Plasma Therapy For Coronavirus: What Its Like To Look For Donors In Delhi

Adwitiya Mal and Mukul Pahwa started Dhoondh , a website to match plasma donors in Delhi with Covid-19 patients in need, in June after Mal’s experience during his father-in-law’s treatment for the disease exposed him to glaring gaps of information in the system.

“This did seem like a problem that could be solved with information,” Mal told HuffPost India over the phone. 

The two friends invested roughly Rs 2.27 lakh from their savings in setting up the website in the second week of June, even as the Delhi government estimated cases in the capital would shoot up in the next few weeks.

Plasma therapy uses antibodies from people who have recovered from a disease to treat patients and boost their immunity. In the case of COVID-19, this is still considered an experimental treatment and usually used to treat critical patients. In India, 113 medical institutes are participating in a clinical trial led by ICMR to test the efficacy of the treatment. The health ministry last week said   plasma therapy may be considered for patients with moderate illness with no improvement in condition despite the use of steroids.

“Everybody is constrained in how to go about doing this. It’s a complex process, the matching is a complex process. It has to have enough people (working) on it, to be meaningful. We got lucky, but the more people there are, the more people will get luckier, both on the donor and the recipient side,” Mal said.

Their initiative has been functioning with the help of Mal’s wife Kanupriya, and volunteers who man the phones. Currently, the team receives 25-30 requests in a day.

“I’m sure there are people better equipped than us to do this. We’ve just taken it head on,” he said.

In an interview with HuffPost India, Mal talked about the work that goes into finding plasma donors in Delhi, where the gaps in information lie and what the government could do. 

You have created a website to coordinate between patients and donors. Are there other platforms you are working on as well?

We have volunteers to contact people who are registering on the website. We find that the website is probably the best way to coordinate. We are also going to be on social media soon. People who have our number do reach out to us through that. But we end up spending more time on it. It’s ok, desperate times call for desperate measures. We try to respond as fast as we can. But we are trying not to break the flow of the system.

When a patient or donor reaches out to you, how do you verify the information they are providing?

We have to call up both the donor and the patient and these are two separate work streams where we are trying to vet the information they have got. Sometimes we have to clarify to them what a donor can be and what a donor cannot be. For eg: it has to be a recovered Covid patient who can donate plasma. A lot of people don’t know that but also want to come forward and help people who are in trouble. We have to vet that. Those kind of things we are solving for so that we can bring down the matching time as far as possible.

It has to be 14 days since the donor has recovered (from COVID-19), according to most recent information we have been getting. Some hospitals want 28 days, some say 14. It really depends from hospital to hospital.

We are not an authority on it, we just connect the right people to each other and then the patient speaks to their doctor. It’s left for the doctor to decide.

In the process, do you end up coordinating with the hospital or the doctor?

No, we only connect the donor and whoever is acting on behalf of the recipient. Once a match has been made— and there is criteria for that as well, a donor cannot be above a certain age, should not have conceived, shouldn’t have high BP or kidney problems — but even after that the donor goes to the hospital where the treatment is going to take place, the hospital does its own tests, then they call the donor the next day if they have passed the tests. Every hospital has its own checks in place. Our job is restricted to connecting the patient and the potential donor.

How difficult was it when you were looking for donor for your father-in-law?

It is difficult. It took us about four days and when a patient has reached the plasma stage, then they’re getting into a critical stage. At that point, every minute, every second, every hour matters. So four days in that scenario is like an eternity.

It took us two days to find someone and once we did find someone, when the donor reached the hospital they got rejected because of a certain criteria. So we had to start all over again. So that set us back by two days and we had to do it all over again.

It’s basically a lot of information gaps also that end up wasting time, that’s really why we thought this initiative might be important.

At the time, how were you looking for donors?

Just through WhatsApp, Facebook , messaging people we know, everybody in our address book. I think we got lucky. There’s no method to this madness.

Now that you are helping others through this process, do you feel the process has been made easier in some way?

It’s still tough at the moment. Let’s be honest, we’re just a few days into this. We are also building up our database of donors and cleaning it up and so on. I don’t know if we’ve been able to do what we want to do just yet. But we’re seeing snippets of it. My ideal would have been a one-day exercise, we’re still not there.

How many requests do you get in a day on an average?

We’re getting about 25-30 people.

What has it been like for you to do this, trying to fill a gap as we go through this unprecedented situation?

On the one hand, it’s extremely saddening talking to someone’s parent, brother  or loved one is in a critical stage. It’s emotionally wracking. And it’s not just me, my wife whose father was going through this, she’s been manning the phones more than I am. She goes through that with every call. What’s keeping us going is that somebody’s got to do something, right? And we’re all trying to figure out our way through this pandemic. And better than sitting around, it’s probably now time to get on the frontlines and do something.

Cases in Delhi are projected to increase significantly in the coming weeks. Do you have a sense of what managing this will be like for your team?

We’re trying to automate as much as we can, on one hand. On the other, we’re trying to get as many volunteers as we can and some volunteer coordinators. Because all of us right now have other responsibilities, so this shouldn’t falter in the midst of that. So the best way to do that is to build up our resources and abilities to do this.

Where we are today in terms of volume of requests, we actually thought we would be 2-3 weeks away from that. I’ll be honest, we were at that stage within 2-3 days (of starting the Dhoondh website). This is probably going to get (more) significant in terms of people who are going to reach out to us.

How many people are currently working on this?

It’s about ten odd people on a volunteer basis.

Is there anything that the medical infrastructure or government could do to make this process easier?

See, the government knows who is a positive patient. And you have to be former positive patient to be a donor. So, I think this is a system government should be using, or something like this, to accelerate what needs to be done. It’s just a system that we have set up. It’s just a process of matching donors, and they have that information.