A Pathway for Nursing Home Residents

The Problem

While the Covid Plasma Initiative, along with its affiliates, has made tremendous strides towards ensuring that plasma is available in all hospitals, there is one type of facility that has not had access to convalescent COVID-19 plasma thus far: nursing homes. Filled with the elderly and ill, nursing homes have borne startling numbers of COVID-19 patients - and deaths. Over 5,000 deaths in New York have been of nursing home residents, and some estimate that a third of COVID-19 deaths in the United States have been nursing home residents or staff.


The Solution
The Covid Plasma Initiative has been advocating for a pathway for nursing home residents to receive convalescent plasma without having to visit a hospital. There is support for this pathway on multiple fronts, including the NYC Emergency Management Department, the Mayo Clinic, and the New York Blood Center. Three entities must coordinate to enable this pathway to occur:

  1. Mayo Clinic, via their Expanded Access Program:

    • The Mayo Clinic Expanded Access Program (EAP) is an FDA-approved approach for hospitals to obtain access to convalescent plasma. Almost all hospitals that administer convalescent plasma do so using this program.  The Mayo EAP clears any FDA hurdles to treating patients with convalescent plasma.

    • We expect the EAP Protocols to be amended within the next few days to allow convalescent plasma transfusions outside hospitals.

    • Once that happens, physicians at nursing homes will be able to join the EAP, using the EAP website uscovidplasma.org.

    • The Covid Plasma Initiative has been coordinating this with Dr. Joyner of Mayo, who heads the EAP.

  2. Blood Banks​:

    • Blood banks must agree to supply the nursing homes with convalescent plasma. The New York Blood Center (NYBC) has already agreed to do so.

    • Dr. Shaz, CMO of NYBC, has proposed the following protocol for this to occur:

      • Nursing home would partner with a hospital transfusion service.

      • Nursing home would draw an appropriately labeled specimen and send to transfusion service for ABO typing.

      • Transfusion service would issue the convalescent plasma unit to the nursing home, and the nursing home would administer the unit.

      • Nursing homes would need to be trained on transfusion procedures - how to give plasma, double checking it is the right patient, looking for adverse events, and reporting adverse events.

      • Plasma can be administered at the patient’s bedside without the need of transport or hospitalization.

  3. NYS Department of Health:​​

    • The Department of Health must issue a waiver for transfusions to occur in nursing homes.

    • Dr. Shaz, CMO of NYBC, has contacted the Department of Health to explain the proposed protocol for transfusions