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   We are amidst the pandemic by Novel Coronavirus (COVID-19) and we experienced a horrible 2nd wave in April-May in India: it was 4th wave in Delhi. There is lot of talk about a potential "3rd wave" and its effect on children. Nevertheless, there is nothing to panic about, but it is essential to remain alert and help the authorities in manage the situation. The most important is to take it seriously and follow the do's and don't, as being informed by authorities from time to time,  religiously.   The website Ministry of Health and Family Welfare, Govt. of India is being updated regularly and has all the necessary information. Following is a consolidated list of Helplines being run by various authorities and would be useful in times of need:







National helpline: 011-23978046

National toll-free helpline: 1075
National helpline email IDs: ncov2019@gov.in and ncov2019@gmail.com
Delhi Govt Helplines: 011--22307145,22300012, 22300036, 22301028, 22302441, 22307133, 22304568, 22307745& 22307135. 
Delhi Govt 24*7 Whatsapp suggestion/ grievance number: 8287972050
​Control Room for our South-West District: 011-25066674
For Ambulance: 102 and 1099 (Toll-free); 7291000071, 7291000078, 7291000093 & 7291000094

AIIMS, New Delhi COVID19 National teleconsultation Centre (CONTEC): +91-9115444155


To increase access to reliable information, WHO has partnered with WhatsApp and Facebook to launch a WHO Health Alert messaging service. This service is providing the latest news and information on COVID-19, including details on symptoms and how people can protect themselves. To access it, one has to save +41 798 931 892 in the contact list and send the word "hi", "hola", "नमस्ते", "oi", “salut”, "ciao" or "مرحبا" to this number on WhatsApp to activate the conversation, prompting a menu of options that can help answer their questions about COVID-19. Similar Whatsapp Chatbox of Government of India can be accessed by adding the number: +91-9013151515 in contacts and sending "Hi" by Whatapp. Alternatively, this link can be clicked. Similarly, here is the link for "Corona Hub" by the Govt. on Facebook messenger. There is a link for connecting to Corona Newsdesk of the Govt through "Telegram" also. In addition, a mobile app called "AarogyaSetu" has been developed for Android and iOS platforms which helps in self-assessment for corona symptoms and can alert a person if one comes close to a patient of Covid19.


Prevention: ​As per authorities globally, there is no evidence to confirm the effectiveness of any of the home remedies like ginger or lemon of any use in this virus. Contrary to popular perception on social media and elsewhere, there is no strong evidence to confirm the effectiveness of any oral medicine (Allopathic/ Ayurvedic/ Naturopathic/Homeopathic/ Unani) for the prevention of Covid19 that can be taken by anyone for prevention. But, there is no need to panic. In addition to Vaccines that are now available (see details below) some simple and basic steps are very helpful to prevent this infection and need to be followed by all (even after getting the vaccination done, since it requires high percentage of population to be vaccinated to stop the raging pandemic):

1. Masks: It is recommended that a cloth mask is to be worn by all when stepping out of home. The mask is to be washed daily and a clean one worn every day. Authorities are issuing a spot challan of Rs. 2000/- to anyone found without a mask in a public place). Wearing a "double mask" is preferable. But it is emphasized that the use of the mask is effective only when it is properly worn (covering mouth and nose with no gaps) and is combined with frequent and thorough hand washing. Also, avoid touching the mask as much as possible; be very careful while removing the mask. A surgical mask is recommended for people who have a cough and cold and caregivers of people with cough and cold. The N95 mask is recommended for health care workers who are in close contact with Covid-19 patients. 

Please note that  use of face mask is NOT recommended for kids below 5 years of age and mask shoule be used under careful supervision of adults for kids between 5 and 12 years of age.


2. Cough etiquette (using..and disposing well...of tissue while coughing/ sneezing and using elbow/ sleeve if tissue is not available...avoiding the use of hands to cough/ sneeze.


