My colleagues and I wrote our concern in Lancet Infect Dis about the inappropriate and irrational use of Hydroxychloroquine for preventing and treating Covid in India. We wrote this when the pandemic had just started.
The Indian Council of Medical Research, under the Ministry of Health and Family Welfare, has recommended chemoprophylaxis with hydroxychloroquine for asymptomatic health-care workers treating patients with suspected or confirmed COVID-19, and for asymptomatic household contacts of confirmed cases.
We are 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.
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. A blanket recommendation for chemoprophylaxis in the absence of credible evidence might be contentious to say the least.
If hydroxychloroquine is to be used, a clear informed choice needs to be offered to every contact, explaining the scarcity of evidence for its efficacy and its potential risks. Additionally, all outcome events should be recorded. If this is not done, the riskโbenefit 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.
