Friday 27 November 2020

News Analysed, Opinions Expressed

KALZANTLYAN

Covid19 is not a picnic, it's a monstrous villian!

 

Whatever any naysayers may tell you, this is something Man has never ever seen before. From relatively stable patients crashing suddenly, to CT scans consistently showing savage infiltrations in almost all patients, to the unpredictable response of the myriad drugs in our armamentarium, this is one monstrous villain that is truly treacherous.



It's been a gruelling month for a team that I'm part of.  We have started treating COVID-19 patients, in a small way, at a private set-up in Panaji.

A few ramblings then on what I hope to look back on, hopefully soon, as the single biggest medical adventure of our times.

 

1. We read about it, we heard about it, we relentlessly googled it. But boy-oh-boy, we were dumbstruck by the ferocity and cunning of this virus, only since we have actually lived it.

 

2. Whatever any naysayers may tell you, this is something Man has never ever seen before.

From relatively stable patients crashing suddenly, to CT scans consistently showing savage infiltrations in almost all patients, to the unpredictable response of the myriad drugs in our armamentarium, this is one monstrous villain that is truly treacherous.

Remember the scene of the Tyrannosaurus Rex in Jurassic Park peering through that car window. That's the terror we experience every day.

 

3. But there is Hope.

Very clearly we have learnt priceless lessons from the initial errors in management in the US and Europe.

For one, a ventilated patient is as good as a dead patient.

The trick therefore is to keep maintaining patients on High Frequency  Nasal  Oxygen when critical.

For as long as possible.

Till the virus ebbs and the lungs recover.

This happened with Boris Johnson.

This has happened with many of our high-profile patients.

Also Remdesivir and steroids have worked a trick or two.

And plasma, most certainly, when a cytokine storm has approached.

I fervently urge many of the charitable organisations to donate HFNOs in abundance to government institutes caring for COVID.

We can never have enough of them. But do it ASAP.

 

4. Home isolation and COVID care centre management can be tricky.

Besides monitoring your pulse temperature and oxygen and CLANGING all your alarm bells, the moment your oxygen is less than 92 to 93, you must watch out days 6 to 10 from onset of symptoms.

This is the roughest period.

Your fever may come with a vengeance, your cough may spectacularly worsen, and you will feel as exhausted and drained of all your energy, as if you have binge-watched Arnab Goswami for a continuous 12 hours.

But if your oxygen is good, you are NOT GOING TO DIE.

However, if you feel breathless and, if elderly, you start becoming incoherent or exhausted, you must be in a hospital, come hell or high water.

 

5. The situation in Goa is grim, people. Post-Chaturthi, there has certainly been a spike and beds are going to run short.

I have been assured by the authorities that more beds will be deployed and no one will die breathless outside a casualty ward.

But we need volunteers.

There is a massive, massive, manpower crunch.

In war-like situations, throughout history, we have had common folk volunteer their services for the common good.

But I do not know if it's a massive political failure that people are not inspired enough to come out and help on the ground.

Or a blue-print has just not been prepared for them.

But that nurses, resident doctors and attendants are way past breaking point is now evident.

Something must be done.

How???  I frankly admit I do not know.

 

6. The one peculiar and almost eerily consistent observation during our management has been that women beat the pants off this virus far better than men.

We always suspected women were/are the stronger sex. This just about confirms it.

And I jokingly told my ever- energetic colleague Amol Mhaldar, "Maybe we should inject oestrogen in men to see if they get better!!”

A lady colleague, close by snarkily muttered: "One of the pleasant side-effects of that will be that men may actually grow a brain."

Ouch, that hurt !!

 

7. And finally, when all this is done and dusted—I give this another month or so to peter out—and congratulatory meetings and sabhas are held all over Goa, felicitating the "warriors" or “angels" or whatever, the prime position of honour should not be us consultants but front-of-the-line to be honoured should be the remarkable, resilient resident doctors, the never-complaining, ever-obliging nurses and the amazingly valiant and heroic attendants who keep our bodies and surroundings clean.

The latter two must be given substantial cash rewards, not some plaques and potted plants.

These heroes in the government sector have given their all to serve you, under the most impossible circumstances in living memory.

In sum then, take this virus very very seriously, it knocks you out for a good 15 days, learn to detect the danger signals, understand that this is no easy picnic for those treating you, and those of you who are fit, volunteer your services and plasma.

HUM HONGE KAAMYAAB ZAROOR,

MAGAR HUME REHNA HAI HOSHIYAAR, ISKE LIYE.

Disclaimer: Views expressed above are the author's own.



2. Whatever any naysayers may tell you, this is something Man has never ever seen before.

Is there a man still alive who has seen everything?

As usual, a load of nonsense and elementary stuff camouflaged as something very novel and ground breaking!!

 
Nornonha |

Very well explained and even a common men like me could actually feel the reality and brutality of this decease, may b an eye opener for those people who neglect it by saying....Ye kaay jaay naa.....

 
Siddhesh bapat |

Excellent

 
Darshan Valaulikar |

Goans should bring AAP Health Care Model To Goa. The Best Health Care Model of AAP.

 
Jack De Goan |

2020 - Conquest of the Apocalypse

 
Bernard Francis Sirur |

Well written. Please give your lady colleague a big high five from me for her remark about brains 😏

 
Liza |

Thanks Dr. Rebelo for your great service, concern and guidance.

God bless you.

 
Vincent Bartholomew |

Blogger's Profile

 

Dr Oscar Rebelo

Dr Oscar Rebelo is one of the leading social activist of Goa and a practicing doctor. He led the historic peoples’ movement in 2006-07 to get the anti-Goa Regional Plan scrapped and save Goa from total destruction of Goa’s ecology and natural beauty. He is a Goa-based leader of Aam Aadmi Party. He is also a columnist.

 

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