I wish we were in happier times but the Covid-19 pandemic is something we will be talking about a lot in the days to come. As a doctor, treating Covid patients for the past year, I am sharing my learnings from these trying times in the hope that it helps everyone out there. Self-medication, which was already a global phenomenon, has now increased to catastrophic proportions and become a major cause of concern among the medical fraternity.
The Covid-19 pandemic has posed challenges to healthcare systems globally, considering it requires novel treatment and prevention strategies to continually evolve and deal with the impact of the pandemic. In these difficult and challenging times, medical professionals and patients are both dealing with the ‘unknown’ and left feeling out of control. With no definitive treatment for this viral infection, an element of fear and anxiety has set in.
A dangerous turn
The combined nervous energy and collective confusion over the prevailing situation has led to an almost compulsive, panic-driven behavioural pattern among the public to rely on various social media platforms that only lead to misinformation about medications and increased use of self-medication, including home remedies, without established safety or efficacy norms. People are confined to their homes and are more vigilant about updates on Covid-19, particularly on treatments and preventive measures. In addition, suggestions that may come from friends, family, neighbours, pharmacists and prescriptions from other Covid-positive patients has made this phenomenon take a disastrous turn.
Generally speaking, self-medication is defined as the selection and utilisation of medicines to treat self-recognised symptoms or ailments without consulting a physician. The most commonly self-prescribed medications are analgesics, antipyretics, antitussives, antidiarrheals, calcium and vitamin supplements, anabolic steroids, sedatives, certain antibiotics, and many herbal and homeopathic remedies. This rampant and irrational use of medication without medical guidance may result in greater probability of inappropriate, incorrect, or undue therapy, missed diagnosis, delays in appropriate treatment, pathogen resistance and increased morbidity.
Let doctors do their job
Medicines are being stocked, hoarded and consumed. These include steroids, antibiotics, antiparasitics (Ivermectin) and antivirals (Favipiravir and Remdesivir) to name a few. Numerous patients ask me if they can start steroids early because a family member has recovered after consuming it. The family member obviously had Covid complications with markedly reduced oxygen saturation or was on a ventilator when the medication was prescribed. I tell them that a steroid is not to be equated to a supplement. I dread to imagine how many anxious people are not even consulting their doctors before they start steroids or even antibiotics or any other prescription medications.
Please remember that doctors are the only professionals trained to handle medical issues of any kind and they fall back on years of training and experience before prescribing the treatment regime specific to a patient’s symptoms. These medicines are referred to as “Prescription Medication” for a reason, since they carry a great risk along with benefit, have specific indications for administration and are considered an aggressive treatment, which is pushed back until ‘later on’ when the medical opinion warrants their use. A case in point being, I wouldn’t rush to prescribe steroids to my diabetic patients. Nor would I put anyone immunosuppressed on steroids unless critical. I certainly don’t advise these without a medical person monitoring the patient. ‘Under doctor’s supervision’, a term I can’t emphasise enough, is where steroids and other treatments like antibiotics should be prescribed and administered. The rush to start steroids ‘before I get too sick’ is a mistake.
How to be ‘ready for Covid’
This nervous response to the pandemic is leading to patients/attendants compelling doctors to start steroid or plasma therapy or remdesivir even when not indicated; the latter now being removed from the Covid-treatment protocol. The collective compulsive panic behaviour is leading to self-medication, seeking hospital admission when not needed and choking the system of both medicines and hospital beds.
I empathise and wish to reassure everyone that staying at home and following the Covid-appropriate behaviour is the best way forward. If you must be ‘ready for Covid’, then the pills to have are Vitamin C and Zinc. These, taken in the right doses, along with a healthy citrus and protein-rich diet are likely to see you through the Covid pandemic by making your immunity robust. I also see that those of my patients who practise spirituality or pranayama and yoga are coming out stronger from Covid due to their healthier state of mind and natural immunity. What we need is positivity, not an environment of fear, to conquer this pandemic. The medical fraternity stands by you today and always.
The author is Director, Internal Medicine, at Max Healthcare. Views are personal.
(Edited by Prashant Dixit)