‘Choosing Wisely’ task force makes recommendations for patients, HCWs

‘These are especially relevant in low- and middle-income countries, where resources are scarce’

The Choosing Wisely initiative, started to promote conversations between patients and physicians about avoiding unnecessary medical interventions, has come out with 10 evidence-based recommendations on COVID-19 for the general public and healthcare workers (HCWs).

A paper on the recommendations authored by an 18-member task force of public health experts including C.S. Pramesh from Tata Memorial Centre, Homi Bhabha National Institute, Mumbai and Giridhar R Babu, who heads Lifecourse Epidemiology at Indian Institute of Public Health, Bengaluru has been published in Nature Medicine on July 5.

The recommendations are related to following precautionary practices to decrease the risk of being infected; measures to be taken if someone has symptoms or has been diagnosed with COVID-19; vaccination; judicious use of drugs and investigations in managing COVID-19 and health systems and policies.

According to the paper, the first two recommendations are most relevant in regions of high community spread and low vaccine coverage, whereas the remaining eight are relevant regardless of the setting.

“Adopting and implementing the list of recommendations will promote more evidence-based implementation of policy and practices in managing the COVID-19 pandemic in various parts of the world. Most importantly, this list emphasizes the critical role that evidence-b ased medicine should serve, even during a raging pandemic,” stated the paper.


The task force was created in April 2021 with multi-stakeholder involvement, with members drawn from various areas of specialisation. Patient and civil-society representatives were also included. Advisors to the group included leaders of the World Health Organization and senior government officials.

“The recommendations for the prevention, care and control of COVID-19 include the best evidence available at present, and address practices that are common, inefficacious, of low value or harmful in the response to COVID-19 in several countries. All recommendations are based on robust evidence and can improve outcomes for pandemic control globally. These are especially relevant in low- and middle-income countries, where resources are scarce, government expenditure on public healthcare is low, and optimum utilization is crucial,” the paper stated.

“We emphasize that these recommendations are not meant to replace treatment protocols; instead, they are intended to promote shared decision-making by patients and physicians, and to provide guidance to treating physicians and the general public,” the authors said.

The paper also asserted the importance of maintaining essential non-COVID-19 healthcare areas such as cancer, tuberculosis, renal and cardiac disease, mental health and reproductive health even during major pandemics, as the consequences of not doing so are dire.

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Sagar Biswas

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