With a vaccine for coronavirus at least a year away, a group of scientists is hoping that a technique used during the 1918 Spanish flu outbreak can be used to fight the coronavirus pandemic.
Researchers hope that a “convalescent serum,” which uses antibodies from the blood of recovered coronavirus patients, can be pumped into people most vulnerable to the disease, either to prevent them from getting sick altogether or alleviate their symptoms if they do fall ill.
More than 4,600 Americans have tested positive for coronavirus as of Tuesday. Eighty-five have died, and health experts expect many more fatalities as the number of cases peaks in coming months.
In a paper published Friday in the Journal for Clinical Investigation, Dr. Arturo Casadevall, chair of the molecular microbiology and immunology department at the Johns Hopkins Bloomberg School of Public Health, said that a convalescent serum could work as a stop gap while scientists work on a vaccine.
“As we are in the midst of a worldwide pandemic, we recommend that institutions consider the emergency use of convalescent sera and begin preparations as soon as possible,” wrote Casadevall and co-author Liise-Anne Pirofski, of the Albert Einstein College of Medicine.
“Time is of the essence.”
While the first dose of a trial vaccine was administered to a patient in Washington on Monday, scientists say that it will be at least 12-18 months before a cure will be developed, tested and approved for widespread use.
Dr. Peter Hotez, the dean of the National School of Tropical Medicine at Baylor College of Medicine in Houston, is among those working to develop a vaccine. But in the meantime, he is coordinating with Casadevall to generate support for a convalescent serum.
“Drug development, vaccine development is a slow process,” Hotez told The Daily Caller News Foundation. “It’s the hardest thing to do to accelerate vaccines and drugs for an epidemic with a new pathogen.”
“The question is what do we do now to protect people.”
Hotez, who is also the co-director of the Center for Vaccine Development for the Texas Children’s Hospital, said that more than a dozen hospitals and medical schools, from Baylor School of Medicine, to Johns Hopkins, to the Mayo Clinic, are involved in developing a serum.
“It’s really sort of a throwback,” says Hotez.
“It was actually done during the 1918 flu pandemic where you isolated serum from individuals who had recovered from the virus, isolate the antibody, and then give that to patients either, sick patients, as a therapy, or give it in smaller doses to frontline health care workers or first responders, and they can be protected for a period of a couple of weeks. ”
Casadevall cited research from eight studies that found that serum use during the 1918 Spanish flu pandemic led to lower mortality rates. Serum was also used during the SARS outbreak in 2003 and swine flu pandemic in 2009, with positive results.
He cited a paper published in the journal Clinical Infectious Diseases in January 2011 that found that the use of convalescent serum during the 2009 swine flu pandemic reduced the viral load in patients’ respiratory systems, and mortality rates.
Hotez says that a serum faces several hurdles that could be overcome with a concerted effort from academia, the private sector and federal government.
“We’re going to need the federal government to help us with this because of all the regulations, and we need to ship serum across state lines, and all the FDA approval,” he said.
“It’s a bit of a complicated response, and therefore we’re hoping to bring the federal government into this.”
Health professionals would also have to identify donors willing to provide plasma, while coordinating with blood banks.
Hotez says the team has yet to speak with the White House about the proposal, but he hopes to raise awareness of the serum option through a sort of public relations campaign.
He estimates that antibodies from one recovered patient could potentially be used treat one person infected with the virus. Or, antibodies from one patient could be used in smaller doses as a temporary preventative measure for dozens of people.
“That antibody is usually enough to treat a very sick other patient. As a treatment, that doesn’t go very far,” he said.
“As a prophylaxis for first responders, health care providers,” he said, “a single donor can maybe protect 100 or more healthcare workers or first responders.”
Hotez emphasized a concern shared by other health experts over higher rates of infection for doctors and nurses who interact with coronavirus patients.
He cites reports from China suggesting that medical personnel there have relatively high rates of coronavirus infection, and have fared worse than expected with coronavirus. Hotez said that the cause of the adverse outcomes is unclear, but that it could be due to exposure to higher concentrations of the virus.
He pointed to reports who are in critical care after coming down with coronavirus.
“If this starts happening on a wide scale then that’s going to be very destabilizing.”