Interview by Laura Campanelli and Manuela Zafferani – IppocrateOrg
October 24th , 2020
Interview to Dr Dilip Pawar, Global Medical Head, Clinical Pharmacologist, Cancer Research Scientist and recently a Covid expert in Mumbai, India. An example for all of to follow.
Q: May You please tell us any information about You, You deem appropriate and interesting for this interview and how did you discover the existence of IppocrateOrg Movement?
A: Myself Dr Dilip Pawar, am a physician and Preventive Oncologist and during the last 8 months I have been working on Covid-19, helping in treatment of patients developing treatment protocols and doing research on Use of Steam Inhalation therapy for Prevention as well as treatment .
I am associated with Grace Cancer Foundation and Orchid Cancer Trust. On behalf of Grace Cancer Foundation, we have screened the largest number of self- diagnosis cases for Breast Cancer and we have Guinness Book of World Record for the same. On behalf of Orchid Cancer Trust we are doing research on steam therapy in Covid prevention and treatment.
While working on Covid-19 and during interaction with few of my international team colleagues I came across IppocrateOrg Movement and I got associated with it as I found it interesting, promoting health for common people across the word. I am currently coordinating Ippocrate for Asia.
Q: First of All we would like to congratulate You and Your colleagues for the extraordinary and excellent job performed on the Study (recently published on the International Medical Journal) which refutes the content about the Recovery Trial done by Oxford University , supporting the utilization of Hydroxychloroquine for COVID-19.
May you please summarize in few and simple words the content of this study so that people can understand and why did you decide to give Your contribution to it?
A: For management of Covid-19 patients in different countries, various medical associations identified a mix of active principles to be used to treat the disease. Even though these indications differed from one country to another (but also, within the same country, they frequently differed from one hospital to another and from one region to another), they, however, envisaged a similar approach that contemplated combination, at the initial stage of the disease, of drugs that jointly achieved an immunomodulation and antiviral action.
In the Recovery Trial there were two main issues:
- First: in the trial monotherapy (based on HCQ) has been used, whereas in most countries the combination of HCQ with different therapies was used.
- Second: High dosage of Hydroxychloroquine was used. The Recovery protocol used a dosage of 2400 mg of hydroxychloroquine in the first 24 hours of treatment. The initial dose was then followed by administration of 400 mg every twelve hours for another nine days, for a total amount of 9.6 g of drug in ten days. Consequently due to high dose of HCQ usage in the study, more adverse events and mortality were observed.
In India we still use HCQ for prophylaxis of Covid-19 and mild cases treatment: if HCQ is used correctly it is safe and effective for both prophylaxis and treatment. Many medical professionals are still on HCQ prophylaxis in India.
Q: We know that in July 2020 You received important Annual Awards from Indian Medical Association and from India Red Cross Society as “Corona Warrior” for Your contribution to the fight against COVID-19.
A: Yes, I have received several awards for my service to the country in last eight months. I have got the following Awards in India:
- INDIAN MEDICAL ASSOCIATION CORONA WARRIOR AWARD, 2020
- Times of India Corona Warrior Award on Doctors Day, 2020
- Indian Red Cross Society Corona Warrior Award, 2020
- Mumbai Municipal Corporation BDBA Hospital, CORONA WARRIOR AWARD, 2020
- Corona Yoddha Award by MLA, Vidhan Parishad, Govt of Maharashtra, 2020
- India Today, Top Mumbai Doctor Award for Corona Warrior, Aug 2020
I was also invited by INDIAN ARMY to join Army at Indian Borders to serve Indian Army for treating and guiding the Army for Covid Management.
I would like to say that despite my Awards, I work for my patients and to save lives and I am not interested in money. I love my profession and my goal was to help both doctors ad common man to fight fear of COVID-19 and COVID-19 itself. At the beginning all people was scared about COVID-19 and doctors were scared as well. But all doctors , not only virologists or pulmonologists had to take part to the fight against this new virus, so my first step was to help them to overcome fear. After that I helped them to fight the virus teaching precaution and prevention, daily actions to be transferred also to common people. This was really useful to overcome stress and psychological diseases also.
