According to health experts, the recommendation of Tocilizumab for severely ill COVID patients is not part of the clinical management protocols for COVID-19 patients. Moreover, a study by the New England Journal of Medicine revealed Tocilizumab was not effective in preventing intubation or death in moderately ill hospitalised patients. ‘Some benefit or harm cannot be ruled out, however, because the confidence intervals for efficacy comparisons were wide,’ the study concluded.
Owing to low research evidence on the effectiveness of Ivermectin in the case of COVID patients, the drug was recently ruled out. The World Health Organisation had stated that the current evidence on the use of Ivermectin to treat COVID patients is inconclusive. The expert committee members of WHO also objected to the use of the anti-parasitic drug for such patients.The new guidelines also rule out plasma therapy as the PLACID trial done to find the effectiveness of plasma in the treatment of COVID did not show any benefits in the patients but, in turn, was harmful in certain cases.
As per ICMR guidelines, plasma was not associated with reduction in mortality or progression to severe COVID-19. The trial failed to find benefits of the plasma therapy and was thus not recommended for corona patients. However, SOS calls and messages for the requirement of plasma continue to circulate upon recommendation of doctors in private hospitals.
The Director of Public Health and Preventive Medicine Dr TS Selvavinayagam said that the drugs recommended as part of the protocol are being followed in government hospitals and private hospitals should also adhere to them. “However, particular cases that require specialised treatment due to other medical conditions are exceptional,” he said.
Remdesivir useful only in early stages, say doctors
The frantic rush for Remdesivir at hospitals across the state and sheer number of cases police book against those selling the anti-viral in black market has resulted in state deciding to book offenders under Goondas Act.
But, experts point out that the drug is not effective in all cases and does not even find a place in the case management protocol by the state.
“Remdesivir was developed to treat Hepatitis C. The antiviral drug was approved for the treatment of COVID-19 by the World Health Organisation for treatment of sars-cov-2,” said Emergency Physician at the Tiruchy Government Hospital Dr A Mohamed Hakkim.
“Remdesivir is given in the initial replicative stage and it is effective in the first few days of the infection. However, due to ignorance and lack of awareness, most of the patients do not reach the hospitals on time and also remain unclear on the history of symptoms. This leads to mismanagement,” said Dr K Shanmuganandan, Immunologist and Professor of General Medicine at Dr Rela Hospital.
“The current hype over Remdesivir and black-market price of the said drug is unwarranted,” added Dr Hakkim.