Yes, the fourth wave of Covid is making people sick for just three or four days. But before you dismiss it as being a mild flu, answer these questions. Does a mild flu leave you breathless for weeks while climbing stairs? Does it mess with your heart and lung function? Does it lead to sudden death?
Adrija Rahman Mukherjee, consultant physician and specialist in family medicine, has seen a sudden surge in Covid cases over the past three or four weeks. “Of course, since the symptoms are similar to flu, not everyone is getting tested despite doctors’ advice but 90 per cent of those testing are returning positive,” says the doctor who sits at Apollo Clinic City Centre. “For instance, today 70 per cent of the cases I saw were Covid-related,” she said recently.
Physician Rajesh Chel, who sits at Parkview Super Speciality Hospital and also visits homes of patients, is getting 10 to 12 Covid patients a day.
Soumyadip Chakraborty, who has been treating Covid cases both in hospital and privately, has witnessed a surge since mid-June. “We had five to 10 patients in June and by early July the figure rose to around 20,” says the general physician who practises critical care medicine at AMRI Salt Lake.
Even Sutapa Pal, consultant physician at different corporate houses including one in Sector V, says the offices she is working at have once again returned to working with skeletal staff on site as lots of employees are testing positive. “I’m sending anyone coming with fever or body ache for Covid tests and nearly half of them are testing positive,” says the resident of DA Block in New Town.
Off with the masks
Pritha Chaudhary had been extremely careful with her mask and sanitiser for two years, “but of late the threat of Covid seemed to be less and so I attended two back-to-back events—- a wedding and a pool party. The wedding had hundreds of guests and not a single mask among them. The pool party couldn’t be attended with masks, of course, as they would get wet,” says the CK Block resident who got sick the very next morning. She and her mother both tested positive.
Pal, the consultant at corporate houses, says awareness is adequate but that people are deliberately ignoring protocol. “After two years of pandemic, who doesn’t know they must wear masks and maintain distance? Why do I have to separately mention that no one may enter my chamber without mask,” she asks.
The fear factor, she says, has dissolved. “The other day at one of the offices, a lady whose son had fever was eating lunch with colleagues at the same desk. Soon the entire table tested positive,” says Pal.
Rahman Mukherjee, who has also been helping Covid patients over video call, is shocked to see them flanked by aged mothers or young children, all without masks. “When I ask them why they are being so callous, they say it’s all right as they are all from the same family,” she shakes her head at the negligence.
Kids bring it home
Doctors say that this wave has been attacking children more than before. “Even kids as young as two years of age are getting Covid. We must remember that while adults have got three or at least two jabs, this age group hasn’t got any. And they are then spreading it to grandparents,” says Rahman Mukherjee.
Chel is getting a high proportion of teenagers and Arpit Kapoor, a physician attached to Apollo Hospitals, is getting very young and very old patients. “The youth seems to be passing the germs on and since people aren’t taking isolation seriously this time, entire families are getting sick,” he says.
Alina Mazumdar of CB Block says her school-going daughter got sick after attending just two or three days of school this term. “Many others in her class got sick and from her my son and I got it too. I recovered a few weeks ago but still have body ache back-downwards and pant while climbing the stairs. I had got Covid in July 2021 too and nearly needed hopsitalisation. This time the severity was less but I am still suffering,” says Mazumdar. There have been Covid cases in four of the five occupied flats in her building.
Illustration: Roudra Mitra
Booster negligence
Pritha says she is the only one in her friend circle who has got the third dose of the Covid vaccine. “The others are living in denial of the disease,” she says sadly.
A New Town resident, who is still suffering from post-Covid chest congestion, says she had got over-confident. “I had eluded Covid for so long! Even when my husband — a doctor in Delhi — got it, I was spared. But this time that I’ve come for a holiday, my mother, our domestic help, my mother-in-law, her domestic help and I are all down. The point to reflect upon is that I hadn’t taken my booster dose. I was eligible but was dilly-dallying,” says the resident of Sree apartments.
Kapoor agrees that over the last month he has been getting many patients who were eligible for the booster but had not taken it yet.
“They’ve seen that the booster is not ruling out infection. They ask why they got the omicron strain despite two doses and have no trust in the vaccine anymore,” rues Pal.
Rajarshi Roy, a critical care specialist with AMRI Hospitals, always asks for vaccination history when treating patients. “People who have taken three vaccines are seldom getting it severe unless they have a primary lung condition,” says the AD Block resident.
Rahman Mukherjee is tired of explaining to patients that the vaccine is not meant to prevent them from getting Covid. “It creates antibodies, which are like soldiers to fight off Covid if you do acquire the infection. But your job is to prevent infection in the first place by wearing masks,” says the doctor who has been getting all sorts of patients —- those having taking one, two, three shots as well anti-vaxxers who, despite getting sick, believe the pandemic is a “media-made myth”.
