But what the article doesn't mention is that when ICMR began prescribing the drug as prophylaxis, there were zero RCTs showing the drug's prophylactic efficacy (this continues to be the case today)
So, ICMR basically began prescribing the drug as prophylaxis based on conflicting evidence from RCTs *for treatment.
So, for an article that claims to explore nuances (which I appreciate), it is surprising that it missed the nuance that there are no prophylaxis RCTs today.
To conclude: comparing the ICMR's observational study with The Lancet's observational study (which, btw, seems to have several flaws https://statmodeling.stat.columbia.edu/2020/05/25/hydroxychloroquine-update/) is a strawman argument.
The real question is: what are RCTs of HCQ prophylaxis saying? And the answer is: there are none, yet.
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