FM Piyush Goyal challenges Congress’ Mallikarjun Kharge to fight poll against him from Mumbai

Beijing/Zurich, Mar 4: China has approved the use of Swiss drugmaker Roche's anti-inflammation drug Actemra for patients who develop severe complications from the coronavirus as it urgently hunts for new ways to combat the deadly infection that is spreading worldwide.

China is hoping that some older drugs could stop severe cytokine release syndrome (CRS), or cytokine storms, an overreaction of the immune system which is considered a major factor behind catastrophic organ failure and death in some coronavirus patients.

Actemra, a biologic drug approved in 2010 in the United States for rheumatoid arthritis (RA), inhibits high Interleukin 6 (IL-6) protein levels that drive some inflammatory diseases.

China's National Health Commission said in treatment guidelines published online on Wednesday that Actemra can now be used to treat coronavirus patients with serious lung damage and high IL-6 levels.

Separately, researchers in the country are testing Actemra, known generically as tocilizumab, in a clinical trial expected to include 188 coronavirus patients and running until May 10.

Roche, which donated 14 million yuan ($2.02 million) worth of Actemra during February, said the trial was initiated independently by a third party with the aim of exploring the efficacy and safety of the drug in coronavirus patients with CRS.

It added that there was currently no published clinical trial data on the drug's safety or efficacy against the virus.

More than 3,000 people have died and 93,000 have been infected by the novel coronavirus thought to have originated in Wuhan, China, before spreading to around 90 countries including the United States, Italy, Switzerland, France and Germany.

The Swiss company, for which China is its No. 2 market behind the United States, also makes diagnostic gear to detect the coronavirus.

Since Actemra's approval a decade ago, it has become a go-to drug against other inflammatory conditions, including cytokine storms in cancer patients receiving cell therapies from Novartis and Gilead Sciences.

In 2012 it helped save the life of a young U.S. girl, the first child to be treated for leukaemia with Novatis' Kymriah, from a post-treatment rush of IL-6.

Priced at between $20-30,000 annually for RA according to SSR Health, Roche's medicine is also used for rare juvenile arthritis and giant cell arteritis, or inflammation of the blood vessels.

The Ministry of Health and Family Welfare has prepared a draft for guidelines for home quarantine, as well as for the use of masks by public, in view of coronavirus.

What to do in Home Quarantine?

The government says, for those taking refuge to home quarantine should stay in a well-ventilated single-room preferably with an attached or separate toilet. It adds that if another family member needs to stay in the same room, it's advisable to maintain a distance of at least 1 metre between the two.

The government advised, coronavirus patients to stay away from elderly people, pregnant women, children and persons with co-morbidities within the household as their immune system may be low. The health minister also suggested to restrict the patient's movement within the house. "Under no circumstances attend any social/religious gathering e.g. wedding, condolences, etc, said the guideline.

It also instructed the corona virus infected person to avoid sharing household items like dishes, drinking glasses, cups, eating utensils, towels, bedding, or other items with others at home. The guideline also demanded that even though home quarantine, the patient should wear a surgical mask at all times. "The mask should be changed every 6-8 hours and disposed off. Disposable masks are never to be reused, it added.

"Masks used by patients/ caregivers/ close contacts during home care should be disinfected using ordinary bleach solution (5 per cent) or sodium hypochlorite solution (1%) and then disposed of either by burning or deep burial," instructs the government.

Even for family members of a patient, the health ministry clearly instructs to use disposable gloves when cleaning the surfaces or handling soiled linen. No visitors, under any circumstances will be allowed, said the guideline.

"In case the person being quarantined becomes symptomatic, all his close contacts will be home quarantined (for 14 days) and followed up for an additional 14 days or till the report of such case turns out negative on lab testing," states the draft.

How to wear & dump masks?

There is a specific and elaborate do's and don'ts also released by the ministry. For those unsure in which mask to choose, it says, "Medical masks of different sizes and shapes are available in the market. The common ones are flat pleated masks of woven fabric which covers the nose and mouth and affixed behind the head with straps/ elastic fasteners. There are also conical or duck bill shaped masks with valves (or without valves) that fit in the contour of face over the nose and mouth, but are costlier."

However, the ministry warns, medical masks should not be used by healthy persons who are not having any symptoms "because it creates a false sense of security". Instead, it suggests to refrain from touching face, mouth, nose and eyes as well as washing hands regularly with soap for 20 seconds each time.

However, when a person develops a cough or fever, the suspected patient needs to switch to medical masks. "Use of medical three layer masks when ill, will prevent your infection from spreading to others. However you also need to wash your hands frequently to avoid spreading infection to others," read the guideline.

Even if one is not tested positive but showing symptoms, they are advised to wear masks while visiting a healthcare facility. "Close family contacts of such suspect/confirmed cases undergoing home care should also use Triple layer medical mask," it warns.

