AIIMS director Dr Randeep Guleria

The central government will form a national policy in coming days to keep tabs on the misuse of the Tocilizumab and other injections necessary for treating Covid-19 patients, said AIIMS director Dr Randeep Guleria in Surat on Friday.

The four-member team which came down to Surat on Thursday evening from Delhi comprised AIIMS director Dr Randeep Guleria, Niti Ayog member Dr Vinod Paul, ICMR Director General Dr Balram Bhargav, Additional secretary to Union health Ministry Aarti Ahuja. This was the first time when the heads of institutions such as ICMR and AIIMS along with other central government officials were in the state. Earlier, an AIIMS team of two headed by Dr Guleria had visited Ahmedabad on May 9. On June 26, joint secretary at Union health ministry Lav Agarwal had visited Ahmedabad.

Addressing mediapersons in Surat, Guleria said, “We are coming up with a national policy on use of Tocilizumab and other injections to check its misuse. The injections are easily available, and should be given to those patients who are in actual need… sometimes misuse might lead to complications in a patient. Some control should be laid on misuse of it.”

In further interaction with the media in Gandhinagar on Friday evening, Guleria explained that drugs such as Tocilizumab and Itolizumab are for emergency use. “If we look at global information, these drugs are only for emergencies, we have not seen any definite result yet. It has only shown that when there is a cytokine storm, these drugs may work. But there are side effects as well. Internationally, it has been seen that in several patients, superadded bacterial infections, fungal infections occurred or lungs filled with pus.”

“There is not enough awareness among people or even physicians on the usage of this drug. Thus we are conducting meetings with doctors over video conferences on Tuesdays and Thursdays. When we did these video conferences, we found in several states that many think that they prescribe this prematurely. That is not necessary, it may cause more harm (than benefit)… If we use it judiciously then there will neither be a shortage or hoarding,” he said.

Guleria added that Tocilizumab is to be used after examining specific markers. “Patients who are in a severe stage are few in numbers (who may require it). Unfortunately, because people don’t have an idea, this being prescribed even in mild cases. If we reduce the body’s normal inflammation, then one may contract other infections. Tocilizumab is a double-edged sword.”

Guleria added, “The main treatment is oxygen therapy, steroids in mild to moderate patients, anticoagulants and prone positioning. These will save more lives than Tocilizumab or Remdesivir.”

NITI Aayog member V K Paul also clarified that Tocilizumab procurement is under state jurisdiction and is not procured by the Centre.”Tocilizumab is procured from the US, while Itolizumab is being made in India by Biocon.”

In Surat, the team met with the private, municipal and government doctors involved in treating the coronavirus patients. Over hundreds of medical doctors participated in the meeting. The team shared their working pattern to treat positive patients.

After the meeting, the teams paid a visit to Limbayat and Katargam areas in Surat city, which had been badly affected by coronavirus.

About the strategy to reduce the cases, Guleria said, “If proper care is taken along with contact tracing and testing, as were done in Ahmedabad, the cases in Surat will also dip. We have given certain suggestions to the government and private medical professional and advised them to act on it accordingly.”

Adding to Paul, Guleria added that Gujarat’s industrial workers are “unique in (the sense) that there are a lot of workers in the diamond and textile industries who come from elsewhere and as the economy opens…it is important that we formulate a module so as to control infections, or if we can administer any prophylaxis such as hydrochloroquine, so that they remain protected for a while. It is also important to monitor them regularly to see if they are showing any influence-like illnesses’ symptoms, as they live in close quarters and may risk spreading the infection.”

Guleria added, “Patient management systems should be followed in terms of medicines as well as in isolation sector or plasma related works. We heard the issues which the medical professionals of Surat are facing and have suggested them solutions. We are hopeful that the cases will go down in Surat.”

Guleria and his team were satisfied with private Covid care centres and new upcoming dedicated Covid hospitals of thousand beds coming in Surat. He said, “Through such new hospitals, more patients will be benefited through private partnerships.”

Guleria also said that the Ahmedabad Municipal Corporation’s strategy of containing cases has been “effective” and has resulted in “remarkable change,” since his last visit here in the second week of May.

The team had conducted a meeting with AMC officials on Friday afternoon followed by a visit to Chief Minister Vijay Rupani’s bungalow.