key: cord-0962244-qzt096l6
authors: Naik, B Sadananda
title: Low-value health care in the COVID-19 pandemic
date: 2021-08-17
journal: Lancet Glob Health
DOI: 10.1016/s2214-109x(21)00353-3
sha: 80338d1e52cfde1828c04dddf13b113a263dd00e
doc_id: 962244
cord_uid: qzt096l6

nan

Many of the drugs mentioned in the Comment (eg, hydroxychloroquine or ivermectin) do not make it into the prescription of any medical professional who practises evidencebased medicine. However, statutory obligations must be followed by all law-abiding citizens in any country. The public health departments of the Union Government and various state governments in India publish guidelines 2,3 and protocols to be followed by all medical professionals while managing patients with COVID-19. These guidelines are updated from time to time based on the changing scenario of the pandemic and are legally binding for medical professionals, however unscientific or irrational they are. The courts in India consider these guidelines issued by the public health departments as a credible source of reference while adjudicating litigations pertaining to COVID-19 patient management, because evidence-based medical publications are difficult to understand and interpret in the given situation. Moreover, medical professionals could be prosecuted for not following the guidelines published in strict laws such as the Epidemic Diseases Act, 1897, and the Disaster Management Act, 2005. This is also evident in the late policy decision to vaccinate pregnant and lactating women in India.

Therefore, the state machinery is as responsible as the medical professionals in India for not following evidence-based medicine while treating patients with COVID-19.

2 Ministry of Health & Family Welfare, Government of India. Clinical guidance for management of adult COVID-19 patients

Circular: revised treatment guidelines for asymptomatic and mild symptomatic COVID positive persons in home isolation/home care and CCC