Supplies of Monoclonal Antibodies in Texas are Gone

11,495 Views | 92 Replies | Last: 2 yr ago by bullard21k
PJYoung
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DannyDuberstein said:

I'm not pushing Ivermectin. I just find people spiking the football on it with nothing else to offer to be fairly offputting as well

I also think the lack of education and push on monoclonal when it was working to be extremely disappointing. Lots of folks were having to learn about it and seek treatment based on message boards, bot their doctor.

One of the 3 main monoclonal antibody treatments DOES work against omicron but it is now in very short supply. More of it is on the way but it will won't be available for a few weeks.

Quote:

The one monoclonal antibody treatment that has performed well against Omicron in laboratory experiments is also the most recently authorized: sotrovimab, made by GlaxoSmithKline and Vir Biotechnology and cleared in May.

Already in high demand even before Omicron arose, the supply of sotrovimab is very limited for now. But the situation is likely to improve somewhat in the coming weeks. The Biden administration is in talks with GlaxoSmithKline about securing more doses to be delivered by early next year, the administration official said.
Quote:

When the coronavirus variants began emerging a year ago, researchers found that some had gained resistance to monoclonal antibodies. A mutation to their surface proteins prevented the antibodies from sticking to the viruses, a necessary step in neutralizing them.

For several months, the government paused distribution of Eli Lilly's antibody treatment nationwide because it proved ineffective against variants such as Gamma, which emerged in Brazil and spread to many countries last spring.

Fortunately, doctors could still give out Regeneron's treatment, which remained effective against the variants and was in abundant supply. Other variants largely vanished from the United States as Delta surged to dominance this summer.

Delta proved susceptible to all of the authorized antibody treatments. The Biden administration gave the green light to Eli Lilly's treatment once more and ordered hundred of thousands of doses.

But Omicron has changed everything.

When the new variant was identified last month in southern Africa, researchers began laboratory studies testing monoclonal antibodies to see how well they worked against it. Scientists found that both Regeneron and Lilly's antibodies did a poor job of blocking the variant virus from invading cells. Sotrovimab, by contrast, remained potent.

George Scangos, the chief executive of Vir, attributed the resilience of sotrovimab to the strategy researchers used to find it. Rather than look in the blood of Covid survivors, researchers examined the blood of people who had survived the 2003 SARS epidemic, caused by a related coronavirus.

They identified an antibody from a SARS survivor that also protected against the coronavirus that caused Covid. That double action suggested that the sotrovimab antibody attached itself to a part of the virus that has changed very little over the course of its evolution. And it would be unlikely to change in new variants, the researchers reasoned.

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"I think we got here not by good luck, but by a thoughtful process," Dr. Scangos said.
Quote:

When it became clear that Omicron was gaining a foothold, the government allocated 55,000 sotrovimab doses to states, with shipments arriving as soon as this week. GSK is expected in January to deliver 300,000 more doses to the United States.

"What matters most is the supply we can have in January and February and March, and we're doing everything we can to increase that," Dr. Scangos said.

Kathleen Quinn, a spokeswoman for GSK, said that the companies are "actively working to expand our capacity," adding another production facility and accelerating production plans.
Quote:

Dr. Griffin, who sees patients in New York City, said he expects difficult conversations now that major health systems have halted their use until the more effective treatment arrives.

Vaccinated patients should still do well, he said. But those most likely to be upset will be patients who "didn't want to get vaccinated but thought, 'I can trust the monoclonals. If I need them, they'll be there for me.'"
Quote:

Both Regeneron and Eli Lilly say they are developing monoclonal antibodies for Omicron, but it will be months before they are ready for use
https://www.nytimes.com/2021/12/21/health/covid-monoclonal-antibodies-omicron.html
bay fan
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BeastmodeAg said:

Been sick for 5 days, feel like I'm almost over it. It's manageable but sucks. But now I have "natural immunity"?
Sure, just like the vaccine, until you catch it again.
SjAg
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So current treatment state (2years into this and during the largest outbreak yet) we have Tylenol/advil and a vitamin regime.
samsal75
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Skywalker18 said:

I took ivermectin religiously and still ended up in the ICU less than 2 months ago. Good luck with that


Is it reasonable to wonder what your outcome would have been had you not taken the Ivermectin??
I appreciate research indicates Ivermectin isn't effective but given the positive anecdotal evidence for taking Ivermectin that many have attested to, why not give it a try?
You obviously did and feel it didn't help but others have had opposite experiences.
So I suspect many will continue to try it regardless of the many who see no benefits.
PJYoung
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bay fan said:

BeastmodeAg said:

Been sick for 5 days, feel like I'm almost over it. It's manageable but sucks. But now I have "natural immunity"?
Sure, just like the vaccine, until you catch it again.

Worth noting the 2nd time you catch covid your case will PROBABLY be much more mild (unless you had a very mild case the first time).

GAC06
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bay fan said:

BeastmodeAg said:

Been sick for 5 days, feel like I'm almost over it. It's manageable but sucks. But now I have "natural immunity"?
Sure, just like the vaccine, until you catch it again.


