Dr. Prakash Budhathoky

Some two years ago, the COVID-19 pandemic was first detected in Wuhan, China. We have come a long way since December 2019 when the deadly virus reared its ugly head. Knowledge and experience gained over this time have certainly helped better manage the patients. A timely diagnosis and treatment give the patient the best chance to recover from COVID-19.

It is important to carefully elicit the medical history of the patient. Otherwise, important health cues can be missed and the disease may be misdiagnosed, which may prove costly for the patient. What should be done and what should not be done in the given clinical situation is crucial for the treatment of patients.

Here are a few do's and don't's concerning the diagnosis and management of COVID-19. Recently, a new variant of the coronavirus pandemic has gripped many countries.
WHO named the virus Omicron on 26 November and called it a variant of concern. Until now, scientists and public health professionals have been eagerly waiting for data and scientific evidence to better understand the behaviour of Omicron.

Spread Facts, Not Fears
As a health professional, this scribe attends WHO, WMA, CMAAO webinar regularly. One webinar was on preparedness on the mental health aspects of the coronavirus. The coronavirus so far has infected tens of millions of people in more than 200 countries.

In Nepal, the total number of infected persons is 8,25000 whereas the number of persons cured is nearly around 98 per cent. To date, about 11,559 people have died of the virus.
Now, all over the world, coronavirus is causing a condition, I call this condition 'coranxiety', which is anxiety related to coronavirus. It is common during epidemics for individuals to feel stressed and worried. The common symptoms and responses may include –

Fear of falling ill and dying
Avoiding or not approaching healthcare facilities due to fear of becoming infected during care
Fear of losing livelihood
Fear of not being able to work during isolation
Fear of being dismissed from work if found positive
Fear of being socially excluded
Fear of being put into quarantine
Fear of being separated from loved ones and caregivers due to quarantine
Refusal to take care of unaccompanied or separated minors
Refusal to take care of people with disabilities or elderly because of their high-risk nature
Feeling of helplessness
Feeling boredom
Feeling of depression due to being isolated
The stigmatisation of positive infection
Possible anger and aggression against the government
Unnecessary approaching the courts
Possible mistrust of information provided by the government
Relapse of mental illness in already mentally-ill patients
Increased stress on people to cover the work of infected colleagues, quarantined for 14 days.
Insufficient or incomplete information

Formula For Control - Remember C
Coronavirus or COVID-19 starts with C. China Pneumonia was the earliest name, Containment is feasible and the chain of transmission needs to be broken.
Fear of the spread of coronavirus has led people around the world to abandon handshakes.
Hands can pass viruses and other germs that can cause disease, especially respiratory infections like colds or the flu. A handshake can transfer the virus from person to person, though that doesn't necessarily mean either person is infected.

The biggest concern is that when the virus lives on a person's hand, it can more easily contact the eyes or mouth, after which infection takes place. If people wash their hands regularly and sneeze into their elbows, handshakes won't be as risky. But that hardly happens.

The handshake supposedly began as far back as 5 B.C., as a gesture to prove to a stranger that you were unarmed and meant no harm. The Singapore government recently launched a "no-contact" policy on how to avoid spreading the novel coronavirus in business meetings.
Namaste Trump greeting in India can be the best opportunity for the world to talk about corona prevention in the form of "CORONA NAMASTE". Alternative greetings include waving, bowing, clasping, your hands at chest height in the Chinese style, prayer-hands style of the Thai wai, elbow rub or touch and fist bumps.

Three Cs: 1st Case, 1st Cluster and 1st Community spread whenever a new Case comes.
-Avoid COHORT of Contacts, Appraisal of essential items; Contact tracing is the most important step,
Care for the elderly, they are at higher risk,
Convince the patients to wear surgical masks,
Cough, do not ignore it as it can be coronavirus or TB,
Follow CDC and Nepal Government Public Health guidelines.
Colour Coding: Red, Yellow and Green are Important For Risk, Area and Behaviours
Stay connected with updates
Critical cases: requiring mechanical ventilation, has a high mortality
No CONTACT policy with social distancing
Condom: No evidence that it protects
Congenital: No evidence of congenital Covid-19
Remaining CALM
Communication is the key
Cold-blooded animals are not the source

Requirements
Creating multiple coronavirus helplines
Training for mental health counsellors
Communicating only credible information based on facts and not fear or myths.
Following public health measures and cover everybody with vaccination
When mobile phones entered the world, they ended up giving rise to a society engrossed in social media and a term called ringxiety, a situation in which people used to have anxiety after missing the ringtones for some time. Similarly, Coronxiety has come up with coronavirus. It will go away once the pandemic subsides. But, please pay attention as long as COVID-19 stays with us.

(Central Treasurer of Nepal Medical Association, Dr. Budhathoky works at Curative Service Division, DOHS, Nepal)