Monoclonal antibodies, which Louisiana relied on during its fourth surge, are currently in short supply.coronavirus

The supply of monoclonal antibody therapies, which Louisiana relies heavily on to prevent the aggravation of COVID-19 patients, declined by about 30% as demand increased in other states suffering from delta mutations. Health authorities.

The drug, manufactured by pharmaceutical companies Regeneron and Eli Lilly, is one of the few treatments that studies have shown that it can prevent hospitalization when given to COVID patients in the early stages of the disease.

They became prominent in October when former President Donald Trump received monoclonal antibodies to treat COVID infections before the vaccine became available. The Food and Drug Administration granted an emergency use in November and increased access, making it available to anyone over the age of 65 or with many common medical conditions.

But even if it has become much more common in recent months, its supply in the United States is still lagging. It is currently assigned to states by the federal government based on the number of cases.

As the number of cases of coronavirus continues to decline in Louisiana, lower doses arrive. In late August, the state consumed more than 7,100 treatments a week. This corresponds to about 7% of the 100,000 weekly dose distributions nationwide. However, less than 4,400 doses were administered during the week ending September 8.

Flagging usage is a good sign, as Louisiana has shown that it is likely to have passed the peak of the fourth epidemic of the virus caused by the highly contagious delta mutant. However, increased use in other parts of the country currently suffering from delta variants can make it difficult for people here to obtain it, especially if another surge occurs.

“The new cuts haven’t hurt us yet, but they could happen in the coming weeks,” said state health officer Dr. Joe Canter. “We are on a downtrend, but we still have more COVIDs than in other states.”

When the use of monoclonal antibodies in Louisiana peaked in August, there was no limit to the treatment state doses that could be ordered from the federal government.

However, low vaccination rates in many parts of the United States, combined with delta variants, create supply constraints. Monoclonal antibody use has increased 20-fold since mid-July, according to the US Department of Health and Human Services, the federal agency that distributes treatments.

Recently, states such as Florida and Texas are pushing for monoclonal antibody therapy rather than preventative measures such as masking and mandatory vaccines, even if the deadly surge in Delta reaches these areas. In response, HHS has changed its formula to determine how much each state will get.

Currently, the drug is delivered based on the state’s share of coronavirus cases, and the state receives weekly shipments only if it uses at least 70% of its supply, Canter said.

“Given this reality, efforts must be made to ensure that the federal-purchased supply of these life-saving treatments remains available in all, but not all, states and territories. “Hmm,” an HHS spokesman said in an email statement.

Louisiana was one of seven southern states using 70% of the country’s supply in recent weeks. At Oxner Health, 13,000 of the total 17,500 doses of the system occurred during the delta surge.

Louisiana’s COVID cases have fallen from a record high for the fourth surge, but Louisiana remains in the upper half of the state on hospitalization, with approximately 1,220 deaths across the state and 9 deaths per person last week. It is the second largest. An average of about 37 per day.

About 55% of the state’s population remains unvaccinated. However, despite hesitation in receiving safe and effective FDA-approved vaccines, medical professionals say that most unvaccinated patients infected with COVID accept treatment. He said he had an emergency use permit.

“That’s what we see in the hospital:” Oh, sign me up, I’ll get an IV drip. “But they’re not willing to vaccinate,” said New Orleans Health Director. Dr. Jennifer Avegno said. “It’s really a little confusing.”

The drug costs about $ 2,100 and is borne by the federal government. By comparison, vaccines cost less than $ 100 to manufacture, deliver, and administer, Avegno said.

Dr. Julio Figueroa, an infectious disease expert at LSU Health New Orleans, said that to be effective, potentially severe people need to use monoclonal antibodies in “sweet spots” within 10 days of their first symptoms. It states that there is. Patients do not get sick enough to get oxygen or need hospitalization and need to be referred by a doctor.

Drugs given by intravenous infusion consist of synthetic antibodies that mimic the antibodies produced by the body when someone fights the virus after infection.

However, these synthetic antibodies are more targeted than the antibodies that the vaccine produces by moving the body. Therefore, using this remedy is a bit like being defended by the Army, as opposed to having the Army, Navy, and Air Force. Also, unlike vaccines, it cannot prevent infection or infection.

“When we vaccinate, we provoke a polyclonal reaction.” Poly “means more than one,” Figueroa said. “You can make many antibodies that will protect you. One or more of those antibody sets will protect you from the various variants that are there.”

Giving antibody IV will also occupy most of the hospital’s resources, according to Figueroa. Administration may take several hours and is only available in certain locations. Staff need to monitor patients, and hospitals need to create areas that can accommodate large numbers of COVID-positive patients.

Patients who test positive for the PCR can be referred for antibody treatment by a doctor if they meet any of the following criteria:

• Has a body mass index (BMI) of over 25
• Have chronic kidney disease, diabetes or immunosuppressants
• Currently receiving immunosuppressive treatment
• Are you over 65
• Over 55 years of age with one or more of cardiovascular disease, hypertension, chronic obstructive pulmonary disease / other chronic respiratory illness

Children aged 12 to 17 years are in the 85th percentile of BMI, or have other problems such as sickle cell disease, heart disease, cerebral palsy, asthma, or ventilator, tracheostomy, or other problems requiring gastrostomy. You can also get treatment if you have many illnesses.

Louisiana’s proceedings continue to decline, but the state plans to set up 13 federal support sites by the weekend. There are 143 other providers that can manage it.

Louisiana has no current plans to change the criteria for receiving it, but other states have caused controversy after changing plans based on human immunization status. Tennessee officials have recently limited treatment to unvaccinated people.

“This is a very American approach to healthcare,” said Avegno about the broad willingness to take monoclonal antibodies against the hesitation surrounding the vaccine. She compared the COVID response to how people think about heart disease.

“The cost of angiography, stents, catheterization laboratories, and cardiac surgery is quite high, but not the cost of vegetables that prevent them all in the first place,” Avegno said. So much money to deal with complications, not a little prevention. “