“Plasma therapy needs to be explored, may turn out to be a life saver”

Bringing hope to the battle against COVID-19, plasma therapy is being seen as one of the key options of treatment for many infected patients. While the Karnataka government recently inaugurated the state’s first plasma bank, there are plenty of instances where COVID-19 recovered patients across India have come forward to donate plasma.

The HealthCare Global (HCG) Cancer Centre Bangalore led by Dr Vishal Rao has recently received the funding grants from ACT Grants to facilitate the setting up of the plasma bank as well as the plasma council. ACT Grants is a not for profit coalition set up by top VC firms and start-up founders who have come together to provide grants between INR 1 lakh and INR 10 crore to start-ups and initiatives that are harnessing technology to create large-scale impact in the detection, prevention and eradication of COVID -19.

In an exclusive interaction with the BioVoice, Dr Shekhar Kirani, Spokesperson, ACT Grants and Dr Vishal Rao  Regional Director, Head Neck Surgical Oncology and Robotic Surgery, HCG shared their views on the operations of their respective organizations, why they feel that the plasma bank initiative is important besides various other aspects related to the plasma therapy.

For those who don’t know, Dr Vishal Rao is the inventor of the Aum Voice Prosthesis, a 1$ speaking device for throat cancer patients – an innovation that has been considered among the 100 global social innovations across the globe and received wide recognition from BBC, Harvard Business Review and Forbes.

With over 23 years of experience in business and tech leadership roles across several startups and large companies, Shekhar Kirani is the plasma therapy track lead in ACT Grants. Shekhar holds a PhD in Computer Science from the University of Minnesota and a master’s degree from the Indian Institute of Science, Bangalore.

Read the detailed interview below:

What is ACT Grants? Please tell us more about the ACT’s foundational story and its vision?

Shekhar Kirani: ACT Grants – Action COVID-19 Team was set up as an INR 100 crore grant created by India’s VC and start-up community to give wings to ideas that could combat COVID-19 with immediate impact. ACT Grants is looking at capital-efficient, scalable solutions from NGOs and innovative start-ups which need an initial seed grant to fight the spread of the pandemic.

The 3C approach adopted by ACT Grants will help the grantee companies by equipping them with Capital (1 Lakh to 10 Crores), Connections (Stakeholders like hospitals, governments, businesses etc.) and Consulting (strategy, planning and execution)

ACT Grants is a collective initiative of the Venture Capital firms and the start-up community of India. ACT Grants aims to enable teams that harness technology to create scalable impact within all the sectors in the battle against COVID – Prevention, Detection and Eradication.

What have been the key activities of ACT Grants and milestones achieved so far?

Shekhar Kirani: ACT has made some tremendous progress since its inception in April in terms of distributing PPR kits, testing across the country, tracking of high risk individuals, mental health and wellness, telemedicine and remote ICU facilities among others.

Across the country, more than 22 lakh testing kits have been delivered, 5+ lakh PPE kits have been provided, 16 million+ high risk individuals have been tracked, 3 million+ calls have been triaged and over 75000 Mental Wellness tele-consultations calls have been enabled. Overall, in terms of awareness about COVID-19, ACT has been able to reach over 100 million individuals.

What is the purpose of giving grants for plasma therapy? Why did you choose Dr Vishal’s project?

Shekhar Kirani: ACT is not only looking at creating awareness about COVID-19 but also focussing on the sustenance and post-COVID-19 phase. We are trying to reduce the impact of COVID-19 by whatever means possible and plasma therapy is one potential solution which could prove to be a lifesaver.

But there are a lot of open questions around the therapy – whether this works, what should be the dosage, etc.

Dr Vishal Rao from HCG has been conducting trials to establish whether the therapy works and if yes, what should be the SOP. Additionally, the team is creating awareness amongst donors and is also working to set up a plasma council to support and train others who want to set up a plasma bank. Dr. Rao is very passionate about helping COVID-19 patients in any way possible and brings a lot of expertise, experience and value which is why we decided to give grants to this project.

Which are the other areas of focus for your organization amidst COVID-19?

Shekhar Kirani: ACT Grants focuses on reducing the impact of COVID-19 and aims at attempting to flatten the curve. As of now, ACT is focussing on 8 tracks towards fighting the pandemic –Prevention of COVID19 spread, Scaling Testing, Disease Management at home, Enhanced support for healthcare workers and hospitals, Management of critically ill patients, Support for mental health, Sustenance and Vaccination and treatment

How much grant has been received by HCG from ACT? How has it helped?

