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COVID-19 Advisory by States - India

A. COVID 19- Important advisory links for Maharashtra

1. Clinical Management Protocol: COVID-19

2. Fixation of rate conducting RtPCR COVID-19 test in NABL & ICMR approved private laboratories

3. List of Laboratories

4. Maharashtra state-dedicated COVID-19 facilities

5. National teleconsultation service

6. COVID-19 Awareness material (for authentic information)

7. Maharashtra COVID-19 dashboard

8. COVID-19 portal

9. COVID-19 waste management – do’s & don’ts

10. COVID-19 pandemic situation deaths handling guidelines

11. Additional guidelines on rational use of Personal Protective Equipment

12. Summary of guidelines COVID-19

13. Equipment required and their specification

B. COVID-19 Important advisory links for Delhi & NCR

1. COVID-19 helpline number

2. Order to carryout compulsory Rapid Antigen Detection Testing for high risk group of individuals

3. Corrigendum in respect of circular regarding fixing of rates for COVID-19 related treatment

4. Order creation of hospital beds for COVID-19 in banquet halls in all districts

5. Advisory newer additional strategies for COVID-19 testing

6. Order fixing of hospital rates for COVID-19 related treatment for private hospitals

7. Order modification of order issued on 19 June 2020 regarding home isolation

8. Order fixation of COVID-19 RTPCR test rate at INR 2,400

9. Order to declare small nursing homes 10 to 49 beds as COVID-19 hospitals

10. Revised allocation of beds in private hospitals to admit COVID-19 patients

11. To set aside the order Dt 07.06.2020 regarding treatment to bonafide residents of Delhi

12. Protocol for COVID-19 patients and non-COVID-19 patients

13. 24x7 help desk at each hospital to ensure smooth, hassle-free admission in hospitals

14. Standard Operating Procedure (SOP) for handling of COVID-19 positive patients

15. Order better management of dead bodies of COVID-19 positive persons

16. District wise COVID-19 cases

17. Containment zones

18. COVID-19 testing

19. Dedicated COVID-19 hospitals

20. Revised guidelines for domestic travellers

21. Entry & exit plan at railway station

C. COVID-19 Important advisory links for Karnataka

1. List of private hospital empanelled with SAST for the treatment of COVID-19

2. Regulation of movement of persons from other states to Karnataka

3. Quarantine norms of Government of Karnataka passengers’ returnees travelling by (air, rail, road)

4. Regarding COVID-19 RT-PCR fixed fee structure for testing

5. Regarding new guidelines for keeping home quarantine and isolating patients tested positive for COVID-19

6. Regarding rates fixed for treatment of COVID-19 patients

7. Citizens notice regarding reservation of 50% of the beds in the following hospitals along with the beds in Government run Institutions for free treatment to COVID-19 patients

8. Empowering citizens for testing of SARS-Cov-2 virus to save precious lives and contain the virus

9. Notification regarding fixed package rates for the Government and referred COVID-19 patents be treated at recognized private hospitals

10. Guidelines for international arrivals

11. Guidelines for domestic travel (air/train/inter - state bus travel)

12. Guidelines for disinfection and maintaining cleanliness of vehicles during the COVID-19 pandemic

13. Shut down of Namma Metro train services

14. D.O - regarding expedited approval of TruNat/CBNAT for COVID-19 testing in private labs/hospitals

15. Triaging of COVID-19 positive persons who are eligible for home isolation

16. SOP for Hair - cutting salons and parlours

17. Designated hospitals in Bangalore

18. Dedicated COVID-19 health centres

19. Circular for private testing Labs

20. Containment zone information

21. Testing centres

D. COVID-19 Important advisory links for Tamil Nadu

1. COVID-19 Dashboard

2. Status of private hospital capacity

3. COVID-19 treatment package fixation

4. Guidelines for international arrivals

5. Guidelines for domestic travel (air/train/inter-state bus travel)

6. COVID-19 - Health and Family Welfare Department - guidelines on dead body management

7. COVID-19 - Standard operating procedure for preventive measures to contain spread of COVID-19 in offices in the state

8. COVID-19 – Health and Family Welfare Department – additional guidelines for COVID-19 management - testing and quarantine strategy

