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Your guide will cover…
COVID-19
How it spreads
Do’s and Don’ts for wearing mask
COVID-19: How it manifests
Home treatment- Do’s
Home treatment- Don’ts
When to seek emergency medical advice
Home treatment - Instructions for Caregivers
COVID-19: Winning smaller battles
Managing your cough
Fatigue Management
Quit Smoking – it will help
Taking care of your emotional wellbeing
Maintaining a Healthy diet
Post COVID-19: Regaining your strength
Breathing exercise
Chest exercise
Positions to manage breathlessness
Relax!
Resuming your physical activities after coronavirus
Gaining your physical strength back
Managing problems with your voice
Managing problems with attention, memory & thinking clearly
It’s give back time…be a Plasma Donor!
COVID-19: Frequent doubts that come to mind
COVID-19: How it spreads
COVID-19 is an infectious disease caused by the recently discovered
coronavirus. The COVID-19 virus spreads primarily through droplets of
saliva or discharge from the nose when an infected person coughs or
sneezes. The virus enters the body via nose, mouth and eyes. Some
recent studies suggest that virus may be airborne and can be spread
through fine infected droplets that remain suspended in the air in closed
air-conditioned environments of offices, AC cabs-buses, shopping malls
and theatres due to absence of cross-ventilation, even when you are not
in direct contact with an infected person.
COVID-19 transmission can be reduced by:
• Staying at home if possible, especially if you are more than 60 years or
less than 5 years of age, or have comorbidities like diabetes,
hypertension or chronic ailments. Avoid meeting visitors at home.
• Washing your hands and face at regular intervals with soap and water.
• Wearing a mask at all times when out of the house.
• Social distancing – keeping a distance of 6 feet from others when out
of the house.
• Cleaning the frequently touched surfaces with disinfectant regularly.
• Avoiding closed spaces with central air-conditioning like offices, malls,
etc. with inadequate fresh air
• Ensuring proper nutrition through balanced diet, maintaining
hydration with plenty of fluids, boosting immunity through fresh fruit
juices, herbal drinks and turmeric in milk.
• Daily exercise and meditation.
• Taking your daily prescribed medicines regularly. Don’t self-medicate.
• Avoid going near sick people.
• Seek medical advice whenever needed. Teleconsultations are
available at Medanta. Register on Medanta eClinic or call 0124
4834566 for help.
COVID-19: How it manifests
The most commonly reported symptoms of COVID-19 are:
Dry cough, cold, sore throat
Fever or chills
Fatigue, tiredness, muscle or body aches
Headache
Congestion or runny nose
Shortness of breath or difficulty breathing
Loss of appetite/taste/smell
The severity and duration of symptoms for people who have COVID-19
can vary; for most people, usually the symptoms take 7-14 days to
subside. Some people may have no symptoms while others may require
hospitalization to treat these symptoms. Recovery from symptoms varies
from person to person. In some cases these symptoms might persist even
after testing negative for COVID-19.
If you have any of these symptoms, you should consult your physician
who will advise for COVID testing if indicated. If you test positive and you
have mild symptoms, the doctor may advise home treatment. Else,
hospitalization may be advised.
Every positive test result is also informed to government and government
representatives may visit your house for checking on you and isolating the
family members.
.
Home treatment - Do’s
• Stay at home all the time, unless there is a medical reason for travel.
• Practice good hand hygiene. Wash your hands for more than 20
seconds, including in between your fingers and under fingers and
under your nails using plenty of soap and water. Otherwise, use an
alcohol based sanitizer with more than 60% alcohol. Do this
frequently, especially before you eat, after you use the restroom, blow
your nose or cough, or before you touch your face.
• Cover your cough and sneeze. The best way to cough or sneeze is into
your elbow.
• Stay in separate room with door closed. Use separate bathroom.
• Wipe all surfaces i.e. doorknobs, countertops, stairway railings and
switches, you come into contact with. Any bleach-containing
household product is effective.
• Wipe your phone with disinfectant wipes or 70% isopropyl alcohol as
it touches your hands and your face often.
