Public awareness intititive by COVID-19 in Pakistan from Healthcare Professionals

PUBLIC SERVICE MESSAGE REGARDING MEDICAL TREATMENTS OF CORONAVIRUS (COVID-19)

This is a public service message from the under-signed critical care doctors in Pakistan in the interest of improving the panic-like situation, fear, and unnecessary profiteering occurring in the sale of medications for COVID-19 disease.

More than 90% of patients with coronavirus disease recover safely at home. Home care can easily be performed by checking temperature and oxygen saturation daily. If the oxygen saturation is greater than 93%, the patient can safely be managed at home with fever reducing medicines such as Paracetamol. Common home remedies for the flu or common cold like honey may be used in moderate amount. No other medications (e.g. antibiotics or anti-virals) or herbal remedies have any proven benefit. If the oxygen saturation is normal, then symptoms such as fever more than 100F, chest pressure, shortness of breath, difficult breathing, or choking should be further evaluated by consulting a doctor.

Patients whose oxygen saturation drops below 93% should seek hospitalization in a designated coronavirus treatment facility.

Delay in seeking hospitalization can be detrimental to the patients’ health and may make it more difficult to find an available hospital bed when the patient becomes sicker. It is best to start looking for a hospital bed when the saturation is between 90-93% on room air to allow sufficient time for a bed to become available. In this situation, most patients improve with oxygen therapy and daily treatment plan created by a qualified doctor under direct monitoring. Attempting to manage such patients at home can worsen the condition of the patient due to lack of facilities such as BiPAP, daily laboratory testing, and specialized medicines.

In patients who develop severe COVID-19 disease, there is currently NO treatment that has clearly shown a benefit. There are several experimental treatments that are being considered e.g. Remdesivir, Convalescent Plasma Exchange, and Tocilizumab (Actemra). These treatments required highly specialized environments for administration and should only be used in selected patients who fulfill criteria e.g. Cytokine Release Syndrome (CRS).

In particular, the only clinical trial on convalescent plasma therapy did not show any difference between patients who received convalescent plasma and those who did not. Further research studies are ongoing but this treatment should not be given to patients without appropriate monitoring and under the direct supervision of a qualified doctor.

Since the therapies listed above have side effects and NO PROVEN BENEFIT, the use of these treatments is not indicated for asymptomatic or mildly symptomatic patients. Even in severely ill, hospitalized patients, these treatments have shown benefit in selected patients. These treatments should not be considered as a cure and used indiscriminately.