Only three therapies — oxygen, steroids and blood thinners — have shown strong and consistently positive impact in COVID-19 treatment, says Prof. Anjan Trikha, Chairperson, Clinical Managerial Group, Jai Prakash Narayan Apex Trauma Centre, Designated Covid Hospital AIIMS, Delhi. He also cautions against misuse of medicines, stating that abuse can cause more problems than benefits.
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The dynamic list of medicines and therapies for COVID-19 treatment and management of patients approved by the government has left the general public exhausted and confused. Medicines disappear from the markets or their costs escalate as soon as an announcement about their usefulness is made by the government. What then is the best course of action recommended?
No one alive today has seen a pandemic of this nature. We have had about 14-16 months of learning and research work that forms the backbone of all therapies and treatment modalities now being offered to the patients. The learning is dynamic as is the virus. Trials and changing treatment protocols are part of the situation that we find ourselves in today. But what we know now for certain is that oxygen (which is also a drug), steroids and blood thinners play a positive role in treating patients with COVID.
Even in these (oxygen/steroids/blood thinners), what to use and when to use it play a critical part. This is vital. There are specific indications on when to use which therapies. The rampant misuse and miscalculation of time of administration of drugs and therapies is also landing many of us at the hospital. We are seeing a rise in diseases associated with abuse of the drugs. People in India are exposed to a cocktail of medicines, therapies, home remedies and various Ayurvedic and homeopathic drugs that we are compelled to take because — simply put — we want to stay alive. Abuse/misuse of these cocktails sadly may have some very unwanted outcomes.
As for medicines and even medical equipment disappearing from the market…India is being punished for not having a robust control on sale of drugs and medical equipment. In many countries across the world, people can’t even buy antibiotics without prescription. India has laws, but the enforcement is an issue. What can’t also be ignored is the fact that a strained medical infrastructure and rise in COVID numbers and deaths do put tremendous pressure on the general public.
But, surely, we can’t blame the general public for opting to do everything they possibly can to tide over the second wave? The general public is worried about deaths even after two doses of vaccine.
Prevention continues to be the best cure. This is to be done through vaccination and strictly following COVID-appropriate behaviour. This virus has shown that no person from any socio-economic strata is safe. Yes, we have patients in the ICU who have had two doses of COVID vaccine but then what the general public has to realise is that these vaccines have also ensured that several who could have had very poor outcomes of COVID have shown mild to moderate form of the disease.
I would also appeal to the general public to not put pressure on your treating doctors for a particular drug or therapy. Don’t go by the posts on social media on treatment protocol. Let your doctor take the call. Not everyone needs [to go to] a hospital, not everyone will end up in the ICU; in fact, 80% people will have a mild variety of the virus. The disease is new and self-treatment has to be avoided at all costs.
The general public has to understand that the timing of giving drugs is essential in treating this virus. Like in the case of steroids….if given in the first week of the disease, they are actually counterproductive. So, the general public must go with the medical advice.
There is now talk about a third wave and further mutation in the virus. Does this mean that we will never be able to go back to the pre-COVID times?
Nobody can accurately predict the trajectory that this virus will take. The previously known disease patterns, etc. are only indicative of the possible road that the virus will take. They are known to have spike, plateau and a dip and a spike again. Masks and COVID-appropriate behaviour are definitely here to stay for the next couple of years. Also, people need to know that while mutations in a virus are a known phenomenon it always need not be for the worse.
But having said that, we don’t want to find ourselves in the same state as we were in the second wave and have to work with the government to ensure that if a third wave comes it is not able to wreak havoc. Mental health of children, meanwhile, is now emerging as an area of grave concern. This needs urgent attention.
