Bolivians Recovered from Covid-19 Get Job Offers in Exchange for Blood Plasma

RIO DE JANEIRO, BRAZIL – In Bolivia, a 400-milliliter bag of blood plasma from a person who has recovered from Covid-19 can be exchanged for a job, the payment of debts, or cash amounts ranging from between some R$2,500 (US$500) to over R$15,000.

This trafficking is one of the collateral consequences of the Ministry of Health and most Bolivian hospitals’ bet on hyperimmune plasma, a blood component of those who have overcome the disease and which, in this country, is considered a last hope for critically ill patients.

Most donations were voluntary, but health officials admit that there have been “multiple violations” as incentives for those willing to donate plasma have multiplied: many companies and businesses offer discounts or gifts to clients who have donated, and at least two universities have announced that they will accept students with no entrance exam if they prove they have donated.

Several countries, including Brazil, are doing research on the use of plasma from convalescent individuals to fight the coronavirus. In the procedure, which has already been used in other epidemics, the plasma from a cured patient is transferred to an infected person.

The goal is for the antibodies in the plasma to provide immunity, helping to reduce infection and the viral load of people with the disease. However, no studies have yet proven the efficacy of this therapy.

In Bolivia, which recorded a total of 26,389 cases and 846 deaths on Wednesday, the pandemic produced an opportunity for people with scarce resources who survived the disease. Given the despair of patients’ families, there are some who accept to join the illegal plasma sales trade, which thrives amid the collapse of health services and can be punished with up to eight years in prison.

“What has distorted voluntary donation? The fear, turned into panic, of losing a relative. First, people start asking for plasma on social media after the first diagnosis, the first positive result, unsure whether their relative will get to treatment or whether or not they will need the plasma. Just in case…,” says journalist José Pomacusi, who covers the impact of the pandemic in the populous eastern city of Santa Cruz de la Sierra, the most affected by Covid-19 in the country.

“Secondly, whoever has money or a company offers a payment or a job in exchange for plasma. Some offer US$500 (R$2,576) and others pay up to US$3,000 (R$15,458). Those who own a company offer the potential donor a job, should they become unemployed”, says Pomacusi.

In Santa Cruz and two other cities, Trinidad and Cochabamba, public and private medical services, in particular ICUs, are paralyzed. In La Paz, the seat of government, the situation is only slightly better. Every day there are reports of people dying just after searching several hospitals and not finding a ventilator to withstand the infection.

“I wish no one what I have been through… I know everything is paralyzed, but doctors should be a little more humane and patiently deal with a family that has its loved one in agony… I am angry… Because everything that comes out on the news is just for show because there is no life-saving equipment. Everything is a lie,” the daughter of one of these people told El Deber newspaper.

The situation in blood banks, where plasma is extracted from donors, is no different. In Santa Cruz there is only one machine for apheresis plasma. Its hard-working operators have managed to move from 10 to 30 extractions a day to meet the emergency, but they are still unable to cope with the extraordinary demand. For weeks they have been requesting the purchase of two more machines, but the Ministry of Health has not replied to them.

Even if plasma donation is free, when recipients do not have health insurance, they must pay 3,200 Bolivianos (R$2,400) to access the blood bank. It is a public service, but the amount is charged to replace the equipment and substances used in the extraction. The sum exceeds the national minimum wage by over R$500.

This is not the only obstacle that the poorest face in search of medical care. For plasma to be used, donors must prove that their Covid-19 tests were positive first, and then have a negative result. In other words, prove that they actually became sick, and healed. The problem is that the public services do not deliver a document where the test result is recorded as positive; this only occurs if the test is conducted in private laboratories.

This bureaucratic hurdle hinders the recruitment of donors. On the other hand, the plasma beneficiary must pay for the private test from his or her own pocket to confirm that the donor is negative at the time of transfusion, since free tests provided by the state are scarce. In order to do so, an additional 1,000 Bolivianos (R$750) are required.

In short, plasma treatment is only available to wealthy Bolivians, as is the case with other procedures against Covid-19. Before the pandemic, 60 percent of ICU beds and 80 percent of ventilators in Bolivia were private. Possible changes in the current pandemic have not yet been quantified.

Private hospitals charge between US$500 and US$1,500 per day for critically ill patients, excluding the ventilator fee. A citizen denounced that he was forced to pay 70,000 Bolivianos (over R$ 52,000) for four days of care of his son at the most luxurious clinic in Santa Cruz. Most private insurance companies do not cover the consequences of a pandemic, so a special one emerged that costs about R$800 per year.

In parallel, the mixed health plans, which are owned by the state, employers, and unions, and which in the country are called “health insurance companies,” only authorize the hospitalization of patients who are up-to-date with their monthly fees.

Source: El País