Watchdog With A Bone


Some time back (November 2019), our institute had organized an international workshop on ‘Clinical Research Ethics.’ It was an agenda setting workshop for our institution and had representations from several other institutes such as the Department of Bioethics, National Institute of Health (NIH), USA, Indian Council of Medical Research (ICMR), Niti Ayog and Drug Controller (India), CDSCO. We were informed that ICMR is the watchdog of bio-ethical practices in clinical research in India and had formulated guidelines as good as anywhere else in the world. ICMR had placed mechanisms to guide institutional ethical committees in matters of research if required.  There were also discussions about special situations such as research on vulnerable populations such as children, tribal and the underprivileged.

In a few weeks after the workshop, COVID-19 outbreak started unfolding. It was declared as a pandemic by WHO on 11 March 2020.1 We were struck with shock and awe, as it was an unprecedented situation for all of us. Our institute played its part by creating a separate 500-bed COVID-19 hospital. We, as everyone else, were groping in the dark as to how we should treat our patients with this disease, as very little information was available. In this scenario, ICMR took a bold decision. On 23 Mar 2020, it recommended that health care workers (HCW) in close contact with COVID-19 patients should take a prophylactic dose of hydroxychloroquine (HCQ) weekly for 7 weeks.2   The advisory document suggested that both preclinical and clinical data had supported this strategy.

I remember, a couple of days later a junior colleague had asked me if he should start taking HCQ. I had hesitated for a while. As a professor, I am supposed to give an evidence-based reply, and I wasn’t aware of a single study where prophylactic use of HCQ was found to be useful. I knew that the rheumatologists frequently used HCQ for the treatment of rheumatoid arthritis and systemic lupus erythematosus due to its immunomodulatory actions. It is a close cousin of chloroquine (the antimalarial drug) and its antiviral properties have been known since 1990s, as it could inhibit viruses like HIV, Dengue, Ebola and SARS-1 in vitro.3 Its clinical safety profile was better than that of chloroquine (for long-term use) that can allow higher doses with fewer concerns about drug-drug interactions.4 A Chinese study demonstrated that chloroquine and HCQ inhibit SARS-CoV-2 in vitro and HCQ was found to be more potent than chloroquine. A small clinical trial conducted in Chinese patients, showed that chloroquine had a significant effect, both in terms of clinical outcome and viral clearance, when compared to control groups.5 Chinese experts recommended that patients diagnosed as mild, moderate and severe cases of COVID-19 pneumonia and without contraindications to chloroquine, be treated with 500 mg chloroquine twice a day for ten days.6 Another French study also showed that HCQ treatment was associated with significantly higher viral load reduction/disappearance in COVID-19 patients and its effect is reinforced by azithromycin.7 These trials have been on a small number of patients and do not really prove the efficacy of the drug beyond reasonable doubt.

Was this evidence enough to recommend this drug in a ‘prophylactic role’ in a healthy population of healthcare workers? That too for a disease with very low mortality in healthy young population? I was not sure. Since the ICMR recommendation had the backing of the Government of India, it was difficult to ignore. 

It appears that the apex body that supervises bioethical principles of all medical research done in the country, prescribed an unproven drug to thousands of healthy healthcare workers without even informing them of its real value. More explicitly, ICMR failed to disclose the experimental nature of prophylactic intervention (the results of which were going to be published later). The ‘participants’ were to report any side effects voluntarily and there was no provision to screen them for SARS-CoV-2 before, during or after the drug was taken. In a nutshell, it was a large, poorly designed, unmonitored human trial conducted without an informed consent.8,9

Meanwhile Lancet published a study that added a new twist.10 It concluded, “We were unable to confirm a benefit of HCQ or chloroquine, when used alone or with a macrolide, on in-hospital outcomes for COVID-19. Each of these drug regimens was associated with decreased in-hospital survival and an increased frequency of ventricular arrhythmias when used for treatment of COVID-19.” These conclusions suggested that we should be moving with great caution. In fact, WHO rapidly went on to drop an arm using HCQ from its studies on COVID -19 treatment. The media has been having a field day talking about HCQ. Before Lancet-COVID-19 paper 11, US President Donald Trump had warned India that the US may retaliate if it did not export anti-malarial drug HCQ to the USA despite his personal request (07 April 2020).12 Three days later Donald Trump described Prime Minister Narendra Modi as “terrific” for allowing the export of the anti-malarial drug hydroxychloroquine to the US.13

