Karan M wrote:We really need to look at prophylaxis and drug treatment cocktails now, beyond Remdesivir alone. And need to take that up on a war footing. There is little chance we can vaccinate all our population this year.
I am not a health care professional and all my information comes from tons of reading, collating all the reports about COVID for many months. The "best/gold standard" care anyone can get in the U.S. is the Trump treatment (all given at a fairly early stage in the disease cycle). Remdisivir, Monoclonal Antibody (MAB) therapy (Lilly or Regeneron) and Dexamethasone. I am not aware India has any supply, contract for the MAB therapies which seem to be the most promising of all the therapeutics for COVID.
The one promising anti-viral that seems to have shown good efficacy against COVID is being developed by Merck (in partnership with a smaller Bio Tech). Still in phase 3 clinical trials. This is a pill and seems to be more easy to administer with "take at home" potential.https://www.bloomberg.com/news/features/2021-03-25/merck-mrk-molnupiravir-pill-could-change-the-fight-against-covid
It is very clear from all the anecdotal evidence that the Eli Lilly and Regeneron mono clonal antibodies are effective as well but ONLY during early phases of disease progression. In fact they also seem to work as prophylactics. However the Trump admin had signed contracts for a few hundred thousand doses at an exorbitant amount something like $2-$3K per treatment course. Also they were supply limited back then and now may have a few million doses on offer. However, the monoclonal antibody treatment needs to be IV infused in a clinical setting (which is cumbersome for a "outpatient"). It also requires 5 days, 1 dose per day so requires as many clinic visits for 2-3 hours of IV treatment. One of the reasons that a lot of the U.S. supplies are apparently going unused (per 1 WSJ article) in U.S. hospitals.
When a country like India or Brazil is dealing with 100'sK infections per day - unless it is a "pill like" "take at home" prescription medication it would be logistically difficult to use mono clonal antibodies as therapeutics. However, they could be used as "vaccine bridges" and could provide immunity for 3-6 months till more vaccine supplies become available but even if GOI is able to procure 10M+ doses within 3-4 weeks and administer it as a "vaccine bridge" to high risk population that needs "immediate" immunity the #s India is dealing with (for ex. 10M doses is 3 days of vaccinations at the current rate) they will not move the needle. However they do have the ability to save 1000's of lives if administered to "high risk" patients early in the disease cycle before they worsen enough needing to be hospitalized.
Indian medical community seems to be using Remdisivir, Invermectin, Tocilizumab, Favipiravir in certain combinations. Other than Remdisivir I do not believe any of the other treatments above are being employed in the U.S. As luck would have it the much touted Remdisivir has been declared a "dud" by the WHO.
In addition to the above, for seriously ill patients Indian doctors seem to be combining the above treatments with Oxygen supplement and steroids such as Dexamethasone. Very few patients that have to be put on a ventilator seem to make it out of the hospital. There is no miracle cure at this point for this horrible virus if the patient arrives at the hospital at a very late stage with a serious pneumonia, low oxygen & damaged lungs.