â¢ Inoculation of grade 9-12 students begins in the province today
â¢ Sheet allows the use of alternatives for Actemra
KARACHI / ISLAMABAD: In a significant development, the Sindh health department decided to introduce a compulsory vaccination scheme against Covid-19 in restaurants, hotels, banks, post offices and courier services .
Meanwhile, the Drug Regulatory Authority of Pakistan (Drap) has approved alternative drugs and allowed healthcare facilities to use them for critically ill Covid-19 patients.
As many as 3,747 people have been infected and 61 have lost their battle with the disease in a single day. The national positivity rate was 6.47%, according to data shared Sunday by the National Command and Operation Center (NCOC).
Sindh’s interior ministry approached NCOC to enforce the ruling on banks and post offices.
The provincial government has also decided to start immunizing students in grades 9 to 12 from Monday (today).
While critically ill patients do not get tocilizumab – sold under the brand name Actemra – due to its shortage or their inability to buy it on the black market at almost 10 times the rates, Drap approved. alternative medicines and authorized hospitals to use them to treat critically ill Covid-19 patients.
An official statement from the Department of National Health Services (NHS) said tocilizumab, especially in combination with dexamethasone, had been effective in reducing the death rate in Covid-19 patients whose respiratory systems had broken down quickly and needed a high flow oxygen supply. device or non-invasive ventilation.
âHowever, there is now a shortage of this life-saving drug (Tocilizumab) not only in Pakistan but around the world. Regulators in various countries have redirected healthcare providers to alternatives. According to the latest guidelines issued by the NHS Department, baricitinib or tofacitinib are suitable alternatives to tocilizumab. Both belong to the same class of anti-inflammatory drugs, namely Janus Kinase Inhibitors (JAK). Baricitinib (or tofacitinib) should only be given in combination with dexamethasone or another corticosteroid, âhe said.
âHealthcare workers, especially those involved in the intensive care of Covid-19 patients, should visit the National Command and Operation Center (NCOC) website and review the guidelines which include more details on dosage and precautions. Â», Concluded the press release.
A senior ministry official, asking not to be named, said tocilizumab – sold under the brand name Actemra – had been given to critically ill patients, but its shortage was felt worldwide.
âWe tried to get 1,000 vials of Actemra last month, but even the company couldn’t arrange for the injection because the drug ran out. We have no choice but to opt for alternatives which have the same characteristics as Actemra but which have not been authorized by Drap to be administered to Covid-19 patients, âthe official said.
Responding to a question, he said some countries are also using the alternatives and Pakistan is now doing the same.
Talk to Dawn, a pharmacist said Actemra contains monoclonal antibodies and is used to lock down the immune system.
Monoclonal antibodies are proteins made in the laboratory that mimic the ability of the immune system to fight off harmful antigens such as viruses.
âDuring Covid-19, the immune system becomes overactive and starts killing human cells that have coronavirus and as a result the patient is more affected. Medicines like Actemra lock down the immune system and prevent it from killing cells. However, this process can also be dangerous as a patient is prone to attacks from all diseases as the immune system stops working, âsaid the pharmacist.
He said Pakistan had less than two-thirds of the population compared to the United States (US), but “we used 10 times more Actemra than America”.
He said the drug had side effects and could be very dangerous. “There are a number of other monoclonal antibodies and they also block the immune system,” he added.
The pharmacist said the injection was priced at 55,000 rupees, but was sold for 400,000 rupees on the black market.
“It is a positive step that Drap has approved alternatives to tocilizumab,” he added.
NHS ministry spokesman Sajid Shah said Dawn that it was a fact that Actemra injection was not available on the market.
“Drap discussed the matter in a meeting and finally came to the conclusion that certain drugs, having the same properties, can be used as an alternative,” he said.
The decisions of the government of Sindh
Sindh Health Minister Mehar Khursheed’s spokesman said in a press release that the latest decision has been taken to ensure compulsory vaccination.
Copies of two letters were attached to the declaration. One of the letters written to the additional chief secretary by the senior technical manager of the health department, Dr Sohail Raza Shaikh, states: âIn order for the vaccination campaign to be more successful, it is strongly recommended that all restaurants / hotels can provide their hospitality services (check-in / open-air catering services) only to vaccinated persons. The health department has asked the home’s additional chief secretary to give direction to affected neighborhoods for strict compliance.
Another letter sent to NCOC states, âFor a further increase in immunization coverage and to ensure the success of the immunization campaign, it is strongly recommended that the necessary instructions to all commercial banks, post offices and other courier services be issued to offer their services only to people vaccinated by checking their Nadra vaccination record.
In a related development, a meeting chaired by Sindh Education Minister Syed Sardar Ali Shah on Sunday decided that vaccination of students in grades 9 to 12 will start from Monday (today), the spokesperson said. word of Minister Saeed Memon.
The meeting, attended by school education secretary Ghulam Akbar Leghari, college education secretary Khalid Hyder Shah and directors of education from all districts in the province, reviewed the measures taken for the vaccination of teachers and students in all public schools and colleges.
Mr. Leghari expressed his dissatisfaction with the performance of the regional directors, the spokesperson said. “I am receiving complaints that you (regional directors) have not been on the ground and such negligence would not be tolerated,” the minister said.
Posted in Dawn, le 6 September 2021