How , where , what

&
Who will win ? YOU or CORONA ?
A series of
Dr. Manoj Gumber

Living with corona
The need of the hour!
During COVID-19
H O W ?
WHEN ?
WHERE?
WHAT?
MD, DM
- FORMER PROFESSOR IKDRC
- SENIOR CONSULTANT NEPHROLOGIST
AND TRANSPLANT PHYSICIAN
APOLLO HOSPITAL INTL LTD
AHMEDABAD
- Hon. Consultant –IIM Ahmedabad
-Hon. Consultant- Sola Civil Ahmedabad
+919879511234
manojrgumber@gmail.com
Dr. Manoj Gumber

This information is a collection of questions and answers regarding COVID-19
to spread awareness amongst the society regarding the pandemic.
How to ? When to ? Where to ? During COVID-19

What are the most
common symptoms of
COVID ?
• Fever
• Cough

What are the
basic precautions
to prevent spread
of corona virus?
• Hand Hygiene
• Avoid touching face ,eyes and
mouth
• Not to shake hands
• Avoid coming in contact with
people with respiratory symptoms
• Maintain Social distancing of 2
meters
• Follow cough /sneeze etiquettes

How should we
maintain
sanitization at
home?
• clean daily
• For non-metallic surface, use
household bleach
(mixture of 10ml of household bleach
containing 5.25% hypochlorite solution with
490ml of water)
leave for 15 - 30 minutes, and then rinse
with water (e.g., tables, countertops, light
switches, doorknobs, and cabinet handles)
• For metallic surface, disinfect
with 70% alcohol
• Maintain drainage pipes properly and
regularly (about once a week) pour about
half a liter of water into each drain outlet to
ensure environmental hygiene

• Keep them aside for
4hrs
• Soak them in baking soda
water for 30 minutes
• Not to eat raw vegetables
How to sanitize
fruits and
vegetables?

• Mouth ,Nose &
Hands
• Plastic bags
• Steel items
• Currency notes
Which are the things
most likely to be
carrying the virus ?

What about
paper/courier etc
,how to receive
them?
• Very less chance of spreading
through newspaper
• Keep newspaper aside for 2 hrs
• After reading newspaper –
hand sanitization
• Courier
–Delivery outside and open them
outside
-Open them wearing gloves,
discard the box
-If plastic package inside –use
hand sanitizer

• Receive them outside
the house
• Pay online
• Keep them aside for
72 hrs before use
How to receive home
delivery of grocery
products?

All are important
• Mask
• Sanitizer
• Vegetable cleaning
• Cleaning & disinfecting the
house /office
• Staying at home
Most important
• Social Distancing
Which is the MOST
important
precaution of all the
precautions?

How to
differentiate
between a
regular flu &
COVID-19?
• No specific clinical features that can
yet reliably distinguish COVID-19 from
flu
• Loss of taste and smell favors COVID-19
• The development of difficulty in
breathing is suggestive of COVID but
that occurs several days after the
onset of initial symptoms
• COVID-19 can spread from
asymptomatic patients
• The mortality rate of routine flu is
0.3% and for COVID it is around 5%

• Preferably Avoid
• Receive them outside
• Open them & throw
away the cover/boxes
• Use microwave to heat
them before eating
Can I eat ordered
food if
circumstances
don’t allow to cook
meal at home?

• Depends upon your profession
• Visiting a hospital –Triple layer surgical mask
• Prefer home made mask with strings
routinely
• Not to reuse disposal surgical mask
• For home made: boiling , pressure boil, soap
&water followed by sunlight/iron
• N-95 mask can be re used with proper
technique
Which mask to
wear ? How to
wear it and
how to reuse
them?

For 6 months
to 1 year !
Till when do we have
to abide by the
precautions?

• After
- Coughing and sneezing
• Before & After
-Eating, drinking & using
the washroom
• Wash hand often with soap
and water at least 40
seconds for COVID patients
otherwise 20 seconds
• While using hand sanitizer
at least 20 seconds
How frequently
hand
sanitization has
to be done?