9. COVID-19 - Health and Family Welfare Department - guidelines for home isolation of very mild/pre-symptomatic cases

10. COVID-19 – advisory for protection of senior citizens aged above 60 Years

11. COVID-19 – Health and Family Welfare Department – standard operating procedure for social distancing for offices, workplace, factories, and establishments

12. Additional guidelines for COVID-19 testing & quarantine Strategy

E. COVID-19 Important advisory links for West Bengal

1. Guidelines for domestic travel

2. Notification regarding fees & testing charges

3. Amended SOP for paying last respect to the COVID-19 deceased

4. Notification regarding home quarantine to combat spread of COVID-19

5. Hospitals in Kolkata earmarked for treatment of COVID-19 cases

6. Information on movement of stranded persons within and outside the State of West Bengal

7. Train Schedule for migrant workers of West Bengal stranded in other states

8. District wise containment zone

9. Advisory on protocol management for COVID–19 patients

10. Initiation of penal action for denial of admission/service by Government hospitals

11. KMCH designated as dialysis unit for COVID-19 positive patient

12. Sale of mask and PPE for doctors from fair price medicine shop

13. Updated list of hotels for self-quarantine centres

14. Satellite health facilities for asymptomatic/mild COVID cases

15. Guidelines for international arrivals

16. Guideline for domestic travel by air

17. Revised detection strategy and testing criteria

18. ICMR-approved Testing Laboratories in West Bengal (as on 05-05-2020)

19. COVID-19 tests not to be considered as mandatory before surgery

20. Earmarked designated hospitals for treatment of COVID-19 related cases

F. COVID-19 Important advisory links for Andhra Pradesh

1. SOP for domestic travel

2. COVID-19 dashboard

3. COVID-19 helpline numbers

4. COVID-19 hospital doctors

5. Dedicated COVID-19 hospitals

G. COVID-19 Important advisory links for Telangana

1. COVID-19 dashboard

2. Guidelines for home isolation

3. Isolation centres

4. Quarantine centres

5. Testing centres

6. Measures to contain COVID-19 in the State of Telangana

7. Fixation of ceiling on rates chargeable by private hospitals and laboratories for treatment and testing

8. SOP on preventive measures to contain spread of COVID-19 in offices

9. Guidelines of do’s and don’ts issued by Health & Family Welfare Department, Govt. of Telangana

10. Ban of spitting in public places

Common advisory links

1. Updated clinical management protocol for COVID-19

2. Mental health in the times of COVID-19 pandemic - guidance for general medical and specialized mental health care

3. State wise quarantine required after travel

4. Standard Operating Protocol (SOP) for private aircraft and charter operations on international sectors in view of COVID-19 pandemic

5. MOCA order regarding sector classification & fare bands

6. Guidelines for international arrivals

7. General Instructions for commencement of domestic air travel

8. Guidelines for domestic travel (air/train/inter-state bus travel

9. Guidelines on disinfection of common public places including offices

10. Revised guidelines for Home Isolation of very mild/pre-symptomatic/asymptomatic COVID-19 cases

11. SOP on preventive measures to contain spread of COVID-19 in offices

12. Guidelines for train services starting from 1st June

13. Revised guidelines for home isolation of very mild/pre-symptomatic COVID-19 cases

14. Additional guidelines for quarantine of returnees from abroad/contacts/isolation of suspect or confirmed cases in private facilities

