Awareness on Covid-19 before and after the Disease

COVID-19
pandemic has disrupted the whole world. It
causes testing and stressful time creating
public health emergency. Due to panic
nature of the condition, there are mis-
guided information and romours among
the public which further affect the recovery
of the condition.
 CONTENTS:
Ÿ COVID-19: How it spreads 3
Ÿ Why is there Stigma? 4
Ÿ Tips to reduce transmission of COVID-19 5
Ÿ The most commonly reported symptoms of Covid-19 6
Ÿ What is recommended for patients in home isolation 7
Ÿ Keep a regular check on some health parameters 9
Ÿ What to eat?What not to eat 10
Ÿ How to take care of family member who is covid positive 11
Ÿ How to behave in presence of Covid positive patient in
neighbourhood 13
Ÿ Method to sanitize common surfaces and articles 14
Ÿ COVID-19 testing - when and how? 15
Ÿ Your Guide to Masks 16
Ÿ Proning for Self care 17
Ÿ Role of AYUSH medicines in the management of Covid-19 & its 20
symptoms
Ÿ Self Help for Good Health: A Naturopathy Perspective 21
Ÿ Support for Rehabilitation Self-Management after COVID-19
related illness 24
Ÿ Managing breathlessness 24
Ÿ Positions to ease breathlessness 25
Ÿ Breathing techniques 26
Ÿ Exercising after leaving hospital 27
Ÿ Warm-up exercises 29
Ÿ Fitness exercises 30
Ÿ Strengthening exercises 31
Ÿ Cool down exercises 35
Ÿ Managing cough after covid 37
Ÿ Managing problems with your voice 38
Ÿ Managing eating, drinking, and swallowing 39
Ÿ Managing problems with attention, memory, and thinking clearly 40
Ÿ Managing activities of daily living 41
Ÿ Managing stress, anxiety, or depression 42
Ÿ Black Fungus or Mucormycosis: Usually Rare But Invasive 44
Ÿ FAQs 45
Ÿ The Covid-19 Vaccine- some common side-effects 52
Ÿ FAQs about Covid Vaccine 53

2
COVID-19: How it spreads
In the late 2019, a new disease condition caused by a
modified strain of coronavirus emerged as a deadly disease.
It was named COVID-19 by WHO, also referred to as SARS-
CoV-2. Soon the disease became pandemic covering all
continents due to its rapid spread. At the end of April 2021,
there were about 150 million cases with 3 million deaths.
Currently, there is no specific treatment for this disease. COVID-
19 is an infectious disease caused by the recently discovered
strain of coronavirus. This virus spreads primarily through
droplets of saliva or discharge from the nose when an infected
person coughs or sneezes. The virus enters the human body via
nose, mouth and eyes. Some recent studies suggest that the
virus may be airborne and can be spread through fine infected
droplets that remain suspended in the air in closed air-
conditioned environments of offices, AC cabs-buses, shopping
malls and theatres due to absence of crossventilation, even
when you are not in direct contact with an infected person.

3
Why is there Stigma?
Stigma associated with COVID-19 is based on three main
factors:

Lack of adequate Fear of the Rumours or

information disease misinformation

Who are facing Stigma and

Discrimination:
Ÿ People affected with COVID-19, their families/caregivers/
friends
Ÿ People under quarantine and their families

Ÿ Frontline health care providers like

doctors, nurses, paramedics, field
workers, hospital staff and
sanitation workers, etc.
Ÿ Those who have recovered from
COVID-19
Ÿ Migrant workers

4
Tips to reduce transmission of
COVID-19 are as follows:
• Stay at home, especially if you are more than 60 years or less
than 5 years of age, or have comorbidities like diabetes,
hypertension or chronic ailments
• Avoid meeting visitors
• Wash hands and face at regular intervals with soap and water
• Wear mask at all times & keep a distance of 6 feet from others
when out of the house
• Ensure regular sanitization of frequently touched surfaces
with disinfectant/sanitizer
• Avoiding closed spaces with central air-conditioning like
offices, malls, etc.
• Take balanced diet & be well hydrated with plenty of fluids
like fruit juices, herbal drinks and turmeric in milk.
• Do Yoga, light exercise and meditation daily
• Avoid self-medication and seek medical advice whenever
needed
• Take extra precaution while attending to patient in family
• Take your medicines regularly as prescribed to you by your
doctor

5
The most commonly reported
symptoms of Covid-19 are:
1. Fever or chills, Fever 100 degree F or above

2. Cough, Sore throat

3. Chest may feel too tight to inhale or

exhale fully

4. Loss of appetite, smell and/or taste

5. Tiredness, body aches, muscular pain or

fatigue

6. Uneasy feeling in stomach and poor

appetite

7. Congestion and running nose

8. Low BP, Mental Fog (confusion),

dizziness, increased heart rate
The duration of symptoms and severity of disease for people who have COVID-
19 can vary; for most people, usually the symptoms take 7-14 days to subside.
Some people may have no symptoms while others may require hospitalization
to treat these symptoms. Recovery from symptoms varies from person to
person.
In some cases these symptoms might persist even after testing negative for
COVID-19. If you have any of these symptoms, you should consult your
physician who will advise for COVID testing if indicated. If you test positive and
you have mild symptoms, the doctor may advise home treatment. Else,
hospitalization may be advised. Every positive test result is also informed to
government and government representatives may visit your house for
checking on you and isolating the family members. Corona is curable, if
diagnosed early. DON’T DELAY.

6
What is recommended for patients in
home isolation?
• Stay isolated in separate well ventilated room with attached
(separate) toilet

• Maintain distance with other members in the family

• Always use triple layered mask. Change the used mask after
every 6 to 8 hours.

• Keep the used mask separately in paper bag and dispose of

after 72 hours

• Cough and sneeze in masks, handkerchief or into your

elbows

• Don’t share your utensils, towel, bed linen etc. with other
members in the family

• Measure body temperature with thermometer and oxygen

level with pulse oximeter twice daily and note down
simultaneously

7
• Continue your medication of diabetes, B.P. etc. with your
doctor’s advice

• Eat fresh fruits and vegetables and prefer more proteins in

diet than carbohydrates

• Avoid smoking and drinking alcohol

• Keep away of your pets

• Download “Arogya Setu App” in your mobile and keep

notification, location and GPD tracking on

• Avoid guests and meeting outsiders at home. Don’t visit

public places like bank, school, etc.

• Avoid social gatherings like marriages, birthday parties, etc.

• It is important for
covid patients to
be in healthy state
of mind and body
both. So enjoy
talking to your
family and friends
on phone. Read
books watch your
favourite TV
programmes and
movies or play
games on mobile
phone.

