The chief medical officer, Dr Roshan Parasram, and his team of epidemiologists at the Ministry of Health should be congratulated on the work they are doing to protect the general public from the ravages of the Covid-19 pandemic. It is my hope that the current political directorate continues to act upon the scientific advice of our technocrats and resist any temptation to allow partisan politics to impact their decision-making.

One must reflect on the massive global loss of life suffered during the 1918 “Spanish flu” pandemic to envisage the horror that can be visited upon us if political self-interest creeps into the mix. We also should, as a nation, be thankful that we have available, through the grace of God, a fully equipped hospital in Couva that the force of nature has compelled us to commission and use for the benefit of all citizens.

The issue now arises regarding a consensual policy in respect of best practice guidelines for treating this dreaded emergent infection. This is where, as a physician, I am left dumbfounded.

President Donald Trump, leader of the free world, has been reportedly openly espousing the use of chloroquine and hydroxychloroquine. But does the little available evidence support this?

A search of the PUBMED database has very little in the way of support for this. There is a lone systematic review (Journal of Critical Care) published on March 5, 2019, and emanating from the University of Palermo, Italy and the Hebrew University, Israel, that has examined this form of treatment.

There are many glaring inadequacies in this review, and the evidence on which it is based is all but non-existent. The Italian Society of Infectious and Tropical Diseases (Lombardy section) provided a “guideline’’ document that was incorporated in this Elsevier publication. One scarcely has to be reminded that Lombardy in the north of Italy has been the most severely affected part of that country, and as of March 21, 2019 has one of the highest case fatality rates (9.3 per cent) globally.

My prayers are with our nation.

Steve Smith

via e-mail

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