Dr Abdul Qayum Hamid Changal, a Kashmir’s General Physician working for the Ministry of Health, in Saudi Arabia, debunks myths and addresses misconceptions linked to the raging Covid-19 pandemic. The WHO accredited doctor for clinical management and rehabilitation Of Covid19 patients talked to Syed Samreen
KASHMIR LIFE (KL): What are some of the ill practices, bad habits that we need to stop, keeping in view the COVID-19 upsurge? What are some of these that can worsen the symptoms in people?
Dr ABDUL QAYUM HAMID CHANGAL (DAQHC): The most horrible is the way we wear the facemask. I have seen people wearing the mask exposing their nostrils. It is of no use, more harm. The virus can enter your body through your nasal passage. People require education on how to wear a face mask.
Second thing, more than 50 per cent of the people are still wearing these fancy cloth facemasks. It does not stop the viral flow to your body. It’s useless. You have to wear triple-layered surgical facemasks available in your medical stores. Better, wear a double facemask. Or, if you work or visit a hospital, wear an N95 Mask.
Third, stop rubbing your eyes, picking your nose, talking too close to each other. Agreed, human beings require social interaction, but these are not normal times. People are still throwing in parties, attending marriages, and visiting each other’s home. Indoor crowds are horrible and the biggest opportunity for viruses to infect us.
Smoking, not many talks about. Smokers are more vulnerable to Covid-19 infection, and their symptoms are more serious as compared to non-smokers. I urge people to stop smoking; it’s the best time to get it done. As per the study, smokers are two times more likely to be hospitalised than non-smokers and need ICU care and mechanical ventilation.
Another important thing is exercise and diet. As we are stuck indoors, our immune system weakens if we don’t exercise regularly. To boost the immune system at least exercise 30 minutes a day. Don’t eat high fat, high sugar, and a high salt diet. Don’t overeat. If you are Covid positive and it’s tough for you to exercise, at least walk around the room. Don’t get stuck at one place. Think positive.
Many of us have this bad habit of sleeping too late. Sleep on time and you require at least eight hours of sleep each night.
In Kashmir what I know is generally we don’t take enough water, fluids. My humble request to Covid positive patients especially drinks plenty of fluids, juices. It’s very important to keep your symptoms in check. Last but not the least, Eid is knocking on the doorsteps, but a virus is already breaching our walls. Don’t visit each other, don’t shop, use phones to wish each other.
KL: Please enlighten us about the modes of transmission of the virus. Do we still need to wash and rewash everything that comes in from outside the house?
DAQHC: Now we have new research. According to current evidence, the COVID-19 virus is primarily transmitted between people through respiratory droplets and contact routes. Droplet transmission occurs when a person is in close contact (within a meter) with someone who has respiratory symptoms and is therefore at risk of having his/her mucosae (mouth and nose) or conjunctiva (eyes) exposed to potentially infective respiratory droplets. Transmission may also occur through fomites in the immediate environment around the infected person. The main modes of spread are from an infected person to others through respiratory droplets and aerosols when an infected person coughs, sneezes sings, shouts, or talks. The droplets vary in size, from large droplets that fall to the ground rapidly (within seconds or minutes) near the infected person to smaller droplets, sometimes called aerosols, which linger in the air under some circumstances.
New research suggests that it’s not required to wash or wipe the things like grocery you get from outside. It only adds to your stress level. Remember, the virus spreads when you are in close contact with people without following SOPs. Take care of that and things will themselves start falling at the right place.
KL: Can two or more positive patients isolate themselves together? We’ve now seen not just one member but the whole family involved, can they quarantine together?
DAQHC: If multiple people in a family are positive, they can quarantine together. Not to worry. But don’t mix confirmed with suspected cases. If you have a big house and enough rooms, you may quarantine separately too. It could add to the comfort level of the patient. Last but most importantly, keep in mind the safety of other family members who aren’t positive.
KL: How important is counselling to a positive patient? What impact can the disease have on a visibly petrified person, mentally?
DAQHC: There are two main reasons for anxiety and depression in Covid positive patients. One is the fear of the virus itself, second, being isolated due to quarantine. It is normal and understandable that people are experiencing fear in the context of the COVID-19 pandemic.
Under such circumstances, it is very crucial to counsel the patients. Those separated from the rest of the family should constantly stay in touch with the rest of the family by using modern technology like video calls. It works wonders. Talking of professional counselling, it could be done on the phone too. I have been looking after many Covid positive cases. I am in Saudi Arabia and the patients are in Kashmir. That doesn’t stop us from communicating with each other. We use Internet calls, video chats. They feel relieved, at the end of the day I too am content.
The fear of getting Covid infection leads to intense emotional and behavioural consequences like sleeplessness, anxiety, boredom is associated with uncertainty, fear for loved ones, unemployment, financial loss, etc. The impact of it is a stress disorder. It is visible that could affect even the family life of an individual. We all together have to see to it. We can’t just leave them alone. Post infections, when they complete their quarantine and are tested negative, many require professional assistance. Talk to them, look for the signs, don’t wait. Be patient with them.
KL: In which cases do the oxygen saturation levels drop? Do all patients at one point or the other check their oxygen levels?
DAQHC: Oxygen saturation level drop is directly proportional to the extent of damage the virus causes to your lungs. As COVID-19 pneumonia progresses, more of the air sacs become filled with fluid leaking from the tiny blood vessels in the lungs. Eventually, shortness of breath sets in, and can lead to acute respiratory distress syndrome (ARDS), a form of lung failure.
Not all Covid positive patients shall have a drop in oxygen level. If you have no breathing difficulties, have mild to moderate symptoms of Covid, it is enough to check your SPO2 levels three to four times a day. Don’t go beyond that. It adds an extra psychological burden.
KL: When does the vaccine start having an effect? After the first dose or the completion of both the doses?
DAQHC: Well, we have had recent research that showed even after the first dose, some vaccines provided more than 50 per cent protection. I’m talking of vaccine efficacy. Various vaccines worldwide have shown different percentages of being effective after the first dose, almost all ranging between 50 to 60 per cent. That means even after one dose you have the certain necessary protection. But, the completion of both doses is compulsory for the vaccine to be effective in preventing Covid19, with immunity building over time.
My request to all is to get vaccinated immediately. It’s for the greater good of all of us.