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Emergency
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Apollo Lifeline
Verified By Apollo Pulmonologist April 24, 2021
After detection of a widespread new ‘double mutant’ variant B.1.617 in Delhi, Maharashtra and some other places, now a triple mutation B.1.618, meaning three different COVID strains combining to form a new variant, has been detected in some parts of the country.
It is believed that the states like West Bengal, Maharashtra and Delhi have COVID-19 cases driven by this new triple mutant. Experts believe mutations are driving fresh infection spikes, not just in India but across the world.
How infectious the triple mutation is, or how deadly, will be known only from more studies. Virus genome studies would need to be done to detect these mutations.
For now, the triple mutation has been classified in India as a ‘variant of interest’ rather than ‘variant of concern’. As per experts, the new triple mutant variant is more transmissible and is making many people sick very quickly. Experts believe mutations are driving the fresh infection spikes, not just in India but across the world.
How deadly or infectious this new triple mutation is will be known only after some more studies.
The second wave of coronavirus seems to be spreading at a faster rate in India. On an average, India has recorded around 1, 00,000 new COVID-19 cases in the first half of April 2021. The total number of cases reported now is almost double of that reported during the first wave.
There is a resurgence of COVID-19 cases in India. There are several reasons for the rapid spread of this virus. Some of them are:
A pandemic or the spread of disease in any country or state is tracked by the government using a graph. The curve on the graph is the speed at which the virus spreads and infects people. Flattening the curve of COVID-19 means extending the time it takes for the virus to spread and infect other people. Some of the ways through which we can flatten the curve are:
India’s COVID-19 trajectory has been steadily increasing in the past several days. We have crossed more than 16 million cases this month. As the second wave intensifies in the country, we may interpret COVID-19’s resurgence in the following manner:
Some of the new symptoms of COVID 2.0 include,
If you`re experiencing any of the above symptoms, seek immediate medical assistance.
No vaccine is 100% effective, providing complete immunity. It is essential to understand that leading vaccines have an efficacy of 95%. That means even after being fully vaccinated, you may contract an infection.
The chances are extremely low, though, about 0.03-0.04% of the total population vaccinated. But the good news is, the symptoms will be very mild, and the disease will not become a life-and-death situation.
Researchers from the John Hopkins Center for Health Security say that it is essential to understand the timeframe of infections. An infection that occurs two weeks after both the doses are administered is considered a breakthrough. We should give our bodies at least two weeks to develop antibodies against the SARS-Cov-19 infection.
Therefore, vaccination is the most effective solution in controlling the spread of COVID-19, and we must all contribute by taking our doses in a timely way.
A negative test of RT-PCR does not rule out the COVID-19 infection and its complications. A false-negative result may happen due to several reasons like improper swab administration, low viral sample quantity, PCR error or test sample contamination.
Timing of tests often causes false-negative of the COVID-19 infection. So it is suggested to test for COVID-19, 5-6 days after the exposure. If the symptoms continue after a negative report, get the RT-PCR test done after three days, from the date of the first test.
A false-negative result may cause spread of infection to others .So, even if the test results are negative, to avoid the spread, practice quarantine measures like
If you’re experiencing COVID-19 symptoms, but the test result is negative, there are still possibilities of you transmitting the infection to other healthy people. So seek immediate medical assistance for early treatment and guidance.
Call 1860-500-1066 to book an appointment
Multiple researchers have concluded that the Reverse Transcriptase PCR test conclusively determines if a patient has COVID-19. But depending on the laboratory testing conditions, other logistical factors, duration of symptoms, viral loads, and test sample quality, it has shown varying results.
Multiple other options, such as the Rapid Antigen Assessment (RAT) or the CO-RADS score, are available, but RT-PCR remains an end tool for definitive diagnosis.
An important issue with the real-time RT-PCR test is the risk of false negatives and false positives. It remains the Gold standard in testing.
Moreover, real-time RT-PCR has adequate sensitivity to help diagnose infection early. Therefore, the criterion-referenced real-time RT-PCR assay can be considered the main method to detect the causative agent of COVID-19.