• Wash your hands thoroughly after handling cash or credit cards as
their surface may have virus.
• Wear a facemask if you step out of your room or if someone enters
your room.
• Wash your hands before you wear your mask. Only touch ear loops.
• Protect your immune system by consuming balanced diet, staying
hydrated, avoiding alcohol, getting enough sleep and maintain healthy
weight.
• Daily monitor symptoms such as dry cough, shortness of breath, fever
>102 F, loss of taste & smell. It is good to have a finger pulse oximeter
at home to monitor oxygen saturation.
• Seek medical advice for chemoprophylaxisfor your family members.
Home treatment - Don’ts
• Don’t panic
• Don’t visit public areas. Don’t use public transport.
• Don’t shake hands or hug. Use an alternative greeting maintaining 6-8
feet distance.
• Don’t touch your eyes, nose, mouth or face without washing your
hands
• Don’tshare water, utensils, towels or bedding with family members.
• Don’t visit older relatives or community members, as they are most
vulnerable. Discourage visitors.
• Don’t discontinue self-quarantine until instructed
When to seek emergency medical advice:
Monitor your symptoms regularly. If you get any one of the following, seek
emergency medical care immediately:
• Worsening shortness of breath/trouble breathing and cough
• If you are using a pulse oximeter, oxygen saturation less than 95%
• Worsening ability to concentrate/confusion
• Bluish lips or face
• A new or returning fever or persistent fever more than 101o
F for 3 days
• Persistent pain or pressure in the chest
• Inability to wake or stay awake
Home treatment - Instructions for Caregivers
Mask: The caregiver should wear a triple layer medical mask
appropriately when in the same room with the ill person. Front portion of
the mask should not be touched or handled during use.
If the mask gets wet or dirty with secretions, it must be changed
immediately. Discard the mask after use and perform hand hygiene after
disposal of the mask.
Hand hygiene must be ensured following contact with ill person or his
immediate environment.
Hand hygiene should also be practiced before and after preparing food,
before eating, after using the toilet, and whenever hands look dirty. Use
soap and water for hand washing at least for 40 seconds. Alcohol-based
hand rub can be used, if hands are not visibly soiled.
After using soap and water, use of disposable paper towels to dry hands
is desirable. If not available, use dedicated clean cloth towels and replace
them when they become wet.
Exposure to patient: Avoid direct contact with body fluids of the patient,
particularly oral or respiratory secretions. Use disposable gloves while
handling the patient. Perform hand hygiene before and after removing
gloves.
Avoid exposure to potentially contaminated items in his immediate
environment (e.g. avoid sharing cigarettes, eating utensils, dishes, drinks,
used towels or bed linen).
Food must be provided to the patient in his room.
Home treatment - Instructions for Caregivers
Utensils and dishes used by the patient should be cleaned with
soap/detergent and water wearing gloves. The utensils and dishes may be
re-used. Clean hands after taking off gloves or handling used items.
Use triple layer medical mask and disposable gloves while cleaning or
handling surfaces, clothing or linen used by the patient. Perform hand
hygiene before and after removing gloves.
The care giver will make sure that the patient follows the prescribed
treatment.
The care giver and all close contact should self-monitor their health with
daily temperature monitoring and report promptly if they develop any
symptom suggestive of COVID-19 (fever/cough/difficulty in breathing/
loss of smell and taste).
If care giver suffers with any of these symptoms, he/ she should consult to
physician immediately who will guide you for COVID testing and
treatment if required.
COVID-19: Winning smaller battles
If you are recovering from COVID 19 or returned home from the hospital,
you will face smaller battles every day until you get back to your routine
life. During and after COVID-19 treatment, you may experience some
symptoms such as:
• Low energy levels and early fatigue
• Difficulty in breathing, and becoming breathless with even a little bit of
physical activity.
• Chest Congestion and excessive phlegm.
