By Dr. Anthony Policastro

There are several components in blood. Red blood cells are the ones most commonly discussed. They are the main component of blood transfusion.

White blood cells are the body’s infection fighting cells. Platelets are the cells used in blood clotting. The component of blood without cells is called plasma.

When a unit of blood is collected, it is separated in the laboratory into its components. That allows only the portion needed to be given to a patient.

For example when I was hospitalized in 2015 with low blood platelets, I was given platelet transfusions.

Widespread use of plasma transfusions began during World War II. Because it does not contain red blood cells, it can be used in any patient without being concerned about blood type.

Thus in wartime plasma could be used on the battlefield to replace blood volume until properly typed red blood cells could be obtained.

Over the years, the use of plasma changed. Even though platelets are the blood cells involved in clotting, there are a number of other clotting proteins that are contained in plasma.

Therefore, plasma’s main use right now is helping people with clotting problems.

During the Ebola virus crisis in 2014, studies were done using plasma from people who recovered from Ebola as treatment. They suggested that it was not very helpful.

Now we have approved the use of plasma from individuals who recovered from COVID-19 as a possible treatment.

We know very little about effectiveness to this point. The one thing we do know is that if you are going to use it, you need to use it early.

If you use it later, the death rate is higher.

We have not yet compared patients with no plasma treatment to patients who receive plasma treatment.

That was where the Ebola trials failed to produce a significant result.

Like all medical treatments there are risks associated with plasma transfusions.

A common one is related to the fact that the increased fluid load produced by the transfusion is sometimes more than the body can handle.

It can produce TACO (Transfusion Associated Circulatory Overload). The frequency of this is about 1 in every 10 to 20 patients.

As is the case with any foreign substance some individuals might have an anaphylactic reaction to some of the components of foreign plasma. It occurs in about 1 in 30 transfused patients.

Fortunately, most of the time it is mild. It only causes hives and itching from the hives.

Serious life threatening anaphylactic reactions are much less common. They occur in less than once out of 18,000 transfusions.

While there are very few cells in plasma, some do exist so transfusion reactions may still occur. Fortunately these reactions are rare.

Over the years, our blood supply has gotten very safe from the standpoint of infection screening.

Different forms of hepatitis and the HIV virus at one time were commonly transmitted via blood products.

That is no longer the case. Rigorous testing now occurs.

We need to make sure that this rigorous testing continues as we look at COVID-19 convalescent plasma.

We don’t want to treat one infection by giving the patient another one.

It is because of all this information that the FDA has given emergency use approval for the use of COVID-19 convalescent plasma as opposed to full approval at this time.

We have been using plasma for many years. We just need to continue to adhere to scientific principles as we have done over all those years.


Between August 23rd and 31st, new cases of COVID-19 remained between 33,000 and 48,000 daily.

This is higher than they were back in May and June. However, it is lower than they were in July and early August.

We appear to be holding steady at present.

It will be interesting to see if there is any kind of increase as schools open up over the next few weeks.

People continue refusing to wear masks claiming it is an invasion of their rights. It is unfortunate that some people’s brains are wired incorrectly.

Refusal to wear a mask is clearly the invasion of other people’s rights to avoid getting COVID from you.

The only right being invaded are those of the people coming into contact with individuals who refuse to wear masks.