THE GIST of Editorial for UPSC Exams : 02 May 2020 (Plasma therapy is no silver bullet (The Hindu))

Plasma therapy is no silver bullet (The Hindu)

Mains Paper 2:Health 
Prelims level: Plasma therapy
Mains level: Development of the scientific study in the field of plasma therapy

Context:

• The COVID-19 pandemic has posed unprecedentedchallenges 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.

Plasma therapy:

• The therapy involves infusingpatients 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. 
• While showing great promise, it is a line of treatment that is yet to be validatedfor efficacy and safety and cannot be deployed widely without caution.

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Possible benefits: 

• The current evidence to conclude anything about the true benefits of this therapy is very thin.
• Scientific research in medicine is the only means to overcome novel and complex diseases such as COVID-19 and that too thriveson the same spirit of debate and criticism. 
• The difference, however, is that the standards of evidence required, to generate consensus and arrive at the most optimalprotocols, are far more rigorousand time-taking than in most other walks of life.

Convalescent plasma therapy:

• The convalescent plasma therapy is being currently studied by the Indian Council of Medical Research, through open label, randomised controlled trial to evaluate it for both safety and efficacy. 
• Already, four patients have been enrolled in Ahmedabad and the study will be rolled out in 20 hospitals by the end of this week and at more centres over the next month.

Need for more research:

• The most important principle in medical ethics is “do no harm”. The transfusion of convalescent plasma is also not without risks, which range from mild reactions like fever, itching, to life-threatening allergic reactions and lung injury. 
• 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. 

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Randomised controlled trial:

• 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.
• Further, convalescent plasma therapy requires intensive resources, healthy COVID-19 survivors to donate, a blood bank with proper machinery and trained personnel to remove plasma, equipment to store it and testing facilities to make sure it has an adequate amount of antibodies. 
• 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.

Conclusion:

• Even these times of collective uncertainty are no reason to lower scientific temper. While it is good to be hopeful, the fact remains there are no real silver bullets in medicine and health outcomes are a result of not just a few pills or therapies but a complex set of factors. 
• Science should be driven by reason and evidence with hope as a catalyst but not by either fear or populism. Pushing one or the other therapy without evidence or caution can only set back our larger fight against COVID-19.

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General Studies Pre. Cum Mains Study Materials

Prelims Questions:

Q.1)With reference to the India COVID-19 Emergency Response and Health System Preparedness Package, consider the following statements:
1. The key objectives of the package include mounting emergency response to slow and limit COVID-19 in the country through the development of diagnostics and COVID-19 dedicated treatment facilities. 
2. It aims to strengthen and build resilient National and State health systems to support prevention and preparedness for future disease outbreak. 
Which of the statements given above is/are correct?
(a) 1 only
(b) 2 only
(c) Both 1 and 2
(d) Neither 1 nor 2

Answer.............

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Mains Questions:
Q.1)What is the plasma therapy? Do you think it is a robust scientific study required to development in this field? Elucidate.