Plasma Or No Plasma

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As plasma therapy is working, the state should continue with it

Even though Union Health Minister Harsh Vardhan has cautioned against the routine use of convalescent plasma therapy and Remdesivir to treat COVID-19 patients, Goa has decided to continue the use of the two. The director of the Indian Council of Medical Research (ICMR) Balram Bhargava had announced that plasma therapy would be removed from the national guidelines on the COVID treatment. Besides, a World Health Organisation (WHO) study has found that Remdesivir has proven to have “little or no effect” on hospitalised COVID-19 patients. However, Goa’s Health Minister Vishwajit Rane said on Friday that the state will continue using a combination of convalescent plasma therapy (CPT) and Remdesivir as part of COVID-19 treatment protocol. “We will continue with the plasma therapy along with Remdesivir and steroids. We don’t want to go by what others are concluding. Our doctors have assessed the treatment protocol, and we feel this is the best for (COVID) patients. The protocols can change from time to time, but we can have our own SOPs for saving lives,” Rane said.

Perhaps the Union Health Minister’s advice against use of plasma therapy came in the wake of a study that convalescent plasma was not associated with a reduction in progression with severe COVID-19 or mortality from all causes. However, researchers from the Indian Council of Medical Research and the National Institute of Epidemiology, Tamil Nadu have found that plasma therapy did reduce symptoms, such as shortness of breath and fatigue, after seven days. The study was published in the British Medical Journal last Thursday. Professor Martin Landray of the University of Oxford says that although there was substantial interest in convalescent plasma as a possible treatment for COVID-19, there remains considerable uncertainty about whether it is effective in tackling the worst effects of the disease. He is of the opinion that though the study results were from the largest randomised trial of convalescent plasma to be completed so far, with just a few hundred patients (464) having been studied upon, it was too small a size to give clear results on effectiveness of CPT.

However, the doctors of Goa who are involved in treating COVID patients endorse the decision of the state Health Minister to continue administering CPT, Remdesivir and steroids, saying that faced with the delicate situation of saving the lives of people affected by coronavirus it is the best option. They argue that there is no cure available yet for the disease. They also say that CPT, Remdesivir and steroids are  not known to cause any adverse impact on the patients, provided they are given at the right time. Of the 263 COVID-19 patients in the state who were under the treatment protocol, 186 (making almost 70 percent) recovered or improved. The treatment protocol also is supported by the example of Delhi Health Minister Satyendra Jain who received plasma therapy. Jain and his cabinet colleague Manish Sisodia have vouched for the safety of CPT.

Goa, like the central government and other states, has been desperately seeking a way out of the health crisis the coronavirus has created. Indeed the whole world is exploring ways but has not been able to find a cure for COVID-19. Doctors of Goa, our frontline COVID commanders, have been using every possible idea in treating patients. As 70 percent of patients in Goa have recovered or shown good progress with the CPT-Remidivisir-steroid protocol it would be worthwhile to carry on with the line of treatment. As this treatment protocol has been found most effective when administered before the condition of the patients deteriorated, it is necessary that patients turn up at the hospitals in the initial stages and they are diagnosed at the earliest. Though Goa excelled in earlier months in testing patients it appears to have lowered its guard by reducing testing. Less testing might help the government in keeping the number of detected COVID-19 cases low on the record, but it also leaves scope of many people infected by the coronavirus going undetected and transmitting it to others. Rane has promised to test up to 2,500 per day. Let us hope he keeps his promise. In the meantime the CPT-Remidivisir-steroid treatment protocol should be continued.