• Cough with phlegm
• Loss of appetite and altered taste in mouth
• Headaches
• Lack of concentration
• Anxiety and Fear
• Insomnia
Some of the symptoms will get better on their own, as time passes. Other
symptoms will require patience and efforts from your side. However, the
actual recovery may take a much longer time
People with serious complications need ICU care and ventilator support for
breathing, which can take a toll on their physical as well as mental health in
the longer run. In many cases, the person may need assistance to breathe
even after coming off a ventilator. The patient may need a mask or a
Continuous Positive Airway Pressure (CPAP) ventilator at home, which
would provide the required oxygen support.
Managing your Cough
Tips to manage a dry cough:
A dry cough is likely to put greater strain on your throat. The following
strategies can be used to manage a dry cough-
• Stay hydrated by drinking plenty of water (lukewarm preferably)
• Take small sips of fluids instead of taking large sips to facilitate
swallowing.
• Steam inhalation is necessary to cure a dry cough. So pour hot water
into a bowl and put your head over the bowl and breathe in the steam.
If comfortable, cover your head and bowl with a towel. You can also use
a steam inhalation machine if you have one.
• Drink warm honey and lemon or another warm drink like kadha to
soothe irritated throat
• Salt water gargle or Betadine gargle (1 part betadine & 3 part of water)
can be effective for treating a sore throat.
• If you feel the need to cough but don’t have a soothing drink or water
at hand,swallow repeatedly.
Tips to manage a productive cough:
A phlegmatic or productive cough can become difficult to manage since
you have to spit out the phlegm-filled sputum regularly. It’s also important
to note that viral infections, especially COVID-19, are contagious, so proper
disposal of sputum is very important. You should also ensure that the sink
where you dispose of your sputum is regularly disinfected. The following
strategies can be used to manage a productive cough:
• Keep yourself hydrated with lukewarm water, broths,soups, herbal teas
and kadha.
• Take steam inhalation at least thrice a day to loosen the phlegm
congested in your lungs.
• Lie on either the left or the right side, instead of lying on your back. This
might help drain the phlegm faster.
• Movement makes the lungs function, and it can also move the phlegm
to facilitate your spitting it out. So, try to be mobile by walking around
your room.
Fatigue Management
Chronic fatigue is classified as fatigue lasting more than six weeks. The
impact of fatigue is more than just lower productivity. You can manage your
fatigue through following:
• Planning for demanding (physically, mentally) and repetitive tasks
• Regular staggered breaks during a day allow for both physical and
mental restoration as well as social distancing
• Days off during the week
• Plan your day schedule to allow you a better plan for completing your
work as well as sleep between work periods
Quit Smoking – it will help
Smoking negatively impacts lung health, inhibits the body’s responsiveness
to infections, and suppresses immunity. Compared to non-smokers,
smokers are 2.4 times more likely to be admitted to an intensive care unit,
need mechanical ventilation or die, according to a study.
The GOOD News: While it is difficult to undo all the damage from years of
smoking, positive results from quitting tobacco are immediate, starting the
second the lungs are no longer exposed to toxic chemicals. Within 20
minutes of stopping smoking, heart rate and blood pressure drop; after 12
hours, the blood’s carbon monoxide level drops; after two weeks,
circulation improves and lung function increases; and after one month,
cilia, which move mucus out of the lungs, begin to regain normal
functioning.
Taking care of your emotional wellbeing
The experience of having COVID-19 can be very stressful with fear and
anxiety. The disease may impact your emotional wellbeing along with your
physical wellbeing. Psychological impact of infection can vary from
immediate effects, like:
• Fear and worry about your own health and the health of your loved
ones, your financial situation or job, or loss of support services you rely
on
• Fear of social stigma
• Irritability, anger, confusion
• Frustration, loneliness
• Denial, anxiety, depression, insomnia,
despair
How to cope with this stress?
Here are some things which you can do cope up the stress, fear and
anxiety:
• Take a break from constant watching the news or limit the time for
news
• Stay connected with your loved ones over audio or video calls
• Re-live your hobbies which you enjoy doing
• Take adequate rest
• Maintain healthy diet
• Do light exercises as your condition permits
• Do not hide your illness
• Speak accurately about the risk from COVID-19, based on scientific
data and latest official health advice
• Share positive stories of those who have recovered from COVID-19
Maintaining a Healthy Diet
Good nutrition is very important before during and after an infection.
