INVESTIGATIVE CASE STUDY

A typical public health investigative medical history ( as investigative journalism). 

Such community spread increases work burden on all healthcare professionals and financial burden on Governments, indirectly on the whole nation. 

Let us adhere to advisory by public health department.

[3/23, 10:53] PGBalakrishnan2: 🛑 *All.. read it carefully* 🛑

Patient name: Anita Vikas Gorad

Age: 41 years, Gender: female

No comorbidities

Occupation: Anganwadi sevika at Varasgaon 

Family: Husband Vikas Gorad

Daughter Priya Vikas Gorad

Son: Abhishek Vikas Gorad

Case history:

3rd March- travel to Vashi in cab for wedding. 1500 guests at wedding, no-one had h/o foreign travel as per husband. 

4th March- return back to Pune by same cab. Taxi driver questioned- no h/o airport pickup/foreigner traveller in month of February. He is Asymptomatic.

6th March- travel to Velha for meeting. Unknown number of contacts there. 

7th March- asymptomatic

8th March- sore throat, dry cough. No relief with inhalation and gargles. Was at home all day. 

9th March- felt unwell, feverish, visited local GP at Shree Clinic- Dr. Rajendra Bhosale. Many patients and 1 receptionist at clinic waiting room. Advised symptomatic treatment. 

10th- cough increased, stayed at home

11th- felt marginally better

12th March- travel to Varasgaon Anganwadi via Jeep (public). Came in contact with 10 women, 1 man and 8 children. Visited in-laws place (contact-mother in law, father in law, brother in law and sister in law)

Returned home in jeep car. 

13th March- travelled again to Varasgaon Anganwadi by jeep car. Felt shortness of breath. Travelled back by public BUS. 

14th March- visited Shree Clinic- again. Many patients+ receptionist+ Dr. Rajendra Bhosale. Symptomatic treatment advised, no relief. 

15th March- relatives visited her at home- Shobha Padwal, sangeeta Kadu, manoj sadhte, aniket Pawale. Couldn't complete sentences due to breathlessness. 

16th March 11am- admitted at Jagtap hospital Sinhagad road

Taken there by mother Muktabai Tulsiram Sashte, Tanaji dhondiba sathe and rickshaw driver Vitthal dattatray Gorad. 

Clinic room contacts- asst doctor, 2 nurses. Xray technician. Admitted in ICU BED 201, Chest xray suggestive of viral pneumonia. Started on antibiotics + antiviral. 

Worsening breathing so shifted to Bharati hospital on 16th March night. 

Admitted at Bharati on 16th night in isolation ward of ICU. initially maintained oxygen saturation on O2 by nasal prongs. Chest xray bilateral fluffy infiltrates most likely viral infection. Started on antibiotics + antiviral oseltamivir.

Swab sent for H1N1 to NIV on 17th March morning. Came back negative. 

19th night, gradual clinical worsening. 

20th March 9.30am- elective intubation and on ventilator since then. 

Got email from NIV on 20th afternoon that she has tested positive for COVID-19.

Symptomatic close contacts-

Daughter Priya

Son- Abhishek

Mother- Muktabai 

Niece- Ankita Pawale.

Forwarded 

This is classic example

one pt creating minimum 100 pts

This is community spread

*Please all read carefully *

*Lesson to be learned*

*Don’t go outside*