Introduction

The outbreak of COVID-19 has taken the world by storm in the last two years. Also known as the Novel Coronavirus, COVID-19 is a disease caused by a virus discovered in December 2019 in Wuhan, China. Overnight, given the contagious nature of the virus, it spread all around the world dangerously and fast. Per WHO statistics, there are 539,119,771 confirmed cases of COVID-19, including 6,322,311 deaths. And with sincere genome sequencing efforts and COVID-19 vaccine drives going on in every corner of the world, 11,912,594,538 vaccine doses have been administered. Let’s understand what to do in terms of recovery and care post-COVID.

What is COVID-19?

COVID-19 is caused by a virus named SARS-CoV-2 from a virus cluster resulting in the coronavirus or the Novel Coronavirus Disease 2019 discovered in Wuhan, China, in December 2019. The virus cluster also includes common viruses that cause various respiratory infections, from the common cold, chest cold, and influenza to more severe acute respiratory syndrome (SARS) and the Middle East respiratory syndrome (MERS). Coronavirus spreads from person to person through close contact with an infected person through nasal droplets by sneezing or coughing or by touching surfaces contaminated by the virus and touching the eyes, nose, or mouth with the same body part.

The word corona means a crown, and the name was given due to the appearance of the virus. It had spike proteins sticking out of it, which is that part of the virus that attaches itself to a human cell and replicates inside and multiplies. It was declared a global pandemic due to its aggressive and dangerous spread resulting in mass deaths across the globe.

Over time, as is the nature of the virus, genetic changes have started trickling down to the lineage of the virus in the form of variants. Today, we have SARS-CoV-2 but with different nomenclatures like – the Delta variant and Omicron, too!

Symptoms of COVID-19

COVID-19 has mostly attacked the respiratory organs and the lungs, though it has also been observed to affect other organs and bodily functions. Once exposed to the virus, symptoms of COVID-19 take 3-4 days to develop and emerge and can range from mild to dangerous, while some remain asymptomatic. The degree of severity decides the treatment and approach to care and recovery measures. Typical signs and symptoms resemble symptoms of most respiratory infections like

• Cold and running nose
• Cough and sore throat
• Fever and Fatigue
• Headache Body Pain
• Difficulty in Breathing
• Stomach ache, Diarrhea, and Vomiting
• Dry mouth, dizziness, and loss of appetite
• Loss of smell and taste

Some Common Side Effects of COVID -19

Depending on the degree of the COVID infection and one’s immunity, most people with COVID-19 recover in a few weeks. Other than testing COVID-19 negative, there is no other scientific measure yet to diagnose post-COVID conditions because of unique health and medical conditions from person to person. The side effects can be wide-ranging – they can go away or revisit. Post COVID-19 recovered people have also reported health issues of different kinds spanning different time slots – from weeks to months to even a year! Commonly said side effects include,

• General tiredness and fatigue that affects daily activities
• Chest pain, cough, shortness of breath, and pounding heart
• Brain fog, sleeplessness, and light-headedness
• Anxiety and Depression
• Change in taste or smell
• Change in the menstrual cycle
• Stomach pain or Diarrhea
• Skin rash and joint/muscle pain

Measures to be Taken at Home Post Discharge

Post COVID-19, the period when you are on the mend and recovering at home is very crucial. The following measures can help.

1. Social Distancing Protocol or COVID appropriate behaviour

COVID appropriate behaviour must be followed and that includes,

• Physical and Social distancing protocol. Try and maintain a social distance of 6 feet with anyone. 
• Respiratory hygiene of wearing a fitted N-95 mask
• Hand hygiene of washing hands frequently with soap and water before and after contact with public common surfaces and activities like eating, touching face, mouth, eyes, or pets. Use hand sanitizer where soap and water are not available.

Living spaces must be airy, well-ventilated, and disinfected regularly. Avoid poorly ventilated areas by all means.

2. Ensure Adequate Nutrition, Hydration, Rest and Sleep

The patient must eat a high-protein diet to restore depleted energy levels and for the body to heal adequately. Include plenty of nuts, healthy seeds, and lentils in the diet, lots of fresh fruit and juices, healthy soups, and easy-to-digest items like rice, oatmeal, and toast. The patient should avoid swallowing anything complicated like hard-boiled eggs, nuts, and whole grains. Also, avoid raw foods, sweets, oily and processed foods, or any leftovers.

