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CORONAVIRUS CASUALTIES (July 3):- GLOBAL:- Total Cases: 1,10,53,545; Total Deaths: 5,25,410 Recovered: 61,91,434 BELGIUM:- Total Cases: 61,727; Total Deaths: 9,765 BRAZIL:- Total Cases: 15,02,424; Total deaths: 62,045 CANADA:- Total Cases: 104,936; Total Deaths: 8,644 CHINA:- Total Cases: 83,542 ; Total Deaths: 4,635 FRANCE:- Total Cases: 1,66,378; Total Deaths: 29,875 GERMANY:- Total Cases: 196,738; Total Deaths: 9,064 INDIA:- Total Cases: 6,33,381; Total Deaths: 18,320 INDONESIA:- Total Cases: 60,695; Total Deaths: 3,036 IRAN:- Total Cases: 2,35,429; Total Deaths: 11,260 ITALY:- Total Cases: 2,40,961; Total Deaths: 34,818 JAPAN:- Total Cases: 18,874 ; Total Deaths: 975 MEXICO:- Total Cases: 2,38,511; Total Deaths: 29,189 NETHERLANDS:- Total Cases: 50,335; Total Deaths: 6,113 PHILIPPINES:- Total Cases: 40,336; Total Deaths: 1,280 RUSSIA:- Total Cases: 6,67,883; Total Deaths: 9,859 S KOREA:- Total Cases: 12,967; Total Deaths: 282 SPAIN:-Total Cases: 2,97,183; Total Deaths: 28,368 SWEDEN:- Total Cases: 70,639; Total Deaths: 5,411 SWITZERLAND:-Total Cases: 32,101; Total Deaths: 1,965 UAE:- Total Cases: 49,469; Total Deaths:317 UK:- Total Cases: 2,83,757; Total Deaths: 43,995 US:- Total Cases: 28,54,976; Total Deaths: 1,31,663 - India Travel Times.Com   [Estd: 1998]       * * *    Travel, More Travel, Travel Means A Million Things     * * *    

India prescribes dexamethasone for coronavirus - But it can be fatal, How?

What is the hoopla over dexamethasone's re-invention, is it a medicine for covid? In the absence of a medicine for the new viral disease, our immune system is the only defence against coronavirus. Dexamethasone, an immunosuppressant, dumps down that. Death is certain.

Doctors are already administering limited doses of other such immunosuppressant corticosteroids in inflammatory complications in covid cases where it can help in terminal cases. That should be the doctor's choice. And here what is the new thing?

A drug for cytokine storm, dexamethasone is commonly used for inflammation in asthmatic exacerbations and arthritis, giving relief. Now the finding is it works in coronavirus, but in advanced stage needing ventilator, and saves one-third of those terminal patients! Difficult to comprehend?

NEW DELHI, June 29: The Health Ministry has revised the clinical management protocol to include a re-purposed dexamethasone in the therapeutic course for terminal patients of coronavirus on ventilator or oxygen support.

Universally available, cheap, safe and well-known, it is commonly used as anti-inflammatory in asthmatic exacerbations and arthritis since 1960s. True, it helps in the management of inflammation associated with critical corona cases too.

The Ministry's decision follows the Oxford researchers' finding in the RECOVERY (Randomised Evaluation of COVid-19 thERapY) clinical trial that dexamethasone saves the lives of one-third of patients on ventilator and one-fifth of patients on oxygen support. The Phase II/III randomised trial had begun in March last. In 175 NHS hospitals in the UK, 2,104 patients were given 6 mg per day of dexamethasone for 10 days. The trial found mortality rate was reduced from 40% to 28% in patients on ventilators and 25% to 20% in those on oxygen. Patients who did not need respiratory assistance did not respond to the medicine!

(Because it is not a medicine for coronavirus. On the contrary, it can be fatal for coronavirus patients. It only helps in associated complications - but not all - acting against cytokine storm. That the treating doctor has to decide. While the British Prime Minister's announcement was misguiding, WHO Director-General Dr Tedros Adhanom Ghebreyesus' encore, "green shoots of hope," showed a lack of adequate medical knowledge a second time!)

There are over 2,000 clinical trials/research going on to find a vaccine or medicine for Covid-19, the new viral disease of which nothing much is known, except what China has provided. After Wuhan, the epidemic has engulfed the world, claimed lakhs of lives, ruined the global economy, and is still on the rampage.

So far the result has been zero. And therefore existing drugs are being re-purposed. Re-purposing usually a doctor's prerogative on a case-to-case basis, has turned into a research industry, re- inventing, re-naming and re-packaging old drugs. Sales are instant and worldwide, needs no other advertisement. Harvest time for the pharmaceutical industry, when the world is on fire!

Dexamethasone works by decreasing extreme response of the immune system to infections and traumas thereby reducing symptoms such as inflammation, swelling and allergic reactions and thereby saving the patient from resulting complications like bleeding, clotting, strokes and abrasions like damage to various organs. That is to say, in the case of covid, these complications and damage caused to other organs is not by the infectious disease but by the body's own defensive system going into an overdrive. Dexamethasone calms the immune system and reduces the inflammation. That's it. But, coronavirus can be become more virulent.

There is nothing new about dexamethasone. Doctors are already administering limited doses of other such corticosteroids in inflammatory complications in covid cases where it can help, not routinely. Why the British Government and the WHO are resorting to such a publicity blitz?

In the absence of a medicine for the new viral disease, our immune system is the only defence against coronavirus. Dexamethasone is an immunosuppressant that dumps down the immune system. Therefore, dexamethasone can be fatal for corona patients when administered as a standard medicine.

Oral dexamethasone is commonly used for inflammation in asthmatic exacerbations and arthritis. It is a common steroid used since 1960, cheap and universally available and well-known. It acts against cytokine storm. A glucocorticosteroid, classified as corticosteroid and more potent than prednisone, it starts acting in 8-24 hours. It has also a role to play as a palliative in hospices at the end of life.

However, remdesivir, favipiravir, hydroxychloroquine, lopinavir- ritonavir, azithromycin, tocilizumab, convalescent plasma etc are being symptomatically administered to patients in India and elsewhere by doctors as experimental drugs in good intention in the absence of a medicine for the new epidemic.

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