3. Avoiding touching your own or other's face, nose, lips, eyes with hands that might be contaminated.


4. Frequent and thorough handwashing with soap and water. Hand sanitizer can be used but not essential at all, if soap and water is available. Proper hand-washing is the most powerful tool against not only this virus but many other viruses that cause various infections from common cold to Swine Flu (H1N1). Please see the following pic and the video and learn to do the hand-washing in the correct manner. Another YouTube video below is an excellent one to know and teach kids why correct technique of handwash is important:



























5. Keeping a physical distance (of at least 3 feet and preferably 6 feet) from other persons you meet outside (who you never know might be infected). 


6. Keep sanitizing the surfaces (in addition to Hands...the most common contaminated surface) that are likely to be contaminated with the droplets from the Covid19-affected patients like ATMs, Lift Buttons, Staircase railing, digital devices, pens, table-tops, train/ metro straps/ handles, doorknobs, gym equipment, outside of a facemask, etc.

              (The high-touch surfaces of the clinic are sanitized after EVERY patient visit)





























7. Strictly avoid spitting in public places.


8. Avoiding overcrowded places and close-contact settings: Although the Nationwide lockdown is over, it is advisable to stay indoors as much as possible and while going out crowding/ crowded palaces are to be strictly avoided. A physical distancing from any other person is to be maintained and everyone must be using a proper face mask whenever going out. Any non-compliance/ disobedience is a punishable offense under the Epidemic Diseases Act, 1897 that has been enforced to manage this crisis. 

                (This clinic, being an essential service provider, continued to provide services throughout the crisis period. The Clinic took the necessary steps to maintain social distancing. Now, any consultation is strictly by appointment, so that there are not more than 2 patients in the clinic at any point in time (one inside the chamber and one in the waiting area). Further, only one attendant is allowed with a patient. Further, formal teleconsultation and hybrid consultation were started on 10th April 2020 to further help in social distancing)
































Further details/ videos on preventive measures are available on the WHO website and the MoHFW website.


Since the situation is evolving rapidly, do keep checking for updates. Avoid panic and acting on unverified forwarded messages on social media and chat apps.


CURRENT SCENARIO:  With decrease in cases, the restrictions have been cautiously eased by the Governments so that we can move forward. This is the most crucial period and we have to remain cautious in every sphere of life, especially whenever we have to step out of the home. In any human-to-human interactions, 3Cs must still be avoided as much as practically possible: Crowded places, Close Contact settings, and Closed and Confined spaces as much as possible. We have to be especially careful in upcoming festive season: any celebration these days should preferably be in digital mode or in open spaces, maintaining physical distances and using masks and of shortest duration possible. 
























Don't be complacent. We have passed over one and a half year in restrictions, just have patience for a few more months.


​​​​Most important: It is strongly recommended to exercise due caution by everyone (family member, colleague etc.) who is in contact with any lab-confirmed case of COVID19. If any such person develops symptoms like cough/ fever/difficulty in breathing, the same precautions need to be followed and a doctor consulted. Most importantly, the history of such contact must be provided to the treating doctor. 


​SCHOOLS REOPENING: Now that schools for senior classes have been opened in Delhi, there are lot of concerns in parents' mind, especially with all the talk of "third wave" potentially affecting kids more. One needs to have a balanced view to take a decision. First, there is no alternative to physical classes and the face-to-face peer group and student-teacher interactions. Online classes do help in bridging the gap somewhat, but the gap is still there and there are already reports of increased behavioral issues in kids after these restrictions were put into place. The adverse effects of increased screen-time are very well known. Secondly, there is no scientific evidence that in third wave, even if it comes will affect kids more severely. There was no difference in severity of illness between first and 2nd waves also. Luckily, the disease is mild in children and adolescents. The rare complicated cases occur in children with underlying co-morbidities. However, COVID-appropriate behaviour must be followed when the kids are sent to school. That is, mask must be worn at all times (removed only while drinking and eating) and carefully handled. Mask should never be pulled to chin, but removed completely when one needs to eat/ drink. Students should not be sitting huddled together. All these needs to be reinforced by parents and teachers alike. 



