Antibody remedies in Hawaii are lagging behind because of robust demand within the US
Monoclonal antibody treatments for COVID-19 have been shown to save lives. But just as the state prepares to make drugs more widely available, a national shortage restricts what the state can offer and forces healthcare providers to limit who can get them.
According to Brooks Baehr, a health department spokesman, the federal Hawaiian government has capped weekly allotments to 680 treatments, half of what local health care providers asked for. The state will have to wait and see whether it will get more supplies in the coming weeks.
“No question about it, we would have liked to have received more,” said Baehr.
The antibody treatments performed by Regeneron and Eli Lilly received emergency approval from the Food and Drug Administration in November. Regeneron’s antibody cocktail, which former President Donald Trump took when he contracted COVID-19 in 2020, has been shown to reduce the risk of hospitalization by 70%. The drugs have also been shown to be highly effective in preventing someone from contracting the virus after known exposure when taken as a preventive measure.
Treatment, which consists of a series of injections or infusions, must be given early after symptoms appear. Once someone is hospitalized and needs oxygen, health officials say it is usually too late.
While the drugs have been in widespread use for months, there has been limited demand at the national level as health officials focused on introducing the vaccines. However, the summer spike in COVID-19 cases due to the highly contagious Delta variant and the resulting strain on healthcare resources have led to renewed focus on drugs as a means of saving lives and reducing pressure on hospitals.
However, this has also created a delivery bottleneck, with seven southern states, where vaccination rates are low, accounting for 70% of orders, according to The New York Times. Recently, President Joe Biden’s administration took over the distribution of the medicines to ensure they get to the areas most in need.
Last week, hospitals and other health care providers ordered the drugs directly from the manufacturers.
In Hawaii, the state has been working over the past few weeks to promote the distribution and recruit 30 federal clinicians to help distribute the drugs. Medical staff who arrived in Hawaii on Sunday have been deployed to Queen’s Medical Center West Oahu, Waianae Coast Comprehensive Health Center, Straub Medical Center, Maui Memorial Medical Center, Kaiser Permanente, and Hilo Medical Center.
The Waianae Coast Comprehensive Health Center, which serves the state’s hardest hit population, is expected to receive only 75 treatments as part of its weekly allocation, said Jacob Schafer, director of infection control and staff health for the clinic.
“It would be great if we could give it to everyone, but we just don’t have the medication to do it,” he said.
It is not clear when these doses will arrive. According to the Ministry of Health, all of the state’s supplies had still not been dispatched by Monday noon.
The Waianae and Nanakuli neighborhoods have some of the lowest vaccination rates in the state and saw a sharp surge if the delta variant of the coronavirus hit this summer. In the past two weeks, 649 new cases have been reported in this zip code, according to national maps, far more than any other area of the state.
Shafer said the limited supply prevents the health center from distributing treatments as a preventive measure if someone at high risk of complications from the virus is known to have been exposed to the virus.
Treatment will also be limited to people who are considered to be at greater risk, including those over 65, pregnant women, and those with diabetes or overweight. The clinic does not differentiate between vaccinated and unvaccinated people.
Shafer stressed that antibody treatment should not be used as a substitute for the vaccine. Unlike the vaccines, treatment does not reduce the chances of someone re-infecting and becoming seriously ill.
“This is absolutely not a substitute for vaccination,” he said. “Vaccination is security. This is an additional level of treatment to relieve an overloaded health system. “
Hilo Medical Center, which serves an area with also high rates of infection, expects 70 treatments per week plus a “little extra” for emergency room and long-term care, said Elena Cabatu, a spokeswoman for the hospital.
“We experience a shortage like everyone else,” she said. Cabatu said treatment will also be limited to people who have risk factors for serious illness.
Health care officials say that while treatment is currently scarce, hopefully the local need for it dwindles as the state appears to be at the end of the surge. Nevertheless, the state reported high case numbers on Monday, including 431 new infections. The state’s death toll from the virus has risen to 714. Among the deaths that month were two women who contracted the virus while pregnant and died shortly after giving birth. KHON reported the second death on Monday.