Revised government advisers recommend the use of hydroxychloroquine as a preventative medicine for asymptomatic health workers working in non-COVID-19 hospitals, frontline staff about surveillance tasks in detention zones and paramilitary / police personnel involved in activities related to coronavirus infection.
As mentioned in the previous advisor, drugs against infection are also recommended for all asymptomatic health workers involved in the detention and treatment of COVID-19 and household contact with laboratory confirmed cases.
The revised counsel issued by ICMR on Friday, however, warned that drug intake should not instill a false sense of security.
The recommendation was made after the Joint Monitoring Group under the leadership of the Directorate General of Health Services (DJCK) and included representatives from AIIMS, ICMR, the National Disease Control Center, the National Disaster Management Authority, WHO and experts drawn from central government hospitals reviewed the use of prophylaxis hydroxychloroquine (HCQ) in the context of expanding it to health services and other frontline workers stationed in non-COVID-19 and COVID-19 areas.
Three new categories – all asymptomatic health service workers working in non-COVID hospitals / hospital areas / COVID blocks, asymptomatic frontline workers such as surveillance workers assigned to detention zones and paramilitary / police personnel involved in COVID-related activities -19 – has now been entered.
According to the revised advisor, “at NIV, Pune, HCQ in-vitro test reports for antiviral efficacy show reduced infectivity and log reduction in viral RNA copies of SARs-CoV2”.
“This drug is contraindicated in people with known cases of retinopathy, hypersensitivity to HCQ and heart rhythm disorders,” he said.
This drug is not recommended for prophylaxis in children under 15 years and in pregnancy and breastfeeding, the adviser said.
The drug rarely causes cardiovascular side effects such as cardiomyopathy and rhythm disorders, he said.
“In that situation the drug needs to be stopped. This drug can rarely cause vision problems including blurred vision which usually heals itself and improves on stopping the drug,” said the revised advisor.
The drug must be given under strict medical supervision with approval, he said.
The National Task Force (NTF) for COVID-19 formed by ICMR reviewed the use of HCQ for prophylaxis of SARS-CoV-2 infection for high-risk populations based on emerging evidence of its safety and efficacy.
Data on HCQ prophylactic assessment among 1,323 health workers showed mild side effects such as nausea (8.9 percent), stomach ache (7.3 percent), vomiting (1.5 percent), hypoglycemia (1.7 percent) and cardio effects -vascular (1.9 percent), the adviser said.
However, according to data from the Indian pharmaceutical development program, there are 214 examples of adverse drug reactions related to the use of HCQ prophylaxis, he said.
Of these, seven are safety reports of serious individual cases with extended QT intervals on ECG in three cases, he added.
Highlighting studies on SARS-CoV-2 infection prophylaxis, the advisor states that a retrospective control case analysis in ICMR has found that there is a significant dose-response relationship between the number of prophylactic doses taken and the frequency of SARSCoV-2 infections in symptomatic health workers tested for symptomatic health workers tested for coronavirus infection.
Other investigations from three central government hospitals in New Delhi showed that among health workers involved in COVID-19 treatment, those who used HCQ prophylaxis were less likely to develop SARS-CoV-2 infection, compared with those who did not use it.
The benefits are less prominent in health care workers caring for the general patient population.
In addition, a prospective observational study of 334 health care workers at AIIMS, of which 248 used HCQ prophylaxis in New Delhi also showed that those who used HCQ prophylaxis had a lower incidence of SARS-CoV-2 infection than those who did not use it.
According to the adviser, the drug should be given only by prescription from the registered doctor and it is advisable to consult a doctor for any adverse events or potential drug interactions before starting treatment, he said.
Frontline workers must use PPE according to guidelines issued by the ministry of health and they should be advised to consult with their doctors (in hospitals / surveillance teams / security organizations) for any adverse events or potential drug interactions before starting treatment, said the adviser.
If a person becomes symptomatic while undergoing prophylaxis, he must immediately contact a health facility, be tested according to national guidelines and follow standard treatment protocols, he said.
Regardless of the symptoms of COVID-19 (fever, cough, difficulty breathing), if a person using chemoprophylaxis experiences other symptoms, he should immediately seek medical treatment from the prescribed medical practitioner, he said.
All asymptomatic contacts from laboratory confirmed cases must remain in home quarantine according to national guidelines, even if they use prophylactic therapy, the adviser added.
(Except for the headline, this story has not been edited by NDTV staff and was published from a syndicated feed.)
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