Multiple researchers have concluded that the Reverse Transcriptase PCR test conclusively determines if a patient has COVID-19. But depending on the laboratory testing conditions, other logistical factors, duration of symptoms, viral loads, and test sample quality, it cannot always be considered reliable. Besides, it takes a very long time for the test reports to be out.
The Coronavirus Disease 2019 Reporting and Data System (CO-RADS) is an assessment to understand the level of pulmonary involvement in a chest CT scan. It has been known to diagnose the infection very well, especially for those with moderate to severe symptoms. The CO-RADS assessment scheme allows for the categorization of a given chest CT scan into groups related to the likelihood of a patient having confirmed COVID-19 with lung involvement. The system was developed and tested in patients with moderate-to-severe clinical disease.
The Cycle Threshold (CT) value or viral load is the amount of virus present in the sample of an infected person. The CT value also refers to the number of cycles completed after it’s detected in the test. The lower the value of CT, the higher the viral load and risk of infection.
According to studies, in the early stages of infection, the CT value is below 30 or even 20 indicating a high level of virus.
The CT value may help you understand the severity of the virus. However, the treatment chosen should not completely rely on it. A higher CT value may indicate lower viral load but treatment and hospitalization should be based on an individual case and the severity of the symptoms.
The RT-PCR tests are the gold standard tests to detect the presence of coronavirus in a sample. The Cycle Threshold (CT value) or viral load is the number of cycles completed before the virus has become detectable.
On the other hand, Computed Tomography (CT) scan can help detect COVID through typical diagnostic features .
Thus, a CT scan may help in gauging the severity of the infection and the damage to a person’s organs more accurately than RT-PCR tests.
Every virus existing in nature undergoes constant changes. It is known as mutation. When a virus mutates, it may change its shape or form a new variant. Some mutations make the virus weaker while others may make it stronger.
The novel coronavirus that emerged last year also mutated and formed a double mutant virus. It simply means that two strains of coronavirus have come together to form a new strain.
The new double mutant virus termed B.1.617 was initially found in India as two mutations – E484Q and L452R. This new mutation is highly infectious and thought to be responsible for the second wave of COVID-19 in India.
However, following proper precautions and getting vaccinated will always help in slowing down its spread.
RT-PCR tests are used to detect the coronavirus in a sample. The RT-PCR test kits used in India checks for more than two genes, so that it does not miss detecting the virus, in case it has changed the signature of genes during mutations.
However, the sensitivity of these tests are estimated at 70%, the same as they were before. This means that there is a 30% chance that the test will not be able to detect the virus and result in a false negative.
The false-negative may also occur due to an error while collecting or testing the samples for COVID-19. Also if a person gets tested very early after being infected then the viral load may be low and may not be detected in the test.
RT-PCR is the gold standard of tests performed to detect the presence of COVID-19 infection in a sample. The test is required to diagnose and treat the infection. However, several reasons may make it difficult for the tests to detect infection. They are:
COVID 19 has been categorized into three distinct stages based on the severity of the symptoms .
The novel coronavirus is transmitted from an infected person through the droplets expelled from his or her mouth while he or she is coughing, sneezing or talking.
During the first phase, the virus enters and starts multiplying rapidly inside the body. This will cause a person to experience a common cold and mild flu-like symptoms.
The second, or the pulmonary phase (Phase 2), when your immune system becomes adversely affected which leades to primarily respiratory symptoms like shortness of breath, low oxygen levels and persistent cough. Problems with blood clotting (particularly with the development of blood clots) may be predominant in Phase 2.
The third phase (hyperinflammatory phase) occurs when a hyperactivated immune system may cause injury to the kidneys, heart as well as other organs. In the hyperinflammatory phase, the study stated that a ‘cytokine storm’ (where our body attacks its own tissues) may occur. Although there can be overlap among these three stages of the disease, the experts said it is important to recognise each stage . However, not everyone may experience all the phases.
Many people who have been infected with COVID-19 and show mild symptoms may recover at home. However, for people showing severe symptoms, there are several medicines and treatments available to curb the progress of the virus. They are as follows:
Please note that not all COVID 19 patients need all these medications . Many will recover with just symptomatic treatment for fever and body pain and plenty of rest . Please do not take any of the above mentioned treatments without medical advice and do not hoard them when they may not even be required or appropriate for you .