People who have contracted COVID-19, like other viral infections, should rest and drink plenty of fluids (water, juices, herbal teas and soups) to rehydrate the body, prevent muscle aches and help their bodies recover. Some people may experience dry mouth, dizziness, muscle aches, fatigue, and low appetite. Avoid regular tea and coffee for some time. Avoid smoking and consuming alcohol by all means.

You should try to get at least eight hours of sleep per night and avoid any old exercise regimen to prevent pounding heart or light-headedness. Maybe, some light walking for 10-15 minutes should do in the initial period of recovery. The key is not to over-exert. This can help you decrease your body’s demand for energy and focus better on recovery. Practise yoga or meditation in extreme moderation and pick up any stress-relieving activity like reading to beat the constant monotony of anxiety when to bounce back.

3. Monitor all health parameters and ongoing medications

Post-COVID recovery, it is essential to monitor all health parameters and keep a daily tab on oxygen levels and temperature. You should also reconsider your ongoing medications for pre-existing conditions with your physician. One has to keep a tab on sugar levels in case of consumption of oral corticosteroids. Also, keep a tab on blood in urine, stools and phlegm if on blood thinners.

Be alert and watch out for any chronic or unusual symptoms of COVID-19. Elderly patients, patients with impaired immunity such as HIV/AIDS, or those suffering from co-morbid conditions such as diabetes, heart, or lung diseases are at elevated risk of fatal outcomes from COVID 19. Keep getting thermal screened and check vitals, especially oxygen levels in the body. Do keep a check on any unusual signs of low oxygen levels, unexplained chest pain, fever, breathlessness, body weakness or fogginess and confusion.

4. COVID Rehabilitation and Routine follow-up with your doctor

It is important not to rush into the old routine of professional work and the attendant volume of work. Recovered patients should resume work in a phase wise manner depending on energy levels per the advice of the doctor. A follow-up with your doctor is a must after 10 days from discharge. Watch your mental health. Also, be vocal about your progress bar around physical fitness at the right time. Be an advocate to clear the stigmas and myths surrounding COVID-19

Testing Frequently

If someone has a mild case of COVID-19, recovered from COVID-19, or has a new strain of the infection, they may need to get tested immediately to rule out any misgivings. We must understand that testing saves lives and leads us to treatment. You can use a rapid antigen test kit at home to detect the presence of the virus in your body or take an RTPCR test at the nearest hospital. You can also use the COVID-19 test kit if you experience any typical symptoms of the virus-like fever, cold, cough, Nausea, Vomiting, or Diarrhea. Make sure the test kit is a medical regulatory body-approved kit for better and more accurate results. The test kit can also help you identify any potential new viruses you may have come in contact with. This can help you protect yourself by staying away from people who could come in touch with you.

FAQs

1. Can people with mild COVID-19 symptoms recover at home?

Answer – People with mild COVID-19 symptoms can manage their condition and recover at home. Full recovery can take anywhere from 14 days to a few weeks to months. Good nutrition, adequate hydration, rest, and sleep can significantly improve the recovery process at home.

2. What are the primary signs of COVID-19?

Answer – The primary signs and symptoms of COVID-19 are,
● Cold and running nose
● Cough and sore throat
● Fever and Fatigue
● Headache Body Pain
● Difficulty in Breathing
● Stomach ache, Diarrhea, and Vomiting
● Dry mouth, dizziness, and loss of appetite
● Loss of smell and taste

3. How long is the incubation period of COVID-19?

Answer – Once exposed to the virus, symptoms of COVID-19 take 3-4 days to develop and emerge and can range from mild to dangerous, while some remain asymptomatic. The incubation period ranges from 1-14 days, most commonly around 3-4 days.

4.Can COVID-19 be transmitted through food?

Answer – There is no scientific evidence that COVID-19 can be transmitted through food.

5. Can COVID-19 be transmitted through fruits and vegetables?

Answer – There is no scientific evidence yet that COVID-19 can be transmitted through fruits and vegetables. But as a thumb rule, we should continue to wash fruits and vegetables under running water so that no germs enter our body through cuts or lesions.

