IASbhai Editorial Hunt
It always seems impossible until it’s done.– Nelson Mandela
“Plasma therapy is no silver bullet“
SOURCES: THE HINDU EDITORIAL/EDITORIALS FOR UPSC CSE MAINS 2020
Plasma therapy is no silver bullet
To recommend it without undertaking a robust scientific study may cause more harm than good
SYLLABUS COVERED: GS 3:Diseases :Therapy :Recent Innovations
What is Plasma Therapy ? True benefits on initial trials are very thin . Comment -(GS 3)
- Why this does not seem to be a good idea ?
- What are the consequences of plasma theory ?
- How does it happen !
- The COVID-19 pandemic has posed unprecedented challenges to governments, health professionals and the general public at large, around the world.
- Every response, administrative, social, economic or medical is being subjected to intense public scrutiny, as it rightly should be in the spirit of mature democracy.
- Scientific research in medicine is the only means to overcome novel and complex diseases such as COVID-19 and that too thrives on the same spirit of debate and criticism.
- The therapy involves infusing patients suffering from COVID-19 with plasma from recovered patients.
- In theory, the antibodies of the recovered person may help that patient’s immune system fight the virus.
NEED FOR MORE RESEARCH
- The most important principle in medical ethics is “do no harm”.
- To recommend a therapy without studying it thoroughly with robust scientific methods may cause more harm than good.
- Till date, there have been only three published case series for convalescent plasma in COVID-19 with a cumulative of 19 patients.
- We cannot conclude the therapy will work on all patients all the time or even believe that the convalescent plasma was the only reason for their improvement.
RISKS INVOLVED :
1. TRANSFER OF BLOOD SUBSTANCES: As the blood transfusion takes place, there are risks that an inadvertent infection might get transferred to the patient.
2. ENHANCEMENT OF INFECTION: The therapy might fail for some patients and can result in an enhanced form of the infection.
3. EFFECT ON IMMUNE SYSTEM: The antibody administration may end up suppressing the body’s natural immune response, leaving a Covid-19 patient vulnerable to subsequent re-infection.
GOLD STANDARD TRIALS :
- To say with certainty whether a drug is truly effective or not, the gold standard in medicine is to conduct a randomised controlled trial, where half the patients get the experimental drug and the other half do not.
- Only if patients in the first half show substantial improvement over those in the second half, it indicates the drug is beneficial.
- While showing great promise, it is a line of treatment that is yet to be validated for efficacy and safety and cannot be deployed widely without caution.
- The current evidence to conclude anything about the true benefits of this therapy is very thin.
- Too much focus on one approach can take away the focus from other important therapeutic modalities like use of oxygen therapy, antivirals, and antibiotics for complicated hospital courses.
- To overcome the pandemic comprehensively, we should focus on strengthening health systems at all levels, including referral systems, supply chain, logistics and inventory management.
- We need to work on protecting our healthcare workers, improving prevention methods, promoting cough etiquettes, effective quarantining and accurate testing.
- Even these times of collective uncertainty are no reason to lower scientific temper.
“Science should be driven by reason and evidence with hope as a catalyst but not by either fear or populism.”