As India encounters a second wave of COVID-19 with a huge spike in the number of positive cases, the rise in the demand for Remdesivir, an antiviral drug used in the treatment of COVID-19, has resurfaced once again in the country.
The demand for the antiviral drug has shot up and is so acute during the second wave that we are witnessing frantic calls on social media to long queues outside a drugstore. With the drug in short supply, there have been multiple cases of theft, selling of the drug at high rates in black markets and illegal hoarding of Remdesivir.
Recently, 850 vials of the Remdesivir were stolen from Bhopal’s Gandhi Medical College in Madhya Pradesh. The antiviral drug had been air-lifted to the capital city after a rise in demand for the drug. According to the FIR, no other drug apart from Remdesivir were stolen from the stores.
Due to increased demand, the central government banned the export of Remdesivir on April 11 this year. Many states including Maharashtra, Madhya Pradesh and Gujarat have sent out urgent requests to stock up on Remdesivir injections. On Sunday, Jharkhand Cheif Minister Hemant Soren wrote to the Central government seeking permission to import a large number of Remdesivir doses from Bangladesh to counter the high demand for the drug in the state. The demand is such that people are running from pillar to post to get their hands on the antiviral drug.
The stocks are flying off the shelves of pharmacies ever since the second wave hit the county. But is Remdesivir really a magic drug that can help in the treatment of the COVID-19? Not really.
Remdesivir was manufactured in 2014 by the US-based biotechnology firm Gilead Sciences for the treatment of Ebola. Subsequently, the drug was also used to treat diseases caused by the member of the Coronavirus family - Middle East Respiratory Syndrome (MERS) and Severe Acute Respiratory Syndrome (SARS). According to experts, Remdesivir is an anti-viral drug that helps in preventing the replication of the virus. It inhibits the enzyme and blocks the replication of the virus in the body. Last year, a US study of Remdesivir by Gilead showed that the treatment of Covid-19 with Remdesivir cut recovery time by five days compared with patients who got a placebo in a trial comprising 1,062 patients.
However, various studies have found that Remdesivir can potentially have very limited benefits. World Health Organisation also stated in its solidarity trial in November last year that Remdesivir had "little or no effect" on mortality.
A study published in The Lancet Journal in November 2020 suggests that the drug is effective only when administered to those who are diagnosed with a risk of hyper inflammation, before 10 days into the infection.
Dr Neeraj Nischal, an additional Professor Internal medicines, AIIMS explained that Remdesivir is not effective on every patient and most patients don’t even require it.
“Remdesivir works by incorporating itself into the genetic material of the virus and prevents the replicating enzyme from making new copies of the virus. The mechanism appears very promising but the actual effect in patients is not so. It is not a miracle cure for Covid and not every patient requires it. In fact, most patients don’t require Remdesivir for surviving this disease,” Dr Nischal told The Times of India.
“Remdesivir is beneficial only in a very small subset (in terms of shortening the time to recovery by approximately 5 days) of patients who present early in their disease and are on low-flow oxygen. Outside this group of patients, it really is not much better than a placebo,” he added.
The jury is still out there to decide whether Remdesivir is the magical cure to COVID-19. However, the various myths surrounding the drug have led to the irrational use of Remdesivir in various parts of the country.