My family and I (3 of us in our 40s) have been afflicted by COVID-19. The first one of us was diagnosed positive on July 4th and the rest of us living in the house tested positive within 8-10 days. We are all on the mend at home presently. We have also been very lucky to have doctors in our family who monitored us closely and advised us constantly. Thanks to them, here are some learnings from our journey so far.

Be Prepared

1. The number of cases in India are increasing and test positive rates are extremely high. I am currently in Hyderabad, which has extremely low incidence of testing and high positive rate. Hence, there is a high possibility of one contracting COVID-19, with all precautions. This is probably the case in many places in India presently, some more than others. Please find the data in this link to understand your risk. For India, we found this site useful.
2. Following a few protocols would help prepare yourself, in the event of a COVID -19 infection:
   1. Breathing exercises – We found our lung capacity decreases drastically and some of
      the following exercises help in preparing yourself and minimize risk of complications
      1. Pranayama – once a day for 20 min
      2. Blow a balloon 5-10 times a day
      3. Blow bubbles through a straw into a glass of water – 10 to 15 times a day
   2. Steaming and gargling – these help in keeping your upper respiratory tract healthy
      1. Steaming – 1 time a day, ideally with any of the following – turmeric, tulsi,
         eucalyptus oil, etc.
      2. Gargling – 1 time a day, betadine mouthwash or warm salt water
   3. Vitamins – people above 20 years could take
      1. C- Vitamin – 1000 mg per day
      2. Zinc – 50 mg max per day
      3. Vitamin D3 – 2000 units per day
   4. Home remedies – these help in improving immunity levels and in minimizing throat
      itching and congestion. I found them effective in several ways
      1. Boil water with ginger and turmeric, add lemon and honey. This is great with reducing early symptoms of throat pain and irritation.
      2. Roasted and powdered cloves and turmeric with honey. This is an allrounder
         and quite effective in providing relief from cough and throat pain.
   5. Things to buy
      1. Thermometer (ideally one per person) – We found the contact thermometers better
      2. Pulse oxymeters – (ideally one per person)
      3. N95 Masks – 5 per person (one per day, can be reused after 4 days)
      4. Face shield – two per person
      5. Steamer – optional as boiling water on a stove is good enough. A
         steamer makes the process easier.
   6. Think of home quarantine facilities, protocols with household help, food, cleaning,
      washing, etc.
   7. Research on the doctors and online consultation options. You would need to reach
      out to a family doctor, or an Infectious diseases specialist who is associated with a good hospital.
   8. Research on reliable testing facilities and labs that provide home testing

If You Develop Any Symptoms

1. Please do not panic and stay positive. It could be just a normal cold or flu.
2. Prepare your surroundings and support system
   1. The severity of infection depends on viral load. So, the more you isolate yourself, the
      safer for your family.
   2. Please use a room to isolate and prepare the room to be quarantined
      1. Table just outside the room to deliver the food
      2. Dish washing facilities in the room
      3. Bucket and washing soap to soak your used clothes. Soak clothes for 30 min
         before leaving them outside your room to be washed.
      4. Entertainment for yourself with a TV, computer, phone charging points, etc.
   3. If possible, keep your bathroom separate from the rest of your family. They are
      known to be one of the primary locations for spread of virus.
   4. If you are alone, find a buddy family to supply you food/ medicines/ conversation
   5. Seek help and use Dunzo and Swiggy Genie
3. Isolate yourself immediately in your room
   1. Wear an N95 mask and face shield while interacting with your family
   2. Anyone interacting with you should also wear an N95 mask and face shield
4. If symptoms persist for more than 2 days or if they are severe, do not ignore
   1. Reach out to your doctor immediately. Follow advise closely.
   2. Get yourself tested for COVID 19 immediately. Please find below the chart on what
      kind of test is useful at what stage. In the initial days, RT PCR is the most useful.
   3. Continue to do all the above and add the following until you receive the test results
      1. Increase the frequency of breathing exercises to 3 to 4 times a day.
      2. Increase frequency of steaming and gargling to 3 times a day. Gargle with betadine mouthwash.

