Prime Minister Narendra Modi held a meeting on Friday with chief ministers of 10 states with the most number of COVID-19 cases. The meeting via video conferencing comes amid a huge surge in coronavirus cases, which have now clocked a daily total of over 3 lakh in the country. Chief ministers of Maharashtra, Uttar Pradesh, Kerala, Chhattisgarh, Madhya Pradesh and Delhi are among those who attended the meeting. Modi will hold a meeting with leading oxygen manufacturers in the country via video conference amid concerns expressed by some states that their supply of the life-saving gas is running short with a number of hospitals sending out SOS.
With cases on the rise and the death toll surging, hospitals across the nation have registered a massive shortage in oxygen. There has also been a surge in demand for tocilizumab, remdesivir and plasma. In light of that, the Union health ministry had issued an updated 'Clinical Guidance for Management of Adult COVID-19 Patients' recommending emergency use authorisation of remdesivir for patients with moderate to severe diseases, requiring supplemental oxygen, within 10 days of onset of symptoms.
The guidelines issued by AIIMS, ICMR-COVID-19 National Task Force and the Joint Monitoring Group (DGHS) under the ministry stated that tocilizumab (a drug that modifies the immune system or its functioning) may be considered in patients with significantly raised inflammatory markers and not improving despite use of steroids with there being no active bacterial/fungal/tubercular infection. They also recommended off-label use of convalescent plasma only in the early moderate disease, preferably within seven days of symptom onset, stating that "no use after seven days" and only on availability of high titre donor plasma.
"Under emergency use authorisation (EUA), remdesivir may be considered for only those patients with moderate to severe diseases (requiring supplemental oxygen) within 10 days of onset of symptoms. It is not recommended for those with severe renal impairment or hepatic dysfunction, the guidelines stated. "Not to be used in patients who are not on oxygen support or in home settings," the ministry underlined.
The guidance note comes in the wake of increasing demand for tocilizumab, remdesivir and plasma, as the COVID-19 cases continue to surge. The note specifies how and in what stages and doses should the drugs be used. According to the guidance note, upper respiratory tract symptoms (or fever) without shortness of breath or hypoxia has been categorised as mild disease' and people have been advised home isolation and care. The guidelines advise physical distancing, indoor mask use, strict hand hygiene. symptomatic management (hydration, anti-pyretics, antitussive, multivitamins), staying in contact with treating physicians, monitoring temperature and oxygen saturation (by applying a SpO2 probe to fingers) for such patients.
-Inputs from PTI
