Mistakes of ’21 being repeated: Doctors warn Indian authorities

Prominent doctors from India, Canada and the US have warned the Union and state governments, and medical authorities, to discourage the use of medications and diagnostics that have no supporting evidence for the treatment of COVID-19.

“While there continues to be much uncertainty amidst the outbreak of this novel disease, there is now substantive high-quality scientific literature that provides unequivocal guidance on the clinical management of COVID-19,” the 32 doctors wrote in an open letter. 

“Despite the weight of this evidence and the crushing death toll of the delta wave, we find the mistakes of the 2021 response being repeated in 2022,” the letter said.

These “mistakes” include prescribing medications like vitamin combinations, azithromycin, doxycycline, hydroxychloroquine, favipiravir and ivermectin, which are backed by limited evidence that they are effective against COVID.

“Such wanton use of drugs is not without harm as the Delta wave has shown. Outbreaks of opportunistic fungal infections like mucormycosis in India and aspergillosis in Brazil were attributed to the widespread abuse of inappropriate medications,” the letter said.

The doctors also spoke out against recommending unnecessary scans and tests in asymptomatic or mild cases, and hospitalising patients without clinical justification.

Such practices not only place undue financial burden on the patients and their families but also “risk the lives of hundreds of thousands of other, non-COVID patients that cannot find a hospital bed for more emergent conditions”.

The letter noted that healthcare workers in India rely heavily on government guidelines, which had unfortunately promoted expensive diagnostics and medications with limited evidence. The public and the medical community are also subject to gross misinformation on social media.

“Update the evidence-based June 2021 DGHS guidelines. In particular, provide specific guidance on the use of monoclonal antibodies, given their limited efficacy for the Omicron variant, and their continued widespread use,” the doctors urged.

Signatories to the letter include Dr Zarir Udwadia from PD Hinduja National Hospital, Dr Richa Gupta from Christian Medical College, Dr Satchit Balsari from Harvard Medical School, Dr Manoj Mohanan from Duke University, Dr Priya Sampathkumar from Mayo Clinic and Dr Bhavna Seth from John Hopkins School of Medicine.