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Monday, October 26, 2020

Fighting Covid-19, With Dolly Parton and The Rock - The New York Times

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NASHVILLE — I got sick in February on a trip to New York. Every time I stepped into an elevator, someone was coughing. On my last day in town, I found myself out of breath walking up a small hill, though I walk on hilly trails nearly every day. At home that night, I went straight to bed. I thought I was just tired.

The next morning, I woke to every symptom of Covid-19 I’d read about, plus some that hadn’t been reported yet: fever, headache, chills, cough, sore throat, body aches, nausea. At the walk-in clinic, my flu test was negative.

I was sick in bed for two weeks. Even after the fever finally broke, I was too weak to do much of anything. I’d take a shower and break out in a sweat as soon as I tried to step out of the tub. I coughed and coughed, and still it felt like an SUV was parked in my lungs. My primary care doctor ordered a chest X-ray, which showed pneumonia — a mild case, luckily. It was so early in the pandemic that Covid-19 tests were administered sparingly, and I didn’t meet the Centers for Disease Control and Prevention’s criteria for testing. “I think it’s reasonable to assume this is Covid-19,” my doctor said. “We just can’t prove it.”

During the next few months, proving it became something of an obsession for me. At a time when so much was frightening and unpredictable, I just wanted to know one thing for sure. In April I volunteered for a study by the National Institutes of Health to determine the scope of the epidemic by testing for antibodies in people, like me, who believed they’d had an unconfirmed case of Covid-19. More than 400,000 people volunteered for 10,000 spots. I wasn’t accepted.

Undaunted, I volunteered for a different antibody study — this one at Vanderbilt University Medical Center here in Nashville. I made the cut this time, but it was late August before I was called in. Would I still have antibodies in my blood six months later?

By the time I was accepted into Vanderbilt’s convalescent plasma study, that question meant something very different to me than it had in the beginning. I was long past looking for proof that the “flu” I’d had in February was Covid-19. More than 150,000 Americans had already died by August, and it felt like a gift to be offered a way to help save others.

Convalescent plasma is a treatment in which antibody-rich plasma from the blood of a Covid-19 survivor is given to a patient with an active infection as a way of inducing passive immunity. This is not the monoclonal treatment President Trump received when he was sick — those antibodies are grown in a lab from fetal stem cells. Convalescent plasma is the treatment the president was referring to back in August when he erroneously pronounced plasma “a cure.”

To be clear, convalescent plasma is not a cure; at the moment, there is no cure for Covid-19. But treating sick people with the plasma of others who have recovered has been practiced successfully since the early 20th century, and a trial started by the Mayo Clinic last spring suggests that it might be beneficial in some severely ill Covid-19 patients. But without placebo-controlled research, it’s difficult to know what truly works, which patients it works for, under which specific conditions it works for them, or what level of donor antibodies is necessary to induce that response.

Enter Dolly Parton.

The reason researchers at Vanderbilt can conduct a convalescent plasma study — and other studies — is that back in April Dolly Parton gave Vanderbilt $1 million for Covid-19 research. Nobody in Tennessee would find this news amazing: Ms. Parton is famous for her philanthropy — giving away nearly 150 million children’s books, for example, and giving each Tennessee wildfire survivor a stipend of $1,000 a month. Just for starters.

Allison P. Wheeler is an assistant professor of pathology, microbiology and immunology at Vanderbilt and one of the principal investigators of a convalescent plasma trial at Vanderbilt that was launched with Ms. Parton’s funding. Through a $34 million National Institutes of Health grant, that research was later expanded to 51 additional sites around the country. The team’s goal is to treat 500 patients with convalescent plasma and 500 others with a placebo.

“I am overwhelmed by the donor response to our study,” Dr. Wheeler said. “This has been a hard year for everybody, and seeing how much people really want to help has been a high point for me. But blood is a limited resource. At this time, we absolutely couldn’t give convalescent plasma to everyone who may benefit. We just wouldn’t have enough plasma.”

Enter The Rock.

The wrestler-turned-movie-star otherwise known as Dwayne Johnson has stepped up to be a spokesman for a public-private initiative called “The Fight Is in Us.” Mr. Johnson encourages Covid-19 survivors to donate plasma: “If you survived it, then you’re the heroes we need,” he says in a P.S.A. “You fought for your life. Now, let’s work together to take down Covid-19.”

The Food and Drug Administration has not yet approved convalescent plasma as a treatment for Covid-19, but it does allow emergency use in life-threatening cases. Creating a stockpile of convalescent plasma would make it possible to treat many more severely ill patients during resurgences of the virus before a vaccine is widely available. (Donating is possible all over the country. Click here to find out how.)

A caveat: Though the early evidence suggests that Covid reinfections are exceedingly rare, at least within this first year of the pandemic, it is far too soon to believe that surviving the virus means you are safe. You still need to avoid large gatherings. You still need to keep your distance from people outside your immediate household. You still need to wear a mask.

But being a survivor means you can help. Donating plasma takes a couple of hours, and it’s no more painful than a needle stick. Your own body will replenish the plasma within a day or two, antibodies included.

At my last donation, I watched a friend’s small, socially-distanced wedding on Zoom while I was connected to the apheresis machine, which was collecting my blood and sorting it into parts — plasma, platelets, white blood cells and red blood cells. Nothing says Peak 2020 like donating antibodies while watching someone get married on your phone. It was joyful event, even on a tiny screen. I held my phone with one hand, and I squeezed a ball with the other, helping the blood move through the machine more quickly. I watched my friends promise to love each other through good times and bad, in sickness and in health, and I prayed for their health. For everybody’s health.

Joy and hope may not be what you expect to find in a university laboratory, but it’s what I felt anyway. Joy and hope and relief that there is finally a way to help.

Margaret Renkl is a contributing opinion writer who covers flora, fauna, politics and culture in the American South. She is the author of the book “Late Migrations: A Natural History of Love and Loss.”

The Times is committed to publishing a diversity of letters to the editor. We’d like to hear what you think about this or any of our articles. Here are some tips. And here’s our email: letters@nytimes.com.

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October 26, 2020 at 04:00PM
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Fighting Covid-19, With Dolly Parton and The Rock - The New York Times

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