‘Liquid gold’: New York’s convalescent plasma donor 0001 gives us a patient’s view into US COVID19 response

COVID19 survivor and New York’s convalescent plasma donor number 0001 Diana Berrent feels like a “superhero” in her new avatar as a potential lifesaver for other COVID19 patients. Doctors are calling her plasma “liquid gold” because she didn’t just clear the virus, she’s also a universal donor. In the of barely four weeks since she got infected with COVID19, Berrent has recovered and built a thriving grassroots movement called Survivor Corps for COVID19 plasma donors. She has a standing appointment at Columbia University to donate plasma every seven days. “It’s just an incredibly powerful experience,” Berrent said in a video interview from her home in Long Island, New York, the epicenter of the US outbreak. Speaking to Berrent affords us a patient’s lens into the US curve. Her anxieties are informed by an intimate experience of infection, recovery and advocacy during a pandemic. In her conversation, Berrent, a photographer who says she never got even a fever for a decade, explains why it will be a “disaster” if governments open up economies without getting the coronavirus under control. Berrent explains how most people who are lining up to donate plasma 14 days post-symptomatic are being sent back because the virus is still being detected in their bodies. Hidden within Berrent’s remarks is a level of granular detailing that’s often missing from the US federal response. We bring you five top takeaways from the Diana Berrent interview.

1. The patient experience of convalescent plasma donation

“I went into Columbia, they did a follow-up nasal swab, a diagnostic test to make sure that I no longer had the virus in my system. They took a couple of vials of blood to make sure that I had the antibodies, and that the concentration of the antibody was high enough for me to be a viable plasma donor. The icing on the cake turned out to be that I am a B blood type which for plasma is the universal donor. That's only four to five percent of the population. So as my doctor referred to it, my plasma is liquid gold, because it can truly be matched with those who have the rare blood types who are finding it harder to get match. A week ago, I called the New York Blood Center. I got the first appointment I could get. And I went in and I'll tell you a little about the process because it was amazing. I mean, in a lifetime, how many times can you save a single life? But in 32 minutes, I have the opportunity to save three to four lives and be able to do that every seven days. So I went to the New York Blood Center, and they took my temperature. They took my blood pressure, they did a finger to prick to make sure that I wasn't anaemic. Once I cleared all of those hurdles, which took about five minutes. I was brought back into the donation area, and it's just like getting blood work done except even better. What happens is they put the IV in and they take out the blood, and there's this machine sitting next to you which looks like it's science fiction, and it separates the plasma from the rest of the blood. It keeps the plasma and puts the blood right back into your system. It was 32 minutes from beginning to end. I drove myself there and home. I mean, it was the most gratifying experience. I have a standing appointment every seven days.”

2. “Disaster” if economies are opened up before virus is controlled

“I think it is a disaster, this idea of opening up before we have it (coronavirus) controlled. One of the unintended benefits of Survivor Corps is that we have collected one of the best data sets on survivors that exists. We were seeing story after story all telling the same thing. People were going to go donate their plasma 14 days post symptomatic — those are the rules in order to qualify for any study or any convalescent plasma program, and almost all of them are proving to still have the virus in their system. Remember in America, the only people who are getting tested on the back end of the virus are those going to give plasma. The convalescent (plasma) programmes weren't advertising this, but if you look at the numbers and you see how many applicants they have and how many people have been screened, and then ask them how many actual units of plasma they've collected — a lot of that (gap) has been because most people are showing up at 14 days still with the virus in their system. Now they could still be contagious. At the same time our CDC recommendation being mimicked by other states like New York which is the epicenter where I live, is that you should be able to release yourself out of quarantine and go back into society at a socially distant basis 72 hours post symptomatic. We now know that is not based on any science.”

3. “Act as if you’re already infected”

“COVID19 presents itself with a variety of symptoms. So each person has a different subset, and if you have any one or two of those, your best bet is to really just assume that you are already infected. Act as if you're already infected and every single person you infect is either your best friend or your grandmother. With the difficulty in getting tested, the chances if you're running around town trying to chase down that test, it's more likely that you're going to be shedding that virus everywhere you go. And if you didn't have it beforehand, I can guarantee you’ll have it after sitting in an urgent care office for four hours waiting for one and you’ll walk out with it. When other countries are looking at best practices, our initial testing would not be a model, for sure. Social distancing is I think a little bit like wearing a mask and gloves. It gives people a false sense of security and allows them to engage in behavior that is really detrimental to the public good.”

4. “No one in, no one out, no exceptions”

“The (US) social distancing guidelines are not enough. Not at all. We're now hearing that it can be 13 feet. We're now understanding that it can be tracked on your shoes. We really don't know a lot about this virus. And that's one of the reasons why I launched Survivor Corps is to basically mobilise an army of survivor volunteers to donate their plasma and to participate in every single study available, because the answers to so many of those questions lie in the bodies of survivors, and we can support those scientific efforts to figure out the answer. My recommendation is very simple. No one in, no one out. No exceptions. Don't go to the grocery store, eat that last can of tuna fish that's been sitting in your pantry for years. Now is the time to get to the bottom of your freezer. I don't think you can be too careful with this.”

5. “A complete Catch 22”: The rabbit hole of US testing 

“I woke up on 13 March, Friday the 13th, with 102 fever and I felt like I had this tremendous weight on my chest. I had a respiratory infection that I woke up with out of the blue. I hadn't had a fever for over a decade. And I had been very careful leading up to this. So the second that I woke up with those symptoms, I went to go get tested and I was told that unless I had traveled to China, Italy or Iran in the last couple of months….I had to prove that I had had 10 minutes of sustained close exposure to somebody who had tested positive, which I realised was a complete Catch 22. And that sort of started me down this rabbit hole of being kind of what I call the canary in the COVID19 coal mine. The system was broken down. The road to my initial testing was quite difficult. And it was only after I posted on Facebook about the situation, and the message — pardon the expression — went viral and it ended up reaching my Congressman who had to intervene to get me tested. This was very good for me but not a scalable solution.”

• Healthcare
• USA and Canada
• Convalescent Plasma
• COVID19
• New York
• Survivor Corps

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