Anesthesiologist and researcher Dr. Michael J. Joyner heads the convalescent plasma program at Mayo Clinic, which has been designated by the United States Food and Drug Administration to be the lead institution providing coordinated access to convalescent plasma for hospitalized patients with severe or life-threatening COVID-19 disease.
“Convalescent plasma” refers to blood plasma that contains antibodies to COVID-19 collected from people who have recovered from the illness and are otherwise healthy. The plasma is then transfused into a patient with advanced illness. The program headed by Dr. Joyner evolved out of a national initiative of physicians and researchers from 40 institutions who self-organized to investigate the use of convalescent plasma during the COVID-19 pandemic.
These institutions include Mayo Clinic, Johns Hopkins University, Washington University, Einstein Medical Center, the Icahn School of Medicine at Mount Sinai and Michigan State University, as well as other academic medical centers and government agencies seeking to establish a national convalescent plasma program to modify the course of the disease.
Fascinatingly, it is the Orthodox Jewish community, thanks to the initiative and organizational efforts of Chaim Lebovits—a Vizhnitzer chasid who resides in Monsey, New York—that has made this national program possible.
I spoke with Dr. Joyner last week.
You seem to have established a remarkable partnership with the Orthodox Jewish community.
The Orthodox community rocks! They really underpinned all of our collection efforts, allowing us to do over 10,000 convalescent plasma transfusions in just over a month, and they’ve also used their business and real-world skills to help us do a better job logistically and think more about customer service. It’s a classic three-legged stool: outstanding individuals, the success of the program and repurposing skillsets to innovate.
Can you tell us how those 10,000 people are progressing?
The safety data are excellent, and we’re pleased that the mortality rate doesn’t appear to be excessive. We just published a big paper, and the treatment appears to be safe when you consider how sick these patients are. We have a lot of very interesting anecdotes and trends that are pointing in the right direction, so as physicians we’re very optimistic. Nonetheless, we have to retain our scientific objectivity so we can make evaluations through the appropriate scientific methods and clinical trials.
There are numerous ongoing efforts right now to produce vaccines and drugs to treat COVID-19. How confident are you about this method matching up against others, and how important do you consider it to be?
One way or another antibodies are going to play an important role, and convalescent plasma is the first shot. Afterwards there are going to be hyperimmune products, which are refined versions of human plasma or laboratory-created antibodies, and in the end we will hopefully have a vaccine that will allow us to generate our own antibodies. I see it as a continuum. Is it going to wipe the scourge of COVID-19 off the face of the earth? That’s unlikely. Can we help temporize things in the short term while these other technologies come on board and hopefully be in a position to offer patients something better than what we currently have? I hope so, and then we can all wait for the vaccine cavalry to arrive.
Tell me how you first got involved in this initiative.
Professor Arturo Casadevall at Hopkins raised the idea of resurrecting this very old technology of passive immunity convalescent plasma in the current crisis. Arturo is a close friend of mine, and I believe he was thinking about doing this for experiments. But I thought we could do it on a larger scale, because as an anesthesiologist I know a little more about blood banking capacity in this country. Those two things sort of merged. But if you want to do something on a large scale you have to have a lot of donors, and that’s where the Orthodox community and Mr. Chaim Lebovits came in.
The people who are donating their plasma don’t know who the recipient will be; all they know is that someone out there will be helped by it. Is the United States the only country trying to do this?
There may be other countries, but we’re the only ones trying it on this scale.
You mentioned that this is an old technology, and I understand that it goes back to the Spanish flu of 1918. If so, why is there skepticism?
Any time what’s old is new again people are going to be skeptical, and you have to prove it to a new audience.