Six or more dosages of HCQ reduce Covid-19 risk in health workers: IMCR study

The study has, however, drawn flak for not coming clean on the issue of “conflict of interest".

Published: 01st June 2020 08:03 PM  |   Last Updated: 01st June 2020 08:19 PM   |  A+A-

A chemist displays hydroxychloroquine tablets (Photo | AP)

Express News Service

NEW DELHI: Healthcare workers, who take at least six or more doses of anti-malaria drug hydroxycholoroquine, are better placed to avoid contracting Covid-19 than those who take none or lesser doses, a study by the country’s apex health research body has said.

The study, by the Indian Council of Medical Research, has also emphasized the need of taking adequate protective measures by the healthcare workers, apart from taking of HCQ prophylaxsis recommended by it, has however drawn flak for not coming clean on the issue of “conflict of interest".

The ICMR, in its advisory issued in March, had asked healthcare workers treating Covid-19 patients and high-risk contacts of positive cases to take HCQ under medical supervision in order to prevent the disease, even though there was no national or international evidence available to show that the medicine works in the prophylaxis of the disease.

Just last month, even though evidence started emerging to show that HCQ could actually worsen the disease outcome in many severely sick Covid-19 patients, the ICMR went ahead and recommended its prophylaxis for more categories of people — all healthcare workers, field workers engaged in Covid-19 containment and police and security personnel.

Now, in a study published in its Indian Journal of Medical Research, data for which was collected only in May, it has said that six or more doses of HCQ had a “remarkably high -more than 80 per cent-protective effect against the coronavirus infection”.

The researchers examined HCQ usage retrospectively in a sample of 378 healthcare workers among 1,073 who had been infected over the past two months, and 373  control healthcare workers who did not have the disease.

The study said that healthcare workers who took one to three doses of HCQ faced a higher risk of infection than those who had not taken the drug. But healthcare workers who took six or more doses were better protected than the others.

Meanwhile, what many are pointing out is the fact that two of the study’s authors include Dr. Balram Bhargava, director-general of the ICMR, and its chief epidemiologist Dr. R R Gangakhedkar, who were directly involved in issuing the earlier two advisories suggesting prophylactic use of HCQ.

The “conflict of interest” column in the study however surprisingly says “none”—a fact that bioethicists say will reduce the credibility of the agency.

“The DG ICMR and Dr. Gangakhedkar were involved in the decision making on the use of the HCQ from the beginning in March. They also defended and implemented that policy. So they should not have been involved in a research project to collect evidence in support or against their own policy,” said Dr Amar Jesani, a researcher and editor of the Indian Journal of Medical Ethics.

“Their presence in the research team reduces the credibility of the research. What is worst is that in the paper-based on that research published in the IJMR, they have even failed to disclose their conflict of interest to the readers of the paper and to the scientific community.”

Dr. Anant Bhan, a public health researcher who specializes in bioethics pointed out that since the study is conducted by ICMR staff after the first advisory was issued on March, 22 and data collected in May, and because it includes senior leadership of ICMR as co-authors, and the paper conclusions show the advisory in a positive light, it would have been good practice to have a Conflict of Interest statement which laid out these conflicts, and how these were addressed.

“This is also required because the article is published in ICMR's own journal,” he said.


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