The use of a combination of drugs, steroids and therapies instilled confidence in doctors.
New Delhi: Even as India crosses the 2 million mark of Covid-19 positive cases, the medical fraternity of the country says that it has grown wiser and much more confident in dealing with the disease than what it was just six months back, when the pandemic had hit India.
The official use of several combination of drugs, steroids, therapies and streamlining of the process to handle the pandemic has given much more confidence to the doctors who are working at the frontline to deal with the disease.
Several doctors treating Covid-19 patients spoke to The Sunday Guardian, sharing their experiences of how the process of treatment has changed over time.
Dr Richa Sareen, senior consultant, Pulmonlogy, Critical Care and Sleep Medicine at the Fortis Hospital, Vasant Kunjin Delhi, who is treating Covid-19 patients, told The Sunday Guardian that doctors have definitely become much more confident and wiser than they were six months ago when the pandemic had hit the country.
“With each passing month or in fact, every few weeks, we are getting more and more information from the studies that are coming out. When we were hit with Covid-19, we did not have any antivirals at hand and though we were giving patients some steroids, there was no proven role of those steroids. But with time, we have seen definite improvement in patients with a combination of medicines, steroids and therapies,” Dr Sareen said.
According to doctors, over time, some of the medicines that have been approved for treatment of Covid-19 positive patients include antivirals like Favipiravir which helps in reducing the viral load significantly in mild to moderate patients; Remdisivir, Plasma Therapies, Hydroxycholoroquine and some steroids which have shown proven improvement in patients.
“From March to now, definite studies have come out on the efficacy of the use of steroids and antiviral drugs like Remdivisir and Favipiravir which are administered to patients on a case-by-case basis. We are giving our patients a combination of these drugs and plasma therapy which acts as an added immunity boost in severe category patients,” Dr Sareen said.
Dr K.K. Agarwal, cardiologist, physician and former president of the Indian Medical Association, told The Sunday Guardian, “As a doctor, we are now very confident that it is possible to reduce the mortality rate of Covid-19 positive patients practically to any level now and we are very clear that this disease is totally manageable like any other disease.”
“We know which patient to treat when and what kind of combination of medicines to be given to which patient and as I said, the medical fraternity is confident that if a patient comes on time and the treatment is given on time, the patient will not die,” Dr Agarwal added.
Dr Agarwal and other doctors are also of the view that the initial panic that was witnessed across the world with respect to Covid-19 was a “knee jerk” reaction as the Covid-19 virus was a new virus and none knew much about it and how to treat it then.
A doctor treating Covid-19 patients at the Lok Nayak Jay Prakash (LNJP) Hospital, one of Delhi’s largest Covid hospitals, told this newspaper that in the initial days, there were a lot of confusion and doctors were clueless about how to handle the large influx of patients, and the panic was coupled with shortages of safety equipment.
“Unlike at the beginning of the pandemic when the system was in chaos and there were shortages of safety gears, machinery and lack of protocols for patient handling, in the last six months, what has happened is that systems have been made and streamlined. We were clueless about things, we were just treating patients based on our experiences of treating patients during the SARS pandemic,” the doctor said.
“But now, the systems are much better, and the doctors have better adjusted. We are now wiser about the medications and patients’ symptoms and presentations and I think over a period of time, Covid-19 will just become like any other viral influenza diseases. Covid was a problem because it was new and most of us did not know much about it,” the LNJP doctor said.
Doctors also say that India is witnessing a more moderate form of the Covid-19 virus than what many of the Western countries have witnessed and this they say is because of the lesser number of sicker patients that India is seeing.
All the doctors that The Sunday Guardian spoke to have said that more than 80-90% of the patients they are seeing falls in the mild to moderate category and just 10 -20% of the total number of cases requires hospitalisation.
They added that out of those, only 3-5% of the patients land up on ventilators, unlike what we saw in the west.
The doctors believe that this is possible due to the antigenic shift and drift in the virus’s genetic composition. They say that it is possible that when it is being transmitted from one person to another, the virus has been losing its virulence over time.
However Dr Arvinder Singh Soin, Chairman Liver transplant at the Medanta hospital says that there is still no silver bullet.
“There is still no single treatment which we can for sure say that yes this will definitely work universally on Covid 19 patients. We are treating patients with drugs on a case by case basis but of course we have grown much wiser and we have learnt that all patients do not require hospitalisation as was the case in the initial days. But we are yet to conquer it.” Dr Soin said.