and sell to whom? friggin europe and US is in lockdown!
India is said to be in the second stage of coronavirus epidemic. The next stage is said to be community spread when infection rises exponentially. Will India with its 135 crore of population- a sea of humanity- be able to ward off the next stage? Looks to be very very difficult and it is hoping against hope. Hence it is better to wait till the next 2 to 3 weeks to see how things pan out. If the magnitude of the spread becomes like that of the European countries, we may have very big human tragedy on hand.
Our main suppliers are from China. They have informed us that they are starting the production. The cargo will be moved to Dubai and exported to other parts of world
Thereâs an opinion of malaria drug is being treated for Corona is doing rounds:
And a Belgian research institute Sciensano stated various drugs that potentially work against COVID-19
(The HIV drugs were used to treat COVID19 in India as well)
Another blog that claims that countries with Malaria are less affected (due to usage of Malarial drugs)
https://docs.google.com/document/u/1/d/12YDytbAsZaruGlhFO7eTTgxSH_BuxJtwFmbhqpkPPSk/mobilebasic
Ok lot of incomplete and useless information has been spread in media which is creating doubts in people minds . So I want to clarify some doubts. Antibiotics donât act against viral infections, people are randomly trying them and they would definitely have doubtful/ benefits. There is no specific antiviral drug yet but there are some antiviral drug candidates which are still in various trial stages hence not much is known about there effectivity. Anyway even if we have specific antiviral drugs but viral infections are usually not controlled or treated effectively using antiviral drugs they are at best useful only for severe cases or immunosuppressed patients or other vulnerable populations where they at best reduce symptoms or reduce disease progression or deaths. Almost all antiviral have many serious side effects so canât be used indescriminately .
Any viral pandemic would need either natural herd immunity or mass vaccination to control it. Both will definitely take time . Also even if we have some vaccine after 6 months to 1 year the target population is huge (almost everyone) so production limitation and destribution problems will be huge.
I have a little different viewpoint
I think vaccine is the only way to get this virus deaths under control
Vaccines should be given to all elderly and high risk people like diabetics
hopefully vaccines will be available soon in less than 3 months .As they are fast tracking it given the severity
Having a good antiviral is very important to prevent deaths in elderly
Oseltamir is very good antiviral in influenza if given very early
Nowadays antivirals are getting better and better with fewer side effects
Also most of the antivirals are better tolerated for short durations
And for acute conditions like corona ,the course will be very short ,so unlikely to see major side effects
Side effects are mainly seen after prolong course (hiv ,hep c etc )
So hopefully we get good antiviral soon
So vaccine and anti virals will be a major milestone
Deaths in coronavirus is mainly due to ARDS .
Vaccines and antivirals can decrease the ARDS incidence as well as severity
Several randomized trials are underway to evaluate the efficacy of
remdesivir ,Lopinavir-ritonavir
and Tocilizumab
for moderate or severe COVID-19
Despite the limited clinical data, given the relative safety of short-term use of hydroxychloroquine with azithromycin, some clinicians think it is reasonable to use them .
A registry of international clinical trials can be found on the WHO website and at clinicaltrials.gov.
Till we get a good vaccine and treatment ,the most important thing is social isolation to flatten the peak ,else we will struggle with resources
Summer is a major advantage for India
@drsachin
Antibiotics have an important role of treating secondary infections which is the ultimate cause of death in viral infections.
This is from an immunologist at Johns Hopkins University:
Feeling confused as to why Coronavirus is a bigger deal than Seasonal flu? Here it is in a nutshell. I hope this helps. Feel free to share this to others who donât understandâŚ
It has to do with RNA sequencing⌠I.e. genetics.
Seasonal flu is an âall human virusâ. The DNA/RNA chains that make up the virus are recognized by the human immune system. This means that your body has some immunity to it before it comes around each year⌠you get immunity two waysâŚthrough exposure to a virus, or by getting a flu shot.
Novel viruses, come from animals⌠the WHO tracks novel viruses in animals, (sometimes for years watching for mutations). Usually these viruses only transfer from animal to animal (pigs in the case of H1N1) (birds in the case of the Spanish flu). But once, one of these animal viruses mutates, and starts to transfer from animals to humans⌠then itâs a problem, Why? Because we have no natural or acquired immunity⌠the RNA sequencing of the genes inside the virus isnât human, and the human immune system doesnât recognize it so, we canât fight it off.
