How To Solve The Problem Of Corona!

Our community’s leading medical luminary, Dr. Keki Edulji Turel commands 47 years of expertise in neurosurgery and is a Consultant Neurosurgeon, Prof. Emeritus, Dept of Neurosurgery at the Bombay Hospital Institute of Medical Sciences. Known for his compassionate outlook towards his patients, Dr. Keki Turel is the Managing Trustee at Mumbai Institute of Neurosciences and the Chairman, WFNS Committee on `Complications in Neurosurgery’.

The COVID-19 Virus, which has been on a ‘World Tour’ for the past three months and has embraced over 2 million people during its ambitious, international flight, has its musketeers now sojourning  in the USA – the ‘Land of Opportunities’, giving a whole new meaning to the ‘dying to be in the US’ preference of people from across the world!

In my article, ‘Quo Vadis’, published by Parsi Times earlier, I cited an official American News Agency quoting that a combination of Hydroxychloroquine (HCQ) and Azithromycin, taken for six days, gives 100% cure against the virus, if taken at the onset of the symptoms. Sounded so optimistic! If this was true, USA wouldn’t have already witnessed over twenty-five thousand deaths (and still counting!). 

So, what’s the truth? HCQ is basically a drug used for relieving Rheumatoid Arthritis (there’s a full-fledged registry of arthritic Americans taking this drug, and the good and side-effects on them, noted). Incidentally, it is also a potent anti-malarial, having been derived from the ‘good’ old Quinine used by our great grandparents. However, HCQ is NOT an anti-viral drug at all! What it does is that it increases the pH of lysosomes, thus barring the entry of the virus into the cells of the lungs of the host it attacks. That was the way it benefitted the patients during the previous SARS pandemic. Moreover, combining HCQ with Azithromycin has higher risks than HCQ given alone, again, in contradistinction from the earlier recommendation. Seems like health officials are in a state of frenzy and responding hastily to the public panic without adequate trial, as this is a novel virus and there’s no time for a proper clinical, double-blind trial.   

So, there is no strong or proven scientific data that HCQ protects you from COVID-19. Nor is there unequivocal proof that it is effective even in COVID-19 proven cases. (Ironically, despite taking HCQ, 25% of people have developed COVID-19). The information is mostly anecdotal. Moreover, it has proven cardiac toxicity. According to our own BMC reports, even as the under-50 age group accounted for 70% of 2334 patients, only 23% of the 171 deaths in the state fell in this group; on the other hand, the 50-plus group which accounted for 30% of positive cases emerged most vulnerable with 77% of the death tally. Many of them had prior heart ailments, or comorbidities such as diabetes. By the same token, the virus has affected fewer children, and the course of the disease in them largely benign. Women are also less affected (41%) compared to men (59%), and death analysis also states that twice as many men (65%) than women (35%) succumb to the disease. In a recent BBC report it was alleged that India was testing far fewer people due to inadequate testing facilities. However, of the 45K people tested since January, only 5% have tested positive thus far.

Nonetheless, Indian Council Of Medical Research (ICMR) has included the use of HCQ in its recommendations and currently have suggested a dose of HCQ 400mg twice on day 1, and 400mg/week for 7 weeks, as prophylaxis (prevention), and 400mg twice on 1st day, and once daily for 4 days, as the treatment in a positive case. Azithromycin has been dropped from its prescription.

However, citing heart complications, the BMC has reversed its plan to give its antimalarial HCQ pills as preventive medication to 1 lac people in Dharavi and Worli, now limiting its use to only a few hundred high-risk contacts, such as frontline healthcare workers, the police force, and those hospitalized with mild COVID-19 symptoms.

The benign word ‘flu’ has now become a frightful terminology. Corona is a flu virus, and its initial symptoms are that of a regular flu- fever, sore throat and cough. Sometimes, diarrhoea too. So what will you do if you have these symptoms?  Ideally go to a ‘fever’ hospital in SoBo Kasturba is THE hospital. HN Reliance and Saifee also do the testing. Their doctors can spot a COVID patient. They also have some kind of a scoring system, and since test kits are in shortage (as in rest of the world) only the highly suspicious patients will be subject to a swab test.

Finally, since HCQ is still not such a safe drug, especially in the elderly, let’s resort to the safe element, Zinc, found in many multivit  preparations. Zinc is a constituent of several alloys, used in the paint industry, an ingredient of some skin ointments, and also used for galvanizing battery electrodes. May it also galvanize our lung cells, and debar the entry of COVID-19 virus.

Our Honorable PM has announced continuation of the nationwide lockdown until 3rd May.This may still not be the final word and is liable of further extension. However, there will be gradual opening of ‘essential’ services, not simply to appease the masses, or ease the woes of the stranded, but rather a controlled mechanism to develop ‘herd’ Immunity. In a pandemic, when drugs have little or no curative role, and vaccine a far-fledged reality, herd immunity seams the most scientific and logical way to contain, if not combat the disease.  

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