An potential medical intervention to contain COVID-19.

Two Johns Hopkins Public Health Professors of Immunology and Infectious Diseases, Arturo Casadevall and Liise-anne Pirofski, have proposed a relatively low cost way to contain COVID-19. The method has a history of effectiveness in other viral diseases and uses the antibodies from recovered patients. It offers promise as a Stop-Gap measure but requires significant numbers of recovered patients.

Passive antibody therapy has been used since the 1890’s to both treat and prevent infection in various diseases, including the 1918 Spanish Flu, a 1930’s Measles outbreak and more recently, the 2009 H1N1 Flu pandemic. The method has been researched and previously shown to have positive outcomes (reduced respiratory viral burden, serum cytokine responses, and mortality) for ICU patients with severe H1N1 infection.

The concept involves obtaining antibodies from the sera (by spinning the blood) of recovered patients. This is called ‘Convalescent sera’ — which is the clear part of the blood containing protective antibodies from patients who have recovered from the viral disease. These antibodies can then be injected into susceptible people or those with active disease. It effectively uses the immune protection afforded to recovered patients and transfers that to newly infected or ‘yet to be infected’ patients.

While every viral disease and its response from the population is different, there is significant evidence from the use of Convalescent sera over the past hundred years to trial this now with SARS-CoV-2 (the virus causing COVID-19).

One other significant advantage is that it is ‘relatively’ low tech and low cost. It requires the blood of recovered patients to be spun so that the serum can be separated and then the antibodies collected. Many countries have the facilities to do this. The technical and production advice could be provided remotely by experts in this field.

It also has the potential for large numbers of people to be both protected and treated. The downside is that it needs high numbers of recovered donors for blood serum.

It has some theoretical promise as a ‘stop gap’ measure until we get a vaccine in production or find other therapeutics.

Here is a link for more background;

https://www.jci.org/articles/view/138003

I would encourage this to be shared with your Public Health, Immunology and Infectious Disease leaders.

Kris Vette was Border Controller for New Zealand’s H1N1 (Swine Flu) Pandemic response in 2009. Previously he managed General Medicine and Infectious Diseases at St Georges Hospital in the NHS during the 2003 SARS outbreak. He is a Clinical Best Practice development expert and now runs an Emerging Technology and Genomic Medicine Consultancy.