Expediting convalescent plasma availability in Bangladesh
Due to rising Covid-19 infections, the demand for convalescent plasma is rising as well, since many countries permit plasma treatment for Covid-19. Convalescent plasma collected from a recovered donor may neutralise the Covid-19 virus on an infected patient, as the plasma may contain antibodies to the severe acute respiratory syndrome. Plasma is the yellowish liquid part of the blood which carries cells, proteins, electrolytes, carbon dioxide, and oxygen. There have been ongoing trials of using plasma to cure Covid-19 patients in many countries.
Recently, Covid-19 patients have been surging worldwide due to the rapid spread of coronavirus variants. Bangladesh is no exception. On April 8, 2021, a report in The Daily Star published data from Icddr'b showing that the recent increase in Covid-19 transmission in Dhaka was due to the South African variant of SARS-CoV-2. Worryingly, researchers have also reported that the AstraZeneca vaccine was found to be not as effective against the South African variant (New York Times, February 7, 2021). Thus, the current findings of Icddr'b came as a shock to public health professionals in Bangladesh. We need to improvise if we are to tackle this challenge.
In the past week, the number of infections have gone as high as 7,600 in 24 hours, and yesterday, 83 people died from the virus. It has been reported that almost all ICU beds are at capacity. The devastating news of a Covid patient's death on the road while searching for an ICU bed also made headlines in several newspapers.
In many hospitals, doctors are recommending plasma therapy to their moderate or severely infected ICU patients. Although we do not know the success rate, this initiative is encouraging. We have been observing a lot of such plasma requests in social media groups since April 2020. The example groups are Plasma Bank Of Covid-19 Survivor's, COVID-19 Plasma Helpline BD, Plasma Hunter Chattogram, Desperately Looking Plasma, Plasma Bank of Bangladesh (Covid-19), Plasma Bank Bangladesh (Covid-19), Plasma Bank, and Coronavirus Emergency Response Bangladesh. These people deserve special thanks for arranging these connections between the donors and patients. They have been putting a lot of effort into managing plasma on such platforms. The Police Hospital and many others must also be commended for managing plasma-related activities.
To improve the mechanism for requesting and collecting plasma donors, we propose a plasma collection framework. We can increase the number of donors simply by asking an additional question during the Covid test procedure. A patient needs at least two tests. The first time, when s/he has symptoms. The second test confirms whether the patient has recovered. If a positive patient transitions to negative, s/he becomes the potential donor. When communicating the second test result, we can ask for their blood groups and determine whether they are interested in donating plasma and want to be contacted. We store the contact information, test result and plasma donation consent in a centralised database. This practice can be introduced in the test centres. In this way, such an approach can increase the number of potential donors. Based on this database, we can develop an SMS-based system for the plasma receiving people. A person with a phone will send a message to a specific number looking for plasma by specifying the blood group and location (for example, O+, Dhanmondi). The mobile network operators then make queries to the central database. A query result contains a set of contact numbers of possible plasma donors in the specified region. The operator will send an SMS to the donors, and the interested donors will contact the patient or hospital.
The frontliners are working shoulder to shoulder to win this fight against Covid-19, but this fight can be won only if we all come forward. Since we have many recovered Covid-19 patients, we can expect a lot of possible plasma donors. We have been studying communications on social media platforms for 11 months, and have observed that there is a significant lack of donors against hundreds of requests. Since these groups are public, all the involved parties' privacy is in jeopardy, often leading to harassment. These platforms also lack sufficient resources to manage a verified donor list. Thus, we believe that the proposed plasma collection framework will reduce the vulnerability of both the patients and donors by managing a central database of personal information and saving lives by connecting plasma donors to patients in need. We request the policymakers to look into this matter with utmost seriousness to reduce the current fatality rate caused by Covid-19.
Dr Mohammad Ashraful Haque is Postdoctoral Fellow at University of Helsinki, Finland. Dr Ruhul Amin is Assistant Professor (Data Science) at Fordham University, NY, USA.