All viruses have genetic materials in the form of DNA or RNA. The coronavirus is an RNA virus that attaches itself to the human cells and creates copies inside those cells.
Remdesivir is essentially an antiviral drug used to stop the replication of viruses in the body. It inhibits the release of the enzyme required to create copies and stops the replication of the coronavirus in the body.
According to ICMR, Remdesivir is supposed to be given to patients who are severely ill and not to people with mild to moderate symptoms. It works fine if administered in the first 10 days of getting the infection but later may not show any effect .
Although Remdesivir has shown to be effective against the spread of the virus, it is not as effective in reducing the mortality rates. People taking this medicine may show improvement if they have moderate to severe symptoms .
Go to the hospital if your oxygen levels have dropped, you’re facing difficulty while breathing, have persistent pressure or pain in your chest, experience loss of speech and movement, and have high fever even after taking medication to reduce fever .
Long COVID, also known as post-COVID, post-acute COVID, long-tail COVID, and long-haul COVID, is a term used to describe the prolonged effects of COVID that remains till 8 to 12 weeks after initial COVID infection. The characteristics of long COVID include:
Long COVID is not just limited to the lungs, but it also affects other body organs: heart, kidney, brain and gut.
Older people and women who develop more than 5 symptoms in the first week of initial infection are at a higher risk of developing Long COVID.
Long COVID, also known as post-COVID, post-acute COVID, long-tail COVID, and long-haul COVID, is a term used to describe the prolonged effects of COVID that remains till 8 to 12 weeks after initial COVID infection. The characteristics of long COVID include:
Long COVID is not just limited to the lungs, but it also affects other body organs: heart, kidney, brain and gut.
Older people and women who develop more than 5 symptoms in the first week of initial infection are at a higher risk of developing Long COVID.
The first thing is not to panic. If your blood oxygen levels are below 93, you have a reason to worry and may require attention. But, as many experts opine, not all cases of oxygen imbalance may need hospitalizations or intensive care support.
Moderate or mild COVID cases can, for instance, be managed well by using machines like oxygen cylinders or concentrators, especially at a time when securing hospital access is quite difficult.
Use of oxygen concentrators and adopting the proning technique. Lying face down is called proning. As per the the Ministry of health and Family Welfare in India, proning is a medically accepted position to improve oxygenation and comfort. If the oxygen level drops below 94, an infected individual at home isolation can lie on their belly as the position improves ventilation, keeps the alveolar units open.
Side effects after vaccination are common and include fatigue, arm soreness, chills and fever. Side effects are usually mild and disappear within 48 hours, and it only indicates that our body’s immune system is responding to the vaccination.
People who are more prone to side effects are:
After the second dose of vaccination: The second dose is given to reach the maximum efficacy of the vaccine. The more intense side effects only show that your body is building protection against the virus.
Each person’s immune system responds differently towards the vaccine. So, if somebody is not developing side effects, it does not mean that their immune system is not responding. People without side effects are also actively developing antibodies.
According to a report by AIIMS, the RT-PCR test is detecting coronavirus in only 80% of the cases; the rest 20% are showing false-negative results. Also, if the sample is not properly taken or if the test is done too early when the viral infection is low, the test may come out to be negative. That is why CT-SCAN AND X-rays are done so that symptoms and severity are detected early, and the treatment is started accordingly.
Very few natural infections generate an immune response that completely prevents reinfection. Instead, what generally happens after an infection is that the body’s immune response gradually declines over months after the infection is cleared.
Reinfection can occur either due to a declining immunity and lack of following precautions due to assumptions of immunity, or it can be from infection from a mutant strain of the virus . It also needs to be seen if it is reinfection or a case of persistent viral shedding from the old infection. According to a study by Indian Council of Medical Research (ICMR), two positive tests at an interval of at least 102 days, with an interim negative test was defined as COVID-19 (SARS-CoV-2) re-infection by Indian scientists for establishing surveillance systems.
