ICMR to endorse or deny benefits of plasma: Delhi's Covid committee member

<p id="content">R.K. Gupta, former president of Delhi Medical Association (DMA) and a member of the Delhi government constituted a committee to check Covid preparedness in the national capital, told IANS that the authority to validate the effect of convalescent plasma therapy (CPT) stays with the Indian Council of Medical Research (ICMR) only.</p>
"There are many elements of the therapy which remain ambiguous. Its efficacy is still questionable. While multiple studies by the ICMR and AIIMS suggest that it has no role in reducing mortality in patients progressing with the severity of the Covid-19 disease, we can also see doctors claiming that many people have recovered after taking the therapy," Gupta said.

"However, it still remains an observation, and not an evidence to arrive at any conclusion," Gupta added.

"It's improbable to endorse therapy on the basis of personal experience. The authority to validate its effects lies with the ICMR which conducted the country's largest trial. One should not conclude on results without evidence," Gupta told IANS.

His remark has come in the wake of an assertive push by Delhi Health Minister Satyendra Jain and leaders of the Aam Aadmi Party to legitimize the benefits of plasma therapy among Covid-19 patients.

Jain had said a few days ago that the convalescent plasma played a big part in his recovery and has saved many lives, right after the ICMR announced that it is contemplating to remove plasma therapy from the national clinical guidelines.

He had also refuted the findings of trials by AIIMS and ICMR, adding that Delhi government itself has commissioned a trial to find out the impact of plasma on Covid-19 patients.

Recently published findings on CPT on Covid-19 patients have triggered a debate over its efficacy. After the country's largest such trial, known by the acronym PLACID, found that convalescent plasma was ineffective in arresting Covid-19, the ICMR has been considering dropping this option from the national guidelines.

However, in several states, including the most-affected Maharashtra and Delhi, health authorities continue to push the option while those running plasma blood banks promote it with anecdotal accounts on social media.

While the experts are of the opinion that ICMR should wait for further studies in order to remove the therapy from the clinical guidelines, they reaffirm that the plasma therapy shows no benefit in curtailing the disease progression or reducing the mortality.

Amarinder Singh Malhi, Assistant Professor, Department of Cardiovascular Radiology at the All India Institute of Medical Sciences (AIIMS) said that every therapeutic intervention in Covid-19 is being run on trial and error method.

"Since the disease is very new, everything, including drugs like Remdisivir and Dexamethasone, are being run on trial and error method. Whatever suits the patient is hailed as a life-saving intervention," he said.

Observing his experience about CPT, Malhi stated that it shows effect only in patients coming at the early stage of the disease, adding that CPT intervention is not required at such a stage. He also observed that efficacy of the plasma therapy cannot be determined since it is administered with a combination of other drugs as well.

"Plasma is not required in patients who come with mild stages of the disease. In AIIMS, very few people were given plasma as it showed effect in the patients at an early stage. However, such patients were given drugs such as dexamethasone, in combination to CPT. Now it's difficult to determine whether plasma played the role in improving the health condition of the patients or the drugs or the combination of both," Malhi said.

However, despite disappointing results, CPT has created a robust belief among the public where it is regarded as a life saving therapy.

"There are multiple reasons which have built this psyche — from partial information passed on WhatsApp and social media hailing the therapy, to the news reports highlighting plasma effects without proper investigation or evidence. Besides, when people read news about a minister who recovered after receiving CPT, it adds metal to their belief that it can save lives, which is far from the truth," said Akshay Budhraja, senior pulmonologist at Aakash Healthcare.

Budhraja also said that the ICMR should ideally remove it from the guidelines since it's unnecessarily putting false hope in the people..