Dr Vishal Rao: Grant of INR 10 lakhs has been given by ACT Grants for conduct of the clinical trials and setting up the plasma therapy project. We have used the grant to create a team of specialists, training the Volunteers, assist the state govt in creating necessary Sops and build a plasma therapy council which will help and support those who want to set up a plasma bank. We have also set up Karnataka’s first and India’s third plasma bank with the help of the grant from ACT Grants.

How does plasma therapy help patients fight COVID-19? How many patients have been treated so far? Could you please share more details?

Dr Vishal Rao: In the absence of standard treatment or vaccine for the novel coronavirus, which has killed over 19 lakh people globally, more and more countries are looking at ‘convalescent-plasma therapy’ as a possible way to treat the viral infection. When a pathogen like novel COVID-19 infects the body, the immune system produces antibodies to fight the invading virus.

In a recovered person, the antibody can be found in the plasma, the liquid that holds blood cells. The plasma constitutes around 55% of blood in the human body. In the plasma therapy, the antibody is taken from a recovered patient and put into the patient’s body. The antibody then creates passive immunization in the patient to combat the virus and recover. Passive immunisation is a technique to achieve immediate short-term immunisation against infectious agents by administering pathogen-specific antibodies.

Karnataka Plasma Bank has till date disbursed more than 48 units of convalescent plasma to most of the leading hospitals across Blr such as Apollo, Columbia Asia, Narayana Health, Fortis, St Philomena’s, Victoria Hospital, Mallige, Vikram, Aster CMI and RV among others. We have also successfully shipped plasma to hospitals in Hubli, Chennai and Mangalore.

A recent Trial from Mayo clinic was done on 20,000 patients using Convalescent plasma (CP) showing the potential benefits and safety of the therapy.

Has plasma therapy been fully validated with enough data through scientific research?

Dr Vishal Rao: A recent Trial from Mayo clinic was done on 20,000 patients using Convalescent plasma (CP) showing the potential and safety of CP. Similar studies published have shown a significant reduction in ventilator requirement in patients receiving CP.

This finding itself can offset the burden on healthcare systems and ICUs.In addition meta-analysis, and several published 12 papers, definitive reduction in viral loads, hospital stay and mortality, and all these subsequent papers have shown less number of days on a ventilator, less number of days in the ward, fewer patients require ventilation and lower mortality.

In our country, this will also help to decrease the burden on the hospitals. Faster recovery is expected to result in an earlier return to work and thus a lower socio-economic impact on families. Another noteworthy point is that this study used CP on severe and critically ill patients some of whom may already have had multiple organ failure. Hence it is important to note that earlier we intervene the better chances we have to save a life. The same may hold true for Plasma intervention.

Also, several studies have shown that convalescent plasma is safe with no side effects. The biggest setback with plasma therapy is no pharma promotion and backing. If it were packaged and sold like remdesivir, it may have necessary attention.

Please explain to us the process and journey of setting up the plasma bank?

Dr Vishal Rao: The COVID India Campaign under the aegis of ICATT Foundation in association with HCG hospital and Government of Karnataka has launched Mission COPE (COVID Plasma Endeavour) to promote Plasma donation from the COVID-19 recovered patients.

The plasma bank first identifies the donors, then collects plasma, stores plasma bags, issues units, then transports and then the transfusion takes place.

Would you like to share the plan and other details regarding the formation of the Plasma Council?

Dr Vishal Rao: The aim of the Plasma Council is to facilitate convalescent plasma therapy for COVID-19 as per statutory regulations. The key objectives include ensuring adequate and safe availability of convalescent plasma for COVID-19 patients; to assist government institutions and hospitals with setting up plasma banks in states, districts; training teams with SoPs for effective implementation of donor and receipt protocols for counselling, transport, Antibody titres, recipient team coordination; prevent illegal black-marketing of convalescent plasma therapy for COVID-19; to assist centres to create data confidentiality platforms for patient/donor data, and to analyse results of the off the label use and maintain data reliability. It also intends to assist innovations and research for studying immune responses and antibody tires for effective analyses of plasma donor and recipient responses.

Plasma Council will be constituted with the inclusion of haematologists, pulmonologists, blook bank officers, immunologists, patient counsellors, a representative from Drug Controller and a representative from the Health Ministry.

What are the future plans of the HCG team for plasma therapy treatment?

Dr Vishal Rao: We plan to help set up and assist state governments for more plasma banks, especially focus on district access and penetrability. In addition, we will also help in building stringent Standard Operating Procedures (SoPs) to utilize plasma banks effectively.