As Covid-19 cases continue to register a spike across India, doctors are noticing “mostly mild” cases not requiring hospitalisation.
The usual symptoms of the infection caused by the latest strain include fever, sore throat, body aches and tiredness. Among those with a medical history, worsening of underlying co-morbid conditions can be noticed along with fever and common symptoms.
As per doctors dealing with Covid-19 patients in multiple states, the majority of the patients are being treated symptomatically and Covid-19 has mostly been an “incidental finding” when patients are being admitted for other complaints.
Dr Sumit Ray, medical director and critical care head at Delhi-based Holy Family Hospital, told News18.com that “people coming to us with serious illnesses have Covid-19 as an incidental finding but it is not Covid-19 which is bringing them to hospitals in the majority of the cases”.
“For instance, it is a bacterial infection in the lungs which has pushed one of our patients on the ventilator but alongside, when tested, he was found positive for Covid-19 too,” he added.
Also, the classic picture of lung damage pattern — which is a known trait of severe Covid-19 disease — is quite different. “That classic pattern is not visible even among those who require ventilator or oxygen support,” Ray said.
Dr Yatin Mehta, chairman of Medanta Institute of Critical Care and Anaesthesia, echoed similar observations. “The primary reason for hospital admissions is not Covid-19,” he said, adding that people requiring admissions due to coronavirus are minimal.
Similarly, Dr Arjun Khanna, head of department of pulmonary medicine, said most Covid-19 patients under his assistance are “doing very well on home therapy, and no specific treatment is being given”.
Khanna also said no antivirals are being administered. “We provide supportive treatment for fever and cough. It is not a variant of concern as it does not cause mortality or morbidity. However, it spreads rapidly from one person to another,” he added.
Trends in hospital admission
Less than 5 per cent patients at Narayana Health City in Bengaluru have been diagnosed with Covid-19. “Of about 50 patients screened, we see 3-4 turn positive (<5%),” said Dr Ranganatha R, head of the department (pulmonology), at the hospital.
“They are mostly mild in nature, not requiring oxygen and mostly treated symptomatically. Only patients with significant co-morbid conditions and people with inadequate isolation facilities are admitted to the hospital,” he said.
On April 10, eight patients --- who were either elderly or had chronic health issues --- were admitted to the Covid-19 ward of Delhi’s Holy Family Hospital. “One patient required oxygen therapy whereas one was earlier on the ventilator but now he is recovering well,” Ray said, adding that this year, there were more patients for influenza, including H1N1 and H3N2.
“Like influenza, Covid-19 will keep coming back in intervals which can be harsh sometimes. But for now, it is not causing any severe illness,” he said.
Trends so far show that vulnerable people are at risk.
Narayana Multispeciality Hospital, Jaipur, noted that around one-fourth of the patients admitted require oxygen therapy. “We have noted that the elderly and people suffering from diabetes, hypertension or heart ailments are coming to us in serious conditions with high fever, disorientation or breathlessness,” Dr Shivani Swami, consultant pulmonologist, said.
“In these cases, ICU admission and oxygen therapy are required. Maybe, it is the right time to get cautious and start following Covid-appropriate behaviour,” Swami said, adding that many have started asking about the need to take pending booster shots.
In another instance, Faridabad-based Amrita Hospital has not admitted any Covid-19 patients so far. “As of now, we have not admitted any patients. The patients who came to us have been successfully treated on OPD basis with symptomatic management,” Khanna from Amrita Hospital said.
Queries on boosters rise
As queries rise on the need to take a second dose of boosters, doctors are appealing to the public to use masks and follow Covid-appropriate behaviour.
Mehta from Medanta said people are taking Covid-19 “too casually” now. “Even if they get symptoms such as sore throat or fever, they don’t get tested and don’t isolate. Hence, they are spreading it to more people and putting the lives of vulnerable people at risk.”
Mehta said he has been receiving several queries from his patients about taking second booster shots. “Many patients are checking with us if they need to top-up shots once again. It’s been around a year or more since they got their precautionary dose. But so far, there is no guideline about the second booster dose.”
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