Those at highest risk for severe COVID-19 often least likely to get monoclonal antibodies

Medical Xpress / Harvard T.H. Chan School of Public Health / JAMA ^ | Feb. 4, 2022 | Ellen Meara et al

[ConservativeMind]

People over age 65 at the highest risk for severe COVID-19 have often been the least likely to receive monoclonal antibodies (mAbs)—a highly effective treatment for the disease—both across and within U.S.

"Monoclonal antibodies should first go to patients at the highest risk of death from COVID-19, but the opposite happened—the healthiest patients were the most likely to get treatment.

Monoclonal antibodies are very effective at treating mild to moderate COVID-19 infection among non-hospitalized patients. But during the pandemic, mAbs have been in short supply. Federal guidelines prioritize patients at higher risk of being hospitalized or dying from COVID-19, including older people and those with chronic conditions.

The researchers wanted to learn how the limited supply of mAb therapy was allocated to patients at highest risk for severe disease.

They found that, among Medicare beneficiaries who weren't hospitalized or who didn't pass away within seven days of their diagnosis, only 7.2% received mAb therapy. The likelihood of receiving mAbs was higher among those with fewer chronic conditions—23.2% of those with no chronic conditions received mAbs, versus 6.3%, 6.0%, and 4.7% of those with 1-3, 4-5, and 6 or more chronic conditions, respectively.

In addition, there were significant differences among states when it came to mAb treatment. For example, Rhode Island and Louisiana administered mAbs to the highest proportion of non-hospitalized patients with COVID-19 (24.9% and 21.2%), while Alaska and Washington administered the lowest proportion (1.1% and 0.7%). Southern states had the highest rates of mAb therapy (10.6% of beneficiaries), while states in the West had the lowest rates (2.9%).

Speculating as to why mAb therapy often failed to reach the highest-risk COVID-19 patients, the researchers said it's possible that higher-risk patients may have had difficulty navigating the multiple steps needed to receive mAbs.

[ConservativeMind]

Almost all prior monoclonal antibody treatments won’t work with Omicron. The supplies of what does work are low and Biden is further restricting them.

Please be ready to call multiple treatment centers for the most vulnerable persons in your life. My wife got COVID-19 in late December 2021 and her symptoms initially got better, then worse, on the eighth day. I had already called six infusion centers by the fourth day and there were no appointments or inventory at five, and the last one did have them, but was five hours away and they said her symptoms with few comorbidities would very likely result in refusal, upon arrival.

Please be prepared with all possible proven supplements and medicines, and do go to an urgent care, if symptoms start to pick back up. You may benefit from Azithromycin, Decadron/Methylprednisone, and Albuterol, in those later days, as my wife did.

I do want to thank Gas_dr for his input on this!

[ConservativeMind]

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[ConservativeMind]

Ping to you, sir.

[goodnesswins]

Azithromycin is the only thing I do not have

[Brian Griffin]

Perhaps monoclonal antibody dispensing could be based on blood oxygen saturation levels taken after sitting or lying down for five minutes.

[ProtectOurFreedom]

I signed up for MyFreeDoctor yesterday morning and in the afternoon got a call from a nearby pharmacy that I had selected from their list. They are getting Ivermectin, but a supply now costs over $400, triple a year ago. The woman said that most patients are getting BOTH Ivermectin AND Hydroxychloroquine. Dr. George Fareed strongly recommends a combination of both.

A year ago, I decided to find an infusion center that would administer mAb treatments. It was almost impossible. In the past year, multiple web sites have come on line that now make it a lot easier to find them, but you still need to call to see if they have the medicine in stock.

Did you take your wife to the sixth infusion center? Did she get the treatment?

On January 24, the FDA amended the EUA for bamlanivimab and etesevimab (Eli Lilly, these are administered together) and REGEN-COV (Regeneron, combination of casirivimab and imdevimab), limiting their use to only when the patient has been exposed to or infected with a COVID variant known to be treatable with these drugs.