Soon after the Lancet-COVID-19 paper 14 was published, Indian Governmental agencies (CSIR, IGIB, CMI, ICMR) and several others severely criticized this study on HCQ as being misleading. They also urged WHO not to suspend trials with HCQ in COVID -19.15 An interesting criticism came from a journalist, “The study ignores zinc entirely. It’s not randomized.  It deals with very sick people and timing of hospitalization has not been mentioned.” He rounded it off by saying, “Even Donald Trump knows that HCQ is meant to be used with Zinc, so it is surprising that the medical researchers have not even mentioned it.”16 A statistician Peter Ellis, who is a chief data scientist at Nous Group, an international management consultancy, alleged that “the data behind that high profile, high consequence Lancet-COVID-19  study (about HCQ being ineffective) was completely fabricated”.17

The infamous lancet- COVID -19 paper has also brought ‘Surgisphere,’ (a relatively unknown company till Mar 2020) into limelight for orchestrating this study in 167 undisclosed hospitals. SS Desai, (one of the lead authors of the Lancet- COVID -19 study) is a cofounder of Surgisphere. (The company has not disclosed all its directors) The first author of the Lancet-COVID-19 paper 18, M R Mehra works at a hospital that regularly conducts Gilead initiated clinical trials for Gilead’s drug, Remdesivir for COVID -19.19

Some media reports have also highlighted the link (read funding) between the authors of Lancet-COVID-19 study and Gilead. The latter obviously benefits if HCQ is debunked as it was promoting Remdesivir (HCQ rival) for COVID -19 in a pandemic. In an open letter to Lancet, several shortcomings of this study have been highlighted by various scientists.20 In face of severe criticism, the authors of the Lancet- COVID -19 paper, have retracted their publication from the journal.21 They also retracted another paper in New England Journal of Medicine (NEJM) about increased risk of in-hospital deaths related to the underlying cardiovascular disease in COVID-19.22 The Lancet and NEJM were considered very reputable journals, but this event has placed a big question mark on the peer view process being followed by the journals.

The same mistake may be committed by Indian Journal of Medical Research (IJMR), which is ICMR’s own journal and carried a good reputation so far. ICMR published the result of its own retrospective study (?‘trial’) of prophylactic use of HCQ in IJMR (paper received on 28 May 2020, published online 31 May 2020; Obviously no peer review!!!).23 In this paper, a graph depicts dose response relationship between HCQ dose and proportion positive for SARS-CoV-2. It shows that 52% HCW had infection when HCQ was not taken. Infection rate climbs to 63% if 2-3 doses of HCQ were taken and falls to <20% if 6 or more doses were taken. The trend line has been drawn going downward with increasing exposure to HCQ. The study results seem to absolve ICMR by saying “Until results of clinical trials for HCQ prophylaxis become available, this study provides actionable information for policymakers to protect HCWs at the forefront of COVID-19 response. The public health message of sustained intake of HCQ prophylaxis as well as appropriate PPE use need to be considered in conjunction with risk homoeostasis operating at individual levels.” What is the veracity of ‘observational data,’ where neither the testing nor the adverse effect monitoring has been standardized and the data has not been made available in public domain? Would IJMR have published a similar paper from a second-tier town of India on the merit of its scientific content?

The question is – ‘Should ICMR feel vindicated by the retraction of Lancet and NEJM papers about COVID-19’? Does that prove that HCQ is effective? To add to the worries of ICMR, three more studies have shown that HCQ does not help.24 This includes the RECOVERY trial from UK,25 Post exposure prophylaxis trial from Barcelona,26 and a meta-analysis of several smaller trials of HCQ.27 This dims the chances that HCQ is going to turn out very effective in treatment or prophylaxis of COVID-19.

Does ICMR- COVID -19 paper prove anything? Has it been published just to support its decision to recommend HCQ? Was the decision to recommend HCQ political and not really based on science? While Lancet-COVID -19 paper28 may be attributed to authors’ personal agenda, what is the reason for the odd behavior of our watchdog? The issue of HCQ efficacy may be considered subjudis, but the ugly influence of business and politics on science is already visible. Industry’s control on the science and professional medical associations due to its financial muscle are well known.29,30 Unbiased scientific opinion seems to be becoming a rarity. Unfortunately, we fail to realize that it is the unbiased science that can lead us out of this pandemic crisis.



