ADVERTISEMENT

ADVERTISEMENT

ADVERTISEMENT

ADVERTISEMENT

New Delhi: Some experts have criticised the endorsement by India’s top health research body for use of hydroxychloroquine (HCQ) on Covid-19 patients and healthcare workers without proper evidence that proves the drug’s ability to reduce the viral load.In the absence of credible evidence, a blanket recommendation for chemoprophylaxis might be contentious, the experts said in an article published online by the Lancet on April 17. Prophylaxis refers to treatment given to prevent a disease.“The shortage of chloroquine , an inexpensive antimalarial in low-income malaria-endemic countries like India, could lead to preventable morbidity and mortality,” wrote Sahaj Rathi, Ashwini Kalantri and Shriprakash Kalantri from the Mahatma Gandhi Institute of Medical Sciences, Sevagram, and Pranav Ish of Vardhaman Mahavir Medical College and Safdarjung Hospital, New Delhi.The experts said they were deeply concerned that in an environment of global panic, an endorsement by the highest scientific body of India and also by the US President would create an overly optimistic perception of the effectiveness of HCQ among the public.“Markets in the USA are already reporting a short supply of both hydroxychloroquine and chloroquine. The situation in India is no different, probably indicating widespread self-medication,” they said.Given that the drug is untested against Covid-19 and its benefits unknown, the risks are not “negligible” at the scale of the use, according to the article.“Moreover, the safety of these immunomodulators in people at risk of a severe viral illness has never been evaluated,” they said.The authors of the article, some working as doctors in government hospitals in India, said “scientific reasoning” cannot be abandoned citing desperate times.They were of the view that if HCQ is to be used, a clear, informed choice needs to be offered to every contact, which should explain the scarcity of evidence for its efficacy and its potential risks.Additionally, they said the outcome events should be recorded.“If this is not done, the risk-benefit assessment would be skewed, adverse events accepted as collateral damage, and a drug accepted provisionally in a time of crisis could become commonplace as standard of care for a long time to come,” they said.The Indian Council of Medical research had recommended the use of HCQ as a preventive medication to healthcare workers and people looking after those who have tested positive. Besides, the health ministry recommended the use of HCQ in combination with azithromycin for severe cases of Covid-19 requiring ICU management.Raman R Gangakhedkar, head of epidemiology and communicable diseases at ICMR, said it has already launched a study on the side-effects of HCQ using data of some healthcare workers who self-medicated themselves with the drug. According to him, the healthcare workers reported side-effects such as abdominal pain, nausea and hypoglycaemia.“The average age of such health workers is 35 years. The most visible side-effect was that of abdominal pain, which was reported in 10% of all those who consumed the medication, while nausea-like symptoms were reported in 6%. About 1.3% had hypoglycaemia,” Gangakhedkar said.