Updated: June 27, 2020 9:07:40 am
In the spring of 1991, Dr Gordon Guyatt from McMaster University, Canada, coined a term — Evidence Based Medicine (EBM). In simple terms, it is the conscientious and judicious use of current best evidence in making decisions in the care of patients. In the last 30 years, EBM has formed the backbone of all medical research globally. Any new drug, implant or technique had to undergo a standardised process of scrutiny, evaluation and re-evaluation before implementation. EBM, thus, made sure that magic and chicanery were kept at bay when it comes to the care of the sick.
Unfortunately, the ongoing COVID-19 pandemic has seen a sequential erosion of EBM across the world. The havoc and fear created by COVID-19 has led us into a dark abyss of knowledge where it is assumed that anything relating with a cure for COVID-19 could be easily researched and published. Even the most highly reputed medical journals, like The Lancet, have not lagged behind in publishing research which could not stand the scrutiny of EBM. A website called Retraction Watch has reported a total of 22 papers of COVID-19 being retracted from different journals, world-wide, between January- April this year.
In this mayhem of fear and anxiety, Patanjali Ayurved Ltd group in India launched two ayurvedic medicines, namely Coronil and Swashir Vati, and claimed that the two drugs can cure patients suffering from COVID-19. Although the Union Ministry of Ayurveda, Unani, Siddha and Homeopathy (AYUSH) barred Patanjali from advertising and publicising the two drugs, in a press conference in Haridwar the owner of the group, Ramdev, claimed that the said drugs have treated 69 per cent COVID-positive patients at the end of three days of administration and 100 per cent after seven days of administration. Interestingly, the terminology used by Ramdev was full of EBM jargon. He used words like “clinical case study” and “clinical trials” throughout the press conference, albeit without making too much sense of the usage.
As a scientist and an allopathic practitioner, I have no problem with the use of Ayurveda, Homeopathy or other alternative systems of medicine in the treatment of diseases. The problem is in the absoluteness of cure which those like Ramdev claim. His so-called drugs for COVID-19 claim to cure 100 per cent patients. This is the flaw and should raise a red flag. The inability to question their own assertion is what is problematic when it comes to alternative systems like the one practised by Ramdev. The beauty of science lies in its ability to question its own hypotheses. Nothing is absolute in science. No allopathic drug claims to cure 100 per cent patients. No surgical intervention remains 100 per cent free of side effects.
Having said that, the “discovery” of drugs for the treatment of COVID-19 by Ramdev’s group is clearly indicating something more important vis-à-vis the current pandemic. Businesses like the Patanjali conglomerate are eagerly looking to cash in on the market which is ripe for the introduction of a drug or vaccine for COVID-19. The fear that has engulfed the world needs to be urgently doused. This is happening equally vigorously in other countries as well. According to a report published by the Austrian Institute for Health Technology Assessment (AIHTA), a total of 155 drugs and 79 vaccines are currently being developed worldwide to combat COVID-19. These figures imply that besides the humanitarian need for a cure or vaccine for the dreaded virus, the clear space to earn money through such curative tools is up for grabs and this has been realised by many. The crisis of capitalism, as described by Marx a century ago, is at its best during the current pandemic. No wonder, market forces are pushing their best foot forward to combat the crisis and emerge victorious. It is a matter of investigation how most countries with a socialised (if not socialist) system of healthcare, like Norway, Japan, Israel and Germany, have done particularly well in controlling the present pandemic.
The case in India is different. In the absence of literacy, and in the presence of deeply rooted traditions and religion, a large chunk of the populace falls easily for magic and gimmickry. Being a specialist of bone cancers, I am witness to many patients being lured into alternative systems of medicine for the “cure” of their cancers. Most, if not all, return with disastrous complications and disease progression. The absence of a scientific temper and the presence of a deeply religious society creates an appeal for magic and gimmickry, the narrow corridor in which players like Ramdev operate. But more painful than the noise of destroyers of science in India, is the silence of the scientific community to the hubris of the unscientific.
In the last few years, the erosion of science has happened at a more rapid rate. Unfortunately, this has been heralded by the unscientific and unempirical rhetoric of the current political leadership. The prime minister, Union ministers, sitting justices and even doctors are on record quoting religious and traditional jargon against established scientific facts. Interestingly, countries like China, Korea and Japan, considered leaders in scientific thinking, are also deeply traditional. It is important for us to learn how they keep their science insulated from traditions. Despite the current pandemic being born in Wuhan, China, I have yet to see a claim of a Chinese medicine curing COVID-19. China’s approach to the pandemic has been as per the set rules of epidemiology, and hence science.
Even though COVID-19 continues to rule and ruin our daily worlds, it still does not give the right to the righteous of the land to promote cures, remedies and preventions which are beyond the realm of their understanding and operation. Prudence is the need of the hour and prudence comes from wisdom. We need to strengthen our healthcare system which has been exposed like a bleeding wound by the ongoing pandemic. The chaos and complexity which the current pandemic brings to the fore cannot be dealt with by tradition or magic. We need solid science to combat the virus. We need to strengthen our present, not dwell in the past. In his book, In Light of India, Nobel laureate and author Octavio Paz has said modernisation can only begin by being a critique of our past.
This pandemic has given us a golden opportunity to choose modernisation.
This article first appeared in the print edition on June 27 under the title “A cure for COVID-19”. The writer is professor, Department of Orthopaedics, AIIMS, New Delhi. Views are personal.
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