• Any one with 70% alcohol
• Rub on your hands ,you should
feel some coolness in hands with
a good quality one
• In case of good quality one , your
hands should get dry early
within 20 sec
• A typical pungent odour should
come with the use
• Any perfumed sanitizer is usually
not good
Which sanitizer to
use ? How to
know whether it is
original and not
fake?

I am a high risk
patient ,can I
rejoin work?
• Yes
• Taking all precautions
• Maintain social distancing
• Respiratory hygiene
• Carry a small bottle of hand
sanitizer
• Use Mask
• If u have to interact with
public within a distance of 2
meters- use face shields

Can pregnant
woman work?
Yes
Taking precautions

Can an organ
transplant patient
start working ?
• Yes
• Taking all precautions
• Respiratory hygiene
• Carry a small bottle of hand
sanitizer
• Use Mask
• If u have to interact with public
within a distance of 2 meters-
use face shields
• Do not miss your drugs

Is there any
prophylactic medication
for corona that can be
taken?
Yes
• Only HCP should take
• Hydroxychloroquine
• To be taken after proper
evaluation by
physician/cardiologist
• Inquire about drug
interactions

How to run
your
residential
AC?
• Individual residential room AC re-
circulate air within a single occupied
area
• Set Temp 25-30 °C
• Normally the Humidity in air
conditioned room is 40-50%
• Keep a bucket/ a pan with water so
that humidity never falls <40%
• Keep a window slightly open to allow
outside air to get in

My office is centrally air
conditioned ,can that
spread the virus?
How to operate it
Yes & No
• Switch on 2hrs before
& keep it on for 2hrs
after the office hours
• Maintain 12
exchanges of air per
hour
• Maintain 26-30
degree temperature
• Keep the exhaust fan
/ keep ceiling fan on
at a slow speed
• Keep a window open

NO
Reduction can lead
to rejection
increase in
immunosuppression
Should a transplant
patient reduce his
immunosuppressive
drugs?

• Get your routine
tests done
• Preferably do online
consultation with
your doctor
• Visit hospital only if
doctor calls u for
face to face
consultation
I am a transplant patient
due for follow up, what
should I do?

Yes
• We’ll have to wait for
some time
• Continue hemodialysis
as per doctors advice
Will kidney
transplant be done in
the near future?

Who can be
labeled as a
contact with
COVID?
A healthy person who is at high risk
of developing COVID due to
association with
-A person living in the same
household as a COVID-19 case
-A person having had a direct
physical contact with a COVID-19 case
-A person who was in a closed
environment or had face to face
contact with a COVID-19 case at a
distance of within 2 meters

• How many minutes >15 or <15 minutes
• Were you wearing a mask at that time
• Was the infected person wearing a
mask
• What was the distance between you &
him/her at that time
• Contact your doctor & take guidance
regarding the need of quarantine
If there is a
history of contact
with COVID
patient what
should I do?

What to do if
symptoms of
COVID start ?
• Do not rush to the Lab to get tested
• Do not panic
• Call your doctor
-Get a prescription that you require
COVID-19 & ICMR form filled
-Ask him where to quarantine yourself
• Till the results come strict isolation
• If difficulty in breathing hospital care

How to home quarantine for COVID?

DR. MANOJ GUMBER PH.: 9879511234 EMAIL-ID : manojrgumber@gmail.com
9
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Summary –Home Quarantine
No Bed Rest
Stay Positive
Maintain Hydration
Make a List
-Cleaning Items &
Schedule
Follow
Strict Hygiene
Strict Room Isolation
Home /Hospital
Care
Watch For
Difficulty In Breathing
& Chest Pain
Be In Touch with Your
Doctor
Inform Your
Institute/Company
Make a list of
People U Have Met In
Last 3 Days
Call 104/Doctor
Do Not Rush To
Hospital
Monitor your
symptoms
Note down the day you
become afebrile
without paracetamol
Do Not Panic
DR. MANOJ GUMBER PH.: 9879511234 EMAIL-ID : manojrgumber@gmail.com

It is heard that a vaccine has been
developed & are we close to its
launch ?
Yes
But at present we need to take precautions and not vaccine
• A lot of research is going on
• mRNA-1723 by US based modern company
• The rate of development of Neutralizing antibodies is similar to the
COVID infection
• Dose dependent immune response is a good news

