Post covid 19 care and vaccines

1. POST COVID-19 CARE AND
VACCINES DEVELOPMENT
BY – PANKAJ

2. CONTENT
1. Post COVID care.
a) Need for post COVID care.
b) Thing to be done after COVID recovery .
c) Black fungus and COVID-19 relation.
2. Vaccines.
a) What we know about vaccines?
b) Major vaccines in India.
c) Major questions related to vaccines.

3. WHAT IS COVID-19
 COVID-19 is a disease caused by a new strain of corona virus.
 'CO' stands for corona, 'VI' for virus, and 'D' for disease.
 Formerly, this disease was referred to as '2019 novel corona virus' or
'2019-nCoV.

4. COVID-19 AFFECTS DIFFERENT PEOPLE IN DIFFERENT WAYS. MOST
INFECTED PEOPLE WILL DEVELOP MILD TO MODERATE ILLNESS AND
RECOVER WITHOUT HOSPITALIZATION
 Most common symptoms:
 fever
 dry cough
 tiredness

5.  Aches and pains
 Sore throat
 Diarrhoea
 Conjunctivitis
 Headache
 Loss of taste or smell
 A rash on skin, or discolouration of fingers or toes
Less common symptoms

6. THE OF POST COVID CONDITION
Long COVID is a range of symptoms that can last weeks or
months after first being infected with the virus that causes
COVID 19 or can appear weeks after infections. Long
COVID can happen to anyone who has had COVID 19 ,
even if the illness was mild , or they no symptoms . People
with long COVID report experiencing different
combinations of the some symptoms .

7. SYMPTOMS OF LONG COVID
 Tiredness or fatigue
 Difficulty thinking or concentrating (brain fog)
 Headache
 Loss of smell or taste
 Dizziness on standing
 Fast beating or pounding heart (heart palpitations)
 Chest pain
 Difficulty breathing or shortness of breath
 Cough
 Joint or muscles pain
 Depressions or anxiety
 Fever
 Symptoms that get worse after physical or mental activities

8. MULTIORGAN EFFECTS OF COVID 19
 Multiorgan effects can affects can most , if not all, body
systems including heart, lungs , kidney , skin and brain
functions. Multiorgan effects can also include
conditions that occur after COVID 19 , like multisystem
inflammatory syndrome (MIS), and autoimmune
conditions . MIS is a condition where different body
parts can become swollen . Autoimmune conditions
happen when your immune system attacks healthy cells
in your body by mistake , causing painful swelling in
the affected parts of the body.
 It is unknown how long multiorgan system effects
might last and whether the effects could lead to
chronic health conditions.

10. POST COVID 19 CARE
 Recovering from COVID usually takes around 2 weeks (for
mild cases) and about a month for people with a serious
infection. But COVID has an excellent recovery rate in India
right now which is above 90%. That is why most people
who contract this viral infection recover soon and slowly
get back to their old lifestyle.
 If you or someone you know got infected and recovered,
congratulations! But remember, even though the virus is no
longer in your body, you still need to be cautious about
what you do in the next few days. Here is a complete guide
to post-COVID care.

12. THE NEED FOR POST-COVID CARE
 The corona virus is a nasty microbe that can do a lot of damage to your
body. If your infection was moderate to severe, it is possible that the
virus did some amount of damage to your respiratory system.
 Even people with mild infection have to be alert in the post-infection
stage because symptoms of other health conditions triggered by the
corona virus may surface. The body becomes weak after having battled
the dangerous virus for so many days. You may feel drained and
lethargic, which is quite natural.
 That is why, even if your body has killed off all the viruses, you still need
to shower yourself with a lot of love and care.
 This will ensure that you are completely healed and if there is any
requirement for additional healthcare checks, you will be able to take the
right action at the right time.

