What if the treatment you’re getting isn’t for the disease you actually have?

Earlier this month, I had the honor of being an invited faculty at the ERS ICS India Summit in Cochin – a collaboration between the European Respiratory Society (ERS) and the Indian Chest Society (ICS).

Pulmonologists from across India and Europe came together to discuss one crucial question:

Where are we lagging, and how do we bridge the gap?

The diagnosis delay:
One of the most eye-opening discussions was on the time gap between symptom onset and diagnosis.
➡️ In Europe, Interstitial Lung Diseases (ILDs) are diagnosed within a year on average.
➡️ In India? It takes 4.5 years.

That’s 4.5 years where patients could have received treatment, 4.5 years of disease progression, and a massive loss of quality of life.

We know that early intervention changes outcomes – the longer we delay, the steeper the decline.

Beyond TB: The rising trends of lung infections:

Another crucial takeaway was chest infections – for decades in India, everything was TB until proven otherwise.

Empirical TB treatment became the norm, but now, we are seeing a major shift:

• Fungal infections are on the rise.
• Autoimmune diseases like rheumatoid arthritis are being diagnosed earlier, and immunomodulators (used for treatment) are Increasing patient vulnerability to fungal infections.
• Unlike bacterial infections, fungal infections need a completely different approach to diagnosis and treatment.
  
  

We cannot afford to treat all chest infections the same way anymore. A broader diagnostic mindset is the need of the hour.

Medicine is Not Just About Numbers!!

Yes, TB still makes up a large percentage of cases in India.

But medicine is not mathematics – even one undiagnosed case of another serious infection matters.

• Every misdiagnosed fungal infection is a lost battle.
• Every delay in ILD diagnosis leads to irreversible damage.
  
  

The discussions at the summit reinforced the need for a shift in approach, improved diagnostic timelines, and better awareness.

The way forward:

• Strengthen early diagnostic pathways.
• Move beyond empirical TB treatment and consider other possible infections.
• Increase awareness about fungal infections and ILDs in clinical practice.

This summit was a powerful reminder of how small changes in diagnosis can make life-changing differences for patients.

What are your thoughts? How do we improve early diagnosis in India?