I am a retired pathologist and the former director of the Blood Bank at the Veterans Administration Hospital in Washington DC, where I served from 1971 until 2005 when I retired.
Throughout my career, I authorized the release of plasma to many thousands of patients. Quite frankly, I am shocked that there has not been more publicity about how recovered COVID-19 individuals can donate plasma to help infected patients – particularly here in Israel where I now live.
Convalescent plasma therapy transfuses the antibody-rich plasma from recovered patients into sick patients.
Every COVID-19 patient over the age of 50 or with latent risk factors would immensely benefit from donor plasma transfusions at the time COVID-19 symptoms begin. And here in Israel, we have a perfect database to find plasma donors and begin plasmapheresis (the process in which the liquid part of the blood – the plasma – is separated from blood cells that contain antibodies).
Let me back up for a moment to just reassure you: modern blood banking makes this medical transaction – plasma transfusion – inordinately safe for both plasma donors and patient recipients. And this is why I am at a loss to understand why COVID- 19 plasma donation, the most valuable treatment for newly diagnosed patients, is not being extensively practiced to help us fight this coronavirus.
From the research that I have done, I can tell you at least one of the reasons: current practice in Israel is to save very scarce plasma therapy for very sick patients because donors are scarce.
The other reason, I believe, is that people just don’t know about it.
So the question that I keep asking myself is how can it be, given that as of the time of writing there are 98,550 cases of COVID-19 in Israel and 789 deaths – that we can go to sleep at night knowing that there is more we can be doing to help save lives?
Even if only 20% were plasma donors and volunteered for plasmapheresis, it would be enough to treat all new patients over 50 years of age. Moreover, each donor could volunteer more than once. And with increased testing, the database will only grow in size over the coming months and year.
Does Israel have the will to do it?
The answer in my mind is a resounding yes. As the Talmudic saying goes, “whoever saves a life it’s as if they have saved an entire world.”
Not only will plasma donors help save lives, but it will also help to lessen the awful long-term COVID-19 consequences for survivors.
Prof. Eilat Shinar, Blood Services Director at Magen David Adom, shared with me this past week over email, “We agree with you regarding the use of convalescent plasma in COVID-19 patients. Please direct COVID-19 recovered patients who wish to donate to [call] 03-9101101 and we’ll be glad to invite them.”
If all the sick in Israel were treated on the first day onset of their illness as outpatients with the donated plasma of recovered COVID-19 patients, I strongly believe that the death rate and seriously ill population would drop to a negligible number.
We should not have to wait until someone is really sick before they become eligible for convalescent plasma therapy; the earliest clinical diagnosis is absolutely key. In the Mayo Clinic convalescent plasma for COVID-19 therapy study, 35,322 COVID-19 patients were given plasma treatments between April and July. The lead researcher, Michael J. Joyner, M.D., shares that plasma treatments were used with the 1918 influenza (Spanish flu) and was commonly used before the advent of antibiotics and vaccinations. Specifically, prior to the antibiotic era, “treatment of respiratory infections with antibody therapy was most effective if initiated within three days of hospitalization.” Joyner comments about the best time to begin plasma therapy, “We want to treat people early, before they are on a mechanical ventilator, within a few days of diagnosis..use it early, early, early, early.”
Waiting for a laboratory result is precious time lost. Patients should be treated even before they get laboratory confirmation of their clinical diagnosis. Every hour makes a difference.
Moreover, rationing donations and limiting the plasma to the desperately ill is just not enough. There should be enough plasma so that everyone can be treated. Giving the plasma to someone only once they are desperately ill with COVID-19 is like braking your car after the collision. Waiting for extensive multi-organ calamity makes no sense.
My hat is off to the Orthodox community and Chabad in the United States who have championed the massive recruitment of convalescent plasma. We must do the same in Israel, and consider our antibodies as gifts to those who are ill.
Let’s use donor plasma and not fear it.
We need more recovered COVID-19 patients to donate their plasma. Plasma donations can be made 14 days after patients are declared recovered. Call Magen David Adom in Israel: 03-9101101.