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Omicron treatments for high-risk patients in short supply

Posted at 10:14 PM, Jan 10, 2022
and last updated 2022-01-10 23:14:21-05

Omicron is spreading rapidly in the community, and treatments for vulnerable patients are limited.

Omicron may be shown to be less severe for most, with 50% to 80% lower rates of hospitalization. But because the variant is so contagious, the people who are high-risk are more likely to get seriously sick according to Dr. James Lawler, an infectious disease expert with Nebraska Medicine.

“Yes, on an individual basis your chances are lower of ending up in the hospital," Lawler said. "On a community scale and on a population scale, we’re going to end up with lots more people who need hospitalization, and we have no extra capacity right now.”

Doctors are doing what they can to treat ill patients before they end up in the hospital.

Unlike with other variants, omicron doesn’t respond to most monoclonal antibody treatment.

“Unfortunately most of the monoclonal antibody products we have, don’t appear to be very effective against omicron," Lawler said. "They don’t bind and neutralize the virus the same way they do with other variants. ‘There’s only one monoclonal antibody product that’s effective against omicron and it’s in very short supply.”

That treatment is called Sotrovimab. On Friday, Nebraska Medicine posted a plea on Facebook, asking people to take precautions like getting vaccinated and wearing a mask because this treatment is in such short supply.

The hospital currently has enough Sotrovimab for five patients a day. In reality, they need enough for 75 to 100 patients a day.

They do, however, have enough doses of Remdesivir, a three-part daily antiviral medication. The treatment was first approved for inpatient use but is now being used to prevent hospitalizations for sick patients.

“But getting the logistics of three daily infusions for people who are outpatient is a challenge," Lawler said. "So the hospitals and health systems are trying to ramp that up now.”

Another option that was just approved is the antiviral pill. Both Pfizer and Merck have a pill, but it too, is in short supply.

According to records from the U.S. Department of Health and Human Services, 99,960 courses of the Pfizer pill, Paxlovid, have been distributed in the United States.

Nebraska has gotten only 460 courses.

399,920 courses of the Merck pill, Molnupiravir, have been distributed.

Only 1,840 thousand have gone to Nebraska.

“We don’t have many tools in our arsenal, unfortunately, to be able to give to folks who are high risk for developing severe disease," Lawler said. "We need to be really aggressive about doing what we can there. But our options are a lot more limited, unfortunately, than they were with some of the previous viruses.”

Doctors continue asking the community to do what it can to prevent spread — stay home when sick, avoid large groups, get vaccinated, and wear a mask in public.

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