The Moving Curve: Episode 35

Hello and welcome to The Moving Curve. I’m Rukmini, a data journalist based in Chennai. Every night on this mini-cast, I consider one question around the novel coronavirus epidemic in India. Tonight I’m considering this question — how did we get to a point where we make an unproven drug mandatory?

New guidelines that allow covid positive people with no symptoms or mild symptoms to be quarantined at home (first page, sub-head called “eligibility for home isolation”, #8): https://www.mohfw.gov.in/pdf/GuidelinesforHomeIsolationofverymildpresymptomaticCOVID19cases.pdf

Here’s the story until now: hydroxychloroquine first made an appearance in the current context in a March 23 advisory which said that a National Task Force on Covid-19 constituted by the ICMR which recommended the use of HCQ as a prophylaxis for high risk populations — namely health workers treating covid-19 patients and the household contacts of lab confirmed cases. https://www.mohfw.gov.in/pdf/AdvisoryontheuseofHydroxychloroquinasprophylaxisforSARSCoV2infection.pdf

Since the end of March, the health ministry has also said that hydroxychloroquine “may be considered as an off — label indication in patients with severe disease and requiring ICU Management.” https://www.mohfw.gov.in/pdf/RevisedNationalClinicalManagementGuidelineforCOVID1931032020.pdf

The US Centre for Disease Control had on March 21 published a document, Information for Clinicians on Treatment Options for COVID-19 Patients, that included a section that said: “Although optimal dosing and duration of hydroxychloroquine for treatment of COVID-19 are unknown, some U.S. clinicians have reported anecdotally about different hydroxychloroquine doses.” https://www.reuters.com/article/us-health-coronavirus-usa-guidance-exclu-idUSKBN21M0R2

That line has now been quietly deleted and the CDC’s treatment guidelines now say: There are insufficient clinical data to recommend either for or against using chloroquine or hydroxychloroquine for the treatment of COVID-19: https://www.cdc.gov/coronavirus/2019-ncov/hcp/therapeutic-options.html

There are some proper trials under way now, both in India and overseas:

https://clinicaltrials.gov/ct2/show/NCT04329923?cond=COVID-19&draw=6

https://clinicaltrials.gov/ct2/show/NCT04328285?cond=COVID-19&draw=5

Thank you for listening. This episode was edited by Anand Krishnamoorthi. Tomorrow — a new question.

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I am a data journalist based in Chennai, India.

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