By Pramod Thomas
A DOCTOR who helped set up Kerala’s first plasma bank has described how the move helped save the lives of 55 critical Covid-19 patients in the south Indian state.
Dr Shinas Babu is a nodal officer of the special Covid treatment centre at the Government Medical College Hospital (GMCH), Manjeri, in north Kerala. Since the start of the coronavirus pandemic, he has treated more than 14,000 Covid-19 patients and saved the lives of 500 patients who were in a critical condition.
He said, “The Covid-19 pandemic was a great learning experience for me.
“My first patients were two people who had returned from Saudi Arabia after performing Umrah. Initially, I was worried as it was a new disease and I relied on journals and the internet to know more about it. In the past few months, I have gained thorough knowledge about what to do with Covid patients and can predict which patient’s condition will become worse.”
He added, “If we are alert and give proper treatment and medication, we can save the patient’s life.”
Among treatments used by doctors is plasma therapy; however, the Indian Council of Medical Research (ICMR), the apex medical research body in the country, recently said it was not effective.
Dr Babu’s experience tells a different story.
He said, “We started the plasma therapy treatment on June 5. Of the 75 patients who received it, we saved the lives of 55; so, the success rate is 73 per cent.
“Of the 20 patients who lost their lives, four were negative for Covid-19 in their post-mortem sample test. We are now also doing a study regarding this.”
In his opinion, the ICMR study was conducted on patients whose condition had worsened. According to him, identifying the “correct” patients and providing plasma therapy at the right time is important if the treatment is to work.
“Besides, it is very cheap and has no systemic side effects,” he said.
“We could not save a patient through plasma therapy after his/her situation became worse. As per the guidelines by the state government, we should administer plasma therapy during the time of exhibiting cytokine storm features.”
A cytokine storm, also called hypercytokinemia, is a physiological reaction when the immune system causes an uncontrolled and excessive release of pro-inflammatory signalling molecules called cytokines.
So far, 181 people have donated plasma to the bank and Dr Babu’s team provides the therapy for patients who have Covid pneumonia and show cytokine storm features.
Kerala began its preparation when the first Covid-19 case was reported in Wuhan, China.
On January 24, the state government appointed nodal officers to all hospitals.
Dr Babu said, “We diagnose the disease before it becomes complicated. If we provide proper treatment at an early stage, it is unlikely the situation will become worse. The contact tracing mechanism in Kerala is really good. The state quickly hospitalises vulnerable patients and starts treatment as early as possible.”
He added, “It is very difficult to save a patient when the situation becomes worse; the oxygen level in the blood will reduce and there will be no symptoms. This is called ‘silent’ or ‘happy’ hypoxia. It is a condition in which patients have extremely low blood oxygen levels, yet do not show signs of breathlessness.”
According to him, around 85 per cent of Covid patients will have only minor symptoms or are asymptomatic
“About 40-45 per cent of patients will be asymptomatic. There will be minor symptoms for 40 per cent of patients. So, around 85 per cent of patients will have minor symptoms or are asymptomatic. The situation of only 15 per cent of patients is likely to become worse. As a result of local transmission, people of all ages are getting affected now,” Dr Babu said.
“Vulnerable people, including pregnant women, people with heart and kidney diseases needed intensive care.”
Asked if there is a chance the virus spreads through the air, Dr Babu said, “If it is airborne the number of patients would have been much higher. It is transmitted through droplets. The size of the virus is big. Hence it cannot sustain in the atmosphere for long.”