While no foods or dietary supplements can prevent COVID-19 infection,
maintaining a healthy diet is an important part of supporting a strong
immune system
Eat a variety of foods to ensure adequate intake of important nutrients
• Energy-rich foods: These foods are a source
of carbohydrates that provides energy to the
body. It includes cereals (wheat, rice, maize,
etc), fats/oils, sugars
• Body building foods: These foods provide
protein to the body. Pulses (all dals, beans,
legumes), animal foods (eggs, meat, poultry,
fish), milk and milk products. Requirements
of proteins also increase during infection for
the proliferation of immune cells and the
synthesis of chemical compounds
• Protective foods: These foods are the
sources vitamins and minerals that play a
significant role in immunity. Seasonal fruits
and vegetables (dark green leafy, yellow and
orange coloured, citrus, and other fruits).
Vitamin A, vitamin E, vitamin C, minerals such
as zinc, copper, iron, selenium are known to
influence the immune responses.
Maintaining a Healthy Diet
Immunity Boosters: Ayurvedic Immunity Promoting Measures:
• Drink herbal tea / decoction (Kadha) made from Tulsi (Basil), Dalchini
(Cinnamon), Kalimirch (Black pepper), Shunthi (Dry Ginger) & Munakka
(Raisin) - once or twice a day. Add Jaggery (natural sugar) and / or fresh
lemon juice to your taste, if needed.
• Golden Milk- Half tea spoon Haldi (turmeric) powder in 150 ml hot milk
- once or twice a day.
• Add Ginger and Garlic to cooking
• Drink warm to normal water and keep hydrated
Healthy Tips:
• Do not skip meals and divide your daily calories in to 5-6 small
meals
• Use whole grain cereals, whole grams and pulses, whole wheat
porridge, whole wheat bread, oats etc. to incorporate fiber in your diet
• Supplement wheat with whole channa and do not sieve flour (wheat
and channa 4:1 ratio). Mix rice with whole grams or dals in a ratio of 1:1
to incorporate fiber
• Consume at least 4-5 servings of fresh green vegetables and fruits/day
• Use olive /canola/ rice bran / soy /mustard oil. Change oils in couple of
months.
• Almonds, walnuts, flax seeds are good sources of antioxidants include
in everyday diet
• Water intake: 2 litres/day
• Limit intake of excess salt, processed and preserved foods
• Avoid eating from out
• Restrict alcohol, tobacco and smoking
Maintaining a Healthy Diet
An adult with no pre-existing disease and with no co-morbities (like
hypertension, diabetes, chronic kidney disease, cardiac disease) have a
2000 calorie diet plan.
Persons with any co-morbity and any underlying condition should take
consultation from professional (Doctor/ Dietician/ Nutritionist) for their
individualized diet plan.
