Centre sends teams to 50 municipalities showing COVID19 surge

Medibulletin Desk
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Centre sends teams to 50 municipalities showing COVID19 surge

Special central teams have been despatched to 50 municipalities where there is a sudden surge in COVID cases

Ministry of health and family welfare has deployed high level multi-disciplinary Central teams to 15 States/UTs with more than 50 districts/municipal bodies that are witnessing high case load and high spurt of cases to assist the State Governments by providing technical support for containment and facilitate management of COVID-19 outbreak. These States/UTs are:Maharashtra (7 districts/municipalities), Telangana (4), Tamil Nadu (7), Rajasthan (5), Assam (6), Haryana (4), Gujarat (3), Karnataka (4), Uttarakhand (3), Madhya Pradesh (5), West Bengal (3), Delhi (3), Bihar (4), Uttar Pradesh (4), and Odisha (5).
The districts are  Akola, Jalgaon, Raigad, Kolhapur, Satara, Aurangabad, Solapur, Plghar, Pune and Thane in Maharashtra, Hyderabad (Telangana), Madurai, Kallakurichi, Tuticorin, Tirunelveli, Ariyalur, Villupuram, Kanchipuram, Cuddalore, Tiruvannamalai and Thiruvallur in Tamil Nadu, Udaipur, Jhalawar, KOta, Nagaur, Pali, Jodhpur in Rajasthan, Faridabad and Gurugram in Haryana, Vadodara and Surat in Gujarat, Anantnag, Kupwara, Kulgam in Jammu &Kashmir, Madya and Yadgir in Karnataka, Nainital (Uttarakhand) and Ujjain (Madhya Pradesh).
COVID19
Shortage of hospital beds is one of the challenges in COVID19
 
The three-member teams are composed of two public health experts/epidemiologists/clinicians and a senior Joint Secretary level nodal officer for administrative handholding and improving governance. These teams are working in the field and visiting health care facilities to support the State health department in implementation of containment measures and efficient treatment/clinical management of cases within the districts/cities. In order to ensure better coordination, quick action on the ground, adoption of a more granular strategy, these districts/municipalities have been urged to regularly remain in touch with central teams which are already coordinating with the States.
Such frequent interaction would further strengthen the surveillance, containment, testing and treatment related action on the ground. The central teams are assisting the States/UTs in addressing some of the challenges such as testing bottlenecks, low tests/per million population,, high confirmation rates, high testing confirmation rate,  risk of capacity shortfall over the next two months, potential bed shortage, growing Case Fatality Rate, high doubling rate, sudden spike in active cases, etc. Many districts/municipalities have already formalised a dedicated Core Team at the district level comprising of district level medical and administrative officials to coordinate over regular basis with the Central Team.

COVID19 cess on tobacco can generate over Rs 49000 cr: health groups

Medibulletin Desk
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COVID19 cess on tobacco can generate over Rs 49000 cr: health groups

Public health groups have urged the GST council to put a special COVID19 cess on tobacco products, that could cover 29% of the stimulus package

 

Public health groups have urged the GST Council to consider a special COVID -19 cess on tobacco products to raise additional tax revenue needed to contribute to funding the COVID-19 stimulus package. They are appealing for a COVID cess on cigarettes, bidis and smokeless tobacco products that can provide revenue of Rs. 49,740 crores (497.4 billion) which could cover about 29% of the stimulus package.

Imposing COVID cess on all tobacco products will not only help raise the much needed revenue to fund the stimulus, it will also prevent the further spread of the virus especially amongst vulnerable populations by making tobacco products unaffordable and forcing them to quit. . Based on studies conducted in several countries, smokers and smokeless tobacco users may be at greater risk for severe illness when confronted with COVID-19 since it attacks the lungs and behaviors that weaken the lungs put individuals at greater risk.

COVID-19 appears to be one of the biggest economic shockers India may have ever experienced. Immense financial resources will be needed for the government to repair the damage caused by this pandemic. The Government of India has announced several stimulus measures (including a mega Rs. 20 lakh crore package) to revive the economy and to make India self-reliant. Among other programs, the Government has also announced in March, a Rs. 1.7 trillion ($22.6 billion) economic stimulus package providing direct cash transfers and food security measures to relieve millions of poor Indians hit by the nationwide lockdown over COVID-19.

