One of the country’s top studies on a potential therapy to COVID-19 could be delayed due to a stroke of irony: it’s struggling to find enough patients to treat.
Researchers across Canada have joined together to conduct a study, known as CONCOR (Convalescent Plasma for COVID-19 Research), to see if antibodies taken from people who have recovered from the disease caused by the new coronavirus can treat those still battling the illness. Dr. Dana Devine, the chief scientist at Canadian Blood Services (CBS), which is leading blood collection for the study, told iPolitics on Thursday that it may be prolonged because of a shortage of patients who are still sick with COVID-19.
“We want to do a study that has a total of 1200 patients in it. We know that’s going to take a while, particularly because, you know — it’s a good problem to have — but the study will take us longer to do than we thought, now that (the spread of the coronavirus) is slowing down,” Devine said.
For the first time this week Canada passed the threshold of having more recovered COVID-19 cases than active patients. As of Thursday evening, the federal government reported near 81,000 total cases in Canada, which includes around 41,000 people who have recovered.
According to iPolitics’ recorded data on infections, there have been between 428 and 1,915 new reported cases each day. There have been a varying number of tests conducted each day and there is no clear trend in the number of new cases rising or falling in Canada. A Health Canada page tracking new infections however says that while “new cases continue to be reported across the country… a decreasing trend in daily reported cases [has been] observed.”
“It is slowing down. So we end up with this predicted second waves then we’ll get more patients in the fall when that second wave comes,” Devine said.
The federal government has warned for weeks that it’s anticipating a second wave of infections. Loosening but not entirely peeling back social restrictions are provincial governments’ means of re-starting parts of the economy while mitigating another flurry of outbreaks.
The first transfusion of convalescent plasma to a patient with COVID-19 in Canada took place on May 14, at Montreal’s CHU Sainte-Justine hospital. Blood plasma is where antibodies are found. Scientists have theorized that drawing those antibodies from people who have recovered from COVID-19 and giving them to people who are still sick could help them recover from the disease. The same treatment was used to treat patients during the catastrophic Spanish flu epidemic of 1918 and people sick with Ebola.
The Canadian trial incorporates CBS, Héma-Québec (the Quebec equivalent of the national blood collection agency), 10 dispersed research teams and some fifty hospitals. The study is still accepting donors, but to date, according to Devine, has signed up around 1,000 people – around half of whom will qualify for donation.
Currently, convalescent blood plasma treatment is only permitted in Canada in a clinical trial setting. Per typical medical research protocols, the study will publish preliminary data.
“If it worked really, really well, and you could statistically show that with a much smaller trial size then you would stop your trial early,” Devine said. “And similarly, if you’re seeing it doesn’t work at all, and you can tell that early, then you would stop doing your trial as well.”
Health Canada has the discretion to expand the treatment beyond clinical trials, should the federal health department determine that available data proves it to be safe and effective.
A U.S. study of 5,000 hospitalized COVID-19 patients found last week that convalescent blood plasma treatment was safe, but was non-declarative about it’s effectiveness.
One observation so far during the study that Devine said she’s found interesting is the discrepancy in how different patients have reacted to COVID-19.
“In what kind of antibodies (the) body makes when it gets infected and how strong they are and how fast they build up and whether they are going to go away or stay there, the person to person variation is quite high,” she said.