Question

In a detailed paragraph (2) please write about current prevention methods, and treatment when it comes to covid 19

- 1 paragraph for prevention methods

- 1 paragraph for treatment

Please be as detailed as possible ... Please do not just write anything that doesn't Make sense!!! AND PLEASE WRITE IN PARAGRAPH FORMAT TO ANSWER BOTH PARTS AND NOT BULLET POINTS!!!!!

Thank you

IMPORTANT: If you are going to write please make sure your writing is neat, legible, and easy to read. Please write in print (not cursive). Thank you

Answer 1

CORONA VIRUS DISEASE (COVID-19)

It is an infectious disease caused by a newly discovered corona virus. Most people who fall sick with COVID-19 will experience mild to moderate symptoms and recover without special treatment.The virus that causes COVID-19 is mainly transmitted through droplets generated when an infected person coughs, sneezes, or exhales. These droplets are too heavy to hang in the air, and quickly fall on floors or surfaces. People can be infected by breathing in the virus within close proximity of someone who has COVID-19, or by touching a contaminated surface and then eyes, nose or mouth.

PREVENTION METHODS

Prevention is better than cure. As COVID-19 is an infectious disease it is necessary to follow some precautions to prevent it from getting infected. It includes social distancing, wearing a mask, cleaning your hands, keeping rooms well ventillated, avoiding crowds, and coughing into a bend elbow or tissues.

Social distancing: Maintain at least a 1-metre distance between yourself and others to reduce your risk of infection when they cough, sneeze or speak. Maintain an even greater distance between yourself and others when indoors.

Do not gather in groups: Being in a group or gathering makes it more likely that you will  be in close contact with someone. This includes avoiding all religious places of worship, as you may have to sit or stand too close to another congregant. It also includes not congregating at parks or beaches.

Wearing a mask:  Make wearing a mask a normal part of being around other people. The appropriate use, storage and cleaning or disposal are essential to make masks as effective as possible.

Points to be kept in mind while wearing and handling a mask

• Clean your hands before you put your mask on, as well as before and after you take it off, and after you touch it at any time.
• Make sure it covers both your nose, mouth and chin.
• When you take off a mask, store it in a clean plastic bag, and every day either wash it if it’s a fabric mask, or dispose of if it is a medical mask in a trash bin.
• Wash your mask after each use.
• You can transfer the virus from your hands to the mask. If you’re wearing a mask, avoid touching the front of it.
• You can also transfer the virus from the mask to your hands. Wash your hands if you touch the front of the mask.
• A mask shouldn’t be worn by a child under 2 years old, a person who has trouble breathing, or a person who can’t remove the mask on their own.
• Don’t use masks with valves.

Cleaning your hands: Regularly and thoroughly clean your hands with an alcohol-based hand rub or wash them with soap and water. This eliminates germs including viruses that may be on your hands. Avoid touching your eyes, nose and mouth. Hands touch many surfaces and can pick up viruses. Once contaminated, hands can transfer the virus to your eyes, nose or mouth. From there, the virus can enter your body and infect you.

Use hand sanitizer when you cannot wash your hands properly. Rewash your hands several times a day, especially after touching anything, including your phone or laptop.

Hand washing should be done:

• after coughing or sneezing
• when caring for the sick.
• before, during and after preparing food
• before eating
• after toilet use
• when hands are visibly dirty
• after handling animals or animal waste

Coughing into bend elbows or tissues: Cover your mouth and nose with your bent elbow or tissue when you cough or sneeze. Then dispose of the used tissue immediately into a closed bin and wash your hands. By following good ‘respiratory hygiene, you protect the people around you from viruses, which cause colds, flu and COVID-19.

Stop shaking hands and hugging people: Skin to skin contact can transmit COVID-19 from person to person. So these must be avoided.

Don't share personal items: Do not share personal items like phones, makeup items, and combs. It’s also important not to share eating utensils and straws. Teach children to recognize their reusable cup, straw, and other dishes for their own use only.

Clean and disinfect surfaces: Use alcohol-based disinfectants to clean hard surfaces in your home like countertops, door handles, furniture, and toys. Also, clean your phone, laptop, and anything else you use regularly several times a day. Disinfect areas after you bring groceries or packages into your home. Use white vinegar or hydrogen peroxide solutions for general cleaning in between disinfecting surfaces.

Avoid eating or drinking in public areas: Now is not the time to go out to eat. This means avoiding restaurants, coffee shops, bars, and other eateries. The virus can be transmitted through food, utensils, dishes, and cups. It may also be temporarily airborne from other people in the venue. You can still get delivery or takeaway food. Choose foods that are thoroughly cooked and can be reheated.

Wash fresh groceries: Wash all items under running water before eating or preparing. Do not use soap, detergent, or commercial produce wash on things like fruits and vegetables. Be sure to wash hands before and after handling these items.

Self-quarantine if sick: Call doctor if you have any symptoms. Stay home until you recover. Avoid sitting, sleeping, or eating with your loved ones even if you live in the same home. Wear a mask and wash your hands as much as possible. If you need urgent medical care, wear a mask and let them know you may have COVID-19.