13. THINGS TO DO AFTER
COVID RECOVERY

14. TAKE REST
 Most doctors suggest that you stay isolated for
another 7 days, especially now that some studies have
found that even if the symptoms disappear, the virus
may still linger in your body. If possible give yourself a
week of complete rest after recovery.
 A well-rested body can focus on healing. Get enough
sleep because when you sleep, your body speeds up
the recovery procedure.
 Do not resume your old lifestyle right away. Too much
work, stress and anxiety will make you ill.

15. HAVE A NUTRITIOUS DIET
 Food eases the path to recovery. The right kind of
food will help you gain your strength back in days.
 Make sure your diet includes plenty of proteins such
as lentil soup, legumes, seeds, nuts, boiled eggs, and
chicken stew. Proteins repair the body.
 Eat small portions for easy digestion. Don’t forget to
eat at least 1 fruit a day.
 Drink plenty of water to stay hydrated.

17. EXERCISE A LITTLE EVERY DAY
 Exercising may sound unappealing, but it is essential
for a speedy recovery.
 Working out improves blood and oxygen circulation.
It helps to detoxify your body.
 It can also help your brain produce more happiness
hormones which will lift your spirits – something that
is greatly needed after you’ve contracted COVID.
 Only exercise as much as you can. Do your favorite
kinds of exercise and don’t push yourself too much. 10
minutes a day will sufficient.

19. PLAY A FEW MEMORY GAMES
 COVID is known to damage brain and neural cells.
 To prevent future memory problems, try playing some
memory games like Sudoku, mathdoku, crossword,
jigsaw, etc.
 this will also help you while away the time without
getting bored and irritated.

20. CHECK YOUR BLOOD OXYGEN LEVEL
 Continue to monitor your blood oxygen saturation
level with your oximeter.
 Even if you have recovered from COVID, there could
be lung damage that you don’t know of.
 If so, your oxygen level will fluctuate and dip below 90.
You will need to visit the doctor.

22. WATCH OUT FOR OTHER SYMPTOMS
 COVID can have long-term consequences for your
health.
 So you have to be alert.
 COVID can cause both lung and heart damage.
 If you begin to experience shortness of breath,
tightness in the chest, warm flushes, consult a doctor
right away.

24. WHAT HAS THE HEALTH MINISTRY RECOMMENDED AS
POST COVID MANAGEMENT PROTOCOL ?
 In its post-Covid management protocol, the Health Ministry says the first
follow-up visit (physical/telephonic) for a recovered patient should be within
seven days after discharge.
 "Subsequent treatment/follow-up visits may be with the nearest qualified
allopathic/AYUSH practitioner/medical facility of other systems of medicine.
 Poly-therapy (use of multiple medications) is to be avoided due to the
potential for unknown drug-drug interaction, which may lead to Serious
Adverse Events (SAE) or Adverse Effects (AE)," the protocol says.
 If there is a persistent dry cough or sore throat, the Health Ministry
recommends saline gargles (with turmeric and salt) and steam inhalation.
Cough medication should be taken on the advice of a doctor.

27. BLACK FUNGUS

30. Black fungus
attack

31.  States across India have begun declaring a
“black fungus” epidemic as cases of the fatal
rare infection shoot up in patients
recovering from Covid-19. ... The disease is
caused by fungal spores found in soil and
organic matter, usually inhaled by humans
from the air.

32.  Mucormycosis, colloquially known as
black fungus, is a serious fungal
infection that was seen in far smaller
numbers in India before Covid-19, too.
 But it is now affecting post-Covid
patients in large numbers.

33. HOW MUCORMYCETES ENTER OUR BODY
?
 Mucormycosis is caused by a group of molds
called mucormycetes. It is naturally found in air,
water and even food. It enters the body
through fungal spores from the air or can also
occur on skin after a cut, burn, or skin injury

34.  Mucormycosis, or black fungus, is a rare but serious
infection that requires medication or removal surgery.
 SARS-CoV-2 infection and COVID-19 treatment make
the immune system vulnerable to other infections,
including black fungus.
 With the rise in black fungus cases, India faces a
shortage of treatments in the face of two epidemics.

