I seriously feel uncomfortable responding to this specific example but here’s the guidance on monoclonals that medical staff have to follow. monoclonals have a tight window. If the parameters aren’t met, i.e., progresssed to severe, then in-hospital treatments are probably best:
“Given the sustained increase in variants resistant to bamlanivimab alone and bamlanivimab/etesevimab, the Assistant Secretary for Preparedness and Response (ASPR) within the U.S. Department of Health and Human Services (HHS) stopped the distribution of both products to California.
The FDA recommends that health care providers in California instead use casirivimab plus imdevimab (i.e., REGEN-COV) therapy until further notice.”
“Monoclonal antibody treatments are not authorized for use in patients who are hospitalized due to COVID-19 OR who require oxygen therapy due to COVID-19 OR who require an increase in baseline oxygen flow rate due to COVID-19 in those on chronic oxygen therapy due to underlying non-COVID-19 related morbidity.”
Can a patient who is asymptomatic receive this treatment?
No
Can a patient without positive results from direct SARS-CoV-2 viral testing receive this treatment?
No
Can a patient who is hospitalized due to COVID-19 receive this treatment?
No
Can a patient requiring oxygen therapy due to COVID-19 receive this treatment?
No
Actually the criteria have changed in the last week. It can be given as post exposure prophylaxis for anyone not vaccinated or at high risk of not mounting a sufficient immune response to the vaccine (immune suppressants, age, etc) with a known exposure prior to developing illness. For those with ongoing exposure (nursing homes, prison etc) it can be repeatedly monthly for as long as documented exposure continues. This is in addition to existing parameters Use in patients with severe disease has been found to be not beneficial and possibly harmful. For those with severe disease a drug called tociluzimab now has an EUA.