Andhra: State IMA issues advisory to handle second wave of COVID; stresses on genome sequencing

In a letter to the State COVID nodal officer, the association recently mentioned that the second wave of coronavirus can last up to 3 months and such waves will keep coming till 75% of the population is vaccinated and herd immunity is achieved. The newly mutated virus has the potential to skip immunity and even vaccine and can prey on children also. " Routine RT-PCR tests may not detect the mutated virus. However, loss of smell is a very strong indicator that a person is corona positive. Stomach upset, diarrhea, severe headache, extreme fatigue are some of the new symptoms in this second wave", added the association.

Hence, IMA, AP placed special importance on genome sequencing and stated, " patients' samples are not sequenced to find out if a variant might have been involved; some labs are throwing out test samples before an analysis can be done; govt should look into this issue." It was further mentioned, " A 'double mutant' variant of COVID-19 virus found in India is a cause of growing concerned. The variant, named B.1.617, has been found in more than 60% of the sequenced samples from Maharashtra and also detected in nine other states of the country. Double mutant' means the B.1.617 variant of SARS-CoV-2 carries two mutations, E484Q and L452R. Both are separately found in many other coronavirus variants, but they have been reported together for the first time in India."

IMA doctors have also appealed for the proper distribution of medical oxygen. According to the letter, the daily production capacity of medical oxygen in our country is 7000 MT. Currently, daily medical oxygen consumption in the country was 4000 metric tonnes. Despite sufficient production, there is a marked scarcity in distribution. Hence, IMA urged the govt administration to look into the matter.

Commenting on the illegal hoarding of Remdesvir, the association urged the government to react immediately and make arrangements so that this antiviral drug can remain available. The government should take initiative for enhancing production capacities and for proper distribution, suggested the association. IMA also placed importance on strengthening covid infrastructure and human resources. "As cases are rising at an alarming rate and test positivity is at 16% now, it's high time that the govt should enhance the workforce and strengthen the covid care hospitals. adhoc recruitment of doctors and paramedical &nursing force should be initiated to maintain the proper care.", added the association.

Moreover, IMA AP clarified that along with ensuring the availability of healthcare workers, protecting the frontline force is equally important. The association mentioned some of the measures which can be adopted to protect health workers and front line force, for instance, 2 weeks COVID duty followed by one week quarantine; and supply of quality PPE kits, daily monitoring of spot temperature, and weekly rapid antigen tests. " Govt must implement the quad principle – "Test –trace-treat-vaccinate" and see that public adhere to it at any cost", stated the association.

Talking to Medical Dialogues, IMA AP President, Dr Neralla Subhrahmanyam stated, " genome sequencing may prove to be useful as the new strain of COVID might show the presence of the mutated virus. Moreover, Ramdisiver is commonly used in treating COVID patients as it can reduce the stay in the hospital but it is important to use and distribute the medication very judiciously. If people keep on getting hold of this from outside and start self-medication at home then moderate and severely ill COVID patients who are in actual need of the medication might get deprived of it. Moreover, hoarding of any medication can lead to serious consequences. Hence, authorities must pay attention to this problem as well."