Essential kit for the home to help prevent hospitalisation in Covid times

Oxygen concentrators are expensive and can also be bought at the community level for emergency use. Other items can be kept at home for monitoring, prevention and cure

When you're fighting a battle as intense and prolonged as the Coronavirus pandemic, you must have enough ammunition and weapons in your armoury. With hospitals choked to capacity, the onus is on each one of us to stock the Covid essential kit at home.

Prashant Tandon, Co-founder & CEO, 1MG, says the absolute basics every Indian household must have now include a thermometer, a blood pressure machine and an infection-prevention kit consisting of a set of masks, gloves and sanitisers. Important devices include a glucose monitor and pulse oximeter. In case there is an existing condition in the family, you must even consider buying a nebuliser and an oxygen concentrator.

Home care is the answer to this pandemic problem, says Dr Suneela Garg, Member, Covid-19 Task Force of India. She says families should learn how to use equipment with the help of instructions given on the manual as well as videos available in the digital medium. Make sure you isolate the patient, quarantine the rest of the family, monitor vitals and regularly tele-consult with a general physician. Make structural changes at home where possible. Corona patients should ideally be kept in a separate room with an attached bathroom. If this is not feasible, then all the shared spaces must be sanitised before and after use by the Corona infected person.

Across the spectrum everyone is realising that care outside the hospital has played a key role. Sangita Reddy, Joint Managing Director, Apollo Hospitals Group, says, "The first line of defence is really the data, information, video consults, care pathways. The second is where a healthcare worker is involved, whether in the realm of diagnostics or home care, or remote care happening at home, or isolation rooms in hotels etc. With the help of technology, devices and internet of (medical) things, remote care will play a very important role. Nurses have an important role to play and we will try to enhance their skills and move them up the ladder of knowledge and roles in times to come.”

Everyone has been fighting for that elusive hospital. Your biggest contribution would be to desist from straining the existing infrastructure and manage your problems at home if you can. Says Dr Alexander Kuruvilla, Chief Healthcare Strategy Officer, Practo, “Many Covid patients can be taken care of at home, if they manage to avoid going from the first phase to the second.” He suggests an oxygen concentrator be bought at the community level by pooling resources. Everybody may not need it at the same time. It's expensive and costs Rs 40,000-80,000, so it is better to have one or two 10-litre oxygen concentrators within your gated community and identify people who can operate it.

Besides stocking the house with medicines and a wellness tool kit, you need certain documentation and know-how. Patient charting is the most important thing for the caregiver and this should be done till day 14. Says Dr Nidhi Bhatnagar, Faculty, Central Health Services, Maulana Azad Medical College, “Family members need to closely monitor the disease instead of rushing for blood tests and CT scans. You must do a day-wise charting of temperature, BP, respiratory rate, SPO2 and even the overall perception of health." 

She says, depending on the patient charting over the first 4-5 days, plus risk stratification (comorbidity) and medical history, the general physician will be able to classify a Corona infection as mild, moderate or severe. Many cases don't need a cocktail of medicines and 80 per cent do not actually need any blood or radiological investigation and are okay with just multivitamins, paracetamol and zinc. 

"However, if fever persists beyond seven days and it is hi-grade fever, then leave it to the doctor to decide on tests and steroids to administer. Often after day-5, if the oxygen level is low and fever persists, doctors recommend a complete RBC (red blood cell), D-Dimer, C Reactive Protein. However, Chest X-rays and CT scans done at the outset of infection cab, apart from straining the healthcare infrastructure, also expose the patient to harmful radiation and the caregiver to high virus load in clinics and healthcare facilities.

Your Covid Kit

A little alertness on your part will go a long way in keeping you safe. Fever may often be the first symptom of Covid-19. A thermometer is a must-have at home. Mercury thermometers have been banned but one must have digital or non-contact (laser) thermometers, which allow temperature measurements from a safe distance. Keeping a torch may be useful when the doctor is doing a tele-consult and asks you to open your mouth to see if your throat has turned red.

Diabetics or hypertensive patients who develop Covid-19 are more prone to fatalities. A BP instrument and a glucometer are vital for such patients. Keep obesity at bay by regular using a measuring tape and weighing scale to check if you have gained extra kilos or inches.

