The irrational use of plasma therapy could raise the possibility of more virulent strains

The Government has dropped plasma therapy on COVID patients from the list of clinical management guidelines which earlier allowed its off-label use in the initial days of the disease. The reason given is that it is ineffective in reducing the severity of the disease or the chances of death. The decision to remove it from the guidelines comes in the backdrop of some scientists warning against the arbitrary use of plasma therapy. Indian vaccinologist Gagandeep Kang and others, in a signed letter, said the irrational and non-scientific use of plasma therapy could raise the possibility of more virulent strains developing. The Government has already come out with scientific explanations why the Remdesivir medication and the use of Ivermectin are also not advisable for use on the COVID patients. If at all Remdesivir is to be used, it should be used in extremely critical cases and, even then, strictly under medical supervision, give between the first and seventh days of the onset of the disease to reduce its severity and not prescribed thereafter. However, there is no ban against its use under any condition and it is this loophole that has led to its mass use. The British and American guidelines discount any efficacy of Remdesivir on mortality of patients or the need for mechanical ventilation. The use of Ivermectin and paracetamol depends on the immunity level and other patient-specific conditions and, along with Azithromycin, should not be taken without doctor’s advice.

Ivermectin’s manufacturer, Merck, stated that they found no meaningful evidence for efficacy against COVID. Along with Remdesivir, originally meant to treat Ebola, these are ‘repurposed’ drugs, essentially made for some other infection but not repurposed to treat COVID-19. With this, the three key elements of Covid “treatment”, popularised on social media and believed to be God’s gift to patients, are rendered useless. There are hardly any patients whose relatives have not given him or her any or all of the three products in the hope that they will get better. There are reports of people obtaining print outs of ready-made COVID prescriptions, available on the social media, and buying them in bulk and literally hoarding them for use in case anyone contracts the disease. The use of these products spiralled out of control, leading to its scarcity in hundreds of cities and towns of the country, as hospital beds, oxygenated beds and oxygen concentrators and cylinders became scarce. In nearly the majority of the cases, doctors are scarcely consulted before taking a medicine. The doctors themselves, so much under pressure, have been at their wit’s end trying to explain to the impatient relatives the relative merits and de-merits of these drugs. After over 1.5 crore positive cases since COVID struck us, and nearly two lakh deaths, we are still grappling with the fundamentals of clinical management and drug protocols. That shows how disoriented the national COVID management plan is.