|LETTER TO THE EDITOR
|Year : 2022 | Volume
| Issue : 7 | Page : 114-115
COVID-19: Our quest to find solutions
Department of Medicine, KG's Medical University, Lucknow, Uttar Pradesh, India
|Date of Submission||16-Sep-2021|
|Date of Decision||29-Dec-2021|
|Date of Acceptance||30-Dec-2021|
|Date of Web Publication||18-Mar-2022|
Department of Medicine, KG's Medical University, Lucknow - 226 003, Uttar Pradesh
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Gupta H. COVID-19: Our quest to find solutions. Med J DY Patil Vidyapeeth 2022;15, Suppl S1:114-5
Atre and Walinj wrote a Guest Editorial entitled, “COVID-19 situation in India: Fundamental epidemiological, operational, and ethical questions for the policy-makers,” which is published on August 28, 2021, on the web. The authors looked at several events as these unfolded recently, searched for answers to several still unanswered posers, and provided a logical way of thinking ahead.
Notwithstanding that, there are a few points of disagreement too there which is possible for any novel illness where there is not a universally agreed treatment protocol, and we enhance our information on a weekly and fortnightly basis. In the third paragraph, the authors underscore that numerous case reports suggest that people were hospitalized out of fear to acquire beds … However, in this scenario, what we need to recall is that it occurred in the backdrop of overwhelming of hospital beds in the second wave when several genuinely ill patients were denied admission due to lack of vacant beds, stocks and inventories ran out of oxygen, essential drugs and sometimes they were informed to be discharged when oxygen pressure fell further because their supplies remain unfilled.
Private citizens called for help on social media and sought the help of their representatives, NGOs, and other influential persons. Several hospitals approached courts subsequently,, some got relief, whereas others did not. Under such circumstances, if a person less than seriously ill acquires a bed out of fear (or may not getting one when he/she actually/crucially/desperately needs it), a poser that who is responsible for the generation of the fear demands an honest answer. I think that it is too an easy escape route to blame patients for everything wrong and not introspect any further.
Then, they emphasize that as per the same case reports, the admitted patients died due to comorbidities and over-medication and were labeled as COVID-19 deaths. What we should realize here is that comorbidities are a risk factor for the development of severe COVID and that in turn increases possibility of death. Moreover, at the same time, if the COVID-19 pandemic would not have been around, those patients could have been surviving. Hence, by this logic, it is not a wrong practice to attribute these deaths to the novel coronavirus pandemic. There are several illnesses around which claim a selected profile among demography as their victims. Here too, we are witnessing the same phenomenon and the same rules are applicable as anywhere else in Medicine.
Subsequently, the authors highlight that nosocomial transmission in crowded hospital settings also could not be ruled out, which might have led to localized epidemics in some settings. Here perhaps they are referring to outdoor setting where persons come in and go out, unlike indoors, where visitors are not allowed, or under very specific circumstances only. However, it is for this purpose we need more testing and isolation facilities for the cases, not less, as the Guest Editorial appears to be concluding.
The authors mention over-medications and provide an example of Remdesivir. We should realize that Solidarity trial states some benefits of the antiviral drug only in moderately ill patients and in the 1st week. Prescription outside this window is irrational, unnecessary, and maybe injurious.
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Conflicts of interest
There are no conflicts of interest.
| References|| |
Atre S, Walunj G. COVID-19 situation in India: Fundamental epidemiological, operational, and ethical questions for the policy-makers. Med J DY Patil Vidyapeeth 2021;14:479-80. Available from: https://www.mjdrdypv.org/text.asp?2021/14/5/479/324787
. [Last access on 2021 September 16].
Gupta H, Nigam N, Verma SK, Kumar S. Mortality data of COVID-19 remain illusive and inconsistent. J Family Med Prim Care 2020;9:5413-4. [Full text]
Gupta H, Gautam M, Kumar A, Verma SK. Patient and hospital building-related factors should also be considered for mitigation purposes. J Family Med Prim Care 2021;10:1799-800. [Full text]
Hsu J. COVID-19: What now for remdesivir? BMJ 2020;371:m4457.