In an interview on May 14, 2020 with Radio Ibero, Mexico, Jorge Diener, the Associate Director of Hadassah International, spoke enthusiastically about the treatment, research and innovations that the Hadassah Medical Center is using in the battle against COVID-19.
Among the exciting innovations is the use of plasma. Diener stressed that this is an “experimental treatment” in which the antibodies of patients who have already recovered from COVID-19 can be used as a remedy to cure patients in a serious condition who have not manage to generate enough of the antibodies which are necessary to overcome COVID-19.
Diener clarified that these treatments are being implemented by a Hadassah research group that is collecting plasma from patients that had been infected with the Coronavirus and have now recovered. This plasma collection is being carried out in communities that have experienced a high presence of the virus. Using these samples, scientists can identify and test in laboratories the most effective ways to use this plasma to defeat the virus.
Diener mentioned that this is a very complex virus. Much is new and has not been seen previously. The symptoms and effects it causes in each patient are different. Medical professionals are still in the process of learning about it. “It is true that we need to find solutions immediately, but we have no choice but to trust that doctors are doing everything that can be done, to find the cure as quickly as possible, but also to do it in a way that really it works on all patients. ”
Regarding plasma treatment, he mentioned that it works like a “transplant”, so he stressed the importance of being very careful. The clinical trials need to show both feasibility and safety, and to show they do not harm the patient.
“What has to be measured very effectively and with great care is the dosage, the amount of antibodies that must be used for a patient who is sometimes in a very complicated condition. One of the problems is the anti-immunological storms that occur in COVID-19 patients when the patient’s body produces too many antibodies. This storm causes rapid deterioration, so it is all a matter of balancing what is being done to achieve the desired effect. The new antibodies must attack, but not too much, so that they do not also produce deterioration.”
In addition, Diener mentioned some measures that were carried out in Israel which helped to reduce the spike in infections. He said that the success in Israel was based on two fundamental elements. The first was the rapid and early closure of the importation of the virus by quarantining people who returned from abroad in institutions controlled by the State. The second was to minimize contact between people, to reduce community contagion.
“Very drastic measures of isolation were instituted requiring people to stay in their homes for a very long period. This lasted for several weeks and included a period when there were important festivals within the Jewish calendar such as the celebration of Passover. This helped to protect the most vulnerable population, which is the elderly.”
This isolation made it possible to really control the contagion and keep the number of infected people relatively low, thereby flattening the curve of infection. Israel was able to ensure that the hospitals would not be overwhelmed. They did this because they understood that:
- If there were an overflow of patients, there would not be enough beds or respirators for all seriously ill patients. (This was one of the major causes of death worldwide).
- It provided the time to learn and understand more about the virus.
- This time also allowed time for clinical trials to test some existing drugs on the market to determine how to use them at different stages of the infection and to make sure that they were effective.
Diener stated that “The Hadassah Medical Center is the leader in medical research in Israel. 60% of medical research is carried out in our center, by doctors who are researchers at the same time. The doctors continue to care for patients in intensive care where they are isolate. When they leave the ward, they go directly to the laboratory 3 meters away. Hadassah researchers are working to find the solutions. Flattening the curve bought them time to understand more about the virus. Before finding the solution, you have to understand what the question is. Before you find the solutions to the virus, you have to know more about the virus you are dealing with.”
Another Hadassah innovation is a method to carry out more testing for the virus at a much lower cost. Diener explained that:
“90 individual tests tubes can be tested every hour. Hadassah has introduced a system of pooling 8 samples into each test tube. This allows 8X90 = 720 tests to be done at the same time. If any of the test tubes come back positive, then only the 8 individuals who were pooled together in that test need to be tested again. Everyone else is known to be negative. ”
It is thanks to these type of innovations that it has been possible to save time and achieve a “less than one reproduction” coronavirus infection rate. This is allowing Israel to start to open up the economy. Israelis have now started to go out if they maintain the new normality that is social distancing together with the use of masks and hygiene.
Diener explained that in this “new normal”, economic, educational, social and cultural activities have to adapt to measures of social distancing until the vaccine is found. He clarified the importance of handling the release stage with great care so as not to return to a wave of infections once life is back to normal.
“You have to be very careful with the measures and the speed of the release. You have to decide what type of release is appropriate, understanding the risks associated with removing each of the restrictive measures.” He added “It is more than a health process. It is a process of social construction, of generating a new system for society. One that manage activities in a different way.”