The purpose of this page is to make it easy for NOBA members to find helpful information on how to prevent or manage Covid. Readers are responsible for carefully considering all information and seeking advice from their own doctors when needed.
Table of Contents
- Location-wise NOBA Contacts (if you need help with finding bed, Oxygen, etc.)
- Covid Protocol - from Prevention to Post-Covid Care (courtesy Dr Dinesh Ranjan Ji)
- Covid Protocol - from Prevention to Stage 2 (courtesy Dr J P Mandal Ji)
- Free Appointments, Zoom Calls, and Q&A Groups with Doctors
- Location-wise Resources (beds, Oxygen, etc.)
- Guideline PDFs from AIIMS and other hospitals
______________________________________________
1. Location-wise NOBA Contacts (if you need help with finding bed, Oxygen, etc.)
- Patna and Overall Bihar: Sujeet Kumar (1989 Batch) +91 93349 94833, Sumit Shashi (1993207) +91 62051 96026, Manish Kant (1996501) +91 82523 53635, Sunny Kumar (2010596) +91 83405 59462
- Patna and Delhi: Satyendra Kumar (1986167) +1 860 990 4330
- Ranchi: Nagesh Jha (1969107) +91 82102 94847
- Global Central Contact: Vikash Ranjan (1998055) +81 90 8010 2250
______________________________________________
2. Covid Protocol
Shared by Dr Dinesh Ranjan (1965305) Oregon, US
a. Covid Prevention
- Mask and social distancing.
- Wash hands when come from outside.
- Wipe shopping cart before use.
- Vitamin D and C supplement.
- Low dose Aspirin daily.
- Gargle after potential exposure.
- Vaccinate, but still stay cautious.
- CDC has recently documented several cases of breakthrough infections and a few deaths after full vaccination. Full analysis is still pending.
________________________
b. Home Management
- If you suspect Covid:
- Get the following tests: RT-PCR, CBC with differential, C-reactive Protein (CRP), LDH and d-Dimer.
- Make sure that you have a pulse-oximeter and BP cuff at home.
- Daily Routine:
- Record your BP, Oxygen level, heart rate and resp rate twice a day.
- Ambulate in your house for about 15 minutes/ day. Do not exert.
- Steam inhalation 4-5 times/ day followed by vigorous coughing. Make sure to do it just before going to bed and after waking up. This can be aided by someone tapping on your lower back for a few minutes before you cough. Do deep breathing and exhalation breathing exercises.
- Check your pulse-ox twice a day with resting respiratory rate (counted by someone else).
- Check your BP and heart-rate twice a day.
- Eat a healthy balanced meal.
- Medicines:
- Enteric coated low dose aspirin / day, after meal
- Vitamin C and D supplement daily
- Zinc 50-100 mg daily
- Famotidine 20 mg twice/ day – empty stomach
- Ivermectin 12 mg /day for 5 days
- Doxycycline 100 mg twice/ day for 5 days
- Paracetamol 500-1000 mg 3-4 times/ day for fever, aches
- Budesonide puff 200 mic twice / day
- Mmontair LC once/day
- Obtain Dexamethasone 5 mg tabs, Enoxaparin 40 mg injection, but don’t take it yet.
- If CRP is >15 and/or CBC-differential shows low lymphocyte count: This means moderate inflammation and severity of disease.
- Start Enoxaparin 40 mg subcutaneous injection once/ day.
- Make sure to work on your lungs aggressively – key is to protect your lungs.
- Get sputum cultures if fevers.
- Start Augmentin 500 mg twice a day for 10 days.
- If d-Dimer is high:
- Enoxaparin 80 mg subcutaneous twice a day.
- If CRP > 100:
- Tocilizumab may be needed.
- If oxygen level is =/<90 and/or resp rate > 25:
- Hospitalization may be needed.
- Oxygen may be needed.
- Prone positioning: lie on your stomach for 15-20 minutes few times / day and check Oxygen level after this. There is a risk of vomiting, so make sure to avoid full stomach. This will need to be done during night also. Someone needs to help with this.
- Budesonide inhaler (Pulmicort) 2 puffs twice/ day.
- Dexamethasone 6 mg / day.
- Re-check sputum culture – alert to look for MRSA and fungal elements.
- If CRP is >15 and/or CBC-differential shows low lymphocyte count:
- This means moderate inflammation and severity of disease.
________________________
c. Outpatient Treatment
- Symptoms of flu, anosmia, pos RT- PCR
- See last section: Home Management.
- DON’T ALLOW PNEUMONIA TO PROGRESS TO ARDS.
- This is the key. ARDS is what separates seriousness of Covid infection from flu.
________________________
d. Post-Covid Care
- Approximately 3 months after recovery:
- Pulmonary function test
- Liver enzymes
- Urinalysis for protein
- A1C
- Bone mineral density
- Monitor for hypertension, cardiovascular disease
________________________
e. Vaccine Questions
- AstraZeneca / Covidshield /Janssen- JnJ Vaccine Clotting Concerns
- Extremely rare, current incidence 0.0001%. So don’t lose sleep over it. It is similar to a known medical problem called TTP. Also seen in a syndrome called HIT.
- Severe headaches, abdominal pain, leg pain/ swelling and peticheae 1-3 weeks after vaccination. Tests show low platelets (<30k), positive antiplatelet antibody, d-Dimer and fragmented RBCs.
- Don’t give heparin products. Use a DOAC or Coumadin to prevent further clotting.
- May use intravenous immunoglobulin.
