Asymptomatic people just as vulnerable, say experts

BENGALURU: More Covid-19 patients who are initially categorised as asymptomatic are dying than those who show

symptoms

right from the start, a top virologist, has said.


Dr V Ravi, who is also a member of the state’s Covid technical advisory group, said one reason is that those with acute symptoms immediately seek medical help and are therefore safe, while those who develop symptoms later on, suffer the most.

“It’s common sense,” said Dr Ravi. “Symptoms worsen between Day 5 and Day 9 of infection, which is why monitoring home isolated patients is so important. These people struggle immensely when they suddenly develop symptoms which worsen rapidly as against those who are symptomatic from the beginning.”

Examples are aplenty. A 17-year-old boy was brought dead to a hospital in Bengaluru on April 14. He had no comorbidities. Another expert said most of those who pass away at home and are brought dead to hospital, are those who had no tell-tale symptoms initially. The doctor said these people would not have sought treatment at the right time when symptoms showed up and began to worsen. He said, this could be out of personal ignorance or lack of hospital beds.

No home monitoring

“There is no efficient home monitoring system to check on people who are infected,” the expert told TOI. “One private agency hired by the government cannot shoulder the load of three lakh active cases. There should be multiple agencies following up on patients and ensuring hassle-free ambulances and bed allotments. Ensuring timely treatment in hospitals can save lives, but that’s not happening.”

However, Dr S Sacchidanand, vice-chancellor,

Rajiv Gandhi University of Health Sciences

, said everyone infected by the virus will have faced some symptoms but people may not have noticed them.

“In the initial stages, they may be pre-symptomatic or asymptomatic,” Dr Sacchidanand said. “If they improve that is good. But if they don’t improve and symptoms worsen, they must seek medical attention. There may be an element of negligence in such cases.”

Currently, the revised guidelines say those who have symptoms don’t have to wait for results and can go ahead with the treatment, said Dr Sacchidanand, who is also chairman of the Covid-19 clinical expert committee. He said it’s being advocated that high-risk primary contacts should also be on treatment without waiting for results.

Simple awareness

“Viral replications happen from the first day of symptoms to Day 7,” he said. “By day 9, replication falls, and the body’s immunity takes over. Cytokine storm, the inflammatory process, is what causes the disease. Simple awareness that the disease worsens between Day 5 and Day 11, could help avert bigger damage.”

When contacted,

Rajendra Cholan

P, special commissioner (health),

BBMP

, said efforts are on to quickly identify worsening signs among patients who are in home isolation.

“We are strengthening our tele-triaging system so that Covid patients can be treated as per their requirement,” he said.

Cholan said there are four teams working to monitor patients in home isolation – the Apthamitra helpline, primary health centres, zonal war rooms, and Step One, a private agency hired to monitor people in home isolation.

However, ground realities are very different. Most infected people in home isolation say they have not received any calls from the BBMP, checking on their health.