[samdarshi.pali]

Originally Posted by carboy

I think HCQ has always been a prescription drug. But in India, you can get most prescription drugs over the counter without the prescription. Only difference now may be that Govt may be monitoring it, so medical shops may be a little wary of giving it without prescription

HCQ was made a prescription drug on 27th March 2020. Please see the relevant news story from the Hindu newspaper site.
https://www.thehindu.com/news/nation...le31178859.ece

I'm only trying to suggest that HCQ is commonly considered a safe medication and is widely used by us Indians because of malaria.

[venkyhere]

TLDR - testing-testing-testing mantra is a one-glove-fits-all solution, it doesn't suit every country.

There are so many rants in social media in different styles, but the message seems to be :
"why is India's number of tests/million such a low number, if we had the brute-force testing strategy like Germany/S.Korea, we could have selectively quarantined, instead of this nationwide lockdown. What a poor choice of strategy this current lockdown is, severely impacting the economy".

Well, the counterpoint is - the scale of activity and infrastructure, if we are to adopt a brute-force-testing-instead-of-lockdown approach, is of Himalayan proportions, for a country with 130 crore population.

Let's take S.Korea, a country which exactly followed the "brute-force-test-everyone-in-the-locality" whenever/wherever anyone who is contract-trace-suspected showed up ; and hence didn't have to impose a nationwide lockdown, thus insulating their economy from a cardiac arrest. Their peak testing rate was 0.35 tests per 1000 people per day, for a country with 5 crore population. That means ~17500 tests per day. India's current testing rate (as of 8th April) is ~13000 tests per day, something not far off from the S.Korean numbers. But because of the size of the population, this works out to 0.01 per 1000 people per day. If India were to approach the problem like S.Korea, the testing infrastructure has to scale up 35 times, to ~455000 tests per day. It's just not possible to expand labs within such tight time constraints.

Lets take Italy. Ever since March 27, they are conducting more than 36000 tests per day. That works out to >0.65 tests per 1000 people per day (almost double the Koreans), for a country with 6 crore population. But despite that, their caseload added per day only reduced from +6k/day to +4k/day, over the two weeks since this happened. Too little too late, their medical infrastructure was already reeling, even before March 27th ; and their current lockdown is like bandaid over a gangrenous war wound.

So what does this show ? two countries with 5 and 6 crore populations, one who started aggressive testing early, and was able to manage without lockdown; and the other who started aggressive testing late, and who never had a lockdown until too late, paying the price by struggling to keep the spread and deaths at bay. Crucially, both of them have the capacity, but even more crucially, the timing in deciding to scale up testing was way off in once case.

All this implies -

(1) There are always going to be millions of people across the world (not just in india) who contract the virus, get a mild infection, suffer fever/cough/cold and autorecover, and continue staying at home ; who never ventured to any CoVid hospital and reported their condition because they did not have 'great difficulty to breathe'. This is because everyone has been told to inform and approach a hospital only if the condition is severe. These people will never appear in any stat. So ? So what ? the importance (and focus area) of all the plots/graphs and stats that are flying around right now, is not so much as to actually determine the accurate % of penetration of the virus in the population (only academics are interested in this) as much as it is in spotting 'trends' in the way the data is changing. The latter is what helps make decisions, even with the big hole (the people who get infected, autorecover, and never report to hospital) in the entire stats spectrum, across the world.

(2) a country with the size of population of india, simply cannot tackle it the S.Korea way. Since the lockdown was imposed at an earlier stage (relative to italy), the hope is that mass-quarantine will work out (of course at the expense of economy and hunger deaths, which is an entirely separate topic to debate) and help us not go the Italy way; whilst allowing in the meantime, the valuable window to atleast build testing infrastucture. There is no way a country like India can do 455000 tests per day, right from the onset. India is extemrely poor w.r.t
(i) testing infrastructure per 1000 people
(ii) number of hospital beds per 1000 people.
Trying to attack the problem the S.Korea way, without a strict lockdown, will be a disaster of unimaginable proportions, compared to the current disaster we are in.

Let's just hope that :
(i) the newer strategy for cluster-testing of hotspots works out well, given that our testing infrastructure has improved a lot (still poor if we talk in terms of tests per 1000 people per day) in the recent few weeks.
(ii) it is actually true that the strain(s) of virus in india is a milder, less lethal version that in other countries
(iii) all the seemingly wishful theories/claims of indians having better immunity due to : growing up and living in less hygienic environments OR from BCG vaccination OR rampant usage of turmeric & ginger in any indian household for cooking ; actually turn out to be true ; because any hope is a welcome hope at this point.

[DigitalOne]

I am afraid in India it is still not very well understood that the most vulnerable age-group is the senior citizens.

See the Italian age-wise death statistics: [source]

More people of age > 90 years are dead due to Covid-19 than people < 60 years. Read that again.

So govt should just move the senior citizens from the Red and Orange Zones to the Green zones, to hotels/old-age homes, other families, wherever.

