To treat Covid-19 patients with monoclonal antibodies -- one among the few lifesaving treatments available -- Piedmont Healthcare in Georgia had to restructure office areas, lay in new IT, and recruit staff.
They had to try to do it everywhere during the vacations. During an epidemic.
"It's been a huge effort on tons of people's part," said Scott McAuley, executive of the pharmacy for Piedmont, who had to work out the way to create the Covid-19 antibody treatment program.
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Giving someone these treatments isn't as simple as swallowing a pill. Because they're infectious, patients undergoing this treatment get to be kept away from others. A nurse fully protective gear must administer the treatment for about an hour then monitor the patient for an additional.
"It does prevent hospitalizations, but the logistics of it are daunting and in fact staffing with nurses in our current national health crisis has its struggle also," McAuley said.
Covid-19 antibody treatments.
Piedmont's program now treats about 250 Covid-19 patients every week, but around the country, health officials have said the treatments haven't been used nearly enough within the months they have been available.
In Michigan, for instance, but 10% of obtainable Covid-19 antibody treatments are used, Dr. William Fales, the medical director at the Michigan Department of Health and Human Services, said during a news briefing last week.
California health officials told CNN that facilities in their state had administered 8% of antibody stock available during the week.
Since the therapies received an emergency use authorization from the US Food and Drug Administration in November, the US Department of Health and Human Services said it's allocated nearly 800,000 courses. As of Monday, it's delivered 454,087 courses of Eli Lilly's bamlanivimab and 96,923 courses of Regeneron's cocktail, casirivimab/imdevimab.
But because the Biden administration rolls out its national strategy to regulate the pandemic, it isn't clear exactly what percentage of the distributed antibody treatments have treated patients, or where. That information isn't posted on the HHS website or tracked on state dashboards.
HHS told CNN in early January that the typical utilization of the antibody therapies was at 25%. Eli Lilly said Wednesday that utilization for both antibody therapies authorized within the US rose to 39%, consistent with information Operation Warp Speed shared with the corporate last week.
Surgeon General Dr. Jerome Adams last week urged doctors to prescribe the treatments "much more frequently," and told people that test positive to hunt them out.
"We need you to ask your provider about monoclonal antibodies as to how to keep you out of the hospital," Adams said.
"The medications, these therapeutics aren't getting used the maximum amount as I, or the doctors on the task force, or the experts, career experts here within the HHS feel that they ought to be. I would like to remind everyone that we're not helpless in our crusade against the virus."
Piedmont's program now treats about 250 Covid-19 patients.
Aggressive public outreach underway
A spokesperson for Eli Lilly, Molly McCully, said in an email the corporation is seeing "steady improvement in utilization week to week." She added the corporation is partnering with the government to boost awareness about the treatments.
Alexandra Bowie, a Regeneron spokesperson, said the corporation recognizes there "have been challenges with the last 10 yards in terms of easily administering the antibody to patients."
"Our team has worked so hard to develop and test this medicine in record time, and that we want it to succeed in as many patients as possible, as quickly as possible," Bowie said in an email.
"Given the antibody rollout coincided with a surge within the virus in most states, it has been understandably difficult for healthcare providers/centers that are already maxed out," Bowie said. "But we are on calls a day with government leaders who are responding to patient/physician feedback and dealing to form sure more Americans have access to those medicines."
Regeneron said it's also been trying to teach providers and lift awareness through social media.
Education seems to be working. North Dakota, for instance, said that it, too, has been trying to assist get the word bent clinicians and therefore the public. it is also something contract tracers mention once they reach bent people to allow them to know they have been exposed to someone with Covid-19.
"Initially there was tons of skepticism with these medicines," said Dr. Joshua Ranum, the vice-chairman of the North Dakota Medical Association. "Now there has been an aggressive public outreach here. I've seen tons more patient awareness and acceptance and we have seen some pretty dramatic results with efficacy."
While the utilization of antibody treatments was "low" it's been steadily growing, consistent with North Dakota public information officer Heather Steffl. She said the utilization of the treatments has grown from 450 infusions during the primary six weeks to a mean now of 650 every week.
'There's now something that they will do to help'
One health care system that has embraced the treatments is South Dakota-based Sanford Health, which manages 46 hospitals and 200 senior care locations in 26 states.
Sanford said it's treated quite 1,400 patients so far with both Lilly and Regeneron antibody therapies.
"Don't get me wrong, there was a little bit of a build to try to do this," said Dr. Jermey Cauwels, Sanford's chief physician. "But quite honestly, once we saw that this is often something that's getting to help us through the worst of the crisis, we said 'Let's see how briskly we will set this up.' "
Sanford's electronic record system was one key to the program's success, Cauwels said. It's now set it up to automatically flag when someone tests positive for Covid-19. The system notifies a gaggle that quickly determines if the patient is eligible for the treatment and if they're, Sanford calls to urge them into the clinic as soon as possible.
Cauwels said the treatments have already prevented a minimum of 40 hospitalizations, several deaths "and quite a year's worth of hospital days."
"That's only for doing this for a few months," Cauwels said.
"We had much anxiety about setting it all up, but once we got it up and running, it's just been very rewarding to ascertain patients so appreciative," Ollis said. "And the staff, they're feeling very hopeful that there is now something that they will do to assist the patient and hopefully stop the disease process from getting so bad."