Who will apologize for plasma therapy? It was a disaster for Kovid-19, government hospitals knew

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TeaHe’s Closing the Pages of an 18th-Century Masterpiece story of stone Revealed the essence of the message of the Tao. In Lao Tzu’s words, it means that “things are not as they seem, that the eloquent may stammer, that perfection may seem flawed, that truth is fiction, that fiction is truth.”

The truth is neither black nor white, it is gray – tackling the second wave of COVID-19 is a testament to that fact.

Disaster escaped from public eye

Amidst the second wave of COVID-19 with panic all around, a lot of medical disasters played out, and undoubtedly, they were driven by a lack of knowledge. Instead, he was fueled by a desire for one-upmanship and copycat fame. Some doctors inadvertently made this medical mistake. On one hand we had chair specialists who were not running the COVID-19 centers and they had closed their institutions. On the other hand, doctors were running outpatient departments (OPDs) and wards in central government hospitals like Delhi’s Ram Manohar Lohia Hospital. They were probably following a half-baked diet and there was little evidence that lives were at stake.

While some drugs were probably harmless and inexpensive such as Ivermectin or HCQS, others were ridiculously expensive, and no one was the wiser about their efficacy. One of them was plasma therapy. Of course, the Indian medical system and health service didn’t have the time for a randomized trial to test a placebo. But the filth thus originated here in the capital of the country.

One might ask – who will be the expert to decide on its efficacy? The obvious answer is a physician in a hospital who handles patients with an active plasma extraction center. But what happened is that a center dedicated to liver care with zero experience in COVID-19 treatment proposed the idea that plasma could help. Then came the famous statement of Chief Minister Arvind Kejriwal till now, Saying That Delhi opened the world’s first plasma bank. It set off a chain reaction, and within a few weeks, hospitals followed suit.

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it was not the solution

Plasma is a component of blood that is believed to contain antibodies to diseases. Here, it was believed that such therapy would benefit the patients of Kovid-19. This was when the use of intravenous immunoglobulin (IV IgG), a related plasma-based therapy that had been available for years, was not effective in most disorders. This was even when we all knew that the so-called antibody tests of Covid-19 patients are negative or less positive. In fact, what is even more ridiculous is that the amount of antibodies in the plasma is probably too low to do anything. And the biggest irony is that therapy works differently, but here we had a lot of drugs being given, and it was not possible to tell what was working behind the treatment.

Plasma does not come cheap, as it has to be extracted from patients. Thanks to the CM’s call to donate plasma with great enthusiasm and fanfare, the concept spread like wildfire. Middlemen and ‘scamsters’ come, and patients have paid Lakhs of rupees for treatment, that too with dubious effect. Most of the doctors were flooded with calls for plasma, and we didn’t know what and where to arrange it for so many patients.

I know of patients who sold their stuff and broke down, partly because of plasma therapy and, of course, remdesivir, which has now been removed from all guidelines. One of the members of our department, who had recovered from COVID-19, had to give plasma to his own grandfather. He was admitted to the hospital, given plasma but to no avail.

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Trading Facts for Fame

Therefore, it is essential to understand the value of the placebo test. Here, a lookalike therapy is given to assess whether the active therapy—plasma, in this case—is anything significant. A 30 percent response rate is mostly considered placebo or inactive, and this is the value of a placebo-controlled study.

There are many factors that determine the success of therapy in COVID-19, and tell me Credit to the plasma showed a marked lack of foresight. On this occasion, the Indian Council of Medical Research (ICMR) in a multicentre study published in the British Medical Journal (BMJ), found it That plasma was not that good. But the hospitals that pioneered the concept swayed public opinion and distorted the paper. Such was the distrust in our own country’s research that no one wanted to get off the plasma bandwagon. Countless patients spent their life savings on a highly questionable therapy. And this trend continued till the end of the second wave.

the breakthrough

As always, we waited for a foreign magazine to agree to a local finding, which was not a surprise to many of us in government hospitals. milestone pepshowed in R in the New England Journal of Medicine (NEJM) that “there was no significant difference in clinical status or overall mortality between patients treated with convalescent plasma and those receiving placebo.” It has been cited 455 times since it was published in February 2021. This number is more than the citations of any paper published by ‘experts’ who launched an untrained therapy on the nation.

To add insult to injury, a section of the print media refrained from criticizing him because his publications were the beneficiary of full-page advertisements on plasma banks. To make it worse, some of the names suggested for the Padma Awards this year Involved Pioneers of plasma therapy.

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Who takes the responsibility?

Looking back, it needs to be asked – who will pay for the loss of life savings and the death of patients given plasma therapy? Who will fill the gap for mistrust in medical care? Will the experts apologize? Who will apologize for falsifying the ICMR report, which could have suppressed it in the beginning? But no one really apologizes for such things in India.

As Donald Keough said, “The truth is, we are not that dumb, nor are we that smart.” Plasma Blitzkrieg was neither dumb nor smart; It was harsh, and someone must pay for negligence today or tomorrow.

The author is Professor of Dermatology at RML Hospital, New Delhi. Thoughts are personal.

(Edited by Likes)

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