Contextualising evidence-based recommendations for the second wave of the COVID-19 pandemic in India

Abstract

Contextualising evidence-based recommendations for the second wave of the COVID-19 pandemic in IndiaDuring the second wave of the COVID-19 pandemic in India, which began in March, 2021, demand on the health-care system has far exceeded capacity. Despite crippling shortages, patients are prescribed a battery of ineffective therapeutic interventions. 1 Ivermectin, hydroxychloroquine, and herbal cocktails continue to receive state patronage. 2,3,4 On May 8, 2021, 2-deoxy-D-glucose was given emergency authorisation, stating that it will "save precious lives" without any published evidence that it impacts mortality. 5 An entrenched culture of polypharmacy and gestalt-driven practice among physicians has resulted in indiscriminate and unwarranted use of remdesivir, favipiravir, azithromycin, doxycycline, plasma therapy, and most recently baricitanib and bevacizumab, regardless of disease severity or drug efficacy. Excessive and inappropriate use of steroids could be contributing to the alarming rise of mucormycosis in patients recovering from COVID-19.In rural India, where health-care infrastructure is threadbare, and families are poor, patients can ill Lancet Infect Dis 2021

India's COVID-19 vaccination drive: key challenges and resolutions

“…Recommendations for the second wave of COVID-19 in India have been described elsewhere. 2 Here, we highlight challenges and resolution measures for mass vaccination of the second-most populous country in the world.…”

The modeling and analysis of the COVID-19 pandemic with vaccination and treatment control: a case study of Maharashtra, Delhi, Uttarakhand, Sikkim, and Russia in the light of pharmaceutical and non-pharmaceutical approaches

“…Recently, several drugs have been discovered to have a quicker recovery from COVID-19. Such as the drug 2-deoxy-D-glucose (2-DG) originated by the “Institute of Nuclear Medicine and Allied Sciences (INMAS-DRDO)”, in collaboration with Dr Reddy’s Laboratories (DRL), Hyderabad, and also approved by the drug controller general of India (DCGI) [ 46 , 47 ]. Its clinical trial demonstrated that this drug is very beneficial in hastening the recovery of hospitalized patients and also in reducing the need for supplemental oxygen.…”

Is indiscriminate use of medicines the main reason for problems faced during the second wave of COVID-19 in India? – Authors' reply

“…We are concerned that many experts, including those from reputable academic institutions and national agencies, offered opinions that did not reflect the latest and publicly available science. We are pleased to note that the revised guidelines 1 for COVID-19 management published by the Directorate General of Health Services reflect the sound evidence-based principles we advocate in our Comment 2 and do not include unwarranted medications.…”