1 WHO Director-General’s opening remarks at the media briefing on COVID-19 – 11 March 2020. (—11-march-2020)
3 Ferner RE, Aronson JK. Chloroquine and hydroxychloroquine in covid-19. BMJ 2020;369:m1432 doi: 10.1136/bmj.m1432 (Published 8 April 2020)
4 Wang L, Wang Y, Ye D, Liu Q. Review of the 2019 novel coronavirus (SARS-CoV-2) based on current evidence [published online ahead of print, 2020 Mar 19]. Int J Antimicrob Agents. 2020;105948. doi:10.1016/j.ijantimicag.2020.105948
5 Wu Z, McGoogan JM. Characteristics of and important lessons from the coronavirus disease 2019 (COVID-19) outbreak in China: summary of a report of 72 314 cases from the Chinese Center for Disease Control and Prevention. JAMA. 2020 Feb 24. doi: 10.1001/jama.2020.2648. (Epub ahead of print)
6 Colson P, Rolain JM, Raoult D. Chloroquine for the 2019 novel coronavirus SARS-CoV-2. Int J Antimicrob  Agents. 2020 Mar;55(3):105923. doi: 10.1016/j.ijantimicag.2020.105923
7 Gautret P, Lagier J-C, Parola P, Hoang VT, Meddeb L, Mailhe M, et al. Hydroxychloroquine and azithromycin as a treatment of COVID-19: results of an open-label non-randomized clinical trial. J Antimicrob Drugs 2020. doi: 10.1016/j.ijantimicag.2020.105949
8 Kalantri SP. Hydroxychloroquine and COVID-19: Can we go back to science?
9 Rathi S, Ish P, Kalantri A, Kalantri SP. Hydroxychloroquine prophylaxis for COVID-19 contacts in India. Lancet Infect Dis 2020; Published Online April 17, 2020.
10, 11, 14, 18, 28 Mehra MR, Desai SS, Ruschitzka F, Patel AN. Hydroxychloroquine or chloroquine with or without a macrolide for treatment of COVID-19: a multinational registry analysis. The Lancet 2020.
20 Open letter to MR Mehra, SS Desai, F Ruschitzka, and AN Patel, authors of “Hydroxychloroquine or chloroquine with or without a macrolide for treatment of COVID19: a multinational registry analysis”. Lancet. 2020 May 22:S0140-6736(20)31180-6. doi: 10.1016/S0140-6736(20)31180-6. PMID: 32450107
23 Chatterjee P, Anand T, Singh KJ, Rasaily R, Singh R, Das S, et al. Healthcare workers & SARS-CoV-2 infection in India: A case-control investigation in the time of COVID-19. Indian J Med Res, Epub ahead of print DOI: 10.4103/ijmr.IJMR_2234_20.
29 Moynihan R, Albarqouni L, Nangla C, Dunn AG, Lexchin J, Bero L. Financial Ties Between Leaders of Influential US Professional Medical Associations and Industry: Cross Sectional Study. BMJ 2020 May 27;369:m1505. doi: 10.1136/bmj.m1505.
30 Anand AC. The pharmaceutical industry: our ‘silent’ partner in the practice of medicine. Natl Med J India. 2000;13(6):319-21.



  1. very true sir. an eye opening article for all of us who practices without validating studies from European journal. We forgets that they are also like indian journals and they are also accepting many studies which are not genuine. many thanks for sharing your work sir. truly inspirational. 🙏🙏

    14 June 2020
  2. Sankar prasad Gorthi said:

    Sir a very detailed assessment and narrative. The chronology of events is very well summarized where are the medical ethics? It’s a shame that SOLiDARITY trial was halted and restarted by WHO. A trial published in NEJM on 03 June regarding HCQ and post exposure prophylaxis is full of biases. The issue can only be settled with a properly designed trial. I hope one of the 63 trials registered with HCQ in COVID 19 infection will be robust enough to give us the answer.

    14 June 2020
  3. Dr Abhay Ahluwalia said:

    A well written article shedding some light in the HCQ controversy. Hydroxychloroquine the controversy should be solved India is in the fifth month of the pandemic with more than 3 lac cases of COVID 19 . The number of health care workers exposed to the virus would be a few thousands . This number should be enough to collect a retrospective data on the disease manifestation and severity of disease with or without HCQ If a prospective trial may not be feasible at leaster can have a hard data on real time exposure to the virus

    14 June 2020
  4. Dr. Rajiv Mehta said:

    Great write-up…very true… majority of our colleagues are taking HCQ since the beginning of the pandemic…our protocol….. every Sunday HCQ and every Wednesday Ivermectin….. ivermectin is probably under reported….

