Science behind Delhi’s five-point Covid strategy
Declaring a war on the coronavirus disease (Covid-19), armed with hospital beds, testing kits, pulse oximeters, oxygen concentrators, and surveyors with pens and notebooks, may sound laughable on the face of it, but in the absence of a vaccine or cure, these are the most effective tools to save lives and stop the spread of a virus that has infected 529,485 and killed 16,101 in India.
Fortunately for us, these work when used in combinat i on with self- protection measures, such as frequent handwashing, wearing a mask, and social distancing of at least two metres in public places.
Here’ s why t he s e five weapons are part of Delhi chief minister Arvind Kejriwal’s arsenal.
Around 22% of Covid-19 deaths in Delhi occur within 24 hours of hospital admission, and another 40% within 48 hours of admission, which i ndicates t hat people are seeking treatment in severe or critical disease stages, when treatment options are limited.
The Union health ministry on Saturday asked the Delhi government to analyse data for all Covid-19 deaths to find out why people were reaching hospitals too late for treatment, which was happening for many reasons, including delays in admission because of bed shortages, fear of infection, and poor disease assessment, among others.
To ensure everyone who needs treatment get it, Delhi now has 13,335 Covid beds, and plans to add another 1,000 next week in a field hospital in Dhaula Kuan run by army doctors and paramedics.
A key clinical sign of Covid-19 is extremely low blood oxygen level, which can lead to hypoxia or death from oxygen starvation.
The healthy range of SPO2 (peripheral oxygen saturat i on) i s between 95% and 100%, but in people with Covid-19, it may fall below 90% without inducing symptoms of breathless, chest discomfort, lethargy or confusion.
Doctors recommend that the moment symptoms begin, oxygen l e v e l s mus t b e checked frequently with a pulse oximeter, which is a small device that measures SPO2.
Low oxygen levels are a red f l ag f or hospitali s at i on, where oxygen support can help save lives.
“Higher SPO2 levels after oxygen supplementation were associated with reduced Covid-19 mortality independently of age and sex,” accordi ng t o study published i n Mayo Clinic Proceedings in June.
“Plasma therapy is being used by many now. This doesn’t work for patients who are on ventilators or who have multi-organ failure but helps those with moderate symptoms,” said Kejriwal. The chief minister is partly right.
Plasma therapy is recommended for patients with moderate disease but its effectiveness is still under review, which makes this experiment al t herapy “hopeful but unproven” at best.
Identifying undiagnosed infection in people who may have missed getting tested because they were asymptomatic, had mild symptoms, or testing wasn’t accessible, helps to calculate the real number of people affected. “People with mild illness go out and spread infection, so even asymptomatic and presymptomatic close contacts of a positive case must quarantine themselves even if you don’t feel ill. If you don’t, you become part of the chain and transmission doesn’t stop,” said Dr Randeep Guleria, director, All India Institute of Medical Sciences Delhi.