Doctors in Nebraska warn that effective treatments for the omicron variant of COVID-19 are so rare that not all high-risk patients who qualify for them receive them.
The result: treatments, some of which are new and promising, will not be an option for the vast majority of Nebraskans in the near future.
This means that vaccinations and boosters remain the best way to prevent serious illness, hospitalizations and death.
While efforts are underway to scale up production of the treatments, ramping up to the point where they will make a difference during the omicron wave “will simply not be logistically possible,” said Dr Mark Rupp, chief of the University of Nebraska Medical. Division of Infectious Diseases of the Center.
“I don’t want people to have the misconception that, ‘Oh, they have all these drugs that they can now treat people and either keep them from getting more seriously ill, or if they are seriously ill, we can. saving them in the hospital, “Rupp said.” That just isn’t the reality, unfortunately. “
The warning comes as COVID-19 cases in Nebraska jumped to 14,799 for the week ending Wednesday, more than double the 7,176 cases recorded in the previous seven days. The tally was the second-highest weekly total in the entire pandemic, just below the 15,348 cases recorded in the second week of October 2020.
COVID-19-related hospitalizations, which delay infections by about two weeks, continued to rise after a brief drop over the Christmas holidays, reaching 568 statewide on Thursday. This included 352 in Omaha metro hospitals.
The state has recorded 78 more deaths in the past seven days, the highest weekly figure in exactly one year. However, it is not clear whether these deaths, which also delay infections by several weeks, are attributable to the delta variant or the omicron.
Dr Barbie Young Gutshall, a doctor at O’Neill, wrote in a social media post that the hospital now has an entire wing of COVID-19 patients and that its family room has been turned into an infusion center.
She also pointed out that healthcare providers will soon have little to offer patients due to the limited supply of therapies that can target omicron.
Rupp said some of the monoclonal antibodies that providers have used successfully in previous waves to keep people with COVID-19 from getting seriously ill are not effective against the omicron variant. This includes the infusion which has come to be commonly known as the BAM drug.
Effective monoclonal therapy for omicron, called sotrovimab, is rare across the country. The state receives an allowance and distributes it among providers throughout the state.
Nebraska Medicine, the clinical partner of UNMC, posted on Facebook on Friday that the healthcare system is currently receiving enough therapy for about five people per day. But the hospital has 75 to 100 outpatients per day who meet federal criteria to receive intravenous infusions of the drug.
“We far exceed the number of people who would meet the criteria for use,” Rupp said.
CHI Health officials said their hospitals also have limited supplies of treatment. The healthcare system randomly chooses who will receive the infusions based on extensive criteria and review by a multidisciplinary team.
“The best current treatment that we have to recommend is that patients get vaccinated and get a booster if they have already been vaccinated,” CHI Health officials said in a statement.
Rupp said Nebraska Medicine also has enough of another long-acting treatment called evusheld to infuse between 50 and 100 high-risk people per week. This drug, a preventative, gives people about six months of antibody protection. There are approximately 10,000 eligible patients in the health care system, including 1,000 in the highest risk group. This group includes people who probably have not developed an immune response despite vaccination, a group that usually consists of transplant patients and high-risk cancer patients.
The healthcare system is also starting to administer three days of intravenous remdesivir to ambulatory patients. A recent study showing that the drug, which was previously used in critically ill patients requiring oxygen support, could significantly reduce the risk of progression in high-risk patients. It is best to use it within five to seven days of infection.
But administering it is not easy. “We will be maximizing the number of infusion chairs in our infusion centers for this,” Rupp said.
Two new oral treatments are also available. The first, molnupiravir, prevents progression in about 30% of patients. Nebraska Medicine currently receives approximately 40 classes per week. “But that doesn’t change the game in any way,” Rupp said.
Data suggests that the more promising of the two, paxlovid, is up to 90% effective in preventing people from becoming seriously ill and requiring hospitalization. Rupp said the hospital, to the best of its knowledge, has not received any doses of the drug.
The first doses of the drug have apparently been directed to clinics that serve people with limited access to health care, such as OneWorld Community Health Centers in Omaha and Charles Drew Health Center.
Andrea Skolkin, CEO of OneWorld, said the health center has received enough four patients per day. More is to come, but officials do not know how much or when. The health center must prioritize who receives it.
President Joe Biden said on Tuesday he had doubled the national order for the drug to at least 20 million courses and is speeding up delivery. The first 10 million courses should be available by June and the rest by the end of September.
Meanwhile, health systems are bracing for more patients and urging Nebraskans to help avoid a wave, including getting vaccinated and boosted, wearing quality, well-fitting masks in public, and avoiding large crowds. .
Jeremy Nordquist, president of the Nebraska Hospital Association, tweeted on Tuesday that hospitalizations from COVID-19 could double in Nebraska in the next two or three weeks.
“At the same time, hospital staff will be limited due to the spread of COVID,” wrote Nordquist, a former state senator. “This could very well be the worst of the pandemic. Nebraskans, you know how to help our hospitals and #HealthcareHeroes. Please do it! “
Rupp said: “There is a popular belief that omicron is very sweet and people don’t have to worry about it. But the problem is, there is such a wave of sick people that even though a much lower proportion of become seriously ill and require hospitalization, this will still result in a very high number of hospitalizations and a high level of stress on the medical system. “
World-Herald editor-in-chief Henry J. Cordes contributed to this report.