Misinformation
MemorialTXAg
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[Check your email. We do not want the trolling and disrespect on this forum. - Staff]
SjAg
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Who is freaking out? I simply stated that the fact we are 2 years into this thing and we are where we are from treatment protocol is pathetic. And we abandoned one of our best treatments. And yes agreed Omnicron is mostly mild but there are people still getting pretty sick (currently have a healthy 36 year old buddy in hospital) and they gave him a steroid and penicillin.
FlyRod
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Quote:

The treatment protocol will be revised monoclonal antibodies and, eventually, the Pfizer pill will be a massive game changer based on their FDA approval data. It will make it into nothing honestly once we have a good supply of those pills + rapid testing so we can identify the COVID sniffles vs other sniffles and get treatment for age 12+

That is assuming that the original Pfizer data holds up in post marketing and no dangerous side effects pop up, which has been known to happen.

But right now you are correct, there is minimal to no evidence that any early treatment helps aside from monoclonal antibodies which were rendered largely ineffective 2-3 weeks ago.

Boy I hope you're right. My one experience with anti-virals was with a case of shingles (was too dumb to get the vaxx), and (a) the anti-virals made me pretty ill, and (b) it took two months to get better.

Obviously this is a different beast at least.
DannyDuberstein
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The pfizer interactions with statins and blood thinners is very discouraging. That is likely to remove large swaths of fat and old people (hello high riskers) from being able to take that treatment

I'm hopeful the monoclonal can get back on track, but still disappointed this was not pushed anywhere near as much as it could and should have been in 2021. We knew in 2020 this was a promising avenue, yet throughout 2021 saw a very disjointed, under-promoted/under-utilized, and slow to react approach. It certainly seems like the view was that pushing this was going to undermine the vaccine, which is nuts
Coates
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SjAg said:

Who is freaking out? I simply stated that the fact we are 2 years into this thing and we are where we are from treatment protocol is pathetic. And we abandoned one of our best treatments. And yes agreed Omnicron is mostly mild but there are people still getting pretty sick (currently have a healthy 36 year old buddy in hospital) and they gave him a steroid and penicillin.


The Gov has not invested in treatment, only vaccines so here we are now constantly being told to take more and more shots but nothing if you're actually sick.
PJYoung
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Coates said:

SjAg said:

Who is freaking out? I simply stated that the fact we are 2 years into this thing and we are where we are from treatment protocol is pathetic. And we abandoned one of our best treatments. And yes agreed Omnicron is mostly mild but there are people still getting pretty sick (currently have a healthy 36 year old buddy in hospital) and they gave him a steroid and penicillin.


The Gov has not invested in treatment, only vaccines so here we are now constantly being told to take more and more shots but nothing if you're actually sick.

They spent a ton on monoclonal antibody treatments.

Saved a bunch of lives.
DannyDuberstein
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Except for the part where they cut Texas supply in half in September
PJYoung
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DannyDuberstein said:

Except for the part where they cut Texas supply in half in September

Yeah I'm not saying they handled it perfectly.

I wish we had invested way more.
KidDoc
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DannyDuberstein said:

The pfizer interactions with statins and blood thinners is very discouraging. That is likely to remove large swaths of fat and old people (hello high riskers) from being able to take that treatment

I'm hopeful the monoclonal can get back on track, but still disappointed this was not pushed anywhere near as much as it could and should have been in 2021. We knew in 2020 this was a promising avenue, yet throughout 2021 saw a very disjointed, under-promoted/under-utilized, and slow to react approach. It certainly seems like the view was that pushing this was going to undermine the vaccine, which is nuts
This statement is simply incorrect. I received a LOT of emails about monoclonal infusions, how to order them, who qualifies for them, where to get them done. Literally weekly if not more often. Then the state (Tx) opened regional infusion centers for people to get in ASAP. They are closed now for obvious reasons but if you do not think monoclonals were heavily promoted then you were not paying attention.


I had several pediatric patients during the delta spike get infusions locally.
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Coates
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PJYoung said:

Coates said:

SjAg said:

Who is freaking out? I simply stated that the fact we are 2 years into this thing and we are where we are from treatment protocol is pathetic. And we abandoned one of our best treatments. And yes agreed Omnicron is mostly mild but there are people still getting pretty sick (currently have a healthy 36 year old buddy in hospital) and they gave him a steroid and penicillin.


The Gov has not invested in treatment, only vaccines so here we are now constantly being told to take more and more shots but nothing if you're actually sick.

They spent a ton on monoclonal antibody treatments.

Saved a bunch of lives.


I was more speaking the fed government, fauci and the rest. Their message has been vaccines and masks.
DannyDuberstein
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As of September, 7 states were making up 70% of orders for the treatment. That by definition means it was not widely promoted and utilized. This was a treatment authorized in 2020, but in Q3 2021, less than 30k doses per week were being ordered. It jumped because 7 states started pushing it hard when in reality this push should have been national early in the year

You may have been getting updates and pushing it. Many were not. I know too many people that had no idea. This board has had a lot of people who have had to seek it out

And my statement about statins and blood thinners is correct as well. I left out antidepressants though. Those have negative interactions too.
PJYoung
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Coates said:

PJYoung said:

Coates said:

SjAg said:

Who is freaking out? I simply stated that the fact we are 2 years into this thing and we are where we are from treatment protocol is pathetic. And we abandoned one of our best treatments. And yes agreed Omnicron is mostly mild but there are people still getting pretty sick (currently have a healthy 36 year old buddy in hospital) and they gave him a steroid and penicillin.