TREATMENT METHODS

SYMPTOMATIC TREATMENT

Treatment for Mild cases:

In the containment phase, patients with suspected or confirmed mild COVID-19 are being isolated to break the chain of transmission. Patients with mild disease may present to primary care/outpatient department, or detected during community outreach activities, such as home visits or by telemedicine. Mild cases can be managed at Covid Care Centre, First Referral Units (FRUs), Community Health Centre (CHC), sub-district and district hospitals. Detailed clinical history is taken including that of co-morbidities. Patient is followed up daily for temperature, vitals and Oxygen saturation (SpO2). Patients should be monitored for signs and symptoms of complications that should prompt urgent referral. Patients with risk factors for severe illness should be monitored closely, given the possible risk of deterioration. If they develop any worsening symptoms (such as mental confusion, difficulty breathing, persistent pain or pressure in the chest, bluish coloration of face/lips, dehydration, decreased urine output, etc.), they should be immediately admitted to a Dedicated Covid Health Centre or Dedicated Covid Hospital. Children with mild COVID-19 should be monitored for signs and symptoms of clinical deterioration requiring urgent re-evaluation. These include difficulty in breathing/fast or shallow breathing (for infants: grunting, inability to breastfeed), blue lips or face, chest pain or pressure, new confusion, inability to awaken/not interacting when awake, inability to drink or keep down any liquids.

Mild COVID-19 cases may be given:

• Symptomatic treatment such as antipyretic (Paracetamol) for fever and pain, antitussives for cough
• Adequate nutrition and appropriate hydration to ensured.
• Tab Hydroxychloroquine (HCQ) may be considered for any of those having high risk features for severe disease (such as age> 60 years; Hypertension, diabetes, chronic lung/kidney/ liver disease, Cerebrovascular disease and obesity) under strict medical supervision, preferably after shifting to DCHC(Dedicated Covid Health Centre).
• Avoid HCQ in patients with underlying cardiac disease, history of unexplained syncope or QT prolongation (> 480 ms).

Treatment for Moderate cases:

Patients with suspected or confirmed moderate COVID-19 (pneumonia) is to be isolated to contain virus transmission. Patients with moderate disease may present to an emergency unit or primary care/outpatient department, or be encountered during community surveillance activities, such as active house to house search or by telemedicine.

The defining clinical assessment parameters are Respiratory Rate of more than or equal to 24 per minute and oxygen saturation (SpO2) of less than 94% on room air (range 90-94%). Such patients will be isolated in Dedicated Covid Health Centre (DCHC) or District hospital or Medical College hospitals.

The patient will undergo detailed clinical history including co-morbid conditions, measurement of vital signs, Oxygen saturation (SpO2) and radiological examination of Chest X-ray, Complete Blood Count and other investigations as indicated. Antibiotics should not be prescribed routinely unless there is clinical suspicion of bacterial infection.

Clinical Management of moderate cases:

• Symptomatic treatment such as antipyretic (Paracetamol) for fever and pain, antitussives for cough.
• Adequate hydration to be ensured.
• Oxygen Support:

Target SpO2: 92-96% (88-92% in patients with COPD)

The device for administering oxygen (nasal prongs, mask, or masks with breathing / non-rebreathing reservoir bag) depends upon the increasing requirement of oxygen therapy.

If HFNC or simple nasal cannula is used, N95 mask should be applied over it.

All patients should have daily 12-lead ECG

• Anticoagulation

Prophylactic dose of UFH or LMWH (e.g., enoxaparin 40 mg per day SC)

• Corticosteroids

Consider IV methylprednisolone 0.5 to 1 mg/kg OR Dexamethasone 0.1 to 0.2 mg/kg for 3 days (preferably within 48 hours of admission or if oxygen requirement is increasing and if inflammatory markers are increased).

• Antivirals

Tab. Hydroxychloroquine (400mg) BD on 1st day followed by 200mg 1 BD for 4 days. (after ECG Assessment)

• Control of co-morbid condition
• Follow up CRP, D-dimer & Ferritin every 48-72 hourly (if available); CBC with differential count, Absolute Lymphocyte count, KFT/LFT daily.
• Monitor for:

Increased work of breathing (use of accessary muscles)

Hemodynamic instability

Increase in oxygen requirement

If any of the above occurs, shift to Dedicated Covid Hospital

Treatment of Severe cases:

Early Supportive therapy and monitoring

• Symptomatic treatment with paracetamol and antitussives to continue
• Oxygenation: Give supplemental oxygen therapy immediately to patients with Severe Covid and respiratory distress, hypoxaemia, or shock: Initiate oxygen therapy at 5 L/min and titrate flow rates to reach target SpO2 ≥ 90% in non-pregnant adults and SpO2 ≥ 92- 96% in pregnant patients. Children with emergency signs (obstructed or absent breathing, severe respiratory distress, central cyanosis, shock, coma or convulsions) should receive oxygen therapy during resuscitation to target SpO2≥94%. All areas where patients with Severe Covid are cared for should be equipped with pulse oximeters, functioning oxygen systems and disposable, single use, oxygen-delivering interfaces (nasal cannula, simple face mask, and mask with reservoir bag). Use contact precautions when handling contaminated oxygen interfaces of patients with COVID – 19.
• Use conservative fluid management in patients with Severe Covid when there is no evidence of shock.
• Anticoagulation: High prophylactic dose of UFH/ LMWH (e.g. enoxaparin 40 mg BD SC) if not at high risk of bleeding.
• *Contraindications: End stage renal disease, active bleeding, emergency surgery.
• Corticosteroids : IV Methylprednisolone 1-2 mg/kg or Dexamethasone 0.2-0.4 mg/kg for 5-7 days
• Investigational therapy: Tocilizumab