According to Dr Rijo John, Economist & Health Policy Analyst, “Unprecedented financial resources will be needed for the country to recover from the economic shock COVID has created. Even though imposing additional taxes on the general public might not be a viable policy option when consumption needs to be boosted., special COVID cess on tobacco, could be a win-win as it will discourage tobacco consumption and reduce COVID related risks while bringing in substantial revenue for the government. A Rs. 1 COVID cess per stick of bidis and significant tax increases on cigarettes and smokeless tobacco products are expected to generate additional tax revenue to the tune of Rs. 50,000 crores.’’

 

  

Proposed COVID Cess on tobacco products and its Impact

Bidis Cigarettes Smokeless tobacco
Proposed COVID-19 cess Rs. 1 per stick Rs. 5 per stick 52%
Estimated additional cess revenue (Rs.) 233 billion 250 billion 13.5 billion
New total tax burden 67% 65% 70%
Estimated percentage decline in consumption 35% 17% 10%
Estimated percentage decline in prevalence 18% 10% 5%
Estimated decline in attributable deaths 9.1 million 3.4 million 7.2 million

 

Increasing taxes on all tobacco products will not only reduce their affordability and therefore consumption, but also to limit the increasing health and fatal damages caused by tobacco.  Tobacco smoking is a known risk factor for many respiratory infections and increases the severity of respiratory diseases. Early evidence from China and Italy has found that patients with underlying health conditions and risk factors, including smoking and diseases linked to smoking, may be at greater risk for severe outcomes or death from COVID-19.

“There is ample evidence about bidis being the killer and not the pleasure of the poor. These should be made unaffordable for the poor to save them from a lifetime of misery and suffering. Imposing cess on all tobacco products, including bidis, is a winning proposition for Government as it will provide the much needed additional tax revenue for COVID 19 stimulus package for providing relief to the people of the country while motivating millions of tobacco users to quit and preventing youngsters from initiating tobacco use,” Dr Harit Chaturvedi, Chairman of Max Institute of Cancer Care.

 

Heart injury associated with higher risk of death from COVID-19

Medibulletin Desk
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Heart injury associated with higher risk of death from COVID-19

Myocardial injury (heart muscle damage) is associated with higher risk of death among hospitalized COVID-19 patients 

Myocardial injury (heart muscle damage) is common among patients hospitalized with COVID-19 and is associated with higher risk of mortality, finds new study. A serious myocardial injury can triple the risk of death. Results were published in the Journal of the American College of Cardiology.

“We found that 36 percent of patients who were hospitalized with COVID-19 had elevated troponin levels – which represents heart injury – and were at higher risk of death,” said lead author Anu Lala, MD, Assistant Professor of Medicine (Cardiology) at the Icahn School of Medicine at Mount Sinai. These findings are consistent with reports from China and Europe.

Troponins are proteins that are released when the heart muscle becomes damaged and higher troponin levels mean greater heart damage. 

Investigators analyzed electronic health records of nearly 3,000 adult patients with confirmed positive COVID-19 admitted to five New York City hospitals within the Mount Sinai Health System between February 27 and April 12, 2020. The median age for patients analyzed was 66, and roughly 60 percent were male. Roughly 25 percent of the patients had a history of heart disease (including coronary artery disease, atrial fibrillation and heart failure) and roughly 25 percent had cardiovascular disease risk factors (including diabetes or hypertension).

Patients with higher troponin concentrations were associated with a three times higher risk of death compared to those with normal levels

Results showed that 36 percent of hospitalized COVID-19 patients had myocardial injury. For those with substantial injury, their risk of death was three times higher than COVID-19-positive patients without myocardial injury.