15. Advisory against spraying of disinfectant on people for COVID-19 management

16. Guidelines for dialysis with reference to COVID-19 infection

17. Advisory on use of homemade protective cover for face & mouth

18. Ayurveda’s immunity boosting measures for self-care during COVID 19 crisis

19. Guidelines on disinfection of common public places including offices

20. Health advisory for elderly population of India during COVID-19

21. Advisory on social distancing measure in view of spread of COVID-19 disease

22. Guidelines for mass gathering

23. Guidelines on use of masks by public

24. Travel alert

25. Current rules and guidelines

26. Pan India lab information

27. Fixation of rates of RTPCR test for COVID-19 in respect of Central services beneficiaries.

28. CGHS rates for treatment at private health care organizations empanelled under CGHS- in view of COVID-19 pandemic.

29. Revised guidelines for Home isolation of very mild / Pre-symptomatic /Asymptomatic COVID-19 patient.

30. Air India evacuation schedule flights ex India PHASE-4

Audio visual links

1. Audio Visual on addressing stigma related to COVID-19

2. Audio visual on how to safely quit tobacco during lockdown (Hindi)

3. Video on yoga for stress management (Hindi)

4. Video on meditation for stress management (English)

5. Audio visual on "How to safely stop drinking during lockdown”

6. Audio visual on "Managing mental stress and depression during lockdown”

7. Video on addressing social stigma associated with COVID-19 (Hindi)

8. Video on addressing social stigma associated with COVID-19

9. Addressing social stigma associated with COVID-19

10. Video on yoga for stress management (English)

11. Video on meditation for stress management (Hindi)

12. Lockdown to knockdown COVID-19

13. Lockdown to knockdown COVID-19 - additional tips

14. Taking care of mental health of children during COVID - 19

15. Taking care of mental health of elderly during COVID -19

16. Psychosocial issues among migrants during COVID-19

17. Video on practical tips to take care of your mental health during the stay in

18. Minding our minds during the COVID-19

19. Various health experts on how to manage mental health & well-being during COVID-19 outbreak

20. Dr. Shekhar P. Seshadri on “Connecting with little ones during the COVID19 lockdown” English

21. Dr. Shekhar P. Seshadri on “Connecting with little ones during the COVID19 lockdown”- Hindi

FAQs on COVID-19 (Source: MOHFW & ICMR)

1. What is coronavirus?

Coronaviruses are a large family of viruses that may cause illness in animals or humans. In humans, several coronaviruses are known to cause respiratory infections ranging from the common cold to more severe diseases such as Middle East Respiratory Syndrome (MERS) and Severe Acute Respiratory Syndrome (SARS). The most recently discovered coronavirus causes coronavirus disease COVID-19.

2. What is COVID-19?

COVID-19 is an infectious disease caused by the most recently discovered coronavirus. This new virus and disease were unknown before the outbreak began in Wuhan, China, in December 2019.

3. What are the symptoms of COVID-19?

The most common symptoms of COVID-19 are fever, tiredness, and dry cough. Some patients may have aches and pains, nasal congestion, runny nose, sore throat, or diarrhoea. These symptoms are usually mild and begin gradually. Some people become infected but do not develop any symptoms and do not feel unwell. Most people (about 80%) recover from the disease without needing special treatment. Around 1 out of every 6 people who get COVID-19 becomes seriously ill and develop difficulty breathing. Older people, and those with underlying medical problems like high blood pressure, heart problems or diabetes, are more likely to develop serious illness. People with fever, cough, and difficulty breathing should seek medical attention.

4. How does COVID-19 spread?

People can catch COVID-19 from others who have the virus. The disease can spread from person to person through small droplets from the nose or mouth which are spread when a person with COVID-19 coughs or exhales. These droplets land on objects and surfaces around the person. Other people then catch COVID-19 by touching these objects or surfaces, then touching their eyes, nose, or mouth. People can also catch COVID-19 if they breathe in droplets from a person with COVID-19 who coughs out or exhales droplets. Therefore, it is important to stay more than 1 meter (3 feet) away from a person who is sick.

5. Can the virus that causes COVID-19 be transmitted through the air?

A recent publication in the New England Journal of Medicine has evaluated virus persistence of the COVID-19 virus. In this experimental study, aerosols were generated using a three-jet Collison nebulizer and fed into a Goldberg drum under controlled laboratory conditions. This is a high-powered machine that does not reflect normal human cough conditions. Further, the finding of COVID-19 virus in aerosol particles up to 3 hours does not reflect a clinical setting in which aerosol-generating procedures are performed—that is, this was an experimentally induced aerosol-generating procedure. There are reports from settings where symptomatic COVID-19 patients have been admitted and in which no COVID-19 RNA was detected in air samples. WHO is aware of other studies which have evaluated the presence of COVID-19 RNA in air samples, but which are not yet published in peer-reviewed journals? It is important to note that the detection of RNA in environmental samples based on PCR-based assays is not indicative of viable virus that could be transmissible. Further studies are needed to determine whether it is possible to detect COVID-19 virus in air samples from patient rooms where no procedures or support treatments that generate aerosols are ongoing. As evidence emerges, it is important to know whether viable virus is found and what role it may play in transmission.

