I want to share the perspective I have on the impressive enthusiasm to use unproven treatments for the SARS-CoV-2 infection (COVID-19).
In many countries, including the USA, lots of unproven therapies have been proposed as treatment for COVID-19; the lack of randomized clinical trials has been the constant. Many colleagues, medical centers and even national organizations in different countries have proposed treatment algoriths, with no evidence to support such.
The appeal as to being ethically questionnable "not to do anything" has spearheaded such behaviors. And time has proven the inefficacy and dangerous consequences of such treatments.
Doctors aim to offer the best for their patients. We are not used to a pandemic, and certainly is morally devastating to see the impressive mortality that this viral infection has brought along. Yet, when we reflect on the 1918 Influenza pandemic, the mortality rate was of millions of people worldwide. And the basic hygiene and isolation measures were key for its control. And nowadays it is no different than then.
I wrote along with a colleague from Mexico a perspective on the use of unproven treatments for COVID-19 in ACP Hospitalist (a publication from the American College of Physicians). We titled it "Primum non nocere: Two hospitalists muse on the current pandemic". I hope this reading provoke thought and reflection.
Basic supportive care is the cornerstone of our clinical success in our organization. Both in the regular nursing floor and the ICU. The medications are adjuncts to oxygen and good airway clearance.
In my search for the source of the coining of the phrase primum non nocere, the esteemed professor and world renowned bronchologist Dr. Atul Mehta shared with me that it was Auguste Francois Chomel (1788-1858). Certainly Hippocrates work and philosophy is fundamental for this thought.
