2021's mistakes being repeated in 3rd Covid wave; unnecessary medication should be avoided, doctors say

As many as 32 prominent doctors from India and abroad have written a letter to the Union as well as state governments and warned about "inappropriate" diagnostic methods and medications being used to deal with the current wave of the coronavirus pandemic.

"Wanton use of drugs" can be harmful, as seen during the earlier two waves of the pandemic, they warned in the open letter. “Despite the weight of available evidence and the crushing death toll 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.

The "vast majority of patients" who are asymptomatic or have mild symptoms will require little or no medication, it said. "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.

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Outbreaks of fungal infections like mucormycosis in India and aspergillosis in Brazil were attributed to the widespread abuse of inappropriate medications, the letter pointed out.

It also said that most Covid-19 patients will need no additional tests after the initial positive rapid antigen or PCR test, except, in some cases, home monitoring of oxygen levels. The Omicron variant can infect even those who had contracted the infection earlier or who are vaccinated, but the "mortality" will be lower among these patients, it said. “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.

Patients are being admitted to hospitals "without clinical justification," which adds to such burden and also leads to non-Covid patients not getting hospital bed in emergency, it warned. The government as well as medical associations must put an end to such practises, the letter said.

The signatories to the letter included 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 and Dr Richa Gupta, Christian Medical College, Vellore. The group also included some Indian-origin doctors living in the US and Canada.

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