As new symptoms emerge, TN experts struggle with changing testing protocols

Chennai

Initially in February, the most common symptoms included fever, dry cough and difficulty in breathing. However, shortly after, Health Department officials noted that influenza-like illnesses (ILI) were also being recorded. Now, in addition to respiratory distress, other symptoms such as sudden loss of taste or smell are being considered more accurate parameters. Prabhdeep Kaur, deputy director, National Institute of Epidemiology and a member of TN’s medical experts’ panel, said the checklist of symptoms needs to be expanded as fever has not been recognisable in identifying suspected cases and loss of taste and smell are more specific symptoms.

This was validated by Dr C Ramasubramaniam, also a member of the committee. “Many patients complain of loss of taste and smell, even though this is not a specific symptom of COVID 19. It can happen in other viral infections also. We are seeing this as one of the markers. These symptoms usually develop after a few days of fever and body pain.”

As per the testing protocol in the first week of February, all individuals with travel history to countries affected with COVID-19 and their contacts were to be tested. However, with the emergence of Tablighi cases, the protocol included travel history to Delhi and their contacts. Patients with SARI and ILI were later recommended to be tested, as they were among the high-risk category along with those with comorbidities. The experts are now stressing on preventive measures and intensified testing. “Testing needs to be intensified to prevent further increase in the number of cases. Preventing transmission is the key as long as there are no vaccines or definite medication protocol,” said Dr Sivakumar, a member of the expert committee and chief of medicine at Villupuram Government Medical College and Hospital.

Dr Raj Kumar, a doctor at the COVID-19 ward at Government Stanley Medical College Hospital, said hydroxychloroquine (HCQ) was seen as the life-saving drug and Azythromycin along with anti-malarial drugs were used two months ago. Currently, a combination of anticoagulant drugs, HCQ and Azythromycin is used for stable patients. “The protocols are changing every day and we are not even kept in the loop,” he added.

COVID CHALLENGES

•  NEW SYMPTOMS: Respiratory distress, loss of taste or smell considered more accurate parameters
•  NEW TESTING PROTOCOLS: All symptomatic individuals with natl or intl travel history, contacts of high-risk patients and foreign returnees should be tested. Individuals with influenza-like illnesses have to be testd too.
•  NEW QUARANTINE PRACTICES: A month back, symptomatic as well as asymptomatic patients were treated in hospitals. However, now, mild and moderate cases including asymptomatic ones are kept in COVID care centres or under home isolation. The 14-day home quarantine was recommended for returnees from other countries or recovered patients. However, currently, even asymptomatic patients are kept under 14-day home quarantine.