The recent surge of the Omicron virus affecting the bulk of the population in most countries absolved the fear of the pandemic to a considerable extent. The Omicron B.1.1.529 variant or the South African variant increased infection rate and re-infection even on vaccinated and pre-infected people, ranging from a severe to mild viral attack. B.A.2 sub-variant Omicron may have worsened and peaked infections but did not cause severity and the same impact as the Delta virus. 

What changed the perspective of the Pandemic?

However, the good thing about this variant is that it lasted for a week, allowing for faster recovery time. This behaviour of the omicron waves provoked people from dropping masks. Companies, too, felt that the Corona wave was finally over and offices opened to re-welcome employees, social events came back in full force, and for all appearances, we are bidding goodbye to the corona virus even if it may not have left us.

In the United States, the Centres for Disease Control and Prevention’s (CDC) Rochelle Wolensky, in a statement, revealed amid the Omicron wave that people should be given a break from wearing masks when the metrics are better and when the situation worsens, they can be prompted to wearing it again. In Europe, too many countries have done away with the mask and social distancing. However, the World Health Organisation warns not to drop guard, and caution is the best way to downward the curve. The death rate is still increasing worldwide, though reported positive cases have decreased.

After every three months of the international public health emergency, the experts that advised the World Health Organisation (WHO) assess the pandemic to determine whether it merits the same level of caution. In 2022 January, it was unanimously agreed that it does, and the verdict was met with acceptance from the WHO Director-General Tedros Adhanom Ghebreyesus. Although Denmark, the Netherlands, and the United Kingdom have let off an official declaration for the end of the pandemic and have lifted most of the restrictions, countries like New Zealand are still cautious.

How can we check the spread of future COVID 19 viruses?

With the Omicron wave, we have realised that it is imperative to take steps against this rampant pandemic attack, and the only way we can achieve this is by continuing to follow responsible preventive behaviour. The vaccines may have failed in preventing infection, but we must not forget that those vaccinated were protected from the severity of the variant. Death was much less than the Delta variant, and most cases could be controlled with home isolation treatment. Those who had been administered booster doses were well protected from the Omicron virus. Countries where at least one dose of the CORONA vaccine was taken, saw a significantly lower hospitalisation. In countries where the vaccine coverage was intense, cases of hospitalisation and death were recorded in more significant numbers.

Behavioral developments in people 

The pandemic has also revealed an interesting behavioural response from people from different countries and governments. They are under the impression that the health risks associated with COVID 19 will not affect them; it could be related to their vaccination status or some other reason. After the Omicron wave, some governments have concluded that lockdowns are not beneficial to the larger society, and the economic setback it causes affects a larger population, with its outreach being equal to the impact of the pandemic. Governments, though, are strictly adhering to the vaccine policy.

Future variants

Moving further, there is some amount of scepticism concerning future variants. Expert epidemiologists suggest that a more dangerous variant than Omicron is bound to appear in a few months, but the present behaviour of the Omicron in its relatively dormant stage delivers some amount of optimism. While uncertainty still looms, booster intake has been significantly low in most countries compared to the first and the second dose. Another question that typically worries us in India is that the efficacy of Pfizer and Moderna has proved to be stronger than the vaccine that largely dominates in the country. The efficacy duration of the Covishield and Covaxin vaccine against the Omicron variant is still untested.

The new variant may start a new chapter in the Covid 19 pandemic; however, the only hope for society to face this impending challenge is thoughtful preventive measures. Staying safe through vaccinations, wearing masks, and maintaining adequate social distance is still required, especially in populated places and enclosed areas. Each individual must monitor the virus behavior following news from the health authorities, and if the virus recurs, testing and isolation is the best way to break the chain. An endemic, however, is the most desirable option at this date.

Ever since the first coronavirus case was reported on 31^st December 2019 in Wuhan, China, the world has witnessed one of the biggest pandemics in the last two years. The Coronavirus Disease, also known as COVID – 19, is an infectious disease that is caused by the SARS-CoV-2 virus. According to medical experts, COVID – 19 triggers respiratory tract infection. This can affect your upper respiratory tracts, which includes the sinuses, nose and throat, as well as the lower respiratory tract, which includes the windpipe and lungs. The severity of the symptoms and infection can range from mild to severe depending on several factors.