8
Keep a regular check on some health
parameters
• Check body temperature with the help of
thermometer (It should not be more than
100F)

• You can easily check your pulse on the inside of your wrist,
below your thumb. Gently place 2 fingers of your other hand
on this artery. Do not use your thumb because it has its own
pulse that you may feel. Count the beats for 30 seconds;
then double the result to get the number of beats per
minute. Your pulse rate is the number of times your heart
beats per minute. A normal resting heart rate should be
60–100 beats per minute, but it should not be more than 100

• When checking respiration, it is important to also note

whether you have any difficulty breathing. Normal
respiration rates for an adult person at rest range from 12 to
16 breaths per minute

• Switch on the oximeter & place it on your middle or index

finger. The reading takes time to steady, Keep the oximeter
in place for at least a minute or longer if the
reading is not stable. Record the highest
result once it has not changed for 5 seconds

9
What to eat?
• Eat home cooked food
• Prefer wheat, millet, brown rice, porridge, etc.
• Protein rich food…beans, pulses
• Fresh fruits & vegetable esp. citrus fruits
like orange, tangerine
• Drink 8-10 glasses of water daily
• Prefer spices like turmeric, ginger, garlic, etc.
• Toned milk and milk products
• Non vegetarians can take skinless chicken, fish and eggs
• Wash fruits and vegetable under running water before use
• Prefer low cholesterol fat to cook

What not to eat

• Avoid fried, fatty, oily and junk foods
• Canned foods & drinks (eg carbonated drinks)
• Non veg only two to three times in a week
• Mutton, liver, fried and processed food

10
How to take care of family member who
is covid positive
Any person between the age group of 25 to 50 years can
take care of Covid positive patient in the family, provided
he is not suffering from any serious diseases like cancer,
asthma, diabetes, hypertension, kidney disease, any
respiratory disease etc. with following precautions:

• Always wear triple layered medical mask, disposable gloves

and plastic apron. Always keep the apron clean, use sodium
hypochlorite for cleaning

• Change the used mask after every 6 to 8 hours. Keep the

used mask separately in paper bag and dispose of after 72
hours

• Wash hands under running water with soap for 40 seconds

or use hand sanitizesr with 70% alcohol

• Don’t touch your nose, mouth or face without washing

hands

• Washing of hands is very important before and after cooking

and going to toilet

• Wipe your hands with tissue or paper napkin after washing

hands

11
• It is advisable to sanitize room, bathroom and toilet of
patient

• Follow the treatment and guidelines prescribed by the

doctors

• Avoid coming in direct contact with body fluids of patient

like sneeze, saliva, etc.

• Place the stool outside the room or the bedside of patient to

serve the food in disposables and avoid to come in direct
contact with the patients as much as possible

• Keep a check on your health parameters like temperature,

O2 level etc. Immediately contact your doctor if you suffer
any symptoms like fever, cough, cold or difficulty in
breathing

• If any family member who is above 60 years of age or

suffering from any serious diseases like cancer, asthma,
diabetes, hypertension, kidney disease, any respiratory
disease etc or any pregnant lady is there than ask them to
keep away from Covid patient

12
How to behave in presence of Covid
positive patient in neighbourhood
• Don’t panic if there is any covid positive patient in your
building or society. Following few precaution can help you
to keep your family safe
• Sanitize the building common area twice a day with 1%
sodium hypochlorite solution
• Avoid touching the frequently touched surfaces of building
like railing of staircases & lift buttons
• Help the patient until he/she becomes alright (declared
negative)
• Ask them on phone & make the daily needs available to
them like vegetable, fruits, medicines, groceries etc. Keep
these things at their door step and settle the accounts
digitally or after they become healthy again
• Keep in touch with them regularly on phone and motivate
them by sharing the talks about those patients who have
recovered successfully
• Don’t look down upon the covid patient better consider
them as fighter
• Don’t pose any difficulty to patient or its family as our fight is
not with them but with the disease

13
Method to sanitize common surfaces
and articles

What How Time When

Toilet First clean with 10 After every
detergent and water minutes 4 hours
and then wipe with
1% sodium
hypochlorite solution
Apparatus like Clean with Sanitizer 2-3 Before and
Pulse oximeter, minutes after every
Thermometer, use
Stethoscope, B.P.
Apparatus,
Glucometer,
Nebulizer,
Thermal scanner,
etc.
Frequently With 1% sodium 10 After every
touched surfaces hypochlorite solution minutes 2 hours

Floor First clean with 10 After every

detergent and water minutes 8 hours
and then wipe with
1% sodium
hypochlorite solution
Roof and walls With 1% sodium 10 Once in a
hypochlorite solution minutes day

Corridors With 1% sodium 10 After every

hypochlorite solution minutes 8 hours

Linen With 1% sodium 30 In a day or

hypochlorite solution minutes two

14
COVID-19 testing - when and how?
WHOM TO TEST
• All individuals need not be tested, because Disease is
primarily reported in Individuals with travel history to the
affected countries or close contacts of positive cases
• All symptomatic people who
o Have history of international travel in last 14 days
o Had come in contact of confirmed cases
o Are healthcare workers
o Are hospitalized patients with Severe Acute Respiratory
Illness (SARI) or Influenza Like Illness (ILI) or severe
pneumonia
• Asymptomatic direct and high-risk contacts of confirmed
cases should be tested once between day 5 and day 14 of
coming in his/her contact. Direct and high-risk contact
include:
o Those living in same household with a confirmed case
o Healthcare workers who examined a confirmed case
without adequate protection as per WHO
recommendations

List of labs (Govt. & Private)

can be accessed at: [Link]

15
Your Guide to Masks
WEAR YOUR MASK CORRECTLY
Ÿ Wash your hands or use hand sanitizer
before putting on your mask.
Ÿ Put the mask over your nose and mouth
and secure it under your chin.
Ÿ Fit the mask snugly against the sides of your
face, slipping the loops over your ears or
tying the strings behind your head.
Ÿ If you have to continually adjust your mask,
it doesn’t fit properly, and you might need
to find a different mask type or brand.
Ÿ Make sure you can breathe easily.

HOW NOT TO WEAR A MASK

Around your neck On your forehead Under your nose Only on your nose

On your chin Dangling from one ear On your arm

How to take off a mask

1 2 3 4
Carefully, untie the strings Handle only by the ear Fold the outside corners Be careful not to touch your
behind your head or stretch loops or ties together eyes, nose, and mouth when
the ear loops removing and wash hands
immediately after removing

16
Proning for Self care
Ÿ PRONING is the process of turning a patient with precise,
safe motions, from their back onto their abdomen (stomach),
so the individual is lying face down.
Ÿ Proning is a medically accepted position to improve
breathing comfort and oxygenation.
Ÿ It is extremely beneficial in COVID-19 patients with
compromised breathing comfort, especially during home
isolation.
Ÿ IMPORTANCE OF PRONE LYING

Ÿ Prone positioning improves ventilation, keeps alveolar units

open and breathing easy.
Ÿ Proning is required only when the patient feels difficulty in
breathing and the SpO2 decreases below 94 (less than 94).
Ÿ Regular monitoring of SpO2, along with other signs like
temperature, blood pressure and blood sugar, is important
during home isolation.
Ÿ Missing out on hypoxia (compromised Oxygen circulation)
may lead to worsening of complications.
Ÿ Timely proning and maintaining good ventilation could save
many lives.
POSITIONING OF PILLOW
Ÿ One pillow below the
neck
Ÿ One or two pillows
below the chest
through upper thighs
Ÿ Two pillows below
the shins

17
For Self-Proning:
Ÿ You will need 4-5 Pillows

Ÿ Regular alterations in lying position

Ÿ Best is to not spend more than 30 minutes in each position

1. 30 minutes -2 hours: laying on your belly 2. 30 minutes -2 hours: laying on your

right side

3. 30 minutes -2 hours: sitting up 4. 30 minutes -2 hours: laying on your left side

Then back to Position 1. Lying on your belly!

CAUTION:
Ÿ Avoid proning for an hour after meals

Ÿ Maintain proning for only as much times as easily tolerable

Ÿ One may prone for up to 16 hours a day, in multiple cycles,

as felt comfortable
Ÿ Pillows may be adjusted slightly to alter pressure areas and
for comfort
Ÿ Keep a track of any pressure sores or injuries, especially,
around bony prominences

18
AVOID PRONING IN CONDITIONS LIKE:
Ÿ Pregnancy

Ÿ Deep venous thrombosis (Treated in less than 48 hours)

Ÿ Major cardiac conditions

Ÿ Unstable spine, femur, or pelvic fractures

NON-SELF PRONATING PATIENTS (IN EMERGENCY):

Five-step method to place a patient in the prone position using
a regular bed, flat sheet, and family members
Ÿ Using a flat sheet, pull the patient to one side of the bed.