24 hour food intake (For reference)
Foods Wight (g) Calories Protein
Cereals- Whole wheat atta/ porridge/ Whole
wheat bread/ brown rice/ oats
180 630 18
Milk low fat- 3% (Toned) 500 302 17
Curds (low fat milk) 240 145 8
Paneer (low fat milk) OR 75 217 12
*Egg White 2 32 8
*Fish/ lean chicken 60 150 14
Legumes (with husk) 75 240 15
Fruit (seasonal) 400 160 -
Vegetable A (tori, lauki, capsicum, brinjal,
cauliflower, spinach, mustard, tomato)
250 40 3
Vegetable B (Peas, beans, carrot, pumpkin,
ladies finger, onion, radish)
200 64 4
Cooking oil 20 ml 180 -
Sugar (honey, jiggery, jam, jelly) 15 60
Maintaining a Healthy Diet
FOOD EXCHANGE
Cereal Exchanges: Each Exchange contains 15 g
carbohydrates, 70 calories and 2 g proteins
Chappati(20 g atta): 1 in no
Cooked Rice(75 g): ½ bowl
Idli: 1 medium size
Bread (30g): 1 large slice
Potato (75g): 1 medium size
Cornflakes (20g): 1 ½ table spoon
Noodles cooked (75g) : ½ bowl
Biscuits: 2 in nos
Meat Exchange: Each Exchange contains 7g
proteins, 75 calories and 5 g fat
Chicken: 25 g
Fish : 30-40 g
Egg whole : 1 medium
Sausage: 20 g
Mutton : 40 g
Ham : 20 g
Milk Exchange ( 240 ml): Each Exchange contains 12
g carbohydrates, 145 calories, 8 g proteins and 7 g
fat
Milk *(240 ml): 1 glass
Curd* (240g ): 2 bowls
Cottage Cheese *(Paneer) : 50 g
Skimmed Milk powder (45g): 3 tablespoons
Khoa (30g ): 2 tablespoon
*Milk /Curd/Paneer: 3% fat milk
Pulses and Legumes Exchanges: Each Exchange
contains 15 g carbohydrates , 80 calories and 5
g proteins
Moong (25g raw): 1 bowl cooked
Arhar (25g raw): 1 bowl cooked
Rajmah (25g raw): 1 bowl cooked
Lobia (25g raw): 1 bowl cooked
Soya Nuggets: 20 g
1 Bowl: 125- 150g
Fruit Exchange: Each Exchange contains 10 g
carbohydrates and 40 calories
Orange (100g): 1 medium
Apple (90g) : 1 small
Pear (90g) : 1 small
Banana (40g) : ½ medium
Mango (60g) : 1 slice
Water-melon (300g) : 1 large slice
Papaya (120g) : 1-2” slice
Guava (100g) : 1 medium
Vegetable Exchange: Vegetables are broken
into 3 groups as follows:
A Group (100g-1bowl ) 3 g carbohydrates, 16
calories and 1 gm proteins : Cabbage, Spinach,
Mustard greens, cauliflower, Brinjal, Capsicum,
Lauki, Tori
B Group (100g- 1 bowl) 6 g carbohydrate, 32
calories and 2 g proteins: Peas, Green beans,
Carrots, Pumpkin, Bhindi, Onions, Radish
C Group (Roots & Tubers- 25 g) ) 5 g
carbohydrate, 20 calories- Sweet potato,
Colocassia, Beet root, Yam
Fat/Oil Exchange: Each Exchange contains 5 g fat,
45 calories
Oil (vegetable) 5 g : 1 tsp
Ghee, Vanaspati 5 g : 1 tsp
Butter 5g : 1 tsp
Cream 10g : 2 tsp
Nuts: Almonds(5), walnut(2), Peanuts (10)
Sugar Exchange: 20 calories
Sugar 5 g :1 tsp
Jaggery (Gur) 25 g
Post COVID-19: Regaining your strength
Due to the damage caused by the virus to the lungs and other organs, the
body takes time to recover and get back to its former state. You should
reach out an occupational therapist for help in adjusting to your new
energy levels and limitations. Additionally, some of the things that could
help are
Taking support from your family members and friends.
Take gradualstepstowardsregaining strength.
Re organizing some things in your life so they require less energy over
the next few weeks and months while you recover. Organizing daily
routines to allow completion of essential activities when you have
most energy.
Keep frequently used items in easily accessible places.
Don’t plan multiple activities for same day as it may cause fatigue.
Keep low pace for doing activities so as to sustain energy level
throughout the activities.
Prioritize the activities- do only those which are absolute necessary.
Eliminate unnecessary tasks and steps of activity.
Eating a balanced protein- rich diet, with at least five daily servings of
different fruits and vegetables.
Give plenty of rests in between the activities.
Store items at convenient level of height so as to avoid excessive
stretching. Keep optimum height of all work place surfaces.
Facilitate bathing by using shower seat/ hand held shower head.
Breathe easily and properly during the activities. Don’t do strenuous
activities which cause lot of physical exertion.
Doing breathing exercises regularly.
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