Oximeter is the new thermometer. A pulse oximeter is basically a small, clip-like device that attaches to a body part, most commonly the index finger and measures your oxygen saturation level. Since this virus is known to attack the respiratory system and lungs, it is critical to keep tabs on your oxygen level. Fingers should not be wet and one must avoid long nails or nail polish on the fingers as these can cause errors in the reading.

A set of steam vaporisers, nebulisers, peak flow meter, respirometer, three-ball breathing exercisers can be used to manage respiratory issues. Nebulisers differ from steamers as they not only convert medicine capsules to mist for inhaling but also ensure the right drug delivery at the right location in the respiratory tract and are used to treat both, the upper and lower airways. A peak flow meter measures one's lung capacity expressed as peak expiratory flow rate (PEFR). It is a portable and washable device, used for one person (not to be shared). 

Then you have oxygen kits. Dr Behram Pardiwala, Internal Medicine, Wockhardt Hospital, Mumbai Central says, “This Corona infection is going to be around for the next 4-5 years. There may not be such a crisis situation again but you should expect some local outbreaks here and there. I think it will be worthwhile to keep an oxygen concentrator at home since this virus affects your lung badly. Make sure devices are from good brands and technique is right.” 

He cites an example of a patient who rushed to the hospital in panic with a 70 oxygen reading from a ‘cheap, local, unreliable oximeter’ but as soon as he came to the hospital it was a good 94-95. 

Alternate medicine

From an Ayurveda viewpoint, every house must stock some basic herbs such as Gilohi, Ashwagandha, Amla. Says Dr Partap Chauhan, Director, Jiva Ayurveda: “Try to keep your system clean because poor gut health is a breeding ground for microbes and viruses. Your digestion should not be compromised. When your (digestive) fire is strong, it will eat up everything, even garbage. If you're constipated, take triphala at night. Do everything to strengthen your respiratory system with steaming, gargles, oil pulling and applying anu oil inside the nostrils. Go for home remedies of having water with saunth (ginger powder), saunf (anise), jeera (cumin seeds) and dhaniya (coriander seeds) to keep your digestion in check.”  

Most Ayurvedic solutions are available on e-commerce platforms such as Amazon and are reasonably priced, like Himalaya Ashvagandha (60 tablets for Rs 135), Dabur Giloy (60 tablets for Rs 165) and JivaAyurdeva Triphala (300 grams for Rs 120)   

Finally, keep your mind strong and relaxed. Try to stay positive by taking your mind off news and messages of negativity. Nourish your senses on good things such as listening to music, breathe in aroma through essential oils and stay connected with friends and family. After all, you are braver than you believe, stronger than you seem and smarter than you think.

Table: Constituents of the Essential kit

Wellness Gadgets	Key Brands	Price Range (Rs)
Blood Pressure Monitor	Omron, Dr Trust, Dr Morepen, Beurer, Circa	1,400-5,500
Fingertip Pulse Oximeter	DrTrust, Choicemmed, Vandelay, AccuSure, Newnik, Beurer	1,000-4,750
Glucometers	Dr Morepen, Accu-Chek, Dr Trust, OneTouch, Bayer, Contour Plus, BeatO, FreeStyle Libre	850-5,500
Portable Oxygen Concentrators	Philips, Devilbiss, Nidek, Spicejet, Inogen	50,000-2,95,000
Portable Limited ECG	AliveCor, SonoHealth, CONTEC	10,000-18,000
Non-Contact thermometers	Vandelay, BPL, Dr Trust, Dr Odin, Microtek, Dr Morepen, Sahyog Wellness	1,200-4,300
Digital Thermometer	Dr Trust, Rossmax, Vandelay,  Carent, Hicks, Amkay, BPL, Omron	200-600
Peak flow meter	Rossmax, Omron, Microlife	600-900
Nebuliser	Dr Odin, Omron, Dr Trust, Dr. Morepen, Rossmax, EasyCare, BPL	999-3,500
Smart Fitness Watch	Apple Watch, Fitbit, GOQii, Noise, Amazfit, Mi	2,500-53,000
Lung Exerciser	Romsons, Newnik, Entair, Infi	280-450
C-pap/bipap machines	Philips, Devilbiss, Carent, Resmed	62,000-2,97,000
Air Purifier	IQAir HeathpRO, Dyson, Samsung, Mi Air, Philips, Sharp, O2 cure, Havells	6,499-1,30,000
Tech Enabled Hygiene products and disinfectants	Daily Objects, Live.able, LOG 9 Materials	1,500-15,000

Source: Market Research