As India's cities begin unlocking again after a COVID peak, Centre's Directorate General of Health Services (DGHS) has issued revised COVID-19 treatment guidelines on Monday, specifying the criteria for the use of certain drugs in treatment. The new guidelines drastically cut down on the usage of several antibiotic drugs, steriods while warning against the excessive usage of Remdesivir, Tocilizumab etc. Currently, India has 14,01,609 active cases, 2,71,59,180 recovered COVID cases and 3,49,186 fatalities.
As per the DGHS guidelines, no medication is to be given to asymptomatic patients, while mild cases have been advised to take antipyretic, anti-tussive medicines along with inhalational budesonide. DGHS has eliminated the use of popular drugs like Favipiravir, Ivermectin, Azithromycin, Doxycycline, Zinc, plasma therapy etc for mild cases. Similarly, for moderate cases, DGHS advises use of steroids on SpO2 levels falling below 92% and usage of anticoagulants, steroids. For severe cases, DGHS recommends immediate oxygen therapy, intubation and ventilation, steroid usage, anti-coagulants, immune-modulators etc.
Apart from these guidelines, DGHS has detailed usage of Remdesivir - stating that the drug must be used in select moderate/ severe hospitalised COVID-19 patients on supplemental oxygen within 10 days of onset of disease, highlighting it is an experimental drug. Similarly, DGHS has advised usage of Tocilizumab only in severe and critically ill patients under select conditions. The 9-page guidelines also advise on the usage of steroids in hospitalized moderately severe and critically ill COVID-19 cases, advises conducting a High-resolution CT (HRCT) scan of the chest only if a suspected and confirmed cases of moderate COVID-19 continue to deteriorate clinically and details the treatment for Mucormycosis.
Several doctors have hailed the clear and precise instructions set by DGHS, cutting down on excessive drug usage. Some doctors have pointed out good practices highlighted by DGHS such as not using antibiotics, anti-parasitic, plasma therapy, Coronil, 2DG, Favipiravir and routine CT scans. WHO's chief Scientist Dr Sowmya Swaminathan too hailed the guidelines, urging Centre to issue it in all languages.
Evidence based guidelines from @mohfw DGHS - simple, rational and clear guidance for physicians. Should be translated and disseminated in all Indian languages.— Soumya Swaminathan (@doctorsoumya) June 6, 2021
Can be updated as and when new evidence becomes available @drharshvardhan @WHOSEARO https://t.co/xNX0Ngj35y
I couldn't believe my eyes. So I asked my colleague to read to me the recent Covid19 guidelines by DGHS @MoHFW_INDIA. I couldn't believe my ears too.— SP Kalantri (@spkalantri) June 6, 2021
The 9-page-PDF guides how to treat, investigate and monitor patients with Covid19 infection.
What is the first surprise? 1/N
WOW!— Madhu Pai, MD, PhD (@paimadhu) June 6, 2021
This #COVID19 guideline by DGHS @MoHFW_INDIA is what 🇮🇳 needs!
No antibiotics, anti-parasitic, plasma, Coronil, 2DG, Favipiravir & other unproven meds!
No routine CT scans!
O2, rational use of steroids, Remdesivir/Toci in specific, limited caseshttps://t.co/QolDqj9vo6 pic.twitter.com/EkWdK7R1ft
In the second COVID wave, India grappled with acute oxygen supply with Delhi being hit the worst - several hospitals moved the High Court seeking oxygen supply. While the Centre and Delhi govt blamed each other for the ongoing oxygen crisis in the national capital, Railways started 'Oxygen Express' to transport liquid oxygen to the states via green corridors. SC has constituted an 11-member panel to decide on oxygen allocation to states, pulling up Centre over its vaccination plan. Meanwhile, India's vaccination drive has hit a roadblock due to shortage of supplies. Centre has approved an advance payment of Rs 4,567.50 crores to Serum Institute of India (SII) & Bharat Biotech (BBL) to ramp up vaccine production. Soon enough, most state governments placed lakhs of orders with the two vaccine manufacturers, but met with delayed delivery dates. India plan to vaccinate all adults by December.