Mistakes of 2020 Covid response being repeated, doctors write to Union Govt

In a letter to the Union and state governments, 32 prominent doctors from both India and abroad warned against the inappropriate diagnostic methods and medications being used to deal with the current wave of the coronavirus pandemic.

"Despite the weight of available evidence and the crushing death numbers of the delta wave, we find the mistakes of the 2021 response being repeated in 2022 during the clinical management of COVID-19. We urge you to intervene to stop the use of medications and diagnostics that are inappropriate for clinical management of COVID-19," the letter said.

As witnessed in the earlier two waves of the pandemic, the "wanton use of drugs" can be harmful, they warned. The vast majority of patients who are asymptomatic or have mild symptoms need little to no medication. Furthermore, most patients need no additional tests besides the initial positive rapid antigen or PCR test, the doctors explained.

"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," said the doctors.

The widespread abuse of inappropriate medications has been found to cause outbreaks of fungal infections like mucormycosis in India and aspergillosis in Brazil, the doctors noted. Though the Omicron variant can infect people who were infected earlier or those who are vaccinated, the mortality rate amongst those patients would be lower, they added. Furthermore, hospital admissions without clinical justification are also causing non-Covid patients to be denied the care they need in emergencies.

"However, CT scans and a battery of laboratory tests like d-dimer and IL-6 are routinely being prescribed by practitioners across the country in asymptomatic and mild cases, placing undue financial burden on families," the letter said.

The letter urged the government and medical associations to put an end to such practices. The signatories include Dr. Sanjay Nagral of Jaslok Hospital, Mumbai; Dr. Cyriac Abby Phillips, the Liver Institute, Rajagiri Hospital, Kerala; Dr. Rajani Bhat, Bengaluru; Dr. Bharat Gopal, Delhi; Dr. Richa Gupta, Christian Medical College, Vellore and others living in the US and Canada.