Coronavirus ourbreak: ICMR gets nod for ‘restricted use’ of
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The Indian Council of Medical Research (ICMR) has obtained permission for “restricted use in public health emergency” of two second-line HIV medications for use against the novel coronavirus (nCoV).

Top Health Ministry officials said these medications are to be used only in “vulnerable” cases, as they are not without side-effects.

Senior citizens, children, those with existing conditions such as diabetes and heart disease are among those considered vulnerable.

Meanwhile, two of three nCoV patients in the country have already started showing signs of lower viral load with traditional treatment, officials said. According to sources in the Health Ministry, although they continue to test positive for the virus, the lowering of viral load seems to suggest that in healthy young individuals — like all these three patients — the virus may not need aggressive medication.

The progress of the three patients who had tested positive is in line with initial estimates which suggest that while it is extremely infectious, nCoV 2019 is not exactly a deadly virus; it has a fatality rate of only 3 per cent, according to officials. Hong Kong-based expert Malik Peiris also said coronavirus is less severe, although it is much more difficult to control. He said that in the absence of specific anti-viral medication or vaccine, “good hospital management can dramatically improve clinical outcomes and survival”.

A senior official said, “The viral load of the first two nCoV patients has come down tremendously on its own. Although they are still positive, they are showing very good recovery. This shows that if you are young and healthy, the virus can be controlled.” On the second-line HIV medications, officials said 70 per cent of HIV-positive people in India are on first-line drugs. The combination of Lopinavir and Ritonavir has been approved for emergency medical use only if the nCoV situation in India turns into a public health emergency. Guidelines have been framed for their use.

A ministry official said, “The drugs for which ICMR has got approval are for restricted use in a public health emergency – they have not yet been administered to anyone.”

Meanwhile, Hong Kong-based public health virologist Prof Malik Peiris, who played a key role in identifying the SARS virus in 2003, told The Indian Express that anti-viral medication used during SARS and MERS-coronavirus outbreaks had included anti-HIV medication.

“The drug works in test tube but it is not clear whether it is beneficial in patients. (So) randomised clinical trials are required,” he said. “Another new drug Remdesivir, designed to treat Ebola but which has shown activity against coronavirus, is being tested,” Peiris added.

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