The
numbers are increasing
like the score at a cricket match featuring Viv Richards and Sachin Tendulkar
batting at the crease. The number of deaths in the country as of this evening
is set to cross sixteen thousand plus comfortably. The fight and the race for a
cure is on and is being egged on by various governments and organisations. News
on the website of an international media website revealed that a cheap and
widely available drug could possibly help save the lives of patients seriously
ill with coronavirus.
According to experts in the UK, dexamethasone
a steroid given in low doses could be a major breakthrough in the fight against
the virus. According to researchers, it
reduces the risk of death by a third for patients on ventilators and for those
on oxygen, it cut deaths by a fifth.
What is
relevant for a country like India which is not as rich as the countries in the
west is that it is cheap. High-risk patients can be helped by this drug. According to doctors contacted in Goa, the
drug is already being used to reduce inflammation in a range of other conditions,
including arthritis, asthma, and some skin conditions. Dr. Noel Britto medical
superintendent of Healthway Hospital said the drug helps to stop the
overreaction called a cytokine storm which is caused by damage that is caused
to the immune system when it goes into overdrive.
Reactions to this drug have been varied from
medical professionals in the state. A senior member of the pharma industry who
spoke on the condition of anonymity said dexamethasone was not a new drug. The
drug, this person said was around fifty-two years old and was even being made
in Goa by a pharma major. The steroid helped accelerate the reaction and was
used for various uses. The senior pharma executive went on to say that it was
very possible the virals of COVID had possibly mutated and this had ensured
that it was less virulent in India with just 3.5 percent mortality rate whereas
in Italy it was ten percent.
Dr. Shekhar Salkar of Manipal Hospital
reconfirmed the facts presented by the pharma executive. He said “It has been
around for a very long time. It has been used in treatments of various
ailments. One however has to be careful. It can worsen diabetes. It has to be
used very carefully for very serious patients”. The drug he said was not
curative but was used to support the body. It would decrease the inflammatory
action.
Another senior medical professional, Dr. Eric
Britto said “We are possibly immune because we have faced various epidemics
over the past 100 yrs. Perhaps our body is immune to these infections. Also,
remember we have all received the BCG vaccine and perhaps it could be a
hypothesis that it is due to these reasons we have not seen the spate of
deaths. We have guidelines and available literature which was written following
the post-mortems in Italy”.
He went on to say the country and the world
generally was generally following the PALM treatment protocol for COVID*. P
stands for prone position (lying on the stomach), A for avoiding activity, L
for low molecular weight heparin, and M for Methylprednisolone.
Prone position may seem like an ordinary thing
but it is very useful for the management of COVID. Oxygenation is improved in
the lungs and becomes better oxygenated. The other most important thing to
watch for COVID patients is activity. The patient may not know that he has hypoxia.
Despite having hypoxia, he may not have breathlessness, he may continue to do
his regular activities. These activities tend to further increase hypoxia and
the patient may suddenly collapse. That is the reason to avoid activity.
Methylprednisolone is used whenever lung lesion and low blood pressure or low
oxygen saturation (below 80-85%) and have some evidence for pro-inflammatory
markers e.g. raised CRP, serum serotonin, interleukin-6 etc. There are localised pulmonary thrombotic
microangiopathy. Low molecular weight heparin releases the block in the lungs,
thereby leading to better oxygenation. COVID is a relatively new disease, there
is no definite protocol.
Dr. Eric Britto said everything is under trial
and there was no definitive cure. He said “ Only AIDS now has a definitive
medicine otherwise none of the other virals have any cure. It is an ongoing
process and we have to get the cure”
One can only hope, that day is not too far away.
