COVID- 19 - Protocol

50+ male patient, asthmatic, returning from a COVID-19-affected European country a few days earlier. Started to feel unwell before departure with fever and shortness of breath. No wheeze, hypoxia, tachypnea or tachycardia on assessment, only pyrexial with persistent dry cough. Arterial blood gas readings are all within range. Would you admit this patient? Would you swab this patient for the virus? Does the fact that he is asthmatic make a difference to your decision making? Would you prescribe antibiotics?

Female 45y, had some mild signs that might suggest COVID in the past 3 weeks (no fever, but mild rhinitis and cough). Since one week has these painful chilblains. Blood tests are on going. Do patients report of same pictures during the COVID pandemic? Please discuss the case.

Patient in early 50s who has a history of SARS when it was going round. Presents with shortness of breath, oxygen saturation in high 80s despite no chronic pulmonary disease. The patient seems to be coping well, but when do you decide to proceed to intubation assuming this is COVID-19? Watch and observe until they begin to deteriorate, or intubate while still well?

Confirmed #covid-19 crp >300, WBC 11, temperature 38.8, spo2 90% room air, RR 30, terrible wheeze, SOB, sweaty. Rapid deterioration in breathing, intubated and ventilated 24 hours later.

Dear Friends, Hand washing is very important for disease prevention.. An US FDA update released today only.. WASHING WITH SOAP AND WATER IS THE BEST? The U.S. Food and Drug Administration today issued a final rule establishing that over-the-counter (OTC) consumer antiseptic wash products containing certain active ingredients can no longer be marketed. Companies will no longer be able to market antibacterial washes with these ingredients because manufacturers did not demonstrate that the ingredients are both safe for long-term daily use and more effective than plain soap and water in preventing illness and the spread of certain infections. Some manufacturers have already started removing these ingredients from their products. This final rule applies to consumer antiseptic wash products containing one or more of 19 specific active ingredients, including the most commonly used ingredients – triclosan and triclocarban. These products are intended for use with water, and are rinsed off after use.   This rule does not affect consumer hand “sanitizers” or wipes, or antibacterial products used in health care settings. ““In fact, some data suggests that antibacterial ingredients may do more harm than good over the long-term.” FDA has deferred rulemaking for one year on three additional ingredients used in consumer wash products – benzalkonium chloride, benzethonium chloride and chloroxylenol (PCMX) – to allow for the development and submission of new safety and effectiveness data for these ingredients. Consumer antibacterial washes containing these specific ingredients may be marketed during this time while data are being collected. Washing with plain soap and running water remains one of the most important steps consumers can take to avoid getting sick and to prevent spreading germs to others. If soap and water are not available and a consumer uses hand sanitizer instead, the U.S. Centers for Disease Control and Prevention (CDC) recommends that it be an alcohol-based hand sanitizer that contains at least 60 percent alcohol. I HOPE THIS INFORMATION WILL BE HELPFUL TO US Thanks. Dr K N Poddar