If you want to change something, you have to start the process , being the promoter of the change.
“Be the change you wish to see in the world” (Gandhi)
Q: We know that India is the second country in the world for Covid-19 cases. May you please tell us how are You facing in India and more in detail in your area, the current COVID-19 situation ?
A: The Covid-19 cases started rising in March, Mid of September 2020 the pick was reached, now the situation is more stable. In the current situation with the availability of few Drugs such as the Favipiravir and Remdesivir, the recovery rate has gone up and mortality rate has come down.
We have recommended the government to make wearing mask for all people mandatory. As a matter of fact the government made a rule in the country for making wear of masks compulsory. In general, people were wearing normal cloth mask or 3 Ply mask , whereas doctors and Healthcare workers were wearing N 95 masks. We also explained how to wear and treat masks.
Media and newspapers also correctly informed people about the above aspects. The communication aspects are really important in similar situation. Media are not diffusing panic and fear and they are not making the count of deaths daily.( Note by the Author: total number of deaths is 118.000 compared to a 1 billion and 300 hundred thousand Indian people).
In addition, for the first time in India , we did research on use of steam inhalation in prophylaxis and treatment of Covid-19 patients and we conducted two clinical trials. We found it extremely useful in prevention. In India most of the population and most of the health care workers are taking steam inhalation and it is also one of the important reason to control the spread of this infection.
Q: We have read that in India homeopathic remedies and traditional medical plants have also been used, is this true and what do you think about it?
A: Yes, that’s true as many people are taking prophylactics medication with Homeopathy and various immunity booster product.
We also mixed our ancient Ayurveda (the traditional Indian medicine) together with the modern medicine. (The Ayurveda is still used all over India and is based on herbs and natural oils, good diet and daily physical exercise). The Ayurveda helps in improving the immune system and together with the modern medicine we can achieve better results on the COVID-19.
Q: Is any prevention protocol used to strengthen immune system?
A: Yes, as already mentioned, for prophylaxis the most important actions to be taken are:
– Steam inhalation Therapy, to be taken twice a day, each time for five minutes. (I will provide further details about steam therapy in the below point in the interview).
Further we advise to take:
– For Health Care workers – HCQ weekly
– Vitamin C, Zinc daily and Vit D3 weekly
– We also advice for Health Care Workers to take Ivermectin 12 mg weekly.
Q: Are patients treated at home ?
A: Yes many mild symptomatic patients are home quarantine and they have been treated at Home, I have myself treated more than 500 patients at Home.
Q: Which are the most used therapies/ medicines for COVID-19 treatment in first phase ? Do you use Hydroxychloroquine ?
A: Yes, it has been used extensively as prophylaxis for Health Care professionals. It is also used in the treatment of patients with mild Covid-19 cases. The Indian protocol includes its utilization together with other treatments for first phase.
Q: Have You specific protocols to be implemented also in the most severe cases of Covid-19 ?
Which are the most used therapies/medicines in second and third phase ?
A: We have specific protocol provided by ICMR team, and it is updated regularly; during this pandemic time, we get daily updates and we need to modify treatment.
Q: Do doctors have freedom of choice of therapy or, as in Italy, must follow fixed protocols?
A: Though the guidelines are given , in India the Doctors are not forced to follow the fixed protocol; they can implement treatment as per their evaluation and as per their examination
Q: How do you think Italy has managed the pandemic?
A: Italy was very slow at the beginning of the pandemic in proposing the basic precautions principles to common people such as managing correctly distances, wearing of masks. The same happened in the hospitals where doctors were not instructed in the right way on how to manage the pandemic and where the right treatments were not implemented.
It is worth to say that the virus can survive up to 3 hours on surfaces and on clothes and this is the reason why all shall be cleaned or washed frequently. In the fresh air the virus has a very short life.
Q: Which are in your experience the main differences between the COVID-19 and the common flu?
A: infectivity is much higher in COVID-19 and one single drug does not work. Only the combinations of different drugs is able to recover the patients.
