The city of Pune as of last week had recorded a total of 4107 positive COVID-19 cases. Of these 44 patients were critical, with a total of 1698 active patients. The recovery rate of patients stood at 53.1 percent and the death rate at 5.5 percent.

The protocol undertaken by the Pune Municipal Commission includes early identification of comorbid patients. These patients are diagnosed via the use of mobile diagnostic buses, which help in immediate response. The PMC has also set up a committee to audit deaths; it met 4 times last week where each death was reviewed in detail.

When it comes to medications, the PMC is using anti-malarial drug Hydroxychloroquine or HCQ. They are giving HCQ on top priority to suspected patients with no co-morbidities who are in institutional quarantine, as a preventive drug. Currently, around 800 patients--half the total patients currently in institutional quarantine--fall in this bracket and are being administered HCQ. The remaining patients are being administered HCQ under supervision after investigations such as ECG and blood sugar.

The use of HCQ comes at a time when there are rising concerns about the likely side effects of the drug. The Indian Council of Medical Research last week issued a revised government advisory recommending the use of HCQ as a preventive medication in asymptomatic healthcare and frontline workers such as the police. The advisory was issued around the same time that the medical journal The Lancet issued a study on the usage of HCQ saying it didn’t benefit patients with Coronavirus. The drug as per the study indicated it was linked to an increased risk of death and heart issues. In light of this fresh data from the Lancet, the World Health Organisation or the WHO stopped enrolling patients into a trial using HCQ on COVID-19 patients.

For more serious cases, the PMC is administering the drug Tocilizumab, the drug developed by Roche to treat rheumatoid arthritis. Cipla has the license to sell the drug in India, and it is being tried on critical COVID-19 patients. The biggest deterrent to the wider use of the drug according to medical experts, is the price. At Rs 40,000 for one 400 mg vial, most hospitals in Mumbai are currently depending on donations to source the drug. The PMC is planning to use the drug initially on 25 patients and analyse the results before further use. The patients will be administered a dose of either 5 to 6 mg or a maximum of 400 mg once a day, with a 24-hour gap. between each dose The Task Force in Pune has decided to recommend the drug only in specific situations. The 25 patients will be treated with 2 injections per patient. The PMC has given an order worth Rs 15 lakh for 50 injections.