6. Can COVID-19 be caught from a person who has no symptoms?

The main way the disease spreads is through respiratory droplets expelled by someone who is coughing. The risk of catching COVID-19 from someone with no symptoms at all is very low. However, many people with COVID-19 experience only mild symptoms. This is particularly true in the early stages of the disease. It is, therefore, possible to catch COVID-19 from someone who has, for example, just a mild cough and does not feel ill.

7. Can I catch COVID-19 from the faeces of someone with the disease?

The risk of catching COVID-19 from the faeces of an infected person appears to be low. While initial investigations suggest the virus may be present in faeces in some cases, spread through this route is not a main feature of the outbreak. The ongoing research on the ways COVID-19 is spread and will continue to share new findings. Because this is a risk, however, it is another reason to clean hands regularly, after using the bathroom and before eating.

8. What can I do to protect myself and prevent the spread of disease?

Protection measures for everyone

Stay aware of the latest information on the COVID-19 outbreak, available on the national, state, and local public health authority. Many countries around the world have seen cases of COVID-19 and several have seen outbreaks. Authorities in China and some other countries have succeeded in slowing or stopping their outbreaks. However, the situation is unpredictable so check regularly for the latest news.

You can reduce your chances of being infected or spreading COVID19 by taking some simple precautions:

· Regularly and thoroughly clean your hands with an alcohol-based hand rub or wash them with soap and water.

Why? Washing your hands with soap and water or using alcohol-based hand rub kills viruses that may be on your hands.

· Maintain at least 1 metre (3 feet) distance between yourself and anyone who is coughing or sneezing.

Why? When someone coughs or sneezes, they spray small liquid droplets from their nose or mouth which may contain the virus. If you are too close, you can breathe in the droplets, including the COVID-19 virus if the person coughing has the disease.

· Avoid touching eyes, nose, and mouth.

Why? Hands touch many surfaces and can pick up viruses. Once contaminated, hands can transfer the virus to your eyes, nose, or mouth. From there, the virus can enter your body and can make you sick.

· Make sure you, and the people around you, follow good respiratory hygiene. This means covering your mouth and nose with your bent elbow or tissue when you cough or sneeze. Then dispose of the used tissue immediately.

Why? Droplets spread the virus. By following good respiratory hygiene, you protect the people around you from viruses such as cold, flu, and COVID-19.

· Stay home if you feel unwell. If you have a fever, cough and difficulty breathing, seek medical attention, and call in advance. Follow the directions of your local health authority.

Why? National and local authorities will have the most up to date information on the situation in your area. Calling in advance will allow your health care provider to quickly direct you to the right health facility. This will also protect you and help prevent the spread of viruses and other infections.

· Keep up to date on the latest COVID-19 hotspots (cities or local areas where COVID-19 is spreading widely). If possible, avoid traveling to places – especially if you are an older person or have diabetes, heart, or lung disease.

Why? You have a higher chance of catching COVID-19 in one of these areas.

Protection measures for persons who are in or have recently visited (past 14 days) areas where COVID-19 is spreading

· Follow the guidance outlined above (protection measures for everyone)

· Self-isolate by staying at home if you begin to feel unwell, even with mild symptoms such as headache, low-grade fever (37.3 C or above), and slight runny nose, until you recover. If it is essential for you to have someone bring you supplies or to go out, e.g. to buy food, then wear a mask to avoid infecting other people.

Why? Avoiding contact with others and visits to medical facilities will allow these facilities to operate more effectively and help protect you and others from possible COVID-19 and other viruses.

