As per an analysis by the Union health ministry, nearly half the people who have died of Covid-19 are aged below 60 years. Dr Randeep Guleria, Director of the All India Institute of Medical Sciences (AIIMS), recently raised concerns on how the rising air pollution combined with coronavirus infection and lung complications can possibly lead to serious consequences.
With Russia and the United Kingdom already experiencing a second wave of Covid-19, aggravated by winter, there is no reason to dismiss the possibility of the same in India as the mercury dips. The National Centre for Disease Control (NCDC) has warned Delhi of witnessing around 15,000 Covid-19 cases daily in winter because of the prevalence of respiratory illnesses during this season that worsen symptoms of the disease.
NCDC recommended that festivals like Durga Puja, Dussehra and Chhath be celebrated low key with little or no gathering. Since the vaccine for Covid-19 is likely to become widely available only by mid-2021, it is important to be educated about the correct dosage of medicines, especially paracetamol, for self-medication required to cure common symptoms of fever, cold and body pains in the winter flu season.
In an interview with Hindustan Times, Dr Ramakanta Panda, leading cardiovascular thoracic surgeon and VC, Asian Heart Institute revealed, “Young people more at Covid-19 risk than ever before.” The risk is increased by the fact that healthy, young adult population has started to travel and move about while ignoring basic precautions such as steam inhalation, social distancing, wearing masks and using a hand wash as they perceive that they are not in the Covid -19 risk group.
“They may be a-symptomatic and unaware; transmitting the infection rapidly as they move about. They have undiagnosed diabetes and hypertension which is not being treated. Hence, they have a ‘latent’ risk that they’re completely unaware of. This is worse than a 60+ person who is aware of and hence being treated for diabetes and hypertension,” Dr Panda warned.
He said that they are more likely to be “asymptomatic and unaware; transmitting the infection rapidly as they move about, thus spreading Covid-19 to high risk groups within and outside the family.” Even as asymptomatic, there is a risk of damage to lungs, hearts and other organs and their long term implications are still not clear.
“Since diabetes, hypertension and heart disease occur among Indians at a much younger age compared to western population, many young people are not diagnosed or treated. When they catch Covid-19, they will more likely have increased complications as well as difficulty to manage than an elderly person with the same disease but is already on treatment,” Dr Panda highlighted.
Though self-medication is not a recommended practice, when some people do, they do not realise the importance of right dosage and therefore tend to under-dose. In the encroaching winter flu season, dosing appropriately as recommended will help in better symptomatic control within the safety profile of the drug while under-dosing may result in concentrations too low to enable efficacy and show results.
Paracetamol is one of the most popular and widely used medicines for the treatment of fever (antipyretic) and pain (analgesic). Dr. AK Gupta, Joint Secretary of Association for Prevention and Control of Rabies in India and Family Physician at New Delhi told HT, “For an average Indian adult, Paracetamol 650mg is the optimal dose as compared to the 500 mg. It can be safely taken for faster and more effective relief from fever. Under-dosing with 500 mg may lead to delay in fever control and also may require frequent repetition of doses.”
Paracetamol can be taken every four to six hours as necessary, with a maximum daily dose of 4000 mg in any 24 hour period and with a minimum 4-hour dosing interval but taking more pills could lead to overdosing/serious side effects. Dr Gupta added, “Treatment depends on the cause of your fever. It is therefore important to take the recommended dose for all medications, follow all instructions before taking them and take care of overall health by drinking enough liquids to prevent dehydration and get adequate rest. It is always advisable to consult your doctor to understand the underlying cause of your fever and the recommended treatment for the condition/disease.”
On the other hand, most of the expert studies say that having been cured of coronavirus does not mean that you are infective. Dr Panda shared, “Most likely the first 2 weeks are infective. Before joining work, depending on the extent of Covid-19 affliction on various parts of body, tests like ESR , CRP, Interleukin, D-Dimer, Lung function test, HRCT lungs and Echocardiography of Heart can be taken. Not everyone needs to get all of them done because Covid-19 is a spectrum disease and the person-to-person outcomes of this disease are so maddeningly variable.”
The winter chill makes people lock the doors and windows of their houses to stay cosy inside which increases the levels of stagnant air. This causes silent injuries inside the body and studies have shown that the incidence of Covid-19 goes up due to stagnant air indoors. Hence, minimizing cross ventilation is not recommended this winter season.