Should we wear PPE kit if we are in
business and public dealing?
• For you a proper mask is your PPE
• ADD a face shield if u are supposed to be dealing with people
less than 2 meters
• Maintaining social distancing and hand hygiene is important

Any guidelines for shop owners ?
• Maintain social distancing at all times
• All precautions to be taken

I am asthmatic , I often get breathless
How to differentiate from COVID symptoms?
• Loss of taste & smell favours COVID
• Your routine history of attacks related to season is important
• History of exposure to an infected person
• When in doubt contact your doctor
NOTE: Not to discontinue inhaled steroids if you are using them

How to visit a doctor
during corona times ?
• Preferably online consultation
• Wear mask in face to face consultation
• Spend minimum time in the hospital

Should I shave off my beard?
YES
No mask will be protective for you

Should I wear a cap while going out?
No

What precautions one should take if a family
member in house is found COVID +ve and
returns after 7 days of hospitalization?
• All as per home quarantine guidelines
• Strict Isolation to continue as advised
• Note down the date ,you became afebrile
• All family members to wear a mask
• Cleaning & disinfection as per home quarantine guideline

Is a kidney donor who is suffering from BP at risk?
• Hypertensive persons are at risk of complications
• As a donor no additional risk if your creatinine is normal

What to eat for increasing immunity?
• Home made food
• Eat what our grand parents used to eat

How to increase our immunity?
Sleep for 7-8 hrs
Eat Balanced diet, Maintain Hydration , Avoid Alcohol
Stay In Touch With Others
Thank God & Meditate
Have Patience, Stay Positive
Do what u enjoy & Do a job which u enjoy-peace of mind
Stay Away from COVID Media

What care should be taken when taking
aged people and kids to hospital?
• Avoid taking them unnecessarily to the hospital
• Do not miss routine vaccinations for kids
• For kids less than 2 years do not use mask
• For aged people use wheel chairs after sterilizing the handles
• Family member to be the driver of the the wheelchair

What are the precautions
for kidney patients?
• Take care of yourself
• Follow up- preferably online doctor consultation
• Take all precautions religiously
• Consult your doctor if u feel difficulty in breathing
• Do not be over enthusiastic in taking ayurvedic medicines
• Do make a list of items high in potassium and avoid them

Does HCQ have any side effects if taken
with Tacrolimus / Cyclosporine ?
• Yes
• Prolongation of QT interval and risk of sudden
cardiac arrest
• NOTE: Not to take HCQ without your transplant
physician advice if you are on these medications

How useful is the AAROGYA SETU app?
• Useful but if all of us fill up honestly
• Useful If we keep it on active mode
• U know whether anybody in your neighborhood is suffering
from COVID or not
• Self assessment is possible
• All updates are available
• Contact tracing is possible using this app

How to sanitize footwear?
• Washable or not
• If washable use soap and water
• If not washable use sanitizer and cloth /tissue paper
• You can use a mop soaked with 1% sodium
hypochlorite

How frequently hand sanitization
has to be done?
• After
- Coughing and sneezing
• Before & After
-Eating, drinking & using the washroom
• Wash hand often with soap and water at least
40 seconds if infected otherwise 20 seconds
• While using hand sanitizer at least 20 seconds

Soap or sanitizer and why?
• Soap better
With soap
-No chance of side effects
-Reliable
-Should be used with soiled hands
-Can be used for all ages

In these times of crisis , how to make
ourselves strong and reduce fear?
• Stay away from COVID media
• Update yourself for only 15 minutes per day
• Think about corona warriors
• Exercise
• Avoid alcohol
• Stay positive
• Stay in touch with others via digital media

At what time the sun emits vitamin D?
• Early morning with 40% of your skin exposed
• 11 am-1 pm is also good but chances of skin
burns
• No Vitamin D via sunlight when your shadow
becomes longer than your height
NOTE: Vitamin D deficiency can increase the
chances of complications of COVID

What is the mechanism by which the
virus invades different organs of our
body?
• It enters via ACE receptors
• lungs have highest receptors so commonest
organ to be affected

Would a covid-19 survivor have a
permanently weakened immune system?
• No
• In fact he can develop neutralizing antibodies
against the virus (30%)

