Issue 97

A hodgepodge of antibodies, the research bill no one wants to pay, and all the things your Clorox wipes are may be made of.

August 30, 2020

Hello friend! Welcome to Scrap Facts.

I'm a reporter covering health and science with insatiable curiosity. I love everything I learn, not all of which gets its own story. Each week, I'll bring you some of my favorite facts that I picked up on the job or while out living life.

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No one really knows how convalescent plasma works...

Found while reporting: What we (don’t) know about convalescent plasma treatment for Covid-19

This week, the US Food and Drug Administration gave emergency use authorization to convalescent plasma as treatment for Covid-19.

The thinking behind convalescent plasma is that it contains antibodies against Covid-19. Antibodies are the proteins our bodies make when you get sick from a virus and are in the process of recovering. They work best when your own body makes them for you, but that can take about a week. If you’re really sick, doctors can try to treat you with someone else’s antibodies—a technique called “passive immunity.”

The theory makes sense, but the particulars are super murky. This is because scientists don’t know exactly what all the antibodies in plasma are doing.

Our bodies don’t just make one type of antibody against an infection—they make several. Essentially, our immune system recognizes the pathogen in question, and makes a bunch of different proteins that may tackle the infection in different ways. Some can neutralize the virus, others can flag it to be killed by another cell, and others may do nothing at all. It’s really like a throwing antibodies at the wall (virus within the body) and seeing what sticks.

To complicate matters further, scientists don’t know if our hodgepodge collection of antibodies against a virus are working alone, together with each other, or in conjunction with other chemicals in blood plasma. Or if the collection of antibodies from one person are the same as another person.

Ideally, scientists would be able to isolate one type of antibody that’s most effective against Covid so they could reproduce that in the lab, and then give sick patients high doses of just that specific antibody. But they can’t right now, because they don’t even know which one to look for. For now, that’s why they’re doing their best to see if giving patients’ convalescent plasma helps them at all.

…And no one wants to fund the kind of rigorous trials that could actually find out.

Found while reporting: Why we don’t know if convalescent plasma works to treat Covid-19.

Usually, the therapies that the FDA clears for use have gone through three tiers of trials in humans that show that they are safe, effective, and better than any existing treatment out there. The gold standard of these experiments are called randomized controlled trials, or RCTs. Ideally, in RCTs, neither patients nor their doctors know what treatment they’re getting to avoid the placebo effect.

Unfortunately, these trials are expensive. Like, a median cost of $19 million expensive. Normally, drug companies are happy to eat these costs as part of their “research and development” budget. If the therapy works, they can always make up those costs through sales (hello, monopoly pricing!).

But plasma is unprofitable. You cannot patent (and therefore sell) a biological product. Which is part of the reason why, even though the idea of plasma therapy has been around since the 1880s, no one has done a large-scale, randomized controlled trial on convalescent plasma as a therapy for any disease.

But wait! I’m sure you’re thinking, isn’t this where federal research funding comes in? Well reader, normally you’d be right. Except federal grants often go to new and exciting work—not an old idea. It’d look like buying a horse and buggy when there are Teslas available, one source told me.

The good news is, there’s been enough federal funding so far to show that plasma seems to work well enough to merit proper RCTs. US National Institutes of Health and a handful of private donors (including the NBA??) funded the expanded access program that led to the FDA’s decision to grant plasma an emergency use authorization. Hopefully, if scientists can gather data on plasma therapy for Covid-19, they can learn more about the therapy overall for future pandemics.

Read my more detailed Twitter thread on convalescent plasma here.

A brief list of all the things you Clorox wipes could be made out of.

Found while correcting: The cheaper, greener alternatives to Clorox wipes.

Corrections are never fun, but sometimes they are funny.

I reached out twice to Clorox for a comment on the above story; the company never got back to me. Based on reporting from other outlets, I gathered that their wipes are made out of “polyester spunlace”—a material also used in masks and other PPE.

After the article published, I got an email from Clorox’s PR team saying that this was not true—but that they couldn’t tell me what the wipes are made out of because it was proprietary information. My editor found the patent for Clorox wipes, and I proceeded to ask the PR team if they could clarify if the wipes were any of the following material listed:

  • nonwoven, fibrous sheet materials

  • meltblown, coform, air-laid, spun bond, wet laid, bonded-carded Web materials, and/or hydroentangled (also known as spunlaced) materials

  • woven materials, which include cotton fibers, cotton/nylon blends and/or other textiles

  • a sponge and/or sponge-like material from regenerated cellulose and/or polyurethane foams 

  • wood pulp, a blend of wood pulp, and/or Synthetic fibers, which include polyester, rayon, nylon, polypropylene, polyethylene, and/or cellulose polymers

Our Clorox PR friend refused to answer citing the need to keep proprietary information secret, but he did say the wipes used to use polyester spunlace. They aren’t any longer. He also refused to spell my name correctly throughout the exchange.

A gif of an animated wipe container and a hand removing a wipe.

Other stuff you may have missed:

Do you need a Covid-19 test in the US? LabCorp will send you one via FedEx—and it’s covered by most insurance.

Don’t give up on your buff just yet. Poor science journalism at a major US newsroom led to #Buffgate on Twitter, a debate about whether buffs could actually spread more droplets than wearing no mask at all. That’s not actually what the scientific paper behind the headlines said—read my story on it here, or a concise Twitter thread here.

Please get your flu shot early this year. It won’t help you fight Covid, but it will help keep you out of the hospital, or from getting two nasty infections in a row. They’re already giving them out at some pharmacies, and are free with most insurance.

The future of journalism belongs to those who stay optimistic and stay curious. I got a chance to talk with some of the folks at OnePitch podcast about my outlook for the field, and other aspects about my job.

Why are Covid-19 cases high in one neighborhood, but low in an adjacent one? Systemic racism. I talked to my colleague Dan Kopf for his excellent newsletter, The Golden Stats Warrior.

That’s all for now—stay curious, friend ❤️

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Top image by E. Y. Smith, headshot drawing by Richard Howard.