You and Me…. Is Remdesivir life-saving? (Or only reduces hospital stay?)

Dr Mangala Borkar

You: What will save us from getting Corona?

Me: Mask, and distancing. Stay home and if you must, go out very carefully. Wear a mask that covers your nose, all the while. No break for the mask -not even for drinking water- in any outsider’s presence!

You: And if we get the infection?

Me: Don’t panic but take the utmost care. Get tested at the earliest, seek medical guidance.

You: But I am young, so I guess I needn’t worry.

Me: No, you should. There’s an 85% chance that you may be asymptomatic. Means, 15% chance that you can be sick or very sick! Plus, the chance of taking the virus home to your family is very real. You can’t predict who at home may be hit hard by it.

You: Is there a cure ? I mean, what really works? I suppose Remdesivir must be the main lifesaver?

Me: Actually, no, it’s useful to shorten the duration of illness but its not lifesaving.

You: What! What do you mean it’s not lifesaving? Just look around you. It’s the raging craze everywhere! See the long queues of relatives outside any medical store that is supposed to dispense it, the media is full of reports of black-marketing, hoarding, overuse, thefts and shortage of Remdesivir. And you say its not lifesaving?

Me: The real lifesavers in Corona are oxygen, the humble steroids and heparin and its related medicines that prevent abnormal clotting of blood.

The life-threatening problem in Corona is the drop in oxygen levels in the body of the patient. Hence, oxygen is needed and in huge quantity.

The second danger in Covid is the kind of severe allergic reaction to the virus that may occur- the cytokine storm - that can kill the patient. Steroids given at the right time can tide over this crisis. They are the real lifesavers.

And the third problem that can kill the patient is the increased tendency of blood to clot, that can block the blood vessels of the heart, lungs, kidneys and brain. Heparin can prevent this. Generally, a safe type of heparin, the low molecular weight heparin and some clot preventing medicines given as tablets are used.

These three are the game changers.

You: And Remdesivir?

Me: Like I said, Remdesivir shortens the length of illness and hospital stay, but studies have shown that it does not affect survival. Experts would agree with what I say.

You: Then are we focusing on the wrong drug? Why the hype?

Me: I won’t say that. Who doesn’t want to recover early? But Remdesivir won’t save your life, which is what one finally wants, in this terrible pandemic. If its available, fine. If its not, the trio of oxygen, steroids and heparin will save you. So, don’t panic.

You: So, why this craving, craze, obsession with something that does not change the mortality? Does every patient really need it?

Me: No. Government is trying to control it’s injudicious use. It should be only given at the right time to severe cases, not too early, not too late. It is definitely not to be used in mild or naturally recovering cases. There are criteria based on the person’s condition and tests that tell the treating doctor whether to give or not, and when. False hopes should not be pinned on it. That’s how panic is created when it is not available.

Try your utmost to save yourself from getting infected. Get vaccinated, wear a mask properly and consistently. Avoid crowds. If everyone adopts this trilogy, Corona will disappear.

(The expert writer is professor of geriatrics, Government Medical College and Hospital, Aurangabad).