COVID-19 Family desperately scrambles for access to plasma therapy

Stephen Garcia’s family is desperate. A car bodyworker, just 32 years old, was staying in a ventilator at a hospital in the Los Angeles area for nearly two weeks, was severely ill with COVID-19 and was unresponsive and they went for him. I’m not aware of the fight.

For days, Garcia’s mother, his aunt, and his girlfriend, asked a doctor at Kaiser Permanente Downey Medical Center to seek treatment (recovering from COVID-19) in hopes of saving his life. Have been asked to try).

They know that it is not certain at all. But they have seen stories from all over the country: Colorado Anesthesiologist, Three Orlando Fathers, Dozens of patients in a Texas hospitalAll are under investigational treatment to stop the deadly virus called convalescent plasma. And I’m wondering why Garcia, the 9-year-old girl’s outgoing and ambitious father, can’t get it either.

“Why not give it a try?” Said Garcia’s mother, Irma Hornes, 52.

So far, their efforts have been futile. Hospital officials have declined through the Federal Food and Drug Administration to seek Garcia registration for clinical trials or extended access programs or for urgent personal use of convalescent plasma. Recently approved these routes For use in critically ill patients.

“The doctor just said no. His hospital did not participate in the treatment,” said Garcia’s aunt Sylvia Richard. “I don’t know how they say they are trying everything.”

Garcia’s plight highlights the lack of coordination and access inequality as COVID-19 patients are jockeys for unsuccessful families to receive unproven treatment. Even as the efforts to collect plasma from the first survivors of the novel coronavirus increase, the likelihood of being treated is limited to geographic accidents, social media savvy, and the treating physician. It seems to be motivated.

“Demand is going to be very high, but we expect that things like pipelines will take weeks to move from product streams to rivers,” said Chief Researcher Dr. Michael Joyner. of Convalescent Plasma Extended Access ProgramCoordinated by Mayo Clinic.

“This disparity exists in our system — not ours,” he said.

Blood centers across the United States in the last two weeks Accelerated efforts Theoretically, to collect COVID-19 convalescent plasma, COVID-19 contains protective antibodies that can transfer immunity from diseased patients to those still suffering.

Experimental practice was used during the devastating 1918 flu, as well as in the treatment of measles in the 1930s. Recently, plasma therapy has been used to treat victims of Ebola, SARS, and H1N1 influenza. this year, Early review of 5 patients with severe COVID-19 In China, it appeared to improve after receiving convalescent plasma.

However, the cure is currently being studied. Multiple clinical trials. FDA officials have revealed that while authorities have approved treatments for emergency use in patients with severe or severe COVID-19, many remain unclear. “Promising, convalescent plasma has not yet been shown to be safe and effective as a treatment for COVID-19,” officials wrote.

For example, it is unclear when the treatment will be most useful. Arthur Caplan, head of the Medical Ethics Department at the New York University School of Medicine, said in early studies that convalescent plasma might be most effective when given to people before or early in the disease. Has been suggested.

But it did not prevent the family from longing for a solution, he admitted. “You may want us to do anything, anything,” he said.

According to AABB, an international non-profit organization focused on transfusion medicine and cell therapy, fewer than 100 people have ever been treated with plasma through emergency procedures approved by the FDA. The group is affiliated SurvivorCorps, A grassroots exercise aimed at encouraging donated plasma to recovered COVID-19 patients.

So far, the use of COVID-19 plasma has been largely limited by the number of eligible donors. “The biggest problem, now the main problem is to increase supply,” said Joyner.

Potential donors were those with confirmed cases of testing for COVID-19 who recovered from the virus and tested negative for the virus. Eduardo Nunes, Vice President of Quality, Transfusion and Standards at AABB, said the blood center expects to eventually be able to collect tens of thousands of COVID-19 convalescent plasmas. .

But for now, supply is still in short supply. Dr. Alyssa Ziman, Transfusion Director at UCLA Health, said the blood center has begun collecting plasma this week.

Plasma’s promises against supply shortages have led families to seek their own sources. Last week, the family of Dr. Priya Khanna, a New Jersey nephrologist, turned to Twitter after being fed up with COVID-19.

“Plasma Donor was urgently needed for my beautiful sister who devoted her life to helping others,” read Wrench’s April 8 Tweet, widely shared by healthcare workers. The Canna family reported finding a donor within a day.

In Grapevine, Texas, Susendry began recruiting potential donors on Facebook after her husband, 64-year-old Billy Sendley, was hospitalized at COVID-19 on March 22. “I got 17 names on the weekend.”

One volunteer was found to be eligible. A young woman donated plasma at Carter Bloodcare in Bedford, Texas. One of the centers Collect plasma. The center’s medical director, Dr. Zeta Paranjape, said plasma was reserved for the Baylor Scott & White Medical Center Grapevine, where Billy Sendley is being treated.

“We rely on doctors using it in the best possible way,” said Paranjape.

On April 9, Billy Sendley received the plasma. “Don’t you want to give people a chance?” Susendrey said. “If you can do this, do it.”

Returning to Los Angeles, Steven Garcia’s family said he was denied the opportunity and was barely explained.

Garcia’s mother said she had repeatedly asked her son’s doctor about getting plasma in convalescence. “They don’t have much information and they don’t participate,” she said.

In an email, Kaiser Permanente spokeswoman Mark Brown promises that hospital officials will provide “state-of-the-art care for patients with COVID-19,” but will not comment on specific patients. I said no.

Brown did not send a Garcia doctor to the interview. Kaiser Health News contacted one of their doctors, Dr. Timothy Hulbert, a critical care expert, directly and did not respond to requests for comment. (Kaiser Health News is not affiliated with Kaiser Permanente.)

Brown did not address the question of whether the hospital system would provide convalescent plasma to any patient, not just Garcia.

“Based on both risk and potential benefit in a particular clinical situation, individual treatment decisions, including the compassionate use of potential therapies outside the scope of clinical trials, should be made between patients and physicians. It will be done, ”said Brown’s email.

To provide access to unproven treatment, hospital systems are not legally or ethically necessary, said Kaplan, a bioethics professor.

“Physicians can’t do it if they don’t think it makes sense given their previous use and the diversion of the resources needed to do it,” Caplan said. It was

Joyner does not deny that some patients have access to convalescent plasma and others do not. “Many of these decisions are made at the level of individual providers or groups of providers,” he said.

Obtaining plasma from a patient may not be beneficial. Despite the efforts of the Texas state donors, Billy Sendley remained unconscious at risk for a few days after treatment, his wife said. In New Jersey, Dr. Priya Kanna died early Monday. Family reported on twitter. She was 43 years old.

The sad truth is that it’s not yet clear how best to treat COVID-19 patients, especially those who need ventilators, says anesthesiologist Joiner. Doses of antibody-rich plasma remain promising, but not certain.

“The idea that a single intervention can produce a Lazarus-like effect? ​​It’s possible, but very rare,” said Joyner. “Turning those people around is a very difficult proposition.”