https://blogs.bmj.com/bmj/2020/05/01/rolling-out-mass-hydroxychloroquine-prophylaxis-for-covid-19-in-indias-slums-risks-public-trust/
The municipal corporation of Greater Mumbai (BMC) has decided to roll
out a seven-week-long course of chloroquine (CQ) and hydroxychloroquine
(HCQ) mass community prophylaxis for the people living in slums [7].
The decision is apparently backed by the announcement of the Indian
Council of Medical Research (ICMR) dated 22nd of March, for the
prophylaxis of asymptomatic healthcare workers involved in the care of
suspected or confirmed cases of covid-19 and asymptomatic household
contacts of confirmed cases [8].
This is a baffling decision for while some of the studies suggest
these antimalarial drugs may be effective [9–12] as well as safe
[13,14], there are also concerns [15,16] that the evidence is not robust
and adverse effects will be likely if the drugs are rolled out
indiscriminately for mass prophylaxis, without rigorous monitoring [17].
Contradictory statements have been issued about ongoing studies and
trials for CQ and HCQ prophylaxis in India [15] and concern expressed
about promoting its use as a prophylactic therapy on the basis of
insufficient evidence [17]. Muddled and contradictory messages about the
benefits and risk of using antimalarials for mass prophylaxis to the
marginalised communities in the slums are fuelling confusion and
mistrust.
