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What Is Convalescent Blood Plasma, and Why Do We Care About It? What Is Convalescent Blood Plasma, and Why Do We Care About It?
(about 16 hours later)
A medical procedure doctors have used to treat novel diseases for a century has emerged as a focal point in the fight against Covid-19: convalescent plasma.A medical procedure doctors have used to treat novel diseases for a century has emerged as a focal point in the fight against Covid-19: convalescent plasma.
Conva-what-now…?Conva-what-now…?
Convalescent plasma is the term used for plasma that is removed from the blood of a person who has recovered from a disease, then transfused into a patient still battling it.Convalescent plasma is the term used for plasma that is removed from the blood of a person who has recovered from a disease, then transfused into a patient still battling it.
Yes, it sounds a little confusing. So allow us to break down everything you need to know about convalescent plasma — and why it matters right now.Yes, it sounds a little confusing. So allow us to break down everything you need to know about convalescent plasma — and why it matters right now.
Let’s start with a little biology lesson. I promise it’ll be fun.Let’s start with a little biology lesson. I promise it’ll be fun.
Plasma is the liquid part of your blood. It’s light yellow, and made up of about 91 percent to 92 percent water. It accounts for around 55 percent of your blood, with the other 45 percent being red blood cells, white blood cells and platelets. (Platelets help your blood clot.)Plasma is the liquid part of your blood. It’s light yellow, and made up of about 91 percent to 92 percent water. It accounts for around 55 percent of your blood, with the other 45 percent being red blood cells, white blood cells and platelets. (Platelets help your blood clot.)
Here’s why we’re talking about it now: When your body is exposed to a foreign pathogen, your body’s response is to produce antibodies, “which are proteins that can bind to the virus and help to deactivate it, clear it from circulation and prevent it from invading the body’s cells,” according to Dr. Jeffrey Jhang, medical director of clinical laboratories and transfusion services for the Mount Sinai Health System in New York.Here’s why we’re talking about it now: When your body is exposed to a foreign pathogen, your body’s response is to produce antibodies, “which are proteins that can bind to the virus and help to deactivate it, clear it from circulation and prevent it from invading the body’s cells,” according to Dr. Jeffrey Jhang, medical director of clinical laboratories and transfusion services for the Mount Sinai Health System in New York.
Those antibodies — your internal army working to vanquish foreign invaders — are contained in plasma. And once you’ve recovered, or convalesced, from a given virus, those antibodies stick around in your plasma for a certain amount of time, ready to fight that virus if it comes back. That length of time varies, and each virus requires its own antibodies, meaning that SARS antibodies, for example, are powerless to stop MERS.Those antibodies — your internal army working to vanquish foreign invaders — are contained in plasma. And once you’ve recovered, or convalesced, from a given virus, those antibodies stick around in your plasma for a certain amount of time, ready to fight that virus if it comes back. That length of time varies, and each virus requires its own antibodies, meaning that SARS antibodies, for example, are powerless to stop MERS.
But here’s the thing: Your soldiers can sometimes fight for other people. Doctors can extract convalescent plasma from a recovered patient, then transfuse it into a patient who is fighting the disease you recovered from. This means your antibodies may help that person’s own immune system in its war against the disease by accelerating the time it takes to develop its own army of antibodies.But here’s the thing: Your soldiers can sometimes fight for other people. Doctors can extract convalescent plasma from a recovered patient, then transfuse it into a patient who is fighting the disease you recovered from. This means your antibodies may help that person’s own immune system in its war against the disease by accelerating the time it takes to develop its own army of antibodies.
However, before we get too excited, it’s important to note that when it comes to Covid-19, we don’t actually know yet if our antibody soldiers can fight for other people. More on that below.However, before we get too excited, it’s important to note that when it comes to Covid-19, we don’t actually know yet if our antibody soldiers can fight for other people. More on that below.
Yes! Doctors have been using convalescent plasma transfusions to help patients fight diseases as far back as the Spanish Flu of 1918. More recently, the procedure has been used in patients with SARS, Ebola, H1N1 and more.Yes! Doctors have been using convalescent plasma transfusions to help patients fight diseases as far back as the Spanish Flu of 1918. More recently, the procedure has been used in patients with SARS, Ebola, H1N1 and more.
The name for this therapy is passive immunity. When you develop your own antibodies — say, through a vaccine — that’s active immunity. But when you “borrow” them from another person via convalescent plasma, it’s passive. This has been used when no other treatment options are available, and studies have suggested that it can help improve the condition of patients still suffering from various diseases, including H1N1 and SARS.The name for this therapy is passive immunity. When you develop your own antibodies — say, through a vaccine — that’s active immunity. But when you “borrow” them from another person via convalescent plasma, it’s passive. This has been used when no other treatment options are available, and studies have suggested that it can help improve the condition of patients still suffering from various diseases, including H1N1 and SARS.