Ÿ Place the flat sheet around the arm that will pull through
(the side you are turning toward).
Ÿ A second flat sheet is placed on the bed and tucked under
the patient. This sheet will pull through as you are turning
the patient.
Ÿ Using the sheet, turn the patient over and position the
patient prone. The arm and sheet will pull across the bed.
Ÿ Pull and center the patient. Discard the sheet that was used
to place the patient in the supine position. Straighten lines
and tubes.

This may need modification with emerging evidence

19
Role of AYUSH medicines in the
management of Covid-19 & its
symptoms
Use of AYUSH ( Ayurveda, Yoga and Naturopathy, Unani,
Siddha and Homeopathy)
Ÿ Can be an effective way in boosting immune response against
the infections. In addition, it was found that the use of vitamins,
in general, is beneficial in improving immune health and
function. However, as a few clinical investigations show the
effectiveness of AYUSH in the prevention and treatment of
infectious diseases.
[Link]

Ÿ Herbal medicine is considered one of the alternative

approaches in the treatment of COVID-19. In China, the
National Health Commission has declared the use of herbal
medicine combined with Western medicine as a treatment for
COVID-19, and has issued many guidelines on herbal medicine-
related therapy.
Integr Med Res. 2020 Jun;9(2):100407.

Ÿ Scientific evidence in various epidemics clearly showcase that

Homoeopathy can be used both therapeutically and /or as
prophylactic with success….. Its greatest successes have been
recorded in the prevention & treatment of flu like illnesses.
Varanasi R, Nayak D. Homoeopathy in the management of infectious diseases: Different facets of its use
and implications for the future. Indian J Res Homoeopathy 2020;14:110-21

PLEASE NOTE THAT AYUSH MEDICINES CAN BE USED AS SELF CARE FOR
PREVENTION AND DURING MILD SYMPTOMS AS ADJUVANT AND BEYOND
THAT CONSULT YOUR PHYSICIAN FOR STANDARD THERAPY.

20
Self Help for Good Health:
A Naturopathy Perspective
Ÿ While there is no medicine for COVID-19 till date, it will be
good to take preventive measures which boost our
immunity in these times with the following self-care
measures.

SELF CARE MEASURES FOR OPTIMAL IMMUNITY

Ÿ Sunlight: Exposure to the sun and air

in the morning and evening hours is
known to reduce stress and confer
immunity by improving Vitamin D
metabolism.

Ÿ Sleep: Regular healthy sleep of 7 to 8

hrs is essential to modulate immunity.

Ÿ Nutrition: Food rich in proteins,

vitamin C and D are recommended.
Lemon juice with honey, Zinc and
Selenium rich foods like spinach,
beans, legumes, pumpkin seeds,
cashews, Flax seeds etc can be had
frequently. Plenty of colored fruits
and vegetables, Millet based diets,
should be included in everyday diet.

Ÿ Note: Opt for locally available

seasonal fruits and vegetables. Try to
include maximum colors (fruits and
vegetables) in the plate.

21
Ÿ Exercise & Yoga: Exercises of
moderate-intensity like brisk walking
covering 4 kms in an hour with an
optimal frequency of three to five days
a week, and activities like gardening,
etc for an optimal duration of 20 to 30
minutes can be done.
Ÿ Yoga practice for an hour everyday including
breathing practices, Pranayamas and Kriyas,
play a crucial role in preventing infections and
strengthening the Upper Respiratory Tract.

Ÿ Stress reduction: To overcome stress

and inculcate positive attitude towards
life the practice of Meditation,
Mindfulness, Relaxation techniques,
Music therapy, engagement with
nature (gardening, sun walk, star
gazing, bird watching, pool sitting, bare
foot walking, swimming, forest walks,
mountaineering, hiking, cycling etc.),
learning to sing, dance, new language,
cultivating a hobby, engaging in social
work, helping others or care for plants
and animals and so on can be resorted.
Sufficient evidence exists to justify the
practices mentioned above in
maintaining immunity at an optimum
level.

Ÿ Salt water Gargling: Salt water gargles

are the recommended for symptomatic
relief for sore – throat. It also helps
reduce viral load by expelling it at
regular intervals and more importantly
before going to bed.

22
Ÿ Use of Steam (with or without)
Essential Oils: Steam inhalation is for
relieving congestions & mitigating
cold and flu like symptoms. Steam
generated with 3-6 drops of essential
oils like Eucalyptus, Rosemary,
lavender, sweet orange or lemon
when added to 50 ml of boiling water
can help in alleviating symptoms of
common cold, stress and anxiety.

Ÿ Netikriya: Jalaneti or Nasal Irrigation

is the application with warm saline
water, poured into one nostril and
expelled through the other and then
another nostril, with the help of Neti
pot. It will help to reduce nasal
congestion, dryness and airway
reactivity. This practice should be
followed by Kapalabhatikriya twice a
week to reduce airway reactivity.

Ÿ Hot foot immersion: A local

immersion bath covering the feet and
ankles at temperatures ranging from
39° – 43°C / 103-110°F can be taken to
relieve congestion headache and
chest congestion.

Ÿ Fasting: Fasting or abstinence of food

voluntarily for a certain period of time
giving physiological rest can help Eat
boost immunity, decrease Fast

inflammation, and increase resistance

to oxidative stress.

23
Support for Rehabilitation
Self-Management after
COVID-19 Related Illness
Ÿ Your healthcare professional may indicate the exercises that
are appropriate for you from this leaflet. The exercises and
advice in this leaflet should not replace any individualised
exercise programme or advice you may have been given by
healthcare professionals when you left hospital.

Ÿ Your family and friends can help support you as you recover,
and it may be helpful to share this leaflet with them.

Managing breathlessness
Ÿ It is common to experience breathlessness after being in
hospital. Feeling breathless can make you feel anxious,
which can make breathlessness worse. Staying calm and
learning the best way to manage your breathlessness will
help.
Ÿ Your breathlessness should improve as you slowly increase
your activities and exercise, but in the meantime, the
positions and techniques below can also help to manage it.

If you start to feel severely short of breath and it does not

get better with these positions or techniques, contact your
healthcare professional.

24
Support for Rehabilitation Self-Management after COVID-19 Related Illness

Positions to ease breathlessness

Ÿ These are some positions that may reduce your
breathlessness. Try each of them to see which one/s help
you. You can also try the breathing techniques described
below while in any of these positions to help ease your
breathing.

1. High side lying

Lying on your side propped up by pillows,
supporting your head and neck, with your
knees slightly bent.

2. Forward lean sitting 3. Forward lean sitting (no

Sitting at a table, lean forwards table in front)
from the waist with your head Sitting on a chair, lean forwards
and neck resting on the pillow, to rest your arms on your lap or
and your arms resting on the the armrests of the chair.
table. You can also try this without the pillows.
without the pillows.

4. Forward lean standing 5. Standing with back support

While standing, lean forwards Lean with your back against a
onto a windowsill or other stable wall and your hands by your
surface. side. Have your feet about a foot
away from the wall and slightly
apart.

