensure minimal risk and exposure for the newborn and the mother. Most healthcare institutions segregate COVID-19 patients in isolation wards and buildings as a precaution as well.

If you have any more questions regarding your pregnancy, the risks, and a healthcare plan to manage an ongoing or upcoming pregnancy, book an appointment with our OB/ GYN specialists at the Department of Obstetrics and Gynaecology at Sagar Hospitals. To learn more about preventable diseases and illnesses like COVID-19 call our experts at the Department of Preventive Healthcare at Sagar Hospitals.

Sources:

WHO:

https://www.who.int/southeastasia/outbreaks-and-emergencies/novel-coronavirus-2019/protective-measures/pregnant-women-and-new-mothers

CDC:

ICMR:

Reinventing hospital care during the COVID-19 pandemic

As the world continues to battle the Novel Coronavirus (SARS-CoV-2) in homes, communities, the workplace, public areas, and pretty much anywhere where public life bustled with everyday normalcy, one institution has been a surprising and worrying battleground—the hospital. During the early months of the pandemic, hospitals struggled to control infection rates inside their premises. NHS England reported around mid-May that nearly 20% of patients hospitalised with COVID-19 contracted the disease while being treated for other illnesses in hospitals. Similar figures were reported around the world: in a study involving a tertiary care university hospital in Turkey (March-May 2020), positivity rates for SARS-CoV-2 among doctors, nurses, and support staff were found to be nearly 6%, 8%, and 11% respectively.

In such dire situations, it has been necessary for hospitals and healthcare leadership to quickly adapt and reinvent patient care to ensure the safety of their frontline staff, patients, and their communities. Though hospitals and healthcare systems did struggle initially with challenges, such as overwhelming patient inflow, near-capacity occupancy, and scarcity of protective equipment and ICU beds with ventilators, they have over time also been able to strengthen and improve measures to curb virus transmission inside their facilities.

Recent data now shows that rigorous and robust infection control measures implemented in hospitals can effectively prevent the transmission of COVID-19 to visiting or admitted patients. This is a promising development since a widespread fear of contracting COVID-19 in a hospital setting has discouraged many patients to seek essential care.

New preventive measures and COVID-19 infection control in hospitals

Crisis management teams (CMT) and similar leadership in hospitals play a major role in steering the healthcare system in difficult times like these. Operational updates are required in CMT policies, admission protocols, staff and resource utilization, and treatment guidelines to restrict the virus from spreading inside hospitals.

The following are the infection control measures to help hospitals safeguard their patients and medical personnel:

1. Universal masking of all hospital staff, patients, and visitors:

The foremost preventive measure against COVID-19 in public places remains the diligent and correct usage of face masks. Hospitals must ensure proper face coverings for patients/ visitors/ attendees and personal protective equipment (PPE) for all hospital staff.

2. Testing and screening measures/ admission protocols:

• For routine consultations, patient screening must begin at the hospital gate/ entrance with mandatory temperature checks and by providing sanitizer dispensers.

• Patients with special needs and attendants must undergo isolated screening outside the building.

• COVID-19 testing facilities should be located in blocks isolated from the main hospital building.

• Fever clinics should operate outside the main hospital building for patients with flu-like symptoms.

• All hospital employees (medical and non-medical) must be screened daily at separate staff entries.

3. Personal protective equipment (PPE) in accordance with the Ministry of Health and Family Welfare (MoHFW) recommendations:

• PPE must be available for all medical as well as non-medical staff.

• Specific zones and protocols for donning and doffing personal protective equipment by hospital stall must be created.

4. Daily symptom screening for doctors and patients:

• Any healthcare personnel that might be exposed to COVID-19 must be managed and monitored.

• Communication should be effective within the hospital facility and external communication related to COVID-19 should be planned for the availability of accurate information to the wider community.

6. Dedicated non-Covid OPDs and wards:

• Separate wards, rooms, and bed spaces for non-Covid patients must be made available in separate hospital blocks/ buildings/ branches to prevent contact between patients.

• Distancing protocols must be maintained in OPDs with socially distanced seating arrangements.

• Regular sanitization of all waiting areas, consultation rooms, restrooms, and passageways must be carried out periodically.

7. Effective intra-hospital communication channels:

• The communication between frontline staff and the CMT must be continuous to mitigate and meet challenges.

• All additional/ pop-up ICUs and wards must be connected to communications systems for quick response.

8. Restricted visitor policy:

• With visitors not being allowed family meetings should be organized via web-based applications to reduce stress of the patients and their families.

9. Tele or video consultations:

Remote consultations or online appointments should be provided with doctors through video calling as per government guidelines for at-risk patients, senior citizens, and anyone hesitant to visit the hospital premises.

While the unprecedented pandemic has forced people to stay home and made them scared of visiting hospitals, the healthcare needs of patients remain ever-present and require professional care. In such a situation, reinventing hospital care and ensuring a safe environment with robust infection control protocols is an important duty for hospitals.

Carefully adapting, implementing, and following comprehensive infection control measures can prevent the spread of COVID-19 within a hospital. Educating the community about these safety and preventive measures will further help reassure patients and create confidence in the public to visit healthcare institutions. Sagar Hospitals are committed to the complete safety and health of their patients. The Jayanagar branch of Sagar Hospitals is dedicated exclusively to the treatment of non-Covid patients and out-patient consultations. Complete infection control measures, including proper distancing and sanitation protocols, have been implemented. Additionally, RT-PCR testing (the standard and reliable test for COVID-19) facilities have been kept outside the hospital premises to ensure safety for all patients and attendants. If you are suffering from non-Covid medical conditions, but are afraid to seek the required medical attention, please reach out to our experts at Sagar Hospitals for booking an appointment and receiving necessary safety-related information. Book an appointment with our experts at the Department of Preventive Healthcare at Sagar Hospitals for more information on preventive measures against dangerous illnesses and diseases.