Babies and children don’t seem to be at high risk. Most of the children have mild symptoms or no symptoms at all. In rare cases, children with the new coronavirus can get a serious illness, such as fluid collecting in their lungs or organ failure. The risk of children being the carriers of SARS-CoV-2 is very high. The only way to make sure that they don’t spread the virus is to wash their hands regularly, keep them away from infected people, and make them wear a mask everywhere. Unlike the first wave, this time around in India, the virus is also known to be infectious to children.
Unlike the first wave, this time around in India, the virus is also known to be infectious to children. This time, children are also more likely to spread infection in adults. While in the first wave, many kids were asymptomatic, this time, they are developing symptoms like fever, cold, dry cough, diarrhoea , vomiting, fatigue, loss of appetite, including other common symptoms. Some may also have breathing difficulties as well, while a few may have rashes like any other viral fever.
Most children with COVID-19 have mild symptoms or have no symptoms at all. However, the primary symptoms to watch out for in kids:
You need not worry if your child tests positive for COVID-19. Many children with COVID-19 have mild symptoms and recover on their own. At home, you need to monitor your child continuously for the common signs of COVID-19. Give your child lots of fluids, medicines for fever and pain (if your child has these symptoms), and make sure your child sleeps well.
If you notice that the child becomes sicker and shows symptoms like difficulty breathing, vomiting or diarrhea, or high fever, visit a pediatrician immediately.
Teach your kids safety practices and reinforce preventive actions every day.
If you find your child fidgeting around and touching their face frequently, patient handling will be required. Hence it is important to teach:
Children learn when adults also do the same. So, set examples in front of children by practising healthy activities yourself too.
MIS-C means Multisystem Inflammatory Syndrome in Children. It is a severe disease condition and is considered a complication resulting from COVID-19.
Many children with COVID-19 develop a very mild illness. But only a few of them develop MIS-C. Several vital body organs and tissues, including the heart, lungs, blood vessels, kidneys, digestive system, brain, skin, or eyes, become severely inflamed.
Commonly observed signs and symptoms of MIS-C are as follows:
If you see any of these symptoms in your child, contact the pediatrician immediately. However, you need to remember that not all children have the same symptoms.
The doctor may ask you to perform few laboratory tests of your child like Chest X-ray, blood tests, abdominal ultrasound, and heart ultrasound (echocardiogram). Treatment usually involves supportive care for symptoms like fluids for dehydration and medicines to reduce inflammation.
You can get COVID-19 infection, no matter how hot or sunny the weather is. Many countries with hot weather have also reported cases of COVID-19 infections. Make sure to clean your hands often and thoroughly, and avoid touching your eyes, mouth, and nose with unwashed hands too protect yourself.
The second wave of COVID-19 is sometimes getting a person’s entire family infected.
Experts suggest that the person under supervision, or who has had contact with a confirmed case, should isolate themselves. When the entire household tests positive, then it is essential to quarantine in different rooms, if that is not possible, then at least maintain a 6 feet distance.
Everyone should still use individual utensils as this will help in decreasing the viral load from being transferred from one person to another.
The recovery time of all the family and the severity of symptoms also differ; hence it essential to quarantine and follow all precautions.
The COVID-19 has hit the nation hard with the second wave. More and more people are testing positive, and their entire families are being put at risk.
If multiple family members fall sick at the same time, it is advised that all of them quarantine separately as the viral load from different people will be different. It is okay to help the other family members, but it must be done by maintaining a 6 feet distance at all times and wearing masks. But try to maintain individuality as much as possible.
Earlier it was thought that only patients with COVID-19 symptoms (cough, high fever, or breathing difficulty) are responsible for the spread of the disease. But recent studies have shown that a person with no symptoms (asymptomatic) can spread the virus.
Therefore, for the safety of people around you, asymptomatic people should follow the guidelines:
There were few cases of newborns who tested positive for COVID-19 shortly after birth. But it is unknown how these babies caught the virus, whether before birth or during delivery, or afterwards. Most cases of newly born COVID-10 positive cases showed mild or no symptoms and recovered on their own. Cases of severe COVID-19 in newborns are very rare.
Discuss with your gynaecologist the risks and benefits of sharing the same room with your newborn baby if you have COVID-19.
The content is verified and reviewd by experienced practicing Pulmonologist to ensure that the information provided is current, accurate and above all, patient-focused
August 26, 2023
