No evidence of the young being at greater risk in ongoing COVID wave: ICMR

Aditi Tandon

Tribune News Service

New Delhi, April 19

India’s apex medical research body ICMR on Monday shared data from hospitalised COVID patients during the first and the second wave of the pandemic, saying that there is no evidence of the younger population being at greater risk in the ongoing wave and that the proportion of death in the hospitalised patients also hasn’t changed between the two spells.

What has changed is more hospitalised patients (47.5 pc) reporting shortness of breath in the second wave than in the first (41.7 pc), significantly raising the requirement of supplemental oxygen in the country in the ongoing wave.

Also more asymptomatic people have been admitted to hospitals in the second wave, of which the ICMR has done interim analysis and larger studies are ongoing.

More than 70 per cent of the hospitalised COVID patients in both waves have been over 40 years old, data from 9,485 patients (6,642 between September and November 2020 and 1,405 between March and April 2021) shows.

Only marginally higher number of youth (0 to 18 years) have been hospitalised this time — 5.8 per cent as against 4.2 per cent last year despite the opening up of economic activities, the ICMR study says.

Even the Integrated Disease Surveillance Programme data, which the Member Health NITI Aayog today shared, shows 31 per cent of the 49,000 COVID infected last year were under 30 years as against 32 per cent among 50,000 positive persons this time.

“The proportion of 30- to 40-year-olds has remained static at 21 per cent between the two waves. The conclusion is that there is no overarching extra risk to the youth of becoming COVID positive this time. There has been no shift in the age prevalence of COVID in India. The older people continue to be more vulnerable,” Paul said today.

The government experts also came out to caution people against irrational use of Remdesivir noting that no study in the world had shown it reduced mortality.

“Remdesivir is only to be used in moderately ill COVID patients who are hospitalised, and have very low oxygen levels and lung damage. It is of no use in mild patients. In fact, UK has only given paracetamol, hydration and multi-vitamins to mild patients and that’s the way management,” AIIMS-New Delhi Director Randeep Guleria said, noting that Remdesivir was no magic bullet and this anti-viral injection was not meant to be taken at home.

On plasma therapy, the AIIMS Director said large studies in India had shown it was not useful in COVID patients.

On Tocilizumab, he said it was meant for severely ill COVID patients in whom cytokine storm had set in and no other treatment— steroids, anti-coagulants, etc — was working.

Paul also said people must understand Remdesivir was not a mainstay drug for COVID and was used in hospitalised patients only because no other effective anti viral was available.

“Remdesivir is an experimental drug cleared for emergency use. It is not to be taken in home settings,” said Paul.

The experts’ message to people with mild illness was not to panic and to follow basic home management.

ICMR chief Balram Bhargava said oxygen remained critical to COVID management and its use has increased because several people got admitted to hospitals out of panic.

Medical oxygen availability was being ramped up across India, said Paul.

All about Covid drugs

Mild patients will recover at home with paracetamol, hydration, multi vitamins

Remdesivir: No magic bullet; useful only in hospitalised patients with low oxygen; doesn’t reduce deaths; of no use in mild patients

Steroids: Useful in moderate to severely ill, but must be given at the right time, mortality is higher if given before oxygen levels fall too low

Plasma: No evidence that it’s useful

Tocilizumab: Needed in less than 2 per cent Covid patients who are severely ill and in whom steroids and other drugs have stopped working

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