    14 June 2020
  5. Rajat Kumar said:

    What a welcome, balanced and objective commentry by Prof AC Anand!! Unfortunately the perceived benefits or harms of hydroxychloroquin have assumed a nationalistic hue, with many “experts” vehemently using the retracted Lancet and NEJM as evidence that hydroxychloroquin works! The IJMR should not make a similar error in publishing studies with insufficient science. The credibility of ICMR should not be compromised by any perception of political considerations.

    14 June 2020
  6. Dr Kaushal Madan said:

    An unbiased and brutally frank account of the biases involved in medical research and how the same research shapes real life clinical practice , that ultimately affects millions of lives !!

    14 June 2020
  7. Sunil Kohli said:

    As usual, an incisive, will researched article. I have always enjoyed reading your articles and the way you present hard scientific data in an easy to understand format. Please write more

    14 June 2020
  8. VSSR Ryali said:

    Dear Admiral AC Anand,

    Interesting review …

    You have managed to disrobe many institutions with your incisive analysis …

    But in retrospect
    they did to themselves,
    which you didn’t do
    to them …

    Namely, not being able to
    maintain objectivity,
    subject oneself to scrutiny,
    avoid ego &
    keep patient interest foremost …

    I don’t know,
    how much pleasure
    you derived by your systematic denocuement of
    the ICMR, WHO
    (complied to both Lancet & ICMRs
    quick demolition jobs
    in rapid succession),
    Lancet & NEJM …

    It was more of a relief
    to most of us,
    reading your piece,
    for sheer objectivity,
    in these circus times …

    Thanks & Regards
    Surgeon Rear Admiral VSSR Ryali VSM Retd

    14 June 2020
  9. Dr Sakir said:

    It is a very adequately researched and well written piece.
    Maybe I can add a couple of facts.
    1. Weekly dosing of HCQ can never lead to a steady state concentration of the drug. So it cannot cover the entire week. With malaria it can kill the parasite with once a week. But it cannot prevent viral entry if steady concentration is not reached
    2.HCQ has been shown to prevent viral entry of HIV. That doesn’t mean it works in HIV.

    ICMR people are dealing more with malaria. So they get an “idea” About weekly dosing. Meanwhile all other trials for HCQ prophylaxis are using daily doses. No clear evidence yet.

    However in my personal opinion the effect size of HCQ is very small, but remdesivir is no different from HCQ. If we want HCQ to have any inflammatory or anti thrombotic role, then that will take at least 3 months of daily intake.

    14 June 2020
  10. Prof. Kanchan K Malik said:

    This is so good. An insightful reflection on the ethics of publishing evidence-based research, peer review process of medical journals, and of course, as you put it, “the ugly influence of business and politics on science.”
    You’ve woven all facts together brilliantly (not missing out on Trump & HCQ), and analysed the diverse dimensions of this race to come out with a drug for COVID-19.
    Interesting to read for a non- expert like me too.

    14 June 2020
  11. Neeraj Nagpal said:

    That medical research across the world ispharma industry driven is well known. What is an eye opener is that it may also be driven by political agenda. It is unfortunate that journals like Lancet have obviously not remained trustworthy. I cannot but find the similarity of the situation with Indian TV news channels and their credibility. But more importantly what a presentation of facts. Great writing sir. This article should have been in lancet

    14 June 2020
  12. Maj Gen RP Choubey(Retd) said:

    Dear AC,
    As always, you are again at your best in putting your thoughts & opinion on avery relevent but controversial topic in such a simple way using all the scientic armamentorium needed for research & medical writing. None of the studies thus far conducted on the prophylactic / therapeutic use of HCQ have been conclusive. To my naive mind, time was too short to derive any conclusive evidence far or against, of the use of HCQ.
    My only criticism of your article is , you seem to. have absolved the Lancet & NEJM of their complicity in this whole sordid saga of vindicating falsehood using your reputation of past.
    COVID-19 is a newer virus inflicated disease , in existance for maximum 6-7 months, a pandemic of which,none across the globe had any clue . I dont think enough time had elapsed to gather sufficient & authentic data to derive such far fetching conclusions.
    Mr Horton,(editor Lancet) cann’t absolve himself by accepting that “Pharmacological companies are financially so robust that they pressurise the journals to publish something of their choice” . If the principal autors of the article, Mr Desai & Mr Mehra had some financial interest & one of them also had some dubious past, why it was not ascertained earlier , why the article of so much of consequence was not peer reviewed. Why only authors are to be blammed for financial misdeeds & not the 2 journals. To my mind , they cann’t be absolved of their responsibilty based on their past reputation. If one is not interested infurthering his/her financial fortune, how come he/ she can be pressurised by the pharmacological industry lords.
    Your articcles are such a treat to read, so simple but so informative backed with hard Evidence.

