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People on the threshold of dying were saved: Dr Dheeraj Kaul on C- Plasma treatment

WION
New Delhi, Delhi, IndiaUpdated: Aug 24, 2020, 06:14 PM IST
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Photograph:(AFP)

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In an attempt to answer major questions surrounding convalescent plasma as a COVID-19 treatment, WION spoke to New York-based Dr Dheeraj Kaul

The Food and Drug Administration (FDA) on Sunday issued an emergency authorisation for doctors to treat coronavirus using blood plasma from patients who’ve recovered from the disease. The announcement has brought a number of questions to many minds and in an attempt to answer major questions surrounding convalescent plasma as a COVID-19 treatment, WION spoke to New York-based Dr Dheeraj Kaul who happens to be a specialist in Nephrology geriatrics and pain management and has been following the developments. 

What is convalescent plasma, and how does it work?

When people get infected with COVID-19, their immune systems generate antibodies to fight the disease. Those antibody proteins float in their blood plasma, which is the liquid component of blood that suspends blood cells.

In the convalescent plasma process, doctors harvest the plasma, test it for safety, and then purify it to isolate those antibodies. That convalescent plasma can be injected into another patient sick with COVID-19, and the antibodies it contains can help fight the virus early in an infection until the patient’s own immune system generates its own antibodies in sufficient quantities to beat back COVID-19. 

Doctors in the US started using convalescent plasma as early as April but only for patients who were very sick and were in the ICU on ventilators. “Over the months, we saw that people who were on the threshold of dying, a significant number of those people got better when given convalescent plasma, they were extubated and were out of the ICU and we were able to save lives,” said Kaul.  

On being asked the reason behind the delay for the authorisation, Dr Kaul said that there weren’t enough good studies that could support the data doctors could see, hence every hospital had to take individual permissions from patients to follow the process which also made the procedure cumbersome. Also, the limited number of convalescent plasma collecting sites like the Red Cross were not getting the green signal to go about with the process. In August, Mayo Clinic carried out a study based on a larger group of 35,000 people who were further divided into two groups- The first section getting the plasma within first 3 days of manifestation and infection. The second group was given the treatment after 4 days or more of getting infected. All of these people were hospitalised. 

Categorising the people who were involved in the study, Kaul said, “half of them were white, 38% were Hispanic, 16-17% were black and 3-4% were Asian and from other ethnicity. On day 7, they were checked for response and doctors found out that there was a startling 35% mortality reduction, which is huge in medical sciences.” It meant, if infected people are given C plasma earlier, 35 out of 100 people who are otherwise going to die, can be saved save from dying. One life in every three possibly dying people can be saved. Hence C plasma is being pushed with scientific backing and I have seen it work for first hand.

Talking about FDA and the delay happening, it isn’t exactly a delay according to Dr Kaul because “every new idea is tested numerous times” and considering the unprecedented times we are living in, “this is a record time in which FDA has approved anything even for authorisation. Hence this is the fastest FDA could come. Most important things to be assured were that it does no harm and it does its work.” 

Dr Kaul looks satisfied with the US announcement that comes on the eve of Republican National Convention, where Trump will be nominated to lead his party for four more years. 

However, Dr Kaul definitely had something to say about the Russian vaccine that is surrounded by controversies and questions since the start despite Russian President Vladimir Putin mentioning that his daughter was one of those who took the vaccine. “Never have we used a vaccine that has not passed Stage 3 trials, it’s a very risky proposal. I as a physician will not be comfortable prescribing a Stage-2 passed vaccine to my patient,” said Dr Kaul. 

Report by: Anshu Dubey