Centre may review HCQ use for Covid
nNEWDELHI:INDIA could be taking a relook at the use of the anti-malarial drug hydroxychloroquine (HCQ) for treatment of Covid-19 after the World Health Organisation on Saturday announced that it had discontinued HCQ clinical trials because it did not reduce mortality in hospitalized patients, based on interim trials.
India uses HCQ as a prominent drug not just for the treatment of Covid-19 patients, but also as a prophylaxis (for prevention) medicine for use among frontline workers involved in managing Covid-19 patients or close contacts of a laboratory positive case.
“Covid-19 is a new disease and it is an extremely dynamic situation that we are dealing with, and newer data is constantly being generated. What we knew of the virus’ behaviour say a couple of months ago has undergone a sea change now, and same is applicable for the drugs and other treatment modalities being given to the patients,” said one of the members of the National Task Force constituted by the Indian Council of Medical Research (ICMR), to tackle the pandemic. The person requested anonymity
The evidence generated from across the globe is being constantly scrutinized by experts here and guidelines and protocols are being revised accordingly. The experts will be reviewing the guidelines and protocols and if they feel a need for a revision, they will change them, the member added.
The recommended dosage for HCQ is 400mg twice a day for one day, followed by 200mg twice a day for four days; and for treatment it was being given along with antibiotic azithromycin, as part of the Union health ministry protocol on Covid management.
“When you start a drug for a condition based on some evidence then there is a need for even stronger evidence to withdraw that drug. Science works on evidence,” Dr RR Gangakhedkar, ICMR’S former epidemiology head said about the HCQ controversy earlier.
A section of doctors has been saying that more evidence was required to keep the drug a part of the treatment protocol for Covid-19 management.
Based on its Solidarity Trial’s International Steering Committee recommendations, WHO also discontinued the trial’s Lopinavir and Ritonavir arms for the same reason. Both these drugs are antivirals meant for HIV/ AIDS treatment, and had shown promise initially in treating Covid-19. India dropped these medicines from its list of drugs to treat Covid-positive cases in April.
“These were initially being given under the emergency use authorization but later ICMR had withdrawn these drugs from the regimen as the results weren’t really great,” said an official of the Union health ministry, requesting anonymity.
ICMR has also collaborated with WHO in the public health emergency Solidarity Trial – an international randomised trial of additional treatments for Covid-19 in hospitalised patients, and will be stopping these arms of the trial.
“It is a WHO trial and the rules are governed by them. Since they have suspended these arms of the trial, it will obviously be suspended at trial sites in India also,” said an ICMR official, requesting anonymity.
nMUMBAI:AS a non-practising medical doctor, Dipannita Kaushik decided she had to pitch in as the coronavirus pandemic raged across the globe. So the 29-yearold from Guwahati, Assam, who is currently pursuing a Masters in public health, decided to make face shields and masks for workers on the frontline with the help of her mother and her fiancé, reusing old X-ray and projector sheets.
“I know what it’s like to not have proper gear, even in ordinary times,” said Kaushik, who has served as a resident at an Apollo hospital and at Pratiksha Hospital in Assam.
“During an outbreak like this one, I can’t even imagine the risks. Often the most underequipped and severely affected are the Asha [accredited social health activists], multipurpose health workers and anganwadi workers who are actually doing the grass root data collection and who act as a bridge between the healthcare community and the population. So I wanted to do this for them.”
Kaushik’s mother, Simarekha Bhagowati, 56, a college professor, had plenty of old OHP sheets lying around, leftovers from Math lectures in earlier decades. They use multiple strips of the stiff X-ray sheets to make each frame; the projector films form the veil.
Kaushik’s fiancé, Tuhin Bhuyan, 28, a software engineer, helps put the shields together using craft glue. Her mother pitches in with the masks, on their sewing machine.
Their first batch of 40 masks and shields was ready by the first week of April. “The second part of my job was to reach the right people,” Kaushik said. She contacted Dr Santimoyee Barua, the surveillance medical officer at the ministry of health and family welfare in Guwahati, who said she would be glad to have the consignment.
The second batch was ready by the middle of May and went to Dr Nabin Bhuyan, medical superintendent at the Morigaon Civil Hospital, a designated facility for Covid-positive cases.
“Such quick thinking can be life-saving,” said Barua. “The shields especially, because of the greater protection they offer, are very useful to the Asha and multipurpose workers who are out in the field, tracing suspected Covid-19 infections.”
DIPANNITA KAUSHIK