    14 June 2020
  13. Prof Dr Amitabh Sagar said:

    Sir . Read the article in full ..
    You have brought out the whole issue very succinctly . Our own ICMR seems to be lost the plot. Either they don’t understand the strength based evidence system , or the so called experts are far way from reality locked in their castles in air, or they simply got confused by the blitzkrieg of the whole event . Whatever the truth , we have the whole time to analyse that till the cows come home .
    The truth is that the world messed the HCQ issue and so did ICMR . They can’t take the plea of the innocent .
    Very well written sir as usual . Regards . 🙏

    14 June 2020
  14. Prashant Singh said:

    Probably HCQ was a placebo given to the front line workers in war against Covid 19, so that they think at least they have some thing protecting them as they do not have PPE kit ( the recommended safety gear). But then somebody asked, based on what you are recommending this? Then the answer in defence came “its a study we are doing”. Otherwise how do you explain a total lack of data accumulation. No one knows how many people, which age group, risk of contact, prior status of covid infection, have taken HCQ as proprophylaxis. It was a blanket notice to whoever want to take, can take it.
    This does not look like study. And I think people at ICMR do know how to design a study. It was just a political boost to our front line workers ( just like talli, thali and puspvarsha) so that they do not fall behind asking for more protective equipment.

    14 June 2020
  15. Sudeep Khanna said:

    Wonderful write up as usual.
    My take:In times when we are lost and no help is seen coming from anywhere, we try to latch on to whatever is available and hope for the best.
    It’s like believing in jadu tona

    14 June 2020
    • Dr Amogh Dudhwewala said:

      Sir, drowning man will clutch at straw.।

      I guess nobody is in a position to practise evidence based medicine as we are fighting a Novel disease.

      Anand sir, it is always a treat to read your articles.

      14 June 2020
  16. Ranjith K Nair said:

    The answer to the question raised at the beginning of your succinct and incisive analysis is still pending! So did you or did you not advise your junior to take hydroxychloroquine?

    14 June 2020
    • Anil C. Anand said:

      One may advise, after informing ‘participants’ of its known value, and in a study protocol

      14 June 2020
  17. Dr Bhushan Chopra said:

    Nicely brought out all aspects related to HCQ. Such uncertainties and different schools of thought bring lots of doubts even in practicing professionals leave alone normal people. I feel all professionals must read this and get enlightened. ICMR shouldn’t be casual at all otherwise it’s long earned reputation may be at stake.

    14 June 2020
  18. Rakesh said:

    A hard hitting , to the point analysis which disrobes our premier medical research agency . Four months into the pandemic we as a nation are trying to hide behind recovery rate and denying the fact that we need to test more . Are our scientists subservient to political bosses ? ANIL you should have been in Delhi .

    14 June 2020
  19. Pradeep Patnaik said:

    An excellent read. As usual Prof. AC has converted all the complex facts and developments in to a fountain of knowledge. Easy to understand & stimulus to ponder over. 1. Should we absolve ICMR who suddenly faced an unprecedented quagmire to react? 2. Lancet & NEJM the so called holier than thou need to be questioned internationally. Simple retraction of an article is not enough.

    14 June 2020
  20. Rajeev Shandil said:

    Succinct analysis! The musical chairs has roasted the frontal lobe too . It gets even more muddled with HCQ and remdesivir both being recommended now ( local markets had accumulated enough to unleash it ) . The road ahead is more finance than science !!

    14 June 2020
  21. Mohanish Anand, PhD said:

    Dear Prof. Anand,
    Very well written, did not know about ICMR guideline for healthcare workers. Less said about Trump is better to be honest.

    When ICMR recommended HCQ, it should have been under emergency use authorization with a mechanism to capture any AEs, with a level of transparency in an informed consent.

    From a bioethics perspective, should evidence threshold change in face of a global health emergency?

