*Should we be worried about increasing covid 19 cases in India? Has lockdown helped us deal with Covid 19?* Dr D P Prakash FRCS American Eyecare&Lasik Centres Many of you must be wondering whether the lockdown of India for 2 full months from March 23rd 2020 as we now have more than 400,000 cases of Covid-19 in India on June 22, 2020. Was it worth the loss of livelihoods that has plunged the entire national economy to crisis? **In my view lockdown has given Indian citizens a greater chance of being alive than citizens of UK, ITALY, SPAIN or USA. **If we compare the death rates of these countries with Indian deaths it’s as high as 5-10% in these countries whereas our deaths are less than 3% . This despite the fact that these above nations have a healthcare delivery system that’s far more advanced than ours. *The answer for this is TIME*. As time passes in a pandemic there’s a greater chance of survival for those getting infected 3 months later like June 2020 than those who got infected 3 months earlier say February 2020. The reason for this is that Doctors and scientists know more about Covid-19 now than 3 months ago and hence are able to treat patients better. I will list *5 important things* that we know now that we didn’t know in February 2020 for your understanding. 1. COVID-19 was initially thought to cause deaths due to *pneumonia- a lung infection*- and so Ventilators were thought to be the best way to treat sick patients who couldn’t breathe. *Now we are realising that the virus 🦠 causes blood clots in the blood vessels of the lungs* and other parts of the body and this causes the reduced oxygenation . Now we know that just providing oxygen by ventilators will not help but we have to prevent and dissolve the micro clots in the lungs. This is why we are using drugs like *Asprin and Heparin ( blood thinners that prevents clotting) as protocol in treatment regimens in June 2020. * 2. Previously patients used to drop dead on the road or even before reaching a hospital due to reduced oxygen in their blood- OXYGEN SATURATION. This was because of *HAPPY HYPOXIA*- where even though the oxygen saturation was gradually reducing the COVID-19 patients did not have symptoms until it became critically less, like sometimes even 70%. **Normally we become breathless if oxygen saturation reduces below 90%. **This breathlessness is not triggered in Covid patients and so we we’re getting the sick patients very late to the hospitals in February 2020. Now since knowing about happy hypoxia we are monitoring oxygen saturation of all covid patients *with a simple home use pulse oxymeter and getting them to hospital if their oxygen saturation drops to 93% or less*. This gives more time for doctors to correct the oxygen deficiency in the blood and a better survival chance in June 2020. 3. We did not have drugs to fight the corona virus 🦠 in February 2020. We were only treating the complications caused by it... hypoxia. Hence most patients became severely infected. ```**Now we have 2 important medicines FAVIPIRAVIR & REMDESIVIR**``` Which are ANTIVIRALS that can kill the corona virus 🦠. By using these two medicines we can prevent patients from becoming severely infected and therefore cure them BEFORE THEY GO TO HYPOXIA. This knowledge we have in JUNE 2020... not in February 2020. 4. Many Covid-19 patients die not just because of the virus 🦠 but also due the patients own immune system responding In an exaggerated manner called *CYTOKINE STROM*. This stormy strong 💪 immune response not only kills the virus 🦠 but also kills the patients. In February 2020 we didn’t know how to prevent it from happening. Now in June 2020, we know that *easily available medicines called Steroids,* that doctors around the world have been using for almost 80 years *can be used to prevent the cytokine storm in some patients*. 5. Now we also know that people with hypoxia became better just by making them lie down on their belly- known as prone position. Apart from this a few days ago Israeli scientists have discovered that a chemical known as Alpha Defensin produced by the patients White blood cells can cause the micro clots in blood vessels of the lungs and this could possibly be prevented by a drug called Cholcicine used over many decades in the treatment of Gout. So now we know for sure that patients have a better chance at surviving the COVID-19 infection now in June 2020 than in February 2020 for sure. India has not peaked in March or April because of the lockdown. This strategy has postponed the Covid-19 pandemic in INDIA by 3 crucial months that has enabled us to save thousands of lives. Going forward there’s nothing to panic about Covid-19 if we remember that a person who gets infected later has a better chance at survival than one who got infected early. Let’s all follow simple precautions like -6 feet distancing from others -Wear proper masks -Work from home whenever possible -Order delivery and take away of food groceries and vegetables - Stay at home during lockdown - Hand 🤚 wash & hygiene With this we can beat the virus 🦠. If someone tells you every one is going to get infected, tell them that you are willing to wait to be the last person... who knows by then we might even have a VACCINE. A very highly positive post⁉