Evolving Covid care

Of late, remdesivir, an intravenous anti-viral drug that showed effectiveness and was first recommended in the US, has been conditionally included in India’s Covid care management protocol under medical supervision. It is not advisable for patients with signs of liver and kidney impairment, pregnant mothers, and children below 12 years. Even as the licensed manufacturers are ramping up its production, it is shameful that the costly medicine (in thousands of rupees) has been hoarded and sold at prices jacked up by five to 10 times. The cost factor has, sadly, deterred states like Punjab to go a bit slow in its use and make do with the cheaper dexamethasone.

Pending a vaccine, the past five months have seen the medical fraternity experimenting and trying to combat Covid-19 by focusing on treating the symptoms in the best possible manner so as to give supportive relief to the patients and reduce their hospital stay and mortality rate. The scenario is evolving rapidly as hundreds of clinical trials and studies — none of which as of today stands 100 per cent scrutiny— are being conducted the world over. This dynamic situation has warranted that the medical bodies monitoring the situation regularly send out clear guidelines on the mandatory procedure for treatment based on the latest developments in the field, to the states and nodal hospitals, which pass on the protocol down to the district levels.

In a change of strategy in May, the ICMR directed that asymptomatic patients or those with mild symptoms and no comorbidity did not need hospitalisation as they could be treated at home. In hospitals, the use of ventilators has also seen a downward revision for the not so critical patients, for whom the preferred the mode of oxygen supply is now non-invasive. Doctors have also wised up to the benefits of proning and recommend it early on. Medication suggested includes hydroxychloroquine and plasma therapy, depending on the patient’s condition. Indeed, the healthcare workers need to be on their toes and keep themselves abreast of any breakthroughs till the scientists’ quest for the magic bullet yields result.

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