ICMR dropping plasma fuels debate in Mumbai

Days after ICMR dropped plasma therapy from Covid19 treatment guidelines some city doctors have insisted that the therapy works well if given within 72 hours They say plasma is useful for patients with low immunity as they canrsquot be given drugs like RemdesivirDr Om Shrivastav said he has used plasma in at least 100 cases and 94 of them have done wellThe announcement by the Indian Council of Medical Research ICMR had prompted many to wonder if they could donate plasma However a few top private hospitals said that they would continue to accept plasmaDr Om Shrivastav an infectious disease expert and a member of the state Covid19 task force said ldquoPlasma therapy has shown to be lifesaving in the early part of the infection The ICMR should look at fresh trials rather than going back to last yearrsquos datardquo He said he has used plasma therapy on at least 100 patients and 94 of them have done wellAlso Read India drops plasma therapy from Covid19 management guidelinesWhile ICMR says plasma therapy can be used in emergency cases doctors say a delayed usage of plasma doesnrsquot work and should continue to be used in the mainstream Dr Arpita Dwivedy a critical care consultant at Dr LH Hiranandani Hospital said they had encouraging results from plasma therapy at the early stage of infection during the first wave ldquoThis time most of our patients have taken vaccines and have a good amount of antibodies Patients whose antibody levels are not high I do give them plasma therapy In the very critically ill I donrsquot think anything worksrdquo Dr D wivedy saidDr Vasant Nagvekar an infectious disease expert at Global and Lilavati hospitals said he will continue to use plasma on those with ldquohaematological malignanciesrdquo transplant patients who are on immunosuppressants or have kidney or liver diseasesDr Rahul Pandit an intensivist at Fortis Hospital and a member of the Covid19 task force said he hasnrsquot used a single bag of plasma in this pandemic ldquoThe window period to use plasma is essentially between two or three days and by that time no patient is in the hospitalrdquo he saidSir HN Reliance Hospital one of the private centres authorised to collect plasma said it will continue collecting plasma ldquoIt is the ICMRrsquos decision but the FDA hasnrsquot stopped it We are seeing the benefits of plasma therapyrdquo said a doctorDr Sujit Chatterjee CEO of Powai Hiranandani hospital added ldquoFDA has no information We will use it till we receive some official order Right now it is a merepress reportrdquoWas quality a concernDr Khusrav Bajan intensivist from PD Hinduja Hospital though welcomed the ICMR decision he questioned the quality of plasma used in initial days ldquoYou need plasma which has a very high neutralising antibody level and that probably in the initial days was not usedrdquo Dr Bhajan said plasma is still good in select casesTherapy discontinuedDr Kedar Toraskar a critical care specialist at Wockhardt Hospital said they have stopped using plasma therapy for the last three months ldquoWe have to go with data We have done enough studies including the ICMR and recovery trail report that clearly says plasma therapy doesnrsquot helprdquo he said agreeing with its use on those who come early to the hospitalDr Anant Bhan a global health and bioethics researcher said ldquoWe must follow the evidence We should focus on interventions for which evidence of benefit existsrdquo