COVID-19: 32 doctors from three nations write to Centre, seek to discourage unwarranted medications

The letter noted that healthcare workers in India rely heavily on government guidelines which had unfortunately promoted expensive diagnostics and medications with limited evidence.
Health workers shift a patient on a stretcher at a COVID-19 hospital in Ahmedabad (File Photo for Representational Purpose| AP)
Health workers shift a patient on a stretcher at a COVID-19 hospital in Ahmedabad (File Photo for Representational Purpose| AP)

BENGALURU: In an open letter to the Indian Health Ministry, state health departments, Indian Medical Association (iMA) and all medical professionals, 32 doctors across India, the USA and Canada urged authorities to revise policies to discourage use of medications that have no supporting evidence for the treatment of COVID-19, including alternative therapies, potions, antibiotics, cocktails, drugs like Molnupiravir, vitamin combinations, Azithromycin, Doxycycline, Hydroxychloroquine, Favipiravir, and Ivermectin, etc.

Some of the authors of the letter include Dr. Zarir Udwadia from PD Hinduja National Hospital, Dr. Richa Gupta from Christian Medical College, Dr. Raghuraj Hegde from Manipal Hospital, Dr. Satchit Balsari from Harvard Medical School, Dr. Manoj Mohanan from Duke University, Dr. Bhavna Seth from John Hopkins School of Medicine.

"The vast majority of patients with COVID-19, with asymptomatic and mild symptoms, will require little to no medications. 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," an excerpt of the letter written by experts from hospitals, universities and medical colleges.

The doctors sought for the June 2021 DGHS guidelines to be updated and in particular, provide specific guidance on the use of monoclonal antibodies, given their limited efficacy for the Omicron variant, and their continued widespread use.

They called for stopping unwarranted diagnostics such as CT scans and a battery of lab tests such as D-dimer, IL-6, especially for mild and asymptomatic cases, that places an undue financial burden on families. They said a vast majority of COVID-19 patients will need no additional diagnostics after the initial COVID-19 test, and in some cases, home monitoring of oxygen levels. They further wrote that patients continue to be admitted to hospitals without clinical justification.

"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 authors argued.

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. The doctors said it is incumbent on state agencies and on professional medical societies to put an end to this travesty, in the best interest of the nation.

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