Thinking Citizen Blog — Monoclonal Anti-Body Treatment: the South is Ahead of the Northeast
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Thinking Citizen Blog — Thursday is Health, Health Care, Health Insurance and Global Health Policy Day
Today’s Topic: Monoclonal Anti-Body Treatment: the South is Ahead of the Northeast
The South is behind on vaccines, but ahead when it comes to monoclonal anti-body treatments. “Now, as infections continue to climb, and hospitals across the state are stretched thin, Massachusetts is racing to catch up.” So what are these treatments? Why is Boston behind? Experts — please chime in. Correct, elaborate, elucidate.
SAFE, FREE, KEEP PEOPLE OUT OF HOSPITAL, KEEP PEOPLE ALIVE — SO WHAT ARE THEY?
1. “The drugs, which are typically delivered by infusion, are laboratory-made proteins that mimic the body’s immune system and stop the virus, keeping people with COVID from getting seriously ill if taken within 10 days after symptoms appear.”
2. “Research that has not yet been peer reviewed indicates the treatments can reduce the risk of hospitalization and death by about 70%, and can shorten the average duration of symptoms by four days (down from 14 to 10 days), compared to patients who did not receive the treatment.”
3. “Former president Donald Trump brought wide attention to treatment with monoclonal antibodies last October when he was hospitalized with COVID and received infusions of the experimental drugs. The next month, the FDA issued an Emergency Use Authorization for Regeneron’s monoclonal antibody treatment.”
NB: “At that time, with limited data available about the drug’s effectiveness, overwhelmed health leaders in Massachusetts mostly stayed away from the therapy. Many last winter noted the daunting process for administering the drug, typically given intravenously over 20 minutes in an outpatient setting, followed by an hour of monitoring for adverse side effects.”
FLORIDA IN THE LEAD, BOSTON TO CATCH UP, BRIGHAM TO MORE THAN DOUBLE CAPACITY
1.“(Florida Governor) DeSantis may be better known for blocking public schools from imposing mask requirements, but he also set up 21 monoclonal antibody centers that his office estimates have treated 30,000 patients so far.”
2. “By the first week of August, it was clear that demand (for antibody treatment) was going to outpace our capacity very soon,” said Dr. Ron Walls, chief operating officer at Mass General Brigham, the state’s largest health care network, “The demand tripled between the second week of July and the second week of August.”
3. “Mass General Brigham is poised to more than double its capacity later this month to administer the treatment across the system from 41 to at least 95 doses weekly, and if that still doesn’t meet demand, it can expand to 140, Walls said.”
NB “The system’s hospitals, like many in Massachusetts, are bulging with patients who deferred care for other problems during the pandemic and are now seriously ill. That’s in addition to the recent rise in COVID patients.”
THE TIGHTROPE, ELIGIBILITY, STAFF SHORTAGES
1. “Now, health officials find themselves walking a tightrope. They still want people to get vaccinated, yet they also need to promote a drug that can save patients — even if they don’t get their shots.”
2. “Fueling demand is the FDA’s action in late July to greatly expand eligibility for the treatment. In addition to people 12 and older who test positive for COVID-19 and are considered high risk for complications, the drug can now be given to those who have merely been exposed to someone with COVID and are at high risk for severe illness and hospitalization, such as people with a compromised immune system, or who are obese, elderly, or have chronic kidney disease. However, demand is running so high that at Mass General Brigham currently only high-risk patients who have tested positive. Beth Israel Lahey Health system has also similarly limited treatment, but Dr. Richard Nesto, Beth Israel’s chief medical officer said plans to open a second treatment site at its Burlington medical center next week may allow the system to offer it to more patients.”
3. “Dr. Asif Merchant, chief of geriatric medicine at Newton-Wellesley Hospital and partner of a company that runs medical services for 45 nursing homes in Massachusetts, said too many facilities lack skilled nurses to administer the treatment, so the drugs are not being widely used.” To quote Dr. Merchant: “The state has tried to be helpful, but simply offering the drug without staff who can administer it doesn’t work. This is a drug we know can save lives, but there are too many hoops to go through.”
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YOUR TURN
Please share the most interesting thing you learned in the last week related to health, health care or health care policy — the ethics, economics, politics, history…. Or the coolest, most important thing you learned in your life related to health are or health care policy that the rest of us may have missed. Or just some random health-related fact that blew you away.
This is your chance to make some one’s day. Or to cement in your mind something really important you might otherwise forget. Or to think more deeply than you otherwise would about something that matters.