Triggers of heartburn: what’s burning you?

Heartburn or acid reflux is the sensation of burning and pain in your chest that is often accompanied by a bitter taste. Oesophagus, the tube that connects your stomach and throat, gets irritated by stomach acid backing up, leading to burning discomfort in the area under your breastbone or upper abdomen. The condition draws its name from the region that it affects, which makes the sensation feel like your “heart is burning”.

Heartburn may occur more frequently after a large meal, while lying down, or bending. The specific factors that trigger heartburn can vary from person to person as well. Though heartburn symptoms are fairly common and can be managed at home, if they occur too frequently and interfere with you being able to swallow easily, there may be an underlying medical condition causing it.

The common symptoms of heartburn are:

• A bitter or strong, acidic taste in the mouth.

• A sensation of burning in the chest. It may usually occur after eating and at night.

• The discomfort increases upon lying down or bending.

What causes heartburn?

Heartburn typically occurs due to contents of the stomach backing up the oesophagus. This involves a problem with a valve called the lower oesophageal sphincter (LOS). The LOS is located where the oesophagus meets the stomach. The function of the LOS is to keep stomach acids and the contents contained to the stomach with the help of gravity and your natural upright posture. It opens to let food into the stomach or to allow gases out when you burp.

Sometimes, the LOS can open too frequently or not close tightly enough, allowing the stomach acid to back up into the oesophagus and leading to heartburn. The cause or factors that trigger this problem can be related to eating habits, lifestyle, diet, or even exercise. Let’s examine these factors in detail.

Heartburn triggers: diet

Certain kinds of food and drinks that can trigger heartburn in people who are susceptible to the condition:

• High-fat foods. They sit longer in the stomach longer and are the most common trigger for heartburn.

• Spicy foods such as red and green chillies, various kinds of peppers, garlic, and raw onions.

• Alcohol, red wine in particular.

• Carbonated drinks like flavoured sodas and colas.

• Caffeinated drinks such as coffee, tea, and energy/ sports drinks.

• Chocolate and other sweets.

• Citrus fruits such as lemon, grapefruit, and orange.

• Products made from citrus fruits such as juices and concentrates.

• Peppermint

Heartburn triggers: lifestyle

Lifestyle choices or health conditions can exacerbate heartburn as well:

• Smoking

• Sustained mental stress and anxiety.

• Conditions that put pressure on the stomach, such as obesity, pregnancy, and constipation.

• Overeating, resulting in too much food in your stomach.

• Lying down or sleeping too soon after meals. It is advisable to sleep after 2 hours of eating. This allows the food to pass from the stomach into the intestines and not back up into the oesophagus.

• Consumption of NSAIDs (nonsteroidal anti-inflammatory drugs) such as aspirin and ibuprofen, some types of blood pressure medication, and heart disease medicines such as nitrates and calcium channel blockers.

Heartburn triggers: exercise

Abdominal pressure due to exertion or body positions involved in certain exercises can cause heartburn:

• Exercise positions that involve bending over can increase pressure on the abdominal area and cause stomach acids to be pushed back into the oesophagus.

• Exercises that exert pressure on the abdomen, such as leg crunches, crunches, and other ab workouts.

• Positions and yoga moves such as headstands and the downward dog that can reverse the natural flow of stomach acids.

• High-impact exercises and sports, such as running, football, basketball, and aerobics, which jar your body and slosh stomach contents upwards if you suffer from a weak LOS.

• Exercising on a full stomach or before the food has not left the stomach and travelled down to the intestines.

When should you see your doctor for heartburn?

Heartburn that lasts for more than 2 weeks and does not respond effectively to medication can indicate an underlying medical issue. Heartburn can be a symptom for digestive conditions such as GERD (gastroesophageal reflux disease) or ulcers, which are sores in the stomach or oesophageal lining.

Consult your doctor if you develop the following issues with heartburn:

• Difficulty or pain while swallowing.

• Difficulty in breathing or shortness of breath.

• Pain that spreads outwards from your back to your shoulder.

• Sweating during discomfort in the chest.

• Dark tarry stools with or without blood.

• Dizziness or lightheadedness.

Preventions and treatment

Heartburn prevention mostly involves avoiding the triggers discussed above. The lifestyle or diet changes should suffice in most cases to alleviate a tendency to develop heartburn. Your doctor may also prescribe you medication to treat occasional instances of heartburn, such as antacids, H2 receptor antagonists to reduce the production of stomach acids, and proton pump inhibitors to block stomach acid production. You can also maintain a log of heartburn instances to track your heartburn triggers and decide appropriate portion sizes for yourself.

However, if these measures do not improve your symptoms and the condition persists, your gastroenterologist will have to conduct a few tests to diagnose your condition accurately for a timely intervention.

These include:

• An endoscopy to check for ulcers or signs of irritation in your stomach lining or the oesophagus.

• An x-ray of the abdominal region.

• A ph-test to determine the acid levels in your oesophagus.

Identifying and understanding what triggers your heartburns can go a long way in managing and avoiding the discomfort of heartburn. Occasional episodes of heartburn are easily managed at home and little cause of concern, but chronic heartburn can limit your food choices and interrupt daily activities and sleep. Keeping a record of when and what you eat can help your doctor diagnose your symptoms better to identify the root cause of the heartburn. If you are facing issues with heartburn too frequently and it is beginning to affect your daily activities, you are advised to consult the gastroenterologists at the Department of Gastroenterology and Hepatology at Sagar Hospitals.