Houston-area hospitals could run out of a single effective monoclonal antibody treatment against omicron within two weeks
Hospitals in the Houston area say they could run out of sotrovimab within two weeks, the monoclonal antibody treatment that has been shown to be most effective against the omicron dominant variant of the coronavirus, if they do not receive another state shipment amid a nationwide supply shortage.
Governor Greg Abbott publicly called on the federal government, which took over the distribution of the treatment in September, to send in another shipment of sotrovimab and other effective therapies against previous variants on Friday. The Texas Department of State Health Services said earlier this week that regional infusion centers in Austin, El Paso, Fort Worth, San Antonio and The Woodlands had already depleted their sotrovimab supplies.
Intended for symptomatic or high-risk patients, monoclonal antibodies block the ability of the virus to enter cells, giving the body’s natural immune system time to mount its own response. Treatment given intravenously does not replace vaccination, but prevents the worsening of COVID symptoms and has become an essential tool in preventing long-term care in overwhelmed hospitals.
The shortage comes at a precarious time for Houston healthcare providers as new COVID cases and hospitalizations increase rapidly. The weekly average of new COVID cases in Texas Medical Center hospitals hit an all-time high last week, rising from 2,094 to 5,390. medium hospitalizations in medical centers almost doubled during this period, from 110 to 201.
It took just seven days for hospitalizations in the 25-county area surrounding Houston to drop from 1,000 to 2,000, the fastest record on record. Regional hospitalizations Thursday reached 2,017.
A spokesperson for the state health agency said he would likely learn more about future monoclonal antibody allocations on Monday. Hospital administrators don’t know what to expect.
“We’re pretty sure we’ll get it, we just don’t know how many – and we’re definitely going to get it,” said Victoria Brownewell, chief nurse at Houston Methodist West Hospital, who also oversees the system. monoclonal infusion centers.
Methodist, which treats around 500 people a week with sotrovimab, has enough supply to meet demand until Jan. 13, she said.
Demand for monoclonal antibodies exploded during the Delta Wave in August and September, when some states with high infection rates used an inordinate portion of the country’s supply. Seeking to prevent future shortages, the federal government took control of distribution and purchased more than a million additional doses.
Omicron created a new problem in November. The variant’s ability to mutate and evade immunity made most antibody therapies less effective, including the very popular treatment made by Regeneron, and sotrovimab emerged as the most effective antibody treatment against variant. Now, states are calling for more doses amid the omicron-fueled surge.
The variant now accounts for about 60% of COVID cases in the United States, according to the Centers for Disease Control and Prevention, but represents a higher percentage in Texas and Houston.
Genome sequencing efforts at the Houston Methodist earlier this week found that 94% of its symptomatic patients have the omicron.
The University of Texas medical branch network of four hospitals will likely process its remaining 600 doses of sotrovimab in 10 days, said Dr. Gulshan Sharma, chief medical officer of the system.
“We just hope and wait and see what we get,†he said. “Anyone can guess what the allowance would be. “
For the record, Sharma said most COVID patients in UTMB hospitals appeared to have milder symptoms than in previous outbreaks, allowing doctors to be more insightful about who needs antibodies. monoclonal. Many hospitals in the Houston area, including the UTMB, prioritize immunocompromised and unvaccinated people at risk for serious illness.
If the UTMB does not receive another shipment of sotrovimab, Sharma said the hospital system would likely replace treatment with a three-day course of remdesivir, an antiviral drug now commonly used to treat the virus. He hopes the newly available antiviral pills, nirmatrelvir and molnupiravir, will avoid the need for antibody treatments.
Across Texas, 116 pharmacies will distribute the pills. In Harris County, the drugs will be available by prescription at HEB, Kroger, Walmart and Walgreens. DSHS provides maps of pharmacies that will have them.
“I think it would be a game changer in the way we handle this,†Sharma said.
Zach Despart and Becca Carballo contributed to this report.
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