Now⌠sometimes, the mutation only allows transfer from animal to human, for years itâs only transmission is from an infected animal to a human before it finally mutates so that it can now transfer human to human⌠once that happensâŚwe have a new contagion phase. And depending on the fashion of this new mutation, thats what decides how contagious, or how deadly itâs gonna beâŚ
H1N1 was deadlyâŚbut it did not mutate in a way that was as deadly as the Spanish flu. Itâs RNA was slower to mutate and it attacked its host differently, too.
Fast forward.
Now, here comes this Coronavirus⌠it existed in animals only, for nobody knows how longâŚbut one day, at an animal market, in Wuhan China, in December 2019, it mutated and made the jump from animal to people. At first, only animals could give it to a person⌠But here is the scary part⌠in just TWO WEEKS it mutated again and gained the ability to jump from human to human. Scientists call this quick ability, âslipperyâ
This Coronavirus, not being in any form a âhumanâ virus (whereas we would all have some natural or acquired immunity). Took off like a rocket. And this was because, Humans have no known immunityâŚdoctors have no known medicines for it.
And it just so happens that this particular mutated animal virus, changed itself in such a way the way that it causes great damage to human lungsâŚ
Thatâs why Coronavirus is different from seasonal flu, or H1N1 or any other type of influenza⌠this one is slippery AF. And itâs a lung eaterâŚAnd, itâs already mutated AGAIN, so that we now have two strains to deal with, strain s, and strain LâŚwhich makes it twice as hard to develop a vaccine.
We really have no tools in our shed, with this. History has shown that fast and immediate closings of public places has helped in the past pandemics. Philadelphia and Baltimore were reluctant to close events in 1918 and they were the hardest hit in the US during the Spanish Flu.
Factoid: Henry VIII stayed in his room and allowed no one near him, till the Black Plague passedâŚ(honestlyâŚI understand him so much better now). Just like us, he had no tools in his shed, except social isolationâŚ
And let me end by sayingâŚright now itâs hitting older folks harder⌠but this genome is so slipperyâŚif it mutates again (and it will). Who is to say, what it will do next.
Be smart folks⌠acting like youâre unafraid is so not wise right now.
#flattenthecurve. Stay home folks⌠and share this to those that just are not catching on. 
#reposted
Good stuff,explains things in a very interactive manner.
Yes the only way this viral pandemic would be controlled is either vaccine or herd immunity.
New Vaccines and medicine take lot of time to come to market (actually 2/3 years minimum for Vaccines and for medicines 10-15 years). The biggest time consuming things are various stages of drug trials on animals/human trials for efficiency/ trials for safety. I know most companies are on war footing to bring vaccines in market but nobody believes they would be available before 1 year atleast. To bring them earlier than that may be you will have to forgo some of the trials for safety/ effectivity. I donât think FDA would allow it. Phase 3/4 trials take lot of time as you have to do it on hundred /thousands of people and across many countries.
Yes antivirals are usually given to immunosuppressed/elderly as they easily progress from moderate to severe . So they help in preventing progression if started early. Viruses stay within human cells so you have to kill these viruses thereby causing side affects as you kill human cells too.
Corona viruses/ influenza viruses in moderate to severe cases progresses to ARDS. Once developed its a prolonged treatment course 7-30 days. And not many recover.
Another problem is Corona viruses causing human diseases is a new phenomenon and not widespread epidemics before. so not many critical care experts have any proper treatment guidelines to treat them unlike influenza viruses. So in case of a widespread epidemics it becomes difficult to treat as critical care experts would be available in tertiary care hospitals only.
Oseltamivir/Tamiflu is the most useless antiviral ever made with limited or no effectivity at all. It was not a new medicine and physicians rarely used it to treat influenza infections before. It acted on one of the receptor (N)of influenza viruses but found to be very poor in efficacy. Swine flu/ bird flu virus shared same receptor (N) with usual influenza viruses. The other receptor (H) had mutated hence antivirals which acted on this receptor was not effective at all. So Tamiflu was bought back . It was a case of âsomething is better than nothingâ.The only pharma company which manufactured it smelled opportunity and promoted it.