25
Support for Rehabilitation Self-Management after COVID-19 Related Illness

Breathing techniques
CONTROLLED BREATHING
This technique will help you to relax and control your
breathing:
Ÿ Sit in a comfortable and supported position
Ÿ Put one hand on your chest and the other on your stomach
Ÿ Only if it helps you to relax, close your eyes (otherwise leave them open)
and focus on your breathing
Ÿ Slowly breathe in through your nose (or mouth if you are unable to do
this) and then out through your mouth
Ÿ As you breathe, you will feel the hand on your stomach rise more than
the hand on your chest
Ÿ Try to use as little effort as possible and make your breaths slow, relaxed,
and smooth

PACED BREATHING
This is useful to practice when carrying out activities that might take more
effort or make you breathless, like climbing the stairs or walking up a hill. It is
important to remember that there is no need to rush.
Ÿ Think about breaking the activity down into smaller parts to make it
easier to carry out without getting so tired or breathless at the end
Ÿ Breathe in before you make the ‘effort’ of the activity, such as before you
climb up a step
Ÿ Breathe out while making the effort, such as climbing up a step
Ÿ You may find it helpful to breathe in through your nose and out through
your mouth

26
Support for Rehabilitation Self-Management after COVID-19 Related Illness

Exercising after leaving hospital

Exercise is an important part of recovery after a
severe COVID-19 illness. Exercise can help to:
Ÿ Improve fitness • Reduce breathlessness
Ÿ Increase muscle strength • Improve balance and coordination
Ÿ Improve your thinking • Reduce stress and improve mood
Ÿ Increase confidence • Improve your energy
Find a way to stay motivated with your exercises. Keeping track of your
progress with a diary or exercise ‘app’ on your phone or watch may help.

EXERCISING SAFELY
Exercising safely is important, even if you were independent with your
mobility (walking) and other exercise before becoming sick. It is particularly
important if you:
Ÿ Had difficulty with your mobility before going into hospital
Ÿ Had any falls before going into hospital or during your time in hospital
Ÿ Have any other health condition or injury that may put your health at risk
with exercising
Ÿ Have been discharged from hospital on medically prescribed oxygen
In these cases, you may need to exercise with someone else for safety.
Anyone on additional oxygen MUST discuss their use of oxygen during
exercise with a healthcare professional before starting.
These simple rules will help you exercise safely:
Ÿ Always warm-up before exercising, and cool down after exercising
Ÿ Wear loose, comfortable clothing and supportive shoes
Ÿ Wait at least an hour after a meal before exercising
Ÿ Drink plenty of water
Ÿ Avoid exercising in very hot weather
Ÿ Exercise indoors in very cold weather

27
Support for Rehabilitation Self-Management after COVID-19 Related Illness

If you feel any of the following symptoms, do not

exercise, or stop exercising, and contact your
healthcare professional:
Ÿ Nausea or feeling sick
Ÿ Dizziness or light headedness
Ÿ Severe shortness of breath
Ÿ Clamminess or sweating
Ÿ Chest tightness
Ÿ Increased pain
Remember to obey physical distancing rules when exercising outdoors, if
these exist where you live.

EXERCISING AT THE RIGHT LEVEL

To work out whether you are the exercising at the right level, think about
speaking a sentence:
Ÿ If you can speak the whole sentence without stopping and are not
feeling breathless, then you can exercise harder
Ÿ If you cannot speak at all, or can only say a word at a time and are
severely breathless, then you are exercising too hard
Ÿ If you can speak a sentence, pausing once or twice to catch your breath,
and are moderately to almost severely breathless, then you are
exercising at the right level
Remember that it is normal to feel breathless when you exercise, and it
is not harmful or dangerous. Gradually building your fitness can help
you become less breathless. In order to improve your fitness, you
should feel moderately to almost severely breathless when you
exercise.
Ÿ If you do feel too breathless to speak, you should slow down or stop to
rest until your breathing feels more controlled. You may find the
positions to relieve breathlessness on page 25 helpful.

28
Support for Rehabilitation Self-Management after COVID-19 Related Illness

Warm-up exercises
Ÿ Warming up prepares your body for exercise to prevent
injury. Your warm-up should last around 5 minutes, and at
the end you should feel slightly breathless. Warm-up
exercises can be done in sitting or in standing. If you do your
warm-up in standing, hold on to a stable surface for support
if needed. Repeat each movement 2-4 times.

1. Shoulder shrugs 2. Shoulder circles 3. Side bends

Slowly lift your Keeping your arms Start with your body
shoulders up towards relaxed by your side or straight and your arms
your ears and then resting on your lap, by your sides Slide one
down again slowly move your arm, then the other, a
shoulders round in a short way towards the
circle forwards, and floor, bending sideways
then backwards

4. Knee lifts 5. Ankle taps 6. Ankle circles

Lift your knees up and Firstly, using one foot, Using one foot, draw
down slowly, no higher tap your toes and then circles with your toes;
than your hip, one at a your heel on the repeat with the other
time ground in front of you; foot
repeat with the other
foot

29
Support for Rehabilitation Self-Management after COVID-19 Related Illness

Fitness exercises
Ÿ You should aim to do fitness exercise for 20-30 minutes, 5
days each week.

EXAMPLES OF FITNESS EXERCISES

1. Marching on the spot

Ÿ If needed, hold onto a stable chair or surface for
support, and have a chair nearby to rest
Ÿ Lift your knees one at a time
Progressing this exercise:
Ÿ Increase the height you lift your legs, aiming to reach
hip height if possible
When you might choose this exercise:
Ÿ If you cannot go outside to walk
Ÿ If you are not able to walk very far before needing to sit down

2. Step-ups
Ÿ Use the bottom step of your flight of stairs
Ÿ If needed, hold on to the handrail for support, and
have a chair nearby to rest
Ÿ Step up and down, changing the leg you start with
every 10 steps
Progressing this exercise:
Ÿ Increase the height of the step, or speed of stepping
up and down
Ÿ If your balance is good enough to do this exercise
without holding on, then you can carry weights as you step up and
down
When you might choose this exercise:
Ÿ If you cannot go outside
Ÿ If you are not able to walk very far before needing to sit down

3. Walking
Ÿ Use a walking frame, crutches, or stick if needed
Ÿ Choose a route that is relatively flat
Progressing this exercise:
Ÿ Increasing the speed or distance you walk, or if accessible, include walking
uphill in your route
When you might choose this exercise:
Ÿ If you can get outdoors to exercise

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Support for Rehabilitation Self-Management after COVID-19 Related Illness
4. Jogging or cycling
Ÿ Only do jogging or cycling if it is medically safe for you
When you might choose this exercise:
Ÿ If walking is not making you out of breath enough
Ÿ If you could jog or cycle before you became unwell

Strengthening exercises
Ÿ Strengthening exercises will help improve muscles that have
become weaker as a result of your illness. You should aim to
do three sessions of strengthening exercise each week.
Strengthening exercises will not make you feel breathless in
the same way as fitness exercises. Instead, your muscles will
feel like they have worked hard.
Ÿ You should aim to complete up to 3 sets of 10 repetitions of
each exercise, taking a short rest in between each set. Do not
worry if you find these exercises hard. If you do, start with a
smaller number of repetitions in each set and build up to
achieving sets of 10. As you get better with the exercises, use
heavier weights to make your muscles work harder. You can
use tins of food or bottles of water as weights.
Ÿ Some strengthening exercises for your arms and legs are
described below, which can be done in sitting or standing.
These can be done in any order. Keep a good posture, with
your back straight and your tummy tucked in, and complete
the exercises slowly.
Remember to breathe in as you prepare to do the hardest part
of the exercise and breathe out as you make the effort.

