– The Liangs, Bangalore August 2020

there is a volcano of info on dealing with Covid …..

    

But most of them is about the patient as an individual.

Unfortunately, the reality is …..

…..Covid is infecting entire households, not just individuals. This is especially the case in India where it common to have many generations living together.

• 8 members of our household in Bangalore across three generations ranging from 14 years to 79 years, got infected with Covid in the past one month.

• At the same time, three other households of extended family members across 2 other cities of Kolkata and Lucknow were also infected with Covid….

• In the hospital too, we found entire families – across generations – admitted due to Covid.

• With many friends & their families now asking for advice as their family members also start getting infected, this is an attempt to share lessons we have learnt through our experience.



Lesson #1 – this virus is unpredictable…..

• The same virus affects members of a household in completely different ways – varying degrees of cold, cough, throat pain, fever, loss of smell, nausea & appetite loss, fatigue & body ache, breathlessness & pain in chest. e.g. loss of smell ranged from 4-5 days for some to a 20 year old niece who has not recovered her smell fully even after 25 days!

• Severity varies – mild to moderate to severe – from one day fever to 5 days in the ICU! 2 of 8 were hospitalised – a 50 year old brother and 79 year old mother.

• Onsetofsymptomsalsovary–theoldestmembergotherfirstsymptoms20days after the first 18 year old member got hers.



Lesson #2 – Buy time to Rotate Care Responsibilities



•

Within households it is very difficult to prevent members infecting one another, and it is almost inevitable that people will fall sick in succession, falling like dominoes.

• Our struggle was to try and buy some time and pace when people fall sick and others begin to get better so that caregiving responsibility can be passed on to others as caregivers fall ill.

We held family meetings – though video conferencing too – to discuss the protocols and make sure everyone – from the youngest to the oldest – know and are given roles and tasks to help everyone follow it.



•

Lesson #2 (cont.) – Buy time to Rotate Care Responsibilities

Strategy 1 – Isolate & Quarantine
• We divided two nearby houses into three categories – isolation room for

those with symptoms, quarantine for those recovering but symptom-free and separating those without symptoms (as yet) in different spaces.

• Sanitising and moving members to appropriate rooms on time we believe helped pace out the illness of different members and perhaps also lessened the intensity of infection for some.

Strategy 2 – Immunity Build Up

To boost our general immunity and delay/ keep from falling too sick, we took to herbal drinks & khadas and alternative therapies suggested and sent by friends – herbal teas, homeopathy pills, Tibetan medicine, sunlight to build up Vitamin D, exercise, yoga stretches, physiotherapy etc. Perhaps this helped delay the main carer from falling sick for over 20 days and that too, she got the mildest of symptom when she did fall sick.

 

Lesson # 3 – Support of a doctor friend is

critical

• Our doctor within the family – was on the phone monitoring the patients and supporting and advising their carers across three cities, himself in a fourth city!

• Even before you fall sick, it is critical to identify and enlist the support of a doctor – someone within the family or a family doctor or a doctor friend.

• The doctor must be knowledgeable on Covid (or be willing to read up or consult others on it), be rational, calm and yet cautious enough to help you take decisions on time. .

• We created a WhatsApp group and had video consultations with the doctor regularly – to take decisions regarding home management protocols, medicines, handling emergencies, hospitalisation etc.



Lesson # 4 – On testing for Covid

• Allofusdidnotgettested.Outof8ofus–fourgot tested (2 members tested positive in the hospital) while the last member to get the mildest of symptoms was negative (but remember there is a false negative rate of 30%, even with the best tests); the test result of one young member was declared “inconclusive”.

• We assumed Covid for anyone in our household with symptoms and just dealt with the symptoms as and when it came – being especially cautious with our elderly mother.

• Two weeks after the first symptoms, we all got the anti-body test done to see if we had developed Covid anti-bodies and were safe; also if some of us could donate plasma for others.



