New Delhi, April 24, 2021: Three prominent doctors of the country, Prof (Dr) Randeep Guleria, Director, AIIMS, Dr. Devi Shetty, Chairman, Narayana Health and Dr. Naresh Trehan, Chairman, Medanta Hospital, addressed various issues being related to the rational utilization of Remdesivir, included under the category of Investigational therapy under the National Treatment Protocol of the Health Ministry, and use of Oxygen for treatment of COVID patients in hospitals.
Dr. Guleria exalted the vaccine as the key to beat the gloom that is usually associated with COVID: although it may not prevent us from getting the infection, the vaccine prevents us from getting the disease in the form of severe illness. He said that it was important to understand that even after the vaccination, we may become infected with COVID which makes it important to continue to wear a mask even after getting vaccinated.
Dr. Guleria reassured that healthy individuals with oxygen saturation in the range 93-94% do not need to take high flow oxygen just to maintain their saturation at 98-99%. Even those with oxygen saturation less than 94 need close monitoring (oxygen being optional).
“Oxygen is a treatment, it’s like a drug” he stated to drive home the point that taking oxygen intermittently is an absolute waste of oxygen. There is no data that shows that this will be of any help to the patients and is therefore ill-advised.
Dr. Trehan echoed his observations and observed that the country has enough oxygen if we try to use it judiciously. He requested the audience not to use Oxygen as a “security blanket”. Waste of oxygen will only lead to depriving someone who needs it.
Dr. Shetty noted that a saturation above 94% is no problem. A doctor may be consulted if it dips after exercise/effortful work.
All the doctors unanimously requested the audience to desist from seeing Remdesivir as a wonder drug. Most of the active cases who are in home isolation or in the hospital don’t actually need any specific treatment. Only a small percentage require Remdesivir.
They were of the view that as a country, if we work together, use oxygen and Remdesivir judiciously, then, there will be no shortage anywhere. In terms of the number of people who need oxygen and oxygen supply, we are well balanced, they noted.
Dr. Trehan agreed and added that his hospital has now made a protocol that Remdesivir is to be given not to everyone who tests positive. It is to be given only after doctors look at test results, symptoms, comorbidities of a patient. Remdesivir isn’t a ‘Ram-ban’, it only decreases viral load in people who need it.
Dr. Guleria said that when it comes to COVID, more than 85% of people will recover without any specific treatment in the form of Remdesivir etc. Most will have symptoms like common cold, sore throat etc and over 5-7 days, they will recover with symptomatic treatment. Only 15% may go to moderate phase of the disease.
He advised against being in groups irrespective of somebody being infected and observed that Cross ventilation reduces the risk of infection in closed places.
Dr Trehan echoed the sentiment that since less percentage of people require hospitalization, the hospital beds should be utilized judiciously & with responsibility which rests on all of us.
Dr Shetty advised to see a doctor and get their opinion if one is positive. He further advised to not panic if the report is positive as the problem can be solved provided one gets the medical help at an early stage & follow doctor’s instructions.
There is a possibility that patient may be asymptomatic prompting the doctors to tell them to stay at home, isolate themselves, wear a mask and check their oxygen saturation every 6 hours. He also suggested to get tested if anyone have any symptom like body ache, cold, cough, indigestion, vomiting since that is the basis of any further treatment.
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