This story is from May 29, 2020

Hyderabad: Cops taking HCQ shield but doctors warn of unchecked use

With a spurt of Covid-19 positive cases in the police force, the men in khaki have started taking hydroxychloroquine (HCQ) as a prophylactic drug to safeguard themselves against the virus. As per the advisory of Union ministry of health and family welfare, IPS officers as well as field-level staff have been taking HCQ tablets under medical supervision. However, with the World Health Organisation (WHO) suspending use of HCQ for treatment of Covid-19 patients in view of high mortality rate, city doctors warn that indiscriminate use of the anti-malarial drug may lead to drug resistance against some strains of malaria.
Hyderabad: Cops taking HCQ shield but doctors warn of unchecked use
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HYDERABAD: With a spurt of Covid-19 positive cases in the police force, the men in khaki have started taking hydroxychloroquine (HCQ) as a prophylactic drug to safeguard themselves against the virus. As per the advisory of Union ministry of health and family welfare, IPS officers as well as field-level staff have been taking HCQ tablets under medical supervision.
However, with the World Health Organisation (WHO) suspending use of HCQ for treatment of Covid-19 patients in view of high mortality rate, city doctors warn that indiscriminate use of the anti-malarial drug may lead to drug resistance against some strains of malaria.
During the past two days, 17 police personnel posted in various units of the city tested positive for Covid-19. With the number of coronavirus cases increasing in the department, senior officials have decided to take preventive medicine as per the Union health ministry advisory issued on May 22.
As per the advisory, apart from asymptomatic healthcare workers involved in containment and treatment of Covid-19 and asymptomatic healthcare workers in non-Covid hospitals, asymptomatic household contacts of laboratory-confirmed cases, the prophylactic use of HCQ has been recommended for, “asymptomatic frontline workers, such as surveillance workers deployed in containment zones and paramilitary/police personnel involved in Covid-19 related activities.”
Subsequently, Telangana police officials started advising the staff to go for prophylactic use of HCQ under strict medical supervision. “We have advised staff on Covid-19 field duties to consult a doctor and, based on doctor’s advice, take prophylactic doses of HCQ. The stock is available at government hospitals,” additional director-general (Law & Order), Jitender said.
According to experts, HCQ is known to cause severe health issues in case of overdose or indiscriminate use. Major health problems triggered by HCQ include change in heart rhythm, heart failure, change in blood sugar levels and muscle damage. It may also trigger suicidal tendencies and may trigger depression.
Health experts claim that species of malarial parasite have already developed resistance to some known drugs including chloroquine (CQ) and HCQ. Many areas in Telangana and AP are endemic to malaria and doctors warn that uncontrolled use of hydroxychloroquine will result in a scenario wherein the drug may not work when it is needed to treat malaria.

Dr Shyamala Iyengar, senior consultant, internal medicine, Apollo Hospitals, Hyderguda, said HCQ and CQ, though widely used antimalarial drugs, have immunomodulatory effects and are thus prescribed for experimental therapies for Covid-19 patients. “Chloroquine had developed resistance way back in 1973 first to falciparum malaria and later to vivax malaria. “Indiscriminate use of the drug is definitely a threat. New drugs have come up for malaria treatment since chloroquine. As clinicians we should keep a watch on drug resistance,”Dr Iyengar said.
Dr Suneetha Narreddy, consultant, infectious diseases, said: “We don’t know how much HCQ usage will confer protection or result in ‘breakthrough’ malaria that is chloroquine-resistant. We will need studies to look at resistance of vivax malaria to HCW on HCQ prophylaxis. As a rule of thumb, any vivax malaria in someone on HCQ prophylaxis should be tested for CQ resistance. This cannot be done on a regular basis. It can be done only in research settings”.
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