VACCINES: Thanks to the extreme hard work of scientists around the world, we now have specific vaccines that have been shown to be effective in preventing Covid-19. India has three brands of Covid19 vaccines (Covishield, Covaxin and Sputnik) that have been authorized by the Govt at present. Because of a huge number of doses of vaccines required and associated logistics, the vaccine was been rolled out in a phased manner and was prioritized for individuals who are at higher risk of infection and severe disease. Accordingly, the vaccine was initially administered to health care workers (doctors, nurses and other hospital and health care staff) and other frontline workers (like police personnel, sanitation workers etc.). After this, vaccination of people above 60 years of age and adults below 60 years of age who have co-morbidities like diabetes, heart diseases, hypertension etc. began in March, 2021. followed by vaccination of all adults above the age of 45 years was started. From 1st May, 2021, all adults (above 18 years of age) are now eligible to get vaccinated. Recently, Govt has also allowed vaccination of breastfeeding mothers. Very soon, the vaccine would be available for adolescents (above 12 years of age) as one Indian vaccine (ZyCov-D) has been approved for use in this age group. However, with limited supply initially, it is likely that the vaccine would not be available to all adolescents immediately and those at high risk (with co-morbidities) would be prioritized. 


Please note that the Covid-19 vaccine is available only by registration and followed by invitation by the government. The registration is to be done through Aarogya setu app or web portal www.Cowin.gov.in. Please note that the registration is not to be done through Cowin app or any other app/ website. It is strongly advisable to take the vaccine at the first opportunity as it is only the best and fastest way to return to our usual lifestyle. The vaccines are as safe as any other vaccines and we should not get dismayed by the rumours being floated on social media. In case of any concern/ doubt, do confirm from your doctor/ govt authorities. 


As per current Government of India guidelines, persons who have suffered from Covid-19 infection should wait for 3 months after recovery to get the vaccine. Even those who suffered from Covid19 infection after getting the first dose of Covid-19 vaccination should wait for 3 moths after recovery before getting the second dose.


The doctor and the clinic staff of this clinic have already taken the vaccine (2 doses) at the first opportunity (on January 19 and February 23, 2021). 



Lab tests for diagnosis of COVID-19

Should all patients with cough/cold/fever be tested for Covid19?The latest govt. guidelines (dated 4th September 2020) regarding the people who need to be tested are given in the image below. This is an evolving strategy, that would be modified depending on the situation and the data regarding the cases that are being diagnosed on a daily basis.




















 


































The list of all the labs (Govt. and private) that are designated to test for Covid19 can be accessed here. Tests are done only for persons that qualify the Govt-designated criteria as given above. Testing in private labs requires a prescription by a doctor (Registered Medical Practioner), ID proof and other details and the test will be done only if the criteria in the image above are met.

More recently, different types of tests are now available for testing for COVID19 and each test has its own unique utility. The "Rapid Antigen Tests" are increasingly being available that can give results within 30-60 minutes. ICMR has encouraged wide availability of this type of test in govt and private labs.  Further, the government of Delhi is providing "rapid antigen tests" at almost all its dispensaries. This test can be done by anyone by walking-in any of the Delhi Govt dispensaries. However, it is advisable that the test should be done only if recommended by your doctor. Just like any lab test, no test is foolproof and needs to be tested cautiously in a clinical context. Getting test done blindly often adds to confusion and stress rather than helping these. Another type of test being done and widely advertised by private labs is rapid antibody test. One should be aware that this antibody test has no role in the diagnosis of COVID19. 

Lockdown/ Restrictions, Uncertainties and their impact on Mental Health: A pandemic of this severity has struck the world nearly after 100 years. Hence, none of us in the current generation and last 1-2 generations (of the general population or even medical experts or political leadership) have experienced such a scenario in our lifetime. With so many advancements in medical science and successful containment of previous similar outbreaks of new viruses (like SARS, MERS, Ebola etc.), hardly anybody had even imagined such a scenario that is being faced by all of us today. Further, all the efforts by all stakeholders are seemingly taking a lot of time to show any perceived desired results. Thus, it is natural to feel anxious and a bit worried about the whole thing. The lockdown(s) and restrictions to attempt to suppress the spread of the virus has also resulted in widespread concerns regarding and financial/ economic impact and that adds to the stress/ negativity. Nevertheless, it must be clear and needs to be re-emphasized to ourselves repeatedly that it is just a dark phase that will surely pass. Only when we as parents/ grandparents are positive and calm we can support our children/ grandchildren in this difficult, unforeseen times. If we forget Covid19 for some time, this lockdown in a way answered many of our prayers: time for family/ kids, work-life balance, saving time spent on roads/ traffic jams, time for yoga/ reading books/ hobby/ spirituality...just think about it that way: it is a blessing in disguise...a once in a lifetime opportunity!! With the second wave now surging very fast, there may be some restrictions again. One must remember some ways to stay positive and cheerful even in such times:


