They avoided COVID-19 vaccines but switched to antibody treatment
Lanson Jones didn’t think the coronavirus would come for him. An avid tennis player in Houston who hadn’t caught a single cold during the pandemic, he had refused a vaccine because he feared it would spoil his good health.
But contracting COVID-19 shattered his faith in his body’s defenses – so much so that Jones, with his nose stuffed and his appetite gone, started looking for anything to save himself from a nightmarish illness.
The answer turned out to be monoclonal antibodies, a one-year-old lab-created drug no less experimental than the vaccine. In a glass-walled enclosure at Houston Methodist Hospital this month, Jones, 65, became one of more than a million patients, including Donald Trump and Joe Rogan, to receive an infusion of antibody as the virus hit the United States.
Vaccine-resistant Americans look to treatment with a zeal that has at times mystified their doctors, chasing long infusions after rejecting vaccines that cost a hundred times more. Orders have exploded so quickly this summer – to 168,000 doses per week in late August, from 27,000 in July – that the Biden administration warned states this week against a decrease in national supply.
The federal government, which already covered the cost of treatment – currently about $ 2,100 per dose – has now paid for its distribution as well. For the coming weeks, the government has told states to expect reduced shipments due to looming shortages.
With seven southern states accounting for 70% of orders, the new process has destabilized some of their governors, who have made antibody treatment central to their strategy to endure a catastrophic wave of the delta variant.
More supplies are on the way. The federal government purchased an additional 1.8 million doses this week, which are expected to arrive in the fall and winter. But for now, some hospitals are unsure of their supply, state health officials have said, even as patients continue to seek doses.
“We have suppliers who are struggling to get the product we need,” said Kody Kinsley, who heads operations for North Carolina’s COVID-19 response. “I think what happened is a classic logistics problem, where all of a sudden there is a lot more demand.”
Amid a din of anti-vaccine lies, monoclonal antibodies have become the rare coronavirus drug to achieve near universal acceptance. Defended by traditional doctors and conservative radio hosts, the infusions have kept the country’s death toll – 2,000 a day and rising – from rising even higher.
And after months of work by President Joe Biden and governors in the South to promote treatments, they won affection from vaccine refusals who said the terrors and uncertainties of getting COVID-19 had them. made desperate for an antidote.
“The people you love, who you trust, no one has said anything bad about it,” Jones said of the antibody treatment. “And I 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 while opposing vaccination mandates, frustrating even some of the drugs’ most ardent supporters. Increasing vaccination rates, the scientists said, would eliminate the need for many expensive antibody treatments in the first place. The infusions last about an hour and a half, including monitoring afterward, and require constant attention from nurses that badly affected conditions often cannot spare.
“It’s cumbersome on resources, it’s hard to give, and a vaccine costs $ 20 and could prevent almost all of that,” said Dr Christian Ramers, infectious disease specialist and head of population health at Family San Diego Health Centers, a community provider. Growing antibodies while minimizing vaccines, he said, was “like investing in auto insurance without investing in brakes.”
Government-supplied monoclonal antibodies, made by Regeneron and Eli Lilly, have been shown to dramatically shorten patients’ symptoms and reduce their risk of hospitalization – by 70%, in the case of Regeneron’s antibody cocktail. The treatments, given in one sitting, use lab-made copies of the antibodies people naturally generate when fighting an infection.
Treatments were neglected by patients and doctors during the wave of winter infections. But hospitals and health centers have now stepped up their offerings, turning dental clinics, mobile units and auditoriums into infusion centers. In states like Texas, where elective surgeries have been postponed to make room for COVID-19 patients, operating room nurses have been enlisted to give infusions. One of the factors driving the demand is that many patients, including vaccine skeptics, have publicized their seemingly miraculous cures.
“They say to me, ‘I have COVID, I want this treatment, my friend or family told me about it,'” said Jennifer Berry, Houston Methodist nursing director of infusion services. “Now the word is out.”
At Houston Methodist, nurses delivered nearly 1,100 treatments at eight sites during the first week of September, more than double the number of any week last winter. The hospital has reduced the average time between orders and infusions to two days this month from three days in early August, giving patients a better chance to fight infections.
Juggling infusions with more seriously ill COVID-19 patients this summer forced the hospital, in one case, to move a monoclonal antibody clinic to a mall storefront.
But the Texas Department of Health helped, providing 19 nurses for another Houston Methodist infusion clinic, said Vicki Brownewell, the hospital’s senior program administrator. The Biden administration also invested $ 150 million in expanding access to monoclonal antibodies, and the Houston Methodist used federal money to organize medical taxis for patients struggling with transportation.
Even so, infusions remain inaccessible to many. Due to the high demand on staff and the need to create separate infusion rooms for infectious patients, some communities, especially in rural areas, do not have clinics.
In San Diego, Ramers said, some large for-profit hospitals decided not to administer the antibodies at all because of logistical hassles, leaving wealthier, well-insured patients to search for doses at his publicly funded clinic. Some of the nurses he hired for the IVs left for short, better paid assignments in hard-hit intensive care units.
“The natural and capitalist incentives for for-profit healthcare organizations don’t really promote this practice,” Ramers said. ” It’s a lot of work.
Of the 2.4 million doses of monoclonal antibodies shipped nationally, at least 1.1 million have been used. It is difficult to determine precisely how many are still sitting on shelves due to gaps in reporting. Yet declining federal supplies and soaring demand from less-vaccinated southern states have caused what several states have described as large shortages in deliveries.
Suppliers in North Carolina have requested 15,000 weekly doses, the Department of Health said, more than double what the federal government has allocated. Florida said its last weekly allocation left clinics 41,000 doses less than they wanted.
Hospitals could previously order drugs themselves. But the Department of Health and Human Services will now decide how many doses each state will receive based on case rate and treatment use. State governments, in turn, will decide on doses for individual sites.
The new ordering process, which the Biden administration says would ensure “fair distribution,” has unsettled some supporters of the drug. Florida Gov. Ron DeSantis, a Republican, warned on Thursday that state officials were unprepared for the new responsibility of spreading doses.
And in heavily vaccinated states, like New York, people coordinating treatment fear shipments could collapse due to the low case rate, leaving hospitals with so few doses that they are closing their programs. Some hospitals have recently reported an increasing number of vaccinated patients receiving infusions.
Diana Berrent, founder of Survivor Corps, which has worked to help patients find monoclonal antibody treatments, said involving state governments will cause delays: “You are layering 50 new layers of bureaucracy,” he said. she declared.
Doctors have warned that antibody treatments alone cannot keep pace with outbreaks of bloating. While one vaccination protects others from exposure, a single infusion helps only one patient. Infusions should be given within 10 days of symptoms; they are unnecessary for most hospital patients. And getting the antibodies once doesn’t stop people from getting seriously ill if they catch the virus again later. “Something like that just isn’t to scale,” said Dr. Howard Huang, medical manager of the Houston Methodist infusion program.
As a result, health officials have warned that vaccine skeptics could become so enamored with monoclonal antibodies that they would become even more resistant to the protective injection.
A few days after his infusion, Jones had left the room where he had been quarantined and resumed his job as a landscape architect. But he still weighed if he needed to be vaccinated.
His doctor was pushing for it, he said. But the monoclonal antibodies had worked so well that he was tempted to just come back for another infusion if he caught COVID-19 again.
“If I can go get myself an infusion and feel as good as now, man, I’d rather not take a vaccine that has just been developed,” he said. “It makes me nervous, again. “