Adopt plasma therapy sooner for potentially complicated Covid patients and counsel survivors to donate plasma, doctors on the frontline of battle against coronavirus in Mumbai said, suggesting there needs to be a shift in its use to save more lives.
The appeal comes as India continued to clock a rise in daily coronaviruses cases. Mumbai is the second worst affected city in the country with a case count of 70,990, with 1,365 fresh cases being reported in the last 24 hours.
Dr Om Shrivastav, who is familiar with plasma therapy trials in Mumbai told NDTV, "I don't think we should wait to try CPT till patient's disease becomes severe, when nothing is working and the patient is on ventilator. Let us try plasma once we know we are dealing with somebody whose condition may become complicated. Offer plasma therapy at that stage."
The CPT, or Convalescent Plasma Therapy, has proved to be useful in fighting other coronavirus diseases, such as SARS and MERS, and its use against COVID-19 has shown encouraging results on patients across the country and the world.
Doctors sought repositioning of the therapy in the backdrop of the Indian Council for Medical Research (ICMR) coming down heavily on the Mumbai civic body-run Nair Hospital for distribution of plasma units to hospitals not registered for the trial.
Sources said the country's top medical research body had threatened that the trial could be taken away for Nair Hospital if they did not stop giving therapy to patients without permission.
In Mumbai, only hospitals registered for clinical CPT trials can collect plasma and administer it to patients after due permission from ethics committee of the hospital and after informing the relevant authority of the state government.
Earlier, only Nair Hospital and Kasturba Hospital had been allowed to conduct plasma therapy trials in Mumbai by ICMR. Now, more medical colleges and several private hospitals have received the approval to conduct clinical trials for CPT.
Sources in the state government agreed hospitals need to be given more leeway.
Mumbai doctors, some of whom have seen success with the use of CPT in patients battling COVID-19, have also highlighted "lethargy" and "red tape" in its use, stating it could lead to loss of lives that can otherwise be saved.
"We try to save our patients. But when you put restrictions on us that you should have paper work and if you don't have paperwork we will file cases against you, if you give plasma we will file a case against you, if you give Remdesivir we will file a case it cause difficulties for us in saving lives. Remdesivir is not available, tocilizumab is not available. We don't want to go through red-tape to save patients," said senior pulmonary physician Dr Jaleel Parkar, who has recovered from COVID-19.
Dr Shrivastav also said there is "lethargy" when it comes to applying plasma therapy on patients who are dying. "A term that can be applied loosely here is lethargy. We are not making it important enough for people who have recovered to donate plasma. It is very important for this to be made into the mindset of the people who have recovered that this can easily become a therapy," he said.
"This is my second birth. My request to all my Indian brothers and sisters, who have recovered from COVID-19, is to donate plasma. It is the need of the hour. We will be able to save many lives," said Dr Parkar.
Though the recovery rate in Maharashtra and Mumbai are above 50%, the death rate is 4.69%, which is a worry.
Multiple Covid survivors of Delhi Police came forward to donate plasma amid reports of families of Covid patients struggling to find plasma donors.
Plasma, which is the liquid part of the blood, can be donated three weeks after recovery by those whose blood contains enough anti-bodies. Each Covid survivor can donate at least twice, thereby saving the life of four people.
An average of 400-500ml plasma is collected per donation. Each critical patient is administered 200ml in under two hours.