- Dexamethasone has been approved as a second treatment of COVID-19 by Japan’s Health Ministry.
- This steroid is cheap and widely used. Trials in Britain has also showed the drug reduced mortality rates in hospitalised patients.
- The Ministry included dexamethasone as an option for treatment along with Gilead Sciences Inc’s antiviral drug remdesivir in a recent revision to its handbook.
Hike in sale & share
- After the news aired in Japanese media the shares of Nichi-Iko Pharmaceutical Co, among those that produce the drug, gained as much as 6.5% in early trade.
- Dexamethasone sales across our country also increased as compared with other crucial steroids like prednisolone (around 12 per cent) and methylprednisolone (around 17 per cent), it saw the highest growth — around 22 per cent — among high burden states like Maharashtra, Tamil Nadu, Karnataka and Delhi during this period.
- Data for sales of the drug so far in July are not available yet, but doctors treating COVID-19 patients attest to a rise in its use following the results of the Oxford study.
This made Doctors confident
- Max Healthcare, which has treated around 5,000 patients since April, now uses either dexamethasone or methylprednisolone in “at least” 50-70 per cent of the COVID-19 patients.
- “The benefit of steroids is their effects start within 8-12 hours. It really helps control hyper inflammation,” Max Hospital medical director Dr Sandeep Budhiraja said.
- The study has also added to confidence among doctors in Delhi to use steroids overall as part of COVID-19 treatment.
- Going by the new evidence, Fortis Hospital-Mulund’s director of intensive care, Dr Rahul Pandit, has switched a “majority” of his ventilated patients over to dexamethasone from other steroids like methylprednisolone.
Other options also
- Prednisolone and methylprednisolone also have a wider spectrum of action than dexamethasone, according to Dr Om Srivastava, who treats COVID-19 patients at different hospitals in Mumbai.
- But, for him, the results of the Oxford study show that dexamethasone “definitely” has a role to play in the treatment of patients of moderate disease.
- “In patients who are not critically ill, I start with dexamethasone. In patients who become critically ill, I switch back to any preparation of … prednisolone,” he said.
2. India will never be a part of an alliance system
- External Affairs Minister S. Jaishankar said that non-alignment is an old concept today, but India will never be a part of an alliance system.
- He said that the consequences of global shifts, including the United States and the assertiveness of China were opening spaces for middle powers like India, Japan, the European Union and others.
- “Non-alignment was a term of a particular era and geopolitical landscape. One aspect was independence, which remains a factor of continuity for us,” Mr. Jaishankar said.
- He was addressing at a virtual conference organised by CNBC-TV18 on the “Geopolitics of opportunity: as the world rebalances, how should India capitalise?”
Time to take more risks
- Mr Jaishankar said that India must now take more “risks”, as the world expected it to take a more proactive stance on the “big issues” of the day, including connectivity, maritime security, climate change and terrorism.
- In his comments he did not mention the ongoing tensions over the Line of Actual control though cited an example of comparison.
- The Minister said that India had moved slowly in comparison to China on the economic front, and that China’s economy was now five times that of India’s despite them being the same size in 1988.
‘We could have done better’
- “In comparison with China and with South East Asia, we could have done better. We didn’t intensively industrialize and push manufacturing, we opened up much later, a full decade and a half after China, and then didn’t commit to full reforms the way China did,” Mr. Jaishankar said.
- However, he defended India’s decision to stay out of Free Trade Agreements (FTAs) like the Regional Comprehensive Economic Partnership (RCEP).
- He also pointed out that India had not benefited from them in the past, and trade deficits had increased.
Issues with neighbours
- When asked about India’s issues with neighbouring countries, where it is seen as a dominating force, he said that it was natural for smaller countries to feel insecure about their “independence and identity”.
- “If you are a big country with smaller neighbours around you there is a natural dynamic. We need to create structural linkages that help our neighbours take care of their political cycles,” he said.