Coronavirus: AYUSH Ministry’s dangerous prescription

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When a passenger with symptoms suggestive of novel coronavirus infection is found at an airport, should he/she be quarantined and tested/treated in a hospital or allowed to go home and receive supportive management with Unani medicines?

At a time when the number of novel coronavirus cases has touched 7,711 and deaths at 170 in mainland China alone and the virus has spread to 20 countries/regions, the AYUSH Ministry has once again resorted to dishing out dangerous prescription to people who might get infected with the virus. In a press release sent out on Wednesday, the ministry has recommended certain Unani medicines for “symptomatic management of novel coronavirus”, and certain Ayurveda and homeopathy medicines to help prevent coronavirus infection.

Nearly a month after China intimated the World Health Organization about the novel virus, no drugs to specifically target the virus are currently available and no candidate drugs are at any stage of clinical trial.

In the absence of specific drugs to treat the novel coronavirus, patients are only provided with symptomatic treatment. They are being provided enough oxygen so that they survive long enough for the immune system to fight the disease on its own.

In such a scenario, not only is the Ministry’s recommendation highly irresponsible and dangerous, but also runs counter to the Ministry of Health and Family Welfare’s current practice of quickly isolating even suspected cases to prevent the spread of the virus and providing them with symptomatic treatment if found infected.

No clinical validation

None of the medicines mentioned in the release have ever undergone any form of clinical validation. These medicines have not been tested on people infected with the novel virus to study their ability to provide any kind of relief or prevent infection, either. Yet, the AYUSH Ministry has no hesitation in recommending the untested medicines to treat the virus about which little is known so far.

Even as the ministry has issued an advisory to symptomatically manage infected people by providing them with Unani medicines, it has not cared to list out the symptoms that people infected with the novel virus exhibit. Nor has it mentioned which medicines should be taken to treat which symptoms.

People infected with the novel virus exhibit a wide range of symptoms. While most people exhibit milder symptoms akin to common cold such as fever and cough, about one in five manifest severe illness, including pneumonia and respiratory failure. Much like in the case of the Middle East respiratory syndrome (MERS) caused by another coronavirus, some patients have been said to have had gastrointestinal symptoms, including diarrhoea.

Encouraging self-medication

The press release is a mishmash of information put together in haste. While the press release detailing about Ayurveda medicines does clearly state that the “advocacy is for information only and shall be adopted in consultation with registered Ayurveda practitioners only”, no such cautionary note is found for Unani and homeopathy medicines.

By recommending Unani medicines and asking people to use them for symptomatic management of the infection, the AYUSH Ministry is in fact encouraging people to self-medicate, which is alarming.

With no evidence that the medicines would indeed provide even symptomatic relief, self-medication outside the healthcare system would put close contacts at grave risk of getting infected. After all, human-to-human transmission from infected cases to close contacts has been documented in China and other countries. In fact, even fourth-generation transmission has been recorded in Wuhan city, the epicentre of the disease outbreak.

The AYUSH Ministry neither seems to be aware of the kind of precautions that need to be taken while attending to people with the infection nor of the fact that 16 healthcare workers who have been wearing all the mandatory protective gear while treating the infected cases fell ill themselves.

To quarantine or not

So when a passenger exhibiting symptoms suggestive of infection with the novel coronavirus is found at one of the 20 airports where thermal screening has been undertaken, will the passenger be immediately quarantined and admitted to a hospital for further testing/treatment or will the passenger be able to allowed to self-medicate at home with Unani medicines?

This should be a reminder that especially at a crucial time like this, the Health Ministry and the AYUSH Ministry cannot afford to work at cross purposes.

Published in The Hindu on January 30, 2020