On Covid, Govt’s twin concerns: spreading reach, rising case count

Elaborating on the “twin concerns”, the Ministry flagged eight states with rising positivity rates and a significant increase in caseload: Maharashtra, West Bengal, Delhi, Tamil Nadu, Karnataka, Uttar Pradesh, Kerala, and Gujarat (see box).

The Ministry also pointed to six other states that have reported more than a six-fold rise in cases from the previous week. Bihar tops this list with a 11-fold rise in cases followed by Madhya

Pradesh, Rajasthan, Odisha, Punjab and Chhattisgarh.

“The intensity of the pandemic has increased. It is quite  clear from the data that it is being driven and powered by Omicron. It is rapidly replacing or has replaced the previous dominant Delta variant. Omicron has high transmissibility and growth rate…we are seeing phenomenally high test positivity rates,” Paul, who is also a NITI Aayog member, said.

He reiterated that Omicron is “not a common cold” and said that the latest variant has the potential to overwhelm health infrastructure.

“Understanding the disease from an Indian experience…it looks that the hospitalisation rate may be low. Maybe. But it is spreading at a large scale. One is infected, the entire family gets infected. We cannot lower vigil and preparedness. I endorse the statement of WHO: Omicron is not a common cold. It is not a simple or ordinary infection. We cannot take this lightly,” Paul said.

“Also, the current situation is like this because of high vaccination rates… because vaccines provide protection against severe disease. So Omicron is not a common cold and because of it, many health systems have collapsed in a few countries. Many health workers have been forced to stay at home. There is more pressure. We have to slow the transmission,” he said.

The Centre, meanwhile, cautioned against “rampant and irrational use” of Molnupiravir, the first antiviral drug granted emergency use authorisation by the national regulator, and emphasised that efforts should be made to restrict its use as “known and unknown harms far outweigh its claimed benefit”.

ICMR chief Dr Balram Bhargava cited experts in the Covid task force to warn that certain risks warrant caution in the use of Molnupiravir.

“We had extensive debate and discussion among national experts….The final conclusion was that Molnupiravir has certain risks that warrant caution in its use. Number two, experts present at the meeting opined that there is a rampant and irrational use of Molnupiravir. Number three, efforts should be made to restrict its use as known and unknown harms far outweigh its claimed benefit,” Bhargava said.

“Number four, the currently available synthesised evidence was reviewed, and the members unanimously agreed that it does not merit the inclusion of Molnupiravir in national treatment guidelines. The emerging evidence will be constantly reviewed,” he said.

s“Lastly, it was further highlighted that the current clinical window of an application appears extremely narrow for Molnupiravir with relevance only to the following: elderly, unvaccinated with other comorbidities. There is no evidence of benefit in diabetes, and those who were previously infected with Covid-19 or were vaccinated,” he said.

Paul, too, expressed “concern” over the irrational consumption of drugs for Covid treatment.

“Whichever medicines are being given, there should be a rational approach in using them. There cannot be overuse. In the last wave, we witnessed a scary situation, where the overuse of drugs caused mucormycosis (black fungus)…There is a guilt that there was an overuse. Steroids are very potent and life-saving drugs, but they also have side effects. They disturb many biochemical pathways. We have learned our lessons. We don’t want that situation to repeat,” he said.

“For mild symptoms, in case of fever, only paracetamol should be given. For cough, one can take cough syrup, warm water, and gargle…if cough persists for more than five days, in selected cases, you can use inhalation budesonide (a repurposed medication to prevent asthma symptoms). These are the only three things to be done,” Paul said.