The day before I donated convalescent plasma, I almost backed out.
I was already screened for eligibility over the phone after having a positive antibody test showing I'd had the COVID-19 virus at some point. I had an appointment set at a local donation center.
But then, I got an email from the American Red Cross, likely in error, telling me they weren't scheduling appointments based on antibody tests anymore. "Over the past month, test results have shown that donors with a positive COVID-19 diagnostic test had COVID-19 antibodies more than 90% of the time," they said. "However, donors who did not have a COVID-19 diagnostic test, like you, only had antibodies present about a third of the time."
As a potential donor who was seeking to do something to help fight this virus—typically I'm only able to write about the folks who are able to do something—it felt like a blow. Did that mean, more likely than not, I wouldn't actually be helping?
That's simply a part of the reality that we are still living in, said Erin Goodhue, M.D., executive medical director of direct patient care with the Red Cross Biomedical Services.
"I've heard from my clinical colleagues and there have been some suggestions that, clinically, convalescent plasma can be really helpful but there are recent studies out that have shown it is not as helpful. That study did have some concerns with it which the researchers did discuss. But we're still not sure," Goodhue told me. "However, at this time in this pandemic, it is the most specific treatment option we have against COVID-19."
The answer to my antibody test question is also evolving, she said.
"If you get antibody result back that is not reactive or positive with us, it does not mean you did not have it," Goodhue said. "It's just that with the testing platform, with the information we have at this time, we can't use your plasma in that manner. But your plasma will still have amazing clinical use."
That clinical use includes, for example, helping patients bleeding in the hospital who are having trouble clotting, she said.
I ultimately decided there might only be a 33% chance my plasma could be used to help a COVID-19 patient, but a 100% chance it could help someone. (And I thought about Tom Hanks. If a national treasure could spare some time to donate, I supposed I could.)
For those who are unfamiliar, the process of plasma donation requires a needle in both arms. That's right, no bending your arms to look at your cell phone for an entire hour.
Your blood is removed from one arm and put into a sterile machine which separates the plasma from the other parts of your blood. Your plasma—which has the yellowish appearance of liquid cooking fat—is collected in a container while the other parts are safely returned to your body.
In this pandemic era, the blood donation center requires an appointment. Everyone must get their temperature checked the moment you walk in the door. You are not allowed to go back into the center until they are ready for you. The reclining chairs used for donors are spread at least six feet apart from each other. Everyone wears a mask.
I was the only convalescent plasma donor that day among a collection of people who clearly donate blood products such as platelets on a regular basis. The room took on the feel of a nursery, each adult covered in blankets as they were tended by a collection of donation center staff.
"What was your experience with COVID like?" the woman in charge of my donation asked about as she hooked up my left arm with a needle and some tubing. I told her I'd had a bad cough and a lost sense of smell back in March, but otherwise had a mild case. She told me I was lucky. While some donors have said they've had no symptoms when they tested positive for COVID-19, others have told her horror stories.
She tucked me in under a blanket and checked on me periodically for the next 45 minutes as I laid back and listened to music and tried to forget the fact that I couldn't bend my arms.
The only sign of discomfort I felt was about 20 minutes in when my lips began to feel tingly. I told the staff. They'd warned me that might happen and knew what to do, pulling down my mask and popping three antacids in my mouth. I don't know really why that works but it seemed to help.
At the end, I was finally freed from the needles and the tubes and handed snacks. "Here's your donation," the woman said to me, showing me a bag of the yellow liquid.
I decided to give myself some extra time to recover before I stood up to walk after my donation. (I've had a blood donation-related passing out experience once before and wasn't taking any chances.) But as I got up, I felt totally fine. That's probably because the parts of my blood that are returned were mixed with saline which helps rehydrate the body, I was told.
What happened next with the plasma is very similar to the process of a typical blood donation. It's screened for an infectious disease and blood type in the same way. (That also raises new questions for me since a recent study found some correlation between blood type and how sick some individuals got from COVID.)
In the early days of convalescent plasma collection, Goodhue said the Red Cross set up an online form for hospitals to sign up for convalescent plasma which was distributed on a first-come, first-serve basis. Now, hospitals are able to order the plasma in the same online ordering system they typically place their orders for other blood supplies. Supply is currently meeting demand.
That being said, they are still very open to accepting new convalescent plasma donors, as well as blood donors, to help continue to meet supply needs. On June 15, the Red Cross also added a perk for blood donors: a free antibody test for all donors.
I asked Goodhue if there would eventually be a feedback loop for donors to learn if their plasma had been used for convalescent purposes. She said the Red Cross is working on extending a feature on its smartphone app—which already tells blood donors which hospital their blood was sent to—to include plasma donors. But getting more specific than that about how it was used would be unfeasible.
Since the convalescent plasma program began, the Red Cross has collected more than 9,000 units of convalescent plasma aimed at helping save patients with COVID-19.
Hopefully, one of those units is mine. If not, I feel OK about that, too.