PROVIDENCE – The vaccines that prevent serious illness with COVID-19 are in short supply in Rhode Island.
Paradoxically, a treatment for mild to moderate COVID-19 is widely available, and yet isn’t getting used as much as it could.
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The R.I. Department of Health is trying to create more awareness of a treatment option for COVID-19, which has evolved over the now- 11-month-old pandemic.
“This is one of the secrets of the pandemic. In late 2020, it became a treatable disease,” said Dr. James McDonald, medical director for the R.I. Department of Health. “It became a curable disease. That is an important thing.”
A treatment of monoclonal antibodies, manufactured by Eli Lilly and Co., or Regeneron Pharmaceuticals Inc., two large, U.S.-based pharmaceutical companies, is available for mild to moderate COVID-19 symptoms. The people who are eligible have to be either 65 or older, or have underlying health conditions that could lead to severe illness. This includes people who have a body-mass index of 35 or above, or people with conditions such as diabetes.
The treatment requires a one-time, one-hour, intravenous infusion followed by another hour of observation. Usually within a day or two, people feel much better, McDonald said.
Rhode Island started administering the monoclonal antibody treatments on Nov. 22. Since then, 1,776 people have been treated with the infusions, including 330 in the week that ended on Sunday, Jan. 31.
The pace is picking up, but Rhode Island still has plenty of the infusions available, unlike many states, which have been forced to use a lottery system for it, he said. The federal government distributes the drugs to the states on a weekly basis. Rhode Island received ample amounts of it because it made a one-page proposal that described its infection rates and hard-hit, densely populated communities.
“We have plenty and we keep getting more,” McDonald said. “Other states have a shortage and are using a lottery to get it. We don’t have a shortage and we’re pushing it as much as we can,” he said.
The state has educated physicians about the treatment option and has trained contact tracers, who may be working directly with people as they learn they are COVID-19 positive.
“If you don’t have a doctor, we can get you to a doctor. The doctor will make a referral to one of the infusion sites,” McDonald said.
The drugs work by preventing the virus from replicating. It is not effective for patients who need supplementary oxygen, he said, because by that point the virus has moved beyond the ability of the drug to block the replication.
Preliminary results, he said, indicate it’s keeping people out of hospitals in Rhode Island.
He spoke to the physicians at Rhode Island Hospital who told him that about 1 percent of the people who had had the monoclonal antibody treatments were ending up in the hospital. Before November 22, about 10 percent of the patients considered high-risk for COVID-19 were hospitalized.
When the treatments were approved through an emergency use authorization through the U.S. Food and Drug Administration, the clinical studies showed a reduction from 10 percent to 3 percent in hospitalization rates among the eligible population, Dr. McDonald said.
“We’re seeing results that are on par with the [emergency use authorization findings]. That’s encouraging to me.”
The drugs are provided to the states by the federal government, which has purchased them. There is a cost for the infusion service, about $309. Health insurance will cover that. For people without insurance, he said, infusion centers will work out payment arrangements.
One worrisome trend, he said, is the emergence of the variants for COVID-19 that are more highly infectious. There is no research that the treatments work against them.
“As a culture, we really need to make our push now to eliminate COVID before the variants come en masse in the United States,” he said. “Most of the vaccines work against the strains we have. Right now, the monoclonal antibodies work. Right now all the public health measures work. It’s important to take advantage of the season we have now.”
Mary MacDonald is a staff writer for the PBN. Contact her at macdonald@pbn.com.
