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Comment by Retric | Hacker News Reader

You’re injecting blood products from another person so catching some other deadly disease is a real risk. Plasma is tested for AIDS and several other diseases, but prions for example are much harder to detect. Further, when you consider the risk of someone messing up on the supply side that opens up a host of issues.

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This paper has a good overview, they say the rate of adverse events is around 1/1700. So if it reduces your risk of death from respiratory failure in the next week by almost any positive amount, it's worth doing.

This is only going to be used in hospitalized patients who are already developing respiratory failure (low blood oxygen levels), not in random people off the street with a cough.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3356109/#S1titl...

I agree with you, but here is a direct quote from the article:

“it can be used for prevention of infection for people who are being exposed or it could be used for therapy for those who are sick.” This is not something to generally be handing out to people after simple exposure.

Researchers always talk about what could be but not necessarily what should be. Don't worry too much, in practice what you suggest will most likely happen.

I think your position is reasonable.

In the full perspective article [0], they advocate more for using this treatment to keep medical professionals from succumbing from the disease until a vaccine can be developed.

And they propose what seems like a pretty robust set of safety requirements

[0]: https://www.jci.org/articles/view/138003

That’s why there is comprehensive screening of donated blood which has essentially eliminated pathogen transfer and it’s used en masse everyday.

Screening is not perfect. https://www.redcrossblood.org/faq.html#eligibility-medicaltr...

“ You may not donate if you received a blood transfusion since 1980 in the United Kingdom or France (The United Kingdom consists of the following countries: England, Wales, Scotland, Northern Ireland, Channel Islands, Isle of Man, Gibraltar or Falkland Islands). This requirement is related to concerns about variant CJD, or 'mad cow' disease.”

That’s because methylene blue doesn’t kill prions.

https://www.medscape.com/answers/1389957-195354/what-is-the-...

That is interesting. I have always been told it was stricter than that - basically this:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1116429/

The US Food and Drug Administration (FDA) has imposed a ban on blood donations from anyone who has spent more than six months in Britain from 1980 to 1997 because of the possible risk of transmitting the human form of bovine spongiform encephalopathy, known as variant Creutzfeldt-Jakob disease (vCJD)

Nothing about receiving a transfusion there, just having lived in the UK was enough to make you ineligible to donate.

The American Red Cross restriction is weaker. Can anyone clarify?

Looking at the Red Cross page there is a separate travel section which says “ Persons who have spent long periods of time in countries where "mad cow disease" is found are not eligible to donate. This requirement is related to concerns about variant Creutzfeld Jacob Disease (vCJD). See - Eligibility Reference Material“

So i think there is a travel restriction and a transfusion restriction which are independent.

As you say pathogen transfer and other complications like GvHD are rare, but that’s also in normal situations. In a pandemic things change. This example is using plasma from China which is very much outside of normal channels.

Further, in a pandemic when staff are overworked and possibly sick, mistakes are going to increase. Viable in a life threading situation, less so: “for prevention of infection for people who are being exposed.”

Based on the HIV epidemic back in the 1980s, techniques have been developed to inactivate any pathogen in donated plasma. They can use detergents or heat.

Could something slip by? Sure, but it’s a pretty robust system.

What do those techniques do to antibodies?

Presumably nothing.

IV Ig is a very common plasma product. The therapeutic entity is the antibodies and they survive the sterilization process.

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