New Delhi: Plasma therapy, one of the experimental lines of treatment being explored amid the Covid-19 pandemic, has shown some promise in treating critical patients, with Delhi Health Minister Satyendar Jain counting among its success stories.
The treatment requires patients to be transfused with plasma from a recovered Covid-19 patient — rich in antibodies, the plasma is believed to help boost recipients’ immune response to the coronavirus infection.
This, however, means that plasma therapy depends on the willingness of recovered patients to donate plasma, and finding willing donors has proved a tough prospect on the ground.
Adding to the dilemma of hospitals and Covid-19 patients is the fact that donors have to meet certain conditions before they qualify for donations, and the blood groups of recipients and donors must match too.
The plasma bank inaugurated at the state-owned Institute of Liver and Biliary Sciences (ILBS) in Delhi hopes to bridge the gap between donors and recipients. Doctors as well as patients say they are hopeful the plasma bank will help address the shortage and prove a key nerve centre that will spare them the chaos the search has entailed so far.
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‘Last resort’
Divya Singh, a 26-year-old Delhi resident, said finding a plasma donor for her Covid-positive father “was a task that took her across several social media groups and blood banks in the city”.
“Looking for a plasma donor is like looking for a needle in a haystack,” she said, speaking to ThePrint in the days before the plasma bank was inaugurated.
Despite a week-long search, Divya said, she was unable to find a positive match for her father. With the help of NGOs and volunteers, she found six donors but none of them tested positive for antibodies.
Given that plasma therapy remains an experimental treatment for Covid-19, which is itself a new disease still being studied across the world, government guidelines allow hospitals to try it with patients not responding to other treatments, under certain conditions.
“The private hospital (Fortis Vasant Kunj) where my father was admitted agreed to conduct plasma therapy with one of the negative donors as a last resort to save his life, on compassionate grounds,” she said.
Before the therapy, Fortis Vasant Kunj made the family sign an undertaking that the facility isn’t responsible for the outcome of the donation. The therapy didn’t help, and Divya’s father passed away on 25 June.
Approached for comment, the hospital initially claimed they were not conducting any plasma therapy trials. On further questioning, the hospital spokesperson said, “We can neither confirm nor deny anything. What has been done is done. We can not divulge any information owing to patient confidentiality clauses.”
A health expert, however, said the hospital was justified in pursuing the therapy with a plasma sample negative for antibodies.
“If the plasma is antibody-negative it will most likely not be able to protect the patient but it won’t cause them any harm either,” said Dr Ram Vishwakarma, director of the Indian Institute of Integrative Medicine under the Council of Scientific and Industrial Research (CSIR).
“There are subpopulations of antibodies that we are not testing, it may end up doing some good. If the doctors have given this plasma then they must have put some thought into it.”
The donor, he said, might have tested negative for antibodies because “the titre (concentration of antibodies) may not be high enough”. “But in cases where a patient’s life needs to be saved, doctors have to take a chance,” he added.
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In the hunt for donors
For 22-year-old Sarfaraz Ali, the search for plasma was still on when he spoke to ThePrint earlier this week. In his desperate bid to find a plasma donor for his 37-year-old brother, who is in the ICU of a private hospital at Dwarka, Delhi, Sarfaraz said he had sent WhatsApp and Facebook messages to all his contacts
“Everyday I send messages to people. Very few people respond positively to my messages. Those who agree to donate bail out on my brother at the last moment. People are scared of donating, they say they don’t want to catch the virus again.”
“We have been looking for a plasma donor for the last four days,” he said.
The search for plasma donors requires a massive outreach effort by patients, even as hospitals say they also tap their own database of recovered Covid-19 cases to arrange for donations.
Without divulging its numbers, Max Hospital told ThePrint in a statement, “Patients who undergo treatment for Covid at our hospitals are a part of the database. We have a dedicated team, which tries to contact patients who have recovered from Covid and might be potential donors.”
The search for plasma has also spawned organisations like Dhoondh. Started by Delhi couple Adwitiya and Kanupriya Mal, the organisation hopes to spare other patients the ordeal suffered by the latter’s 68-year-old father after he was diagnosed with Covid-19.
“Our website is a portal where we try to match donors with patients. As of now, we have 1,400 patients and 240 donors registered,” said a team member of the organisation.
“We sometimes get multiple registrations for the same patient. Family members think if they register several times, they might find a donor faster,” the team member added.
Asked about the low donor number, the team member said they had seen “cases where people back out at the last minute”.
“The fear of the disease and hospitals has made home in the hearts of individuals. Recovered patients are under the impression that they should save their chance to donate, in case a family member falls sick.”
A fellow with the Delhi Assembly Research Centre, an initiative of the Delhi legislature, said they had received “over 250 requests for plasma donations in the last one month”.
Placed under the Integrated Disease Surveillance Programme (IDSP), a government initiative meant to prevent and mitigate epidemics, in the capital, the fellow is involved in coordination efforts with respect to plasma donations.
Due to the increasing demand-supply gap, they added, they have only been able to help 61 patients in the last one month.
ThePrint reached Delhi Health Secretary Padmini Singla and ILBS director S.K. Sarin through calls and texts for a comment about plasma therapy in Delhi, but there was no response until the time of publishing this report.
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‘A good initiative’
The Delhi government inaugurated the plasma bank at ILBS Thursday, with the aim of establishing a nerve centre for plasma donations in the capital. It was the country’s first plasma bank, and the second was set up in Assam Friday.
As mentioned before, plasma donations require donors to meet certain conditions. Delhi Chief Minister Arvind Kejriwal announced Thursday that donors had to have tested negative for Covid-19 14 days before a donation, should be aged 18-60 years, and weigh 50 kg or more. Women who have ever been pregnant can’t donate, and neither can patients with comorbidities.
Willing donors can call 1031 or contact the bank via WhatsApp on 8800007722 to register for donations.
Dr Suresh Kumar, medical director at the Delhi government’s Lok Nayak Jai Prakash Narayan Hospital said the plasma bank is “a good initiative”.
“Not only will it help patients in private hospitals, it will help government hospitals as well. For our trials as well, we can always reach out to the plasma bank in times of emergency,” he added.
Dr Anupam Sibal, group director of Apollo Hospitals, had a similar view. “We have looked at studies and the results show encouraging results for plasma therapy. The therapy helps fight the SARS-CoV-2 virus. However, this is not an established therapy, which is why patients need to enrol in a trial. Opening of a plasma bank is a positive step that the Delhi government has taken.”
He added that the media and government can together step up to encourage plasma donation.
Rajiv Bhatt, a 31-year-old entrepreneur, said he felt hope when the Delhi government announced the opening of the plasma bank. “My 20-year old brother has tested positive for Covid. I had seen the trouble that a friend had to go through to find a plasma donor for his relative. With the bank coming up, I know where to reach out for plasma when required.”
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