The ministry has also given point by point guideline on how to use a mask like to make sure that they are facing down while unfolding or for that matter to ensure there are no gaps on either side of the mask.

It even warns, "Fit flexible nose piece (a metallic strip that can easily be located) over nose-bridge" to ensure no one else are infected. The government also warns against simple dumping of the masks once used. Instead one should disinfect "using ordinary bleach solution (5 per cent) or sodium hypochlorite solution (1 per cent) and then disposed of either by burning or deep burial," says the Health Ministry.

COVID-19 emerged in early December 2019 in China's Wuhan province and has now spread to over 100 countries. As on March 9, 2020, India has reported 42 cases mostly among those who had travelled from affected countries.

However the government says, "It causes a minor illness in majority of patients with symptoms of fever and or cough. A small proportion of such persons may progress to severe disease with difficulty in breathing."

Mar 18: Madhya Pradesh Congress Party sought in the Supreme Court on Wednesday that the trust vote in the state assembly be deferred till by-polls for the vacant seats are concluded, saying "heavens are not going to fall" if its government led by Kamal Nath is allowed to remain in office till then.

A bench, comprising Justices D Y Chandrachud and Hemant Gupta, was hearing cross petitions filed by former Madhya Pradesh Chief Minister and senior BJP leader Shivraj Singh Chouhan and MP Congress on the ongoing political crisis in the state after 22 rebel MLAs of the ruling combine purportedly offered to resign.

"Heavens are not going to fall if Congress government is allowed to continue till by-polls and the Shivraj Singh Chouhan's government must not be saddled on the people," said senior advocate Dushyant Dave, appearing for Congress.

"Let them face re-elections and then hold trust vote... You (BJP) have engineered it. My petition raises the frontal attack that you have launched a conspiracy," he said.

Senior advocate Mukul Rohatgi, appearing for Chouhan, vociferously opposed the submission saying that the party which killed the democracy by imposing emergency in 1975 is now referring to "lofty ideals" of B R Ambedkar.

He said that after the resignations of 22 Congress MLAs, out of which six resignations have been accepted, the state government should not be allowed to continue even for a day.

"It is lust of power because of which all these lofty arguments are being made.

"It is unheard of that a person who had lost majority says that he wants to continue for six months and there should be re-election before the trust vote.

Rohatgi said the Kamal Nath government wanted to stay in power by hook or crook.

Earlier in the day, the Madhya Pradesh Congress told the bench that a probe is needed on the resignation letters of its rebel MLAs that have been submitted by BJP leaders to the Speaker of the state Assembly.

Dave said the Governor has no business to send messages at night asking the Chief Minister or Speaker to hold floor test.

"The Speaker is the ultimate master and the Madhya Pradesh Governor is overriding him," he said.

The party alleged that resignations of its rebel MLAs were extracted by force and coercion and they did not act as per their free will.

It also said that its rebel MLAs were taken away in chartered flights and are currently incommunicado in a resort arranged by the BJP.

The advancing of arguments will resume after lunch.

The Madhya Pradesh Congress Legislature party (MPCLP) had Tuesday moved the Supreme Court seeking direction to the Centre and the BJP-led Karnataka government to grant it access to communicate with its rebel MLAs allegedly kept at Bengaluru.

Earlier on Tuesday, the court had asked the Kamal Nath government in the state earlier in the day to respond by Wednesday to a plea by senior BJP leader Shivraj Singh Chouhan seeking immediate floor test in the Assembly.

MPCLP, in its plea filed by Govind Singh, an MLA and chief whip of Congress legislature party, urged the apex court to declare as illegal the action of the Centre, Karnataka government and the MP BJP of illegally confining its MLAs in Bangaluru.

The plea, filed through senior lawyer Devdutt Kamat, said the trust vote would be a "sham" if 22 MLAs did not take part in it as almost 10 per cent of constituencies go unrepresented.

The plea filed by Chouhan and nine BJP lawmakers was moved in the top court just after the Speaker cited coronavirus concerns and adjourned the House till March 26 without taking the floor test apparently defying the directions of Governor Lalji Tandon.

The plea alleged that the Speaker, the Chief Minister and the Principal Secretary of the Assembly have "flagrantly violated the constitutional principles and have deliberately and wilfully defied the directions" issued by the governor asking the government to prove the majority on the floor of the house on March 16 when when the budget session was to commence.

On Saturday night, Tandon wrote to Nath asking him to seek a trust vote in the Assembly soon after the Governor's address on Monday, saying his government was in minority.

After the Speaker accepted the resignation of six Congress MLAs on Saturday, the party now has 108 legislators.

These include 16 rebel legislators who have also put in their papers but their resignations are yet to be accepted.

The BJP has 107 seats in the House, which now has an effective strength of 222, with the majority mark being 112.