A new mom came to see me after contracting COVID-19. She was too weak to lift her 3 month old baby boy off her chest. And she was afraid.
A surgical nurse was having lunch when he realized he couldn’t smell or taste his sandwich. He went straight home in quarantine.
Many patients note the inability to walk short distances around the house due to shortness of breath.
We inject these patients with plasma from someone whose body has rallied to produce antibodies that have already beaten the disease. With this additional immediate support from a survivor’s blood plasma – known as convalescent high titer antibody – many patients report improvement within days.
I cannot yet claim that this treatment will work for more people. My colleagues and I are trying to prove it. We are investigating whether convalescent plasma versus control plasma, administered in a double-blind, randomized clinical research trial, can prevent infection from developing in a person exposed to COVID-19 and prevent further development. infected person to fall if sick hospitalization. This tandem trial approach offers the dual potential of moving COVID-19 treatment from the hospital to an outpatient setting and providing a “ring of protection” around those exposed so they never get sick.
If our benchmark trial proves plasma is effective in both of these ways, consider the potential of the applications: A poultry processor that works closely with 15 others goes down with COVID-19. The patient receives a dose of plasma to get better, and each colleague receives a dose of plasma to prevent him from falling ill. The poultry line never stops.
Now apply that to a high school, a second shift in a distribution center, or an aircraft carrier.
The positive results of these ambulatory plasma trials could drastically affect how quickly society and the economy return to normal – even as we wait until promising vaccines and drugs are proven to be both “safe” and “effective” , the FDA standard for wider use.
Even with a vaccine, we will need immediate treatment options that can quickly reach huge numbers of people. Vaccine distribution takes time and it takes one to two months to develop antibody protection. Finally, vaccines are not always effective: some of the most vulnerable groups, such as the elderly and the immunocompromised, generally do not respond well.
Antibodies work. We need a therapeutic option between preventing infections with a vaccine and hospitalization with COVID-19.
Convalescent plasma was proven safe decades ago. Low cost technology has a long and successful story: It won the Nobel Prize in 1901 for curing diphtheria in children, was used in the last great pandemic of 1918, was used to curb outbreaks of measles, polio and mumps, and has been used successfully on more than 70,000 COVID-19 patients in U.S. hospitals.
The element of immediate early-stage effectiveness is what Johns Hopkins is currently working on, in collaboration with test sites across the country, and with the support of at least 1,100 volunteers who believe in finding a safe solution that has proven to be effective in making people better, earlier. We could find out if convalescent plasma is effective in the methods we’re testing as early as a month after full enrollment.
However, it is important for business and society to understand that our ultimate goal with outpatient plasma research is not to eradicate COVID-19: it is to keep people out of hospital, to make less harmful disease and cure people earlier.
If this treatment proves to be effective, we would be able to mark the curve flat and live with COVID-19, instead of stopping for two weeks every time infection rates rise too high.
Because plasma uses local blood bank systems, treatment and prevention of convalescent plasma can expand rapidly around the world such that time-dependent vaccines and drugs ramp up, supply chains, and international distribution networks simply cannot.
Blood plasma is already used around the world to treat other diseases. Sites that are already ready to provide blood plasma for these diseases would be ready to go and treat COVID-19. All they would really need, if found to be effective, would be a supply of high titer antibody plasma from recovered patients, a freezer for blood products, and a safe site for sterile infusions. No one owns the intellectual property of blood plasma. The price could be much lower than other options that will eventually emerge, making plasma a fair and affordable option.
There is hope in the darkness of the pandemic. If you are diagnosed with or exposed to COVID-19, or are a clinician working with patients who are, please follow the advice of health officials. Protect yourself and your loved ones.
Each of us can make a difference by creatively struggling to find ways to regain what we value. We can do it.
David Sullivan is Professor of Molecular Microbiology and Immunology at the Johns Hopkins Bloomberg School of Public Health and Principal Investigator for the Johns Hopkins University sponsored plasma trials. To see if you are eligible for the study, please visit CovidPlasmaTrial.org or call 888-506-1199.
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