Covid-19 pandemic has devastated the whole world and with vaccine still eluding mankind, Home Therapy could go a long way to checkmate the fatality rate, Professor Luigi Cavanna, Chief of Onco-Hematology at the Hospital in Piacenza, near Milan, Italy who pioneered Home Therapy in Italy and cured hundreds of patients says in an exclusive interview with Dr. Pratapaditya Mishra.

Excerpts from the Interview:

At what point you have realized that there is a need for Home Therapy for the people of Italy?

I realized the need for Home Therapy when I became aware that many patients arrived at the emergency department after too much time, more than 7-10 days, of symptoms characterized by fever, cough, asthenia, dyspnea. Secondly, the emergency department was saturated with Covid -19 positive patients, it was difficult to treat them all.

What are the data on the cases you’ve been treating? Have you made a study of it?

The data covers about 300 patients that I have treated at home at an early stage. No deaths. Hospitalization rate: less than 5%. Percentage of discharged patients who recovered: 100%. We are writing a third research paper to send out for publication in scientific journals, after two of our research papers have already been published in Future Science Group.

What were the necessary steps for proper home care that you established? Would you change them today?

The steps are: home visit, chest ultrasound, swab. Then, if the clinical picture is compatible, start therapy immediately: i.e. isolation of the patient and administration of the correct dose of medicine. However, it is essential to follow the patient remotely, leaving a blood oxygen monitor, and asking every day how he or she is progressing: are the patients taking the medication, are they eating, what symptoms do they have, are they experiencing any side effects from the treatment. Arrangements should be made for telephone calls at least twice a day, and a contact telephone number should be left that the patient can call at any time if needed.

Does Hydroxychloroquine (HCQ) drug work?

Our experience shows that HCQ works, if used early. In the coming months I hope that additional research on the effectiveness of HCQ will be published by ourselves and other health centers. This evidence could change the WHO’s position. Our statistics indicate two fundamental positive points for HCQ: safety and efficacy, provided that adequate doses are used early, and for a treatment period of no longer than 10 days! Subcutaneous heparin is used in all bedridden patients, both at home and in the hospital.

What do you suggest for India, where it is on a rise?

In general, I would first suggest a strong public information campaign to continue about how the virus spreads and taking preventative measures. Home Therapy can be initiated for the identified patients at the early stage to arrest the spread and reduce the burden on the hospitals. India has very large young population and the recovery shall definitely be faster.

There is a speculation that there may be another Corona pandemic wave shortly. What are your suggestions to tackle this?

I apprehend a second wave of Corona pandemic may be there by October/ November this year and for that one should get ready from now onwards and the experience of last six months will help the government to step up its preparation to tackle it in a much better way.

Today, we know a lot more than we did in February and March 2020. Above all, we know that if the treatment starts early, serious complications are avoided, and therefore, mortality and hospitalization are reduced. In case of new peaks, I would organize by first offering fundamental information, that is to advise the attending physician about the first symptoms of cough and fever.

In the presence of these symptoms, a home swab test and chest ultrasound should be performed. If there is any pneumonia, immediately start the HCQ treatment, with the following dosage: 800 mg on the first day, then 400 mg/day for another 6 days.

Should you practice Home Therapy at the early stage of Corona infection and follow all the prescribed protocol then situation will not go out of your hand. Hopefully, the vaccine should be available and be accessible to the people by then.

Thank you, Prof. Cavanna for picking up a leaf from the Italian book of treatment in this difficult hour of Covid-19 pandemic and showing the people a different way.

It is a great pleasure speaking with you and sharing my experience.

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