By Dr. Chandan Raman
As the world fights with coronavirus crisis, battling rumors and misinformation is a challenge for the human race to cope with this critical situation.
COVID-19 is an infectious disease caused by the severe acute respiratory system (SARS-Cov-2). The virus is primarily spread through contaminated people by means of close contact via small droplets produced by coughing, sneezing and talking. The virus is most contagious during the first three days after the onset of symptoms although the transmission is possible before the symptoms appear. Therefore social distancing, use of face masks, handwashing with soap on a regular basis and obtaining the method of self-quarantine (especially those with symptoms like cough, fever and respiratory disease) are few essential methods to be aware about the COVID-19.
On April 11, major scientific database and clinical trial repositories were done for COVID-19, SARS-Cov-2 and role of BCG vaccine to find/rule out its association on the immune system of an infected patient. The experimental evidence from both animal and human studies showed that the BCG-vaccine has non-specific effects on the immune system of a COVID-19 patient. Even the use of NSAIDS (paracetamol, aspirin etc.) has no direct evidence of positive outcomes on these virus-infected patients. The limitation of NSAIDS use on acute health care utilization, explicit quality of life measures or long-term survival only reduced fever and associated minor sing and symptoms. Few western countries like Germany and the United States reported that the use of ventilators in an early stage of the COVID-19 patients who developed signs and symptoms of respiratory distress reduced the mortality rate.
Rapid diagnostic test (RDT) detects the presence of viral proteins (antigens) expressed by the COVID-19 virus in a sample from the respiratory tract of a person. These proteins detected are expressed only when the virus is actively replicating. Therefore such tests are best used to identify COVID-19 cases only during the acute stage or early infection.
The chances of “false positive” results are also associated with factors like quality of the specimen, time from onset of illness and concentration of virus etc. WHO does not recommend it for patient care but encourages the continuation in disease surveillance and epidemiological research whereas PRC-testing of respiratory tract samples in the recommended method for laboratory confirmation of COVID-19 cases globally.
No pharmaceutical products have yet been shown to be safe and effective for the treatment of COVID-19. A number of medicines are still on clinical trials and research purposes though.
Further, “off label” use of medicine prescribed by doctors may subject to national laws and regulations governing their practice and should be prescribed on a case-by-case basis. Until the standard management protocol of COVID-19 has not been approved by the WHO, it is possible and feasible for treating a patient as a part of a clinical trial but this should only be done unless the patient declines to participate in the trial.
If it is not possible to give the treatment as a part of a clinical trial, the consent of a patient must be taken and appropriate records of the use of medicines must be kept safely in a respective hospital as well as in a government record.