TMC PULSE

8 t m c n e w s . o r g Donating Plasma to the Critically Ill COVID-19 survivor Daniel Knight explains his role in convalescent serum therapy F rom the moment Daniel Knight felt the first symptoms of COVID-19 to the day he donated lifesaving plasma to help critically ill patients, only four weeks had passed. But to him, it felt like an eternity. Local health officials first reported commu- nity spread of COVID-19 in the second week of March. The Houston Livestock Show and Rodeo shut down March 11 and then, on Friday the 13th, schools announced closures. That weekend, Knight, a 41-year-old attorney, spent the day in his back yard gardening, laying 25 bags of cedar mulch over the flower beds. Although he developed congestion in his lungs and a cough shortly afterward, he chalked up those ailments to the cedar and other outdoor allergens. "It came on so suddenly that we just thought it was a really bad sinus infection or something like that," Knight's wife, Lyndsey, recalled. Lyndsey Knight, 40, suffers from rheumatoid arthritis and is on a regimen of an immunosup- pressant drug, tocilizumab. The immunosup- pressant induces a condition, called secondary immunodeficiency, in which her body is unable to produce the necessary antibodies to fight off infections. As a result, she relies on plasma dona- tions for intravenous immunoglobulin treatments to manage her diminished immune function. On Monday, March 16, Daniel Knight's law firm, Chamberlain Hrdlicka, sent home all at-risk employees and those with at-risk household members. Knight wasn't going to take any chances exposing family, especially his wife. That same afternoon, he came down with a fever. Knight immediately called his doctor, who prescribed antibiotics to treat the symptoms. On Wednesday, March 18, he went to get tested for COVID-19. By then, Knight's symptoms had wors- ened. He was experiencing fatigue, body aches, chills and shortness of breath—all the tell-tale signs of COVID-19. "The physical aspect of it was bad. It was like a really bad case of the flu," Knight recalled. His resting heart rate, which normally sits between 65 and 70 beats per minutes (bpm), shot up to 100 bpm, and his coughing spells lasted for a minute or two at a time. Without the test results to confirm whether it was COVID-19 or the flu, the Knights could only COVID-19 has been so difficult to contain. On top of that, the virus is highly contagious. The seasonal flu has an R 0 value of 1.3, the basic reproduction number that indicates how contagious a virus is. By comparison, the SARS- CoV-2 virus has an R 0 of 5.7. In other words, one person infected with COVID-19 can transmit the disease to 5.7 other people. "When you're told that you're positive and you've actually been transmitting it up to a week before your symptoms—I just felt awful," Knight said. "There's no way I could have known, but I felt terrible because of how many people I exposed. … It's something you have to be able to work through mentally, otherwise, it could just eat you alive." Although he no longer exhibited any symp- toms, his second COVID-19 test came back positive on April 3. For nearly a month, he kept his distance from his wife and kids. "Even when we're in quarantine staying at home, most folks are still around a partner, a husband or a wife, or some other civil arrange- ment," he said. "You can still hug them on the couch or snuggle while you stream a show. But when you're in isolation, you have no physical B y S h a n l e y P i e r c e Daniel Knight, a COVID-19 survivor, donates plasma at Houston Methodist Hospital. speculate, but they weren't taking any chances. Daniel Knight grabbed his clothes and moved into the garage apartment of his home to start Day 1 of isolation. So close yet so far Knight's symptoms resolved six days after he was tested, but it wasn't until March 31—nearly two weeks after his test—that he finally received his results: COVID-19 positive. "I don't think I could have changed anything to avoid it," he said. "I think that's part of what the frightening reality of this is—that it's out there and a lot of people are going to get it." Studies have shown that individuals who test positive for COVID-19 often carry a high viral load shortly before and after symptoms appear, suggesting that people are more likely to transmit the virus to others while they're pre-symptom- atic and soon after they begin to show signs of sickness. With up to 50 percent of cases being asymptomatic, according to National Institute of Allergy and Infectious Diseases director Anthony Fauci, M.D., people may be unwittingly spreading the coronavirus to others. These silent spreaders are one of the reasons

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