A troubling prescription

At a time when the novel coronavirus, 2019-nCoV, has spread to 20 countries/ regions, when the number of 2019-nCoV cases has risen to 7,711, and the number of deaths to 170 in mainland China alone, the Ministry of AYUSH has published a misleading advisory. In a press release circulated on Wednesday, the Ministry recommended certain Unani medicines for “symptomatic management of Corona Virus infection” and certain Ayurvedic practices and homeopathy medicines to help “prevent the infection”.

Nearly a month after China intimated the World Health Organization about 2019-nCoV, there is no drug to specifically target the virus. Nor is there any candidate drug that is at any stage of clinical trial to combat the virus. In the absence of specific drugs to treat the virus, patients are being provided with symptomatic treatment. They are being given 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 patients suspected of carrying the virus to prevent its spread, and providing them with symptomatic treatment if they are found infected.

No clinical validation

None of the medicines mentioned in the advisory has undergone any form of clinical validation. These medicines have not been tested on people infected with 2019-nCoV to study their ability to provide any kind of relief or prevent any infection. Yet, the Ministry has recommended untested medicines to treat a virus about which little is known.

Even as the Ministry has issued an advisory to symptomatically manage infected people by providing them Unani medicines, it has not cared to list the symptoms that people infected with the novel virus exhibit. Nor has it mentioned which specific medicine should be taken if a particular symptom is noticed. People infected with 2019-nCoV exhibit a wide range of symptoms. While most have mild symptoms such as a fever and cough, about one in five show more serious symptoms such as pneumonia and respiratory failure. Similar to those who had the Middle East respiratory syndrome caused by another coronavirus, some patients with 2019-nCoV have also had gastrointestinal symptoms, including diarrhoea.

The press release is a mishmash of information put together in haste. While the part of the press release detailing Ayurvedic practices states that the “advocacy is for information only and shall be adopted in consultation with registered Ayurveda practitioners only”, no such cautionary note is found under the Unani and homeopathy recommendations.

Self-medication is dangerous

By recommending Unani medicines and asking people to use them for symptomatic management of the infection, the AYUSH Ministry is encouraging people to self-medicate, which is alarming. With no evidence that the medicines will provide even symptomatic relief, self-medication outside the healthcare system would put those in close contact with each other 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, the epicentre of the disease outbreak.

The AYUSH Ministry neither seems 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 had been wearing protective gear while treating infected persons in China fell ill themselves.

When a passenger exhibiting symptoms suggestive of 2019-nCoV is found at one of the 20 Indian airports where thermal screening is being undertaken, will she be quarantined and admitted to a hospital for further testing/treatment or allowed to self-medicate at home with Unani medicines? At a crucial time like this, the Health Ministry and the AYUSH Ministry cannot afford to work at cross purposes.