India has officially removed the use of convalescent plasma, popularly known as plasma therapy, on Covid-19 patients from its clinical management guidelines for the disease. The therapy has been a subject of intense debate ever since the Delhi government allowed its use in some cases last year. The previous guidelines allowed "off label" use of plasma therapy on Covid-19 patients during moderate stage within seven days of the onset of symptoms. However, in many cases, doctors advised plasma therapy in critical cases of Covid-19.
Here's why the government dropped plasma therapy.
Plasma therapy "irrational" and "harassing"
Many a time, the prescription for plasma therapy was held "irrational" and "harassing" for the attendants of the Covid-19 patients. Reports of "plasma bidding" also surfaced as the attendants scrambled for a "high titre [having a high concentration of antibodies] donor".
"Non-scientific use" of convalescent plasma
A group of scientists and clinicians wrote a letter to Principal Scientific Adviser K Vijay Raghavan recently objecting to the "non-scientific use" of convalescent plasma for Covid-19 across the country. The letter was also marked to Indian Council of Medical Research (ICMR) chief Dr Balram Bhargava and All India Institute of Medical Sciences (AIIMS) director Dr Randeep Guleria.
May have caused emergence of SARS-CoV-2 variants
The scientists and clinicians said the erratic and imprudent use of plasma therapy might have contributed towards the emergence of different variants of SARS-CoV-2 which had "lower susceptibility to neutralising antibodies". The issue was already in public debate with independent health experts questioning the rationale for keeping plasma therapy in the protocol of Covid-19 management.
No favourable data for plasma therapy
Scientific studies, such as one published in The Lancet, showed no favourable data for plasma therapy in reducing mortality or period of illness.
Guidelines changed for plasma therapy
Plasma therapy is based on using antibody-rich plasma from those Covid-19 patients who have recovered recently. The ICMR had, however, last month changed its guidelines for plasma therapy restricting its use for only moderate cases of Covid-19, and not after seven days of the onset of symptoms. The ICMR finally dropped it from Covid-19 management protocol. The decision was unanimous among the members of the ICMR-National Task Force for Covid-19.