So you have to get a COVID diagnosis that does the genetic sequencing to determine what variant you have. Isn’t that a very high hurdle? I understand patients are not told which variant they have.

The NIH authorized Sotrovimab by GlaxoSmithKline for the Omicron variant. There are huge supply problems. Why in the world doesn’t GSK do an urgent license of their product to Eli Lilly and Regeneron and have them make it? The three of them could agree to cross-license products for future variants. There is huge demand right now and they all could make a lot of money via this business approach. Why doesn’t the Biden administration tell them to get together and cross-license?

[sopo]

Also How many doctors don’t know about them? From my contacts many people in at risk population have not been offered the treatment by their doctors. The advertising budget for vaccines was enormous, I never saw an ad for monoclonals on any website, billboard or broadcast medium. Further, DeSantis forcefully rebutted the CDC/FDA withdrawal of the Regeneron and Lilly products at the advent of Omicron as there was no way to confirm that any individual did not have Delta, as well as very limited in vitro assessment was what they based the withdrawal on. If in vitro alone is evidence, bring on HCQ, ivermectin and whatever else, though plenty of clinical evidence to back their use as well.

[ConservativeMind]

I did not take her to the sixth one.

A ten hour round trip for a 1% chance of getting them did not seem worth it. Additionally, the three drugs our local doctors prescribed were what gas_dr said would be helpful.

She got over what remained within nine additional days.

[Chuzzlewit]

I had it as well. My doc said day 8 is the pivotal day, you get better or worse. I was able to obtain the monoclonal antibodies thanks to my sister who spent a day working on it. I’m 69 with cancer. Was important I receive those.

[FamiliarFace]

*** Why doesn’t the Biden administration tell them to get together and cross-license?***

Do you really think the government is here to help US citizens in any way? Especially this administration, which is the biggest disaster of my life, including the Carter administration.

[faucetman]

“monoclonal antibodies (mAbs)—a highly effective treatment for the disease” contains antibodies from cloned (cancerous) fetal tissue cell line and chimeric mouse/human antibodies.

EXPERIMENTAL (EAU) treatment.

YOU are the “experiment”.

https://rumble.com/vsufkx-live-exclusive-first-look-at-kid-vax-contents-monoclonal-antibody-secrets-e.html

Starts at 10:13 Stew Peters Show Dr. Carrie Madej

[Paul R.]

So you have to get a COVID diagnosis that does the genetic sequencing to determine what variant you have. Isn’t that a very high hurdle? I understand patients are not told which variant they have.

FWIW, I believe that from the standpoint of clinical diagnosis, Delta tends to go for the Lower Respiratory Tract, Omicron the Upper. gas_dr posted about this a few days ago. However, current fatalities even with Omicron's dominance would suggest that as an absolute number, quite a few Omicron cases ARE still progressing to the lungs.

This leaves me with the question: Do the now limited monoclonals actually do harm if administered to a patient declining quickly, variant only suspected, and then it turns out he / she has Omicron?

The NIH authorized Sotrovimab by GlaxoSmithKline for the Omicron variant. There are huge supply problems. Why in the world doesn’t GSK do an urgent license of their product to Eli Lilly and Regeneron and have them make it? The three of them could agree to cross-license products for future variants. There is huge demand right now and they all could make a lot of money via this business approach.

Darn good point. I don't know. These companies have press conferences and interviews -- SOMEBODY should ask!

Why doesn’t the Biden administration tell them to get together and cross-license?

Well, the most likely explanation is incompetence. But, the Admin. has even more press conferences and interviews -- SOMEBODY should ask!!!

[ProtectOurFreedom]

Do the now limited monoclonals actually do harm if administered to a patient declining quickly, variant only suspected, and then it turns out he / she has Omicron?

I've wondered the exact same thing! Is there any potential harm administering the existing Eli Lilly and Regeneron MABs on the chance that the patient has Delta? The government was awfully quick yanking their authorization when Omicron took over, but Nextstrain shows that only 5% of samples taken on January 22 in North America are Delta.

Is efficacy zero against Omicron? Or just diminished?