THURSDAY, APRIL 25, 2024
DR OSCAR REBELO
Unless you have been living under a rock, chances are that you must have noticed a sense of utter panic that has gripped Goa, since the last 10 days. And when panic grips the land, common sense goes on a hike. At the rate our government has been changing SOPs, no mother must have changed as many diapers of a child with acute cholera. When Goa was in the green zone, all was calm, composed and confident. Now that cluster upon cluster starts pounding us, everyone is in a tizzy.This is not to suggest that our epidemiologists and health department are not working round the clock, and with complete sincerity. It’s just that the dam has burst so furiously that putting a finger in the dyke is not going to stop the flood. Quarantine, Isolation, Contact tracing, is what we are all familiar with. God, if there's one, only knows how effective this is.I would like to focus on Hydroxy chloroquine.Somehow the Trump drug has been drowned out in the cacophony. Here is my familiar litany on this drug, particularly relevant to our surge in Goa. - Didier Raoult, a French physician from Marseilles, was the first to suggest HCQS and AZT as treatment for early Covid- 19, and he emphatically claimed that the combination definitely prevented patients turning serious.Predictably this was rubbished as the work of a madman, a maverick. A cheap drug like HCQS (each tab costs 10 rupees not dollars ) could not possibly work for a glamorous, high-profile disease like COVID-19.How dare it.- So a massive and now proven dubious study published in the gospels of medicine, The Lancet, and The New England Journal of Medicine by an organisation called Surgisphere, utterly threw HCQS in the trash can, claiming it killed thousands by inducing a fatal heart arrhythmia. - To the extent that Richard Horton, editor of Lancet, while apologising for gross oversight in reviewing the afore-mentioned article said: “Pharma companies are so powerful that they are able to pressurise us to accept papers that are methodically correct, but draw conclusions that pharma companies want...” Criminal.- Big pharma couldn’t afford to have an off-patent, cheap molecule like HCQS, hog the limelight. To cut to the chase then. - The one and only thing all of us doctors in Goa, and my guess across the country, share with the disgusting orangutan Trump is: We all take HCQS from the month of April, mind you. The one attribute of Trump is that, like a cockroach, he knows how to survive. - The ICMR (our Indian Council of Medical Research) mercifully, not hijacked by big pharma, is unequivocal and categorical in its recommendations: With informed consent, all frontline workers must take HCQS weekly as a prophylactic. There are caveats of course, including G6PD deficiency, retinopathy and cardiac issues where the drug may be contraindicated or require strict monitoring.
- It also recommends that asymptomatic contacts of Covid- 19 patients get on to HCQS with a medical prescription and monitoring.- And finally a casual observation which may not hold water but needs to be explored. Doctors and nurses in India may have been infected, but there have been no wave of deaths among them as in the US/UK/Europe. Could HCQS be the answer?
In India you have had a large number of brave cops and sanitation workers succumbing. Are they not being prescribed HCQs? Or are they careless in adhering to protocol? Can we check whether all health workers connected to Mangor took their HCQs regularly?In sum, HCQS is by no means a magic bullet. This virus is too bloody smart for that. But then, a drowning man should cling to some rope, however, flimsy its life-saving potential may be.Is HCQs an ally then? Most certainly! And as Goa gets encircled in this gladiatorial contest, our gladiators must at least remember to use their shield once a week, without fail.POST SCRIPTThere are another two allies we have in Goa during our gloomy, pandemic times. Rajdeep Naik, talking to his imaginary Vasanti and Succorina Fernandes. Their short takes on you-tube are a hoot. You will seriously cramp up laughing at their antics. Pure genius. HCQS and a few laughs. Maybe that’s all we are left with, as Goa deals with its month of reckoning.
