What if you test positive for COVID-19 in the second wave

The number of infections and the death toll from the second wave of the COVID-19 pandemic has been rising steadily across India. Dr Ritesh Malik explains how you can protect yourself from the mutant virus and what to do if you test positive.
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Dr Ritesh Malik, Founder and CEO of Innov8 Coworking, who has been on the frontline of the COVID-19 fight at his family-owned hospital in Delhi, Radix Healthcare, in an exclusive conversation with YourStory laid out important tips on how to protect yourself from the second wave of the COVID-19 pandemic and what to do if you test positive for the virus.

Following are Dr Ritesh’s learnings over the past year from closely observing the virus, which he says has mutated a lot from the one that originated in Wuhan, China.

(We are publishing his words, near verbatim)

Ritesh has been on the frontline of the COVID-19 fight at his family-owned hospital.

Fast action is key

First thing is you get positive after a long time, there is a 7-11 day incubation (period). When you have COVID and meet me for dinner, I will get symptoms after nine days. Till I develop symptoms, I have already transmitted it to my family. So, the moment you have symptoms just isolate to prevent family members from getting it.  Observe and make a list of your symptoms.

Fever, dry cough and fatigue are the most common symptoms. If you have them you likely have COVID, so isolate.

Old people can have symptoms for 21-25 days. People who are thin with no comorbidity tend to recover fast, but for smokers it’s dangerous. We had a patient with a ‘smoker’s lung’, we lost him, smoking as such is very dangerous

Which are the medicines typically prescribed? 

It’s a basic regimen of antibiotics (like Azithromycin), Fabiflu (anti-viral), and a lot of vitamins. The antibiotic (under prescription) is to stop the super infection or secondary infection.  You’ll have to take water solubles like Zincovit (multivitamin and multimineral supplement) and Limcee (Vitamin C supplement) as well. Montair-LC (a combination of two medicines: Levocetirizine and Montelukast, which relieves sneezing and runny nose) and cough syrups may also be prescribed.  

How to decode the ‘viral load’ in COVID-19? 

Earlier we saw with the CT (cycle threshold) value that people with lower value were more susceptible, and the ones with higher were less.

But the second wave is different, a patient with a CT score of 8 is doing well and one with 32 is going to the ventilator. It has taken us by storm.

We do not know where we are heading. I lost a 34-year-old family friend in a matter of 7-8 days. The patient was a non-drinker and non-smoker, we are seeing a lot of these kinds of cases too. No answer to why these things are happening. No post mortem to understand the true cause of death.

Representational image

How to protect yourself from COVID-19 now? 

To not get COVID stay indoors and create a sanitary bubble around you and become paranoid. Whoever you are talking to, whoever is coming into your bubble, consider them COVID positive. Don't leave anything to chance. Best thing you can do for your country is not get COVID. There is a waitlist of over 100 at my hospital. Create a bubble, if you have a house help, request them to stay with you or do laundry and housekeeping yourself. Nothing is more important than your health, for the next two months stay home no matter what. 

Why do we need double-masks now? 

New research suggests it’s an aerosol infection, it doesn't go down to ground like a droplet infection, aerosol is much smaller and stays in the air.

Even if there was a COVID positive person in a closed room 10 hrs before, the virus can still be there.

That is why double-masks are suggested now. Wear a cloth mask, on top of that take an N95 mask and tighten the nose band, and do not touch your mask. The problem is Indians do not follow instruction, we are very indisciplined. 

How to avoid infection from vaccination centres? 

Vaccinations centres can become super spreaders. We are vaccinating at a community centre, not at the hospital. It is the responsibility of the hospital to take care of these things.

Go by an appointment, if there is too much crowd do not go there. Better to wait than to go to a super spreader vaccination centre.

Masks cannot be taken off at hospitals at any cost, the hospitals need to ensure that. The moment you get out of the hospital change your mask and wear a fresh one. 

Can you get re-infected? 

New and bizarre thing is that earlier reinfection was not happening for 4-5 months, now people who got it in September are again getting it now due to the new mutation. Typically 3-4 days symptoms last and it’s still rare. Get an antibody test done to see how susceptible you are to getting the infection again. If you have gotten infected, 21 days after testing negative you can get vaccinated, this is what has been clinically practised. 

Why does COVID affect people differently? 

It’s because of different (levels of) immunities. The first wave last year saw a very interesting pattern, males above 50 (years of age) were heavily affected. This wave everyone is affected, and there are no answers.

No virus that has been this infective, it’s mind bogglingly infective.

Comorbidity of obesity is very dangerous, diabetes too, and non-vaccinated and heart patients are also obviously susceptible. COVID causes coagulation disturbance (disruptions in the body's ability to control blood clotting).

Read the full interview here, where Dr Ritesh talks about various things, including where we went wrong as a nation, when the second wave of COVID-19 will peak, and what to expect from the third wave. The doctor-turned-entrepreneur and investor, has donned his whites again amidst the raging pandemic that has engulfed the entire country. Since selling his coworking startup to Softbank-backed OYO in 2019, Ritesh has been an extremely active angel investor, while also being involved at the family hospital fighting the pandemic.