- Question about Interval between Vaccine Doses
- This is coming from study published by Oxford University that showed in a statistical modeling possible 8% increased antibody level after the second dose was delayed up to three months.
- This was not based on real clinical data.
- Therefore you should take your second dose vaccination 6- 8 weeks after the first dose, if offered.
______________________________________________
3. Covid Protocol
Shared by Dr J P Mandal (1972354), Muzaffarpur, Bihar
a. Prevention
- It is very painful to have any death due to Covid. It can be prevented most of the times by:
- Proper masking.
- Avoiding crowded areas, close sitting, and confined AC room.
- Taking Vaccine but with Covid appropriate behavior.
- Healthy lifestyle, food and hydration.
- Keeping watch on:
- SpO2 by Pulse Oximeter
- Temperature
________________________
b. Primary Home Care
- Timely and early starting of primary home care - using low-cost and easily-available medicines - can prevent more than 75% of cases from becoming severe.
- In this pandemic time, if you have Covid symptoms, it is Covid. There is NO need to confirm it by Antigen or RT-PCR tests. These tests may be false negative or time taking.
- If you have the following symptoms and signs:
- Covid symptoms (any or all):
- Cold
- Cough
- Fever
- Throat Pain
- Body Ache
- Loss of smell /taste
- Contact with Covid patient
- Along with the following signs (any):
- Temperature persisting more than 101°F after 4 days
- SpO2 less than 94% on any day
- 5% Fall in SpO2 after 6 minutes brisk walk
- Persistent cough or breathlessness when walking or talking
- CRP more than 10
- Covid symptoms (any or all):
- Start treatment at home with advice of your family doctor:
- Prone Position - deep breathing exercises - inhalation, breath holding, and exhalation
- Oral Steroids
- Oral Anticoagulant
- Budesunide inhaler 400 ug ×2
- Oxygen
- No need of tests and expensive medicine at this stage:
- No need of RT-PCR
- No need of CT- CHEST
- No need of various lab tests
- No need of Ramdisivir
- No need of plasma
- Hospitals and labs are overcrowded. Please don't waste your time, money, and life.
________________________
c. Subsequent Investigations and Treatment
- Investigations at home in mild cases on day 3 and repeated on days __:
- CBC with NLR
- CRP
- D-dimer (very important after day 3)
- Blood Sugar
- Additional investigations in moderate cases:
- CT Chest
- No need of CT Chest in early days of Covid. If needed, it may be done on days 5-7. Otherwise, there may be misinformation.
- Ferritin
- LDH
- LFT
- KFT
- IL-6
- CT Chest
- No need of plasma therapy. It is a wastage of time and money.
- Antivirals (Faviflu / Ramdisivir) have limited role in early days. They may be needed in the replication phase (Days 4 to 9).
______________________________________________
4. Free Appointments, Zoom Calls, and Q&A Groups with Doctors
- Indian-American Doctors - Free Appointment for Home Care Consultation: www.mdtok.com/org/covid19 voucher code - mdtok2021
- PRAN-BJANA Daily Zoom Call with Doctors (7am IST): https://zoom.us/j/99977009789?pwd=K3R5clJDQmo0SDJxcmJMc0lCYjAxQT09 Passcode - covid
- PRAN-BJANA WhatsApp Q&A Group for Covid concerns and home management: https://chat.whatsapp.com/BepHhCEWTjWDRslEJiwuLm
- NOBA GSR Facebook Page: https://www.facebook.com/groups/nobagsr
- NOBA GSR Weekly Call (NOBA members only, Saturdays 8pm IST): http://tiny.cc/NOBAGSROpenForum
______________________________________________
5. Location-wise Covid Resources (beds, Oxygen, etc.)
- Chatbot for Covid help (by clicking here: wa.me/12345178991?text=COVID) Just say COVID to IntroBot and let it know what you're looking for!
- Sewa International https://www.covidsewa.com/
- Location-based Dashboards made by Sprinklr: Click here
- Covrelief App made by IITD Alumni: https://covidrelief.glideapp.io/
- Covid India Resources: https://www.covidindiaresources.com
- Covid Bihar Portal: http://www.covidbihar.com
- Patna / Bihar / Jharkhand Resources compiled from NOBA GSR group: Click here
- West Bengal Official Bed Availability: https://excise.wb.gov.in/CHMS/Portal_New_Default.aspx
- Hyderabad COVID Resources compiled by student volunteers: https://hydcovidresources.com
- Karnataka-Bangalore Covid-19 Handbook compiled by VMWare volunteers: Click here
- Tamil Nadu-Chennai Covid-19 Handbook compiled by VMWare volunteers: Click here
- Bengaluru Official Bed Availability: https://bbmpgov.com/chbms/
- Delhi Corona Beds: https://coronabeds.jantasamvad.org/beds.html
- Delhi Oxygen: Click here
- Rajasthan Official Portal: https://covidinfo.rajasthan.gov.in/COVID19HOSPITALBEDSSTATUSSTATE.aspx
- Nationwide Remdesivir Suppliers: Click here
- Dashboard Covid Free Jharkhand: http://amritvahini.in/DashBoardNHM.aspx
______________________________________________
6. Guideline PDFs from AIIMS and other hospitals
- AIIMS COVID Algorithm Version 2.0: Click here
- Medanta - Your Complete Guide on Recovery from COVID: Click here
- Sir Ganga Ram - Initial Covid Care at Home: Click here
______________________________________________
Please suggest other useful content for this page by filling out the Contact NOBA form.
