Doctors, Science and Covid-19
The other day a friend (NM) based at Lucknow had to be rushed to hospital since his oxygen level had dropped below 70. NM was suffering from Covid-19 and was doing fine in home isolation when the sudden drop in oxygen level was noticed. NM is more than 70 years old and has been diabetic for decades. His doctor had prescribed him many medicines including steroids. The steroids caused his diabetes to shoot up leading to a chain reaction which landed NM on oxygen in ICU.
Was NM's doctor correct in prescribing him steroids during home care stage of Covid-19? The answer must be a clear NO. Steroids like Dexamethasone have been found to be useful for patients on respiratory support. Scientific studies have shown clearly that steroids caused no benefit to patients in early stage Covid. Scientists are of clear opinion that during early stage or during mild Covid, steroids do more harm than good. In case of NM the steroids caused his sugar levels to rise, led to dropping of his blood oxygen level and brought him very close to death. Obviously, Covid cannot be blamed for NM's condition. The fault must surely rest with the doctor who prescribed the steroids. In any developed country, the concerned doctor would have lost his / her licence to practice and might have also been forced to pay hefty compensation. Not so in India!
My comments about steroids given in the paragraph above are based on an extremely well researched and scholarly presentation titled Current Treatment Options for Covid-19 - What Works And What Doesn't by Dr. Zarir F Udwadia, Consultant Physician, Hinduja Hospital and Research Center, Mumbai . The presentation was recorded around March 2021 and is available on YouTube.
Sad part is that the practicing doctors in India are ignoring sane and scholarly voices like that of Dr. Udwadia as well as of WHO and are prescribing a cocktail of drugs which are doing enormous harm to Covid-19 patients.
Some medicines which are being prescribed by Indian doctors, despite strong scientific evidence being against them, can be summed up as follows:
- ANTIBIOTICS - Azithromycin and Doxycycline. Often both are prescribed.
- ANTIVIRAL drugs like Lopinavir-Ritonavir, Oseltamivir
All the above are often given simultaneously along with steroids and other medicines (I speak from personal experience). This strong cocktail plays havoc with the body's immune system and effectively kills any chance of the patient's body being able to fight the Corona virus. Immediately after start of these medicines, the digestive system collapses, hormonal balance is disturbed and the situation tends to become hopeless. Fortunately for the doctor, the blame must rest squarely with the infamous virus and not with his / her unscientific medication.
While the above mentioned seem to be almost a standard first blast that Indians suffering from Covid-19 are exposed to, there are many others that have dubious or practically zero benefits. Some of them can be summed up as follows:
- Vitamins -
- In small quantities vitamins can be harmless. However, excessive dosage can be harmful. There is absolutely no evidence about any vitamins being of any benefit in fighting with Covid-19.
- Plasma -
- Dr. Udwadia tells me that most studies across the world have shown no benefit from plasma treatment.
- Tocilizumab / Actemra -
- This is an immunosuppressant drug. The theory is that it suprresses Cytokine storms. The theory is not accepted by the scientific community. The drug can be extremely harmful since it can cause sepsis.
Having said what does not work, let me for the sake of completeness, also state what is likely to work in case of Covid-19. Again, I base my comments entirely on Dr. Udwadia.
- REMDESIVIR -
- It probably works if given in early stage. WHO does not think so. FDA approval of Remdesivir was despite WHO objections. Indian studies have shown that it causes no significant reduction in mortality. However, for patients on recovery path it speeds up the recovery by a few days. Remdesivir may also sometimes be used in combination with Barcitinib.
- FAVIPIRAVIR or Fabiflu -
- It is not permitted in either USA or Europe. It may be useful for mild or moderate cases where it is likely to reduce the recovery time by about 2 days. Its advantage is that it is administered orally and has low side effects.
- ANTICOAGULANTS -
- Covid-19 has a tendency to cause blood clotting. So, LMWH (Low Molecular Weight Heparin) is recommended.
In addition to the above three, there is likelihood that Inhaled Interferon nebulized and some Monoclonal antibody treatments might work in future. However, presently more work is needed in these lines of treatment.
Let me end by once again quoting Dr. Udwadia, "Many drugs in current use (for treatment of Covid-19) are likely to do more harm than good". Dr. puts it mildly. As a lawyer, I am inclined to say that the doctors are killing more than the virus. That may be an exaggeration. Nevertheless, it is high time that we realized that a pandemic is too important a matter to be left to only doctors who follow no scientific advice or recommendations.