The health condition of all of Nepal's eight live cases of Covid-19 is “normal” and at least three are likely to be discharged soon, according to doctors involved in their treatment. All of the patients are being treated with symptomatic drugs while one is being administered an additional dosage of hydroxychloroquine, the controversial anti-malarial drug.

Of the eight patients—two are being treated at the Sukraraj Tropical and Infectious Disease Hospital in Teku, two at the Dhaulagiri Zonal Hospital, and four at the Seti Provincial Hospital in Dhangadhi.

According to Dr Sagar Rajbhandari, director of the Sukraraj Hospital, the health condition of the two patients at the Teku hospital is “normal”.

“We are waiting for them to test negative so that they can be discharged,” Rajbhandari told the Post. “We are going to perform two tests in 24 hours and if both tests are negative, then we will discharge the patients.”

Both patients are likely to be discharged within a week, said hospital officials.

According to Dr Anup Bastola, spokesperson for the hospital, both patients have only been treated with symptomatic drugs.

“We’ve only given them medicines for their cough and fever,” said Bastola. “Now, both of them are normal.”

At the Dhaulagiri Zonal Hospital in Baglung, where two patients—a 19-year-old student and 65-year-old woman who had returned from Belgium—were being treated, officials said both are recovering.

Condition of the 19-year-old girl is normal while the 65-year-old is being administered medicines for high blood pressure and asthma, Dr Shailendra Pokhrel, medical superintendent at Dhaulagiri Zonal Hospital, told the Post over the phone. “Their health condition is normal.”

In Baglung too, the hospital has only been giving symptomatic drugs to patients, which include medicines for fever, cough and any other symptoms.

But at the Seti Provincial Hospital in Dhangadhi, where four patients are currently receiving treatment, one of those infected with the coronavirus is being administered hydroxychloroquine, an anti-malarial drug that has acquired a notorious reputation after being touted by US President Donald Trump. The health of all four patients is normal, said hospital officials.

“We have given hydroxychloroquine to one patient and symptomatic medicines to others,” Dr Jagadish Joshi, spokesperson for the hospital, told the Post over the phone. “Though it is not recommended by the Health Ministry, we have given it as a supportive drug.”

Hydroxychloroquine was first used to treat malaria but is now also used to treat rheumatoid arthritis, lupus and other autoimmune diseases. It is believed that hydroxychloroquine interferes with the communication of cells in immune systems. Trump has called hydroxychloroquine a “game-changer” in the fight against Covid-19, leading countries like India to ramp up production and place export restrictions. India, however, has allowed exports to a handful of countries, including Nepal.

Doctors, however, stress that there is no evidence that hydroxychloroquine is effective in treating Covid-19 and could instead have a number of side-effects, including loss of vision and heart ailments.

Despite no clear consensus on the efficacy of hydroxychloroquine, the Health Ministry has directed concerned agencies to stockpile a million tablets of hydroxychloroquine for use as a supportive drug for patients if they take a turn for the worse.

“Though it is not a first-line drug, it does have antiviral properties,” said Dr Khem Karki, the health minister’s advisor. “We might have to use that medicine if cases rise in significant numbers and the condition of patients deteriorates and there is no other alternative.”

Deurali-Janta Pharmaceuticals has already committed to providing 400,000 hydroxychloroquine tablets to the Health Ministry with 250,000 tablets arriving on Sunday, said Karki.

Narayan Prasad Dhakal, director-general at the Department of Drug Administration, said that his office had held a discussion with officials from the Nepal Medical Council, the national regulatory body of medical doctors, and the Nepal Medical Association, an umbrella organisation of medical doctors, regarding the use of hydroxychloroquine.

“We have not yet recommended hydroxychloroquine for Covid-19 patients and we will not recommend it unless physicians agree to prescribe it,” Dhakal told the Post. “But we have discussed with all stakeholders, including drug manufacturing companies, and asked them to stockpile the medicine should a consensus develop.”

Nepal has so far reported nine Covid-19 cases—eight live cases, with one recovered.