Dr Rakesh Maurya, lead scientist at Redcliffe Life Sciences, spoke to NewsX’s Managing Editor on the benefits of plasma therapy in fighting Covid-19.
Q. About 4,257 people have recovered in India. They now carry within them some kind of antibody to coronavirus. Of what use could this pool of population be?
A. The good news is not just the 4,257 that have recovered, but also 80% of the population globally who are showing mild symptoms. They can be potential donors for plasma therapy.
Q. Are you saying that people that are falling sick, but are showing mild symptoms, therefore means they have some natural immunity or natural resistance to this virus?
A. Yes, you got it right. They can be better donors, it is advisable. It is being seen globally in plasma therapy. If you have patients that have not taken any medicine or any drug and have a better natural immune response, they are better donors for plasma therapy.
Q. How is the plasma taken from a person who has recovered and has natural immunity?
A. Let’s go back to the science behind this. When an infection happens, our body has an immune response to target the virus, and then antibodies come up. When a person recovers, there is a technology called plasmapheresis, by which you can automatically separate plasma from the red blood cells. You can then infuse this plasma which is rich in antibodies into the patients who are severe or critically ill. We can also check the amount of antibodies in people, and find those donors have no other existing condition. This is very important. When we are selecting donors, testing has to be done as for any blood transfusion. HIV tests are conducted.
Q. Do blood types have to match in plasma therapy?
A. To some extent, yes. Success rates are very high with the blood groups O and B. Success rate of plasma therapy is lesser in blood group A. That is what clinical trials are for. We have to identify the doses at which to infuse the plasma.
Q. How much plasma can we produce? One or two units of blood per person is the recommended donation amount. So how much blood can a person give?
A. About 600 ml plasma, drawn from 1 or 2 units of blood, is sufficient for 3-5 doses. The good news is that these donors can donate every 14 days. Immunity can last for up to 3 to 4 months, maybe longer. You can use a single donor every 14 days, take 1-2 units of blood. Each donor, each donation can treat 3-5 patients. See the statistics of this. The reproductive rate of coronavirus is that it can infect two people, one person can infect two. But here one person can cure 3-5 people.
Q. There are studies going on here and globally on how effective plasma therapy can be. Unless we have a quantifiable scientific study, we can only guess and hope. How would it generally work? So, one person has recovered or has antibodies; you’ve taken a unit or 2 — about 600 ml of blood from them. You’ve then removed the RBC, so that’s why the plasma resembles whitish-yellow fluid. And then, after doing the HIV testing, etc, you distil the plasma and introduce the plasma into the donee’s bloodstream. What happens then?
A. The initial few days are for prophylaxis. When you inject the plasma, the patient’s body prepares the immune response. You will see some antibodies. Like when you inject a vaccine, you see fever rising. Just like that when you inject plasma, you will see prophylaxis, and then it moves into the therapy mode. The action may take anywhere between 4 to 12 days. In China, there were two trials done, and we saw the results being quite good, especially for critical patients that were on ventilators. Patients that were on ventilator were out of the ventilator within 5-7 days, which is a very good sign for this therapy. There is one more good part I would like to talk about. During the previous SARS outbreak, a large clinical trial was done using plasma therapy. The results were quite promising. This virus has a genome that is 80% similar.
Q. Once I get the plasma, which already has X antibodies in it. Is my body then able to replicate those antibodies? Or am I simply using those donated antibodies?
A. This is an innate response. You are supplementing your body with some antibodies from outside temporarily. The resistance of that patient is not that high against the virus. Yes, it can trigger to a certain extent the inane immunity of the patient. But right now, we can say that it is a temporary measure to reduce the amount of symptoms.
Q. So, the donated antibodies stay in the system for a few days?
A. Yes. They can stay for almost a month or two.
Q What are the risks with this kind of plasma therapy?
A. Risks are there for a certain section of patients. Those who are severely ill and have co-morbid conditions, like diabetes, hypertension, asthma or respiratory illness. Their immune response is already very weak. Even after infusing plasma, you may not see clinical signs of recovery. There is a fine line between a severe patient going into critical condition. If the therapy is administered at a time when the patient can be treated using this method, then the fine line has to be identified through these clinical trials. So that patients who have to be given this therapy can be identified at the right time.
Q. We have over 4,000 official recoveries. These are people who have tested negative twice, they are Covidfree now. Every day, that number is going up by 4oo-500. So potentially, as you mentioned, we potentially have 14,000-15,000 doses of plasma therapy, which incidentally would cover every single patient we have currently. So how do we encourage people who have recovered to come and donate the blood?
A. This is like a normal blood donation camp that we conduct. But we do have to sensitise people. The Indian population is very unique in terms of the response received. India’s well-placed in its battle against coronavirus. Nowhere else in the world is 20% of the population recovering. We have seen that it is usually 10- 11% or less than that. So, we have controlled the disease, we have a large number of donors. First, we have to screen them for all the antibodies. Once we have identified people who have sufficient antibodies in their system, only those can be prospective donors for us.
Q. Is the rapid kit the only way to screen people for antibodies? Or are there other ways of finding corona specific antibodies?
