NEW DELHI: A directive by the National COVID Task Force to the ICMR to study the clinical features of coronavirus patients in the Indian context and their diagnostic and prognostic value in different age and gender groups has remained on paper for the last three months.
As a result, there is no centralised information yet on key questions such as profile of those falling sick, how are comorbidities influencing outcomes, and what is the actual cause of death. Even though India has nearly 8 lakh COVID cases, there is no information on whether outcomes are different for patients receiving hydroxychloroquine, remdesivir or plasma therapy.
The lack of these crucial bits of information is hampering clinical decisions of doctors and public policy regarding the outbreak management, experts said. Task force members said the issue was discussed several times in March-April after which the ICMR was asked to develop a protocol for generating the dataset. But, they said, the project never took off.
“The idea was to generate data on a standard format from every hospital where COVID patients are getting treated and analyse them nationally to inform policy decisions,” said a task force member. “It was an important exercise that would have greatly helped our understanding of the disease but it did not get implemented.” ICMR director general Dr Balram Bhargava could not be contacted for his comments despite several attempts.
Experts stressed that a central exercise proposed by the task force was all the more important due to poor culture and practice of clinical research in India. “People are being treated in government and private hospitals, and doctors there have neither the time nor the incentives to write papers,” said Dr Shahid Jameel, CEO of the Wellcome Trust DBT Indian Alliance.
“ICMR being India’s premier medical research agency should have been doing this and maybe they are.” Epidemiologist Dr Jammi N Rao said that no significant studies were reported because private hospitals seem to have no interest and public hospitals may not have the capacity. “One solution might be to require private hospitals to make their raw data available to local medical college departments of social medicine and public health,” he suggested. “Teams of post graduate students in medical colleges pursuing courses in public health or community medicine, if they were well-guided with good statistical support, can churn out such reports to inform both clinical decision making and public policy.”