The Remdesivir mess in Tamil Nadu
In the last week of April, Tamil Nadu announced that it would begin sales of Remdesivir, a drug used to treat moderate cases of Covid-19 but in short supply, directly to patients of private hospitals. In its infinite wisdom, amid the raging second wave of the pandemic, the state chose to make the drug available for sale through counters at a single location in Chennai. To no one’s surprise, masses of people, desperate to purchase the drug, thronged the hospital from across the state. Tokens issued quickly ran out and people took to waiting outside the hospital from the wee hours of the morning, hoping to purchase a drug that experts have cautioned is of limited efficacy (if at all). Despite complaining that it was being wildly overprescribed, officials did not take action against errant hospitals. Meanwhile, black marketing of the drug thrived. Once the DMK government took charge, some decentralisation occurred but did little to mitigate the stress on patients or their families. Finally, on Thursday, the state informed the Madras High Court that it would shift the venue of sale in Chennai from the Kilpauk Medical College and Hospital to a large stadium instead. It assured it would sell 20,000 vials a day.
Yet, this solution remains far from ideal and does little to prevent the chances of crowds gathering or the risk of Covid clusters forming, given that TN’s active caseload is nearing two lakhs. Just as private hospitals have transferred the pressure and cost of sourcing the drug to patients, so has the state. What is the way forward? First, the state must continue to educate doctors when and how to use the drug, especially among those who may not have treated too many Covid cases before the second wave. Second, the state must look at the merits—and flaws—in the methods adopted by Maharashtra and Andhra Pradesh to address the issue. Both supply the drug directly to private hospitals based on their requirements. Neither has fully mitigated the stress on the patients’ families, but they certainly offer a pathway that could streamline the process, reduce stress on already stressed families, keep an eye on overprescribing while also preventing the gathering of large crowds at a time when the state is struggling to meet the demands for beds and oxygen.