“Convalescent plasma has historically been used therapeutically and for prophylaxis” — as prevention — “typically in times when a new disease, virus, bacteria comes on the scene and we don’t have any viral-specific therapies for that new or novel disease,” said Dr. Erin Goodhue, executive medical director of the American Red Cross.“Convalescent plasma has historically been used therapeutically and for prophylaxis” — as prevention — “typically in times when a new disease, virus, bacteria comes on the scene and we don’t have any viral-specific therapies for that new or novel disease,” said Dr. Erin Goodhue, executive medical director of the American Red Cross.
What is particularly noteworthy about using convalescent plasma to treat Covid-19 is that the treatment has never been used as widely as is now being proposed, Dr. Goodhue said. This means that, for the first time, the medical and scientific communities will be able to conduct the type of rigorous studies of the procedure itself to better determine its effectiveness. That type of study hasn’t been possible in previous uses of the treatment.What is particularly noteworthy about using convalescent plasma to treat Covid-19 is that the treatment has never been used as widely as is now being proposed, Dr. Goodhue said. This means that, for the first time, the medical and scientific communities will be able to conduct the type of rigorous studies of the procedure itself to better determine its effectiveness. That type of study hasn’t been possible in previous uses of the treatment.
It is also used to treat burn, trauma and cancer patients — a plasma explainer from the New York Blood Center calls it “liquid gold."It is also used to treat burn, trauma and cancer patients — a plasma explainer from the New York Blood Center calls it “liquid gold."
Remember when I said not to get too excited yet?Remember when I said not to get too excited yet?
As we learned from our biology lesson earlier, once a person recovers from Covid-19, his or her blood — more specifically, his or her plasma — contains antibodies that can fight the virus. Since this coronavirus is novel — no one had been exposed to it before this outbreak — our bodies don’t already contain the antibodies needed to fight it.As we learned from our biology lesson earlier, once a person recovers from Covid-19, his or her blood — more specifically, his or her plasma — contains antibodies that can fight the virus. Since this coronavirus is novel — no one had been exposed to it before this outbreak — our bodies don’t already contain the antibodies needed to fight it.
The medical community is racing to determine whether convalescent plasma will help those still battling Covid-19. But it’s simply too soon to know conclusively whether it works — the Food and Drug Administration only announced its initiative to collect convalescent plasma about a month ago. Some hospitals got a small jump on that, but it will likely be months before we have a definitive answer, experts said.The medical community is racing to determine whether convalescent plasma will help those still battling Covid-19. But it’s simply too soon to know conclusively whether it works — the Food and Drug Administration only announced its initiative to collect convalescent plasma about a month ago. Some hospitals got a small jump on that, but it will likely be months before we have a definitive answer, experts said.
“I’ve heard anecdotes of some patients improving, but I don’t have any results of any kind of rigorous nature to be able to share,” Dr. Jhang said.“I’ve heard anecdotes of some patients improving, but I don’t have any results of any kind of rigorous nature to be able to share,” Dr. Jhang said.
Dr. Goodhue echoed Dr. Jhang’s caution in drawing conclusions, but said there are encouraging signs.Dr. Goodhue echoed Dr. Jhang’s caution in drawing conclusions, but said there are encouraging signs.
“I’m still continuing to hear positive anecdotal evidence,” Dr. Goodhue said. “But to balance that out, there have been some cases where it just hasn’t seemed to work for a patient at all, unfortunately.”“I’m still continuing to hear positive anecdotal evidence,” Dr. Goodhue said. “But to balance that out, there have been some cases where it just hasn’t seemed to work for a patient at all, unfortunately.”
Still, more convalescent plasma donations means more opportunities to study its effectiveness. As of Wednesday, about 35,000 people have reached out to Mount Sinai, in New York, to see if they are candidates; about 6,000 have been screened for antibodies; and more than 1,000 high-antibody producers have been identified. Mount Sinai has given plasma to more than 150 people and counting, according to a spokeswoman.Still, more convalescent plasma donations means more opportunities to study its effectiveness. As of Wednesday, about 35,000 people have reached out to Mount Sinai, in New York, to see if they are candidates; about 6,000 have been screened for antibodies; and more than 1,000 high-antibody producers have been identified. Mount Sinai has given plasma to more than 150 people and counting, according to a spokeswoman.