All patients had a blood test for this within 24 hours of admission and were grouped into three categories: 64 percent were in the normal range (0.00-0.03 ng/mL); 17 percent had mild elevation (between one and three times the upper limit of normal, or >0.03-0.09 ng/mL), and 19 percent had higher elevation (more than three times the upper limit of normal, or >0.09 ng/mL). Higher troponin levels were more prevalent in patients who were over 70 years old and had previously known conditions including diabetes, high blood pressure, atrial fibrillation, coronary artery disease and heart failure. 

After adjusting for factors including age, sex, body mass index, history of cardiovascular disease, medication, and illness at hospital admission, researchers found that patients with milder forms of myocardial injury were associated with lower likelihood of hospital discharge and a 75 percent higher risk of death compared to patients with normal levels. Patients with higher troponin concentrations were associated with a three times higher risk of death compared to those with normal levels. Additionally, when adjusting for relevant factors including heart disease, diabetes and high blood pressure, troponin was independently associated with risk of death. 

“The study concludes that myocardial injury is common among patients hospitalized with COVID -19 but is more often mild and associated with low-level troponin elevation. Despite low levels, even small amounts of heart injury could be linked to a pronounced risk of death, and COVID-19 patients with a history of cardiovascular disease are more likely to have myocardial injury when compared to patients without heart disease,” explained Dr. Lala.

Surge in COVID19 cases in 45 municipalities in 10 states: Govt takes stock

Medibulletin Desk
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Surge in COVID19 cases in 45 municipalities in 10 states: Govt takes stock

Health secretary Preeti Sudan holds review meeting with officials of 45 municipalities across the country that are showing a surge in COVID cases

 

Health secretary Preeti Sudan on Monday held a high level review meeting (through video conference) with the officials from 45 municipalities/municipal corporations across 38 districts in ten states, that are witnessing a surge in COVID-19 cases.

These districts are  Akola, Jalgaon, Raigad, Kolhapur, Satara, Aurangabad, Solapur, Plghar, Pune and Thane in Maharashtra, Hyderabad (Telangana), Madurai, Kallakurichi, Tuticorin, Tirunelveli, Ariyalur, Villupuram, Kanchipuram, Cuddalore, Tiruvannamalai and Thiruvallur in Tamil Nadu, Udaipur, Jhalawar, Kota, Nagaur, Pali, Jodhpur in Rajasthan, Faridabad and Gurugram in Haryana, Vadodara and Surat in Gujarat, Anantnag, Kupwara, Kulgam in Jammu &Kashmir, Madya and Yadgir in Karnataka, Nainital (Uttarakhand) and Ujjain (Madhya Pradesh).

The main issues discussed were the widespread infection in densely populated urban areas, with areas that shared public amenities; importance of house-to-house surveys; prompt testing followed by prompt isolation and clinical management of cases and containment strategy to be implemented.

To reduce the case fatality rate, the officials were briefed on measures to be taken like prioritising the high-risk and vulnerable segments like elderly people and people with co-morbidities

The State officials were advised on the measures to be taken in the containment zones for case management and buffer zones surveillance activities and promotion of COVID appropriate behaviour. To reduce the case fatality rate, the officials were briefed on measures to be taken like prioritising the high-risk and vulnerable segments like elderly people and people with co-morbidities while contact-tracing to prevent deaths; active surveillance measures, adequate testing and promoting health seeking behaviour for timely detection of cases; ensuring timely shifting of patients without escalating the symptoms.

With regards to the infrastructure and human resource management for the containment of COVID-19, it was advised that adequate planning for health infrastructure should be taken up; adequate number of surveillance teams to be provided; a system to be put in place for bed availability management; Centres of Excellence to provide hand-holding for medical professionals and senior officers to be deployed for hospitals to offer help to citizens to find health services as per their need.

While speaking on field governance, Municipal authorities were advised to take leadership and put the whole municipal infrastructure for containment measures using the ‘whole of Government approach’.  It was also highlighted that along with COVID-19 management efforts, care needs to be given to the regular and essential health services that are also available for the citizens.

Areas that need constant attention included active house-to-house survey for timely detection; augmentation of the survey teams; efficient ambulance management; efficient triaging of patients at the hospitals and bed management; clinical management of the hospitalised cases through rotational 24*7 teams to ensure reduction in the fatality rates they were also advised to ensure that the testing results were returned by the labs in time for ensuring early identification and timely treatment.

