Covid-19

Protocols
WE SHOULD FOLLOW
TABLE OF CONTENTS

Overview 3

Covid-19 Prophylactics (For Seniors 65 Years+) 4

Home-care (Ambulatory Care) 5

If Symptoms Show Day 1 6

Day 2 7

Day 3, 4 8

Day 5, 6, 7 9

Day 8 10

Day 9 11

How Long to Stay Isolated? 12

Essential Care 13

Critical Care 14

Glossary 15
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OVERVIEW

Take a printout of this and put it up where

everyone in the house can see. Keep a list
of important phone numbers plus your
doctor and the hospitals of your choice.

This note is only meant as a guide,

you should consult your doctor
before taking any meds, especially
if you have any underlying
conditions (such as diabetes, high
blood pressure, heart disease,
asthma, etc.)

Remember, it is estimated that about 80% of

those infected with COVID-19 show mild
symptoms and may only need home and
ambulatory care. About 15% will be
moderate and need essential care. About
5% will need ICU care.

Also, note that these three diseases have

been showing up recently
• Dengue
• Influenza (seasonal flu)
• Malaria
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COVID-19 PROPHYLACTICS
(FOR SENIORS 65 YEARS+)

Healthy lifestyle + Vitamin C, D, Zinc,

Black Cumin daily

Meds for cold and runny nose:

• Fexofenadine Hydrochloride
(120mg once at night)
To relieve allergy symptoms
• Montelukast
(e.g. Monas 10mg once at night)
To treat shortness of breath/asthma

Taking lemon tea with honey gives some

benefit.
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HOMECARE (AMBULATORY CARE)

Be vigilant, observe for the following

symptoms.

Most Common
• Fever
• Cough
• Tiredness

Serious
• Difficulty breathing or shortness
of breath
• Chest pain or pressure
• Loss of speech or movement

Less Common
• Aches and pains
• Sore throat
• Diarrhea
• Conjunctivitis
• Headache
• Loss of taste or smell
• A rash on skin, or discoloration
of fingers or toes
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IF SYMPTOMS SHOW

Day 1
• Isolate patient
• Check temperature every 4 hours
(fever if > 98.6 F)
• Check pulse @6-hour intervals
(normal range: 60-100 beats per minute)
• Check oxygen with an Oxymeter @6-hour
intervals (normal range: O2 > 94%)
• Give Paracetamol 500mg, 2 tablets
every 8 hrs)
• Give Vitamin C, Zinc (8mg females,
11mg males), Black Cumin as supplement
• Hydrate with plenty of fluids such as
juice, coconut water & soup
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Day 2
• Patient to remain in isolation
• Continue all steps taken in Day 1
• Do a chest X-ray to check for pneumonia
• Take first PCR Test
(by PRAAVA BDT 5,000, result in 24 hrs)
If “negative”, observe symptoms
very closely, in case test is false
negative
If “positive”, observe symptoms
very closely, in case test is false positive
• Start Doxycycline 100mg x 2 tablets
as a first dose, followed by 1 tab
every 12 hours for next 5 days.
• After taking the medication be sure
to sit up patient for 30 minutes
• Remember to change dosage to 1
tab every 12 hrs for the next 5 days
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Day 3
• Patient to remain in isolation
• Continue all steps taken in Day 1
• If PCR result was “positive”, continue
• Doxycycline (dosage is 1 tab every 12 hrs)

Day 4
• Patient to remain in isolation
• Continue all steps taken in Day 1
• For “positive” patients, continue
Doxycycline
• If PCR Test on Day 2 result was “negative”,
take a second PCR Test
If “negative”, observe symptoms
very closely, in case test is
false negative
If “positive”, observe symptoms
very closely, in case test is false positive
• Start Doxycycline 100mg x 2 tablets
as a first dose, followed by 1 tab
every 12 hours for next 5 days
• After taking the medication be sure
to sit up patient for 30 minutes
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Day 5 - 6
• Patient to remain in isolation
• Continue all steps taken in Day 1
• For “positive” patients, continue
Doxycycline