The Red Cross has “distributed a couple hundred convalescent plasma products, and is projected to collect and process hundreds more this week,” according to a spokeswoman. It will be collecting donations at more than 170 locations nationwide. Thousands of potential donors have reached out to the organization, but less than 10 percent have met the F.D.A.’s eligibility requirements for donation.The Red Cross has “distributed a couple hundred convalescent plasma products, and is projected to collect and process hundreds more this week,” according to a spokeswoman. It will be collecting donations at more than 170 locations nationwide. Thousands of potential donors have reached out to the organization, but less than 10 percent have met the F.D.A.’s eligibility requirements for donation.
Updated June 5, 2020Updated June 5, 2020
So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement.
A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study.A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study.
The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April.The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April.
Mass protests against police brutality that have brought thousands of people onto the streets in cities across America are raising the specter of new coronavirus outbreaks, prompting political leaders, physicians and public health experts to warn that the crowds could cause a surge in cases. While many political leaders affirmed the right of protesters to express themselves, they urged the demonstrators to wear face masks and maintain social distancing, both to protect themselves and to prevent further community spread of the virus. Some infectious disease experts were reassured by the fact that the protests were held outdoors, saying the open air settings could mitigate the risk of transmission.Mass protests against police brutality that have brought thousands of people onto the streets in cities across America are raising the specter of new coronavirus outbreaks, prompting political leaders, physicians and public health experts to warn that the crowds could cause a surge in cases. While many political leaders affirmed the right of protesters to express themselves, they urged the demonstrators to wear face masks and maintain social distancing, both to protect themselves and to prevent further community spread of the virus. Some infectious disease experts were reassured by the fact that the protests were held outdoors, saying the open air settings could mitigate the risk of transmission.
Exercise researchers and physicians have some blunt advice for those of us aiming to return to regular exercise now: Start slowly and then rev up your workouts, also slowly. American adults tended to be about 12 percent less active after the stay-at-home mandates began in March than they were in January. But there are steps you can take to ease your way back into regular exercise safely. First, “start at no more than 50 percent of the exercise you were doing before Covid,” says Dr. Monica Rho, the chief of musculoskeletal medicine at the Shirley Ryan AbilityLab in Chicago. Thread in some preparatory squats, too, she advises. “When you haven’t been exercising, you lose muscle mass.” Expect some muscle twinges after these preliminary, post-lockdown sessions, especially a day or two later. But sudden or increasing pain during exercise is a clarion call to stop and return home.Exercise researchers and physicians have some blunt advice for those of us aiming to return to regular exercise now: Start slowly and then rev up your workouts, also slowly. American adults tended to be about 12 percent less active after the stay-at-home mandates began in March than they were in January. But there are steps you can take to ease your way back into regular exercise safely. First, “start at no more than 50 percent of the exercise you were doing before Covid,” says Dr. Monica Rho, the chief of musculoskeletal medicine at the Shirley Ryan AbilityLab in Chicago. Thread in some preparatory squats, too, she advises. “When you haven’t been exercising, you lose muscle mass.” Expect some muscle twinges after these preliminary, post-lockdown sessions, especially a day or two later. But sudden or increasing pain during exercise is a clarion call to stop and return home.
States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people.States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people.
Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.
Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.
If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)
Taking one’s temperature to look for signs of fever is not as easy as it sounds, as “normal” temperature numbers can vary, but generally, keep an eye out for a temperature of 100.5 degrees Fahrenheit or higher. If you don’t have a thermometer (they can be pricey these days), there are other ways to figure out if you have a fever, or are at risk of Covid-19 complications.Taking one’s temperature to look for signs of fever is not as easy as it sounds, as “normal” temperature numbers can vary, but generally, keep an eye out for a temperature of 100.5 degrees Fahrenheit or higher. If you don’t have a thermometer (they can be pricey these days), there are other ways to figure out if you have a fever, or are at risk of Covid-19 complications.
The C.D.C. has recommended that all Americans wear cloth masks if they go out in public. This is a shift in federal guidance reflecting new concerns that the coronavirus is being spread by infected people who have no symptoms. Until now, the C.D.C., like the W.H.O., has advised that ordinary people don’t need to wear masks unless they are sick and coughing. Part of the reason was to preserve medical-grade masks for health care workers who desperately need them at a time when they are in continuously short supply. Masks don’t replace hand washing and social distancing.The C.D.C. has recommended that all Americans wear cloth masks if they go out in public. This is a shift in federal guidance reflecting new concerns that the coronavirus is being spread by infected people who have no symptoms. Until now, the C.D.C., like the W.H.O., has advised that ordinary people don’t need to wear masks unless they are sick and coughing. Part of the reason was to preserve medical-grade masks for health care workers who desperately need them at a time when they are in continuously short supply. Masks don’t replace hand washing and social distancing.