It was also suggested to involve the elected representatives in the rural areas for cooperating with the district health authorities for confidence building and timely accessing of available health services. States were reminded to activate the fever clinics for detection of SARI/ILI cases in the buffer zones. In view of the lockdown being eased and curbs being lifted, States were also advised to make a district wise prospective plan for the coming months.

Virus DNA spread to 50% of sites sampled across a hospital ward over 10 hours

Medibulletin Desk
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Virus DNA spread to 50% of sites sampled across a hospital ward over 10 hours

Virus DNA left on a hospital bed rail was found in nearly half of all sites sampled across a ward within 10 hours and persisted for at least five days, finds a new study 

Virus DNA left on a hospital bed rail was found in nearly half of all sites sampled across a ward within 10 hours and persisted for at least five days, according to a new study published in the Journal of Hospital Infection.

The study, aimed to safely simulate how SARS-CoV-2, the virus that causes Covid-19, may spread across surfaces in a hospital. Instead of using the SARS-CoV-2 virus, researchers artificially replicated a section of DNA from a plant-infecting virus at a similar concentration to SARS-CoV-2 copies found in infected patients’ respiratory samples.

Researchers placed the water containing this DNA on the handrail of a hospital bed in an isolation room and then sampled 44 sites across a hospital ward over the following five days. Isolation rooms are made for infected patients or high risk patients to prevent spread of infection.

this study is a significant reminder that healthcare workers and all visitors to a clinical setting can help stop its spread through strict hand hygiene, cleaning of surfaces, and proper use of personal protective equipment (PPE)

Researchers found that after 10 hours, the surrogate genetic material had spread to 41% of sites sampled across the hospital ward, from bed rails to door handles to arm rests in a waiting room to children’s toys and books in a play area. This increased to 59% of sites after three days, falling to 41% on the fifth day.

Dr Lena Ciric (UCL Civil, Environmental & Geomatic Engineering), a senior author of the study, said: “Our study shows the important role that surfaces play in the transmission of a virus and how critical it is to adhere to good hand hygiene and cleaning.

“Our surrogate was inoculated once to a single site, and was spread through the touching of surfaces by staff, patients and visitors. A person with SARS-CoV-2, though, will shed the virus on more than one site, through coughing, sneezing and touching surfaces.”

“Like SARS-CoV-2, the surrogate we used for the study could be removed with a disinfectant wipe or by washing hands with soap and water. Cleaning and handwashing represent our first line of defence against the virus and this study is a significant reminder that healthcare workers and all visitors to a clinical setting can help stop its spread through strict hand hygiene, cleaning of surfaces, and proper use of personal protective equipment (PPE),” added the authors.

 

WHO set to lose US funds; does it really matter to the world?

Dr. Anindya Dasgupta
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WHO set to lose US funds; does it really matter to the world?

Will US President Donald Trump’s decision to cut funding to the WHO have any real impact? Not unless he chooses to set up a parallel organisation

The World Health Organisation (WHO) was founded in 1948 when the world war II ended. It was given the mammoth task to promote world health. Since then WHO has been in frontline when it comes to HIV, Ebola, SARS – the list is quite long.

On 15 th April at the peak of COVID-19 crisis in the US, President Donald Trump announced his decision to halt all US funding to the WHO amounting to about $400M annually.

Well so what?

Even though famous Americans like Bill Gates did not find this move a good one and tweeted his disapproval, Trump remained steadfast on his decision. So, the question remains.

Incidentally WHO has a budget of around $ 5 Billion for 2020-2021 so even if the US does not fund it, it still has the remaining $4.6 Billion. So Trump’s announcement seems to be more symbolic rather than something that could deeply impact world health. Of course, before announcing his decision, Trump did criticize the WHO for taking the side of
China during the COVID crisis; but that was probably for the consumption of his domestic constituency more than the world.

What then is the future for WHO?

