As the number of COVID cases in California increases, antibody treatment will be unused.

The number of Californians hospitalized for COVID-19 is increasing again, even if powerful treatments are no longer used.

The deployment of free, life-saving monoclonal antibody therapies that reduce the risk of hospitalization by 80% has been delayed due to poor communication and administrative coordination and lack of equipment to provide injections. In some cases, the patient may be unaware of the treatment or hesitate to use it.

Dr. Peter Chin Hong, a professor of medicine and infectious disease specialist at the University of California, San Francisco, said: “I have this tool that I haven’t used.”

The state’s COVID-19 hospitalization rate is well below its peak. However, according to the latest data from the California Public Health Service, hospitalizations have increased by 42% over the past month, from 41,357 on November 8 to 58,620 on December 7. The same tendency is seen in severely ill people in need of ICU care.

Although not a replacement for vaccines, monoclonal antibody therapy provides immediate immunity shots for people who are already infected. However, it is an intravenous infusion and should be taken within 10 days of symptoms.

Antibodies produced in the laboratory mimic the body’s immune response to the virus. This not only slows the progression of the disease and reduces the chances of hospitalization or death, but also accelerates healing and reduces the risk of an infected person transmitting the virus to others.

Four different monoclonal antibody therapies have been approved by the US Food and Drug Administration. The latest, approved Wednesday, provides long-term protection for people with weakened immune systems or who cannot take the vaccine because of allergies, even before they are exposed to the virus.

One created by San Francisco’s Vir Biotechnology has already proven to be protective against new Omicron variants as it is designed to target spots on the virus that remain stable across multiple mutations. It has been.

“There is no doubt that antibodies will bring amazing benefits to newly diagnosed patients,” said George Scangos, CEO of Vir.

Special techniques are required to synthesize them. Made in a large fermenter, it takes time to grow from a single cell to a product of thousands of liters. They must be purified, proven stable and checked for safety.

Initially, the supply of monoclonal treatments was tight, creating the perception that only rich and powerful people could access it. States, hospitals and healthcare providers have emphasized the supply chain and ordered manufacturers to treat directly.

However, the federal government took over in September and purchased all supplies. The amount each state gets is now determined according to usage and the number of cases. This week, California received 10,474 doses. This is far less than the 13,000 to 16,000 doses given to the devastated states of Michigan, Pennsylvania, and Ohio, despite their much smaller population.

This treatment is widely used in states with low vaccination rates. Florida, which has a state-owned monoclonal antibody therapy site, says hospitalization rates have dropped by 80% since it opened. No doctor referral is required. Dissatisfied with the federal allocation cuts, the state went directly to the manufacturer GlaxoSmithKline to buy more doses.

California divides its supply into counties that distribute treatment to healthcare providers such as hospitals, clinics, and infusion centers. Since the state has not disclosed the quota, there is no way to calculate the amount used or refrigerated.

Treatment is free, but getting it can be a difficult multi-step process. Due to the narrow time frame, people need the results of the COVID test immediately. And they have to find a place to get treatment. Options are widely available in the Bay Area, but it is much harder to find a site in rural areas. Patients should be qualified through test results or a doctor’s referral.

“The sooner the better,” said Dr. Philis Tien, a UCSF infection expert who is a member of NIH’s influential COVID-19 Treatment Guidelines Panel.

Then, once the appointment is made, the patient will need to be moved to that location for a single intravenous infusion per hour.

Dr. John Zweifler of the Fresno County Public Health Service said:

According to experts, demand from patients, doctors and hospitals is weaker than expected.

“About half of the people I call,” Oh, I don’t need it. I’m not that sick, “said Dr. Upinder Singh, director of infectious diseases at Stanford University School of Medicine. “They think:’I’m going to stick it out. I’m tough.” But by day eight, they couldn’t breathe and were in the hospital. By then, it’s too late. The train left the station. “

Even health care professionals don’t always understand who will benefit from treatment, so don’t make timely referrals, Chin Hong added.

The COVID-19 test site does not promote, promote, or link to the treatment site, resulting in a time lag. There is no state-wide call center with clinicians to efficiently evaluate and book patients.

Billy Taylor immediately contacted the San Diego County Public Health Clinic for the help of his enthusiastic mother and waited for days for an answer. Then they were told it was too late.

“You call them, and no one answers. You leave them a message. Then they return your phone after 5 days. And they are only open 4 days a week. “Tailer of Vista said. She had passed 10 days by the time they called back. “I’m scared because of her age.”

In Santa Clara, Josipa Matusich’s experience was very different. A patient in the Palo Alto Medical Group who is being treated for an autoimmune disorder, she was immediately sent to Stanford. She received the infusion within 3 days and her symptoms were immediately relieved.

“It was very fast. They made it very easy for me and my whole family to deal with everything,” she said. “It was a good experience.”