The Defense Department wants to collect 8,000 units of plasma from patients who have recovered from COVID-19 -- part of a nationwide effort to study the effectiveness of convalescent plasma as a treatment for the potentially fatal illness.
DoD officials have pledged to collect the amount by Sept. 30, 2020, to boost research on therapies against the virus and treat those with the illness.
"We may want to ask you to stick your arm out and donate blood," Chairman of the Joint Chiefs of Staff Army Gen. Mark Milley said in a virtual town hall in late May. "What that can then do is help others who are severely ill, and if we can do that, then we'll be on a good path toward getting some really powerful therapeutics."
The Food and Drug Administration approved convalescent plasma as an investigational therapy in March for those hospitalized with the illness, and more than 35,000 patients in the U.S. have received it.
But there is no data that proves "definitively" that convalescent plasma works. More study is needed to determine what role it can play in treating the coronavirus, according to Dr. Janet Woodcock, director of the Center for Drug Evaluation and Research at the FDA.
Still, she added, "there have been encouraging reports and a lot of mechanistic reasoning that in fact convalescent plasma may be helpful."
"These studies are being done as we speak ... we need donors. Blood drives are ongoing, and the U.S. government will be trying to accelerate these drives for convalescent plasma," Woodcock said in a call with reporters Monday.
The DoD has started training medical personnel and administrative staff at 15 locations in the U.S. and Germany to conduct the COVID-19 Convalescent Plasma Collection Program. Those eligible to donate plasma include active-duty personnel, dependents, retirees and non-DoD civilians who have recovered from COVID-19 and have access to an installation where collections are being taken.
According to the DoD, military health providers are asking their COVID-19 patients to consider donating after they recover and are encouraging those who were treated elsewhere or who tested positive and self-isolated to consider participating.
"Our goal as a lifesaving program is to always provide a safe and ample supply of blood products. The need is now," said Army Col. Audra Taylor, chief of the Armed Services Blood Program, in a release. "We are calling for all who are healthy, able and eligible to donate today to help us all stand mission ready and save lives."
Research on COVID-19 antibodies continues to develop, but studies show that they appear to diminish in the blood within months of contracting the coronavirus. A new "pre-print" paper published last week suggested that antibody response dropped precipitously a month after symptoms developed.
Woodcock said the research shows there is a "fairly narrow window" of opportunity for collecting plasma containing a significant level of antibodies. "Six to eight weeks after recovery is the optimal collection for plasma," she said.
When a person becomes infected with SARS-CoV-2 -- the coronavirus that causes COVID-19 -- their immune system produces antibodies that attack the pathogen. Some antibodies are able to neutralize the virus, preventing it from entering cells.
It is thought that convalescent plasma helps fight the virus in patients whose immune systems have not generated a response to the invading pathogen. It has been used for more than a century to treat illnesses including scarlet fever, pertussis, the Spanish flu epidemic of 1918 and the Ebola outbreak in West Africa in 2015, albeit with mixed results.
Patients have differing levels of neutralizing antibodies. Part of the research involving the plasma is to determine the best time to collect it after recovery, test it for neutralizing antibodies, and when to provide it to sick patients for maximum effectiveness, according to Woodcock.
The antibodies found in convalescent plasma also serve as a source for another potential treatment for COVID-19: monoclonal antibodies. These are clones of isolated neutralizing antibodies -- either human or artificially created -- which are being developed and are currently in safety testing as an "antibody cocktail" to treat the coronavirus for patients both in and out of hospitals, she said.
The U.S. Army Medical Research Institute of Infectious Diseases, Walter Reed Army Institute of Research, and U.S. Army Medical Research and Development Command are working with companies on monoclonal antibody treatments.
The Biomedical Advanced Research and Development Authority awarded a $450 million contract last week to Regeneron Pharmaceuticals to develop its monoclonal antibody therapy, which is about to enter large-scale human testing.
Plasma taken at DoD locations will be used for such research and to give to severely ill patients.
The following locations are collecting convalescent plasma for the DoD:
- Walter Reed National Military Medical Center, Bethesda, Maryland
- Naval Medical Center Portsmouth, Portsmouth, Virginia
- Fort Bragg, North Carolina
- Fort Gordon, Georgia
- Fort Benning, Georgia
- Keesler Air Force Base, Mississippi
- Lackland Air Force Base Armed Services Blood Bank Center, Joint Base San Antonio-Lackland, Texas
- Fort Hood, Texas
- Fort Sam Houston, Texas
- Fort Bliss, Texas
- Naval Medical Center San Diego Blood Donor Center, San Diego, California
- Joint Base Lewis-McChord, Washington
- Tripler Army Medical Center, Hawaii
- Naval Hospital Blood Donor Center, Guam
- Landstuhl Regional Medical Center, Germany
Donating plasma is similar to donating blood and takes "just slightly longer" than giving a pint of blood, according to Air Force Surgeon General Lt. Gen. Dorothy Hogg.
Given the limited options the world has for treating the coronavirus, it could help save lives.
"We are counting on you to spread the word about this vital program by telling your friends, family and others in our Air Force community about the need for donors," Hogg said in a release.