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Support for Rehabilitation Self-Management after COVID-19 Related Illness

Examples of strengthening exercises for your

ARMS
1. Bicep curl
Ÿ With your arms by your side, hold a weight in each hand
with your palms facing forwards
Ÿ Keep the top part of your arm stationary. Gently lift the
lower part of both arms (bending at the elbows), bringing
the weights up
Ÿ You can do this exercise sitting or standing
Progressing this exercise:
Ÿ Increase the weight you use while doing this exercise

2. Wall push off
Ÿ Place your hands flat against a wall at shoulder height, with
fingers facing upwards, and your feet about a foot away
from the wall
Ÿ Keeping your body straight at all times, slowly lower your
body towards the wall by bending your elbows, then gently
push away from the wall again, until your arms are straight
Ÿ Progressing this exercise:
Ÿ Stand further away from the wall

3. Arm raises to the side

Ÿ Hold a weight in each hand, with your arms by your
sides, and your palms facing inwards
Ÿ Raise both arms out to the side, up to your shoulder
level (but not higher), and slowly lower back down
Ÿ You can do this exercise sitting or standing
Ÿ Progressing this exercise:
Ÿ Increase the height that you lift your arms, but no
higher than your shoulder level
Ÿ Increase the weight you use while doing the
exercise

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Support for Rehabilitation Self-Management after COVID-19 Related Illness

Examples of strengthening exercises for your

LEGS
1. Sit to stand
Ÿ Sit with your feet hip-width apart. With your arms by
your side or crossed over your chest, slowly stand up,
hold the position for the count of 3, and slowly sit back
down onto the chair. Keep your feet on the floor
throughout
Ÿ If you cannot stand up from the chair without using your
arms, try a higher chair. If this is still too hard at first, you
may push with your arms
Progressing this exercise:
Ÿ Make the movement as slow as possible
Ÿ Perform the exercise using a lower chair
Ÿ Hold a weight close to your chest whilst doing the
exercise

2. Knee straightening
Ÿ Sit in a chair with your feet together. Straighten one
knee and hold your leg out straight for a moment,
then slowly lower it. Repeat with your other leg.
Progressing this exercise:
Ÿ Increase the time holding your leg out straight to a
count of 3
Ÿ Perform the exercise more slowly

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Support for Rehabilitation Self-Management after COVID-19 Related Illness

3. Squats
Ÿ Stand with your back against a wall or other stable
surface and your feet slightly apart. Move your feet
about a foot away from the wall. Alternatively rest your
hands on the back of a stable chair
Ÿ Keeping your back against the wall, or holding on to the
chair, slowly bend your knees a short distance; your back
will slide down the wall. Keep your hips higher than your
knees
Ÿ Pause for a moment before slowly straightening your
knees again
Progressing this exercise:
Ÿ Increase the distance you bend your knees (remember to
keep your hips higher than your knees)
Ÿ Increase the time you pause to a count of 3 before
straightening your knees

4. Heel raises
Ÿ Rest your hands on a stable surface to support your
balance, but do not lean on them
Ÿ Slowly rise up on to your toes, and slowly lower
back down again
Progressing this exercise:
Ÿ Stand on your toes for a count of 3
Ÿ Stand on one leg at a time

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Support for Rehabilitation Self-Management after COVID-19 Related Illness

Cool down exercises

Cool down exercises allow your body to return to normal before
stopping exercise. Your cool down should last approximately 5
minutes, and your breathing should be back to normal by the
end. Try working through all these suggestions, but if you
cannot manage all the exercises or stretches, do the ones that
you can.

1. Walking at a slower pace or gently marching on the spot, for

approximately 2 minutes

2. Repeat the warm-up exercises to move your joints; these can

be done in sitting or standing

3. Muscle stretches
Ÿ Stretching your muscles can help to reduce any soreness you may feel
over the one to two days following exercise. You can do these stretches in
sitting or in standing. Each stretch should be performed gently, and you
should hold each one for 15-20 seconds.

Side:
Reach your right arm up to the ceiling and then lean
over to the left slightly; you should feel a stretch
along the right side of your body. Return to the
starting position and repeat on the opposite side.

Shoulder:
Put your arm out in front of you. Keeping your arm
straight, bring it across your body at shoulder height,
using your other hand to squeeze your arm to your
chest so you feel a stretch around your shoulder.
Return to the starting position, and repeat on the
opposite side.

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Support for Rehabilitation Self-Management after COVID-19 Related Illness

Back of thigh (Hamstring):

Sit on the edge of a chair with your back straight and
feet flat on the floor. Place your leg out straight in
front of you with your heel resting on the ground.
Place your hands on your other thigh as support.
Sitting as tall as you can, bend slightly forwards at
your hips until you can feel a slight stretch down the
back of the leg that is stretched out. Return to the
starting position, and repeat on the opposite side.

Lower leg (Calf):

Stand with your feet apart and leaning forwards onto
a wall or something sturdy for support. Keep your
body upright and step one leg behind you. With both
feet facing forwards, bend your front knee, keeping
your back leg straight and your heel on the floor. You
should feel a stretch in the back of your lower leg.
Return to the starting position and repeat on the
opposite side.

Front of thigh (Quads):

Stand up and hold onto something stable for
support. Bend one leg up behind you, and if you can
reach it, use the hand on the same side to hold your
ankle or the back of your leg. Take your foot up
towards your bottom until you feel a stretch along
the front of your thigh. Keep your knees close
together and your back straight. Return to the
starting position and repeat on the opposite side.
You can also do this stretch sitting down on a stable
chair: sit near the front of the chair, off to one side (so
that you are only sitting on about half of the chair).
Slide the leg closest to the edge off the chair and
position it so that your knee is pointing down in line
with your hip and your weight is through your toes.
You should feel the stretch along the front of your
thigh. Repeat on the opposite side.

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Support for Rehabilitation Self-Management after COVID-19 Related Illness

Managing cough
after covid
A person who has contracted the disease can get a cough that’s
either dry or productive (wet cough). If you are recovering from
the infection, taking proper care to cure the cough is very important.
TIPS TO MANAGE A DRY COUGH
A dry cough is likely to put greater strain on your throat. According to the
UK’s National Health Service, the following strategies can be used to manage
a dry cough.
Ÿ Stay hydrated by drinking plenty of water (lukewarm, preferably).
Ÿ Take small sips of fluids instead of taking large sips to facilitate
swallowing.
Ÿ Steam inhalation is necessary to cure a dry cough. So, pour hot water in a
bowl, put your head over the bowl and breathe in the steam. Cover your
head and the bowl with a towel if you’re comfortable. You can also use a
steam inhalation machine if you have one.
Ÿ Drink warm water with lemon and honey, or a drink like the Indian
kadha, to soothe the throat.
Ÿ If you feel the need to cough but don’t have a soothing drink or water at
hand, swallow repeatedly.
TIPS TO MANAGE A PRODUCTIVE COUGH
A phlegmatic or productive cough can become difficult to manage since you
have to spit out the phlegm-filled sputum regularly. It’s also important to
note that viral infections, especially COVID-19, are contagious, so proper
disposal of sputum is very important. You should also ensure that the sink
where you dispose of your sputum is regularly disinfected. The NHS
recommends the following strategies to manage a productive cough.
Ÿ Keep yourself hydrated with lukewarm water, broths, soups, herbal teas
and the Indian kadha.
Ÿ Take steam inhalation at least thrice a day to loosen the phlegm
congested in your lungs.
Ÿ Lie on either the left or the right side, instead of lying on your back. This
might help drain the phlegm faster.
Ÿ Movement makes the lungs function, and it can also move the phlegm to
facilitate your spitting it out. So, try to be mobile by walking around your
room.

