Mumbai: Of vaccines, waiting, oxygen and testing

Dr Dere said they have treated over 22,000 patients at the BKC Jumbo COVID hospital since last year. Pic/Sameer Markande

A recent digital meet with the title ‘Curing Covid Confusion' had Dr Rajesh Dere, Dean of the BKC Jumbo COVID hospital as guest speaker. Hosted by V-Can, a citizen's engagement platform that aims to build bridges between the public and the government, the session showed there is a pressing need for clarity on a number of COVID-related aspects. In her introduction, V-Can trustee Indrani Malkani said that they were "swamped with questions and they are still pouring in". To that, Dr Dere said, "We have treated more than 22,000 persons at the jumbo facility since last year, our practical experience is vast."

Dr Rajesh Dere, Dean of BKC Jumbo COVID hospital

On RT-PCR tests throwing up a negative report despite a person showing symptoms, Dr Dere said, "In a pandemic, as a thumb rule, if your RT-PCR test is negative but you have symptoms like cough, fever, loss of taste, loss of smell, we treat it like COVID." About another aspect of the test, he said, "We have seen on a number of occasions that after Day 10, the test will show that a case is still positive but the case/person is not infective. If this happens, the patient cannot spread the infection, but has to be home-quarantined for seven to 10 days."

Oxygen quotient

There was a flurry of questions over oxygen, including when a person should be put on a ventilator. "It depends on the clinician," said Dr Dere. He explained, "If the oxygen saturation is less than 91-92, we give oxygen, going up to the maximum of 10 litres per minute. If the subject is not maintaining saturation of 94-96 at that, we have to go for a Bipap machine giving oxygen at 18 to 20 litres per minute."

He said some patients cannot maintain saturation even with Bipap. "So we have the High Nasal Flow which gives oxygen at 22 to 25 litres per minute. Today, because of scarcity we are not using High Nasal Flow as much but my experience shows that if this is used, 90 per cent patients won't need ventilators. A senior clinician or intensivist will tell you that when one puts a patient on a ventilator usually recovery is less, mortality is high. Because of the huge demand for oxygen, High Nasal Flow has to be used judiciously," he said.

Time frame

Clearing the air over vaccines, Dr Dere said a person should wait for a minimum of 60 days if she or he contracts COVID after the first dose. "This time frame goes for the second dose, too," he said. He said taking the second jab after six to eight weeks ups one's efficiency of protection to 85 to 90 per cent. "Many will ask, why should we take vaccines at all, then? Remember the benefit that you are 85 per cent protected. There is a 15 per cent chance that one is not protected, but even in that case, two jabs of the vaccination can save one from a dire or severe case or fatality." He stressed that people with comorbidities must take the jab if they meet the eligibility criteria as they are more vulnerable to the infection.