Lesson # 5 – Important Equipment for Home Management of Covid



Hot water …. For salt water gargling, for drinking and helping take care of cough & sore throat

Masks – everyone started wearing masks when near each other but N95 masks when entering room of symptomatic patients

Pulse oximeter – critical to keep a hawk’s eye for oxygen level & pulse; helped us take decision to hospitalise our 79 year old mother early enough when her O2 started falling to less than 90; keep a stock of spare batteries as these oximeters run out of juice very fast

Vapour inhaler – For 4-5 times inhalation a day to help clear the lungs

Thermometer – to keep an eye on the fever and decide when medication is required

   

B.P Machine – useful to have around; to help take decision about need for hospitalisation



Lesson # 6 – Medicines

Betadine Gargle – 3-4 times a day; this helps control the viral load, sore throats & also in helping some of us get back our sense of taste and smell

Other medicines – for those who needed; our doctor sometimes prescribed azithromycin or other antibiotics after a week of symptoms to take care of super- added infections; different members also used herbal teas, homeopathy, Tibetan medicine etc.

Vicks Vaporub – helped clear our blocked noses and helped us breath; also gave huge relief when liberally massaged on a painful chest.

A hot water bottle/ electric heating pad kept under the chest while lying down face down also helped reduce chest pain.

  

Paracetamol – we took sparingly when fever crossed 102/103 F but else we let the body fight the virus naturally



Lesson # 7 – Increasing your O2 levels
Since Covid affects the breathing and clogs the lungs with phlegm, we found that these 4

exercises done 4-5 times in the day help keep the lungs clear of fluids and push up O2 levels.

  

When sleeping, lie on stomach and on your sides. This helps keep the lungs clear. Avoid sleeping on your back.



This exercise called ‘proning’ helps clear the lungs of fluids and we find helps push up the O2 level significantly.

Sitting up and taking deep breaths helps open up the lungs.

Lesson # 8 – Hospitalisation
• We knew that getting a hospital bed in an emergency would be our

biggest nightmare and so, we prepared for that.

• we did our research on possible hospitals, got in touch with friends who could help, got lists of plasma donors etc. The minute symptoms started nearing danger levels, we got our elderly mother admitted. So, she was already in hospital and on treatment when her lungs got infected with pneumonia and needed ICU admission.

Some tips –

a. The best hospitals for Covid may not be your most famous and expensive ones. Do your research and short-
list based on treatment protocols, price, bed availability, insurance cover etc.

b. Even if you can afford it, try not to opt for private single room in the hospital … Your loved ones will be kept in isolation and you will not be allowed to even see them. So, having people around them helps deal with the loneliness, fear, isolation and it can be supportive and therapeutic. Also a good idea to pack a few photographs of family and friends if someone is being hospitalised.

c. Check your Insurance cover – ours was a huge help as it was cashless and paid 80% – 90% of the hospitalisation costs .



Lesson # 9 – Keeping up your Nutrition

• To fight any illness, one needs strength, a challenge in most illnesses as one loses appetite. But in Covid, with loss of smell and taste accompanied many a times with nausea, it becomes a huge challenge to make sure we eat properly.

• With many members ill and with remaining members worrying and caring for those who are ill, or in isolation and quarantine themselves, cooking was a challenge for us.

✓  To focus on healing and reduce the burden of cooking, we got food catered by a caterer in the neighbourhood – to supply home made soups and simple but nutritious dishes.

✓  Friends and the extended family also pitched in with supplying us yummy food and special treats. Even if they can’t help physically their advice, prayers and support was invaluable.

✓  Fruits and juices helped us keep hydrated through fevers and also load up on vitamins needed to fight the virus.



Lesson #10 Keeping Your Sanity & Spirit
• The physical distance and isolation that Covid forces on the family is emotionally the

toughest. You cannot even physically comfort a loved one who is suffering.

Video chatting with friends and extended family.

Talking about our fears and discussing it openly – especially with the kids.

Creating occasions to laugh and be joyful amidst the gloom – a food treat, a movie together even as we keep physical distance

Involving everyone in the healing, including giving responsibilities to the kids – reminding for medicines, taking temperature, checking O2 levels etc.

De-stressing individually – Meditation helped some; prayers helped others; music, playing online board games with friends.

     

We hope you have found this useful.

…we wish you and your family safety, sanity, health and happiness!