A class of drugs made in the laboratory that could protect patients at high risk for COVID-19 from becoming significantly ill is significantly underused, experts say.
Monoclonal antibodies that could neutralize SARS-CoV-2, the virus that causes COVID-19, are highly recommended for those over the age of 65 or who have underlying medical conditions that put them at risk for serious illness. President Donald Trump received treatment with Regeneron antibodies shortly after he was diagnosed with COVID-19.
On Thursday, public health officials called on doctors across the country to take advantage of the abundant supply of these monoclonal antibodies, which are currently the only approved treatment that could keep Americans out of hospitals and halve hospitalization time. according to studies.
“It’s the first time during the pandemic that I remember when our resources far exceeded demand,” said Dr. William Fales of the Michigan Department of Health & Human Services, according to NBC News.
Experts say there are several reasons why monoclonal antibodies are no longer widely used. First, they should be given shortly after a person tests positive for COVID-19 in the first week of illness. While some states, especially Ohio, have put in place an electronic registration system that warns healthcare practitioners if patients’ tampons come back positive, other states do not have such a fast response system.
Second, one-hour infusions of both Regeneron and Eli Lilly monoclonal antibodies should be given intravenously, and appointments can take 3 to 4 hours, according to NBC News. Because patients with COVID-19 can infect others, they should be kept in a separate room. This can seriously prevent the administration of drugs in a local clinic or even in a doctor’s office.
Dr. Peter Chin-Hong, an infectious disease specialist at the University of California, San Francisco, cites public transportation as another obstacle to antibody treatment. Any type of joint trip is not discussed for patients with COVID-19, and some patients cannot afford to spend half a day for treatment away from family and work obligations, he said.
And then there’s the cost. Because the therapy is given intravenously, a single dose costs $ 1,250, according to published reports. Even though the federal government has agreed to distribute the drugs for free, the infusion alone can cost $ 1,000, which can lead to heavy couplings even for insured people.
According to the NPR, the federal government has said it has delivered more than 300,000 doses of monoclonal antibody drugs to medical institutions nationwide. While Chin-Hong says his unit used only 20% of its supply, some healthcare systems have overcome the logistical hurdles of drug delivery.
At Houston Methodist Hospital, doctors have opened special clinics that offer between 50 and 70 infusions daily to eligible high-risk patients and use their supplies as quickly as possible. Experts say setting up similar infusion centers may be the answer to using the resources we have at hand, but it may be an unreasonable demand for some health systems that are already tense under the weight of the pandemic.
“If we had this pandemic under control, we could set up infusion centers,” said Dr. Pieter Cohen, an associate professor of medicine at the Cambridge Health Alliance, according to NBC News. “We could set up quick tests. But we do not have these resources. We are completely swallowed by sick patients. ”
Chin-Hong agrees, adding that patients who are eligible for monoclonal antibody treatment are generally well. “You want to focus on sick patients,” he said.
Another factor that prevents the widespread use of this therapy may be a lack of awareness. Secretary of Health and Human Services Alex Azar said on Tuesday that “patients should ask their doctors or healthcare providers why they are not being offered these antibody therapies.” HHS has an online map showing some, but not all, locations that have received supplies of monoclonal antibodies.
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