Q: In May-June this year, when the corona cases were on rise , You have been the Lead investigator for an Observation Study about the utilization of Steam against the COVID-19. You already mentioned this treatment. May you please explain us in short the effects of heat and humidity on the virus? Have they been successful? Did you observed further transmission in the patients after having administered with the steam?
A: Virus can remain biologically active in a wide range of environments. Envelope virus such as Coronavirus are most active in cool dry conditions and associated with increased incidence of COVID-19.
The mechanism of heat overcome viral infections depends on the setting, source, temperature, humidity, location, and time course of application. In first line of defense of respiratory viruses, the nasal cavity and sinuses provides protective barrier that allows viruses to be blocked, detected by immune system, and swept away. Inhalation of steam directly inhibiting and deactivating virions in the upper airways by providing support to first line of defense of immune system. Heat applied to whole body further provides second line of defense of immune system by inducing heat stress that mimics the effect of fever. Heat stress enhancing cardiac output, plasma volume and peripheral blood flow and induce detoxification through kidney, liver, and skin which some toxic elements eliminates. Heat stress may alter the blood pH as providing action against respiratory infections. Hyperthermia creates alkaline conditions and that more favorable to host defense. The transient alkaline condition able to inhibit viral replication and decrease infection of coronavirus. As per available many evidence that supports the application of heat and humidity for inhibition and treatment of viral infections. Randomized controlled trials further suggest steam and humidified can treat respiratory viral infection at temperature above 43° Celsius for 20 to 30 mins. to reduce viral shedding and immediate relief of symptoms of common cold.
Steam has been used since ancient times for alleviation of Flu symptoms.
Recent studies on inactivation virus of current coronavirus prevention accessories also state the effectiveness of heat on coronavirus.
Steam in a safe setting has a temperature of about 70 to 80 Degree Celsius which is well above the instability temperature of Corona virus.
Thus Steam will directly kill corona virus which gets killed at 58 to 60 degree centigrade
The corona virus which travels through nasal routes which are trapped there gets killed with steam.
There is 10 times increase in T Cells and Natural Killer cells at localized nasal levels which helps in defence mechanism. There is production of Heat Shock proteins , which further increases immunity.
Steam also produces Respiratory Alkalosis which inactivates the virus and it further makes it weak for multiplication.
In the study it showed that it could significantly reduce 90 percent in the symptoms and recovery of mild cases
In many cluster housing in Mumbai where the density of the population is high, Steam therapy as prophylactic has helped in reducing the spread of infection in more than 80 percent of cases.
The treatment have been very successful in India for prophylaxis and treatment of mild cases.
Q: We also know that you are a cancer specialist. In Your view and experience , have the screenings and therapies for other illnesses been delayed by covid-19 emergency?
A: Yes many of the cases were delayed, due to Covid-19 , but the things are settling now.
Q: What do you think about vaccine for Covid-19?
A: Many Biotechnology company in India are working stage and they are confident by December we will get some good news.
Q: But do you think that the vaccine is the solution to this pandemic?
A: At this stage yes, though we have specific medication available for treatment of Covid 19, results are different in different countries. Vaccine will definitely help for the people; initially the vaccine may not give 100 percent protection, but the patient will definitely get significant protection, eventually we will get good vaccine and definitely the protection will be much better
Q: You are the IppocrateOrg coordinator for India. May you please tell us which are the next steps You plan to perform in order to coordinate IppocrateOrg activities in Your Country ?
A: Next step will be to act as the Asian coordinator. During this pandemic we have seen the importance of health care management system. We will like to build up a system where the common man, who is patient, gets integrated with practicing doctors and Hospital, in such a way that the patient can get the on time diagnosis and treatment. Most emphasis will be given to screening and early diagnosis and treatment so that we can prevent the delay in treatment and reduce mortality and save lives, as well as the cost.
This means that treatments and doctors shall reach all people, shall be available for common man and not only for those who have the money.
Our goal is to build up network with doctors in other countries so that we can support each other, compare other’s thepaies in real time and receive continuous update on clinical care.
Q: Any addition question/answer from Your side you deem appropriate.
A: I strongly advice to spread the awareness of the steam therapy not only in Italy, but also in the US and all over the world for prevention.