· If you develop fever, cough, and difficulty breathing, seek medical advice promptly as this may be due to a respiratory infection or other serious condition. Call in advance and tell your provider of any recent travel or contact with travellers.

Why? Calling in advance will allow your health care provider to quickly direct you to the right health facility. This will also help to prevent possible spread of COVID-19 and other viruses.

9. How likely am I to catch COVID-19?

The risk depends on where you are - and more specifically, whether there is a COVID-19 outbreak unfolding there.

For most people in most locations, the risk of catching COVID-19 is still low. However, there are now places around the world (cities or areas) where the disease is spreading. For people living in, or visiting, these areas the risk of catching COVID-19 is higher. Governments and health authorities are taking vigorous action every time a new case of COVID-19 is identified. Be sure to comply with any local restrictions on travel, movement, or large gatherings. Cooperating with disease control efforts will reduce your risk of catching or spreading COVID-19.

COVID-19 outbreaks can be contained, and transmission stopped, as has been shown in China and some other countries. Unfortunately, new outbreaks can emerge rapidly. It is important to be aware of the situation where you are or intend to go.

10. Should I worry about COVID-19?

Illness due to COVID-19 infection is generally mild, especially for children and young adults. However, it can cause serious illness: about 1 in every 5 people who catch it need hospital care. It is therefore quite normal for people to worry about how the COVID-19 outbreak will affect them and their loved ones.

We can channel our concerns into actions to protect ourselves, our loved ones, and our communities. First and foremost, among these actions is regular and thorough hand-washing and good respiratory hygiene. Secondly, keep informed and follow the advice of the local health authorities including any restrictions put in place on travel, movement, and gatherings.

11. Who is at risk of developing severe illness?

While we are still learning about how COVID-2019 affects people, older persons and persons with pre-existing medical conditions (such as high blood pressure, heart disease, lung disease, cancer, or diabetes) appear to develop serious illness more often than others.

12. Are antibiotics effective in preventing or treating the COVID-19?

No. Antibiotics do not work against viruses, they only work on bacterial infections. COVID-19 is caused by a virus, so antibiotics do not work. Antibiotics should not be used as a means of prevention or treatment of COVID-19. They should only be used as directed by a physician to treat a bacterial infection.

13. Are there any medicines or therapies that can prevent or cure COVID-19?

While some western, traditional, or home remedies may provide comfort and alleviate symptoms of COVID-19, there is no evidence that current medicine can prevent or cure the disease. We do not recommend self-medication with any medicines, including antibiotics, as a prevention or cure for COVID-19. However, several ongoing clinical trials include both western and traditional medicines. We will continue to provide updated information as soon as clinical findings are available.

14. Is there a vaccine drug or treatment for COVID-19?

Not yet. To date, there is no vaccine and no specific antiviral medicine to prevent or treat COVID-2019. However, those affected should receive care to relieve symptoms. People with serious illnesses should be hospitalized. Most patients recover thanks to supportive care.

Possible vaccines and some specific drug treatments are under investigation. They are being tested through clinical trials.

The most effective ways to protect yourself and others against COVID-19 are frequently clean your hands, cover your cough with the bend of elbow or tissue, and maintain a distance of at least 1 meter (3 feet) from people who are coughing or sneezing

15. Is COVID-19 the same as SARS?

No. The virus that causes COVID-19 and the one that caused the outbreak of Severe Acute Respiratory Syndrome (SARS) in 2003 are related to each other genetically, but the diseases they cause are quite different.

SARS was more deadly but much less infectious than COVID-19. There have been no outbreaks of SARS anywhere in the world since 2003.

16. Should I wear a mask to protect myself?

COVID-19 spreads mainly from person to person through respiratory droplets produced when an infected person coughs, sneezes, talks, or raises their voice (e.g., while shouting, chanting, or singing). These droplets can land in the mouths or noses of people who are nearby or possibly be inhaled into the lungs. Recent studies show that a significant portion of individuals with COVID-19 lack symptoms (are “asymptomatic”) and that even those who eventually develop symptoms (are “pre-symptomatic”) can transmit the virus to others before showing symptoms. To reduce the spread of COVID-19, CDC recommends that people wear cloth face coverings in public settings when around people outside of their household, especially when other social distancing measures are difficult to maintain.

