Demand for plasma soars again amid Covid wave

Amid the second wave, the demand for convalescent plasma therapy, often termed as debatable, for treatment of symptomatic patients has increased

Amid the second wave, the demand for convalescent plasma therapy, often termed as debatable, for treatment of symptomatic patients has increased. However, the demand is much higher than the supply, leading to harassment of patients’ relatives, claim insiders.

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Convalescent plasma is an experimental treatment where antibodies from the blood of patients who have recovered from the coronavirus are given to those battling the virus. It is believed that it helps produce an immune response to Sars-Cov-2, the virus that causes Covid-19.

The Indian Council of Medical Research (ICMR) conducted a trial called PLACID, involving 464 Covid patients in 39 hospitals across the country. Following which, the council declared the plasma therapy didn’t help in reducing mortality or progression to a severe case. It is the largest convalescent plasma therapy trial in the world to be completed.

Although this had initially discouraged doctors from treating Covid-19 infected patients with convalescent plasma, with the start of the second wave, they believe, it would contribute to faster recovery of infected patients. “Plasma therapy is effective for moderate to severely ill patients. For the treatment to be effective on patients, the selection of candidates and timing plays an important role. If the therapy is given to patients (moderate to severe) within the first three days, the mortality rate reduces to 8.5%. But if it is delayed, the mortality rate can be around 11.5%,” said Dr Farah Ingale, director, internal medicine, Fortis Hiranandani Hospital Vashi, where almost 15% rise in demand has been observed.

Talking about ICMR’s clinical trial, a senior doctor who is associated with the state Covid task force refuting the findings: “During the clinical trial, the researchers did not check antibody levels of the donors. In fact, most of the donors were asymptomatic patients.”

Since the start of the pandemic, doctors in Mumbai have treated over 4lakh Covid-19 infected patients. So public health experts believe doctors have gained enough expertise to decide the treatment protocol for patients.

“Firstly, as this is a new virus, we still don’t have a specific medicine for its treatment. It is a trial-and-error process for doctors across the globe. So, after over a year of treatment, these doctors have the expertise to decide if a patient needs plasma therapy or not. Some decision has to be left to doctors,” said Dr Subhas Salunke, state advisor for Covid-19 treatment.

Dr Sujit Chatterjee, chief executive officer of LH Hiranandani Hospital, Powai, said plasma therapy can’t solely be attributed to the treatment of patients. “At our hospital, we have found that the early induction of convalescent plasma in moderately severe cases, in combination with Remdesivir and anticoagulants, showed very good results,” he said.

But finding a donor has turned into an uphill task, as only 1% of the total 3.5lakh recovered patients in the city have donated plasma. Subhas Nandi, 28-year-old from Dahisar, has been helping people in arranging for plasma donors since last year. Post-October, when the pandemic curve flattened, he was getting one-two queries about donors. But last month, when the city witnessed over 300% rise in active Covid-19 patients, on a daily basis, he has started to get 20 calls seeking help for plasma donors. “Unlike last year, the number of donors has decreased. People aren’t so enthusiastic to donate plasma to help other patients. Also, due to vaccination, many interested public don’t get qualified as after a jab, they can’t donate their plasma. Somedays, it takes us four-five days to arrange for a donor,” he said.

Dr Ingale said a person can donate plasma twice a week with a gap of 48hours. However, the doctor needs to identify the patient wisely for donation. “The donor’s antibody levels should be good. Also, probable donors shouldn’t have any Covid-like symptoms for at least four weeks. They should test negative for RT-PCR for at least two weeks in advance and be free from any infection or comorbidities,” she added.