Heavy doses for patients

Doctors will begin administering heavy doses of medicine during the early stages of Severe Acute Respiratory Syndrome……

Doctors will begin administering heavy doses of medicine during the early stages of Severe Acute Respiratory Syndrome…… Doctors will begin administering heavy doses of medicine during the early stages of Severe Acute Respiratory Syndrome (SARS) in a bid to ease the strain on intensive care units, according to Hospital Authority director Ko Wing-man. But he warned of potentially severe side-effects, including heart, blood and kidney problems.Ko’s announcement came only hours before it was announced that a further seven people had died of the disease, bringing the Hong Kong death toll to 47. It was the highest number of people to have died in a single day since the outbreak began last month.However, Ko’s announcement did not go down well in some quarters.Public Doctors’ Association president Leung Ka-lau said too high a dosage of steroids could suppress a patient’s immune system and increase the risk of other infections.He said it should be up to doctors to decide the dosage for each patient and that the authority should not interfere with their decisions.Associate professor David Hui of the department of medicine and therapeutics at the Chinese University said the most important thing was to administer right dosage at the right time. Ko said later it was unclear whether the SARS mortality rate was rising or whether the increase in the number of deaths was proportional to the increase in the number of patients.But he agreed that the authority had decided on a change of strategy to fight the killer disease following the surprise deaths of six relatively young people with no previous medical problems at the weekend.The decision to increase the dosage of medicine was announced at the Legislative Council’s health services panel meeting yesterday.Ko said that in an attempt to reduce the number of people in intensive care units and to speed up the recovery of the patients, the authority had decided to increase the dosages of the anti-viral drug ribavirin and steroids.Previously, heavy doses were reserved mainly for patients who were severely ill.”Under normal circumstances, we have to balance the risks for every step we take, such as the side-effects of the medicine and the accuracy of the diagnosis. “But we can’t take this approach now,” Ko said. “Even if patients display only slight symptoms, we will administer the full dose.” Ko agreed that the medical cocktail had serious side-effects but added: “Under the present circumstances, we’ll try to increase the doses in the hope that it will prevent the patient’s condition from getting worse.”However, speaking to reporters later, Ko modified his announcement to Legco, saying the higher dosage was only intended as a guideline for doctors who would have to assess the risk before administering the medicine.He said experts were also studying other treatments for those who did not respond to the drugs.Ko reiterated that the ribavirin and steroids treatment was still the best available and that the recovery rate for those receiving it was between 80 and 90 per cent.”The use of the antiviral medicine was a brave decision but it worked as 80 to 90 per cent of the patients are responding well to it,” Ko said.Ko also said he had no knowledge as to whether the coronavirus, which is believed to be the cause, had mutated – one of the suggestions that was advanced after the six unexplained deaths at the weekend.”As we have seen, most younger and previously healthy patients recover. But we also know that no treatment is 100 per cent effective. We are unhappy that, lately, some younger patients with no chronic illnesses could not be saved.”Head of the Hospital Authority, Leong Che-hung, said his organisation would also seek help from abroad as well as from the mainland if local hospitals could not cope with the growing load of patients. “We can’t rule out such a possibility … but we hope this will not happen,” he said.Professor Mary Waye of the biochemistry department at the Chinese University agreed with the increase of medicine for patients. She said that as the coronavirus was prone to mutation, it would be better to increase dosage at an early stage of the illness. The seven people who died yesterday were aged between 49 and 95. Five of them had previously suffered from chronic illnesses. There were 40 new cases yesterday, bringing to 1,190 the total number affected since the outbreak began. They comprised four medical staff, five people from Amoy Gardens and 31 new patients.Among those released yesterday was Medical Authority chief executive William Ho who had spent three weeks in hospital. He has been told to rest at home for a further week before reporting for work.(Source: The Standard.com; Cannix Yau, Matthew Lee and Michael Ng; 15 April 2003, 01:50 AM)