Covid: Evidence, Ethics and Economics

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This afternoon I spoke on several issues that influence our thought processes when we see patients with Covid19- in the community, in the hospital OPD, wards or ICUs. How should we design our therapy? Should we allow ourselves to prescribe untested and unproven therapies because the atmosphere is filled with fear, desperation and panic? What … Read more

Clinical Trials in Covid: Ethics and Practice

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Fear. Panic. Desperation.  Came Covid and most doctors began to prescribe anti-Covid drugs based not on scientific research, but based on anecdotes, media stories, newspapers, TV channels and promotion of drugs by the drug industry. The virus pushed the Evidence-based medicine to the back seat. Physicians were either reluctant to— or didn’t know how to— … Read more

COVID-19: The need for evidence-based medicine

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A number of old drugs approved for other diseases are being “repurposed” and tested for their safety and efficacy in COVID-19, in systematic clinical trials. They have emergency approval for use in COVID-19, but most are not yet proven for this use. Some drugs have received approval without adequate testing. Other drugs are being used … Read more

The struggle to keep India’s Covid-19 patients breathing

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On May 10, 2020, we admitted the first patient with Covid19 to our hospital. We did speedily ramp up critical care, to provide oxygenated hospital beds, ICUs, medicines, and ventilators, gloves, N95 masks, PPEs, and back up supplies.  Oxygen. Perhaps for the first time we realised how important was Oxygen, the sole therapy for managing COVID-19-induced … Read more

Covid and Ayurveda

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I criticised Patanjali Ayurveda’s claimed cure for COVID-19 for making unsubstantiated claims of efficacy. The drugs it is offering are untested and unproven. They haven’t proven their mettle in a well-conducted adequately sized randomized controlled trial. The proponents of Ayurveda, however, ask – can Ayurveda, or alternative medicine in general, be evaluated in the same … Read more

Medical Conferences sans Drug Industry Sponsorship

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Medical conferences are fast degenerating into melas that educate, entertain, amuse and irritate and deceive—not necessarily in that order. One can smell, see and feel the drug industry everywhere, advertising on the walls, shaping the contents and style of educational programmes, tempting with gifts and free meals, travel and other amenities. In 2003, MGIMS became … Read more

Ethical Challenges of Research in a Pandemic

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The pressure for an effective treatment or vaccine for COVID-19 is high. There are more than 2,000 studies on COVID-19 across the world; many of these are trials on humans to develop vaccines, and to test the efficacy of drugs for this new disease. The urgency of this pandemic presents new, acute ethical challenges in … Read more