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Greeting gas_dr:

I am pinging you to the thread and especially to my post #48 for your current expert opinion as a doctor treating covid patients.

PS: The interview with Berenson I linked in post #48 is 5 min.

Even if you disagree with him (and me) about the vaccines, I only included it for his reference to monoclonals with respect to the FDA withdrawal of the Regeneron combo. That caught my attention because he seemed to suggest that the targeted spike protein in mrna vaccines AND the Regeneron combo don’t work with the structure of the omicron spike protein-—thus the FDA Regeneron combo withdrawal.

MY CONCERN:

I had an arrangement with my doctor that if I contracted covid the information I supplied him with was enough that he would immediately prescribe the Regeneron combo (which at the time, 3 months ago, was readily available in my area. Because my doctor works within a hospital system (arg!), I am assuming that that door is now closed. If so, what next for monoclonals in your opinion?

Thank you for the ping and the question. At this time, Regeneron does not appear all that effective for omicron. However, the monoclonal sotrovimab appears to be superior for omicron. That being said, omicron is pretty benign, and we are seeing an awful lot of extremely mild symptomatic patients (hospitalized “with” instead of “for”) and does not require infusion therapy

The Biden administration has effectively co-opted and nationalized this medication, so we are all kind of screwed because the admin has restricted distribution. My colleagues in Florida had an extremely easy time getting monoclonals, but that is no longer the case as of today because of changes in the FDA authorization.

I think this clearly demonstrated the ill will of the administration currently in DC, and I believe I read DeSantis was going to sue over this — which is appropriate.

I have long stated that vaccinations against the original and delta disease were effective at stopping critical illness, but clearly omicron has escaped vaccination, but perhaps because of vaccination, the evolution of a more mild disease has occurred which will “naturally” vaccinate everyone. I am particularly heartened that omicron seems to produce robust antibodies to precious and more serious disease.

You essentially did the exact right thing as I have encouraged those who did not want vaccination to make sure they could get monoclonals. While you are correct that the door is closed, the good news is that omicron causes no critical illness in my experience (I see an occasional delta, but that is a different clinical story). The numbers are crashing, and the receding of omicron will be as impressive as its emergence — take joy that the UK and SA, and now Ireland have stopped all their covid precautions because the have reached herd immunity — and it is over. The only question left is what will the politicians (and I think Fauci is a politician, not physician) do. I have a feeling Biden will use this to declare victory of CoVID (if he were smart), return everything to normal, and take a victory lap — we shall see if he is that smart.