WHO has a long list of dedicated donors including countries like UK, Germany as well as NGOs like the Bill and Melinda Gates foundation, Rotary International to name a few. Clearly there are plenty of entities who would pay WHO handsomely for doing what is doing even though its biggest donor US backs out. Another factor to consider is that WHO is actually a monopoly, unless the US goes further to have its own version of WHO which seems too much of a stretch at the moment.

WHO is actually a monopoly, unless the US goes further to have its own version of WHO which seems too much of a stretch at the moment

So, the WHO does not have any  rivals at present because there are no significant
competitors. How about the causes for whom WHO directly spends the money it gets? At present WHO spends most money for Polio eradication, essential nutrition, vaccine preventable diseases, etc.

Prevention and controlling outbreaks like COVID19 is actually at the bottom of its top 10 list for funding. Clearly the demand for the actions of WHO is not going away anywhere soon as Polio, malnutrition remain big health threats and the world’s quest for effective vaccines will only become more ardent in the aftermath of COVID19.

Having said that let’s consider is it possible for another organization to come up and take the role of WHO? In short, the massive funding and infrastructure required is a big barrier to entry. Just the US stopping funds won’t stop the WHO.

Finally, let’s consider if there are substitutes to WHO. Is there any other organization at present able to deliver what WHO does? Again, the short answer is no. Each country has its own health organization, but none really can deliver anything close to what WHO does in the global scale.

Testing asymptomatic patients key to protecting other hospitalised patients

Dr. Rajesh Dey
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Testing asymptomatic patients key to protecting other hospitalised patients

It is important for hospitals to test asymptomatic patients so that they can protect other hospitalised patients and healthcare workers from COVID19 infection

Testing asymptomatic patients admitted for non COVID illness for COVID- need of the day to protect other patients in a hospital from the novel corona virus infection (COVID19).

Mr Ray had to get his 65 yr aged brother admitted for a heart attack in the middle of the raging pandemic. He was not tested for COVID as he did not fulfil any of ICMR’s testing criteria and the admitting hospital was reluctant to test fearing reprisal from the government for not adhering to criteria. Mr Ray was put up in a twin sharing room where the other patient was a young man. The young man was due to undergo an orthopaedic surgery the next day. He too did not fulfil any of ICMR’s testing criteria, but the treating physician insisted on getting a COVID test before surgery.

Hospitals are wary of testing fearing government wrath . This situation is fraught with danger as COVID positives admitted to hospitals unknowingly for other illnesses are potential disease spreaders in these hospitals

The test came to be positive as most patients with COVID infection are asymptomatic positive. Mr Ray was worried sick, the nurses and other health care workers attending to both the patients in a single room were isolated.

This situation is becoming all too common across nursing homes and hospitals across India. ICMR testing criteria does not recommend testing of asymptomatic individuals unless they are contacts of a positive patient or health care workers – something that presumes lack of community transmission. Patients without any COVID symptoms admitted for non covid illnesses can be asymptomatic positives.

It means that they do not have any symptoms of corona virus illness, yet they harbour the virus and spread them. Identifying such individuals is crucial in the closed confines of a hospital set up. They not only expose health care workers, they are also potential source of infection for other patients and their attendants. Surgeries performed on such patients risk the spread of virus via aerosols and if such patients develop symptoms of COVID, they tend to do poorly.

In a bid to show declining COVID numbers to the media and give false reassurances to the public, governments are restricting testing. Each COVID test has to be accounted for and can be traced to source. Hospitals are increasingly wary of testing fearing government wrath and harassment. This situation is fraught with danger as COVID positives admitted to hospitals unknowingly for other illnesses are potential disease spreaders in these hospitals.

The solution for this dilemma lies in liberating testing policy from outdated guidelines. Or, changing guidelines to include patients admitted to hospitals for non COVID illnesses for a COVID test even if they show no signs and symptoms of COVID infection.

 

Consulted epidemiologists on COVID19, allegations baseless: Govt

MediBulletin Bureau
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Consulted epidemiologists on COVID19, allegations baseless: Govt

Week after AIIMS doctors, research group members slammed government in joint statement on COVID19, comes response from the ministry of health

 

In a strong statement, the government of India has rejected accusations that it did not take inputs from technical experts while drawing up its COVID 19 strategy.

