Rules on social distancing have brought about changes in policies on the schedule and the way by which medical consultations will be conducted.
Hospitals now limit the number of doctors who will do private consultations at a given time, the number of patients each doctor will see, and the duration of clinic hours. Most doctors will also cut down on the number of their clinic days per week. Consultations will be by appointment only, so before your medical checkup, set an appointment with your attending doctor who will in turn include your name in the short list of patients that he or she will see for the day. All patients have to pass through triage stations and those with signs or symptoms have to proceed to the emergency room for assessment.
Doctors in private clinics are now required to wear personal protective equipment: face shield or goggles, a respirator/mask, scrub suit, and a protective coat or apron. Patients are required to wear a mask. An accompanying person will be allowed only for patients who are on wheelchair or need assistance.
Patients are encouraged to keep their appointment and to avoid any cancellation. Social distancing will also be observed among patients in waiting areas.
On drugs for COVID-19
Avigan is the brand name of Favipiravir, a drug that is classified as an antiviral agent. It was first introduced in Japan as a treatment for the common flu and possibly replace or be used like Oseltamivir for this illness. It was eventually reserved for the treatment of severe cases of new types of influenza (not the common seasonal flu). It is being studied and used in Japan to treat the Covid-19 and is set for approval this month as a drug for Covid-19 treatment. Japan has offered to give Avigan pills for free to other countries.
Studies have shown that the drug affects the enzyme that promotes viral replication and may also cause changes (mutations) in the virus that renders it nonviable. It has not been shown to affect the RNA or DNA processes in mammalians (this group includes human beings). It was developed and is being manufactured by Toyama Chemical, a subsidiary of Fujifilm company. It was approved for medical use in 2014 and marketed as a generic drug in 2019. In China, it was approved on March 2020 for influenza treatment under the brand name Favilavir. The Chinese government later supported its use for the Covid-19. It is not commercially available in the United States but research is being done on its effectiveness on the coronavirus.
In studies on animals, it was shown that Avigan can inhibit the replication of the Ebola virus. In humans, it was used only during clinical trials and in desperate attempts to treat Ebola viral disease.
Teratogenecity or the potential to cause birth defects is the dangerous side effect of Favipiravir or Avigan. When used in pregnant women, it restricts the growth of a baby’s arms or legs, similar to those caused by the drug Thalidomide in the 1950s.
While some doctors say that it is effective especially when used early in the course of a coronavirus case, other doctors advise that its use should be backed up by traditional large scale randomized controlled trials to show that it is effective and safe. The Philippines will be one of several countries that will participate in a trial on Avigan and is set to receive 12,200 pills for the study.
Remdesivir, a drug now authorized in the U.S. and in Japan for the treatment of the Covid-19, is still an investigational drug in the Philippines. In the World Health Organization solidarity trial that involves 24 research sites, 500 patients in the Philippines will be enrolled. Department of Health authorities say that 40 patients have already been enrolled as of this writing.