If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.
If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested.If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested.
That’s an easy one: no, and yes — so long as you’re OK with the prick of a needle.That’s an easy one: no, and yes — so long as you’re OK with the prick of a needle.
The process takes between an hour-and-a-half and two-and-a-half hours. Though it’s somewhat similar to a normal blood donation — particularly the screening process during which donors are asked questions about their health history — there are significant differences.The process takes between an hour-and-a-half and two-and-a-half hours. Though it’s somewhat similar to a normal blood donation — particularly the screening process during which donors are asked questions about their health history — there are significant differences.
In a typical blood donation, a phlebotomist inserts a needle into a vein in your arm. That needle is connected to a hose, and that hose is connected to a bag. Your heart does the work here and pumps your blood into that bag, with the usual donation amount being about a pint.In a typical blood donation, a phlebotomist inserts a needle into a vein in your arm. That needle is connected to a hose, and that hose is connected to a bag. Your heart does the work here and pumps your blood into that bag, with the usual donation amount being about a pint.
A plasma donation, however, is like a closed-loop system.A plasma donation, however, is like a closed-loop system.
It starts the same as a regular blood donation, with a phlebotomist inserting a needle into an arm vein. But instead of your blood being pumped into a bag, it is drawn into a machine with a centrifuge, where the plasma is separated from the blood. The plasma is collected in a separate bag, and the blood that was drawn is returned to your body with a saline solution through the needle already in your arm. This process repeats a few times until the proper amount of plasma is collected, which varies based on weight. Side-effects are mostly similar to a normal blood donation, so you might feel a little faint or dizzy, but in most cases that’s about it. (Your body will replenish the lost plasma in a day or two.)It starts the same as a regular blood donation, with a phlebotomist inserting a needle into an arm vein. But instead of your blood being pumped into a bag, it is drawn into a machine with a centrifuge, where the plasma is separated from the blood. The plasma is collected in a separate bag, and the blood that was drawn is returned to your body with a saline solution through the needle already in your arm. This process repeats a few times until the proper amount of plasma is collected, which varies based on weight. Side-effects are mostly similar to a normal blood donation, so you might feel a little faint or dizzy, but in most cases that’s about it. (Your body will replenish the lost plasma in a day or two.)
A single donation can result in two to four units of plasma, each of which can be transfused into an ill patient. Exactly what happens to your plasma after donation depends on where you donate, but it will undergo tests to identify transmittable diseases, per F.D.A. regulations. Eventually it will end up being used to treat Covid-19 patients.A single donation can result in two to four units of plasma, each of which can be transfused into an ill patient. Exactly what happens to your plasma after donation depends on where you donate, but it will undergo tests to identify transmittable diseases, per F.D.A. regulations. Eventually it will end up being used to treat Covid-19 patients.
To qualify, donors must pass normal blood-donation requirements and be symptom-free of Covid-19 for at least 14 days, and, in most cases, must have positive results from a test. (Other restrictions may apply, depending on the organization.)To qualify, donors must pass normal blood-donation requirements and be symptom-free of Covid-19 for at least 14 days, and, in most cases, must have positive results from a test. (Other restrictions may apply, depending on the organization.)
Many health care institutions nationwide are involved in plasma donations, including the Red Cross, so to find a location near you go to the website for the National Covid-19 Convalescent Plasma Project or visit the Red Cross’s website.Many health care institutions nationwide are involved in plasma donations, including the Red Cross, so to find a location near you go to the website for the National Covid-19 Convalescent Plasma Project or visit the Red Cross’s website.
Unfortunately, probably not. The F.D.A.’s eligibility criteria include a positive diagnosis of Covid-19, along with being symptom-free for at least 28 days before donation; or at least 14 days without symptoms and a negative Covid-19 test.Unfortunately, probably not. The F.D.A.’s eligibility criteria include a positive diagnosis of Covid-19, along with being symptom-free for at least 28 days before donation; or at least 14 days without symptoms and a negative Covid-19 test.
However, a regular blood donation is still an option. Check the A.A.B.B. (formerly the American Association of Blood Banks) locator, visit the Red Cross website or call (800) RED-CROSS. You can also find information through the America’s Blood Centers website, or call (202) 393-5725.However, a regular blood donation is still an option. Check the A.A.B.B. (formerly the American Association of Blood Banks) locator, visit the Red Cross website or call (800) RED-CROSS. You can also find information through the America’s Blood Centers website, or call (202) 393-5725.