'It's important to understand that Remdesivir isn't magic bullet and isn't a drug that decreases mortality. We may use it as we don't have an anti-viral drug,' says Dr Randeep Guleria in an interview
As India reels under the massive surge of Covid-19 cases in the second wave of the pandemic, the All India Institute of Medical Sciences (AIIMS) Delhi director Dr Randeep Guleria highlighted some pertinent points of Covid management in the country.
In an interview, AIIMS chief spoke at length about the treatment of Covid-19 through drugs, steroids and CT scans.
Highlighting the usage of the anti-viral drug Remdesivir, Guleria informed, "It's important to understand that Remdesivir isn't magic bullet and isn't a drug that decreases mortality. We may use it as we don't have an anti-viral drug. It's of no use if given early to asymptomatic individuals/ones with mild symptoms. Also of no use, if given late," according to news agency ANI.
Moreover, he added that Remdesivir should only be given to patients who are hospitalised, have a fall in oxygen saturation and have infiltrates on the chest X-ray or CT-scan.
The comments come amid several states reporting a shortage of the Remdesivir drug, injection and oxygen cylinders in order to treat Covid-19 patients. In view of the overwhelming demand, drug manufacturers in the country also recently slashed the price of the Remdesivir injections after government's interventio
"Recovery trials showed that steroids will benefit but it's also important to know when they're given. If given early before your saturation (O2) falls, it has harmful effect. COVID patients who got steroids early had higher mortality than those who didn't. It is of no use if steroids are given on day 1. They are useful only in moderate to severe illness when oxygen saturation is falling," he further added.
Guleria also explained key points from Covid-19 management from last year.
According to the AIIMS director, in the last one year, there are two important learnings from treatment of Covid-19. "We have learnt that 2 things are most important – drugs and timing of drugs," he said.
"If you give them too early or late, it would cause harm. Giving cocktail of drugs on day 1 can kill your patient and would be more harmful," elaborated Guleria to ANI.
Meanwhile, India's top experts on Monday said RT-PCR tests detect coronavirus in around 80 per cent of the cases, so clinical features and CT scans/chest X-rays should be used to rule out false negatives in symptomatic patients followed by a repeat test after 24 hours.
Amid SARS COV-2 'variants of concern' circulating, they said RT-PCR tests do not miss mutations as the ones being used in India target more than two genes.
According to government data till April 15, a total of 1,189 samples have tested positive for 'variants of concern' of SARS COV-2 in India which include 1,109 samples with the UK variant, 79 samples with South African variant and one sample with the Brazil variant.
Based on ICMR data, the current variants are also being picked up by the RT-PCR tests. The RT-PCR test has sensitivity of around 80 per cent and therefore 20 per cent of the cases can still be missed out.
"Also, if the sample is not properly taken or if the test is done too early when the viral load is low, it may come out negative. So, if a person is symptomatic, a combination of clinical features, laboratory reports, CT/chest X-ray can be used for presumptive diagnosis of COVID-19 and treatment should be started accordingly. The test should also be repeated after 24 hours," AIIMS Director Dr Randeep Guleria told PTI.
According to the Health Ministry, India reported 2,73,810 new COVID-19 cases, taking the total number of positive cases in the country to 1,50,61,919. There are currently 19,29,329 active cases in the country as of Monday.
The death toll reached 1,78,769 with additional 1,619 fatalities.
In the last 24 hours, as many as 1,44,178 people recovered from the virus. With this, the total number of recoveries reached 1,29,53,821 in India.
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