New Delhi: Excessive use of CT scans for Covid diagnosis can increase cancer risks and overuse of tests for biomarkers could lead to over-treatment, AIIMS director Dr Randeep Guleria said Monday.
“There is a lot of misuse of CT scans and biomarkers and this can [cause] damage. A lot of people are doing CTs the moment they test positive. There is no point in [doing it for] mild positive [cases]. There will be some patches even in some asymptomatic people and they go away without treatment. If you are in home isolation with mild illness and oxygen saturation is good, there is no point [in doing a CT scan],” Dr Guleria said.
A computed tomography (CT) scan is an imaging technique that gives a detailed image of the body for diagnostic purposes.
Dr Guleria, one of the leading respiratory medicine doctors in the country, noted how one CT scan is equivalent to 300-400 chest X-rays. “Data from the International Atomic Energy Commission show that if young people do too many CTs, the risk of cancer in later life increases. If you have doubts, do a chest X-ray first and then go for a CT scan only when the doctor advises it,” he added.
However, Guleria’s note of caution follows his own earlier statement about the importance of CT scans in Covid-19 diagnosis given that the lower sensitivity of RT-PCR tests often give false negatives.
The AIIMS chief also warned against the overuse of blood tests for biomarkers.
“A lot of people go for CRP, Didimer, LDH ferritin — all these tests. This is not needed for mild illness [if] home isolation with oxygen saturation [is] maintained. This only causes a panic reaction. These are markers of inflammation that go up even when you have a common cold or tooth infection. This does not show if the disease has progressed. Sometimes starting medicines based on this is counterproductive. These should be done when you have moderate illness. Unnecessary reliance on biomarkers can lead to over-treatment,” Dr Guleria cautioned.
He also underscored the importance of doctors’ training as the disease spreads to smaller cities and identified excessive fatigue, falling oxygen saturation levels and chest pain as warning signs that could indicate a person in home isolation needs hospitalisation.
Advance paid for 16 crore more vaccine doses
Sidestepping concerns about vaccine availability, Lav Agarwal, joint secretary in the Ministry of Health, said 12 states had started vaccinations in the 18-44 years age group but for the Government of India, the priority remains vaccinating people in the above 45 years category.
“This (18-44 years) is an additionality … every person in their own way is a frontline worker, but for vaccination purposes, we have chosen those people who have a role in containment operations. We have now expanded the vaccination programme so much that everybody is covered now,” Agarwal said in response to a question about why journalists have not been included in the category of frontline workers.
The joint secretary also refuted allegations that the central government has not placed any new orders for vaccines after March.
“An advance of Rs 1,732.50 crore was released to Serum Institute of India (SII) on 28.04.2021 for 11 crore doses of Covishield vaccine during May, June and July. As on date, against the last order of 10 crore doses for supplies of Covishield vaccine, 8.744 crore doses have been delivered till 03.05.2021. Additionally, 100 per cent advance of Rs 787.50 crore was released on 28.04.2021 to Bharat Biotech India Ltd (BBIL) for 5 crore Covaxin doses during May, June and July. As on date against the last order of 2 crore doses for supplies of Covaxin vaccine, 0.8813 crore doses have been delivered till 03.05.2021,” he said.
In an accompanying presentation, Agarwal displayed a table that showed India’s recoveries in the month of April to illustrate his point that there is a “positive” development on the Covid front. He also cited the marginal dip in daily cases — to 3.92 lakh on Sunday and 3.68 lakh on Monday from over 4 lakh per day — to claim that these are the early signs of Covid numbers stabilising.
“Cases are plateauing in Punjab, Telangana, Uttar Pradesh and Uttarakhand. States that are still showing an increase in trend include Andhra Pradesh, Assam, Bihar, Karnataka, Kerala etc.,” he said.
Both Agarwal and Piyush Goyal, additional secretary in the home ministry, claimed that there is no shortage of oxygen and the need is to rationalise its use.
(Edited by Manasa Mohan)