I disagree sir
FYI giving the meta analysis link
Please have a look
Itâs not a useless drug
Sir all these drug trials upon which these meta analysis were based were funded by ROCHE company who manufactures this drugs. WHO had asked roche to provide full details about these trials numerous times and they have still not shared details for it . It was a big controversy at the time of swine flu epidemic as to why drug controller/regulator/ WHO didnât question the use of Tamiflu. The direct beneficiary of Tamiflu was US president and his friends in the pharma industry. Needless panic was created at the time of birdflu/ swine flu epidemic to push Tamiflu sales. Just google and you would know all the answers.
Anyway I am a critical care physician myself and have used Tamiflu many times in dire emergencies and found it to be of absolutely no use. Itâs mostly used in situations where we know itâs not going to be effective but still use it âhoping against hopeâ. The same way anti malarial medications are being tried now. In this time of crises numerous pharma companies will claim to have vaccines/antiviral drugs/other supportive drugs and will even use dubious means to push sales. They will manipulate regulators/drug controllers/ even WHO officials to include them in treatment guidelines and make billions in the name of human tragedy.
Anyway
Sir there are numerous trials/Meta analysis/RCTs for both pro and against Tamiflu use some are independent but most are funded by ROCHE. None of them is Indian or Chinese by the way. There have numerous past instances where these innovator drug companies have pushed even WHO to include them in treatment guidelines which were later withdrawn by WHO as is the case with Tamiflu also.
We as clinicians Ist like to use WHO guidelines, if not available then expert group recommendations, if these are also not available then are forced to have a look at these trials knowing very well that they might be biased or not properly conducted. Many a times itâs not immediately known who had funded these trials. Sometimes anxious relatives force us to start these innovator drugs or question us as to why we are not using them despite trials based on the information from" Mr Google " not knowing the validity of these claims and we may or may not be able to convince them otherwise.
Most these innovator drugs are insanely expensive and specially in Indian scenerio any experienced intensivist will always assess the risk benefit profile before recommending use. Day in day out medical representatives share these trials suggesting us to start using their drugs . We have to verify the validity of claims after all lot of money is involved and you donât want to use drugs with questionable benefits.
Tamiflu was included in list of essential medicine to treat influenza in year 2009 by WHO it was downgraded by WHO to just complimentary medicines in year 2017 after assessing independent studies. Yes there were guidelines which recommended but most were framed prior to 2017. Some guidelines still recommend as we still donât have any good antiviral yet and caution its use with regard expected efficacy and side effects. No company is interested in discovering newer medicines for swine flu or avian flu as after vaccine discoveries itâs not cost effective anymore. Remember it takes 10-15 year to launch newer medicines to market. And there are no more independent studies after year 2017 as its is not considered ethical/ or cost effective.
With such a big humanitarian crisis around the world, a different perspective on over-anxious analyst and investor community reaching out to company managements that I agree with:
Doctors / Medical professionals on the forumâŚwould love to have your opinion on this.
AlsoâŚthe top 15 countries by number of reported cases are either cold weather countries or had cold weather during the initial outbreak ( temperatures ranging from roughly 0 to 15 degree Celsius ).
These are -
1 China
2 Italy
3 Spain
4 Germany
5 USA
6 Iran
7 France
8 South Korea
9 Switzerland
10 UK
11 Netherlands
12 Austria
13 Belgium
14 Norway
15 Sweden
No exceptions, no hot weather country.
The initial outbreak was reported in hot weather countries like Singapore, UAE, Philippines, some other gulf countries etcâŚBut the spread has not been severe.
Is this a CO-INCIDENCE???
Regards,
Ranvir Dehal
This is a more logical explanation. Triangulate latitude with effective govt and society response you will get infections and mortality result. I think exposure to Sun in terms of time is more important than just temperature alone.
Im not a medic but a PhD in Biochemistry working at Max-Planck institute of Biochemistry. That news article is based on a report in biorxiv which is severely contested. Lockdown would be the only way outâŚ