A. With a rapid point of care kit, you put a drop of blood and you know if the antibodies are there or not. Then there is an advanced version of antibody testing, where you can quantify the amount of IgG and IgM in the body. It’s a machine reader and a fairly simple process. We have to find people who have sufficient antibodies, because then you will use less amount of plasma per patient, and you can treat more patients.
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STERLING’S STRIKE HELPS ENGLAND DEFEAT CROATIA
Raheem Sterling, center, celebrates after scoring goal during the Euro 2020 soccer championship match between England and Croatia at Wembley stadium in London.
A thunderous goal from Raheem Sterling helped England defeat Croatia 1-0 in the Group D encounter of the ongoing European Championships here at the Wembley Stadium on Sunday. England managed to gain full three points from the match against Croatia and now the Three Lions will lock horns against Scotland on June 18 while Croatia will square off against Czech Republic on the same day.
The first half between England and Croatia saw no goals and as a result, the scoreline remained 0-0 at halftime. In the first half, England held on to the ball for 58 per cent of the match, while Croatia held on to it for 42 per cent. The deadlock was finally broken in the 57th minute as Raheem Sterling registered the goal for England. This was Sterling’s first goal at a major tournament. Kalvin Phillips made a stunning run as he beat two players and then he went on to pass the ball to Sterling, and he did not disappoint and successfully netted the ball into the goalpost.No more goals were possible in the match, and in the end, England went away with a 1-0 victory. Austria will lock horns against North Macedonia while in another match, Netherlands and Ukraine will be squaring off against each other.
Mizoram man who headed world’s largest family dies
Ziona Chana, the man from Mizoram believed to head the world’s largest family with at least 39 wives and 94 children and 33 grandchildren, died on Sunday at the age 76.
Taking to Twitter, Mizoram Chief Minister Zoramthanga on Sunday bid farewell to him. “With heavy heart, Mizoram bid farewell to Mr. Zion-a (76), believed to head the world’s largest family, with 38 wives and 89 children. Mizoram and his village at Baktawng Tlangnuam has become a major tourist attraction in the state because of the family. Rest in Peace Sir!” he tweeted along with a group picture of the huge family.
Zion-a featured in Ripley’s Believe It or Not in 2011 and 2013 for having the world’s largest family.
He reportedly lived with his family in a large 100-room, four-story building.
We will be part of the next Union cabinet expansion: JD-U chief
Amid the speculations of the Union Cabinet expansion, R.C.P. Singh, National president of the NDA-ally Janata Dal (United) on Sunday said that JDU is part of the alliance of the ruling NDA coalition at the Centre and the party will be part of the Cabinet whenever there is an expansion.
“There is no confusion. We are a part of NDA. Whenever there will be an expansion in the cabinet in Centre, JD (U) will be part of it,” he said.
At present, the JD(U) has no representation in the Union Cabinet. the JD(U) contested the 2019 Lok Sabha polls in alliance with the BJP.
However, RCP Singh chose not to comment on the inclusion of the Lok Janshakti Party (LJP) in the ‘cabinet expansion’.
Singh also mentioned that everything is good in the alliance in Bihar and there are no clashes in the NDA-led government in the state. “Everyone is together in the NDA in Bihar. The NDA government will complete its present term in Bihar. Everyone is working towards the development of the state,” the JD(U) chief said.
“The RJD is spreading rumours that nothing is good in the NDA to keep its MLA together. There is everything good in NDA but there are clashes in the RJD,” he added.
First three desi nuclear attack submarines to be 95% made in India
In what would be a major boost for the submarine building capability within the country, the first three nuclear attack submarines to be built indigenously would be having 95 per cent Made in India content in them and it would further go up in the next three. The Cabinet Committee on Security is considering a proposal worth around Rs 50,000 crore for indigenously building three nuclear attack submarines which would be built by the Defence Research and Development Organisation (DRDO) in Visakhapatnam. This project is separate from the Arihant class project under which six nuclear-powered submarines are being built with the capability of launching ballistic missiles.
“The nuclear attack submarine project would be a big boost for the indigenous submarine capability as 95 per cent of it would be made in India. This would provide a big boost to the domestic defence sector including both private and public sector,” government sources told ANI.
For the six nuclear attack submarines, the planners are confident that they would be able to complete the project without any external help but if required, they may take help of one of its strategic partner countries, they said.
The project would also be very helpful for the economy as it is expected to generate a large number of jobs in the defence sector, the sources said.
The Navy and DRDO would first get a clearance for three of these boats and will have the option of building three more after the completion of this project. The Indian Navy proposal to have six indigenous nuclear attack submarines was one of the first few major defence modernisation proposals to have been cleared by the Narendra Modi government soon after it came to power in 2014.
Even though marred by some delays, India has been making big headways in the field of indigenous submarine building capability. The first Arihant class boat was commissioned a few years ago and the second one INS Arighat is also undergoing sea trials and is expected to be commissioned in near future.
India has plans of building 24 submarines including six nuclear attack ones which would give it long legs to operate in the Indian Ocean Region and will help it to keep its adversaries in check at long distances.
