SAN DIEGO (KGTV) – There is only one authorized treatment designed to keep patients at high risk of COVID-19 out of the hospital, but hundreds of thousands of doses of the same experimental therapy given to former President Donald Trump are in storage.
Flooded hospitals have been slow in administering monoclonal antibodies because of what an infectious disease expert has called the “perfect storm” of complicating factors. Some health care providers have completely refused the doses.
These challenges include staffing and space limitations during growth in cases, the time required to administer an infusion, and short window providers must reach patients who qualify for treatment.
However, federal and state health officials have called on providers to expand access to experimental therapy, which has proven promising in early-stage studies. A clinical study of the monoclonal antibody cocktail by Regeneron found that hospitalizations fell to 3% compared to 9% in the placebo group.
At Family Health Centers in San Diego, they turned a dental office and several unused medical facilities into a monoclonal antibody infusion clinic.
“My feeling is that we need to do everything we can to prevent our hospitals from being overwhelmed,” said Assistant Medical Director Dr. Christian Ramers.
Dr. Ramers said he and two nurses infuse about five patients a day with laboratory antibodies four days a week. They plan to increase the operation to serve up to eight patients a day, but already the clinic for low-income patients makes more infusions than some large hospitals.
“It is interesting that the offer is not the problem. This is another case where there are hundreds of doses of this drug in refrigerators throughout San Diego County, ”he said.
At the end of last month, the Department of Health and Human Services said that 378,000 doses of monoclonal antibodies were distributed to hospitals and clinics in the county. Only 20 percent of the supply was used.
Regeneron and a second company, Eli Lilly, received emergency use permits in November to treat people at high risk for severe outpatient illness before a person is hospitalized.
The drug itself is free, with thousands of doses paid for by the federal government.
“Everyone thought it would be broken as soon as they went to the centers. But unfortunately, because of a perfect storm of things. It hasn’t grown that much, “said Dr. Peter Chin-Hong, an infectious disease specialist at UC San Francisco.
Some hospitals have avoided treatment because there is limited data. The National Institutes of Health says there is “insufficient data” to recommend for or against drugs. Clinical trials are still ongoing.
The infusions last two hours for the patient, plus some extra preparation time to thaw and mix the solution. This is a challenge at a time when staff are limited.
“This is the middle of a wave right now and there aren’t that many people moving,” said Dr. Chin-Hong. He said UCSF makes about two to four infusions a day.
There is also a narrow window of time for treatment. According to the FDA’s emergency use authorization, qualified patients will be given antibodies within 10 days of their symptoms.
Dr. Ramers said the average patient could wait a few days for a test, then wait a few more days to get results. By then, “you’re already pushing the end of that window, so there’s a lot of work that needs to be done to identify people very quickly.”
Family Health Centers has developed an algorithm to scan positive tests for the best candidates so that they can quickly contact those patients and try to set up an appointment for long-term treatment.
They target people over the age of 65 or with risk factors such as obesity, diabetes, lung disease and other conditions.
Because of the need to quickly analyze medical history and test results, Family Health Centers can only provide monoclonal antibodies to existing patients who have tested positive at one of its clinics, Dr. Ramers said.
However, he said that other providers offer the treatment. Patients just need to know how to ask.