What precautions to take
while travelling in public transport?
• Wear mask
• Carry a small bottle of hand sanitizer
• After using the handle bars use sanitizer
• Enter from rear end & exit from front
• Avoid sitting close to the person coughing

What are restricted food and drinks
during COVID times?
• Outside food to be avoided
• Raw food to be avoided
• Avoid alcohol
• If u are sensitive to cold water ,avoid it
• Avoid chocolates & soft drinks to avoid getting sore throat

What are the exercises and Yoga
to prevent COVID?
• Neither exercises nor yoga prevents against COVID
• They both are good for your health and over all
well being
• You should do it and continue doing them

Can we consume food
from or in canteen?
• Ideally Avoid
• Hand hygiene before &after
• Use disposal plates , glasses or of your own
• Not to speak while eating

Can a COVID +VE mother
breastfeed the baby?
• Yes
• Expressed breast milk
• If above one is not feasible do breast feed ,mother
wearing a mask and using a physical barrier of cloth
between the mother/baby

I have become pregnant during
COVID times ,
should I worry about anything?
• Pregnancy does not increase the susceptibility to the
virus
• Take care
• Take Adequate rest
• Do Regular antenatal visit

What are the natural remedies
to prevent from COVID-19?
• The only thing that prevents COVID is avoid contact with it
• Follow immune booster mechanisms

Any special precautions for elderly
and kids ?
• Yes
• If you are an health care worker, during COVID duty
avoid coming in contact with them
• They both should not move out unnecessarily
• The whole Lock down was, in a way to prevent the
elderly people from getting infected

If my relative is admitted in the hospital for
non COVID illness ,is it safe for me to visit
the hospital?
• Avoid if u are having cough /sore throat
• Wear a triple layer surgical mask
• Avoid using lift
• Follow no touch technique policy
• Spend as minimum time as possible
• When you come back , take shower

What precautions to be taken
while entering & getting out of
the hospital?
• Before you enter - wear mask
• Follow the rules of checking the fever tested
• Avoid lift
• Follow no touch policy
• Before getting in to car – hand sanitize
• After a visit to hospital preferably take a
shower

How to proceed for surgery in
COVID era ? emergency/Planned
• Check COVID pre operatively
• If time constraints due to emergency –treat all patient
as COVID positive, use full precautions and PPE
• For planned- Avoid surgery at present
• For planned surgery think about the risk benefit ratio

Can COVID-19 be transmitted
through foot wear?
• Very little chance
• If you are an health care worker then there are
chances because of secretions on the shoes

What can you advice to people who
use mask only to cover the mouth?
• Mask is to cover both nose and mouth
• Only covering mouth, is of little use

Which releases more virus
sneezing or coughing?
Sneezing

Which is more effective for hand wash
soap & water or hand sanitizer (70%) ?
• Soap & water is better

Is Corona made up of mixture of
HIV virus and malaria mosquito?
• NO
• Its RNA virus

What is herd immunity?
• It’s a stage where naturally occurring antibodies against
the virus will be present in our bodies
• It can happen when 50-80% of us will be infected by the
virus
• The virulence of the virus will decrease as the epidemic
progresses so we all will have asymptomatic infection
and hopefully the antibodies will develop

How do we change our
perception about COVID -19 ?
• We to need educate ourselves and know what to do & what
not to do
• If you approach it correctly , the fear will be less and some
fear is in fact appropriate to remind us to take precautions
• Don’t rely on media news and forwarded things
• Continue taking precautions
• If you follow , your kids will definitely follow
• Be intellectually honest- that’s the key to fight against the
virus

Are breathing exercises
helpful to treat corona ?
No
• In fact should not be done
without maintaining social
distancing
• Forceful breathing
exercises can be aerosol
generating

Do we need to sanitize
our spectacles?
Yes
• With hand sanitizer

Should we use sunglasses?
• Preferably avoid
Or
• Take care not to contaminate them

What is the correct procedure
for thermal scanning ?
• Measurement to be taken from 1-3 cm from the
forehead
• Within 3 seconds the results are available
• Sitting in AC car and getting tested can falsely
show low temperature