17. How-to put-on use take off and dispose of a mask?

o Every individual must wear a mask

o Before touching the mask, clean hands with an alcohol-based hand rub or soap and water

o Take the mask and inspect it for tears or holes.

o Orient which side is the top side (where the metal strip is).

o Ensure the proper side of the mask faces outwards (the coloured side).

o Place the mask on your face. Pinch the metal strip or stiff edge of the mask so it moulds to the shape of your nose.

o Pull down the mask’s bottom so it covers your mouth and your chin.

o After use, take off the mask; remove the elastic loops from behind the ears while keeping the mask away from your face and clothes, to avoid touching potentially contaminated surfaces of the mask.

o Discard the mask in a closed bin immediately after use.

o Perform hand hygiene after touching or discarding the mask – Use alcohol-based hand rub or, if visibly soiled, wash your hands with soap and water.

18. How long is the incubation period for COVID-19?

The “incubation period” means the time between catching the virus and beginning to have symptoms of the disease. Most estimates of the incubation period for COVID-19 range from 1-14 days, most commonly around five days. These estimates will be updated as more data become available.

19. Can humans become infected with the COVID-19 from an animal source?

Coronaviruses are a large family of viruses that are common in animals. Occasionally, people get infected with these viruses which may then spread to other people. For example, SARS-CoV was associated with civet cats and MERS-CoV is transmitted by dromedary camels. Possible animal sources of COVID-19 have not yet been confirmed.

To protect yourself, such as when visiting live animal markets, avoid direct contact with animals and surfaces in contact with animals. Ensure good food safety practices at all times. Handle raw meat, milk, or animal organs with care to avoid contamination of uncooked foods and avoid consuming raw or undercooked animal products.

20. Can I catch COVID-19 from my pet?

While there has been one instance of a dog being infected in Hong Kong, to date, there is no evidence that a dog, cat, or any pet can transmit COVID-19. COVID-19 is mainly spread through droplets produced when an infected person coughs, sneezes, or speaks. To protect yourself, clean your hands frequently and thoroughly.

We continue to monitor the latest research on this and other COVID19 topics and will update as new findings are available.

21. How long does the virus survive on surfaces?

Plastic – 5 days, Wood- 4 days, Stainless Steel - 48hrs, Glass - 4 days, Surgical Gloves- 4/5 days, paper/cardboard- 24 hrs.

22. Is it safe to receive a package from any area where COVID-19 has been reported?

Yes. The likelihood of an infected person contaminating commercial goods is low and the risk of catching the virus that causes COVID-19 from a package that has been moved, travelled, and exposed to different conditions and temperatures is also low.

23. Is there anything I should not do?

The following measures ARE NOT effective against COVID-2019 and can be harmful:

• Smoking

• Wearing multiple masks

• Taking antibiotics (See question 10 "Are there any medicines of therapies that can prevent or cure COVID-19?")

In any case, if you have fever, cough, and difficulty breathing seek medical care early to reduce the risk of developing a more severe infection and be sure to share your recent travel history with your health care provider.

FAQs for Patients with Hypertension, Diabetes and Heart Diseases in view of Coronavirus/COVID-19 Pandemic

1. Are patients with heart disease, diabetes, or hypertension at increased risk to get coronavirus infection?

No, people with hypertension, diabetes, or heart diseases are at no greater risk of getting the infection than anyone else.

2. Among people with the above diseases is there an increased risk of severe illness or complications once infected?

The majority (80%) of people diagnosed with COVID-19 will have mild symptoms of a respiratory infection (fever, sore throat, cough) and make full recovery. Some of the people with diabetes, hypertension, and heart diseases including Heart Failure (weak heart) may develop more severe symptoms and complications. Therefore, extra care is advised for these patients.