[AirbusCapt]

Originally Posted by Vignesh_N/A

There are engineering graduates in mid level roles with salary less than 4L CTC. How do you think these guys would survive for two years?

Iam only stating the fact. A middle/senior level role which involves more managing and less/nil hands on , in any sector is replaceable. Once eliminated, such positions are filled up last. A technical or functional role may still have some demand in a weak economy. Hence a minimum cushion of two years of expenses are needed to survive on current standard, else one will slip lower down in economic profile.
Even if someone has only 4 lakh CTC and is saving 1 lakh per year for the past 5 years and has a monthly expense of 15/20 k, he can survive for 2 years easily.

[carboy]

Originally Posted by samdarshi.pali

HCQ was made a prescription drug on 27th March 2020. Please see the relevant news story from the Hindu newspaper site.
https://www.thehindu.com/news/nation...le31178859.ece

I'm only trying to suggest that HCQ is commonly considered a safe medication and is widely used by us Indians because of malaria.

What was the class before? I am assuming it was H before & was now made H1. Both H & H1 are prescription drugs. Just as an example Ibuprofen (Brufen) is Schedule H & you can get it without prescription at any medical shop. H1 can also be got with prescription. Most antibiotics fall under H1 & you can buy it without a prescription.

Among Schedule H & H1 drugs, medical shops take anti-pyschotics, anti-depressants, benzos & sleeping tablets a little more seriously - but even those can be bought without prescription if you know the medical shop guy well.

In reality, it's only Schedule X drugs where it's taken really seriously. Because the medical shop needs to keep a copy of the prescription in this case.

[Chetan_Rao]

Not able to source a picture of the retail labeling prior to the schedule change (would need one of our BHP-ian doctors to corroborate), but I believe HCQS was moved from Schedule H to H1 last month. That a lot of stuff labeled H is easily procured OTC in India is a different story.

H1 has more stringent stock-keeping requirements, as indicated by this Press Information Bureau release dated Dec 2013.

[carboy]

Originally Posted by Chetan_Rao

H1 has more stringent stock-keeping requirements, as indicated by this Press Information Bureau release dated Dec 2013.

Press Release is theory. In practice, you can get it without prescription although it's just a little harder than H.

[adi.mariner]

From TOI

Pune firm first in India to get government funding for Covid vaccine
https://m.timesofindia.com/india/pun...w/75102784.cms

[ckranjan]

https://www.dailytelegraph.com.au/bl...d33d5b569134a4

Bravo Daily Telegraph.

[AnandB]

Originally Posted by padmrajravi

Handing out drugs to people in slums will be a very bad idea. That drug has got serious side effects in people with pre-existing conditions. How can the government hand out prescription drugs without actually having a look at people? I hope this is just a rumor and not true.

I have to agree that HCQ seems unproven for Covid19 and even for malaria or immune disease it has it's share of side effects. Current thought process seems to be save some instead of none even with risks. Although people in these positions would gladly take the risk to survive.

I read this post from a FB friend couple of weeks back:



I am happy he is doing fine now but have to say he was incredibly lucky with his experience.

[vivek95]

I said this a few days back and now I am glad that on the auspicious day of "Vishu", Kerala has almost managed to flatten the Covid-19 curve and is all set to welcome the new year. Super duper impressive ! Hail Kerala

-- Dr. Vivek

[Latheesh]

Originally Posted by vivek95

I said this a few days back and now I am glad that on the auspicious day of "Vishu", Kerala has almost managed to flatten the Covid-19 curve and is all set to welcome the new year. Super duper impressive ! Hail Kerala

-- Dr. Vivek

I think it is better to extend the lockdown till end of this month. Hope Karnataka and Kerala do the same. It is bit risky to withdraw lockdown now and two more weeks will give us a clear picture. Increase in daily reported cases are worrying especially in MH, TN, and DL.

[mvadg]

Originally Posted by AnandB

I have to agree that HCQ seems unproven for Covid19 and even for malaria or immune disease it has it's share of side effects. Current thought process seems to be save some instead of none even with risks. Although people in these positions would gladly take the

Not everyone in the USA is convinced!

CIA has privately advised its workforce that taking an anti-malarial drug touted by President Trump and some of his supporters as a promising treatment for the novel coronavirus has potentially dangerous side effects, including sudden death.

Article

[subraiyr]

A question to doctors. If there is a theory that people who have been vaccinated with BCG are less susceptible to severe vivid 19 infection does it make sense to provide a booster dose similar to that of polio ? Will this help reduce the risk of contracting severe vivid 19 infection ?

[The Rationalist]

Originally Posted by subraiyr

A question to doctors. If there is a theory that people who have been vaccinated with BCG are less susceptible to severe vivid 19 infection does it make sense to provide a booster dose similar to that of polio ? Will this help reduce the risk of contracting severe vivid 19 infection ?

That BCG theory is what’s classically an example of spurious relationship. I can come up with another theory and say there are less cases in India because we use Onions, Turmeric , Cow ghee or similar things that is used mostly by Indians. What most probably explains our situation may be the virus strain being different from those causing infection in West.