SAN DIEGO (KGTV): There is only one authorized treatment designed to keep high-risk COVID-19 patients out of the hospital, but hundreds of thousands of doses of the same experimental therapy given to former President Donald Trump are sitting in the warehouse.
Flooded hospitals have been slow to administer monoclonal antibodies because of what an infectious disease expert called a “perfect storm” of complicated factors. Some healthcare providers have completely rejected the doses.
These challenges include staffing and space limits as cases increase, the time it takes to administer an infusion, and short-window providers must reach patients who meet the requirements for treatment.
However, federal and state health officials urged providers to expand access to experimental therapy, which has proven promising in early-stage trials. A clinical trial of the monoclonal antibody cocktail performed by Regeneron found that hospitalizations fell to 3%, compared with 9% of the group that obtained a placebo.
At the San Diego Family Health Centers, they have turned a dentist’s office and some unused medical spaces into a monoclonal antibody infusion clinic.
“My feeling is that we need to do everything we can to keep our hospitals from being overwhelmed,” Dr. Christian Ramers, deputy medical director.
Dr. Ramers said he and two assistants infuse about five patients a day with antibodies made in the lab, four days a week. They plan to expand the operation to treat up to eight patients a day, but the clinic for low-income patients is already making more infusions than some large hospitals.
“Interestingly, supply is not the problem. This is another case where there are hundreds of doses of this drug sitting in refrigerators across San Diego County, ”he said.
Late last month, the Department of Health and Human Services said 378,000 doses of monoclonal antibodies had been distributed to county hospitals and clinics. Only 20% of the supply had been used.
Regeneron and a second company, Eli Lilly, obtained emergency use permits in November to treat people at high risk for serious illness in outpatient centers, before an individual is admitted to a hospital.
The drug itself is free, with thousands of doses paid for by the federal government.
“Everyone thought he would retire as soon as they went to the centers. But unfortunately, due to a perfect storm of things. It hasn’t really increased 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. National Institutes of Health says there is not “enough data” to recommend for or against drugs. Clinical trials are still ongoing.
Infusions take two hours to the patient, plus additional preparation time to thaw and mix the solution. This is a challenge at a time when staffing is dwindling.
“This is the center of a wave right now and there aren’t that many people moving,” Dr. Chin-Hong said. He said UCSF makes about two to four infusions a day.
There is also a narrow period of time to administer treatment. Under FDA emergency use authorization, antibodies must be given to qualified patients within 10 days after symptoms appear.
Dr. Ramers said the average patient could wait a few days for a test and then wait a few more for results. By then, “you’re already pushing the end of this window, so there’s a lot of work that has to go into identifying people very quickly.”
Family Health Centers developed an algorithm to analyze the positive tests of the best candidates, so that they can quickly contact these patients and try to schedule an appointment for long-term treatment.
They are aimed at people over 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 offer monoclonal antibodies to existing patients who test positive at one of their clinics, Dr. Ramers.
But he said other providers offer the treatment. Patients just need to know to ask.