“There are some reports in a section of the media expressing concern about the Government’s efforts towards containment and management of COVID-19 to have excluded the larger wisdom of technical experts. These apprehensions and allegations are unfounded and baseless. The Government is constantly in consultation with experts for technical and strategic inputs, scientific ideas and domain-specific guidance to address the COVID-19 pandemic. A National Task Force (NTF) for COVID-19 is constituted by Secretary DHR-cum-DG-ICMR with Member (Health) NITI Aayog as Chairperson and Secretary (DoHFW) and Secretary (DHR) as Co-Chairs. The NTF comprises of 21 members including technical/domain experts from the government and outside the government. Predominant expertise in the Task Force is from public health and/or epidemiology. Given the complexity and implications of the COVID-19 pandemic, the group has experts from medicine, virology, pharmacology and programme implementation domains, as well,” reads the statement.

“The people, the WHO and the global health community have appreciated India’s proactive and pre- emptive approach to COVID-19. There was all round consensus on the lockdown among all state governments”

Last week a joint statement by the Indian Public Health Association (IPHA), Indian Association of Preventive and Social Medicine (IAPSM) & Indian Association of Epidemiologists (IAE) had said that the government did not consult “epidemiologists who had better grasp of disease transmission dynamics compared to modelers”. Among the signatories in the statement were Dr. Shashi Kant, Professor & Head, Centre for Community Medicine AIIMS, New Delhi and Dr. D.C.S. Reddy, Former Professor & Head, Community Medicine, BHU, both members of an ICMR research group on epidemiology and surveillance for COVID19. That joint statement also said that it is unrealistic to expect that COVID-19 pandemic can be eliminated at this stage given that community transmission is already well-established across large sections or sub-populations in the country. The government has consistently denied community transmission.

“A section of the media is also reporting on the decisions regarding India’s approach to the pandemic. The decision on lockdown was taken in the background of rapid escalation of COVID-19 cases. The doubling rate of cases had dropped to a low level pointing toward a dangerous trajectory of high case load and high mortality, as experienced by many western countries. The possibility that our health systems could soon be overwhelmed with COVID-19 patients, seemed to be real. Policies and strategies need to be calibrated to keep pace with the rapidly evolving situation nation is faced with. This virus is a new agent, not everything is known about it as yet. Government is fine-tuning the strategy based on emerging knowledge and experience on the ground,” added the Union health ministry in its statement issued on Sunday.

It added that the different stages of epidemic demand different response. “In fact,
the nuanced, step-wise response is known to be a positive characteristic of a resilient health system. The people, the WHO and the global health community have appreciated India’s proactive and pre- emptive approach to COVID-19. There was all round consensus on the lockdown among all state governments,” the government said.

Universal preoperative COVID-19 screening improves patient safety

MediBulletin Bureau
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Universal preoperative COVID-19 screening improves patient safety

Screening all patients before surgery improves patient safety as half of patients who test positive for COVID-19 have no symptoms

At a time when many states in India are busy barring laboratories from testing for COVID-19 in asymptomatic patients, this study should come as an epiphany.

Universally screening pediatric patients for COVID-19 before they undergo surgical procedures has allowed hospitals to improve safety by identifying all patients who test positive for the virus, half of whom have no symptoms, according to new research led by Children’s Hospital of Philadelphia (CHOP). 

The study, which analyzed universal screening procedures at CHOP and two other major children’s hospitals, found that screening patients for COVID-19 allowed hospitals to ensure patients and physicians were not exposed to the virus. The findings were published in JAMA Surgery.

“CHOP’s commitment to screening every patient preoperatively has significantly improved patient safety,” said lead author Apurva Shah, MD, MBA, an orthopaedic surgeon in CHOP’s Division of Orthopaedics.

Data on preoperative pediatric patients for one month, from late March to late April 2020 was analyzed. Each of the three hospitals used a reverse transcriptase polymerase chain reaction (RT-PCR) assay to detect COVID-19 in patients with scheduled surgical procedures.

