Hydroxychloroquine prophylaxis for high-risk COVID-19 contacts in India: a prudent approach

https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(20)30430-8/fulltext

We read with interest the Correspondence from Sahaj Rathi and colleagues¹ on hydroxychloroquine prophylaxis for COVID-19 contacts in India. The authors see the decision by the Indian Council of Medical Research, under the Ministry of Health and Family Welfare, to recommend chemoprophylaxis with hydroxychloroquine in select groups of contacts at high risk as an abandonment of scientific reasoning in desperate times. We present our counterview on this issue.

The criticisms made by Rathi and colleagues overlook the fact that prophylactic hydroxychloroquine would be targeted to individuals at high risk rather than the general population. Projection of adverse events to the population level causes unjustified alarm. The advisory from the Indian Council of Medical Research includes a section of key considerations that address all such concerns, which have been ignored by Rathi and colleagues. In addition, the argument that there will be a shortage of the drug is not tenable. Production has been ramped up and the Government of India is supplying hydroxychloroquine to more than 50 countries, which has received widespread appreciation.