Doctor recovers, gives first serum donation at Methodist University
Until a month ago, when Dr. Daniel Wakefield tested positive for COVID-19, he and his wife, a nurse, were watching the disease unfold in the city from the front line.
Tuesday, he became part of a second front line by donating his plasma at Methodist University Hospital.
“My body was strong enough to fight this off,” said Wakefield, 30, a radiation oncology resident at West Cancer Clinic. “In a way, giving plasma is sharing that strength with someone else.
“When I think about why I gave, it’s what we do,” he said. “We help our neighbor as a healer. It’s why we train and study and work hard. It’s to help people, to heal people.”
Convalescent serum is plasma — the liquid portion of blood — taken from a person who has recovered from an infectious disease. It’s given to someone sick with the same disease. In a host of illnesses, including the 1918 Spanish influenza, serum helped people recover more quickly because they benefited from the antibodies in donor plasma.
ICU doctors at Methodist will infuse the serum in seriously ill COVID-19 patients and monitor the responses in intervals up to 30 days, as prescribed by the U.S. Food and Drug Administration and the Mayo Clinic.
“We are also in the process of expanding convalescent plasma transfusion across the Methodist hospital system,” said Dr. Arthur Townsend, vice president and chief clinical transformation officer.
Two to four patients could be treated with one donor’s plasma, he said.
Baptist Memorial Hospital has been using the therapy for several weeks. In every use, it is entirely experimental.
The FDA announced Mayo Clinic’s participation April 3. Methodist joined the consortium several weeks later.
“We’ve seen this virus in the Mid-South and across the country especially impact people who have pre-existing conditions like diabetes, asthma and kidney disease, among others,” Townsend said. “An effective treatment will also help us battle this virus if another wave hits our country.”
As of Wednesday, 1,886 health care institutions had joined the consortium, making it one of the largest convalescent serum studies in nation. Doctors in those institutions have registered 3,266 patients who meet guidelines for being moderately to severely ill. Of those, 1,199 have received transfusions, according to Mayo.
“This is an experimental approach sanctioned by the FDA, not a clinical trial. Overall conclusions about how well this works will not be available for some time, and then I suspect they will come from the FDA,” said Mayo spokesman Robert Nellis.
After quarantining at home, Wakefield has fully recovered and hopes his story will encourage other people to step forward to donate convalescent plasma.
“It was easy to give, very safe. The thought that with this simple needle stick and blood draw I could potentially save someone’s life, that was meaningful,” he said.
He recovered from the novel coronavirus in less than a day at home. His wife, who began showing symptoms at the same time, became much sicker.
As his wife’s case of the disease advanced, Wakefield started to worry she may not recover without going to the hospital.
“About day 10-11, she started to turn a corner. On day 13-14, she was asymptomatic again and back to her normal, healthy self. And I was so thankful.”
As soon as he learned he was positive, Wakefield called contacts at Methodist ICU.
“They said they were starting a test here for our patients. I said, ‘When you need my plasma, let me know.’ ”
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Dr. Scott Strome, executive dean of the University of Tennessee Health Science Center, is an enthusiastic supporter of antibody treatment, but wants proof of its effectiveness.
“My enthusiasm is tempered by lack of data. We saw that with chloroquine and other medicines. Sometimes, enthusiasm gets ahead of science, and when that happens, people can get hurt.”
Chloroquine, a malarial drug that has been touted as an effective therapy for the coronavirus, suffered a public blow this week when a Veterans Administration study showed in a study of 368 men who tested positive for coronavirus, that more died when the drug was used versus standard care.
While medical practice has experience giving patients convalescent serum, and there is anecdotal evidence it may work, the problem, Strome said, “is we have to truly show, in an unbiased study, that it does work.”
Antibodies in the serum bind to the virus in the sick patient. If they are neutralizing antibodies, they prevent the virus from entering a new cell.
“The good news is, in theory, if we give these antibodies to a patient, we can block the virus from entering into a cell,” Strome said.
While there is strong scientific rationale for the infusions, there are issues, he said.
First, donors must be able to prove they had the disease, which requires that they donate plasma in the clinic where they tested positive or have a copy of their positive test statement.
Methodist requires donors be fully recovered for at least 14 days. They must have a negative nasal swab test if their recovery has been less than 28 days.
“Each clinical trial will have different guidelines,” Wakefield said. “The main thing is making sure the patients (who donate) have completely recovered and have a negative test to confirm they are no longer sick.”
The second issue, Strome said, is that the level and kind of antibodies can vary from donor to donor.
“There is a presumption if you have been exposed, you are going to have antibodies and they will be neutralizing, but it is a lot more nuanced than that in real life.
“There will be different levels of antibodies in individuals. There will be different levels of neutralizing antibodies in different individuals. So, in order to do a clinical trial properly, you have to test all those things to know what you are giving,” Strome said.
“Right now, it could work in one person and not the other.”
The only way to know for sure, he said, is to administer the serum in patients grouped by age, symptoms and stage of disease and compare the results to the same groups of patients with serum from a donor who did not have coronavirus.
People who meet the requirements and want to participate in the Mayo study through Methodist may have their blood drawn by the American Red Cross or Vitalant.
Topics
Dr. Daniel Wakefield Methodist Le Bonheur convalescent serum Dr. Arthur TownsendJane Roberts
Longtime journalist Jane Roberts is a Minnesotan by birth and a Memphian by choice. She's lived and reported in the city more than two decades. She covers business news and features for The Daily Memphian.
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