Maharashtra needs 10,000 doses of life-saving injections per day

A doctor conducts COVID-19 tests in Mahim. Pic/Ashish Raje

Welcoming a move to restrict the black marketing of life-saving drugs remdesivir and tocilizumab, the Maharashtra chapter of the Indian Medical Association (IMA) has asked the state government to increase the supply of these injections to at least 10,000 vials per day.

The estimation is based on IMA's analysis of the current scenario and the projected requirement. IMA president Dr Avinash Bhondwe told mid-day that there are around 1 lakh active cases of COVID-19 in the state, out of which around 20,000 people need these injections. "If 30 per cent more patients with negative or inconclusive test reports are added, then around 26,000 patients need them," he said.

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According to Dr Bhondwe, every patient needs six injections of remdesivir. "It means Maharashtra needs 1.5 lakh remdesivir injections today itself. But do we have them? If there are 7,500 new patients daily, 1,500 would require the drug, which translates to 10,000 vials daily," he said, adding that the state government must have the present stock assessed and supply chain built formidably as per the need.

Dr Mangesh Pate, chairman of Hospital Board of India (Maharashtra) and member of IMA's National COVID Task Force, said he was surprised to hear a senior doctor from Mumbai (part of state COVID management) saying that only 15 per cent COVID-19 patients need remdesivir. "This is unfounded and yet if we believe him, the state's 15,000 active patients will need it. Do we have that much drug available today?" he said.

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Dr Bhondwe said both remdesivir and tocilizumab are not available even after producing the prescription. "According to the FDA's July 11 circular, the injections will be directly supplied to hospitals for which a prescription and COVID-19 positive report is essential. This keeps asymptomatic or negative patients away from the crucial drugs," he said.

Why insist on test reports?
The IMA also finds the condition of producing a report, Aadhar card and prescription as detrimental to the life-saving mechanism. "It's a welcome policy for people who are admitted, but what about those who show mild symptoms and may not be admitted? What about those who test negative but would undergo test again? They also need to be administered remdesivir in the initial stages," said Dr Bhondwe.

"Tocilizumab is needed in critical patients and the application of remdesivir prevents the patients from becoming critical. The remdesivir doses are fixed, but one can't say about the other drug," he said, adding that the purchase policy should be reworked so that all who need the drugs can benefit.

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