The Gov has not invested in treatment, only vaccines so here we are now constantly being told to take more and more shots but nothing if you're actually sick.

They spent a ton on monoclonal antibody treatments.

Saved a bunch of lives.


I was more speaking the fed government, fauci and the rest. Their message has been vaccines and masks.

Yeah I kind of get where they were coming from - preventive measures - even if they didn't hit what most of us wish they would've hit - obesity.
SanDiegoAg12
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bay fan said:

BeastmodeAg said:

Been sick for 5 days, feel like I'm almost over it. It's manageable but sucks. But now I have "natural immunity"?
Sure, just like the vaccine, until you catch it again.


Vaccine immunity is not equal to natural immunity.
cc_ag92
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Other states were trying to get access to the antibodies, but they were unavailable because 7 states were making up 70% of the orders. That's when the federal government began managing the disbursement of the treatments so that states were receiving amounts related to their needs. I'm quoting your number of 70% because I don't feel like looking it up right now.

I know tons of people who received the treatment because their doctor told them to get it and told them how. I know a few who refused it because Ivermectin was cheap. Two of them ended up in the hospital and left their primary care doctor because he was so insistent they get the treatment. This whole thing has been so damn weird.
DannyDuberstein
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My point is that as of the end of September, we had approx 25 million covid cases in the US in 2021 and had administered 1.2 million doses of monoclonal antibodies. For a treatment approved in 2020. Does that feel widely available, promoted, and utilized? Kiddoc was getting emails, so that's good I guess.

7 states did push it harder (Texas was one of the 7) and were most of the orders when fed gov took over.
Coates
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Agreed, but being able to eat cheeseburgers, pizza, and gallons of soda without thinking about it is more important.
cc_ag92
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I'd really have to dig into the dates and statistics and I don't really care enough about this disagreement to do that, nothing against you, but I have some other things to take care of today.

If that 25 million number is from the beginning, we certainly could not have treated all of the cases with monoclonal antibodies because we didn't have them from the beginning. If I remember correctly, Trump was one of the first people to receive them. That was September of 2020, right?

We also wouldn't treat the majority of cases with them because the majority of cases don't indicate the need for them. While there is and has been a shortage, we can't magically manufacture the people that are needed to manufacture the treatment, then distribute it, then administer it. They aren't administered at a pharmacy. They require more infrastructure than that.

All of that being said, I celebrated their development and encouraged people to get them when needed. Our scientists have honestly been incredible. It's been fascinating to watch.
DannyDuberstein
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Not the beginning. Jan to Sept 2021. We are now at 52 million cases from the beginning of 2020 (surely underreported due to low risk/untested/asymptomatic). When fedgov issued the notice in September that they were taking over allocation, they said facilities had reported 1.2 million doses had been utilized to date nationwide. The push and promotion cranked up in August

I agree that not everyone should get this treatment. At the same time, given the masses of high risk BMI's and olds put there, 4% seems to be extremely low to consider this a widely promoted and available treatment. Texas did better than most until the brakes got applied
Zobel
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What's the manufacturing capacity for monoclonal antibodies in the US? And in the world?
DannyDuberstein
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Not high enough it seems
Zobel
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So on what grounds are you criticizing then? you don't even seem to know what the total available capacity is, and what it might take to increase it. How can you make a judgment about what's going on without the most basic of facts about the situation?
DannyDuberstein
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We've spent a few trillion dollars on this pandemic. We have had one truly effective early treatment identified. We provided 1.2 million doses of said treatment as of the end of Sept. You want to tell me that's the best we could do?

The vaccines were an example of what we are capable of. We did well with that. We have dropped the ball on monoclonal antibodies and treatment in general
Zobel
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I'd love to understand what you're basing this on. Far as I know the USG paid for every dose of Regeneron in advance, up front, as many as they could make. So what should have been done differently? Be specific.
DannyDuberstein
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Same gameplan as vaccines. Massive commitment to purchase so the producers would invest in increasing capacity massively. Massive promotion of it as an effective treatment. We are committing upfront to peanuts right now.
Forum Troll
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We need more rabbits
Zobel
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So in other words exactly what they did? Under operation warp speed they told multiple manufacturers sight unseen, if you have one that works we'll buy all you can make. They bought every dose, and it looks like most every dose is being used.
DannyDuberstein
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Well, at least I got my original question answered in that the only effective treatment available right now happens to not be available at all right now, which followed a few months of Texans having to make an effort to search it out after having its orders cut. I was honestly curious if there was an alternative consistent protocol folks agreed on given this one's unavailability, but it seems the answer is no. Good thing omicron seems to be mild for most people
Zobel
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It's almost as if most viruses don't have effective therapeutics and medicine isn't magic.
DannyDuberstein
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Yet this one does. Well, it did. For a relative few who got it.
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