Doctors in Bangladesh have been administering various drugs to alleviate the symptoms of the disease, including remdesivir, which is being tested as a specific treatment for COVID-19, and ivermectin, alongside convalescent plasma therapy.
According to them, the absence of a proven medicine is leading them to use these drugs to treat patients although they acknowledged that more research to be done to determine their viability.
Experts, however, are wary about the application of any drug before its efficacy is clinically tested and proven.
The Directorate General of Drug Administration approves the protocol for clinical trials of a medicine in the country while Bangladesh Medical Research Council or BMRC issues the ethical clearance.
Notably, both these institutions claim that no healthcare provider in the country has sought their permission to use any drug for the treatment of COVID-19 patients on an experimental basis.
Bangladesh has recently begun the clinical trial of plasma therapy, which involves collecting a blood sample from a recovered COVID-19 patient and transfusing separated plasma to a critically ill patient.
Plasma is a clear part of blood that is left when the blood cells have been removed and contain antibodies and other proteins.
The immune system of an infected person creates natural antibodies to fight the virus. The antibodies grow in number over time in the plasma of an infected person. Through plasma therapy, the antibodies are used to treat other infected patients.
The DGHS has formed a committee to oversee the clinical trial of plasma therapy which is being offered at different hospitals.
Families of COVID-19 patients are pleading with patients who already recovered from the illness to donate their plasma.
On May 16, Dhaka Medical College Hospital began the process of collecting plasma. They collected plasma from 21 people as of May 28.
As part of the clinical trial, these have been administered to 18 patients, four of whom were receiving treatment in DMCH, said Dr MA Khan, head of the hospital’s Hematology Department.
The DMC Research Ethics Committee approved the initiative, and according to the testing protocol, they’ll apply it on 45 patients, according to Khan.
“There’s no harm in trying to treat COVID-19 with plasma therapy, since there is no medicine available as yet. Now everyone is using the process in their own capacity. We can know the details and results of plasma therapy if it is applied in a controlled manner,” he said.
He urged the DGHS to ensure that plasma therapy is used in hospitals across the country in line with the rules.
Earlier, doctors in Bangladesh Medical College Hospital administered ivermectin and doxycycline to 100 patients, but they have since stopped using it on patients, said Prof Tarek Alam Khan, internal medicine and respiratory tract disease specialist.
“I saw a study in Australia that got fruitful results from using this medicine. I tried it on our patients and got good results. I believe we should try it on our patients,” he said.
“We’re preparing the protocol and may submit it to BMRC by next Tuesday. We expect to get approval for the trial on Jun 10, when they have a meeting scheduled,” he added.
Although the DGHS ‘guideline’ on COVID-19 treatment does not include the use of ivermectin and doxycycline, the medicines are being administered to patients in DMCH, Central Police Hospital and some other public hospitals outside Dhaka.
Central Police Hospital’s Director Hassan-ul-Haider said both the drugs were used to treat more than 500 patients with COVID-19 symptoms since Apr 25. The results have been good so far but it still requires detailed research, he said.
The DGHS guideline, however, makes no mention of the drugs and when asked why the hospital is still using them, Hassan said, “Ivermectin and doxycycline are not new medicines. They have no side effects and are easily available at a low cost.
“I have applied them on some of the patients in my hospital who had severe symptoms and they recovered. I haven’t treated them with any other medicine.”
