A promising remedy?
The ongoing week has brought some hope for critical cases of COVID-19 as ICMR approved a clinical protocol for 'Convalescent Plasma Therapy' spearheaded by an expert committee of doctors and scientists set up Kerala. Following the approval from ICMR, the team will now test the feasibility of a technique that is not new per se but could prove to be instrumental in combatting the pandemic. Convalescent Plasma Therapy (CBT) is based on the concept of passive immunity. As people get infected, their immune systems will create antibodies to fight the virus. Since there is no vaccine yet available for COVID-19, the only path of recovery comes down to the immune system of an individual aided by symptomatic treatment administered in a routine manner. A recovered person, in all likelihood, is a gold mine for the antibodies against COVID-19 present in his blood. More specifically, these antibodies are present in the plasma or liquid part of the blood, standing guard to combat the virus in case it attacks the body again. These antibodies can be extracted from the plasma of recovered people and transfused into either sick people (therapeutic measure) or those at high risk of getting infected (prophylactic measure). The US Food and Drug Administration has already spearheaded approvals with clinical trials not just for critical cases but those moderately ill and even in healthy people as a preventive measure. The idea is quite simple: equip an individual's immune system to fight off the virus. The US has begun trials and notably, China also utilised the same technique to improve the conditions of its patients. If clinical trials yield fruitful outcomes, recovered people will be sought by the administration to donate their antibody-rich plasma that can be utilised for patients, primarily those in critical condition. Interestingly, the technique was utilised during SARS, MERS, H1N1, Ebola, Polio and even measles and mumps. While not a vaccine, the technique serves the cause of allowing the body to fight off the virus, preventing the patient from getting critical and requiring ventilators. In frontline healthcare workers, the therapy can be useful as a first line of defence since they remain at high risk of contracting the virus while treating those infected.
Initial studies have shown that patients who were administered antibody-rich plasma registered an improvement in symptoms such as fever, cough and laboured breathing within a day or two. It would be prudent on America's part to share their clinical results with India so that ICMR can regulate hospitals to collect plasmas from recovered people and use them to treat critical patients. ICMR is drafting a protocol for the same as Kerala conducts clinical trials. CBT rests on the safe and well-established method of blood transfusion. If successful, the method can check the outbreak in the country, allowing people to recover safely in the absence of a vaccine. While the ultimate panacea would be a vaccine but CBT can help keep COVID-19 at bay. A member of the Kerala expert team also mentioned non-availability of kits to measure the level of antibodies present in a recovered person's plasma. If Kerala's clinical trials are successful, India ought to procure such kits on a war-footing as CBT would prove to be pivotal in treating patients on ventilators who are likely to succumb to the infection on account of comorbidity. Right now, everything regarding the CBT rests on successful trials and results that the Kerala team reports. If entirely successful, it would be the government's responsibility to make the therapy feasible and equip hospitals across the country to procure and administer the plasma. CBT would be a breakthrough in this fight where our best weapon so far has been social distancing. It would allow healthcare workers to better handle the situation while drastically decreasing the already low mortality rate. Not less than a breakthrough, the therapy would not decrease the infection rate but it would enable us to combat the pandemic in a far better way.
