Most Covid-19 patients with mild symptoms in India recovering at home

BANGALORE - Even as critically ill patients with Covid-19 in India are desperately seeking hospital beds with oxygen support in many states, a majority of infected Indians with mild symptoms are recovering at home or in state-run centres.

Dr Balram Bharghava, head of the Indian Council for Medical Research, has said that the second wave of Covid-19 is leading to a higher proportion of asymptomatic patients. Health experts urge such people and those with mild symptoms to isolate at home and consult doctors by phone.

The mild symptoms are fever, sore throat, cough, nausea, muscle pain, diarrhoea and loss of smell and taste. About 47 per cent of people with Covid-19 in Delhi, 80 per cent in Chennai and 84 per cent in Pune remain in home isolation as at Thursday (April 22).

Not all states report these figures. But since those who isolate at home tend to be asymptomatic, the share of asymptomatic cases in the overall population of active cases can be a rough proxy for patients in home isolation.

The proportion of asymptomatic cases was as high as 79 per cent in Mumbai and 99 per cent in Bengaluru.

"As long as there is no shortness of breath, we recommend home care. Even people without pre-existing conditions that make them susceptible to severe Covid should keep watching their vitals," said Dr Archana Prabhakar, a Bangalore-based doctor with RxDx Healthcare, which does teleconsultations for Covid patients.

As soon as home-based patients feel breathless, and their oxygen saturation drops below 94 per cent, they're asked to contact a physician. Documentary film-maker Shaunak Sen, 33, had isolated in his home in Delhi but contacted a doctor when he felt his mild fever spike on the third day. His oxygen was at 90 and he felt "extremely wheezy".

A doctor his friend recommended told Mr Sen to walk for six minutes in his room and then check his oxygen saturation.

"My oxygen had gone up, but she advised me to look for bed availability in any case. When my wheezing grew the next day, I called an ambulance and rushed to a hospital," he said. But having run out of beds with oxygen support, the hospital staff admitted Mr Sen into the psychiatry ward, where they gave him steroids until his oxygen normalised.

Now, on the seventh day since he tested positive, Mr Sen is recovering in a room in his parents' house. He checks his temperature twice a day, his oxygen every hour. "My sleep has drastically increased to 10 hours. The rest of the time, I read news about the Covid-19 tsunami outside and binge on Netflix," he said.

Private hospitals, clinics and digital healthcare companies now offer 14-day packages for home care, ranging from 5,000 rupees (S$90) to 20,000 rupees, including kits with a thermometer, an oximeter and a blood pressure measuring machine.

Some hospitals also offer patients phone or video consultations with doctors. Nurses call them twice a day to monitor their vitals and give feedback.

On Apr 22, the Indian Health Ministry advised Covid-19 patients at home to lie prone, that is, with their face down as it improves oxygen flow in critical patients and ensures that they are less likely to require ventilator support.

Home treatment unburdens the healthcare system, but experts note that it could lead to excessive self-medication, oxygen stockpiling by panicking families, and late arrival to hospital. Home-based patients who suddenly become critical could also find neither space in hospitals nor essential drugs and oxygen.

Home care facilities call for a separate bedroom and bathroom, which most poor Indians cannot manage. The state authorities worry about virus transmission due to inadequate home isolation but are unable to convince many to come to the state quarantine centre.

Mr Siddhe Gowda's family is struggling to isolate the 60-year-old in their one-bedroom house in Bangalore, but refuses to send him to a Covid centre. "Who will go to that jail? Instead, we will do our best at home," said his granddaughter, Ms Shalini.