I don’t normally post something written by someone else, but given that we are about to be bombarded for the next four days from the Republican National Convention, White House, and FOXy News, about a new emergency cure that has just been given special fast track approval by the FDA, I thought it might help to have the insight of a real doctor who actually knows what the hell he is talking about. Talking heads and politicians are going to tell us that the tRUMPster will finally save us from the doctors and scientists with a miracle plasma cure that works even better than hydroxychloroquine and drinking bleach. And, as usual, it’s utter nonsense meant to play on our hopes and fears by a President who doesn’t give a damn about anything other than getting reelected.
Here is the simple, unvarnished truth from a respected doctor, an old Canyon friend, Dr. Bill Orman. Dr. Bill isn’t some quack, babbling on about demons and aliens. He practiced at Johns Hopkins and is now serving on the COVID-19 front lines, treating patients, with limited resources and support, on the Navajo Reservation. He is the veritable tip of the medical spear and he is a straight shooter. Here’s his medical opinion on Trump’s latest miracle plasma cure. I hope it helps cure what ails you.
“I was asked to comment on convalescent plasma and Trump’s unending attempts to portray himself as some sort of hero fighting the medical establishment and providing COVID cures that us dumb doctors would otherwise for some reason deny the public. OK.
People who have had COVID infections will presumably have IgG antibodies in the plasma (the yellow liquid portion of blood, as opposed to the red blood cells).
If you take that person’s blood and put it in a centrifuge, you can then harvest the plasma, hopefully full of anti-coronavirus antibodies.
You then infuse that plasma into a sick patient. You are hopefully giving the sick patient what we call ‘passive immunity’ — immunity their own body has not had time to develop.
Why?
Because the coronavirus antibodies are tiny Y shaped proteins that the other person’s body has made, and they specifically will latch onto coronaviruses and then allow the patients white blood cells to destroy the virus, by a variety of mechanisms.
Antibodies work best when they are already in your body at the time you get infected. They are waiting there like guard dogs, latch onto the invading virus, and clear it from the body. That’s the basis of what we call immunity. So antibodies are pretty good at preventing infection if they are present in large numbers before infection.
Antibodies are less effective if the virus is already in your body. In this case, you are hoping to Treat the infection, not Prevent it.
Why the difference? Because antibodies latch onto the surface of viruses.
Once a patient is infected, a lot of virus is inside cells and not accessible to antibodies. (The virus latches onto the surface of cells in our body, like in our lungs, and injects its genetic material into our cells, and tricks our own cells into replicating it (by the millions). A lot of the damage of the infection thus happens inside our cells and antibodies can do nothing to prevent this. Antibodies can’t get inside our cells. They literally float around in our bloodstream. If they encounter a virus there, they latch onto it like a magnet and stick to it. But not inside the cells of our body.
To extend my ‘guard dog’ analogy, the dogs will likely prevent the burglar from entering your house. But if you brought the dogs to the yard once those burglars are inside, well, not so effective.
So are antibodies worthless in already infected patients? Not necessarily. Eventually the infected cells will burst, releasing all those new viral particles that were made, and antibodies could help clear some of those out. A lot of damage has already been done, though.
The analogy again. The dogs might catch the one burglar that exits the front door. But the other three are safe out the back. And the damage to your house is done.
So this is not a miracle breakthrough or cure. We have used anti-serum or plasma in medicine for a hundred years or more. It was about all we had before antibiotics for some infections like diphtheria (Balto the sled dog was taking diphtheria anti sera to Nome, Alaska – the origin of the Iditarod sled race.) It might help a few patients. No one was hiding this. It’s already been in use at many institutions.
So how about giving it to the rest of us who aren’t yet infected? Would we then be immune? No. The infused antibodies don’t last long. A few weeks. Then you’d need another infusion. Forever. Not practical or really possible, since there’s limited plasma available.“