The COVID – 19 infection mostly spreads through person-to-person contact. It usually spreads from the infected person’s nose or mouth in small liquid particles when they cough, sneeze or even speak, and is inhaled by another person. The virus can also spread in poorly ventilated public settings, where people tend to spend longer periods of time. People can also get affected by coming in contact with high touch surfaces such as tables, desks, door knobs, faucets and more, as these surfaces are likely to be used by infected people.

Some of the most common symptoms of COVID – 19 include fever, coughing, breathlessness, fatigue, and loss of smell or taste. The other less common symptoms are chills, body ache, sore throat, nasal congestion, runny nose, rash/discoloration on skin, irritation or redness in the eyes, nausea, and diarrhea. People with underlying medical conditions such as cardiovascular disease, diabetes, cancer, and respiratory conditions such as asthma are likely to display severe symptoms as compared to the others, since their immune system is more compromised.

Like any other virus, the coronavirus too has the tendency to mutate or change. There are now several variants of the coronavirus, and some of them are proving to be more contagious and deadlier as compared to the original virus. Scientists and medical experts from across the globe are studying these different strains and variants to understand how fast each variant spreads and how severe can their symptoms can be. Throughout the COVID – 19 pandemic, scientists have kept track of several coronavirus variants such as:

• Alpha
• Beta
• Gamma
• Delta
• Lambda
• Mu
• Omicron

Out of these variants, the Delta variant seems to be the deadliest variant, leading to more hospitalization and fatalities, as compared to the other variants. The latest coronavirus variant is Omicron, and scientists are now thoroughly studying its patterns, transmissibility and severity.

Understanding the Omicron variant

The first case of the Omicron variant was reported on 24^th November 2021 from South Africa to the World Health Organization (WHO). Several medical health experts are studying this relatively new variant to understand the many aspects of Omicron.

In India, the first case of Omicron was detected on 2^nd December 2021 in the state of Karnataka, and is rapidly spreading across the country. Though there is no clarity on whether this variant is more transmissible or severe compared to the others variants, researchers and experts have observed patterns of spread of the Omicron infection across the globe to provide the cure and preventive measures.

According to the World Health Organization (WHO), preliminary evidence suggests that there might be an increased risk of reinfection with Omicron in comparison to the other variants. This means that people who have previously been diagnosed with COVID – 19 could become more easily infected with Omicron, and are more susceptible to the variant.

According to CDC, the Omicron variant is more likely to spread faster than the original SARS-CoV-2 virus. CDC also expects that anyone can get infected with Omicron, regardless of whether they are vaccinated or not.

Symptoms of Omicron

Though the symptoms of the coronavirus disease have more or less remained the same, regardless of the variant, there are some symptoms that are more prominent than the others. During the Omicron, many people are reporting symptoms that are more in line with common cold. The top 5 symptoms of the Omicron variant include:

• Runny Nose
• Headache
• Fatigue
• Sneezing
• Sore Throat

Some of the other Omicron symptoms that were reported are itchiness in the throat, dry cough and lower back pain. The classic COVID symptoms of fever and loss of taste/smell are slightly less frequent with Delta and Omicron in comparison to the original coronavirus and the Alpha variant.

Preventing the spread of Omicron

Though reports suggest that the Omicron infection is milder compared to the other variants, it is highly important to take the necessary precautions to keep the disease at bay. According to reports, the COVID – 19 vaccines are highly effective at preventing severe illness, with lower possibility of hospitalization. Medical experts are now studying how effective the vaccines are against the Omicron variant.

If you are not fully vaccinated, it is important to complete all the doses of your vaccination. You should also ensure that you are fully masked, maintain social distancing, sanitize frequently and stay in properly ventilated spaces. Though there have been very few fatalities pertaining to Omicron, it should not be dismissed as mild. Get yourself tested immediately in case of any symptoms and diligently follow the COVID – 19 precautions, because prevention is always better than cure!

References:

https://www.cdc.gov/coronavirus/2019-ncov/variants/omicron-variant.html

https://time.com/6138293/omicron-symptoms-covid-19/

https://www.who.int/southeastasia/news/detail/18-12-2021-take-all-measures-to-prevent-further-spread-of-omicron-who

https://www.who.int/emergencies/diseases/novel-coronavirus-2019

https://www.webmd.com/lung/coronavirus

Antibodies are specialized Y-shaped proteins that help recognize the body’s foreign invaders, such as viruses, bacteria, and parasites and help neutralize them. They are part of the adaptive immune system in the human body.

