Condensing everything I have learnt about managing Covid after ~2 weeks of getting my parents through it - things that still aren't common knowledge but need to be.

Hopefully this helps:

1. Get a Complete Blood Count (CBC) and C-reactive Protein (CrP) test as soon as ANY symptoms appear. This is an inexpensive (<1k) and relatively fast (although taking 24+ hours in Delhi now) test that is extremely important to measure severity of infection.

2. Doctor: Please try and find ONE good INTERNAL Medicine doctor you trust and stick with them. Explain all history and any medicines given so far. Speaking to too many people (which one is likely to do given such limited availability) creates panic and confusion down the line.

3. On day 1, most doctors will recommend: Ivermectin: This is an anti-parasitic used against Covid across the world last year, now being termed ineffective by most. Some say it helps stop replication of the virus in the early days.

4. The other meds will most likely be: Multivitamins + Cough Syrup + Anti-allergics + Paracetamol (650 mg for adults). The goal from Day 1 has to be to keep fever low if it is high: Hydrate (High fluid intake) + Steam + Paracetamol.

5. Whether to get more aggressive treatment (needs to begin by Day 3-5):
- If CrP values are high (>10 mg/L)
- Fevers above >101°F
- MOST importantly, if O2 sat. values are falling: Please measure this using something known as a 6 Minute Walk Test. If failing, get a CT scan ASAP

6. CT scans need you to travel to labs + cost >5k and reports are available in a few hours. The severity of lung infection is represented in the scan by a value out of 25 (in %). If this is greater than 18, the infection is severe. <18 is better news but no cause to celebrate.

7. Aggressive infection: Please observe trends in O2 sat. and repeat blood tests: If O2 sat. is remaining above 95 and CrP is below 5 on Day 5, then in all likelihood one is out of the woods. If the sat is dropping (<93) and CrP is still high by Day 5 -> needs stronger medication

The only effective treatment for Covid in these cases of pneumonia + high inflammation is: Steroids and Blood thinners. If O2 falls to below 93, either or both of these will have to be used. Three main sorts:
- Budesonide
- Methylprednisolone
- Dexamethasone

8. Medicines: The above are extremely difficult to come by right now (in Delhi) but not impossible: be prepared to speak to 50+ pharmacies and to have to use Dunzo/WeFast to pick up meds from afar.

Tip: Save as many pharmacist numbers in your phone as you can.

9. Oxygen: If oxygen levels are falling below 90 and there is access to a concentrator, please use it. If levels are extremely low (<80), high pressure cylinders are needed; if not, concentrators are useful to maintain levels above 90.

Proning is EXTREMELY helpful.

10. Hospital: As I type this, ICU beds are virtually impossible to come by in Delhi. Please try for Home ICU setup services. I don't know if the situation will improve within the next week. The Chief Minister has promised 1200 ICU beds in a few days. Let's hope this comes through

11. Finally, two cents on the responsibility and accountability debate: Why do we reduce ourselves to who we elect — as Prime Minister and Chief Minister — when we want to find fault? We are more than who we vote for. We are a society, and a society has to be governed by systems.

Our systems are designed according to 19th century needs: to make a computing analogy, we have to decentralise (distribute load) and scale horizontally till we have manageable units of population holding local leaders to account.

I don't know who the DM of my district is. My corporator has disappeared and expectedly so. Cities, towns, districts that are doing (relatively) well are ones that have large, capable, effective municipal organisations. Delhi has 3 Municipal Corps and all of them are non-existent

There will be endless debate about who is at fault and all of it feels irrelevant. The fault is in our systems and we have to rally to change them. When the dust settles, it is this systemic change (DECENTRALISE) that we need to begin effecting.

Thanks and all the best.

Not a substitute for professional medical advice. Just my experience