We Are Blood, the blood bank of Central Texas, has only a day’s worth of convalescent plasma on hand for people hospitalized with COVID-19, and doctors are having to prioritize who gets it and other treatments.
On Sunday, the bank was asked for 30 units of plasma taken from people who previously had the coronavirus, said Nick Canedo, vice president of communications at We Are Blood. One unit treats one patient.
Earlier in the pandemic, We Are Blood was being asked for plasma for 40 to 60 patients a week; after a few weeks, it doubled to 120 patients a week. Now it’s 30 a day, he said.
The Austin metropolitan area has more than 351 people hospitalized with COVID-19, including 60 people on ventilators and 114 people in intensive care units.
Plasma studies recommend treating patients with two units of plasma early on in the disease, said Dr. Kristin Mondy, associate professor and chief of infectious diseases at the department of internal medicine at the University of Texas Dell Medical School.
Now doctors are able to give only one unit, and they are prioritizing who gets it. They give it only to those who have signs of COVID-19 pneumonia. They wait until a patient needs escalating amounts of oxygen or is heading toward needing a ventilator. Patients whom the team does not believe will recover are not being given it, Mondy said.
"This is significantly different than where we were just three weeks ago," she said.
Area hospitals are not facing just a shortage of convalescent plasma, she said. They are also seeing shortages of an antiviral, remdesivir, and a steroid, dexamethasone, that are being studied for use in COVID-19 patients and are producing good initial results. Doctors now have to give the intravenous form of dexamethasone because they cannot get the pill form, she said.
"At the end of the day, we do not have a viable treatment (for everyone)," Mondy said.
Canedo said We Are Blood would like to have a stock of 100 units of convalescent plasma, but "the challenge is finding donors," he said.
Unlike other times of critical shortages, We Are Blood cannot rely on other blood banks to get plasma or blood because their needs are critical, too.
To donate, a person needs to have had a positive COVID-19 test or a positive FDA-approved or Emergency Use Authorization antibodies test, be 28 days away from symptoms, and weigh 110 pounds or more.
We Are Blood has an online form at weareblood.org that potential donors can fill out even if they are not yet 28 days from symptoms. The organization will contact people as they get to 28 days.
After donating, people can donate again 28 days later. We don’t know how long people can continue to donate every 28 days because we don’t know how long the antibodies will last, Mondy said, or whether the antibodies mean that you cannot get COVID-19 again.
Beginning the cycle of donation is still important because plasma can be stored for up to a year, which would help build a stockpile of plasma if cases decrease.
Canedo says that so far 600 people have filled out the form, but not all have qualified to give. The bank has collected from 150 donors. Most donors can give one unit at a time. Some larger people can give a second unit.
It takes about two hours to give plasma through blood donation. Plasma is filtered out by a machine, and the rest of the blood is returned to the body.
We Are Blood is also in critical need of all blood and platelet donations, especially from O+ and O- blood types, Canedo said.
Mobile blood drives have been closed during this time as businesses and schools have been closed. Donors are asked to make an appointment at one of We Are Blood’s three donation centers to allow for social distancing and increased screening and cleaning procedures.
People should not wait to go to the hospital if they are having trouble breathing with COVID-19 symptoms, Mondy said. They should not feel like they are taking a bed from someone else, she said. Often, they can be sent home with oxygen therapy if they are not in critical distress.
Recently, she is seeing more people wait to come in.
"They feel like they are doing OK, then it sneaks up on them," she said. "Don’t put it off."