Day 7
• Patient to remain in isolation
• Continue all steps taken in Day 1
• For patient who tested “positive” on
the first PCR Test on Day 2
• Give last dosage of Doxycycline
• Take a Confirmation PCR Test
If “negative”, observe symptoms
very closely, in case test is
false negative
If “positive”, observe symptoms
very closely, in case test is false positive
• For all other “positive” patients,
continue Doxycycline
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Day 8
• Patient to remain in isolation
• Continue all steps taken on Day 1
• Patient who tested “positive” on the
second PCR Test on Day 4, should
continue Doxycycline
• For patient who tested “positive” on
the PCR Test Day 7
If the patient has breathing difficulties,
refer to the “Essential Care”
section of this document
If the patient doesn’t have a
temperature, discontinue taking
Paracetamol
If other symptoms have also
subsided, it is possible the virus
has left the body
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Day 9
• Patient to remain in isolation
• Continue all steps taken in Day 1
• For patient who tested “positive” on
PCR Test #2 Day 4
• Give last dosage of Doxycycline
• Take PCR Test for Confirmation
If “negative”, observe symptoms
very closely, in case test is
false negative
If “positive”, patient surely
has COVID-19

For mild cases,

recovery time is approximately
2 weeks, and 3-6 weeks
for patients with
severe or critical disease
 12

HOW LONG TO STAY ISOLATED?

It is recommended that patient stays

isolated until the following conditions
have been met, assuming that testing is
not available:
• Patient has had no fever for at least
72 hours (that is three full days of no fever
without the use of medicine that
reduces fevers) AND
• Other symptoms have improved
(for example, when your cough or
shortness of breath have improved) AND
• At least 7 days have passed since
patient’s symptoms first appeared
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ESSENTIAL CARE

At any point outlined above, if the patient

starts experiencing breathing difficulties or
shortness of breath, they will need
thromboprophylaxis. Please follow the
steps below:
• Check oxygen level
If O2 < 90%, patient has Hypoxemia;
provide patient oxygen
with nasal cannula
If O2 < 88% then use CPAP or
BiPAP machine to provide oxygen
If O2 keeps falling, move to
professional care/hospital for
ventilator support
• Give Aspirin 300mg, 1 tablet, first day
only. Second day, switch to 70mg, 1 tablet
every day and continue till recovered
• Doctor may decide on Heparin, but
to be administered only by a doctor
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CRITICAL CARE

As of 9 July, the following line of

treatment is being used with good results.
Please consult your doctor for advice.

A combination of:

Favipiravir (Fluvigan/Avigan) – Antiviral

8 tab, two times on first day

3 tab, two times next 4 days

Remdesivir (Injection) – Antiviral

Dosage depends on patient’s condition

Ivermectin (Ivera/Scabo 6mg) – Antiparasite

2 tab after meal at night x once (single dose)

Doxycycline (100mg) – Antibiotic

2 tab as a first dose, Followed by 1 tab every

12 hours for next 5 days

Dexamethasone (0.5 mg tablets) – Anti-allergic

1 tab, trice a day

Riveroxaban (10 mg tablets) – Safer alternative of Heparin

Convalescent Plasma
Dosage determined based on patient’s condition

Disease modifying drugs (DMDs) – Slows down

immune reaction
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GLOSSARY

1. Pulse - A crucial measure of the heart

rate; is the expansion of the arteries. This
expansion is caused by an increase in
blood pressure pushing against the
elastic walls of the arteries each time
the heart beats.

2. Oximeter - A pulse oximeter is a small,

lightweight device used to monitor the
amount of oxygen carried in the body.

3. PCR Test - The COVID-19 RT-PCR test is a

real-time reverse transcription polymerase
chain reaction (rRT-PCR) test for the
qualitative detection of nucleic acid from
SARS-CoV-2 in upper and lower
respiratory specimens (such as nasal,
nasopharyngeal or oropharyngeal swabs,
sputum, lower respiratory tract aspirates,
bronchoalveolar lavage, and
nasopharyngeal wash/aspirate or
nasal aspirate).

4. False Positive - a test result which

wrongly indicates that a particular
condition or attribute is present.

5. False Negative - A result that appears

negative when it should not.
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6. Doxycycline - A tetracycline antibiotic

that fights bacteria in the body.

7. Thromboprophylaxis - Any preventive

measure or medication that reduces the
likelihood of the formation of blood clots.

8. Nasal cannula (NC) - is a device used to

deliver supplemental oxygen or increased
airflow to a patient or person in need of
respiratory help. This device consists of a
lightweight tube which on one end splits
into two prongs which are placed in the
nostrils and from which a mixture of air
and oxygen flows.

9. Hypoxemia - is an abnormally low level

of oxygen in the blood. More specifically,
it is oxygen deficiency in arterial blood.