Patient 1: Sonoma COVID survivor hopes plasma can help save lives
It’s likely that Mary Flett had the second positive coronavirus test result in Sonoma County, making her “patient one” as it were. Though at the time she considered herself asymptomatic, upon reflection she realized that she had several signs of mild COVID-19.
But almost her first thought upon complete recovery was to donate her plasma, for its antibodies to coronavirus from her exposure. “I had heard that convalescent plasma was being used by hospitals around the country to help, not cure, COVID-19 patients who were in extremis,” said Flett, 67, a clinical psychologist who does phone consultation these days from her home.
Though it’s only recently been in the news having been conditionally approved by use by the FDA, and touted as a breakthrough by President Trump, convalescent plasma has been in use for COVID at least since March, in China, and is a treatment for infectious diseases that dates back to the 19th century.
“It is certainly no secret, and the capacity to collect plasma separate and distinct from other blood products has been around for years,” said Flett. Her physician suggested she might look into donating after her recovery, and Flett found Vitalent, formerly the Blood Bank of the Redwoods.
“According to them I was the first donor in the Santa Rosa lab,” said Flett, proudly.
As reported previously in the Index-Tribune, Flett had been a passenger on a Princess Cruises voyage to New Zealand, a cruise that was cut short by the global onslaught of the virus. The symptoms she had when she got home – runny nose, cough, fatigue – she ascribed to having allergies, being a former smoker, and having just flown halfway around the world. Looking back on it, Flett realized they may have been the mildest of COVID symptoms, but the only ones she ever had.
Mild symptoms, and in some cases no symptoms at all – the so-called asymptomatic positive – has always posed a significant hurdle to understanding the course of the disease and its spread. A not-inconsequential percentage of COVID positives, 15 percent county-wide, display no symptoms at all.
Yet the percentage of asymptomatic varies over age groups – while only 7 percent of victims between 45 and 54 are asymptomatic, 24 percent of those over 75 years of age have no symptoms, yet test positive.
That would put Sonoma County as a whole on the low end of the asymptomatic range: The Centers for Disease Control and Prevention last month estimated that rate at about 40 percent.
“I would isolate somebody who is symptomatic 10 days from their date of symptom onset, plus 24 hours of being asymptomatic,” said Dr. Sundari Mase, the county’s health officer. “Whereas for asymptomatic people, we just isolate 10 days from their test date.”
Flett, too, was declared recovered following her brief bout with COVID, and a 10-day isolation period followed by two negative tests. Yet, from the first, she had hoped to donate her plasma to help others combat the disease, and she did so three times at Vitalant’s blood donation center in Santa Rosa.
Blood bank donations are always important, but now more so than ever. Many blood drives, through schools or businesses, are no longer possible, and even the “bloodmobile” can’t be used because of social-distancing rules. But Vitalant is keeping up with demand to have four days of supply of each type of blood available for hospital use.
“We’re testing every single donor through the end of year to see if they have antibodies; doing this to help identify more people who can give convalescent plasma – there’s definitely a need for it,” said Vitalant spokesman Kevin Adler.
It comes from donors who have recovered from a coronavirus infection, and it’s the only FDA-approved treatment in clinical trials to fight the virus. “It’s the one thing that’s working,” Adler told the Index-Tribune.
Donating plasma is very similar to donating blood; the only difference being the withdrawn blood is run through a centrifuge machine to separate out the antibody-carrying plasma, while the rest of the blood is returned to the donor.
“The reason why the convalescent plasma can be used for severely ill people is simply because you can provide those antibodies, we think, that can fight the virus,” said Mase. “Having said that, I think we’re probably pretty far away from having those therapies available.”
Adler said they test all blood donors for the COVID-19 antibodies, and since April, donors have contributed more than 600 units of convalescent plasma in their bay area locations. “Now, with the FDA’s emergency use authorization these efforts will continue with additional urgency.”
Flett has an active mind and a scientific bent, and she follows the development of coronavirus research in medical journals from Yale and, until recently, the CDC.
“Looking into my crystal ball, we have not seen the fallout from this,” warns Flett. She lists her concerns, including secondary deaths (including suicide) from the psychological as well as physiological effects of the disease – deaths that could have been avoided, or mitigated, by better policy. “Government inaction, lack of policy, and the inability of the medical system as it is now set up to meet the needs of the people who are most in need of it have just made (the situation) worse.”
But she’s a psychologist, not a doctor, so she can only prescribe how to manage daily unrelenting stress, fear, grief in the loss of loved ones, and social isolation for the shut-in elders in our communities.
“The only way I as a psychologist know how to manage fear is to manage risk. I tell my patients, wash your hands, wear a mask, keep social distance, and require that anyone who may visit – including deliverymen, social workers or family – to follow the same rules.
“Take the proactive step of managing risk, and stress is reduced.”
Email Christian at email@example.com.