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Support for Rehabilitation Self-Management after COVID-19 Related Illness

Managing problems
with your voice

Sometime people may have difficulties with their voice after

being ventilated (having a breathing tube). If your voice is raspy
or weak, it is important to:
Ÿ Keep talking when it is comfortable. You will need to keep
using your voice to make progress. If you get tired while
speaking, take breaks.
Ÿ Do not strain your voice. Do not whisper as this can strain
your vocal cords. Try not to raise your voice or shout. If you
need to get someone’s attention, try making a noise with an
object.
Ÿ Take rests. If you run out of breath while talking, be careful
not to work harder. Stop and sit calmly, while focusing on
your breathing. Try the breathing strategies described earlier
in this leaflet. Do these until you feel ready to speak again.
Ÿ Try humming to yourself to practice using your voice, while
being careful not to strain.
Ÿ Use other ways of communicating, such as writing, texting,
or using gestures, if talking is difficult or uncomfortable.
Ÿ Sip water throughout the day to help keep your voice
working.

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Support for Rehabilitation Self-Management after COVID-19 Related Illness

Managing eating, drinking,

and swallowing
If you were ventilated with a breathing tube while you were in hospital, you
may notice you have some difficulty with swallowing food and drink. This is
because the muscles that help with swallowing may have become weak.
Eating well and drinking water/juice are important to your recovery.
Paying attention to swallowing is important to avoid choking and lung
infections. This can happen if food/drink goes the wrong way and gets
into your lungs when you swallow.
If you experience difficulty swallowing, these techniques may help:
Ÿ Sit upright whenever you eat or drink. Never eat or drink while lying
down.
Ÿ Remain upright (seated, standing, walking) for at least 30 minutes after
meals.
Ÿ Try foods of different consistencies (thick and thin) to see if some
foods are easier to swallow than others. It may help to choose soft,
smooth and/or moist foods at first, or to chop up solid foods into very
small pieces.
Ÿ Concentrate when you eat or drink. Try to have your meals in a quiet
place.
Ÿ Take your time when eating. Take small bites of food, take single, small
sips of drink between mouthfuls of food, and chew well before you
swallow.
Ÿ Make sure your mouth is clear before taking another bite or sip. If you
need to, swallow again.
Ÿ Eat smaller meals throughout the day if you get tired eating full meals.
Ÿ If you cough or choke, or your breathing becomes difficult when you
eat and drink, take a break to recover.

If eating and drinking continue to be difficult, contact

yourhealthcare professional.

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Support for Rehabilitation Self-Management after COVID-19 Related Illness

Managing problems with

attention, memory, and
thinking clearly
It is very common for people who have been severely unwell,
especially those who had a breathing tube in hospital, to experience
new difficulties with attention, remembering things, and thinking
clearly. These difficulties may go away within weeks or months, but
for some people, they can last longer-term.

It is important for you and your family to recognise if you are

experiencing these difficulties, as they can have an impact on
your, daily activities, and your return to work or education.

If you experience these difficulties, the following strategies may help:

Ÿ Physical exercise can help your brain recover. While this may be
difficult if you are experiencing weakness, breathlessness, or
fatigue, try gradually introducing gentle exercise into your daily
routine. The fitness and strengthening exercises described earlier
in this leaflet are a good place to start.
Ÿ Brain exercises, such as new hobbies or activities, puzzles, word
and number games, memory exercises, and reading may help.
Start with brain exercises that challenge you but are achievable
and increase the difficulty as you are able. This is important for
keeping you motivated.
Ÿ Prompt yourself with lists, notes, and alerts, such as phone
alarms, that can remind you of things you need to do.
Ÿ Break down activities into individual steps to avoid feeling
overwhelmed.
Some of the strategies listed below for managing activities of daily
living may also help you manage the impact of problems with
attention, memory, and thinking clearly, such as adjusting your
expectations and letting others help you.

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Support for Rehabilitation Self-Management after COVID-19 Related Illness

Managing activities of
daily living
It is important to become active again when you are recovering, but
this can be hard if you feel very tired, breathless, and weak, which is
normal after being severely unwell. Everything we do, including
washing, dressing, and preparing meals, as well as work and play,
takes energy.

After a severe illness, you may not have the same energy you
used to, and some tasks may take more effort than before.

If you feel like this, the following strategies may be helpful:

Ÿ Adjust your expectations for what you can do in a day. Set
realistic goals based on how you are feeling. When you are very
tired, breathless, or weak, even getting out of bed, washing, and
dressing can be achievements.
Ÿ Save your energy by doing tasks sitting down when you can,
such as when showering, dressing, or preparing food. Try not to do
tasks that need you to stand, bend down, reach high, or squat for
a long time.
Ÿ Pace yourself and try to do light tasks between heavier ones. You
may need to leave yourself time during the day to rest.
Ÿ Let others help you with tasks that you may be struggling with.
Things like caring for children, shopping, preparing meals, or
driving may be difficult. Accept offers of support and let people
know what they can help you with. Services that can help with
activities, such as shopping or cooking, may also be useful while
you are still recovering.
Ÿ Ease back into activities. Do not try to take up full activities until
you feel ready. This may mean talking to an employer about a
gradual return to work, taking on a role that is easier for you to
manage, getting support for childcare, and returning to hobbies
slowly.

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Support for Rehabilitation Self-Management after COVID-19 Related Illness

Managing stress, anxiety,

or depression
Being extremely unwell in hospital can be a highly stressful
experience. This can have an understandably difficult impact on your
mood. It is not unusual to experience feelings of stress, anxiety
(worry, fear) or depression (low mood, sadness). Memories or dreams
of being in the hospital may come to you even if you do not want
them to. You may notice difficult thoughts or feelings related to your
survival. Your mood may be further affected by frustrations about not
yet being able to return to your daily activities the way you would like
to.

In turn, these difficult feelings can affect your ability to engage with
daily activities- particularly if you are less motivated because of the
difference between your expectations and what is achievable.

Managing stress and feelings of anxiety and depression are

therefore an important part of your overall recovery.

There are some simple things you can do.

TAKE CARE OF YOUR BASIC NEEDS

Ÿ Get enough quality sleep. Your sleep was likely disrupted during
hospital. Feeling stressed can also affect your sleep. Try to return
to a regular sleeping and waking time, using alarms to remind
you. You or your family/carers can ensure that your environment is
free from things that might disturb you, such as too much light or
noise. Minimizing nicotine (such as from smoking), caffeine, and
alcohol and adding relaxation strategies will help you with falling
and staying asleep.
Ÿ Eating sufficiently and healthily is important for your overall
wellbeing. If you struggle with eating or swallowing, follow the
advice provided in this leaflet or by a healthcare professional.
Family/carers can try to ensure that sufficient food is available to
you.

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Support for Rehabilitation Self-Management after COVID-19 Related Illness

Ÿ Be physically active as this reduces stress and can reduce the

chance of depression. Take small steps in gradually and safely
increasing your physical activity.

SELF-CARE
Ÿ Staying socially connected is important for your mental
wellbeing. Talking with others can help to reduce the stress and
may also help you in finding solutions for challenges in your
recovery journey. If you are living alone, staying in contact with
friends or family on the telephone or online can help you to feel
less alone. Because you may not feel like being socially connected
when your mood is low, let family and friends know that they can
help by reaching out to you during your recovery.
Ÿ Do relaxing activities that do not make you too tired, like
listening to music, reading, or spiritual practices. Slow breathing
also helps to reduce stress and is another example of a relaxation
strategy. These should be done gradually if it is too difficult at first.
Follow the “Controlled Breathing Exercises” described earlier in this
leaflet to learn how to do slow breathing.
Ÿ Gradually increase your involvement in your daily activities or
hobbies to the best of your ability, as this helps to improve your
mood.

