Post-Covid-19 care yet to gain steam as woes worsen for survivors

The problem of Covid-19 survivors exhibiting extended symptoms is worsening by the day, but post-Covid therapies have not yet taken off on a large scale.

In discussions held last week, the government was told about survivors exhibiting a range of extended symptoms and medical health issues, but a protocol to tackle these cases is not in place, medical experts said.

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Dr Thrilok Chandra, head of the Critical Care Support Unit, said that a protocol has been drafted by the Covid-19 Technical Committee, but it is still up for review.

A health official said cases of people suffering from brain fog, fatigue and hyper-inflammatory syndrome are already being reported to authorities in Belagavi, Kalaburagi and Mysuru districts. “Cases are coming on and off,” Dr. Chandra said. Dr. Giridhar Babu, the epidemiologist, said the cases are “just the tip of the iceberg”.

He described the problem as being prevalent in urban areas, where the number of Covid-19 cases have been high. 

Should the existing medical infrastructure be expanded to treat these cases? “Not necessarily,” said Dr. C N Manjunath, nodal officer for testing in Karnataka. He added, however, that it was too early to tell.

Care centres are limited currently and so are the staff. Dr. Sanjiv Lewin, Medical Superintendent of St John’s Hospital, said number of experts in physical medical rehabilitation (PMR) is low in India.

The Bangalore Medical College and Research Institute (BMCRI), which had announced plans to initiate a Post-Covid Care clinic in mid-August, said work was yet to start.

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“The protocol for care is still being formulated, staff have to be hired and more importantly, the Covid-19 survivors discharged from BMCRI will have to be surveyed to determine what issues they face,” said Dr. Smitha Segu, nodal officer for Covid-care, BMCRI.

The lack of data means the scale of the problem is unknown, said Dr. Manjunath. He, however, explained that cases of “people with pulmonary fibrosis, continued breathlessness, extreme fatigue with myalgia and secondary infections had been noticed”. 

Some of the first post-Covid sequelae (PCS) cases in Bengaluru have been seen at Ramaiah Memorial Hospital, which has had 50 patients so far.

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“Out of these, we admitted five. They had pulmonary fibrosis and cardiac events. Many had extreme fatigue to the point of being unable to walk,” said Dr Naresh Shetty, president of the hospital.

At St John’s Hospital, which started its post-Covid care centre 10 days ago, Dr. Lewin said the main form of PCS being seen was cardiac. “We are treating these cases through a combination of chest medicine and PMR, which also covers mental health,” he said.