COVID-19 cases may be slowly declining in Chennai but there should be no room for complacency among the people, doctors say.

Government doctors on COVID-19 duty continue to see sick patients with severe hypoxia and respiratory distress, raising the need to seek medical help at the earliest. According to them, awareness of timely diagnosis is better now, but they see instances of people ignoring early symptoms and delay seeking medical help.

A senior doctor at the Rajiv Gandhi Government General Hospital said if a person has fever, cold or cough, the first thing to be checked and ruled out should be COVID-19. “Seeking medical advice at the earliest is crucial. People should not delay due to stigma or fear of being discriminated against. Many still fear swab tests but early identification is important for prompt initiation of treatment and easy recovery,” he said.

Respiratory distress

The hospital sees at least 40% to 60% of patients with hypoxia and respiratory distress. “This is because people come three to four days after the symptoms manifest. One of the many reasons is fear of discrimination and isolation,” he said.

At another government medical college hospital, a physician said they were receiving patients with severe hypoxia. “The reasons are old age, underlying conditions such as diabetes and late presentation mostly after seven days of fever. Breaking the chain is important and so, prevention is the key. People should not avoid testing, thinking it to be an ordinary viral fever. Report to a doctor or hospital in case of fever. Earlier the diagnosis, better the chances of survival,” he said.

Monitoring of oxygen levels at home with finger pulse oximeters was the best way to avoid late presentation, he added.

Another assistant professor said from their experience, 95% of the patients recovered if they sought medical help early. “Late presentation is resulting in complications and mortality,” he noted.

A number of government doctors said there were many patients whose swab tests returned negative but CT chest scans showed signs of the infection. At least 20% to 30% of cases had such presentations in a government hospital. Doctors said the sensitivity and specificity of tests mattered as well as the proper collection of samples.

“Timing of the CT scan is critical. If taken early, it is usually normal. It should be done five to eight days after the onset of symptoms. Then we can pick up on the findings better,” a doctor added.