35. RELATION B/W COVID AND BLACK FUNGUS
 COVID-19 leads to a weakened immune system, preventing the body
from effectively protecting against infection. As a result, individuals
recovering from COVID-19 are at risk for mucormycosis.
 The virus, as part of its replication cycle, suppresses the immune system,
so the immune system cannot clear other bacteria or fungi. The most
famous example of this is HIV, of course, which causes long-term immune
suppression. But, other viruses do this on a much shorter timescale — i.e.,
the immune system is only slightly suppressed for a few days or weeks
while the virus is there.

36. TREATMENT FOR BLACK FUNGUS
 As Black Fungus infections are on rise, there has been sudden rise in
demand for anti-fungal drug Ampho B, which is commonly used for the
treatment of the infection.
 IN SEVERE CASES REMOVAL OF INFECTED ORGAN (EYES)

38. VACCINES

40. IS VACCINES AVAILABLE ?
 Yes there are now several vaccines that are in use. The first mass
vaccination program started in early December 2020 and the number of
vaccination doses administered is updated on a daily basis At least 13
different vaccines (across 4 platforms) have been administered.
 The Pfizer/Bio N tech Comirnaty vaccine was listed for WHO Emergency
Use Listing (EUL) on 31 December 2020. The SII/Covishield and
AstraZeneca/AZD1222 vaccines (developed by AstraZeneca/Oxford and
manufactured by the State Institute of India and SK Bio respectively)
were given EUL on 16 February.
 The Janssen/Ad26.COV 2.S developed by Johnson & Johnson, was
listed for EUL on 12 March 2021.
 The Moderna COVID-19 vaccine (mRNA 1273) was listed for EUL on 30
April 2021 and the Sinopharm COVID-19 vaccine was listed for EUL on 7
May 2021.
 The Sinopharm vaccine is produced by Beijing Bio-Institute of Biological

42. HOW QUICKLY COULD COVID VACCINES COULD
STOP PANDEMIC ?
 The impact of COVID-19 vaccines on the pandemic will
depend on several factors. These include the
effectiveness of the vaccines; how quickly they are
approved, manufactured, and delivered; the possible
development of other variants and how many people
get vaccinated
 Whilst trials have shown several COVID-19 vaccines to
have high levels of efficacy, like all other vaccines,
COVID-19 vaccines will not be 100% effective. WHO is
working to help ensure that approved vaccines are as
effective as possible, so they can have the greatest
impact on the pandemic.

44. WHAT TYPE OF COVID VACCINES ARE BEING
DEVELOPED ? HOW WOULD THEY WORK?
 scientists around the world are
developing many potential vaccines for
COVID-19. These vaccines are all
designed to teach the body’s immune
system to safely recognize and block the
virus that causes COVID-19.

45. SEVERAL DIFFERENT TYPES OF POTENTIAL VACCINES
FOR COVID-19 ARE IN DEVELOPMENT, INCLUDING
 Inactivated or weakened virus vaccines, which use a form of the
virus that has been inactivated or weakened so it doesn’t cause
disease, but still generates an immune response.
 Protein-based vaccines, which use harmless fragments of
proteins or protein shells that mimic the COVID-19 virus to safely
generate an immune response.
 Viral vector vaccines, which use a safe virus that cannot cause
disease but serves as a platform to produce corona virus proteins
to generate an immune response.
 RNA and DNA vaccines, a cutting-edge approach that uses
genetically engineered RNA or DNA to generate a protein that
itself safely prompts an immune response.

46. BENEFITS OF VACCINATION
 The COVID-19 vaccines produce protection against the
disease, as a result of developing an immune response
to the SARS-Cov-2 virus.
 Developing immunity through vaccination means there
is a reduced risk of developing the illness and its
consequences. This immunity helps you fight the virus if
exposed.
 Getting vaccinated may also protect people around
you, because if you are protected from getting infected
and from disease, you are less likely to infect someone
else.
 This is particularly important to protect people at
increased risk for severe illness from COVID-19, such as
healthcare providers, older or elderly adults, and people
with other medical conditions.