3. Are people with diabetes more prone to COVID-19?

In general, you know that people with uncontrolled diabetes are at increased risk of all infections. People with diabetes are not at higher risk for acquiring the infection, but some individuals are prone to more severe disease and poorer outcomes once infected. Hence, follow your diet and exercise routine (to the extent possible), take your medications regularly, and test your sugar levels frequently to keep your diabetes under control. When diabetic patients become sick, they may require frequent monitoring of blood glucose and adjustment of drugs including insulin, small frequent meals, and adequate fluids.

Some tips for those with diabetes, hypertension, and heart disease:

Take your medicines regularly - It is very important

Make sure that you take all medications prescribed regularly as before even if you are mildly symptomatic. Do not stop any medication unless advised by your doctor. Continue with your blood pressure, diabetes, and heart disease medications in case you are unable to visit your doctor. Medications to control cholesterol (statins) should be continued.

4. What about reports about BP medications increasing severity of COVID-19?

After review of available information, the consensus of various scientific societies and expert group of cardiologists is that currently there is no evidence that the two group of drugs- ACE inhibitors (e.g. Ramipril, Enalapril and so on) and angiotensin receptor blockers (ARBs) (e.g. Losartan, Telmisartan and so on) increase the susceptibility or severity of COVID-19. These drugs are very effective for heart failure by supporting your heart function and controlling high blood pressure. It is harmful to stop these medications by yourself. This can worsen your heart condition.

5. What can I take pain or fever?

Some type of pain killers (called NSAIDs) like Ibuprofen is found to worsen the COVID-19. Such drugs are known to be harmful to heart failure patients and may increase your risk of kidney damage. Avoid NSAIDs or take them only when prescribed by your doctor. Paracetamol is one of the safest pain killers to use if needed.

6. Control blood pressure (BP), blood sugar, and do regular physical activity?

It is also important to control your risk factor levels – Avoid smoking and alcohol, have your BP and blood sugar levels under control, and have some form of regular physical activity (However, please modify your out-door activities according to the norms of social-distancing.). Follow the diet and salt restriction as advised. If you are a non-vegetarian, you can continue to be so. Increasing the fiber and protein content of the diet and more vegetables and fruits in diet is advisable.

7. What should I do if I get symptoms suggestive of COVID-19?

In case you get a fever, cough, muscle pain without shortness of breath, call your doctor, and seek advice on the phone. You need to stay at home (at least for 14 days) and avoid close contact with other family members and maintain hand hygiene and correctly wear a medical mask. If there is shortness of breath or worsening symptoms like excessive fatigue call/visit your doctor (further advice will depend on the advice of your physician)

8. What should you do to prevent COVID19?

COVID-19 is spread by coughs and sneezes, through what are called droplets (tiny amount saliva or other secretions expressed through cough/sneezing or even after a hearty laugh) and through touch. When you touch an object that has the virus particles on it, the virus may get onto your hands and when you touch your face, you may get infected. Virus particles can persist up to 3 days and therefore it is important to maintain the hygiene of your surroundings. Wash the rooms, tables, and other surfaces with floor cleaners or even simple soap solution and sanitize your hands with hand sanitizers or by washing when you touch unknown or suspicious surfaces.

9. What are the important steps you can do to prevent acquiring or spreading infection?

1. Social distancing – Very important.

A. Avoid contact with someone who shows symptoms of possible COVID-19 - anyone having a cold or cough or fever. B. Avoid non-essential travel and use of public transport.

C. Avoid public places, crowds, and large family get-togethers. Keep in touch with friends and relatives using the phone, internet, and social media.

D. Avoid routine visits to hospitals/labs. for minor problems, contact the hospital or HF clinic by phone through helpline number, if possible. If you are regularly checking INR and adjusting blood-thinning medicines, please contact the doctor over the phone if possible and try and avoid a hospital as much as possible.

2. Hand hygiene

A. Avoid handshakes and touching face with hands

B. Wash your hands with soap and water frequently – do this for at least 20-30 seconds and systematically to clean all parts of the hand

C. Alcohol-based hand-sanitisers are also useful.

D. Avoid touching possibly contaminated areas/objects – Public toilet doors, door handles, etc.

Source – WHO, MOHFW- Ministry of health and family welfare, & ICMR- Indian council of Medical Research

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