Senior Pulmonologist Sits Down With Karnataka Health Minister For FAQ On Remdesivir And Other Covid-19-Related Drugs; Details Here

As reports of shortage, hoarding and black marketing of Remdesivir kept making headlines, Karnataka's Ministry of Health clarified that there would be no shortage of the drug in the state.

But, is the drug a ‘wonder drug’ or an indispensable one in the battle against the Covid-19 pandemic?

Does everyone need to be administered Remdesivir?

In a bid to answer these questions that are haunting people as well as to quell the hype around the drug, Karnataka Minister for Health and Medical Education, K Sudhakar, on Thursday at a press meet interacted with Chief of Pulmonology and Critical Care at Apollo Hospitals in Bangalore, Dr Ravindra Mehta, seeking clarifications about it.

Here are excerpts from the conversation:

“Everybody is obsessed or very concerned that Remdesivir has become like a magical drug to treat Covid. How important is it?” asked Sudhakar, adding that, although he isn’t a practising doctor, his reading of the WHO guidelines showed that the drug was taken off the treatment protocol.

“Why then in India are people panicking and obsessed with this drug?”

“Of the last 15 months of dealing with Covid and the use of Remdesivir, some key points can be made. First, earlier it was believed by the WHO that is an effective anti-viral drug, while now it is being doubted. But there will always be differences between a health body like that and clinical practitioners,” explained Dr Mehta.

"Secondly, who needs to be administered the drug — it is now indicated that only moderate to severe disease cases — which means the disease has reached a point where the oxygen level is dipping (93 and below) and it is indicated only in the early part of the diseases — that is the first nine to 10 days — from the day one of having the disease and not the day of testing or when you get the reports.

"We should also remember that we are a naturopathic country. When attacked by a virus, our immune system takes over — that is our first protection. But if the virus turns out to be stronger, with the symptoms persisting and lowering the oxygen levels, then Remdesivir is an add-on therapy. It can help in improving our condition".

Dr Sudhakar then sought to know who should not be administered the drug or doesn’t need it.

To this, Dr Mehta replied explaining that for people who have the symptoms in the first nine days but have good oxygen levels, including those who have other ailments like diabetes, blood pressure or heart ailments "do not require Remdesivir".

And if after 10 days, symptoms like fever are seen, then Remdesivir can do no help. Even if your oxygen falls after 10 days, Remdesivir will do nothing for your illness.

"But the problem is that our understanding of the disease and its handling last year around August was that the drug was mandated while currently it isn’t. If we understand this much, then there would be no need to rush to the stores and create this panic state of demand. Remdesivir will be effectively only when given to the right people at the right time".

“Only those with moderate to severe symptoms in the first nine days need Remdesivir. Nobody else needs it,” he emphasised, asking doctors as well as public to understand and ensure there is no shortage of the drug for those who "require it".

Addressing questions regarding the administration of steroids like Dexamethasone, Dr Mehta said that these too are to be used only day seven onwards.

"These are not to be used on day one. In most people, after day seven, if one still has active Covid-19 with low oxygen, either one gets hospitalised and has to be administered steroids or in the current scenario where we are struggling for beds, then doctors are advised to prescribe Dexamethoson, a simple tablet that doesn’t cost more than 50 paise to Re 1. Take one pill along with an antacid and that has the capability to change the course of Covid-19 within 24 to 48 hours for a lot of people".

A word of warning, said Dr Mehta, cautioning against administering the drug without adequate precaution. “Do not give it to people before day seven unless absolutely ‘indicative’ and the drug is to be only taken under the supervision of a medical doctor”. (emphasis added)