Chel grants that the timing of the current wave has been such that many are falling ill just when they become eligible for their third jab. “But they have to take the jab, sooner or later, it’s not an option. Just like the pneumonia or flu vaccines must be repeated annually,” says the HB Block resident.
“Despite the best of advice, many people refuse, claiming ‘amar shoir, ami bujhe nebo’ and no doctor or government can get them vaccinated by citing health reasons. But I know of people who have finally accepted the shot so they could take flights or get their wards admitted to schools as you need to produce your vaccination certificates at schools these days,” Chel says.
Anwesha Sengupta, who along with her father, have just recovered from Covid, agrees. “I had taken my booster shot but by and large many people are reluctant. My domestic help does not find Covid to be a big deal since she saw me recover in three or four days, just like in the case of flu. Maybe now that the government has made shots free for those under 60, more people will come forward and protect themselves,” says the DL Block resident.
Milder presentation
Doctors concur that the current wave isn’t as serious as the previous ones. “During the first wave, we did not understand the disease; in the second, we did not have the infrastructure and could not give beds to all patients. But since then, we have tackled the pandemic well. This time, patients are seldom requiring respiratory support unless they are having pre-existing conditions like chronic obstructive pulmonary disease (COPD) and interstitial lung disease,” said Roy.
The single mortality his hospital has seen in this Covid wave, he points out, was due to hepatic failure.
Kapoor says hospitalisation is not being needed for Covid patients per se. “Rather, people coming for other issues are being checked before admission and testing positive,” says the Karunamoyee resident.
Chakraborty says there is seldom any fall in oxygen level either. “In this wave, we have had just one patient whose oxygen level had dipped. I had to go on the maximum house calls in the first and second wave. The third wave I could manage with tele-counselling and now I am only having to do house calls in some post-Covid cases,” says the AC Block doctor.
“For now, moderate to high grade fever remains the most noticeable symptom, along with sore throat. The fever remains for two-three days, maximum four, though in some cases it has remained for seven days also. The main problem this time is the tremendous weakness. This kind of weakness was not there in the first and second waves. Those had caused deaths. This wave is not deadly but is leaving people so weak that they are unable to walk in their rooms for a week. Muscle pain in the legs and a feeling of drowsiness persist after the infection is gone,” Chakraborty notes.
New & lingering symptoms
Doctors are also witnessing new symptoms caused by the ever-mutating virus. “Patients are coming after four or five days of stomach-related problems — vomiting, diarrhoea etc. When I see no other cause for this, I ask them to get tested for Covid and 80 per cent are returning positive,” says Rahman Mukherjee.
It is also not uncommon to be getting patients suffering from three or four weeks of general weakness so bad that they cannot get out of bed or attend office. “I ask them if they got fever three weeks ago and they say yes but since it had subsided with paracetamol, they did not bother to get tested for Covid,” she adds. “Such patients casually add that it could well have been Covid but without evidence, do I treat him as a general patient now or a post-Covid one? Covid itself may have disappeared quickly but it is leaving multiple complications,” she adds.
Such patients then go to specialists — maybe neurologists — to diagnosis their weakness but all their expensive and sophisticated tests pick up nothing. “The answer may have been a simple Covid test when the patient got fever a month ago,” Rahman Mukherjee says.
Sudden death
Chel is not worried about the fever or body ache. “For that, there’s paracetamol. It’s what the virus is doing to patients in the long run that needs attention. Post-Covid patients are suddenly getting strokes or cardiac deaths. We are checking the history of unlikely deaths and finding that the patients had got Covid before,” he says.
Chel has seen such patients suddenly develop high uric acid, triglyceride and a drop in lung power,” says the doctor who is advising patients to get thorough check-ups of their lung and heart activity post-Covid.
Chakraborty too has been recommending echocardiography in all Covid patients to check for heart muscle issues caused by the virus. “There have been sudden deaths in patients cured of Covid in the last year and half, who never had any cardiac issues. People aged 25-30 years have suffered heart attacks even a year after Covid. I have had patients complaining of breathlessness after exertions like climbing stairs for months.”
Additional reporting by Sudeshna Banerjee
What has been your fourth wave experience? Tell saltlake@abp.in
Marks of the malaise
Symptoms
• Fever, typically around 103° or 104°C over three or four days
• Body ache, especially back pain
• Cough, sore or itchy throat, stuffy nose
• Vomiting, diarrhoea, abdominal cramps
Many more children are getting affected this time, even those as young as two years of age
Breathing problems are not common this time so oxygen saturation on the pulse oxymeter is not showing alarming results
Post-Covid lingering issues
• Chest congestion
• Body ache
•Weakness
•Breathlessness in performing activities like climbing stairs
• Lung and heart issues