The trial use of Hydroxychloroquine, a malaria drug, is getting momentum in Bangladesh where confirmed cases and fatalities from COVID-19 have been rising steadily.
Some seven patients died and 312 new persons contracted the deadly coronavirus on Sunday (in last 24 hours).
The pandemic is causing concern among ordinary people and front-line healthcare workers alike as nearly 100 medical professionals have already been infected with the virus.
Although there is no robust evidence of the efficacy of the drug, a number of doctors as well as the relatives of COVID-19 patients have started using the medication as early-stage clinical trial.
Hydroxychloroquine has been used for the treatment of malaria since the 1930s.
Doctors, who are exposed to COVID-19 patients, said they are using the drugs as 'prophylaxis treatment' in line with the national guideline issued by the DG Health on the pneumonia-like illness.
The National Guideline for Clinical Management of Coronavirus Disease-2019 (Covid-19), Version 5.0, published on April 9, 2020, said asymptomatic healthcare workers involved in the care of suspected or confirmed cases of COVID-19 may use the 400 mg dose once a week for 40 days.
The guideline has recommended the drug on the basis of limited in 'vitro and anecdotal' clinical data in several case series and observational studies as well as risk-benefit consideration under exceptional circumstances that call for the protection of highly-exposed individuals such as healthcare workers.
Medical experts, however, said it is only recommended for doctors or frontline health workers who are providing treatment to the COVID-19 patients.
It has been found many people are purchasing the drugs without prescription from the doctors, sparking its artificial shortage in the market.
The experts said this is a multi-purpose drug and its shortage will force other patients who use the medication to suffer.
For example, the medicine is also used for the treatment of rheumatoid arthritis or lupus in addition to malaria.
Medical experts and virologists said as the drug has some side-effects, people need to conduct some tests, including ECG, before using it. They warned against self-consumption without taking advice from physicians.
Talking to the FE on Sunday, the Prime Minister's personal physician and advisor to the national coordination committee for COVID-19, Professor ABM Abdullah said they have recommended the drug in the national guideline following some international evidence as there is no proven drug to fight the virus yet.
"It might reduce some risks. We have recommended it in a low-dose for doctors," he said.
There is no adequate evidence of its effectiveness and it will require some time to see whether the drug is working on the virus, he said.
It is a safe drug except for those who have diabetics or other complications, he said.
"We recommend this drug for some patients for three to five years. So its low dose use may not create any severe complications," he said.
Nazrul Islam, a former professor of the Department of Virology at Bangabandhu Sheikh Mujib Medical University (BSMMU), said people who are physically fit can use the drug since there is no curative medicine for COVID-19.
It has no severe side-effect, but patients with heart, kidney, liver diseases should not use it, he said.
Countries like America are showing enthusiasm for using this for preventing the coronavirus, he added.
Dr Shaiful Hassan Shameem, radiation oncologist at the National Institute of Cancer Research and Hospital, said he along with some of his colleagues has started using the drug as a precautionary measure.
"We don't know which patient is COVID positive. Some of the patients are concealing their COVID-like symptoms," he said.
The recommendation from the Directorate General of Health Services has prompted them to use the drug as prophylaxis, he said.
He said the drug is already scarce in the market due to panic buying by some people.
Dr Mostafa Aziz Sumon, assistant professor and head of department of oncology at Kurmitola General Hospital, a designated facility for COVID-19 patients, said the drug may cause cardiac problem so it is mandatory to do an ECG before one can take it.
Currently, it is difficult to do the test due to the exposure of COVID-19 patients in this hospital, he said.
Professor Shahnila Ferdousi, director of the disease control and line director, Communicable Disease Control at the Directorate General of Health Services, said the national guideline has been prepared with the recommendation from the prominent medicine specialists.
They have recommended it for incorporation into the guideline, said Dr Ferdousi.
Companies such as Incepta, Becon, Beximco, and Delta are manufacturing the medicine in Bangladesh.
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