What, If My CT value is —‘
Not the problems of the patient which he is facing, this is the first thing which I get to hear when I see or consult a COVID patient.
Today, because of various myths, quacks, and self-acclaimed doctors from the University of Google, the people are panicking, gulping down a hand full of tablets (including high dose steroids in mild cases also) and rushing door to door to secure a bed in a hospital.
Today, I felt the urge to educate all that the CT value in RT PCR report is in no way associated with severity in COVID. However, it only tells you how infectious you are to others.
If the CT value is low, then you are shedding more virus and hence spreading infection to others more easily.
Therefore, you need to be more stringent in isolating yourself at home and monitor your vital parameters every 4-6 hourly. People taking care of such person should follow the standard precautions more meticulously (social distancing, frequent hand washing/ sanitisation and double masking).
I also want to request my physician fraternity to be a little more cautious in prescribing steroids to very mild or mild cases of COVID. As the patient doesn’t know the importance of tapering the doses of steroids. They will stop high-dose steroids suddenly once they start feeling alright and land up in crisis. I have already managed one such case who came to me with severe hypoglycemia and hypotension.
Recovery Rate in India
The recovery rate of COVID is one of the best in India. So, I urge the people of my country to stand tall and fight in this crisis time against COVID, wrong myths, Panic, hoarding, and black marketing.
Together we can and we shall defeat it.
The other question in my patient’s (COVID positive) mind is
“I have completed 14 days. Can I go out now”?
Here I want to clear the doubts by describing ‘Difference between Quarantine and Isolation’
The word ‘quarantine’ is used when you are perfectly fine (asymptomatic) but had contact or exposure with COVID positive patient. Then the period you need to contain and monitor yourself is 14 days after which if you don’t have any symptoms then you are free to resume your work.
However, the word ‘isolation’ is used when you are symptomatic and have tested positive in RT PCR or rapid antigen test of COVID. This period may vary from person to person. Generally, it is taken as 17 days from first day of symptoms. But ideally, it should be 1 week further from the last day of your last symptoms.
For eg. If you had fever from 01 May to 06 May and cough from 01 to 12 May, then count 7 days from 12 May i.e. 19 May will be the day when you can be out of your isolation room and resume your work.
This is not only for the safety of society but your family too. This will help us to curb the spread of disease.
Together we can fight and defeat COVID.
“HRCT”
Seems to have become an essential investigation today. It’s like, if you have not done it, you will die of COVID. One of my patients did it 3 times in a span of 2 weeks, and he asks me that my lungs are going bad to worse (even while he does not have any fever and his SpO2 is 98 percent on room air). I could only say to him, that you might have survived COVID but you or your future generation might not survive this much of radiation exposure.
So that brings me to million-dollar question today, ‘HRCT Chest – who needs it, who doesn’t?’. (Only in context to COVID)
“Who needs it”
1. People who have persistent fever (temp > 100), or excessive cough even on the 7th day of illness.
2. People who develops breathing difficulty, chest pain, blood in sputum or resting SpO2 falling below 94% on room air.
“Who doesn’t need it”
1. Just for the diagnosis purpose.
2. People who only have mild disease.
3. People who have recovered from the disease and are completely asymptomatic now.
4. Just to see the status after recovery, if you had bad lungs in earlier scan.
One CT scan exposes you to radiations equivalent to 300 X Rays. So, you are not only frying your organs but your future generation also. Rather, few simple blood investigations advised by your physician will give better picture of your illness and guide him in your treatment in a better way.
Please, please, please trust and follow the advice of your treating physician and do not go for HRCT just because it was advised to one of your FB or WA friend.
Together we will fight and win over this pandemic.
About Dr. Amit Sharma – Consultant in Internal Medicine
Dr. (Surg Cdr) Amit Sharma (Retd) is a Consultant in Internal Medicine with an immaculate experience of 15 years in the Indian Navy.
Dr. Amit Sharma is intrigued and takes on the challenges of managing difficult cases of infectious diseases and is a renowned COVID warrior with more than 600 COVID recovered cases to his name.
He strongly believes in finding and treating the root cause of his patient’s symptoms as per latest evidence-based medicine rather than practicing polypharmacy to suppress them.
He has special interest and immense experience in managing patients of Infectious Diseases, Diabetes, Hypertension (BP), Thyroid, Cardiology, Gastro, Respiratory, Hematology and Rheumatological (Joint) disorders.