If Tested Positive

1. Strictly isolate yourself.
   • There are different theories on viral load. In any case, strictly isolate yourself yourself even if all of you are positive.
2. Persevere Positively and Proactively: COVID-19 has different symptoms and takes different directions. The CDC guidelines are clear on how the disease progresses.
   1. It is important that you reach out to a doctor as soon as possible and follow their instructions closely.
   2. Depending on your condition, the doctors could ask you to get blood tests done including D-Dimers, enzyme levels, CRP (C Reactive Protein), etc., and if required chest X Rays/CT Scans.
   3. Do trust your doctor. They are doing their best.
   4. As per CDC guidelines, this is critical as disease impacts in two manners (1) Through lungs and (2) Through blood anomalies as measured by the blood tests. These need to be monitored every 5 days.
3. Continuously Measure and Monitor
   1. You need to keep your temperature down.
   2. Measure (use the Home Observation Chart)
      1. For SpO2 levels, use your pulse oximeter. Please walk for 6 minutes exactly before you take the reading on the middle finger of your dominant hand. Please note, the light inside the monitor has to be over your nail. We have been told to reach out to our doctor if the SpO2 level falls below 94%. Different doctors have follow different guidelines. Again, follow your doctor’s instructions carefully.
      2. For respiration rate, take a deep breath and blow bubbles into a glass of water through a straw. Time your breath out.
4. Concentrate on your lungs – We found lungs deteriorate fast and preparing them with lung exercises helps
   1. Pranayama – 3 times a day for 20 min each (There are many types, choose one that suits you. Please see below for one of the options)
   2. Blow balloons – 5 to 6 balloons, 3 times day
   3. Blow bubbles through a straw into a glass of water – 10 to 15 times, 3 times a day
5. Steaming and gargling – these help in minimizing the risk of the infection reaching your lower respiratory tract from the upper respiratory tract
   1. Steaming – 3 times a day, with any of the following, turmeric, tulsi, eucalypus oil, etc.
   2. Gargling – 3 times a day, with betadine mouthwash and warm salt water
6. Sleep positions – these are extremely important and will help minimize the risk and severity of chest congestion.
   1. Some positions have proven to improve SpO2 levels and alleviate chest congestion even in hospitalized patients.
7. Food and Nutrition – this is as important as everything else
   1. Increase intake of fluids to at least 3 to 4 L a day in the form of coconut water, lemonade, juices, warm water, buttermilk, etc.
   2. Have high protein food – eggs, lentils, meat, etc.
   3. Take vitamins as mentioned above
   4. If you are able to tolerate, continue the home remedies mentioned above
8. Be anxiety and stress free, keep your spirits up
   1. Do not Panic
   2. You could do things that you could not find time for earlier such as reading books, writing, catching up on Netflix, painting, drawing, etc.
   3. Get in touch with family and friends for any help you might need and for conversations
   4. While there are rumours that remidisvir and other medication is not available, most medicines are available at the hospitals near you
9. Take lots of rest
   1. Even after you start feeling better, rest is very important.
   2. It is possible that all your symptoms will subside after the first 4 to 5 days.
   3. However, this infection could take up to 21 days to subside. Be extremely vigilant.
   4. Care should be taken for up to 21 days or as long as your doctor advices you.

A Few Resources and Links

General Links

1. Pranayama – 3 rounds of the following (Video 1 and Video 2)
   1. Kapaalabaati – 30 times
   2. Bastrika – 10
   3. Nadisuddi Pranayama or Sulabha Pranayama – 5 times
2. Sleeping positions
3. Various tests and their efficacies

India Specific

1. Pulse oxymeters
2. N95 Masks – (one per day, can be reused after 4 days)
3. Face shield

Hyderabad Specific

• In Hyderabad, some of the places to get COVID and related tests are Lucid diagnostic centers and Mapmygenome (Madhapur). Dr.C has home testing facility.
• For consultations with an infectious diseases specialist in Hyderabad – Mfine and Apollo 24/7 are good apps.
• Government facilities

About the Authors

Swati and Shalini Puchalapalli are COVID survivors.