August 14 (Reuters) – In early April, a coalition of health systems in New Mexico began asking local COVID-19 survivors to donate their plasma, the anti-antibody blood product used to help people in hospital.
More than 50 people donated in May, but then the figures begin, according to data from Vitalant, a non-profit blood bank working with the coalition to recruit donors. In June, 34 people donated plasma to the attempt, the data show; in July it was just 29.
The struggle of the coalition is not unique. In the United States, home to the worst coronavirus outbreak in the world, the demand for COVID-19 Convulsion Plasma, known as CCP, is growing to keep sick patients alive. But the number of willing donors is not keeping pace, according to interviews conducted by Reuters with more than 25 regional hospitals, blood centers and other players of blood industry across the country.
Many said they had trouble convincing survivors to donate plasma, in part because it was a time-consuming process. This has led to a patchy supply that, in some regions, does not meet demand. It increases fears of CCP deficiency ahead of an expected increase in infections in the fall.
The U.S. Red Cross saw its CCP reserve fall more than 70% in July as the plasma sent faster across the country than it could recruit new donations, said Chief Medical Officer Dr. Pampee Young.
The New York Blood Center, a regional blood bank with 19 donation centers in the New York area, said its plasma stock, built during the city’s COVID-19 spike in the spring, gradually disappeared in June and July. , because the supply to coronavirus is hot spots like Texas and Florida.
Meanwhile, the US government Biomedical Advanced Research and Development Authority (BARDA) told Reuters that it had put earlier pressure to build a national reserve of CCP, acknowledging that there is not enough supply for a surplus.
‘DONOR FATIGUE’
The people who spoke to Reuters mentioned several factors for the challenging climate.
It starts with the relatively limited pool of eligible donors. The United States has had more than 5.2 million confirmed cases of coronavirus and 5 million survivors, but only a fraction meet the standards for giving plasma.
A plasma donor must meet the same criteria as a blood donor, which includes age, weight and health restrictions. Furthermore, to win the field, CCP donors must have tested positive for COVID-19 as its antibodies; many patients with suspected cases have never registered a positive test. They must also be symptom-free for 14 days before donating, according to US Food and Drug Administration guidelines.
“You have to go through 15 or 20 candidates to find a viable donor,” said Dr. Henry Wang, an emergency medicine physician at Memorial Hermann Health System in Houston.
The result is that some blood centers ask the same volunteers to give over and over again, leading to burnout.
“We look tired of donors,” said Drs. Norbert Topf, Chief Quality Officer at Presbyterian Healthcare Services in New Mexico. “People are getting exhausted.”
The process centers on an IV needle that extracts blood, harvests its plasma, then returns red cells and platelets to the donor’s arm. Adding paperwork, health figures and recovery time and visits can take nearly two hours, said Geoffrey Sorensen, a 33-year-old COVID-19 survivor and plasma donor.
And they can be emotional. Sorensen, of Huntington, New York, lost his grandmother to COVID-19 in March. He wiped tears in memory of how he spent each of his eight sessions mourning her.
Sorensen said he was glad he gave up, but added, “If you have a job, and you have a lot of other things to do, I can see where you can possibly say, ‘I went once,’ … I’m done.’ ”
Some blood centers said they could lose potential donors to pharmaceutical companies, which pay premium prices for CCP, and use it to develop anti-body-based drugs to combat the pandemic.
Japanese Takeda Pharmaceutical Company Ltd., for example, pays donors $ 200 for each of their first two CCP donations, before splitting them into regular new donor rates that average about $ 75.
Non-profit blood centers do not compensate for donations based on volunteers.
Sean Hemingway, head of BioLife, Takeda’s plasma collection arm, said Takeda pays premiums “in view of the urgency and importance of CCP collection”. He said the company gives donors the option to donate the money to charity.
A WEIGHT THERAPY
Plasma is the element of blood that carries water, enzymes and blood cells throughout the body. It also carries the antibodies that form humans to fight disease and stimulate immunity.
With no coronavirus vaccine or cure yet available, infusing sick patients with plasma containing COVID-19 antibodies has emerged as an important therapy.
Several studies have shown that plasma infusions can reduce the risk of death for patients in hospital. A preliminary analysis by the Mayo Clinic, which conducts a program to facilitate CCP treatment nationwide, also found that using plasma with higher levels of antibodies, earlier in treatment, reduces mortality compared to patients which were later treated in the disease, with lower levels of antibodies.
Dozens of doctors interviewed by Reuters earlier this year reported improvements in patients who received plasma early in treatment. (Https://reut.rs/3fZW2CR)
An estimated 150,000 doses of plasma have been given to US patients.
BARDA, the federal biomedical authority, had in June requested that blood centers preserve CCP in hopes of building a national reserve of 400,000 units. But it now realizes that it may have to wait.
“Unless collections can be increased, it’s unlikely that the country will be able to make an inventory,” said Elleen Kane, a spokeswoman for the U.S. Department of Health and Human Services, BARDA’s senior executive.
Diana Berrent, 46, a Long Island resident who commissioned COVID-19 in March, said she realized early on the need to mobilize survivors like herself, after receiving an email from Mount Sinai Hospital of New York in search of plasma donations.
Berrent started the Facebook group Survivor Corps “to encourage each survivor to donate plasma as many times as they are allowed,” she said.
The Fight Is In Us, a campaign to promote CCP donation, supported by nonprofit private donors and plasma collectors, uses celebrity sponsors such as actor Dwayne “The Rock” Johnson, and has a website with a searchable list of donation centers.
Blood banks say such efforts are helping. “We absolutely get leads from their registrants,” said Drs. Susan Rossmann, chief medical officer at the Houston-based Gulf Coast Regional Blood Center.
POISON CARDS AND RAFFLES
Yet banks are crawling to coax donors.
In California, the Houchin Community Blood Bank barely meets the demand for plasma, said Brad Bryan, chief executive of the Kern County-based facility. Kern has seen more new coronavirus cases in the last two weeks than any other California province except Los Angeles. Houchin supplies hospitals in her area and runs the country.
It has partnered with local restaurants to await donors with gifts. Houchin is also giving away a daily $ 1,000 split between two winners – not bad odds, given the modest donor pool, Bryan said.
Hoxworth Regional Blood Center, in Cincinnati, built up a large CCP reserve in the spring, when Ohio’s business totals were low. In June, as increasing cases created more potential supplies, donor traffic fell, Chief Medical Officer Dr. David Oh.
He reckons that the decline may have been due to plasma drifting out of the headlines lately, as well as the fact that when people return to work, they have less free time to donate.
To compensate, Hoxworth has relaxed certain donor qualifications, extended hours of plasma donation and improved collection methods to harvest more plasma from each donation.
The good news: Hoxworth has seen a slight uptick in August donations, Oh said.
Other blood banks, too, said this month looks brighter than last.
They include Arizona-based Vitalant, the nation’s largest non-profit blood bank of the nation, with 125 donation centers nationwide. But spokesman Clifford Numark said the “need” remained.
“Some weeks, what we collect is a little more than we need, sometimes it’s a little less,” he said. “But it’s always very, very tight.”
(Report by Nick Brown in New York; Additional Reporting by Francesco Guarascio in Brussels; Edited by Michele Gershberg and Marla Dickerson)
