Ministry of Health
and Family Welfare
One of the lowest globally,
Health Ministry issues FAQs on better Clinical Management of COVID patients in
ICUs
Posted On: 02 SEP
2020 12:35PM by PIB
The deaths per
million population in
As part of the
COVID management and response policy, there has been a sharp focus of the
Central Government on not only containing the COVID related fatality, but to
reduce deaths and to save lives by providing quality clinical care to the
critical and severe patients of COVID. Collaborative efforts of the
A unique
initiative to build the capacities of the ICU doctors in clinical management of
critical patients towards reducing the fatality, e-ICU has been started by
AIIMS,
Till date, 17
tele-sessions have been held, and 204 institutions have participated in them.
To further build
the ICU/clinical management capacities of doctors for treatment of critical
patients, AIIMS New Delhi in collaboration with the Health Ministry has
developed FAQs. These have been posted on the MoHFW website. They can be accessed
at:
https://www.mohfw.gov.in/pdf/AIIMSeICUsFAQs01SEP.pdf
The FAQs are
dynamic in nature, drawing from the experience and knowledge collected during
clinical management of the COVID critical care patients in the ICUs. As new
challenges are posed by the treating doctors, and new concerns raised and
addressed by them, the document shall be accordingly updated incorporating the
evolving knowledge.
FAQs on COVID-19
from AIIMS e-ICUs
·
1.
Should we use HCQ as prophylaxis in health care workers (HCW)?
Hydroxychloroquine
(HCQ) has been advised as prophylaxis in HCW and high-risk contacts without
contraindications. It can be used along with proper use of PPE and other
infection control practices to protect from COVID 19.
·
2.
Can Ivermectin be used for COVID patients?
Ivermectin has
been found to be a potent inhibitor of SARS CoV2 replication in vitro, but the
doses required to achieve this effect in vivo far exceeds the usual dose. It is
currently not recommended in the national guidelines but can be used in
patients in whom HCQ is contraindicated.
·
3.
Should we continue using anticoagulation post discharge?
In our experience,
there have been no delayed post-COVID thrombotic complications. Since the
prothrombotic state parallels the viremic and inflammatory phase, once the
patient has been discharged, the thrombotic risk also decreases. So, we don’t
recommend anti-coagulation at discharge in routine COVID patients unless
indicated for other reasons like DVT, prosthetic valve etc.
·
4.
Sudden deaths in COVID-19
Sudden deaths have
been reported both at presentation to emergency department (ED) as well as in
hospital. Reasons that have been proposed include a sudden cardiac event/ ACS,
preceding silent hypoxia that went unnoticed or due to a thrombotic
complication such as pulmonary thromboembolism. Patients with risk factors to
develop severe COVID or with prior comorbid conditions such as CAD or chronic
lung disease should be strictly monitored for their saturation. They should not
be allowed to move unattended. Anticoagulant should be used in all at-risk
patients who do not have any risk factors of bleeding.
·
5.
Methyl prednisolone vs dexamethasone
Corticosteroids
are currently indicated in moderate to severe COVID-19 patients. Recovery trial
has used dexamethasone. However, both IV dexamethasone or methyl prednisolone
may be used based on the availability.
·
6.
What is the role of Tocilizumab?
Tocilizumab has
been approved by DCGI on compassionate ground in view of ongoing pandemic.
However, it is an experimental therapy, has a limited role, and should be used
only in patients with cytokine syndrome after ruling out active infections.
·
7.
What is the role of Plasma therapy?
Convalescent
plasma collected from ABO matched donors with high neutralizing titers can be
given to patients at risk of developing severe COVID in early stages
of the disease. However, it should also be considered an experimental
therapy and should be used with caution.
·
8.
Role of Favipiravir
Studies have used
Favipiravir mainly in mild or asymptomatic COVID, claiming to prevent
progression, whereas majority of this cohort recover with just supportive care
and monitoring and usually require no specific therapy. Evidence is weak for
the use of Favipiravir and is currently not recommended in national guidelines.
·
9.
Role of antifibrotic in prevention of lung fibrosis
There is no
evidence to support the use of antifibrotic agents like pirfenidone in
preventing COVID related fibrosis and hence should not be used.
·
10.
How to prevent depression in COVID 19 patients?
Depression is a
common finding in patients with COVID which may be because of number of reasons
including staying in isolation, anxiety related to disease, social stigma,
among others. Such patients need empathy and psychological counselling
preferably by a trained HCW like a psychologist / psychiatrist.
·
11.
Can we give Remdesivir/TCZ in a highly suspect patient who
is COVID negative on all reports?
Remdesivir/TCZ are
experimental therapies, approved by DCGI in view of the ongoing pandemic.
Therefore, they should not be used as empirical therapy for suspected cases. You
should use these agents only in proven COVID patients, where clinically
indicated.
