With a vaccine to halt the deadly COVID-19 pandemic a seemingly distant reality, several research institutions around the world, including The University of the West Indies (UWI), Mona, are exploring the use of convalescent plasma as a possible treatment.
The procedure dates back to the Spanish flu pandemic in 1918 and involves the collection of blood plasma – the yellow liquid component of blood stripped of its blood cells – from people who have recovered from a disease.
The UWI project has been approved by the tertiary institution’s research ethics committee but must get the green light from the Ministry of Health and Wellness before it can be administered. The group is also hoping that the health ministry will assist in identifying recovered patients.
“Jamaica started out with not very high numbers, but now, our numbers have climbed, and the number of persons in hospitals has certainly increased to the point where there are limitations on the ability to admit persons,” pathologist and lead researcher Dr Gilian Wharfe told The Sunday Gleaner. “So it seems to me that this is something that we could potentially do and improve outcomes for persons, get them out of hospitals quicker, and prevent them from going on ventilators.”
Last Sunday, United States President Donald Trump announced that the Food and Drug Administration had approved “emergency use” of blood plasma from COVID-19 survivors to treat other patients.
However, the World Health Organization is cautioning that it is still considered experimental therapy.
According to Wharfe, the process could benefit the very advanced cases although there was no guarantee of success.
“The University Hospital doesn’t have a large pool to choose from,” Wharfe said, “ ... so the Ministry of Health would have to allow us access to those persons because we tried to get support through the media, but only two persons have indicated an interest to participate.”
The project is fully funded by the University Hospital of the West Indies (UHWI), with the apheresis kits the last of the equipment to arrive from Uruguay last week even as the project awaits approval from the health ministry.
Health and Wellness Minister Dr Christopher Tufton told The Sunday Gleaner that he was aware of the research exercise but suggested that Chief Medical Officer (CMO) Dr Jacquiline Bisasor McKenzie would be best equipped to respond.
“It is not an option because you cannot take experimentation and give to persons when there is no validation of these things,” Tufton said.
When contacted, the CMO said: “I don’t know about a collaboration with the researching group. I am aware that the ministry’s ethics committee received the proposal for approval about two weeks ago. The ethics committee will look on the procedure to determine if it is safe, but I am not a part of the committee, so I cannot provide you with an update at this time.
“We get these proposals regularly, and we have to ensure that what is offered to our people is safe,” she added.
Bisasor McKenzie was also quick to point out that the deliberation sometimes requires the views of local and international experts to come to a conclusion.
However, Wharfe believes that the rate of the spread locally demands a more urgent response to accelerate the research.
“At the Mona campus research committee, all of the COVID-19 trials were speeded along the process, and for clinical trials, we put on extra meetings,” the renowned pathologist said. “I am not sure what the policy of the Ministry of Health’s ethics committee is, whether or not they put on extraordinary meetings in a situation that we have a pandemic, we have a spike, we have critically ill patients, or that we have a therapy that is being done internationally, a therapy that we would like to do locally.”
Wharfe said that Jamaica would have had a healthy plasma bank now if recovered patients were engaged since the emergence of the pandemic locally, “so that if we have somebody who is ill, we would not be looking around for a donor, but we would have plasma stored and could pull on it, just as you can go to the blood bank and collect the appropriate products that you need to save a life”.
A member of the scientific community, who spoke on condition of anonymity, is also calling for the Government to provide financial support for the research.
“The UHWI trains greater than 90 per cent of Jamaican doctors, and it is where the most challenging medical cases are sent, and it is where the most severe COVID-19 cases are also sent by that same Ministry of Health,” the PhD scientist said. “We are in a pandemic against the SARS-CoV-2 virus. All tools must be on the table, and the medical community needs to collaborate to protect the lives of the Jamaican people.”
“The ministry, of all places, should understand and take the lead by setting the best example as a collaborator. The university was proactive, and its leaders provided the space for its clinicians and scientists to develop this treatment protocol in alignment with internationally accepted guidelines,” said the source. “The Government should be footing the bill for this.”
According to the World Health Organization, nine candidate vaccines are currently being evaluated for COVID-19, including two from China, two from the US, one from the Republic of Korea, one from the United Kingdom of Great Britain and Northern Ireland, and one global, multimanufacture partnership. Two of these are in Phase I trials, two are tech transfers, and the remainder are at the discovery stage.