On 18 June 2020, Dr. C. S. Pramesh, the Director of the Tata Memorial Hospital texted me a message and then called me asking if I would be willing to do a talk on Covid and research during Pandemic. A day after. Although I had little time to prepare, I didn’t blink an eyelid to say yes.

He wanted me to focus on a theme, ‘Has COVID-19 research set back evidence-based medicine?

On April 17, 2020, my colleagues and I had just published a paper in the Lancet Infectious Disease on Hydroxychloroquine prophylaxis for COVID-19 contacts in India. In this paper, we wrote that we were deeply concerned that in this environment of global panic, an endorsement by the highest scientific body of India (and also by the President of the USA) will create an overly optimistic perception of the effectiveness of hydroxychloroquine among the public. 

We were in the midst of a pandemic. We were struggling with fear, panic and desperation. Public was unable to cope with these feelings. Pseudoscience was not only thriving but was pushing good science to the back seat. I argued that if researchers do not generate high-quality evidence during the pandemic we shall lose an opportunity, more so because there is a widespread collapse of scientific reasoning among medical communities. Several drugs have caught the fancy of public and physicians, although they have not been shown to work. If this perception of efficacy hangs on among public and physicians, I argued, it would be difficult to shake it off.

We shouldn’t be losing the metrics during the pandemic. Our clinical trials need to have higher standards. An ongoing pandemic justifies leeway in generation and interpretation of evidence in the interest of public health. However, all scientific reasoning cannot be abandoned citing desperate times. We need clear data to stop treatments that do not work; we need to test new treatment options. 

I covered several studies of COVID-19, including the Remedesivir trial (Lancet 29 April 2020) and NEJM 2020; Lopinavir-Ritonavir trial (NEJM 7 May 2020), Hydroxychloroquine observational study (NEJM 18 June 2020), Hydroxychloroquine pre-exposure trial (NEJM 3 June 2020); RECOVERY and SOLIDARITY trials. I also spoke on the limitations of the ICMR HCQ trial and why we need to interpret it with caution .

I ended quoting Dr Vinay Prasad, who had just said, ““We struggled to protect the globe during pandemic. We struggled to protect ourselves, our principles and medical evidence from fear.”

Here is a YouTube link to my PowerPoint presentation.