If you were previously receiving services to support your mental

health, talk to your provider to ensure that these continue.
Family/carers can also play an important role by supporting
people who are physically recovering after being ill but have
declining mental health. Family/carers may help them access the
support they need, when they need it.

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Support for Rehabilitation Self-Management after COVID-19 Related Illness

Black Fungus or Mucormycosis:

Usually Rare But Invasive
Mucormycosis is a serious but rare fungal infection of the sinuses,
brain, and/or lungs. A sinus and brain infection is called rhinocerebral
infection. A lung infection is called pulmonary mucormycosis. High
risk group include people with uncontrolled diabetes mellitus,
patients with cancer, those who are receiving broad-spectrum
antibiotics for long, and individuals receiving immunosuppressive
agents, including oral or intravenous steroids, etc. It occurs in some
people with a weakened immune system. However now it is very
often found in severe covid patients who were on prolonged oxygen
therapy. The symptoms of mucormycosis depend on where in the
body the fungus is growing. Covid patients after discharged from
hospital especially who were on prolonged oxygen support &
steroids, must be vigilant about the following symptoms & contact
their healthcare provider, if any of these symptoms related to
mucormycosis is observed:

Ÿ Facial pain & swelling

Ÿ One-sided headache behind the eyes

Ÿ Nasal or sinus congestion that progresses to black discharge

Ÿ Black lesions on nasal bridge or upper inside of mouth that quickly

become more severe

Ÿ Fever, cough

Ÿ Acute sinusitis along with eye swelling

Ÿ Chest pain, shortness of breath

Please don't panic take care. Be vigilant.

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FAQs
Ÿ What are the symptoms of COVID - 19?

Ÿ The most common symptoms of COVID-19 are fever, tiredness, and dry
cough. Some patients may have aches and pains, nasal congestion,
runny nose, sore throat or diarrhoea. These symptoms are usually mild
and begin gradually. Some people become infected but don't develop
any symptoms and don't feel unwell. Most people (about 80%) recover
from the disease without needing special treatment. Around 1 out of
every 6 people who gets COVID-19 becomes seriously ill and develops
difficulty breathing. Older people, and those with underlying medical
problems like high blood pressure, heart problems or diabetes, are more
likely to develop serious illness. People with fever, cough and difficulty
breathing should seek medical attention.

Ÿ How is Corona virus transmitted from person to person?

Ÿ People can catch COVID-19 from others who have the virus. The disease
can spread from person to person through small droplets from the nose
or mouth which are spread when a person with COVID-19 coughs or
exhales. These droplets land on objects and surfaces around the person.
Other people then catch COVID-19 by touching these objects or surfaces,
then touching their eyes, nose or mouth. People can also catch COVID-19
if they breathe in droplets from a person with COVID-19 who coughs out
or exhales droplets. This is why it is important to stay more than 1 meter
(3 feet) away from a person who is sick.

Ÿ Is it also transmitted through blood transfusion? Is it safe to donate

or receive blood during Corona infection?

Ÿ Individuals are not at risk of contracting COVID-19 through the blood

donation process or via a blood transfusion, since respiratory viruses are
generally not known to be transmitted by donation or transfusion.

Ÿ Are elderly, children, women, pregnant women at higher risk of

infection?

Ÿ While we are still learning about how COVID-2019 affects people, older
persons and persons with pre-existing medical conditions (such as high
blood pressure, heart disease, lung disease, cancer or diabetes) appear to
develop serious illness more often than others.

45
Ÿ Is there any vaccine or medicine for COVID - 19?

Ÿ YES. Recently Government of India launched COVID Vaccine program. It

was started with elderly people above 60 years of age. Later it was
extended to those above 45 years of age with comorbidities. Recently
Government of India has started vaccination drive for every above 18
years from 1st of May 2021.

Ÿ What one should do to be safe from this disease? What needs to be

done in the family?
Ÿ Maintain appropriate distance (6 feet ) from both the infected/suspected
person;
Ÿ Hand-hygiene for himself and guide the same for family members;
Ÿ Avoid touching your face with your hands, especially your mouth, nose,
or eyes;
Ÿ Avoid crowds.

Ÿ Can drinking/rubbing alcohol on your body kill coronavirus?

Ÿ NO. Spraying alcohol or chlorine all over your body will not kill viruses
that have already entered your body. Spraying such substances can be
harmful to clothes or mucous membranes (i e. eyes, mouth). Be aware
that both alcohol and chlorine can be useful to disinfect surfaces, but
they need to be used under appropriate recommendations.

Ÿ Can the new coronavirus be transmitted through mosquito bites?

Ÿ NO. The new coronavirus is a respiratory virus which spreads primarily

through droplets generated when an infected person coughs or sneezes,
or through droplets of saliva or discharge from the nose. To protect
yourself, clean your hands frequently with an alcohol-based hand rub or
wash them with soap and water. Also, avoid close contact with anyone
who is coughing and sneezing.

Ÿ Can I use hand dryers and ultraviolet disinfection lamps to kill

Covid-19?

Ÿ No. Hand dryers are not effective in killing the 2019-nCoV. To protect
yourself against the new coronavirus, you should frequently clean your
hands with an alcohol-based hand rub or wash them with soap and
water. Once your hands are cleaned, you should dry them thoroughly by

46
 using paper towels or a warm air dryer. UV lamps should not be used to
sterilize hands or other areas of skin as UV radiation can cause skin
irritation.

Ÿ How effective are thermal scanners for detecting infected people?

Ÿ Thermal scanners don't detect infected people. They just detect body
temperature which is one of the prominent symptoms of COVID 19.
People with raised temperature should be assessed for other symptoms
which are seen with COVID-19 and also travel contact history and if
he/she fulfil the criteria than further testing to confirm the disease.

Ÿ If I have cough, cold or fever, should I immediately go for Corona

testing? If not, then what to do in such cases?

Ÿ Not every case is COVID-19. However, if you have come in contact with
any COVID 19 patient within last 14 day, you should consult the doctor.

Ÿ Where to approach, if I want to get tested?

Ÿ As per Ministry of Health and Family Welfare, if you have any of the above
symptoms and have travelled to any of the COVID-19 affected countries
or you are a contact of a laboratory confirmed positive case immediately
call the State Helpline Number or Ministry of Health & Family Welfare,
Government of India's 24x7 helpline Toll free: 1075 ,011-2397 8046 The
helpline service will note down your contact details and contact you with
the testing protocols of COVID-19

Ÿ What is meant by Isolation and Quarantine and how the two are
different?

Ÿ Quarantine refers to separation of individuals who are not yet ill but have
been exposed to COVID-19 and therefore have a potential to become ill.
There will be voluntary home quarantine of contacts of suspect
/confirmed cases.

Ÿ Isolation refers to separation of individuals who are ill and suspected or

confirmed of COVID-19. All suspect cases detected in the
containment/buffer zones (till a diagnosis is made), will be hospitalized
and kept in isolation in a designated facility till such time they are tested
negative. Persons testing positive for COVID-19 will remain to be
hospitalized till such time 2 of their samples are tested negative as per
MoHFW's discharge policy.
Ref: [Link]

47
Ÿ What are Dos and Don'ts for Quarantine?