When a human body recovers from an infection with a virus, the immune system retains a memory of the same, so that the immune cells and proteins in the body can recognize and eliminate the pathogen, if it appears again. This is how the body receives protection against diseases and reduces the severity of the illness. Once made, the antibodies, whether from an infection or vaccination, may protect people from getting severely ill for some time afterward.

The same concept applies to the Coronavirus. Supposing you caught the virus, your body would produce antibodies that can recognize and eliminate foreign substances in your body and provide immunity. Immunity consists of 3 elements which are:

Helper T Cells – Ones that helps recognize pathogens

Killer T Cells – The ones that eliminate pathogens

B Cells – The ones that produce new antibodies when you need them.

On getting the COVID-19 vaccination, the antibodies in it provide T cells and B cells to your body which know how to fight against the virus.

So, what is the Neutralising Antibody (NAB) Test?

After getting the vaccine or an infection, it is important to know how if an individual has developed an immune response post-SARS-CoV2 or post-vaccination. Neutralizing Antibody Rapid Test is a qualitative In-Vitro Diagnostic immunochromatography assay. This test is designed for the use to detect the circulating SARS-CoV-2 neutralizes antibodies in whole blood.

This test is intended for use in any laboratory & non-laboratory setting to check immune response in subjects post COVID-19 vaccination & or infection with the SARS-CoV-2 initiated by the healthcare professional and individuals with the self-collected specimen.

Persons vaccinated against the SARS-CoV-2 virus and persons infected by SARS-CoV-2 infection can take this test.

How to conduct a Post-vaccination neutralizing antibody test using the Anti-body test kit

First things first, let’s look at what comes with the Anti-body test kit.  The box includes 1 test device, 1 Assay buffer, 1 Capillary tube, 1 Alcohol swab, 1 Lancet, 1 Disposal Bag, and 1 User guide

Take the following steps for preparation:

Step 1 – Wash your hands, and make sure they are completely dry before starting the test

Step 2 – Remove the test components from the box and place them on a flat surface

Step 3 – Peel the aluminum foil from the pre-filled buffer tube and secure the cap on the buffer tube

Step 4 – Push the buffer tube on the perforated circle on the box

How to collect a sample

1. Choose your ring finger or the middle finger, clean the tip of the finger with the alcohol swab and let it dry for 5 to 7 seconds. 
2. Twist and pull the tip of the Lancet.
3. Position the Lancet over your fingertip and push back against the skin until you heard a click
4. Wait for a good size of a drop of blood to form. If it does not, squeeze the sides of the finger to help it form
5. Squeeze the top of the capillary tube and bring the capillary tip in contact with the blood drop. Release the top of the capillary tube allowing the blood to flow into the tube

How to conduct the Test

Squeeze the top of the capillary tube to transfer the blood into the sample well of the test device

• Add 3-4 drops of the assay buffer on the sample well of the test device

• Wait for 15-20 minutes to read and  interpret the result.

How to interpret the result

Note: Result post 20 minutes should not be considered valid.

• Only if the control band C is developed, the test result indicates negative

• If the control (C) band and test (T) band is developed, it indicates the presence of COVID-19 neutralizing antibody in the sample. This means the result is positive.

• If no control band (C) is developed then the assay is invalid regardless of the color development on the test (T) band

• If none of the bands have developed, the assay is invalid. Try again with a new device.

How to dispose of the test-kit

• Use a sealed bag to dispose of the assay buffer, alcohol swab, capillary tube, and test device.

• Disinfect all the surfaces that the test Device may have touched and wash your hands after disposal

Do’s and Dont’s

Do not refrigerate the kit, or do not use the kit if the expiry date has passed. Do not interpret the result after 30 minutes. The result should be interpreted only after 20 minutes. The kit should be stored between 2 – 30 degrees Celsius. Follow the guidelines for disposal. Stand up so your hand is below your heart, this helps your blood flow better.

Testing positive on an antibody test does not mean that it should be a factor that determines whether or not to return to work or school. One should take steps to protect themselves and others by getting vaccinated. Before taking an antibody test if you have had COVID-19 symptoms at some point, it is wise to consult with your doctor thoroughly so they can guide you accurately as needed.