    14 June 2020
    • Anil C. Anand said:

      Evidence threshold can change in the face of global emergency, but participants need to be informed of its real reason, value and risks. It is ICMR that teaches us this fact.

      15 June 2020
  22. Dr Sanjay Jain said:

    Dear Dr Anand,
    You have very nicely reviewed sequence of events of Covid therapy including flip flops by various agencies. Pharma industry’s interference in drug trials have always been there but was minor. Slowly this interference has increased and it seems now control is complete. Part of the problem is high stakes and billions ( not millions) of dollars involved. Pressure on editors of these reputed journals have been openly admitted.
    Regarding our ICMR, it has emerged in very bad light as you have well described.

    One question from senior Army person like you.Many of our doctor colleagues posted in Northeast jungles in earlier war time days tell us that they and entire staff used to take Chloroquin for Malaria prophylaxis for long time. No side effects. Is it correct? If yes, do we need better proof of safety.

    14 June 2020
    • Anil C. Anand said:

      Your question about chloroquine is interesting. In reply, I would like to say three things:
      (a) Refer to comments by Dr Sakir to this blog
      (b) Army doctors were told that a mnemonic “ROOP Depresses My Heart” should be remembered for adverse effects of Chloroquine. It stood for RASH, Ototoxicity, Occulotoxicity, Peripheral Neuropathy, Myocardial Depression, and Heart for Hypotension. Of course it did not cover some dyskinesias that we saw in many patients.
      (c) Among personnel under Army Act, “informed consent” has questionable validity.

      15 June 2020
  23. Bipin Puri said:

    A brilliant exposition of the clinical research ecosystem with all the intangibles, choke points and the extent reputed journals are willing to compromise and cast derogatory aspersions on scientific data in the backdrop of personal agendas and conflict of interests.
    The facts have been told, a story is unfolding and now let a retrospective study later in the year tell the *untold, unknown story* backed with evidence, peer review and sound credible data!
    We live in an era of Evidence based Medicine and may Prof AC Anand’s compelling and masterly narrative push the clinical research landscape to ‘rise from the ashes’ and show the world the enlightened path!

    15 June 2020
  24. Brig RK Singh ( Retd) said:

    An excellent contemporary review of nexus between medical research, economics ( pharmaceuticals) and politics. Unfortunate state.

    15 June 2020
  25. Govind K. Makharia said:

    Dear Sir
    A wonderful piece, describing how our governments and regulatory bodies enforced their decisions without taking an informed consent
    How the nexus of pharmaceutical industries scientists cronies and well-reputed journals enforces evidences on vulnerable patients through doctors?
    It is not possible that every doctor knows the summary of evidences. It is a believe system, what my book says is right and worthy of practice. We however do not know, the book might have been written by one of the cronies

    15 June 2020
  26. Lt Gen Akhil Nagpal (Retd) said:

    Dear Admiral Anand
    What a wonderfully articulated piece which highlights the dark side of ” doctored” research.
    You have been admirably forthright in showing that our holy cows like ICMR are not above board and susceptible to unscientific influences.
    As usual ,your moral compass shows up in putting things in the true perspective.

    Greater strength to your writings. Shall eagerly await more of this.
    Warm regards as always.
    Akhil Nagpal

    15 June 2020
  27. Sir,
    Illuminating indeed! And succinctly put forth. Glass cages in these times of intense social media scrutiny should warrant cold introspection. And that’s not going to happen for sure. Change is indeed going to be externally driven, if at all.. Who will drive that change is the multi crore question?

    17 June 2020
  28. Lt Gen ( Dr ) Surendra Panwar, Retired said:

    Dear Admiral Anand,
    An excellent piece of analytical research on a very contemporary subject where the whole medical professionals are struggling to search for an answer to help their patients in dire need. It has shaken our faith in most reputable institutions like ICMR and journals such as Lancet, NEJM, IJMR. Very well analysed piece of write up on the current medical emergency.
    Hope you would keep enlightening the medical field with your articles.
    With best wishes,
    Lt Gen Surendra Panwar ( Retired )

    18 June 2020
  29. Varghese Koshy said:

    A most needed and rationally stated write up about the present situation as regards use of HCQs as prophylactic in India. It’s extremely important to put up a counterpoint and debate issues . Science or rather pseudoscience can spiral away into practices which are bordering on being superstition and nonsense.
    Warm regards

    23 June 2020

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