It is usually essential for the medical group to stay up to date on the present tips and accommodate the brand new adjustments that happen now and again
Coping with the COVID-19 pandemic, for all of us within the healthcare business, has not solely been a really difficult expertise but additionally an enriching one. It has taught us how fallible we may very well be when coping with a brand new illness. As is the observe in any pandemic, tips are issued by the varied scientific and regulatory our bodies to assist us handle the illness.
On this pandemic too, numerous tips have been put forth by nationwide our bodies just like the Indian Council of Medical Analysis (ICMR), Directorate Common of Well being Providers (DGHS) and worldwide ones like World Well being Organisation (WHO), Facilities for Illness Management and Prevention (CDC) of the USA and others. We have to realise and remember that these tips will not be written in stone, they aren’t at all times gospel truths and should turn into misguided as we be taught extra concerning the illness and that is what has occurred on this occasion too.
Simply to offer just a few examples, initially many scientific our bodies together with the WHO thought that there isn’t a human-to-human transmission of this virus and no aerosol unfold, and due to this fact masking is probably not wanted for everybody. All of those turned out to be misguided as soon as we learnt extra concerning the illness.
There have been additionally a number of tips concerning the prevention and therapy of this illness within the preliminary phases, together with an enormous clamour for using hydroxychloroquine each for prevention and therapy of the illness; Vitamin D, Vitamin C and Zinc to spice up your immunity; use of antibiotics like doxycycline, azithromycin, antiviral drug like Oseltamivir and antiparasitic agent Ivermectin. Nonetheless, these didn’t stand up to scientific scrutiny over a time frame and have all been withdrawn from the suggestions at present.
There have been additionally very robust advice/tips to make use of Remdesivir, plasma remedy and an immunosuppressant monoclonal antibody Tocilizumab, which afterward have been both modified or withdrawn. Sadly, a few of these suggestions and a few misinterpretation of those suggestions led to a extreme scarcity of those medication, leading to hoarding and black advertising by unsavoury parts within the society.
Based mostly on all these experiences, the million-dollar query that arises in a single’s thoughts is, ‘What’s the position of tips in a pandemic like this?’
My response to this is able to be that there definitely is a job for tips however with sure caveats, that are:
a) The rules issued by numerous scientific our bodies and regulatory authorities are based mostly on the data they’ve on the time the rule of thumb was issued.
b) In any new illness, the data and the data concerning the illness may change very quickly as we now have seen on this pandemic and as new knowledge comes up, the outdated tips could also be invalid or have to be modified/modified. Therefore, frequent adjustments within the tips are required based mostly on scientific knowledge which is what has occurred within the case of COVID-19 too.
The medical group must be conscious that it is a dynamic course of and should maintain itself up to date on the present tips and make the required adjustments within the administration protocol accordingly.
c) We have to realise that tips are essential instruments for uniformity within the administration of a given illness at a given time however definitely not a mandate of what ought to be performed. As a treating physician, the medical selections on the best administration of the affected person ought to be taken together with the rules in figuring out the suitable administration of a given particular person.
d) It is usually essential that after we comply with the rules it must be performed in a really particular method and meticulous element about using a selected drug, the timing, dose and period have to be considered and deviation from this might result in severe issues. A particular instance of this was the indiscriminate use of steroids with disregard for the specifics famous within the tips, which sadly induced diabetes in some individuals, worsened it in others and had a job in triggering the epidemic of Mucormycosis within the aftermath of the second wave of COVID.
So long as we realise these caveats, tips are definitely an essential software given by the scientific and regulatory authorities to information the healthcare staff in the best administration of the illness at that individual time. However they need to definitely not be thought-about gospel fact that may by no means change.
The creator is chairman, Manipal Hospitals. Views expressed are private.