THE GIST of Editorial for UPSC Exams : 24 March 2020 (Hydroxychloroquine is recommended for very specific cases (Indian Express))

Hydroxychloroquine is recommended for very specific cases (Indian Express)

Mains Paper 3:Science and Tech 
Prelims level:  Hydroxychloroquine
Mains level:Hydroxychloroquine’s efficacy in COVID-19 patients

Context:

• Hydroxychloroquine, a drug that has existed for several decades, could see a resurgence of demand, after the Indian Council of Medical Research (ICMR) on Monday recommended its use as a post-exposure prophylactic (preventive medicine) against the novel coronavirus disease.
• Last week, US President Donald Trump had said a hydroxychloroquine-azithromycin combination could be a “game changer” in the fight against COVID-19.
• What is known about hydroxychloroquine’s efficacy in COVID-19 patients?
• Hydroxychloroquine (not to be confused with anti-malaria drug chloroquine) is an oral drug used in the treatment of autoimmune diseases such as rheumatoid arthritis. 
• On March 19, an article in The Lancet Global Health explored its therapeutic and prophylactic properties. 
• Notably, the drug shows antiviral activity in vitro against coronaviruses, and specifically, SARS-CoV-2 [the virus that causes COVID-2]. 

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What has India recommended?

• The National Taskforce for COVID-19 has recommended hydroxychloroquine for prophylaxis in case of asymptomatic healthcare workers involved in the care of suspected or confirmed cases of COVID-19 and asymptomatic household contacts of laboratory confirmed cases. 
• The new guidelines say: “Hydroxy-chloroquine is found to be effective against coronavirus in laboratory studies and in-vivo studies.
• Its use in prophylaxis is derived from available evidence of benefit as treatment and supported by pre-clinical data.
• The following recommendation… is based on these considerations, as well as risk-benefit consideration, under exceptional circumstances that call for the protection of high-risk individuals.”
• Doctors in the private sector are, however, cautious. ICMR guidelines are very specific for specific people. We have to limit it to them. It cannot become something that everybody uses,” 

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So, should you stock the drug?

• The short answer is, no. If you suspect you have contracted the infection, you should visit a doctor. 
• You must not attempt to self-medicate. Even the government’s guidelines on hydroxychloroquine say the drug has to be given only on the prescription of a registered medical practitioner.

What combination did Trump speak of?

• The combination is hydroxychloroquine with azithromycin, a commonly used antibiotic. On Saturday, following a press conference in which he endorsed the combination, Trump tweeted: HYDROXYCHLOROQUINE and AZITHROMYCIN, taken together, have a real chance to be one of the biggest game changers in the history of medicine. 

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Way ahead:

• While the roles of chloroquine and hydroxychloroquine in management of COVID-19 are still open questions for the scientific community, the azithromycin-hydroxychloroquine combination is part of an upcoming multicountry trial anchored by the WHO in the fight against COVID-19.
• The azithromycin-hydroxychloroquine combination has sometimes been administered to COVID-19 patients in the US, the CDC says. 
• In a small study in the International Journal of Antimicrobial Agents published on March 17, French scientists reported: “Twenty cases were treated in this study and showed a significant reduction of the viral carriage at D6-post inclusion compared to controls, and much lower average carrying duration than reported of untreated patients in the literature. Azithromycin added to hydroxychloroquine was significantly more efficient for virus elimination.”

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Conclusion:

• Simply put, the combination did reduce the viral load but the size of the study is too small to draw a definitive conclusion.

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Prelims Questions:

Q.1)With reference to the Aircraft (Amendment) Bill, 2020, consider the following statements:

1. It aims to amend the Aircraft Act, 1934.
2. The Bill converts only two existing bodies ((i) the Directorate General of Civil Aviation (DGCA) and (ii) the Bureau of Civil Aviation Security (BCAS) under the Ministry of Civil Aviation into statutory bodies under the Act.  

Which of the statements given above is/are correct?
(a) 1 only
(b) 2 only
(c) Both 1 and 2
(d) Neither 1 nor 2

Answer...........................................

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Mains Questions:
Q.1)What is known about hydroxychloroquine’s efficacy in COVID-19 patients?What has India recommended?