·
12.
Can we try Methylene blue?
No, there is no
role of methylene blue in the management of COVID.
·
13.
How long can we give Remdesivir?
Remdesivir is
currently recommended for 5 days in once daily dosing.
·
14.
Can we use Remdesivir/TCZ prophylactically in
asymptomatic patients with comorbidities?
There is no
evidence to support the use of Remdesivir/TCZ in asymptomatic patients with
comorbidities.
·
15.
Should relatives be allowed to visit COVID-19 patients admitted
in the wards?
No, relatives are
not allowed to visit COVID-19 patients as they have chances to get infected and
transfer it to the community.
·
16.
Can parents be allowed to stay with COVID-19 positive children?
Parents can stay
with the children after explaining the risk and taking consent for the same.
·
17.
Should we continue steroids on discharge?
No, there is no
role of steroids at the time of discharge unless indicated for any other
concomitant disease.
·
18.
How do we maintain nutrition in a patient on ventilation?
Patients on
ventilator may require TPN or Ryle’s tube feeding depending on their underlying
condition.
·
19.
When should we shift from NIV to invasive ventilation?
If the patient is
not able to maintain saturation, going into respiratory fatigue, or the GCS is
poor to tolerate NIV, they should be considered for invasive ventilation.
·
20.
When should we consider a tracheostomy?
Patients in whom
prolonged ventilation is anticipated should be considered for tracheostomy.
****
MV/SJ
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Ministry of Health
and Family Welfare
12 States/UTs have Recovery Rate more than the National Average
Recoveries exceed active cases by more than 2.1 million
Posted On: 02 SEP
2020 4:57PM by PIB
The total recoveries in
Last 10 lakh recoveries have been recorded in only 17 days in comparison
to preceding 10 lakh recoveries which were recorded in 22 days.
A significant feature of
Since May 2020, there has been a 58 times hike in the number of recovered patients.
12
States/UTs have reported a Recovery Rate more than
the National Average. Two states,
The number of patients recovering is on a steady rise over the past
several months. As the daily recoveries increase,
The number of recovered cases has overtaken the active cases by more than 21 lakhs. There has been more than 4 times jump in the average weekly recoveries from the first week of July to last week of August.
For all authentic & updated information on COVID-19 related
technical issues, guidelines & advisories please regularly visit:
https://www.mohfw.gov.in/ and @MoHFW_INDIA.
Technical queries related to COVID-19 may be sent to
technicalquery.covid19@gov.in and other queries on ncov2019@gov.in and
@CovidIndiaSeva .
In case of any queries on COVID-19, please call at the Ministry of
Health & Family Welfare helpline no.: +91-11-23978046 or 1075 (Toll-free).
List of helpline numbers of States/UTs on COVID-19 is also available at
https://www.mohfw.gov.in/pdf/coronvavirushelplinenumber.pdf
****
MV/SJ
HFW/COVID
Recoveries/2September2020/2
(Release ID: 1650654) Visitor Counter : 100
Ministry of Health
and Family Welfare
Dr. Harsh Vardhan digitally interacts with Executive Director,
Stop TB Partnership
“Even during COVID times, TB is a priority. Eradication of TB from
Posted On: 02 SEP
2020 6:20PM by PIB
Dr. Harsh Vardhan, Union Minister of Health and Family Welfare digitally
interacted with Dr Lucica Ditiu, Executive Director, Stop TB partnership, here
today.
The Union Minister stated that elimination of TB is a priority for the
Indian government. He added that the Government is committed to scaling up
access to free diagnosis through rapid molecular tests, provide information on
drug resistance and also free treatment for all people with TB with
best-quality drugs and regimens, financial and nutritional support to patients.
Dr Harsh Vardhan added that the Government is committed to the use of
digital technologies for notification and adherence and linking with interface
non-governmental agencies to strengthen private sector engagement.
Dr Harsh Vardhan emphasised that though the country is fighting with the
COVID pandemic for the last eight months, it is ensured that the health
department and health officials in all the states were constantly reminded
about the target of elimination of TB by 2025. “Through our efforts on the
front of fighting COVID, we have shown to the world that India can be a role
model for other countries as we have achieved self reliance in terms of
domestic manufacturing of masks and PPE kits”, he stated.
“India, under the guidance of our Hon’ble Prime Minister, Shri Narendra
Modi, has accorded a high priority for ending tuberculosis in India by 2025,
five years ahead of the Sustainable Development Goals (SDG) target of 2030, and
stepping forward as a leader for a TB-free world”, Dr Harsh Vardhan said during
the digital interaction. In the recent years,
Dr Lucica applauded and thanked the Government of India for its
commendable efforts in fighting TB.
****
MV/SJ
HFW/Stop TB
partnership/2September2020/3
(Release ID: 1650702) Visitor Counter : 42
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