A new mom recently came to me after contracting COVID-19. She was too weak to lift her tiny 3-month-old from her chest. And she was scared.
A surgery nurse was eating lunch when he realized he could not smell or taste his sandwich. He went straight home to quarantine.
Many patients note inability to walk short distances in the house because of shortness of breath.
We infuse these patients with plasma from someone whose body had rallied to produce antibodies that have already defeated the disease. With this added immediate support from a survivor’s blood plasma—known as high-antibody-titer convalescent plasma—many patients report improvement in a few days.
I can’t yet claim this treatment will work for more people. My colleagues and I are in the midst of trying to prove it. We’re investigating whether convalescent plasma versus control plasma, given in the context of a double-blind randomized clinical research trial, can prevent an infection from taking hold in someone exposed to COVID-19 and prevent an infected person from getting so sick they need 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 gold standard trial proves plasma is effective in both these ways, consider the potential of the applications: A poultry processor who works closely with 15 others comes down with COVID-19. The sick person receives a dose of plasma to get better, and each colleague receives a dose of plasma to prevent them from becoming sick. The poultry line never shuts down.
Now apply that to a high school, a second shift at a distribution center, or an aircraft carrier.
Positive results from these outpatient plasma trials could radically affect how quickly society and the economy return to normal—even as we wait for promising vaccines and drugs to be proven both “safe” and “effective,” the FDA’s standard for approval for broader use.
Even with a vaccine, we will need immediate treatment options that can reach huge amounts of people quickly. Vaccine distribution takes time, and they require one to two months to develop antibody protection. Lastly, vaccines are not always effective: Some of the most vulnerable groups, such as the elderly and the immunocompromised, typically do not respond well.
Antibodies work. We need a therapy option in between infection prevention from a vaccine and hospitalization with COVID-19.
Convalescent plasma was proven safe decades ago. The low-cost technology has a long and successful history: It won the Nobel Prize in 1901 for curing diphtheria in children, was employed in the last great pandemic of 1918, has been used to curb measles, polio, and mumps outbreaks, and has been successfully used on over 70,000 COVID-19 patients in U.S. hospitals.
The early-stage immediate efficacy element is what Johns Hopkins is working on now, in collaboration with testing sites across the nation, and with the support of at least 1,100 volunteers who believe in finding a safe solution that’s proven effective at making people better, sooner. We could know whether convalescent plasma is effective in the ways we’re testing as soon as a month after full enrollment.
It’s important for businesses and society to understand, though, that our ultimate goal with outpatient plasma research isn’t to eradicate COVID-19: It’s to keep people out of the hospital, make the disease less harmful, and get people better sooner.
If this treatment is proven effective, we would be able to stamp the curve flat and live with COVID-19, instead of shutting down for two weeks every time infection rates rise too high.
Because plasma utilizes local blood banking systems, convalescent plasma treatment and prevention can scale up quickly worldwide in a way that vaccines and drugs that depend on ramp-up time, supply chains, and international distribution networks simply cannot.
Blood plasma is already used worldwide to treat other diseases. Sites that are already prepared to deliver blood plasma for these diseases would be ready to go to treat COVID-19. All they would really need, if it’s proven effective, would be a supply of high-antibody-titer plasma from recovered patients, a freezer for the blood products, and a safe site for sterile infusions. No one owns intellectual property for blood plasma. Pricing could be much lower than other options that will eventually emerge down the line, making plasma an equitable, accessible option.
There’s hope in the darkness of the pandemic. If you’re diagnosed with or exposed to COVID-19, or if you are a clinician working with patients who are, please follow health leaders’ guidance. Keep yourself and those close to you safe.
Each of us can make a difference as we creatively fight for ways to regain what we value. We can do this.
David Sullivan is professor of molecular microbiology and immunology at the Johns Hopkins Bloomberg School of Public Health and a principal investigator for Johns Hopkins University–sponsored plasma trials. To see if you qualify for the study, please visit CovidPlasmaTrial.org or call 888-506-1199.