Of the 1,295 patients included in the study, the overall incidence of COVID-19 was 0.93%. However, the researchers found significant variation across hospitals, ranging from 0.22% to 2.65%. Even more striking, at CHOP, 55.56% of positive patients were from a single township, indicating that the incidence in children may vary depending on COVID-19 infection rates in the patients’ communities.

Among those pediatric patients who tested positive for COVID-19, half had no symptoms

Among those pediatric patients who tested positive for COVID-19, half had no symptoms. Of those who did have symptoms, the most common were fever and a runny nose. Nevertheless, the researchers noted symptoms were not useful in differentiating those who tested positive for COVID-19 and those who tested negative.

The authors emphasized that the findings show the value of universal screening in protecting both patients and physicians from COVID-19 exposure in all types of surgery at times when the SARS-CoV-2 virus is actively circulating in a community.

“If a patient tests positive for COVID-19, and the procedure doesn’t need to happen immediately, providers can reschedule surgery for a time when the patient has recovered,” Shah said. “But in some cases, surgery cannot wait, and in that situation, knowing a patient is positive for COVID-19 allows staff to protect themselves with appropriate personal protective equipment and prevent that patient from coming into contact with other patients and families.”

“As we start to relax social distancing measures, and children return to their ‘new normal’ with exposure to the community, universal testing for children undergoing surgery will be even more important,” said first author Elaina E. Lin, MD, an anesthesiologist in CHOP’s Department of Anesthesiology and Critical Care Medicine. 

Now investigators at Oxford say hydroxychloroquine doesn’t work in COVID19

Medibulletin Desk
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Now investigators at Oxford say hydroxychloroquine doesn’t work in COVID19

Investigators in the Recovery Trial have announced that they would no longer recruit patients for the hydroxychloroquine arm as the drug has no benefits in COVID19

The curtains are up in the latest act of the hydroxychloroquine (HCQ) drama and now University of Oxford investigators have said that the drug has no benefits in COVID19. It is normally used for auto immune disorders. Investigators in the Recovery Trial will no longer recruit patients for the HCQ arm fo the trial.

Peter Horby, Professor of Emerging Infectious Diseases and Global Health in the Nuffield Department of Medicine, University of Oxford and Chief Investigator of the Trial said: “Hydroxychloroquine and chloroquine have received a lot of attention and have been used very widely to treat COVID patients despite the absence of any good evidence. The RECOVERY trial has shown that hydroxychloroquine is not an effective treatment in patients hospitalised with COVID- 19. Although it is disappointing that this treatment has been shown to be ineffective, it does allow us to focus care and research on more promising drugs.” The multi country Solidarity Trial anchored by the World Health Organisation has just restarted the HCQ arm but may have to take yet another look at the decision.

Recovery had continued to recruit patients for the HCQ arm even after WHO stopped briefly last month following a paper in The Lancet that now stands retracted

Recovery had continued to recruit patients for the HCQ arm even after WHO stopped briefly last month following a paper in The Lancet that now stands retracted. Over 11,000 patients from 175 NHS hospitals in the UK were recruited for the Oxford trial.

The RECOVERY trial is examining the efficacy of Lopinavir-Ritonavir (commonly used to treat HIV), Low-dose Dexamethasone (a type of steroid, which is used in a range of conditions typically to reduce inflammation), Azithromycin (a commonly used antibiotic), Tocilizumab (an anti-inflammatory treatment given by injection) and Convalescent plasma (collected from donors who have recovered from COVID-19 and contains antibodies against the SARS-CoV-2 virus) in treating COVID19.

Professor Horby said: “The independent Data Monitoring Committee has reviewed the emerging data about every two weeks to determine if there is evidence that would be strong enough to affect national and global treatment of COVID-19. On Thursday 4 June, in response to a request from the UK Medicines and Healthcare Products Regulatory Agency (MHRA), the independent Data Monitoring Committee conducted a further review of the data. Last night, the Committee recommended the chief investigators review the unblinded data on the hydroxychloroquine arm of the trial…These data convincingly rule out any meaningful mortality benefit of hydroxychloroquine in patients hospitalised with COVID-19. Full results will be made available as soon as possible.”

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