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They avoided the Covid vaccine but accepted antibody treatment

 


Lanson Jones didn’t expect the coronavirus to come for him. An avid Houston tennis player who has never caught a cold during a pandemic, he refused the vaccine, worried that he might be injured.

But the deal with Covid shattered confidence in his body’s defenses — Mr Jones had a stuffy nose and lost appetite, so he began looking for something to avoid a nightmare illness.

The answer turned out to be a monoclonal antibody. This is a drug made in the lab a year ago that is as as a vaccine. In a glass enclosure at the Houston Methodist Hospital this month, 65-year-old Jones said more than a million patients, including Donald J. Trump and Joe Rogan, were to receive antibody injections after the virus struck the United States. I’m alone. ..

Vaccine-resistant Americans, after rejecting a vaccine that costs one-hundredth of the cost, sometimes wonders doctors and turn to treatment with the enthusiasm to chase long injections. The Biden administration warned this week that the country’s supply was declining as orders exploded rapidly this summer, rising from 168,000 times a week in late August and 27,000 times in July.

The federal government, which was already paying for the treatment (currently about $ 2,100 per dose), has taken over the distribution. In the coming weeks, the government has told the state to expect reduced shipments due to the impending shortage.

In seven southern states, which account for 70% of orders, the new process has disturbed some of the governors who treated antibodies at the heart of their strategy to withstand the devastating waves of delta mutants.

More supplies are on the way. The federal government is expected to purchase another 1.8 million doses this week, arriving in the fall and winter. But so far, state health officials said some hospitals are uncertain in supply, even though patients continue to look for doses.

“Some providers are having a hard time getting the products they need,” Cody Kinsley, who heads the operation of the Covid-19 response in North Carolina, said in an interview. “I think what happened is suddenly a classic logistics problem with much more demand.”

In the false hustle and bustle of anti-vaccines, monoclonal antibodies have become a rare coronavirus drug to achieve near-universal acceptance. Equally endorsed by mainstream doctors and conservative radio hosts, the infusion prevented the country’s death toll (2,000 per day and mountaineering) from rising further.

And after months of working to facilitate treatment by President Biden and the Governor of the South, they said the fear and uncertainty of actually getting Covid made them desperate for antidotes. Won the love of vaccine rejecters.

“People you love, people you trust, no one was saying anything negative about it,” Jones said of antibody treatment. “And I’ve only heard negative things about the side effects of the vaccine and how quickly it was developed.”

Some Republican governors have set up antibody clinics in opposition to vaccine obligations, frustrating even some of the strongest supporters of drugs. Scientists say that increasing vaccination rates eliminates many of the costly antibody treatments in the first place. The infusion takes about an hour and a half, including subsequent monitoring, and requires constant attention from the nurses, who are often spared by the affected states.

Dr. Christian Lamars, an infectious disease specialist and head of population health at the Family Health Center in San Diego, said: Community-based provider. Pushing antibodies while vaccinated was “like investing in car insurance instead of investing in brakes,” he said.

Government-provided monoclonal antibodies produced by Regeneron and Eli Lilly have been shown to significantly reduce patient symptoms and reduce the risk of hospitalization by 70% (for Regeneron’s antibody cocktails). Treatments that are performed while sitting at once use laboratory-made copies of the antibodies that people naturally produce when fighting infections.

Same for patients and doctors I overlooked the treatment during the surge of winter infectious diseases. However, hospitals and health centers are now increasing their offerings, turning dental clinics, mobile units and auditoriums into infusion centers. In states, such as Texas, where selective surgery was postponed to make room for Covid-19 patients, operating room nurses participated to perform the infusion.

One factor driving demand is that many patients, including vaccine skeptics, are disseminating information about seemingly miraculous recovery.

Jennifer Berry, Nursing Director of Houston Methodist Intravenous Services, said: “Now, the words are out.”

At the Houston Methodist, nurses provided approximately 1,100 treatments at eight sites during the first week of September. This is more than double that of any week last winter. The hospital has reduced the average order-to-injection time from 3 days in early August to 2 days this month, increasing patients’ chances of fighting infections.

This summer, managing injections with more seriously ill Covid patients forced hospitals to move their monoclonal antibody clinics to strip mall stores in some cases.

However, the Texas Department of Health has provided and assisted 19 nurses in another Houston Methodist infusion clinic, said Vicki Brownewell, chief administrator of the hospital’s program. The Biden administration has also invested $ 150 million to expand access to monoclonal antibodies, and Houston methodists have used federal funds to arrange medical taxis for patients struggling to transport. ..

Still, many remain inaccessible to infusions. Given the strong demands on staff and the need to create separate infusion rooms for patients with infectious diseases, there are no clinics in certain communities, especially in rural areas.

In San Diego, some large commercial hospitals have decided not to administer antibodies at all due to logistical annoyances, and wealthy and well-insured patients are treated with his public funds. He said he was forced to look for a dose there. Some of the nurses he hired for the infusion left him on a shorter, higher-paying mission in the battered intensive care unit.

“Natural and capitalist incentives for commercial healthcare institutions don’t really like doing this,” said Dr. Lamaze. “It’s a lot of work.”

Of the 2.4 million monoclonal antibodies shipped nationwide, at least 1.1 million are used. Due to reporting gaps, it is difficult to determine the exact number of people still sitting on the shelves. Nonetheless, the decline in federal supply and the surge in demand from the less vaccinated southern states have caused some states to describe it as a major shortage of deliveries.

Health providers in North Carolina are demanding 15,000 weekly doses, more than double the amount allocated by the federal government, the Department of Health said. Florida said the latest weekly allocations were 41,000 times short of what the clinic wanted.

Hospitals were previously able to order their own medicine. However, the Department of Health and Human Services has come to determine the dose that each state receives based on the case rate and the use of treatment. The state government then determines the dose for each site.

The new ordering process, which the Biden administration said would ensure “fair distribution,” upset some supporters of the drug. Republican Governor of Florida Ron DeSantis warned Thursday that state officials weren’t ready for the new responsibility to split the dose.

Also, in high-vaccination states such as New York, treatment coordinators are afraid to drop shipments due to low case rates and stop programs due to very low hospital doses. Some hospitals have recently reported an increase in the number of vaccinated patients receiving injections.

Diana Berrent, founder of Survivor Corps, who has helped patients find monoclonal antibody therapies, said the involvement of the state government would cause delays.

Doctors warn that antibody treatment alone cannot catch up with the outbreak. A single injection only helps one patient, whereas one vaccination protects the other from exposure. Infusion should be given within 10 days of symptoms. They are useless for most inpatients. And once you receive the antibody, you can’t prevent people from getting seriously ill if you get the virus again later.

Dr. Howard Juan, Medical Leader of the Houston Methodist Infusion Program, said:

As a result, health officials have warned that vaccine skeptics may become obsessed with monoclonal antibodies and become more resistant to taking protective shots.

Within days of the injection, a Houston patient, Jones, left the isolated bedroom and returned to work as a landscape architect. But he was still considering whether to get vaccinated.

He said his doctor was pushing the shot. However, the monoclonal antibody worked so well that if he caught Covid-19 again, he was simply tempted to return to another infusion.

“If I get the injection and feel as good as it is now, man, I don’t want to take the newly developed vaccine,” he said. “Still I’m nervous.”

Rebecca Robbins contributed to the report.

Sources

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2/ https://www.nytimes.com/2021/09/18/health/covid-antibody-regeneron.html

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