Mumbai docs want key drugs made available fast as hospital wards swell up

If patients recover faster, they needn't stay in hospital for 14 days and this could free up beds; Remdesivir and Favipiravir are in the process of being made available in India

Aryan Bose (name changed) was asked to go home by a hospital in Central Mumbai earlier this week after he was not showing any symptoms of the novel coronavirus and his vitals were stable. He was admitted there for only four days and had earlier stayed in another hospital in the eastern suburbs of the city from where he hails, for another four days. So, Bose could go home within eight days and no diagnostic test was conducted on him before he was let off. The relaxed guidelines from the Centre now allow patients to go home earlier if they feel better. Asymptomatic patients in the city are being asked to stay home if they have separate rooms as the city's cases continue to soar. 

Mumbai's coronavirus run-rate is hovering around 1,500 cases per day now. The city administration is trying to ensure that more patients recover faster and can be discharged from hospitals sooner. The city doctors are now urging to make two drugs, currently not available in India for patients - remdesivir and favipiravir - available in Mumbai at the earliest to combat the growing crisis. 

The doctors' task force in Mumbai has now urged chief minister Uddhav Thackeray to find a way in which these drugs, that have shown positive results in patients in other countries be made available to clinicians in Mumbai. If patients recover faster, they do not need a hospital stay of 14-days and this could free up beds in hospitals and, in turn, save more lives. 

 

Speaking to Business Standard, Dr. Sanjay Oak, who heads the task force said, "Our first priority is to save lives. These two drugs - remdesivir and favipiravir- have shown promise. So we have requested the government to ensure that these be made available for use as soon as possible. Companies can spring into action and make them once the government gives a nod," he said. 

As such Mumbai doctors are already conducting trials on patients for a Roche drug that is exclusively sold in India by Cipla - tocilizumab. A biologic drug sold under the brand name Actemra is used to treat auto-immune disorders like rheumatoid arthritis. Already some critical patients in Mumbai's Nair Hospital and King Edward Memorial (KEM) Hospital have been administered this drug and have shown significant improvement. 

"Tocilizumab and also favipiravir are top on the list of potential therapies for Covid-19 of the Centre's task force too," said a pharma player here. Dr Oak said that for both favipiravir and remdesivir the drugs can be made by Indian companies, but this process needs to be expedited now. 

Mumbai's Glenmark Pharmaceutials is conducting trials for favipiravir on patients in India and the results are expected around July. Sources claim that at least 100 drug companies in India are gearing up to supply the drug in the domestic market which is administered as an oral dose for a 14-day period. A Pune based company Brinton Pharmaceuticals is even gearing up to export the drug to 18 countries from here and has readied a stock of one lakh tablets. Rahul Kumar Darda, the chairman and managing director of Brinton Pharma said that they would launch the drug in India once they get the drug regulator's nod. 

Remdesivir, on the other hand, is a patented drug from Gilead in US. The company has signed non-exclusive licensing deals with three Indian companies including Cipla, Jubilant and Hetero. All the three are gearing up to make the drug available in the domestic market soon. By June one can expect remdesivir, which was originally developed for Ebola, to be available in the Indian market. The pricing of the drug is yet to be announced. 

 

Apart from looking at new drugs for treating patients here, the city of Mumbai is also gearing up to ramp up its hospital bed capacity. Dr. Oak said that within the next few days the idea is to have around 25,000 Covid-19 beds in the city. If the city continues to add close to 1500 patients every day and only 20 per cent of them need hospitalisation, the daily new bed requirement would be around 300, a tall ask. 

Hospitals aside, Mumbai is thus adding bed capacity for the mild patients on a war footing. Around 1000 beds have already been readied in the city's business hub Bandra Kurla Complex grounds. Covid care centers are coming up over municipal schools, gymkhanas etc. 

A Vapi based company Aryan Papers, that have come up with a cardboard bed, had supplied around 1000 beds to the Brihanmumbai Municipal Corporation (BMC). Sources say that a new requisition for 7000 cardboard beds that can be easily assembled without any glue or taping, and also folded and transported conveniently has been placed with the company. These low cost beds (priced around Rs 900-1000) would be used in the quarantine or isolation centers. 

Another major challenge awaiting the country's business capital is the monsoons. In June the monsoons are likely to hit Mumbai known for its torrential rains. The BMC has thus also started preparing for vector borne diseases like malaria, dengue etc which are common with the monsoons.