The home quarantined person should: Stay in a well-ventilated single-room

preferably with an attached/separate toilet. If another family member needs
to stay in the same room, it's advisable to maintain a distance of at least 1
meter between the two.
Ÿ Needs to stay away from elderly people, pregnant women, children and
persons with co-morbidities within the household.
Ÿ Restrict his/her movement within the house.
Ÿ Under no circumstances attend any social/religious gathering e.g.
wedding, condolences, etc.
Ÿ For further information refer to
[Link]

Ÿ Dos:
Ÿ Wash hands frequently with soap and water or use a sanitizer gels.
Ÿ Stay in a well-ventilated single room.
Ÿ Stay away from elderly, pregnant women, children's and persons with co-
morbidities.
Ÿ Eat healthy to boost your immune system.
Ÿ Limit alcohol and sugary drinks.

Ÿ Don't:

Ÿ Don't smoke. It can exacerbate COVID-19 symptoms and increase your

risk of getting sick.

Ÿ Don't attend any social or religious gathering.

Ÿ What is meant by Home Quarantine?

Ÿ Home Quarantine is used to separate and restrict the movement of a

person who may have been exposed to confirmed Covid 19 patient in
last 14 days .The person is required to stay at home with minimum
social/public interactions. In case of symptoms develop, they need to
stay home till the test comes negative or access medical care if the
symptoms become severe.

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Ÿ Is Corona virus transmitted from humans to animals and vice versa?

Ÿ Coronaviruses are a large family of viruses that are common in animals.

Occasionally, people get infected with these viruses which may then
spread to other people. For example, SARS-CoV was associated with civet
cats and MERS-CoV is transmitted by dromedary camels. Possible animal
sources of COVID-19 have not yet been confirmed.

There is no research to support human to animals spread at this time.

Ÿ How does COVID-19 impact on other illnesses and vice versa?

Ÿ People with pre-existing disease like DM< HTN, CVD have more changes
of COVID infection. COVID 19 infection can worsen pre-existing diseases
like decompensation of chronic liver disease, worsening of pre-existing
renal disease and worsening cardiac functions with heart disease.

Ÿ Is it advisable to go for a walk or exercise during quarantine?

Ÿ Any exercise is advisable only inside the house. No-one should be

walking on roads/ parks.

Ÿ Should I travel from one place to other? If yes, with what

precautions?

Ÿ Nowadays, the disease may spread, so we should not travel unless there
is an emergency.

Ÿ For how long a Corona virus active in human body?

Ÿ It is active from one week to two weeks.

Ÿ How often should I wash my hands?

Ÿ There is no definite frequency defined regarding hand washing. It is

better to wash as often as possible.

Ÿ But remember to wash your hands -

Ÿ After returning from public outing, bath room
Ÿ Before and after preparing food
Ÿ After touching the suspected or infected person

49
Ÿ Is it necessary to use sanitizer? What are other alternatives? How
often should I use sanitizer? Any specifications for sanitizers to be
used?

Ÿ Yes, it is necessary to use sanitizer, if you cannot find means to wash your
hand. Hand washing with soaps which is equally good as sanitizers. Soap
is cheaper but water may not be available in all places. Sanitizers are
useful for those who frequently are in touch with surfaces like paper,
packaging, grocery stores, etc. and need to disinfect.

Ÿ What is social distancing? How to practice it? How long one has to
follow social distancing?

Ÿ Social distancing includes ways to stop or slow the spread of infectious

diseases. It means less contact between you and other people.
Ÿ If you are sick, stay away from others – that is the most important thing
you can do. If unwell, avoid contact with others (stay more than 1.5
metres from people). These simple, common sense actions help reduce
risk to you and to others. They will help to slow the spread of disease in
the community – and you can use them every day – in your home.
Ÿ One should follow social distancing till the time the spread of disease is
completely over.

Ÿ Can we eat together in the family? Can it also spread Corona virus?

Ÿ Yes, one can eat together in the family but if any family is suspected/
infected with virus then need to stop eating together as this can spread
infection.

Ÿ What precautions need to be taken while buying anything from

market and bringing it home?

Ÿ If possible wear disposable gloves while buying anything from market

Ÿ Should I eat at / order food, from restaurants these days?

Ÿ Yes, we can eat at and order food from restaurants but need to take care
of personal hand hygiene.

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Ÿ Is there any relation of this disease with atmospheric temperature?
Will this disease disappear with the rise in temperature?

Ÿ COVID-19 virus can be transmitted in ALL AREAS, including areas with

hot and humid weather. Regardless of climate, adopt protective
measures if you live in, or travel to an area reporting COVID-19.

Ÿ How much time it takes to get cured from COVID – 19?

Ÿ At least two weeks' time.

Ÿ What may happen, if I get infected and I don't get to know and don't
visit a doctor?

Ÿ Then you can infect other individuals and spread the disease in
community. This is why Social Distancing and Lockdown are in effect.

51
 Get the second dose even if you have
side effects from the first shot, unless a
Side Effects should go away in a few days
vaccination provider or your doctor
advises you otherwise

As we all know, the COVID-19 pandemic has led to a dramatic

loss of human life worldwide and presents an unprecedented
challenge to public health and the world of work. The economic
and social disruption caused by the pandemic is devastating.
Currently, there is no specific treatment for this disease.
Immunisation is one of the best ways we can protect our self,
our family and the society we live from this infectious disease.
Below are some of the frequently asked questions with answers
as advised by the Ministry of Health and Family Welfare,
Government of India.

52
FAQs about Covid Vaccine
Ÿ What about the possible side-effects from COVID-19 vaccine?
Ÿ As is true for other vaccines, the common side effects in some
individuals could be mild fever, pain, etc. at the site of injection.
States have been asked to start making arrangements to deal with
any COVID-19 vaccine-related side-effects as one of the measures
towards safe vaccine delivery among masses.
Ÿ What are expected immediate and delayed side effects of this
vaccine?
Ÿ Covishield®: Some mild symptoms may occur like injection site
tenderness, injection site pain, headache, fatigue, myalgia, malaise,
pyrexia, chills and arthralgia, nausea. Very rare events of
demyelinating disorders have been reported following vaccination
with this vaccine but without the causal relationship establishment.
Ÿ Covaxin®: Some mild symptoms AEFIs may occur like injection site
pain, headache, fatigue, fever, body ache, abdominal pain, nausea
and vomiting, dizziness-giddiness, tremor, sweating, cold, cough
and injection site swelling. No other vaccine-related serious adverse
effects have been reported.
Ÿ Which drug should be taken to minimize the adverse effects of
this vaccine?
Ÿ In case of minor adverse effects such as injection site pain,
tenderness, malaise, pyrexia, etc., paracetamol may be used to
alleviate the symptoms.
Ÿ Claims on social media suggested that COVID-19 vaccine could
affect female fertility. Is it true?
Ÿ Rumours or social media posts suggesting that COVID-19 vaccines
could cause infertility are not true and totally baseless. Such
rumours were floated in the past against other vaccines also e.g.
polio and measles. None of the available vaccines affects fertility. All
vaccines and their constituents are tested first on animals and later
in humans to assess if they have any such side effects. Vaccines are
authorized for use only after their safety and efficacy is assured.

53
 Stay Safe… Stay Healthy

References:
Ÿ Ministry of Health & Family Welfare Guidelines
Ÿ [Link]
naturopathy-perspective/
Ÿ Your Guide to Masks From US- Centre for disease Control
(CDC)
Ÿ WHO guidebook for Support for Rehabilitation Self-
Management after COVID-19- Related Illness
Ÿ FAQ- From National Disaster Management Authority
(NDMA)
Ÿ Medanta. Your Complete Guide in Recovery from COVID-19.
Available from:
[Link]
04/[Link]

Issued in public interest by:

Dr. Willmar Schwabe India Pvt. Ltd.

A-36, Sector 60, Noida 201 304, U.P. (India)
Phone: 0120-4016500
E-mail: care@[Link]
Website: [Link]