47. DO VACCINES PROTECT AGAINST VIRUS ?
 The COVID-19 vaccines are expected to provide at least some protection
against new virus variants and are effective at preventing serious illness and
death.
 That’s because these vaccines create a broad immune response, and any
virus changes or mutations should not make vaccines completely ineffective.
If any of these vaccines become less effective against one or more variants, it
will be possible to change the composition of the vaccines to protect against
these variants. Data continues to be collected and analyzed on new variants
of the COVID-19 virus.
 While we are learning more, we need to do everything possible to stop the
spread of the virus in order to prevent mutations that may reduce the
efficacy of existing vaccines. This means staying at least 1 meter away from
others, covering a cough or sneeze in your elbow, frequently cleaning your
hands, wearing a mask and avoiding poorly ventilated rooms or opening a
window.

48. DO COVID 19 VACCINES PROVIDE LONG TERM
PROTECTION ?
 Because COVID vaccines have only been developed in the past months,
it’s too early to know the duration of protection of COVID-19 vaccines.
 Research is ongoing to answer this question. However, it’s encouraging
that available data suggest that most people who recover from COVID-
19 develop an immune response that provides at least some period of
protection against reinfection – although we’re still learning how strong
this protection is, and how long it lasts.

50. MAJOR VACCINES IN INDIA

51. Sputnik V
 Covishield
Covaxin

52. WHAT DO WE KNOW ABOUT
SPUTNIK V?
 The vaccine, developed by Moscow's Gamaleya Institute, initially
generated some controversy after being rolled out before the final trial
data had been released.
 But scientists say its benefits have now been demonstrated.
 It uses a cold-type virus, engineered to be harmless, as a carrier to
deliver a small fragment of the coronavirus to the body.
 Safely exposing the body to a part of the virus's genetic code in this way
allows it to recognize the threat and learn to fight it off, without the risk
of becoming ill.
 After being vaccinated, the body starts to produce antibodies especially
tailored to the coronavirus.
 This means that the immune system is primed to fight coronavirus when
it encounters it for real.
 It can be stored at temperatures of between 2 and 8C degrees (a
standard fridge is roughly 3-5C degrees) making it easier to transport

54. BUT IT HAS A DIFFERENT SECOND DOSE
 Unlike other similar vaccines, the Sputnik jab uses two slightly
different versions of the vaccine for the first and the second dose
- given 21 days apart.
 They both target the corona virus's distinctive "spike", but use
different vectors - the neutralized virus that carries the spike to
the body.
 The idea is that using two different formulas boosts the immune
system even more than using the same version twice - and may
give longer-lasting protection.

55. WHEN WILL SPUTNIK V BE AVAILABLE
IN INDIA?
 The Russian Direct Investment Fund (RDIF), which is marketing the
vaccine, has signed deals to produce more than 750 million doses of
Sputnik V in India with six domestic vaccine makers, according to
reports.
 Hyderabad-based pharmaceutical major Dr Reddy's Laboratories will be
importing the first batch of 125 million doses to India during this quarter.
 Supplies will be ramped up only next quarter when six Indian firms begin
making the vaccine under the supervision of Dr Reddy's.

56. WHAT DO WE KNOW ABOUT COVAXIN?
 Covaxin is an inactivated vaccine which means that it is made up of killed corona
viruses, making it safe to be injected into the body.
 Bharat Biotech, a 24-year-old vaccine maker with a portfolio of 16 vaccines and
exports to 123 countries, used a sample of the coronavirus, isolated by India's
National Institute of Virology.
 When administered, immune cells can still recognize the dead virus, prompting
the immune system to make antibodies against the pandemic virus.
 Caption Bharat Biotech is a Hyderabad-based pharmaceutical company
 The two doses are given four weeks apart. The vaccine can be stored at 2C to 8C.
 The vaccine has an efficacy rate of 81%, preliminary data from its phase 3 trial
shows.
 India's regulators gave the vaccine an emergency approval in January while the
third phase of the trial was still underway, sparking scepticism and questions from
experts.
 Bharat Biotech says it has a stockpile of 20 million doses of Covaxin, and is aiming
to make 700 million doses out of its four facilities in two cities by the end of the

