Dr A Jayachandra - Talks about COVID-19 and Healthcare

Presently a Senior Consultant and Interventional Pulmonologist, at Virinchi Hospitals, Banjara Hills, Dr A Jayachandra has been practising as consultant pulmonologist since 1984. He was one of the firsts to introduce the concept of Interventional pulmonology and the entire spectrum of interventions in the state and is also one of the Pioneers in Flexible Bronchoscopy in pulmonary diagnostics in Hyderabad. With the years of experience, Dr Jayachandra shares with us his thoughts and opinions on the nation’s efforts to cope with coronavirus and the measures that can be taken to fight better.  

What is the current scenario of COVID-19 in India? How are we coping as a nation, how far are we from containing the virus, and are there any new studies on COVID-19? Your views
The COVID -19 pandemic has nearly brought the country to its knees. It has exposed the poor medical infrastructure and the greater organisational ineptitude prevalent in the country. Some have coped well but, by and large, the failure of most of our governments was exposed. As it stands today, the virus is spreading rampantly and without hindrance. The reasons for this are not difficult to find.

 In any epidemic, the scientific approach would be to first identify the source and trace the points of contact and to isolate them. It started out like this, after which the governments took over and began the systematic denial of the problem’s existence. Things went even more haywire the day the Chief Ministers and other officials began dictating the death certificates. I could not figure out the purpose of the forced underreporting, even as our medical infrastructure buckled under the strain of the virus.

How is plasma therapy playing a role in the treatment, and how effective is it? Are there any side effects?
There are new ‘studies’ released every day, purporting to be the miracle cure like HCQS, Ivermectin; the list is endless. The only acceptable approach is to treat the lung inflammatory process with available drugs, without incurring a high cost. The newer drugs I find are not of curative benefit but may have a supportive role.

Are there any practices or measures that can be introduced in our daily lives to keep us safe?
Keep away from potential sources of infection. And how does one identify the patients/infected people? There really is no way to say so, it’s best to keep your distance from everyone as much as possible. Attending parties, weddings, and other social events is a sure way of inviting the disease. The death of the two jewellers due to the virus and many more infected after attending a wedding are standing examples. Your diet plays no role at all in prevention or protection. Avoiding meat and other non-vegetarian food is as silly as it is unsubstantiated. Alcohol consumption is also left to personal choice. 

Most of the hospitals in the city are full, and rarely any beds are available. What can be done to empower the hospitals in terms of accommodating severe COVID cases or the ones with other serious health issues?
Most hospitals have both their wards and ICUs full. There are a large number of people who seek admission at the onset of disease, and some do get admitted more for social reasons. Patients requiring only isolation occupy precious hospital beds, which worsens the problem. What we require are more quarantine centres to spare the hospital surge.

How can mild/moderate COVID-19 patients treat themselves at home?
There is a protocol for isolation and keeping away from the rest of the family to prevent spread amongst them. Sadly, a lack of available space prevents effective isolation in many households. The best thing to do is to take the prescribed medicines and staying comfortable with vitamin and nutrition support.

What are the chances of a person getting re-affected by coronavirus? What should one expect as they recover from COVID?
Reinfection has not been an issue so far. There are few anecdotal reports and are completely unsubstantiated at this point.

A lot has changed since COVID-19 hit us, the way of testing earlier was based on early studies, but now that we have come up with more information and reportedly a lot of patients are asymptomatic. So has the process and protocols of testing changed since then? How are we supposed to identify the asymptomatic cases?
Testing protocols, the number of tests being done and the way they are being done leaves a lot to be desired. Our state is not allowing sufficient testing. The only way to identify these people/carriers is properly testing them for the virus. Everyone needs to be tested despite the huge numbers involved. Isolation is recommended after this.

What we require at this juncture is to test, trace contacts and isolate with all seriousness without regard for caste or creed. Everyday alerts about the areas where infections abound need to be released and those not following directives need to be penalised. Peoples’ lives are at stake, and utter recklessness should not be allowed to ruin our lives.

The need of the hour is to have enough quarantine facilities which will clear out most hospital beds and put them to better use. Closing your eyes and hoping the problem will go away is no way to save people. The virus will go away eventually but will take a large proportion of the population with it.

It just reminds me of Darwin’s theory of evolution, where only the fittest survive.     - Srivalli