Salem resident Sivaraman found himself leaving the comfort of his house on Steel Plant Road and making a temporary shelter on the footpath outside the Kilpauk Medical College in Chennai, within three days of two of his aunts testing positive for COVID-19 The 41-year-old is not from the city, but has challenged near-lockdown conditions in Tamil Nadu to urgently source Remdesivir for his aunts, one of whom suffers from a 40 percent lung damage as shown in her CT scan. On April 28, Sivaraman took an overnight train to Chennai to buy 12 vials of the antiviral drug which was out of stock in the whole of Salem district, and possibly many other districts of Tamil Nadu. “I checked with every private hospital and pharmacy in Salem if they sell Remdesivir. Forget private sector, even the Government Hospital said they have run out of the drug,” Sivaraman tells TNM. He was told that the only place selling Remdesivir now was the Kilpauk Medical College hospital, located 384 kms and a whole district away, in Chennai city. This is how Sivaraman's search for Remdesivir took him to Chennai’s crowded Barnaby Road road. He arrived in the city 4 am on Thursday to find the green gates of the KMC bolted shut. Outside the gate, Sivaraman he joined a sea of COVID-19 patient caregivers, who forgot social distancing protocols, in their desperation to source the drug. “I got off the train and joined the long line,” he says, pointing to a serpentine queue of tired looking men and women waiting outside the hospital gates to get a token. This queue outside the KMC’s gates starts from the end of Barnaby road. Some of these people, Sivaraman included, have even slept overnight on the footpath so that they would not have to give up their spot. On being issued a token, these people are ushered into the college where they once again join hundreds of people queuing up to the counter. “Why is it so bloody hard to get this medicine?” asks Sita, a resident of Annanagar in Chennai. For two days, Sita has been standing inside the KMC campus to source Remdesivir for her brother, who has been admitted with COVID-19 to a private hospital. Sita, a COVID-19 caregiver, waits inside KMC to get six vials of Remdesivir “The doctors treating my brother said it is our duty to purchase the medicine. They said they do not have stock of the medicine and that we have to wait and get it from the KMC counter. So I have been waiting in a queue, without eating or using the toilet, just to get my hands on those 6 vials,” she tells this reporter. For the hundreds of people waiting, there are no adequate sanitation facilities. “I tried to go to the KMC hospital opposite the medical college. But the security asked for my Aadhar card and told me that I can access the toilet only if I am a patient. And the virus has made it impossible to knock on a neighbourhood house to use the loo there,” she explains. At KMC, the drug is sold in packs of six vials and buyers have to strictly pay in cash, and cannot make online or card payments. They also have to keep with them photocopies of the patient’s RT PCR test, CT Scan report to show lung involvement, Aadhar copy, a doctor’s original Remdesivir prescription and the procurer’s Aadhar copy. If any of this is missing, buyers are turned away at the counter, even if they have waited for days to reach the counter in the first place. ‘Remdesivir is no magic medicine’ While hospitals across the country are asking relatives to procure Remdesivir, studies have shown no conclusive evidence that the drug helps COVID-19 patients recover. At the most, administering Remdesivir has been shown to reduce a patient’s hospital stay by three days. In critical COVID-19 cases, the drug is ineffective as a life saving intervention. But across India there is a huge demand for Remdesivir. In Tamil Nadu, the acute shortage in the open market has led to a thriving blackmarket for Remdesivir, where even counterfeit versions of the drug are being sold. While the TN government is giving six vials of Remdesivir for Rs 9400, each vial is being sold for Rs 20,000 in black. Witnessing this situation, Tamil Nadu Health Secretary Dr J Radhakrishnan asked the people of Tamil Nadu to not panic even if they are unable to source the drug. He added that Remdesivir has been found to do very little to save a patient’s life. Dr N Sridhar, Consultant Intensivist, Head-Critical Care at Kauvery Hospital told TNM that relatives and friends should not wait for days to get the medicine, putting themselves at risk. "This is a disease where we have very little medications in our armamentarium. So what happens is that the number of medicines that are effective are extremely small. So when patients are desperate, doctors are keen. All doctors’ goal is to get the patients under their care to get better. So doctors feel that this medicine that is available, may benefit them. We know that it may shorten the duration of illness, it may make you feel like you have less fever. This is conveyed to the family and the family (when desperate) sees it as some sort of life saving drug,” he said. “For me, if a patient meets strict conditions, then I would not mind recommending Remdesivir. However, if it is not available, it is not the end of the world. I would definitely not recommend that people queue up outside of a hospital as that in itself poses a risk,” says Sridhar. Watch what Dr Sridhar had to say from 16 minutes onwards.