58. WHAT WAS THE CONTROVERSY AROUND
COVAXIN ?
 It all began when the regulator in January said the vaccine had been approved
for "restricted use in emergency situations in public interest as an abundant
precaution, in clinical trial mode, especially in the context of infection by mutant
strains".
 Experts wondered how a vaccine was cleared for emergency use by millions of
vulnerable people when its trials were still underway. The All India Drug Action
Network at the time said that it was "baffled to understand the scientific logic" to
approve "an incompletely studied vaccine". It said that there were "intense
concerns arising from the absence of the efficacy data".
 Both the manufacturer and drug regulator had defended Covaxin, saying it was
"safe and provides a robust immune response".
 Bharat Biotech had said that Indian clinical trial laws allowed "accelerated"
authorization for use of drugs after the second phase of trials for "unmet medical
needs of serious and life-threatening diseases in the country". It had promised to
provide efficacy data for the vaccine by February, which it has now done.

59. WHAT ABOUT COVISHIELD?
 The Oxford-AstraZeneca vaccine is being manufactured locally by
the Serum Institute of India, the world's largest vaccine
manufacturer. It says it is producing more than 60 million doses a
month.
 The vaccine is made from a weakened version of a common cold
virus (known as an adenovirus) from chimpanzees. It has been
modified to look more like coronavirus - although it can't cause
illness.
 When the vaccine is injected into a patient, it prompts the immune
system to start making antibodies and primes it to attack any
coronavirus infection.
 The jab is administered in two doses given between four and 12
weeks apart. It can be safely stored at temperatures of 2C to 8C
and can easily be delivered in existing health care settings such as
doctors' surgeries.
 The jab developed by Pfizer-Bio N Tech, which is currently being
administered in several countries, must be stored at -70C and can
only be moved a limited number of times - a particular challenge in

61. HOW EFFECTIVE IS COVISHIELD?
 International clinical trials of the Oxford-AstraZeneca vaccine showed that
when people were given a half dose and then a full dose, effectiveness hit
90%.
 But there was not enough clear data to approve the half-dose, full-dose
idea.
 However, unpublished data suggests that leaving a longer gap between
the first and second doses increases the overall effectiveness of the jab - in
a sub-group given the vaccine this way it was found to be 70% effective
after the first dose.

62.  The Serum Institute (SII), the Indian maker of the vaccine, says Covishield is
"highly effective" and backed by phase III trial data from Brazil and United
Kingdom. Clinical trials are a three-phased process to determine whether the
vaccine induces good immune responses and whether it causes any
unacceptable side-effects.
 But patients' rights group, All India Drug Action Network, says its approval
has been rushed because the manufacturer has not completed a "bridging
study" of the vaccine on Indians.

63. ANY OTHER VACCINE CANDIDATES ?
 The other candidates which are in different stages of trials in India to test safety and
efficacy include:
 ZyCov-Di, being developed by Ahmedabad-based Zydus-Cadila
 A vaccine being developed by Hyderabad-based Biological E, the first Indian private
vaccine-making company, in collaboration with US-based Dynavax and Baylor College of
Medicine
 Hyderabad-based Biological E to produce the vaccine developed by US firm Johnson &
Johnson
 HGCO19, India's first mRNA vaccine made by Pune-based Genova in collaboration with
Seattle-based HDT Biotech Corporation, using bits of genetic code to cause an immune
response
 A nasal vaccine by Bharat Biotech
 A second vaccine being developed by Serum Institute of India and American vaccine
development company Novavax

65. !! PLEASE TAKE CARE OF YOURSELF AND
YOUR FAMILY , WEAR MASK AND STAY
SAFE !!