Doctors write to Union Health Ministry over inappropriate clinical management of Covid-19

New Delhi: Raising alarm against unwarranted testing, medication, and hospitalisation during the Covid pandemic, a group of around 35 doctors have sought urgent intervention of the Union health ministry for an evidence-based response to the current wave.

In an open letter to the Ministry, the doctors have stated in the letter, "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. 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 doctors have identified three main issues of unwarranted medication, unwarranted tests, and unwarranted hospitalisation.

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The letter says that the vast majority of patients with Covid-19, with asymptomatic and mild symptoms, will require little to no medication. "Most prescriptions we have reviewed in the past two weeks include several Covid-19 "kits" and cocktails. The prescribing of vitamin combinations, azithromycin, doxycycline, hydroxychloroquine, favipiravir, and ivermectin for treating Covid-19 is irrational practice. 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", said the letter.

The doctors in the letter have appealed to the central and state health authorities to stop these "unwarranted" practices and promote evidence-based medicine. The letter has suggested to update the evidence-based June 2021 DGHS guidelines. Through public education and professional training, discourage the use of medications that have no supporting evidence for the treatment of Covid-19, the doctors said.

The doctors have also suggested discouraging the use of unwarranted diagnostics, especially for asymptomatic and mild cases, where none are required, except for confirmatory Antigen or PCR tests and to publish guidelines in local languages. Stop any state-sponsored promotion or distribution of medications, cocktails, alternative therapies, or potions that are not scientifically proven therapies, suggests the letter.

Provide all healthcare workers adequate N95 masks and eye protection. Continue to accelerate vaccination, building on current success, said the letter signed by a few Indian-origin doctors from Harvard and Johns Hopkins universities in the US.

Talking to IANS, Dr. Anant Bhan, Yenepoya (deemed to be University), Mangaluru, one of the signatories, said that with almost two years of dealing with the pandemic behind us, it's extremely important that we ensure that evidence based medical and policy decisions are made. Our letter appeals to all relevant stakeholders to focus on public health measures including vaccination, and ensure inappropriate medications and diagnostics are discouraged.

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