1. Be busy. Have a regular schedule. Do some household chores. Involve whole family, especially kids.

2. Distract yourself from negative emotions by listening to music, reading, watching an entertaining program on television. Rediscover your hobbies like painting, gardening or stitching etc.
3. Eat well and drink plenty of fluids.

4. Be physically active. Do simple indoor exercises that will keep you fit and feeling fit.

5. Sharing is caring. Understand if someone around you needs advice, food or other essentials. Be willing to share.

6. Elderly people may feel confused, lost and need help. Offer them help by getting them what they need, their medicines, daily needs etc.

7. Help kids acquire new skills. Online tutorials are freely available on all topics: from sketching/ painting to dance, music, gardening, cooking, magic tricks to stargazing and robotics! Many schools have now started online classes for the current academic session also. Involve with them: this is a never-before opportunity to attend school classes with them and see their participation/ approach yourself!

8. In addition to classical indoor games, you an innovate may new games...some like those that are often played in birthday parties of kids. Here is a Youtube video to ignite your imagination...











What is NOT to be done to maintain good mental (and Physical!) Health


1. Use of Tobacco/ Alcohol: It reduces immunity and research shows that smokers have a higher risk of severe disease in case this viral infection occurs.

2. Follow sensational news/ social media posts: It is sure to cloud your judgment and bring negativity and adversely affect your immunity. Avoid forwarding/ sharing unverified messages. Similarly, repeated checking the statistics of Covid19 will affect mental state adversely, as it is likely that the cases are going to increase for quite sometime and there is no point overly focussing on that. Focus on other things and preventive step instead.

3. Shun or judge people with a Covid19 infection. While you need to maintain a physical distance and keep yourself safe to prevent such infection, remember they need care and concern. If you know someone who might have the infection, tell them about precautions, and how to get medical assistance, if required



Thus, overall two things are essential:

1. Despite Lockdown, the mind should not be under "lockdown"

2. Social distancing is the need of the day, but "emotional distancing" should never be there.


























Red Flag Signs

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​Despite best efforts, sometimes the negative emotions overwhelm us: We are humans after all, not machines or robots! hence it is essential that we are aware of the red-flag signs in ourselves and/ or in our near and dear ones:


​1.Changes in sleep patterns

2. Difficulty in sleeping and concentrating

3. Worsening of health problems

4. Increased use of alcohol, tobacco or drugs 



If these are present, be supportive and keep a close watch. If symptoms persist, help of a mental health professional might be required. Govt of India has started a toll-free helpline for people who need help with behavioral/ psycho-social health issues. The helpline is 080-46110007.


More resources/ videos are available at the Ministry of Health and Welfare website.

The WHO is closely involved in monitoring and advising on the situation on a regular basis. Its website is also being updated on a daily basis. Detailed information, including FAQs on all topics related to this virus, can be accessed here. 


There are a lot of rumors being circulated on social media regarding the disease and the vaccines. Avoid unnecessary panic and acting on messages from unreliable sources. When in doubt, consult an authentic source of information like WHO (link is given above) or consult a qualified health care provider. WHO has made a nice compilation of common myths associated with Coronavirus and its spread that are circulating in social media and elsewhere. One can access it here.



(This webpage is a part/ extension of IEC activities as recommended by the Ministry of Health and Family Welfare, Govt. of India)



(Updated on 1st September, 2021)  


​If you have any further specific queries on Covid19 or any other issue, please feel free to contact us. We will be happy to help.

   

Helpline: +91-9818356846

​COVID-19 (SARS-CoV2): Health Advisories