The first six conventional boats are already under construction in Mumbai under the Kalavati class project while the tender for the next six with greater capability would be issued soon after recent clearance by the Defence Ministry. There is a plan to build six more conventional submarines under the Project 76 but it will take a long time to be initiated.
SECOND WAVE WASHES AWAY DABBAWALAS’ HOPES, FORCES THEM TO TAKE OTHER JOBS
Currently, many dabbawalas are jobless, some of them have returned to their villages while others had to find new ways to earn their livelihood. According to the members of the Mumbai Dabbawala Association, many bicycles can be seen outside railway stations in this lockdown but there are not as many dabbawalas.
The pandemic has brought a halt to their lives. Only some of them are working and delivering dabbas in hotels and hospitals while the rest are earning their livelihood through other means. Some dabbawalas have become auto drivers or are selling vegetables to earn money.
Mumbai’s 130-year-old dabba delivery system has over 5,000 dabbawalas like Kailash Shinde who now operates and provides dabbas for hotels and travels from Andheri to Malad to Borivali and Bandra.
Since trains are being used only for essential services, dabbawalas face a lot of problems in travelling. Due to the lockdown, the places have been shut where they used to deliver dabbas.
Subhash Talekar, President, Mumbai Dabbawala Association says “we demanded the state government to allow us to travel in local trains as essential workers are being allowed. We should also get a nod to commute in trains as it gets difficult to go by any other vehicle to far off places. Lockdown has affected our economy drastically”
A dabbawala told us how this lockdown has impacted his life. Kailash lives in a chawl system in Andheri with his wife and two children. The pandemic and the lockdown have caused a lot of damage to dabbawalas. Kailash showed us his house and opened up about the difficulties he is facing due to the lockdown.
He says, “Before the lockdown, I had a team of 18 people and used to earn from Rs 12,000 to Rs 15,000 from one house and had over 400 orders. But after the lockdown, I have a team of only three people and fewer orders. Now we get only Rs 5000 to Rs 6000 in which we have to survive as the money is divided among three people.”
Kailash and his wife earn to manage somehow and give good education to their children. His wife also works to support her husband and family, yet this is not enough.
Due to the pandemic, Kailash had to face commuting hurdles as half of the money earned goes into travelling. In an emotional appeal to the government, he says, “I request the government to look into the matter and allow us to travel in trains as the lockdown has greatly affected our economy. If trains are opened for dabbawalas, then it will be a ray of sunshine for them from the dark clouds of lockdown.”
Experts find no proof of 3rd wave hitting kids hard, but states in no mood to take chance
With 80,834 Covid-19 reported cases in the last 24 hours, India continued its declining trend of new infections and reported the lowest single-day count in 71 days, the Union Ministry of Health and Family Welfare said on Sunday.
The new cases pushed the Covid case tally in the country to 2,94,39,989. India has been witnessing a continuous fall in the active caseload and the current active number of Covid cases stands at 10,26,159 with a net decrease of 54,531 cases in the last 24 hours.
The weekly positivity rate further dropped to less than 5 per cent and currently stands at 4.74 per cent while the daily positivity rate stands at 4.25 per cent today. It has remained less than 10 per cent for 20 consecutive days now.
Despite the downward trend, most states seem to be gearing up for the anticipated third wave, especially on creating infrastructure for paediatric wards, given the buzz that the coming wave might hit kids particularly hard. In view of the pandemic, the states have kept the health budget of 8-14 % for the current year. The Delhi government allocated Rs 9,934 crore or 14% of the total budget to health. CM Arvind Kejriwal on 12 June cautioned that the chances of the third wave of the Covid-19 pandemic were quite real, while he asserted that his government was preparing on a “war-footing” to combat it.
The Kerala government allocated Rs 2,800 crore to deal with the health emergency. The third wave of Covid-19 is expected to arrive in October, necessitating a larger budget for Covid mitigation.
Bihar has kept Rs 13,264 crore on health this year. The health department has focused its attention on arranging beds with medical facilities for children who, experts fear, could be mostly affected in the third wave. Currently, there are 816 beds for children in the nine medical college hospitals in the state. Of these, only 225 have oxygen facilities.
Uttar Pradesh allocated 5.5 per cent of its total expenditure for health. CM Yogi Adityanath said that the state is now preparing for a probable third wave. Paediatric ICUs in district hospitals and mini-PICU in community health centres were being operationalised. A new 20-bed PICU has been planned for Deoria and a mini-PICU in Laar.
Incidentally, as the states gear up to ramp up their paediatric wards, a new report says that there’s no substantial evidence to suggest that children will be more affected or have greater illness severity in the anticipated third wave.
The Lancet Covid-19 Commission India Task Force prepared the report after convening an experts group comprising leading paediatricians from the country to examine the issue of ‘paediatric Covid-19’ in India. It said that the infection’s symptomatology in children in India appears to be globally comparable.
“Most children with Covid-19 are asymptomatic, and amongst those symptomatic mild infections are predominant. Most children have fever with respiratory symptoms, and often present with gastrointestinal symptoms and a typical manifestation compared to adults. The proportion of symptomatic children increases as age increases as does the severity in such age groups,” the report started.
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