70-80% patients are asymptomatic then
what is the purpose of thermal scanning?
• Symptomatic patients spread the disease much more than
asymptomatic
• Isolate those who have fever so that they can be tested for
COVID-19
• The persons with fever need to be evaluated thoroughly and
if needed should be isolated till results of COVID are available

Is Pulse Oximeter
Useful For monitoring?
Yes
• In this virus infection, there are patients who are
oxygen deficient but are asymptomatic
• These patients need oxygen so pulse oximeter
should be used to monitor all COVID +VE patients

Do we need
to sanitize our cars?
• Yes
• Clean them more often with soap and water

What should organ transplant do
if he has cough/cold & fever ?
• Keep a low threshold to get COVID-19 test & CT
scan chest done
• Consult your doctor online when in doubt

Do transplant patients
require special care ?
• Take all precautions religiously
• If you are an health care worker ,use proper PPE
• Minimize your exposure to the hospital
• Preferably consult online
• Do continue all your drugs as prescribed
• Do not take HCQ prophylaxis ,without ECG monitoring
• If you become COVID +VE get admitted and u need to
document COVID –VE after the quarantine period is over(two
consecutive samples –VE taken 24 hrs apart )
• If you become positive then your treating doctor will reduce
your immunosuppressive drugs

• The virulence of the virus will decrease as the
epidemic progresses so we all will have
asymptomatic infection and hopefully the
antibodies will develop against the virus
• At present young people may be able to fight the
virus but elderly people will not be able to handle
the current virulence of the virus
Why postpone our
exposure to corona?

• No need to check
• Serological test will determine the presence / absence of
IgG titers against the virus
• All IgG antibodies need not be neutralizing antibodies
• The titers of antibodies are important and they should be
neutralizing ones to be protective
How do we know about
immunity against the virus ?

• Wait
• Be on HD/ CAPD
When should a person with ESRD
plan a transplant?

NO
• Alcohol contents above 90% are less effective
Is 90% alcohol sanitizer
better than 70% ?

Is Eye Protection Necessary?
• YES
• The coronavirus cannot penetrate skin, it can
penetrate all exposed mucous membranes, which
includes the eyes
• Eyes are presumably a lower risk as a route of
entrance compared to the mouth, which is
constantly breathing air directly into the lungs

Any Precautions for children
while going to school ?
•Educate the kids -Hand hygiene, Respiratory hygiene ,
importance of taking precautions& instructions especially
social distancing
•Parents should follow all the precautions-very important
•Instruct not to share the snacks in school with friends
•Provide them tissue papers
•Do not give sanitizer bottle to kids less than 10 years of age
•Bus seats no to be given to each student

in the school ?
• Preferably alternate day school to start with
• Fix sitting arrangements in the school
• Do’s and Don’ts & Hand hygiene posters in class rooms
• No breaks in the school
• Reduce the duration of school hours
• Reduce the strength of the class
• Educative sessions to be taken for & by teachers
• Preferably install Mike system in the class
• The distance between teacher & students to be
maintained at all times & in between students too

in the school ?
• No extracurricular activities, no sports period
• Snacks to be taken in the class only
• Water from personal water bottle only
• CCTV ‘s to be installed in all classrooms ,in & around the school
• Masks etiquettes to be taught
• Ventilate rooms ,install exhaust fans
• Cleaning and disinfection protocol to be strictly followed
• Bathrooms to be specifically taken care of

What should be the
sitting arrangement in the school bus ?

YES
• Take all preventive and
precautionary measures
• Be intellectually honest towards
symptoms & history of contact
with COVID patient
• Avoid spreading unauthentic
information
• Avoid going out of house
unnecessarily
• Respect corona warriors
• Stay positive
Can every one contribute
in this epidemic ?

YOU VIRUS WHO WILL WIN
Fresh mind -100 % alert 100% Active Definitely You will win
Casual attitude -less active 100% Active Virus may win
Laziness – less active 100% Active Virus may win
ALERTNESS DECIDES
Who will win ? The virus or you ?

A special thanks to...
And to every person who is protecting himself/herself and others
by taking precautions

Stay Safe
Stay Healthy
Stay Strong
Thankyou,

Dr. Sheetal Agarwal
Dr. Akanksha Gumber
Simran Gumber
Arushi Gumber
Acknowledgements

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