Kozhikode, October 31: A controversy surrounding the alleged administration of expired Remdesivir to Nipah patients in Kerala has intensified after a critical care specialist involved in treating some of the cases said none of the six patients who died during the state’s outbreaks between 2023 and 2025 had received the antiviral drug from Kozhikode Government Medical College Hospital.
Dr A S Anoop, who dealt with some of the Nipah cases, said treatment records and the circumstances surrounding the deaths did not support allegations that expired Remdesivir had been administered to the deceased patients.
His clarification came a day after the Kerala government announced an investigation into whether six deaths associated with Nipah infection were linked to the administration of expired medicines.
The issue has raised questions about medicine procurement, storage, expiry-date monitoring and accountability within the state’s public healthcare system.
According to Dr Anoop, 13 people tested positive for Nipah virus in Kerala between 2023 and 2025. Of these, six died while seven recovered.
He maintained that none of the six patients who died had received Remdesivir from Kozhikode Government Medical College Hospital.
However, the specialist questioned why antiviral medicines continued to remain in stock even after their expiry dates. He said the presence of expired medicines in healthcare facilities required examination, irrespective of whether they had actually been administered to patients.
The state government has said it would not reach any conclusion until the expert committee completes its investigation and submits its findings.
Health Minister K Muraleedharan said the information presented in the state Assembly was based on reports received from responsible officials in the Health Department. He added that the government would examine all relevant aspects, including whether any medicine had been administered beyond its prescribed shelf life.
The minister said there were several unanswered questions surrounding the medicines and their possible use, making an independent examination necessary before any final decision could be taken.
The controversy has brought renewed attention to the medical response during previous Nipah outbreaks in Kerala, particularly the challenges involved in diagnosing and treating patients infected with the deadly virus.
Dr Anoop recalled that following the 2018 and 2019 outbreaks, doctors began using Remdesivir and monoclonal antibodies as possible treatment options for Nipah patients.
However, he cautioned that conclusive evidence regarding the effectiveness of these medicines in improving patient outcomes remained limited because human studies were insufficient.
Nipah is a zoonotic virus that can spread from animals to humans and, in certain circumstances, between people. Infection can cause severe respiratory illness and encephalitis, or inflammation of the brain. The disease is associated with a high fatality rate, making early identification, isolation and supportive medical care particularly important.
Kerala has faced repeated Nipah outbreaks, prompting authorities to strengthen disease surveillance, laboratory testing, infection-control measures and preparedness within hospitals.
Recalling the 2023 outbreak, Dr Anoop said the first patient was admitted to a private hospital in Kozhikode, where doctors began suspecting Nipah after learning that the patient’s father had died with similar symptoms.
According to him, samples from the father had been preserved at the hospital where he had received treatment. Doctors subsequently sent samples from both the father and son for testing, which confirmed Nipah infection.
The son survived after receiving treatment, while his father had died before the infection was diagnosed. Dr Anoop said the circumstances established that the father had not been administered Remdesivir.
He also referred to another patient from Vadakara who was transferred to the private hospital during the same outbreak. The patient died due to a cardiac condition, and Nipah infection was confirmed only after samples were collected from the body following death.
The specialist said similar circumstances occurred in subsequent outbreaks, with some infections being confirmed only after patients had died.
He argued that allegations regarding the administration of expired medicines should therefore be assessed against individual treatment records and the timeline of diagnosis rather than assumptions about the drugs used during the outbreaks.
The issue has also drawn reactions from political leaders in the state.
Former health minister K K Shailaja criticised the allegations and accused the United Democratic Front government of attempting to undermine the credibility of Kerala’s public healthcare system.
She maintained that expired medicines had not been administered to Nipah patients and said the matter should be allowed to proceed through the investigation.
Shailaja also referred to the treatment approaches explored during the 2018 outbreak, including the use of Remdesivir and monoclonal antibodies sourced from Australia.
She urged ministers and public representatives to exercise caution while making statements on medical issues, particularly when allegations could affect public confidence in healthcare institutions.
The controversy has highlighted the importance of transparent medicine management in government hospitals. Healthcare facilities are required to maintain accurate records of pharmaceutical stocks, monitor expiry dates and ensure that medicines past their approved shelf life are not available for routine patient use.
Expired medicines must be clearly identified and segregated from usable stock before being disposed of according to applicable procedures. Regular inspections and digital inventory systems can help reduce the possibility of errors and improve accountability.
The investigation is expected to examine the relevant medicine records, procurement details, storage arrangements and treatment documentation to establish whether any expired drug was administered and whether the deaths had any connection with its use.
The distinction between the presence of expired medicines in hospital stocks and their actual administration to patients is central to the controversy. While the specialist has denied that the six deceased Nipah patients received Remdesivir from the Kozhikode government hospital, the government has maintained that the complete circumstances must be verified.
The findings will be important not only for determining the facts surrounding the allegations but also for identifying any administrative shortcomings in medicine management.
Kerala’s experience with Nipah has demonstrated the importance of rapid diagnosis, effective infection-control practices and coordination between hospitals, laboratories and public health authorities.
As the investigation proceeds, the government faces the task of addressing concerns over medicine safety while ensuring that public confidence in the healthcare system is not weakened by unverified claims.
The expert committee’s findings are expected to provide clarity on the allegations and help determine whether further administrative or corrective action is required.